Inflammation is a key mechanism underpinning socioeconomic inequalities in health. In adults, lower socioeconomic position (SEP) is associated with higher inflammation levels. Early life is an important period for the biological embedding of the social environment, with implications for life course health trajectories. There is therefore increasing interest in the relationship between SEP and inflammation in children and adolescents. We conducted a scoping review to summarise and critically appraise existing evidence. Studies were included if they had exposures of any SEP indicator and outcomes of any inflammatory biomarker. Community and population studies were considered. Twenty-seven of 41 studies identified showed that lower SEP was associated with higher inflammation in childhood or adolescence. Associations were most evident in high-income countries. However, interpretation and translation of findings were restricted by a limited range of SEP indicators and inflammatory biomarkers, and inconsistent or arbitrary timing of exposures and outcomes. Drawing from this review, we make five recommendations for future work in this important domain. We suggest that future studies endeavour to: (1) measure structural and social conditions more comprehensively across early life; (2) use a broader range of inflammatory biomarkers and related measures; (3) investigate effects on long-term immune phenotype; (4) expand study settings globally and across more diverse population groups; and (5) leverage multidisciplinary teams of social and biological scientists to triangulate evidence. Implementation of these recommendations may facilitate an expansion of evidence that better informs specific and timely interventions to address the root causes of socioeconomic inequalities in health.
This research note examines the evolving relationship between counterurbanisation and life course perspectives in post-pandemic migration literature (2020-2025). Through systematic review of 88 articles, we identify significant conceptual diversity in how these phenomena are defined and interconnected. Counterurbanisation is variously conceptualised as demographic movement, hierarchical settlement transition, urban-rural migration, lifestyle choice, crisis response and policy discourse. Similarly, life course approaches range from traditional life cycle models focused on age categories to comprehensive frameworks emphasising the dynamic interplay of agency, structure and context. Our analysis reveals that approximately 78 per cent of studies establish some connection between counterurbanisation and life course concepts, though with varying degrees of theoretical integration. Direct nexuses typically frame life course events as migration triggers, employ life course as an interpretive framework or view counterurbanisation as part of longitudinal biographical trajectories. In contrast, indirect connections often focus on evolving lifestyle preferences, context-dependent migration or changing place attachments without explicitly linking them to rural-bound movements. Understanding this nexus is crucial for assessing the durability and long-term implications of post-pandemic counterurbanisation trends. By contextualising migration within broader life trajectories, researchers can better evaluate whether recent urban outflows represent lasting demographic shifts or temporary crisis responses. Moreover, recognising how counterurbanisation intersects with individual biographies provides essential insights for rural development policies, helping communities anticipate settlers' evolving needs across different life stages and create conditions for sustainable population retention. This perspective ultimately enriches our understanding of rural futures by illuminating how individual life paths and rural transformations are dynamically intertwined.
Using data from the Health and Retirement Study, we examined (a) how childhood socioeconomic status (SES) affects multimorbidity in later life; (b) whether the association between childhood SES and later-life multimorbidity provided empirical support for the critical period model, the sensitive period model, the pathway model and the accumulation model; (c) whether there were cohort differences in the association between childhood SES and later-life multimorbidity. Participants (N = 12,601) were grouped into three birth cohorts (1929-38, 1939-45 and post-1945) and followed up from 1998 to 2020. We performed two-level Poisson growth curve models. We found that the association between childhood SES and later-life multimorbidity was modified by SES in adulthood or older age but remained significant, supporting the sensitive period model. Childhood SES affects later-life multimorbidity via SES attainment in adulthood and older age, supporting the pathway model. Persistent disadvantage in childhood, adulthood and older age is a strong risk factor for later-life multimorbidity, supporting the accumulation model. Our results did not support the critical period model. These findings hold among all three cohorts, although to a different extent. Our findings highlight that childhood is a sensitive and malleable period in the life course of an individual when it is possible to break the chain of risk and prevent accumulation of socioeconomic disadvantage in multimorbidity in older age. Moreover, individual lives are embedded in historical and social contexts, the dynamic interplay between which plays a key role in determining the risk of multimorbidity in later life.
