Aging with Autism Departs Greatly from Typical Aging

Autism has been largely portrayed as a psychiatric and childhood disorder. However, autism is a lifelong neurological condition that evolves over time through highly heterogeneous trajectories. These trends have not been studied in relation to normative aging trajectories, so we know very little about aging with autism. One aspect that seems to develop differently is the sense of movement, inclusive of sensory kinesthetic-reafference emerging from continuously sensed self-generated motions. These include involuntary micro-motions eluding observation, yet routinely obtainable in fMRI studies to rid images of motor artifacts. Open-access repositories offer thousands of imaging records, covering 5–65 years of age for both neurotypical and autistic individuals to ascertain the trajectories of involuntary motions. Here we introduce new computational techniques that automatically stratify different age groups in autism according to probability distance in different representational spaces. Further, we show that autistic cross-sectional population trajectories in probability space fundamentally differ from those of neurotypical controls and that after 40 years of age, there is an inflection point in autism, signaling a monotonically increasing difference away from age-matched normative involuntary motion signatures. Our work offers new age-appropriate stochastic analyses amenable to redefine basic research and provide dynamic diagnoses as the person’s nervous systems age.

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Abstract 88: Increasing False Positive Diagnoses May Lead to Overestimation of Stroke Incidence, Particularly in the Young

Stroke ◽

10.1161/str.51.suppl_1.88 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Abhinav J Appukutty ◽

Lesli E Skolarus ◽

Mellanie V Springer ◽

William J Meurer ◽

James F Burke

Keyword(s):

Older Adults ◽

False Positive ◽

Age Groups ◽

Vascular Risk Factor ◽

The United States ◽

Cross Sectional ◽

Stroke Incidence ◽

Ed Visits ◽

Over Time

Introduction: Stroke incidence is reportedly increasing in younger adults. While increasing vascular risk factor prevalence has been suggested as a cause, the reasons for rising stroke incidence in the young are not clear. We explored several alternate explanations: trends in neurologically-focused emergency department (ED) visits, differential diagnostic classification of stroke and TIA over time, and changes in the use of advanced imaging in young and older adults. Methods: We performed a retrospective, serial, cross-sectional study on a nationally representative sample of all ED visits in the United States to quantify changes in patterns of neurologically-focused ED visits, stroke and TIA diagnoses, and rates of MRI utilization for young (18 – 44 years) and older (65+ years) adults over a 17-year period (1995 – 2000; 2005 – 2015) using National Hospital Ambulatory Medical Care Survey (NHAMCS) data. Results: In young adults, 0.4% (95% CI 0.3% – 0.5%) of neurologically-focused ED visits resulted in a primary diagnosis of stroke vs. 6.8% (95% CI 6.2% – 7.5%) for older adults. In both populations, the incidence of neurologically-focused ED visits has increased over time (+111/100,000 population/year, 95% CI +94 – +130 in the young vs. +70/100,000 population/year, 95% CI +34 – +108 in older adults). There was no evidence of differential classification of TIA to stroke over time (OR 1.001 per year, 95% CI 0.926 – 1.083 in the young; OR 1.003 per year, 95% CI 0.982 – 1.026 in older adults) and no evidence of disproportionate rise in MRI utilization for neurologically-focused ED visits in the young (OR 1.057 per year, 95% CI 1.028 – 1.086 in the young; OR 1.095 per year, 95% CI 1.066 – 1.125 in older adults). Conclusions: If the specificity of stroke diagnosis amongst ED visits is similar amongst young and older populations, then the combination of data observed here, including (1) a lower prior probability of stroke diagnoses in the young and (2) an increasing trend in neurologically-focused ED visits in both age groups, suggests that false positive diagnoses will increase over time, with a faster rise in the young compared to older adults. These data suggest a potential explanation that may contribute to higher stroke incidence in the young and merits further scrutiny.

