Role of cognitive ability in the association between functional health literacy and mortality in the Lothian Birth Cohort 1936: a prospective cohort study

ObjectivesWe investigated the role that childhood and old age cognitive ability play in the association between functional health literacy and mortality.DesignProspective cohort study.SettingThis study used data from the Lothian Birth Cohort 1936 (LBC1936) study, which recruited participants living in the Lothian region of Scotland when aged 70 years, most of whom had completed an intelligence test at age 11 years.Participants795 members of the LBC1936 with scores on tests of functional health literacy and cognitive ability in childhood and older adulthood.Primary and secondary outcome measuresParticipants were followed up for 8 years to determine mortality. Time to death in days was used as the primary outcome measure.ResultsUsing Cox regression, higher functional health literacy was associated with lower risk of mortality adjusting for age and sex, using the Shortened Test of Functional Health Literacy in Adults (HR 0.95, 95% CI 0.92 to 0.98), the Newest Vital Sign (HR 0.88, 95% CI 0.80 to 0.97) and a functional health literacy composite measure (HR 0.77, 95% CI 0.65 to 0.92), but not the Rapid Estimate of Adult Literacy in Medicine (HR 0.95, 95% CI 0.90 to 1.01). Adjusting for childhood intelligence did not change these associations. When additionally adjusting for fluid-type cognitive ability in older age, associations between functional health literacy and mortality were attenuated and non-significant.ConclusionsCurrent fluid ability, but not childhood intelligence, attenuated the association between functional health literacy and mortality. Functional health literacy measures may, in part, assess fluid-type cognitive abilities, and this may account for the association between functional health literacy and mortality.

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Health literacy, health status and health behaviors of German students– study protocol for the “Healthy Habits” cohort study

BMC Public Health ◽

10.1186/s12889-021-11542-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Martin Lange ◽

Alexandra Löwe ◽

Gerrit Stassen ◽

Andrea Schaller

Keyword(s):

Cohort Study ◽

Health Status ◽

Health Literacy ◽

Health Behavior ◽

Health Behaviors ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

The State ◽

The Impact ◽

Study Format

Abstract Background The emerging adulthood is traditionally viewed as a time of optimal health, but also as a critical life span, characterized by changing life circumstances and the establishment of an individual lifestyle. Especially university life seems to hold several challenges impeding the manifestation of a health supporting manner, as many students tend to show a poorer health behavior and a higher amount of health-related problems than comparable age groups. This, along with a steady growth of the higher education sector, brings increased attention to the university setting in the context of prevention. To date, there are few empirical longitudinal and coherent cross-sectional data on the status of students’ health literacy, health status, and health behaviors, and on the impact of the study format on students’ health. The aim of this prospective cohort study is to reduce this research gap. Methods Starting during winter semester 2020/21, the prospective cohort study collects data on health literacy, health status and health behavior on a semester-by-semester basis. All enrolled students of the IST University of Applied Sciences, regardless of study format and discipline, can participate in the study at the beginning of their first semester. The data are collected digitally via a specifically programmed app. A total of 103 items assess the subjectively perceived health status, life and study satisfaction, sleep quality, perceived stress, physical activity, diet, smoking, alcohol consumption, drug addiction and health literacy. Statistical analysis uses (1) multivariate methods to look at changes within the three health dimensions over time and (2) the association between the three health dimensions using multiple regression methods and correlations. Discussion This cohort study collects comprehensive health data from students on the course of study. It is assumed that gathered data will provide information on how the state of health develops over the study period. Also, different degrees of correlations of health behavior and health literacy will reveal different impacts on the state of students’ health. Furthermore, this study will contribute to empirically justified development of target group-specific interventions. Trial registration German Clinical Trials Register: DRKS00023397 (registered on October 26, 2020).

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Children’s Greenness Exposure and IQ-Associated DNA Methylation: A Prospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147429 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7429

Author(s):

Kyung-Shin Lee ◽

Yoon-Jung Choi ◽

Jin-Woo Cho ◽

Sung-Ji Moon ◽

Youn-Hee Lim ◽

...

Keyword(s):

Dna Methylation ◽

Cohort Study ◽

Literature Review ◽

Cognitive Ability ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Association Studies ◽

The Body ◽

Genome Wide Association Studies ◽

Regulatory Pathways

Epigenetics is known to be involved in regulatory pathways through which greenness exposure influences child development and health. We aimed to investigate the associations between residential surrounding greenness and DNA methylation changes in children, and further assessed the association between DNA methylation and children’s intelligence quotient (IQ) in a prospective cohort study. We identified cytosine-guanine dinucleotide sites (CpGs) associated with cognitive abilities from epigenome- and genome-wide association studies through a systematic literature review for candidate gene analysis. We estimated the residential surrounding greenness at age 2 using a geographic information system. DNA methylation was analyzed from whole blood using the HumanMethylationEPIC array in 59 children at age 2. We analyzed the association between greenness exposure and DNA methylation at age 2 at the selected CpGs using multivariable linear regression. We further investigated the relationship between DNA methylation and children’s IQ. We identified 8743 CpGs associated with cognitive ability based on the literature review. Among these CpGs, we found that 25 CpGs were significantly associated with greenness exposure at age 2, including cg26269038 (Bonferroni-corrected p ≤ 0.05) located in the body of SLC6A3, which encodes a dopamine transporter. DNA methylation at cg26269038 at age 2 was significantly associated with children’s performance IQ at age 6. Exposure to surrounding greenness was associated with cognitive ability-related DNA methylation changes, which was also associated with children’s IQ. Further studies are warranted to clarify the epigenetic pathways linking greenness exposure and neurocognitive function.

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