Demonstrating 'impact' has become increasingly important in research and academia alongside growing consideration of the social effects of research and the ethical standards involved. However, there are also concerns about a preoccupation with 'impact' in academia, which may result in a narrow focus on applied research. The most common definitions of impact (for example, UK Research Excellence Framework) emphasise generating measurable change outside of academia. However, this may overlook other important endeavours, such as influencing discourse and development of theory. The implicit assumption that single research projects will trigger measurable policy change is often unrealistic. Data infrastructures are also expected to demonstrate their 'impact', yet existing definitions are levied at the individual researcher or substantive projects. Such definitions do not account for the additional assumptions required for infrastructure to be impactful, and arguably, in their current form are not fit for purpose in demonstrating the full contribution of longitudinal and life course studies to society. We argue that broader definitions of impact should be considered for longitudinal studies and data infrastructure, that account for the importance of 'influence', and recognise the many and multifaceted contributions of longitudinal and life course research. Here we aim to (1) review definitions of impact in the context of longitudinal and life course studies, using UK national cohorts as a case studies; (2) to provide a working definition appropriate for longitudinal research, that incorporates 'influence'; and (3) to consider approaches that can be utilised to track impact.
The death of a parent can profoundly impact psychological and social functioning, particularly among racial-ethnic minority groups. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 9,508), the current study compared the association between parental death timing during different life stages and early-midlife depressive and perceived stress symptoms ('psychological distress') across racial-ethnic identities, while accounting for early-midlife social support and strain. We also investigated the mediating effects of cumulative social support and strain between life course timing of first parental death and midlife psychological distress using the Karlson-Holm-Breen (KHB) method. We found that Black individuals experienced the highest frequency of parental death beginning earlier in life. Stepwise linear regression models showed that parental death during young adulthood and early midlife is associated with early-midlife psychological distress among White individuals, net of covariates. Our results among Black and Hispanic adults indicate that the life course timing of parental death was unrelated to early-midlife psychological distress, exposing an understudied area of the 'Minority Mental Health Paradox'. Early-midlife social support and strain were strongly associated with early-midlife psychological distress across racial-ethnic identities. The KHB mediation analysis further revealed that cumulative social support in midlife independently accounted for approximately 16 per cent and 20 per cent of the association between parental death in young adulthood and midlife stress and depressive symptoms, respectively. Our study highlights that bereavement programmes could tailor interventions to address variations in midlife social support and strain across different racial-ethnic groups to mitigate psychological distress.
Sexual risk amongst female sex workers (FSW) varies across the life-course and is influenced by socio-economic and interpersonal factors that affect behavioural choices and engagement in HIV/STI care. We explored transitions in the life-course of FSW to understand the dynamics of sexual risk in Blantyre, Malawi. We implemented a nested longitudinal qualitative study as part of the AMETHIST Consortium, a study testing approaches to reduce HIV transmission in sex work. We conducted consecutive narrative interviews with 30 FSW at three-time points over 12 months, with a three- to four-month break between each time point. We compared narratives to understand sex work transitions, HIV risk and engagement with HIV services. We identified factors (social and physical) related to sexual risk at the points of (1) transitions into sex work, (2) continuing sex work, and (3) breaks in sex work. At the entry stage, sexual risk was heightened when women lacked the knowledge and skills for protection against HIV/STI. Whilst continuing sex work, women's immediate financial needs were prioritised over their HIV/STI risk. These behaviours occurred whether they were aware of the associated HIV/STI risk. During breaks, women perceived lower risk and reduced engagement in prevention strategies, particularly when they had stable partners, which paradoxically increased their risk. These narratives reveal how social context informs and limits access to health care while concurrently promoting risky behaviours. A multifaceted and dynamically responsive approach that considers risk differentiation from a temporal perspective can strengthen targeted interventions, effectively addressing the multiple challenges faced by FSW.
