Education and Successful Aging Trajectories: A Longitudinal Population-Based Latent Variable Modelling Analysis

ABSTRACTAs the population ages, interest is increasing in studying aging well. However, more refined means of examining predictors of biopsychosocial conceptualizations of successful aging (SA) are required. Existing evidence of the relationship between early-life education and later-life SA is unclear. The Successful Aging Index (SAI) was mapped onto the Cognitive Function and Aging Study (CFAS), a longitudinal population-based cohort (n = 1,141). SAI scores were examined using growth mixture modelling (GMM) to identify SA trajectories. Unadjusted and adjusted (age, sex, occupational status) ordinal logistic regressions were conducted to examine the association between trajectory membership and education level. GMM identified a three-class model, capturing high, moderate, and low functioning trajectories. Adjusted ordinal logistic regression models indicated that individuals in higher SAI classes were significantly more likely to have higher educational attainment than individuals in the lower SAI classes. These results provide evidence of a life course link between education and SA.

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Axial growth and refractive change in white European children and young adults: predictive factors for myopia

Scientific Reports ◽

10.1038/s41598-020-72240-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Sara McCullough ◽

Gary Adamson ◽

Karen M. M. Breslin ◽

Julie F. McClelland ◽

Lesley Doyle ◽

...

Keyword(s):

Predictive Factors ◽

Population Based ◽

Growth Trajectories ◽

Latent Growth ◽

Growth Mixture ◽

Growth Mixture Modelling ◽

Spherical Equivalent Refraction ◽

Refractive Change ◽

Children And Young Adults ◽

Axial Growth

Abstract This report describes development of spherical equivalent refraction (SER) and axial length (AL) in two population-based cohorts of white, European children. Predictive factors for myopic growth were explored. Participants were aged 6–7- (n = 390) and 12–13-years (n = 657) at baseline. SER and AL were assessed at baseline and 3, 6 and 9 years prospectively. Between 6 and 16 years: latent growth mixture modelling identified four SER classes (Persistent Emmetropes-PEMM, Persistent Moderate Hyperopes-PMHYP, Persistent High Hyperopes-PHHYP and Emerging Myopes-EMYO) as optimal to characterise refractive progression and two classes to characterise AL. Between 12 and 22-years: five SER classes (PHHYP, PMHYP, PEMM, Low Progressing Myopes-LPMYO and High Progressing Myopes-HPMYO) and four AL classes were identified. EMYO had significantly longer baseline AL (≥ 23.19 mm) (OR 2.5, CI 1.05–5.97) and at least one myopic parent (OR 6.28, CI 1.01–38.93). More myopic SER at 6–7 years (≤ + 0.19D) signalled risk for earlier myopia onset by 10-years in comparison to baseline SER of those who became myopic by 13 or 16 years (p ≤ 0.02). SER and AL progressed more slowly in myopes aged 12–22-years (− 0.16D, 0.15 mm) compared to 6–16-years (− 0.41D, 0.30 mm). These growth trajectories and risk criteria allow prediction of abnormal myopigenic growth and constitute an important resource for developing and testing anti-myopia interventions.

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Rising High or Falling Deep? Pathways of Self–Esteem in a Representative German Sample

European Journal of Personality ◽

10.1002/per.2063 ◽

2016 ◽

Vol 30 (4) ◽

pp. 341-357 ◽

Cited By ~ 3

Author(s):

Marcus Mund ◽

Franz J. Neyer

Keyword(s):

