Tackling Societal Challenges Related to Ageing and Transport Transition: An Introduction to Philosophical Principles of Causation Adapted to the Biopsychosocial Model

In geriatrics, driving cessation is addressed within the biopsychosocial model. This has broadened the scope of practitioners, not only in terms of assessing fitness to drive, but also by helping to maintain social engagements and provide support for transport transition. Causes can be addressed at different levels by adapting medication, improving physical health, modifying behaviour, adapting lifestyle, or bringing changes to the environment. This transdisciplinary approach requires an understanding of how different disciplines are linked to each other. This article reviews the philosophical principles of causality between fields and provides a framework for understanding causality within the biopsychosocial model. Understanding interlevel constraints should help practitioners overcome their differences, and favor transversal approaches to driving cessation.

The biological embedding of social differences in ageing trajectories.

The occurrence of adult disease is related to lifetime experiences and, at least in part, to early life events. It is now well established that socioeconomic circumstances across the lifetime are major determinants of adult health and disease, and the current economic crisis is amplifying susceptibility to disease and unhealthy ageing in disadvantaged subgroups of the population. In adulthood, the gap between social groups is extensive in terms of mortality, functional performances and cognitive capacity. Since the occurrence of adult disease is related to lifetime experiences, including early life exposures, late-life preventive efforts may be of limited efficacy, particularly in disadvantaged subgroups. We now have the analytical tools to understand mechanisms that underlie life-long susceptibility to unhealthy ageing, and new knowledge can lead to better and more effective mechanisms to prevent diseases and reduce health inequalities. In this perspective, we first discuss the impact of recent changes in the understanding of chronic disease aetiology on our interpretation of the influence of life-course socioeconomic status (SES) on health and ageing. We then propose a model for integrating the exposome concept (the myriad of exposures derived from exogenous and endogenous sources) into the analysis of life-course socioeconomic differentials in ageing.

Lifecourse socioeconomic status and type 2 diabetes : the role of chronic inflammation in the English Longitudinal Study of Ageing.

We examined the association between lifecourse socioeconomic status (SES) and the risk of type 2 diabetes at older ages, ascertaining the extent to which adult lifestyle factors and systemic inflammation explain this relationship. Data were drawn from the English Longitudinal Study of Ageing (ELSA) which, established in 2002, is a representative cohort study of ≥50-year olds individuals living in England. SES indicators were paternal social class, participants' education, participants' wealth, and a lifecourse socioeconomic index. Inflammatory markers (C-reactive protein and fibrinogen) and lifestyle factors were measured repeatedly; diabetes incidence (new cases) was monitored over 7.5 years of follow-up. Of the 6218 individuals free from diabetes at baseline (44% women, mean aged 66 years), 423 developed diabetes during follow-up. Relative to the most advantaged people, those in the lowest lifecourse SES group experienced more than double the risk of diabetes (hazard ratio 2.59; 95% Confidence Interval (CI) = 1.81-3.71). Lifestyle factors explained 52% (95%CI:30-85) and inflammatory markers 22% (95%CI:13-37) of this gradient. Similar results were apparent with the separate SES indicators. In a general population sample, socioeconomic inequalities in the risk of type 2 diabetes extend to older ages and appear to partially originate from socioeconomic variations in modifiable factors which include lifestyle and inflammation.

Problèmes d'échantillonnage lors d'une enquête sur la plombémie d'enfants citadin [Sampling problems in a survey of blood lead levels in city children].

A study on lead pollution was carried out on a sample of ca. 300 city children. This paper presents the errors producing bias in the sample. It is emphasized that, in Switzerland, the difference between the Swiss and the migrant population (the latter being mainly Italian and Spanish) must be taken into account.

Validity of impedance-based equations for the prediction of total body water as measured by deuterium dilution in African women.

BACKGROUND: Little information is available on the validity of simple and indirect body-composition methods in non-Western populations. Equations for predicting body composition are population-specific, and body composition differs between blacks and whites. OBJECTIVE: We tested the hypothesis that the validity of equations for predicting total body water (TBW) from bioelectrical impedance analysis measurements is likely to depend on the racial background of the group from which the equations were derived. DESIGN: The hypothesis was tested by comparing, in 36 African women, TBW values measured by deuterium dilution with those predicted by 23 equations developed in white, African American, or African subjects. These cross-validations in our African sample were also compared, whenever possible, with results from other studies in black subjects. RESULTS: Errors in predicting TBW showed acceptable values (1.3-1.9 kg) in all cases, whereas a large range of bias (0.2-6.1 kg) was observed independently of the ethnic origin of the sample from which the equations were derived. Three equations (2 from whites and 1 from blacks) showed nonsignificant bias and could be used in Africans. In all other cases, we observed either an overestimation or underestimation of TBW with variable bias values, regardless of racial background, yielding no clear trend for validity as a function of ethnic origin. CONCLUSIONS: The findings of this cross-validation study emphasize the need for further fundamental research to explore the causes of the poor validity of TBW prediction equations across populations rather than the need to develop new prediction equations for use in Africa.

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms.

Quantitative ultrasound for the detection and management of osteoporosis.