Background: Defence forces globally face recruitment and retention challenges, with posttraumatic stress disorder (PTSD) often contributing to early discharge.Objective: To systematically review the extent of research on PTSD among Australian Defence Force (ADF) members, focusing on epidemiology, comorbidities, screening tools, and treatment outcomes to establish the evidence base and inform longitudinal research over the life course.Method: Following PRISMA-ScR guidelines, five databases were searched (2002-2023). Studies were included if they examined PTSD among current-serving ADF members. Screening and risk of bias assessments were conducted independently by two reviewers. Data were charted using a standardised form to extract study design, population, outcomes, and key findings.Results: Forty-three studies met inclusion criteria (20 low risk, 17 moderate risk, 6 high risk of bias). Twenty studies reported prevalence, eight examined comorbidities, four evaluated screening tools, and three investigated treatments. PTSD prevalence from structured diagnostic interviews ranged 2-8%, aligning with international estimates. Research on comorbidity identified associations with problem gambling, musculoskeletal disorders, hypertension, and depression. Risk factors included deployment frequency and adverse childhood events. A brief depression screen showed utility for detecting PTSD. Treatment evidence for diagnosed PTSD comprised one randomised controlled trial demonstrating non-inferiority of massed prolonged exposure therapy, and an observational study which found that baseline anger was associated with treatment outcomes.Conclusions: Research on PTSD among ADF members is extensive for prevalence but limited for treatments and longitudinal outcomes. The synthesised evidence reveals associations with physical health conditions and risk-taking behaviours that may compound over time, yet critical gaps include absence of incidence data and limited understanding of symptom trajectories across military careers and civilian transition. Future research should adopt two-phase epidemiological approaches with extended follow-up to establish incidence and PTSD symptom trajectories, prioritise treatment intervention studies, and investigate whether early intervention targeting risk factors prevents PTSD onset and persistence. PTSD prevalence among current-serving ADF members ranges from 2-8% based on structured diagnostic interviews, aligning with international estimates.Critical research gaps exist, including absence of incidence data and limited understanding of PTSD symptom trajectories across military careers.Future priorities include two-phase epidemiological designs with longitudinal follow-up to establish incidence and trajectories of PTSD onset, progression and recovery; treatment intervention studies; and investigation of whether targeting risk factors prevents onset and persistence of PTSD. Antecedentes: Las fuerzas de defensa a nivel mundial enfrentan desafíos en el reclutamiento y la retención de personal, y el trastorno de estrés postraumático (TEPT) suele contribuir a las bajas tempranas. Objetivo: Realizar una revisión sistemática sobre el alcance de la investigación del TEPT entre los miembros de las Fuerzas de Defensa Australianas (ADF en su sigla en inglés), centrándose en la epidemiología, las comorbilidades, las herramientas de detección y los resultados del tratamiento para establecer la base de evidencia y fundamentar la investigación longitudinal a lo largo del ciclo vital. Método: Siguiendo las directrices PRISMA-ScR, se realizaron búsquedas en cinco bases de datos (2002-2023). Se incluyeron los estudios que examinaron el TEPT entre los miembros en servicio activo de las ADF. Dos revisores realizaron de forma independiente la selección de estudios y la evaluación del riesgo de sesgo. Los datos se tabularon mediante un formulario estandarizado para extraer el diseño del estudio, la población, los resultados y los hallazgos clave. Resultados: Cuarenta y tres estudios cumplieron los criterios de inclusión (20 de bajo riesgo, 17 de riesgo moderado y 6 de alto riesgo de sesgo). Veinte estudios informaron sobre la prevalencia, ocho examinaron las comorbilidades, cuatro evaluaron las herramientas de detección y tres investigaron los tratamientos. La prevalencia del TEPT, según entrevistas diagnósticas estructuradas, osciló entre el 2% y el 8%, en consonancia con las estimaciones internacionales. La investigación sobre comorbilidad identificó asociaciones con la ludopatía, trastornos musculoesqueléticos, hipertensión y depresión. Los factores de riesgo incluyeron la frecuencia de despliegue y las experiencias adversas en la infancia. Una prueba breve de detección de depresión demostró su utilidad para detectar el TEPT. La evidencia sobre el tratamiento del TEPT diagnosticado comprendió un ensayo controlado aleatorizado que demostró la no inferioridad de la terapia de exposición prolongada masiva y un estudio observacional que halló que la ira basal se asociaba con los resultados del tratamiento. Conclusiones: La investigación sobre el TEPT entre los miembros de ADF es extensa en cuanto a la prevalencia, pero limitada en cuanto a tratamientos y resultados longitudinales. La evidencia sintetizada revela asociaciones con afecciones de salud física y conductas de riesgo que pueden agravarse con el tiempo; sin embargo, existen importantes lagunas, como la ausencia de datos de incidencia y la comprensión limitada de las trayectorias de los síntomas a lo largo de las carreras militares y la transición a la vida civil. Las investigaciones futuras deberían adoptar enfoques epidemiológicos en dos fases con un seguimiento prolongado para establecer la incidencia y la evolución de los síntomas del TEPT, priorizar los estudios de intervención terapéutica e investigar si la intervención temprana dirigida a los factores de riesgo previene la aparición y la persistencia del TEPT.