Occupational Status ◽

Well Being ◽

Self Esteem ◽

Individual Development ◽

Latent Classes ◽

Individual Change ◽

Personality Psychology ◽

Growth Mixture ◽

Growth Mixture Modelling ◽

Health And Well Being

In many longitudinal studies, self–esteem has been shown to increase up until around age 50 or 60 and to decrease thereafter. These studies have also found substantial inter–individual differences in the intra–individual development of self–esteem. In the current study, we examined whether this variation in change could be attributed to underlying latent classes of individuals following different trajectories of self–esteem development over time. By applying general growth mixture modelling to data from the representative German pairfam study (N = 12 377), four latent classes of self–esteem development across five years were extracted. Based on their mean levels, trajectories, and variability, individuals in the latent classes could be described as having (a) constant and stable high self–esteem (29.00% of the sample), (b) constant but variable moderate self–esteem (31.69%), (c) increasing and stabilizing self–esteem (15.13%), and (d) decreasing and variable self–esteem (24.18%). Furthermore, these latent classes differed in accordance with findings of prior research on self–rated, partner–rated, and objective correlates of the domains of health and well–being, partner relationships, and occupational status. Thus, the current study shows that inter–individual variation in intra–individual change in self–esteem is not random but reflects specific individual trajectories, or pathways, of self–esteem. Copyright © 2016 European Association of Personality Psychology

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Transitioning From Successful Aging: A Life Course Approach

Journal of Aging and Health ◽

10.1177/0898264317737892 ◽

2017 ◽

Vol 31 (3) ◽

pp. 528-551 ◽

Cited By ~ 2

Author(s):

Teresa M. Cooney ◽

Angela L. Curl

Keyword(s):

Life Course ◽

Successful Aging ◽

Later Life ◽

Study Data ◽

Life Course Perspective ◽

Relative Role ◽

Structural Factors ◽

Childhood Experiences ◽

Logistic Regression Models ◽

Social Structural

Objective: The life course perspective and representative U.S. data are used to test Rowe and Kahn’s Successful Aging (SA) conceptualization. Four sets of influences (childhood experiences, social structural factors, adult attainments, and later life behaviors) on SA transitions are examined to determine the relative role of structural factors and individual behaviors in SA. Method: Eight waves of Health and Retirement Study data for 12,108 respondents, 51 years and older, are used in logistic regression models predicting transitions out of SA status. Results: Social structural factors and childhood experiences had a persistent influence on transitions from SA, even after accounting for adult attainments and later life behaviors—both of which also impact SA outcomes. Discussion: The findings on sustained social structural influences call into question claims regarding the modifiability of SA outcomes originally made in presentation of the SA model. Implications for policy and the focus and timing of intervention are considered.

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Do or Decline?

Journal of Health Psychology ◽

10.1177/1359105310368184 ◽

2010 ◽

Vol 15 (5) ◽

pp. 688-696 ◽

Cited By ~ 31

Author(s):

Brad A. Meisner ◽

Shilpa Dogra ◽

A. Jane Logan ◽

Joseph Baker ◽

Patricia L. Weir

Keyword(s):

Successful Aging ◽

Functional Limitations ◽

Later Life ◽

Canadian Community Health Survey ◽

Population Based ◽

Functional Health ◽

Cross Sectional ◽

Community Health Survey ◽

Using Data ◽

Biopsychosocial Health

Research has shown that physical activity (PA) is associated with overall successful aging (SA), but it is unknown whether PA promotes each SA component in similar ways. This cross-sectional population-based cohort study investigates SA in adults aged 60 years+ using data from the Canadian Community Health Survey ( N = 12,042). Multivariate comparisons showed that, compared to those who were PA, physical inactivity was a much stronger associate of functional limitations than either chronic disease or being socially unengaged with life. This effect was not found for moderately active participants. Findings reinforce that PA, even at moderate levels, is an efficient way of optimizing biopsychosocial health, particularly functional health, in later life.

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Growth mixture models: a case example of the longitudinal analysis of patient‐reported outcomes data captured by a clinical registry

BMC Medical Research Methodology ◽

10.1186/s12874-021-01276-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jae-Yung Kwon ◽

Richard Sawatzky ◽

Jennifer Baumbusch ◽

Sandra Lauck ◽

Pamela A. Ratner

Keyword(s):