Quantitative ultrasound (QUS) appears to be developing into an acceptable, low-cost and readily-accessible alternative to dual X-ray absorptiometry (DXA) measurements of bone mineral density (BMD) in the detection and management of osteoporosis. Perhaps the major difficulty with their widespread use is that many different QUS devices exist that differ substantially from each other, in terms of the parameters they measure and the strength of empirical evidence supporting their use. But another problem is that virtually no data exist outside of Caucasian or Asian populations. In general, heel QUS appears to be most tested and most effective. Some, but not all heel QUS devices are effective assessing fracture risk in some, but not all populations, the evidence being strongest for Caucasian females > 55 years old, though some evidence exists for Asian females > 55 and for Caucasian and Asian males > 70. Certain devices may allow to estimate the likelihood of osteoporosis, but very limited evidence exists supporting QUS use during the initiation or monitoring of osteoporosis treatment. Likely, QUS is most effective when combined with an assessment of clinical risk factors (CRF); with DXA reserved for individuals who are not identified as either high or low risk using QUS and CRF. However, monitoring and maintenance of test and instrument accuracy, precision and reproducibility are essential if QUS devices are to be used in clinical practice; and further scientific research in non-Caucasian, non-Asian populations clearly is compulsory to validate this tool for more widespread use.

Performance of younger and older adults in lateralized right and left hemisphere asymmetry tasks supports the HAROLD model

The population of industrialized societies has increased tremendously over the last century, raising the question on how an enhanced age affects cognition. The relevance of two models of healthy aging are contrasted in the present study that both target the functioning of the two cerebral hemispheres. The right hemi-aging model (RHAM) assumes that functions of the right hemisphere decline before those of the left hemisphere. The Hemispheric Asymmetry Reduction in Older Adults (HAROLD) Model suggests that the contralateral hemisphere supports the normally superior hemisphere in a given task resulting in a reduced hemispheric asymmetry overall. In a mixed design, 20 younger and 20 older adults performed both a task assessing a left (lateralized lexical decisions) and a right (sex decisions on chimeric faces) hemisphere advantage. Results indicated that lateralized performance in both tasks was attenuated in older as compared to younger adults, in particular in men. These observations support the HAROLD model. Future studies should investigate whether this reduced functional hemispheric asymmetry in older age results from compensatory processes or from a process of de-differentiation

A study of the aging of fingerprints by GC/MS analysis.

Determining the time since deposition of fingermarks may prove necessary in order to assess their relevance to criminal investigations. The crucial factor is the initial composition of fingermarks because it represents the starting point of any ageing model. This study mainly aimed to characterize the initial composition of fingerprints, which show a high variability between donors (inter-variability), but also to investigate the variations among fingerprints from the same donor (intra-variability). Solutions to reduce this initial variability using squalene and cholesterol as target compounds are proposed and should be further investigated. The influence of substrates was also evaluated and the initial composition was observed to be larger on porous surface than non-porous surfaces. Preliminary aging of fingerprints over 30 days was finally studied on a porous and a non-porous substrate to evaluate the potential for dating of fingermarks. Squalene was observed to decrease in a faster rate on a non-porous substrate.

Ascertaining late-life depressive symptoms in Europe: an evaluation of the survey version of the EURO-D scale in 10 nations. The SHARE project.

The reported prevalence of late-life depressive symptoms varies widely between studies, a finding that might be attributed to cultural as well as methodological factors. The EURO-D scale was developed to allow valid comparison of prevalence and risk associations between European countries. This study used Confirmatory Factor Analysis (CFA) and Rasch models to assess whether the goal of measurement invariance had been achieved; using EURO-D scale data collected in 10 European countries as part of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 22,777). The results suggested a two-factor solution (Affective Suffering and Motivation) after Principal Component Analysis (PCA) in 9 of the 10 countries. With CFA, in all countries, the two-factor solution had better overall goodness-of-fit than the one-factor solution. However, only the Affective Suffering subscale was equivalent across countries, while the Motivation subscale was not. The Rasch model indicated that the EURO-D was a hierarchical scale. While the calibration pattern was similar across countries, between countries agreement in item calibrations was stronger for the items loading on the affective suffering than the motivation factor. In conclusion, there is evidence to support the EURO-D as either a uni-dimensional or bi-dimensional scale measure of depressive symptoms in late-life across European countries. The Affective Suffering sub-component had more robust cross-cultural validity than the Motivation sub-component.

Hemispheric processing of differently valenced and self-relevant attachment words in middle-aged married and separated individuals

The reliance in experimental psychology on testing undergraduate populations with relatively little life experience, and/or ambiguously valenced stimuli with varying degrees of self-relevance, may have contributed to inconsistent findings in the literature on the valence hypothesis. To control for these potential limitations, the current study assessed lateralised lexical decisions for positive and negative attachment words in 40 middle-aged male and female participants. Self-relevance was manipulated in two ways: by testing currently married compared with previously married individuals and by assessing self-relevance ratings individually for each word. Results replicated a left hemisphere advantage for lexical decisions and a processing advantage of emotional over neutral words but did not support the valence hypothesis. Positive attachment words yielded a processing advantage over neutral words in the right hemisphere, while emotional words (irrespective of valence) yielded a processing advantage over neutral words in the left hemisphere. Both self-relevance manipulations were unrelated to lateralised performance. The role of participant sex and age in emotion processing are discussed as potential modulators of the present findings.