Most research on marriage and well-being only looks at current marital status, which fails to address the impact of the timing and sequence of marital events on well-being. To fill in this gap, we use data from the Health and Retirement Study (HRS) and China Health and Retirement Longitudinal Study (CHARLS) to investigate the relationship between marital histories over the life course and loneliness and social participation in late life among older adults aged 65 and over across the US and China, and the gender differences therein. We show that marital histories are associated with loneliness and social participation differently across countries. Off-time marital transition is associated with worse socio-emotional well-being than on-time transition, represented by the higher likelihood of loneliness among Chinese widowed prematurely. On-time transition, featured by mid-life divorce in the US, is otherwise linked to less loneliness. We find weak evidence of gendered differences in the US, such that premature widowhood is linked to higher participation in leisure activities than friend visits for US women but not men. Lifelong singlehood, otherwise, is associated with lower odds of attending leisure activities than friend visits for US men but not women. Our findings reveal the associations between marital histories, including the states and transitions, and the socio-emotional well-being of older adults from three interconnected theories: the life course paradigm, the normative transition theory and the 'gender-as-relational' theory. We also highlight the importance of studying holistic marital histories (rather than current marital status) and their socio-psychological consequences over the life course, with particular attention to non-normative marital transitions that standardised measures of marital status tend to overlook.
This is a reply to 'Re-considering "impact" for longitudinal social science research: towards more scientific approaches to theorising and measuring the influence of cohort studies' by Charis Bridger Staatz, Evangeline Tabor and Dylan Kneale. Should the impact of longitudinal studies include wider dimensions compared to how research impact is defined by the Research Excellence Framework (REF)? The authors argue that this is because there are some unique challenges faced by longitudinal studies in generating and measuring impact. In particular impact can't just be tracked through physical documents and citations. The temporal nature of the studies means looking beyond individual pieces of research to understand the emerging themes in a body of work, and considering the impact of those themes. They also make the case that not all impact has to be economic or policy driven, and here the capacity building contribution of the studies within academia is vital. Both those findings are welcome. REF needs to better reflect the actual contribution of long-term social science studies, particularly as part of UK's data infrastructure. However, the impact of longitudinal studies is not simply constrained by design but also by short-termism in policy making, and the slow progress made on prevention policy across difference domains of life.
While existing research documents heterogeneous later life course employment/retirement pathways, we know little about whether the multiple short-term shifts ('churn') documented among young (20-something) adults around transitions into the labour force also characterise the experiences of significant numbers of adults in their 50s, 60s and early 70s around the transitions out of the workforce. We draw on an intersectional, gendered life course theoretical framing and exploit 16-month panel components of the US Current Population Survey from 1998 through 2018 to examine the incidence and timing of churn in the later work course, and whether it differs at the intersections of gender and age/life stage, together with other social locations. Our longitudinal study reveals, first, that while women and men in later adulthood report similar levels of churn (24 per cent and 23 per cent, respectively) its timing is gendered, with women more apt to encounter churn in their 50s, while at ages 67-74 men's churn rates outstrip women's. Second, churn is heterogeneous, differing greatly by and within gender and age/life stage in intersection with race/ethnicity, health, education and baseline employment status. Third, churn appears to be more constraint-driven during ages 50-59 and more voluntary during ages 60-74. Our findings reveal variable volatility in the later work course, underscoring the importance of examining gender and other structural locations influencing the likelihood and timing of multiple employment shifts by older US adults at different ages/life stages.