Atrial Fibrillation ◽

Longitudinal Analysis ◽

Model Building ◽

Population Based ◽

Patient Reported Outcome ◽

Latent Classes ◽

Clinical Registry ◽

Growth Mixture ◽

Growth Mixture Modelling ◽

Patient Reported

Abstract Background An assumption in many analyses of longitudinal patient-reported outcome (PRO) data is that there is a single population following a single health trajectory. One approach that may help researchers move beyond this traditional assumption, with its inherent limitations, is growth mixture modelling (GMM), which can identify and assess multiple unobserved trajectories of patients’ health outcomes. We describe the process that was undertaken for a GMM analysis of longitudinal PRO data captured by a clinical registry for outpatients with atrial fibrillation (AF). Methods This expository paper describes the modelling approach and some methodological issues that require particular attention, including (a) determining the metric of time, (b) specifying the GMMs, and (c) including predictors of membership in the identified latent classes (groups or subtypes of patients with distinct trajectories). An example is provided of a longitudinal analysis of PRO data (patients’ responses to the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire) collected between 2008 and 2016 for a population-based cardiac registry and deterministically linked with administrative health data. Results In determining the metric of time, multiple processes were required to ensure that “time” accounted for both the frequency and timing of the measurement occurrences in light of the variability in both the number of measures taken and the intervals between those measures. In specifying the GMM, convergence issues, a common problem that results in unreliable model estimates, required constrained parameter exploration techniques. For the identification of predictors of the latent classes, the 3-step (stepwise) approach was selected such that the addition of predictor variables did not change class membership itself. Conclusions GMM can be a valuable tool for classifying multiple unique PRO trajectories that have previously been unobserved in real-world applications; however, their use requires substantial transparency regarding the processes underlying model building as they can directly affect the results and therefore their interpretation.

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Early childhood aggression trajectories

International Journal of Behavioral Development ◽

10.1177/0165025414562239 ◽

2015 ◽

Vol 39 (3) ◽

pp. 221-234 ◽

Cited By ~ 10

Author(s):

Andrea Wildeboer ◽

Sandra Thijssen ◽

Marinus H. van IJzendoorn ◽

Jan van der Ende ◽

Vincent W. V. Jaddoe ◽

...

Keyword(s):

Early Childhood ◽

Aggressive Behaviour ◽

Population Based ◽

Attention Problems ◽

Childhood Aggression ◽

Problem Behaviour ◽

Child Aggression ◽

Growth Mixture ◽

Growth Mixture Modelling ◽

Rule Breaking

High and stable levels of aggression and the presence of aggressive behaviour in multiple settings according to different informants are risk factors for later problems. However, these two factors have not been investigated in early childhood. The present study investigates trajectories of parent-reported child aggression from 1.5 up to 6 years of age and their association with aggressive behaviour, attention problems and rule-breaking behaviour in a different setting, as reported by the teacher. In a longitudinal population-based cohort study, parent-reported measures of aggressive behaviour were obtained using the CBCL when children were 1.5, 3, and 6 years of age ( n = 4,781). Teacher-reported problem behaviour at school was assessed at age 6.5, using the TRF questionnaire ( n = 2,756). Growth mixture modelling yielded three aggression trajectories, with high increasing (3.0%), intermediate (21.3%), and low decreasing (75.7%) aggression levels. Children in trajectories with higher and increasing levels of aggression showed more teacher-reported aggressive behaviour, attention problems and rule breaking behaviour. However, parent-reported aggression at age six predicted problem behaviour at school to the same extent as did the aggression trajectories, suggesting that the incremental value of trajectories is not always self-evident.

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Understanding different trajectories of mental health across the general population during the COVID-19 pandemic

Psychological Medicine ◽

10.1017/s0033291721000957 ◽

2021 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Rob Saunders ◽

Joshua E. J. Buckman ◽

Peter Fonagy ◽

Daisy Fancourt

Keyword(s):