The relationship between social connections and cognitive health is well-established, yet its implications vary significantly across life stages and sociocultural contexts. This study provides new insights by using Gateway to Global Aging Data (2010-18) to examine cognitive functioning trajectories from mid- to later life across four high- and middle-income countries: the United States, England, China and Mexico. We consider overall social isolation as well as its specific dimensions, including partnership status, contact with children and friends, and social participation. Using growth curve models, we assess both levels of cognitive functioning and the rate of cognitive change with age. Results show that socially isolated adults consistently exhibit lower cognitive functioning than their non-isolated counterparts in all countries except England, with gaps more pronounced in China and Mexico than in the United States. Cross-national differences also emerge across dimensions of isolation. For instance, not having a partner significantly predicts lower cognition in China and the United States but not in England or Mexico. Contact with children plays a critical role in China and Mexico and becomes more salient in later life in the United States. Beyond family ties, maintaining friendships and engaging in social activities support cognitive health across most settings and become increasingly important with age. These findings demonstrate that the cognitive consequences of social isolation depend not only on who is isolated, but also on when isolation occurs and how it aligns with broader social contexts and life course dynamics.
Coresidence with parents is one of the most common living arrangements for young adults, and many have returned home after first living independently. Shifting trends in home-leaving and home-returning have renewed research in this area, with a primary focus on how residential transitions are connected to other life course transitions. Fewer studies consider the geographic scope of the residential moves that drive home-leaving or home-returning transitions. The current study explores if life course events similarly predict residential transitions that start and end in the same county compared to those that start and end in different counties. Residential transitions are classified by their geographic scope using the 1997 cohort of the National Longitudinal Survey of Youth. Multinomial regression models explore if the life course correlates of residential transitions vary by geographic scope. For most life course transitions, associations with same-county or different-county residential transitions vary primarily by a matter of degree. For others, such as parenthood and college degree attainment, links to residential transitions are in opposite directions based on the geographic scope of the residential transition. Results provide additional descriptive information on the geographic scope of the moves young adults make when they leave the parental home or return back to it. Variation in the associations between life course events and residential transitions of different geographic scope have implications for the contemporary transition to adulthood.
Professor John Bynner was a pioneer of social research using comparative longitudinal data, with a fine-tuned gift for predicting what many of the key issues were going to be in longitudinal and life course research and related policy spheres. His legacy is one of a truly remarkable researcher and scholar, but also a great colleague and friend to many. John was also the founding father of the Society for Longitudinal and Lifecourse Studies (SLLS) and this journal. Longitudinal and Life Course Studies (LLCS) published an obituary and tribute to John in 2024 (Schoon, 2024). This manuscript relates to a symposium that took place on 26 September 2024, in a special session organised as part of the annual meeting of the SLLS in Essex, UK. Professor Walter Heinz, a long-time friend and colleague of John's, convened the symposium. Professor Heinz won the SLLS John Bynner Distinguished Scholar Award in 2023, with winners invited to present a keynote at the following year's annual meeting. Instead of a keynote, Professor Heinz chose to organise a symposium that would pay tribute to his dear friend, who sadly passed in August 2023. As Professor Heinz could not attend the meeting in person, SLLS president Professor Dario Spini chaired the symposium. Four guest speakers were invited to highlight the key role John played in longitudinal and life course studies. Professors Paul Clarke (on behalf of Professor David Blane who could not attend), Amanda Sacker, Jeylan Mortimer and Dale Dannefer (in collaboration with Professor Ingrid Schoon, who could not attend) served as the speakers. The transcript was collated and edited by Dr Tony Robertson. The transcript, and in turn manuscript, were edited to remove extraneous material and to smooth or clarify text, including linking to slides used by the presenters and including tables. All speakers have seen the full transcript and agree with the final version of the manuscript.
Structural and social determinants across chronosystems critically shape educational transitions and cognitive aging in India by influencing cognitive reserve through life-course. Drawing on Bronfenbrenner's Ecological Systems Theory and the Cumulative Disadvantage/Advantage frameworks, we conceptualize genderism as a structural and social determinant of cognitive health operating across multiple ecological levels - national (macrosystem), regional/states (mesosystem), and household/family or individual (microsystem) - within India's chronosystem. Using Wave 1 of the Longitudinal Aging Study in India (LASI, 2017-2018), we assessed cognitive health across five domains, i.e., memory, orientation, attention, object naming, and executive function among older adults in 36 states and Union Territories of India. Three-level regression models examined how microsystem operating at individual (e.g., age, sex, education, childhood SES, widowhood, health behaviors), and household level (monthly per capita expenditure, indoor air quality, urban/rural residence), and mesosystem operating at state-level (e.g., women's education and employment rates) factors interact to shape cognitive health outcomes. Cognitive health outcomes showed wide gender gaps with regional sex disparities with the largest gap among those with education less than primary education (men: 24; women: 21) which reversed among those with post-secondary education (women: 33; men: 33). Widowed women and those with poor health indicators had significantly lower cognitive health scores. At the microsystem household-level, urban residence (β = 2.64), and households with cleaner cooking fuel use (β = 1.61) while at the mesosystem state-level, the % of women with at least primary education (β = 1.82) and the % of women who were employed (β = 0.62) were associated with improved cognitive health outcomes. The findings reveal how genderism across chronosystems accumulate over the life course highlighting the need for national-state-level policies that enhance women's access to education, employment, health, and nutrition to mitigate gendered disparities in late life cognitive health among Indian adults.
Longitudinal methodology is a powerful study design that focuses on processes and patterns of change; yet it is rarely deployed in research to understand post-conflict circumstances. This article describes experiences and lessons learned from a longitudinal study of an education intervention programme in a post-conflict setting. It illustrates both challenges and successful mitigation strategies for conducting a longitudinal study in a fragile and demanding research environment. Our study identified both methodological (participant recruitment, attrition, contextual variability, instrument modifications and record-keeping) and contextual (community, environmental, security and civil perturbations) challenges that impact longitudinal studies in post-conflict societies. By describing the challenges and successful strategies employed in this longitudinal research study, the article illustrates how researchers and practitioners can utilise this methodology to capture individual change over time, identify impacts and outcomes, and gain a deeper understanding of social phenomena and individual development in post-conflict societies.
While adherence to a low-sodium diet and cardiorespiratory fitness (CRF) are important in heart failure (HF) management, their effects on health-related quality of life (HRQoL) remain unclear. This study evaluated the influence of CRF, sodium intake adherence and demographic and clinical variables on HRQoL, cardiovascular mortality and hospitalisation in individuals with HF. A longitudinal study assessed outpatients at baseline (T0) and every six months (T1, T2) through telemonitoring. Data were analysed using R. Spearman's correlation examined associations between demographic/clinical variables, CRF, sodium intake, hospitalisation and mortality. Variables with significant correlations were included in stepwise multiple regression. Repeated measures ANOVA was used to assess changes over time in HRQoL. A total of 81 patients were included at T0, 74 at T1 and 72 at T2. Sodium intake adherence remained below the good adherence cutoff (≥40 points) across all timepoints. Mean CRF was 3 metabolic equivalents (METs). No significant change in sodium intake or CRF was observed over time. Actively working individuals had a 16.5-fold higher risk of mortality, even after adjusting for sex and age, possibly due to limited healthcare access, occupational stress, comorbidities and treatment nonadherence. The HRQoL physical domain was significantly associated with demographic, clinical and functional factors, including gender, obesity, NYHA class, HF severity and CRF (p<0.01). CRF, gender, obesity, New York Heart Association class and HF severity predicted HRQoL's physical domain. Being actively employed was strongly associated with mortality risk. Despite consistently low adherence to sodium intake recommendations, no association was found with health-related quality of life.
Few longitudinal studies have explored Oral Glucose Tolerance Test markers (OGTT) and both cognitive and brain changes. We investigated OGTT and other glycaemia and insulin resistance markers, and cognitive and neuroimaging changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). At-risk individuals aged 60-77 years without dementia (N = 1259) were randomly enrolled in a 2-year multidomain lifestyle intervention or regular health advice program. 1025 participants without previously diagnosed diabetes underwent OGTT. Brain MRI scans were available for 132 participants and amyloid (PiB)-PET and FDG-PET scans for 47. Cognition was assessed using the modified Neuropsychological Test Battery (mNTB). Higher baseline dysglycaemia measures, particularly those from the OGTT, were connected to less favourable changes in multiple cognitive measures and hippocampal volume. Higher baseline triglyceride-glucose (TyG) index was associated with higher amyloid accumulation and decline in brain glucose metabolism. Higher baseline glycated haemoglobin (HbA1c) was related to favourable changes in processing speed and cortical thickness. There were no significant intervention-control differences in the change in glycaemia markers. Baseline dysglycaemia and glycaemia-related markers did not modify the previously reported intervention benefits on cognition. Higher baseline dysglycaemia measures are linked to more deleterious changes in cognition. Specifically, OGTT measures may be the most sensitive for detecting subtle glycaemic abnormalities associated with both unfavourable cognitive and neuroimaging changes. However, HbA1c shows mixed associations with cognition and neuroimaging in people at risk of dementia without previously diagnosed diabetes. This study emphasises the importance of more accurate glucose-related markers when investigating early stages of glucose metabolism abnormalities and their relationship to subtle cognitive impairment and its structural brain correlates. ID NCT01041989 https://clinicaltrials.gov.