Mental Health ◽

Personal Characteristics ◽

Young Female ◽

Personality Factors ◽

Living Situation ◽

Logistic Regression Models ◽

Symptom Trajectories ◽

Growth Mixture ◽

Growth Mixture Modelling ◽

Common Group

Abstract Background The COVID-19 pandemic and nationally mandated restrictions to control the virus have been associated with increased mental health issues. However, the differential impact of the pandemic and lockdown on groups of individuals, and the personal characteristics associated with poorer outcomes are unknown. Method Data from 21 938 adults in England who participated in a stratified cohort study were analysed. Trajectories of depression and anxiety symptoms were identified using growth mixture modelling. Multinomial and logistic regression models were constructed to identify sociodemographic and personality-related risk factors associated with trajectory class membership. Results Four trajectories of depression and five for anxiety were identified. The most common group presented with low symptom severity throughout, other classes were identified that showed: severe levels of symptoms which increased; moderate symptoms throughout; worsening mental health during lockdown but improvements after lockdown ended; and for anxiety only, severe initial anxiety that decreased quickly during lockdown. Age, gender, ethnicity, income, previous diagnoses, living situation, personality factors and sociability were associated with different trajectories. Conclusions Nearly 30% of participants experienced trajectories with symptoms in the clinical range during lockdown, and did not follow the average curve or majority group, highlighting the importance of differential trajectories. Young, female, outgoing and sociable people and essential workers experienced severe anxiety around the announcement of lockdown which rapidly decreased. Younger individuals with lower incomes and previous mental health diagnoses experienced higher and increasing levels of symptoms. Recognising the likely symptom trajectories for such groups may allow for targeted care or interventions.

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Associations between Free Sugar and Sugary Beverage Intake in Early Childhood and Adult NAFLD in a Population-Based UK Cohort

Children ◽

10.3390/children8040290 ◽

2021 ◽

Vol 8 (4) ◽

pp. 290

Author(s):

Ahlia Sekkarie ◽

Jean A. Welsh ◽

Kate Northstone ◽

Aryeh D. Stein ◽

Usha Ramakrishnan ◽

...

Keyword(s):

Total Energy ◽

Hepatic Steatosis ◽

Population Based ◽

Free Sugar ◽

Alcoholic Fatty Liver ◽

Free Sugars ◽

Logistic Regression Models ◽

Sugar Intake ◽

Sugary Beverages ◽

Alcoholic Fatty Liver Disease

(1) Background: High sugar intake is prevalent among children and is associated with non-alcoholic fatty liver disease (NAFLD). The purpose of this study is to determine if a high intake of free sugars and sugary beverages (SB) in childhood is associated with NAFLD in adulthood; (2) Methods: At 24 years, 3095 participants were assessed for severe hepatic steatosis (controlled attenuation parameter >280 dB/m) and had dietary data collected via a food frequency questionnaire at age three years. Multiple logistic regression models adjusted for total energy intake, potential confounders, and a mediator (offspring body mass index (BMI) at 24 years); (3) Results: Per quintile increase of free sugar intake association with severe hepatic steatosis at 24 years after adjusting for total energy was odds ratio (OR):1.07 (95% CL: 0.99–1.17). Comparing the lowest vs. the highest free sugar consumers, the association was OR:1.28 (95% CL: 0.88–1.85) and 1.14 (0.72, 1.82) after full adjustment. The OR for high SB consumption (>2/day) compared to <1/day was 1.23 (95% CL: 0.82–1.84) and OR: 0.98 (95% CL: 0.60–1.60) after full adjustment; (4) Conclusions: High free sugar and SB intake at three years were positively but weakly associated with severe hepatic steatosis at 24 years. These associations were completely attenuated after adjusting for confounders and 24-year BMI.

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Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00648-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Hossein Farhadnejad ◽

Karim Parastouei ◽

Hosein Rostami ◽

Parvin Mirmiran ◽

Fereidoun Azizi

Keyword(s):

Metabolic Syndrome ◽

Positive Association ◽

Population Based ◽

Population Based Study ◽

Logistic Regression Models ◽

Increased Risk ◽

Confounding Variables ◽

Adjusted Model ◽

Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

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Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03512-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qun Miao ◽

Sandra Dunn ◽

Shi Wu Wen ◽

Jane Lougheed ◽

Jessica Reszel ◽

...

Keyword(s):

Socioeconomic Status ◽

Congenital Heart Disease ◽

Heart Disease ◽

Household Income ◽

Congenital Heart ◽

Population Based ◽

Income Poverty ◽

Lower Odds ◽

Logistic Regression Models ◽

Chd Risk

Abstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation.

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