The U-shaped relationship between age and life satisfaction has been well documented in developed contexts, such as the Western developed world and urban China, but lifespan changes in life satisfaction in less developed contexts, such as rural China, remain underexplored. Applying multilevel growth curve models to a longitudinal dataset (2006, 2009 and 2014 waves) of 1,959 rural Chinese, the overall pattern of life satisfaction across individuals of different ages at baseline, as well as changes in life satisfaction as individuals age, are investigated. Results show that in rural China, the overall pattern of life satisfaction across different ages at baseline resembles a J-shape, with the lowest point occurring at a much earlier age (21), compared to midlife, as observed in Western societies and urban China. In terms of longitudinal changes, individuals aged 18 to 45 at baseline experience a deterioration in life satisfaction over time, with younger individuals experiencing a faster decline, while for those aged 46 and above at baseline, life satisfaction shows an increase over time, with older individuals experiencing more improvements over the eight-year interval. In rural China, young adults experience the lowest level of life satisfaction at baseline. Longitudinally, their life satisfaction further declines the most over the next eight years. Therefore, more targeted policies and support systems should be developed to improve the life satisfaction for young adults in rural China, not only for the present but also over the long term, ultimately contributing to the improvement of societal wellbeing in rural China.
Decisions over the life course, such as stopping school, retiring, or receiving care, are shaped by public policies and have profound implications for health and aging. Yet, studying the impact of these policies is hampered by a lack of standardized and harmonized policy data, making peer review and validation difficult. The Gateway to Global Aging Data addresses these barriers by collecting, harmonizing, and documenting policies over time on education, retirement, and long-term care (LTC) systems, enabling linkages to longitudinal data from international aging cohorts, thus accelerating research on health and aging. Policies are collected using a strict protocol, documented using a common terminology, reviewed by country experts, and made publicly available. Subsequently, policy measures are linked based on individual characteristics in the international network of health and retirement studies and used to highlight cross-country differences in behavioral responses. Application of the harmonized measures demonstrates that policies influence behavior. This is evidenced by changes in years of schooling through compulsory schooling and educational tracking laws, the timing of retirement through legislation on state pension age, and the use of formal care through legislation on eligibility rules for publicly funded LTC benefits. Harmonized data on public policies enable research on how changes caused by policymakers shape human behavior and, ultimately, health outcomes. These data can be linked to surveys across the world. The Gateway Policy Explorer's tools enable accountable and robust policy research on the causal impacts of health and aging policies.
Adverse childhood experiences (ACEs) are well-established predictors of health and socioeconomic disadvantage across the life course, yet their implications for adult violence involvement-both victimization and perpetration-remain less understood. Clarifying these links is critical to understanding the broader social consequences of early adversity. This study investigated the relationship between ACEs and violence outcomes in adulthood, distinguishing between victimization and perpetration, and examined potential gender differences in these associations. Data were drawn from the National Longitudinal Study of Adolescent to Adult Health (N = 14,277). Ten ACE indicators were used to construct a cumulative ACE index as well as individual adversity measures. Violence outcomes in the past year were assessed separately for victimization and perpetration. Negative binomial regression models estimated associations, adjusting for a comprehensive set of individual and family covariates. Gender differences were assessed using gender-specific average marginal effects (AMEs) and AME contrasts. ACEs were strongly and positively associated with both victimization and perpetration. Several specific adversities, including physical abuse and community violence, showed the strongest independent associations. Gender analyses demonstrated that ACEs predicted higher violence involvement for both men and women, but the magnitude of the association was significantly greater for men. Childhood adversity has lasting consequences for adult violence involvement, and the strength of these effects differs by gender. Differentiating victimization from perpetration, modeling dose-response patterns, and probing gender heterogeneity deepen understanding of how early adversity shapes behavioral trajectories across the life course.