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Marketing Up the Wrong Tree? Organisational Perspectives on Attracting and/or Retaining Older Adults in Sport

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.772361 ◽

2021 ◽

Vol 3 ◽

Author(s):

Claire Jenkin ◽

Jannique G. Z. van Uffelen ◽

Grant O'Sullivan ◽

Jack Harvey ◽

Rochelle M. Eime ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sport Participation ◽

Age Groups ◽

Organisational Change ◽

Population Group ◽

Cross Sectional Study ◽

Cross Sectional ◽

Major Barrier ◽

Age Appropriate

Community sport is seen as a suitable setting for physical activity for different population groups. Older adults (aged 50+ years) are a rapidly growing population group. Physical activity is critical for healthy ageing, however sport participation rates for older adults are very low. The aim of this study was to investigate how sporting organisations perceive sport for older adults. This cross-sectional study surveyed 171 representatives from Australian National and State Sporting Organisations. Descriptive statistics were used to summarise the results and the three sporting organisation categories' (high, medium, and low participation) responses were compared using non-parametric statistics. Contextualised in the perspective of organisational change, a framework for marketing to the ageing consumer was used to interpret the results. Older adults are not a high priority group for most sporting organisations, however the benefits of engaging older adults were recognised, particularly in context of increasing participation numbers. A lack of age-appropriate programmes was perceived to be a major barrier of engaging older adults. This lack of programmes stems from older adults being deemed as a less attractive segment than other age groups for sporting organisations. Modifications that sports felt they could make to attract and/or retain older adults included specific marketing and age appropriate opportunities. There was widespread consensus across sporting organisations, suggesting that perceptions of older adult sport participation were comparable across the sector, such as increasing participation numbers and engaging their older fan base. In the context of attracting, and retaining, older adults in sport clubs, it was concluded that most sporting organisations are not (yet) ready to build “age friendly” sporting environments. There is very limited literature on the organisational perspective of older adults and sport, meaning this study is unique in the field. Although sport policy encourages organisations to grow their participation, most organisations do not actively and strategically engage older adults. This research provides an understanding of why this untapped market is not a priority target and provides comprehensive insights for policy makers to better engage with this population group.

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Development of Spanish rhotics in Spanish–English bilingual children in the United States

Journal of Child Language ◽

10.1017/s0305000917000460 ◽

2017 ◽

Vol 45 (3) ◽

pp. 788-806 ◽

Cited By ~ 3

Author(s):

Mandy R. MENKE

Keyword(s):

United States ◽

Age Groups ◽

The United States ◽

Bilingual Children ◽

Phonological Development ◽

Cross Sectional ◽

English Bilingual ◽

Age Appropriate ◽

Target Production

AbstractRhotics, particularly the trill, are late acquired sounds in Spanish. Reports of Spanish–English bilingual preschoolers document age-appropriate articulations, but studies do not explore productions once exposure to English increases. This paper reports on the rhotic productions of a cross-sectional sample of 31 Spanish–English bilingual children, ages 6;8 to 13;5. Children produced taps with high rates of accuracy across age groups; the trill did not reach 80% target production until age 11;3, later than reported for monolingual speakers. Increased English exposure is explored as a contributing factor, arguing a need for continued study of bilingual phonological development beyond the preschool years.

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Health Care Needs in the Aftermath of Hurricane Maria in Puerto Rico: A Perspective from Federal Medical Shelter Manatí

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000339 ◽

2021 ◽

pp. 1-5

Author(s):

Arnab K. Ghosh ◽

Max Mecklenburg ◽

Said Ibrahim ◽

Pia Daniel

Keyword(s):

Health Care ◽

Puerto Rico ◽

Chronic Disease ◽

Disaster Response ◽

Age Groups ◽

Care Needs ◽

Cross Sectional ◽

Adult Age ◽

Medical Needs ◽

Over Time

Abstract Introduction: On September 20, 2017, Hurricane Maria, a Category 4 hurricane, swept across Puerto Rico (PR), wreaking devastation to PR’s power, water, and health care infrastructure. To address the imminent humanitarian crisis, the US government mobilized Federal Medical Shelters (FMS) to serve the needs of hurricane victims. This study’s objective was to provide a description of the patients seeking emergency care at FMS and the changes in their needs over time. Methods: This retrospective, cross-sectional study included all patients presenting to the FMS Manatí from October 6, two weeks after Hurricane Maria’s landfall, to November 2, 2017. Categories were created to catalogue the nature of new acute medical issues by patients presenting to the Shelter. Descriptive, graphical analyses were performed to assess changes to presenting complaints over time, and by age groups defined as infant (age ≤1 years), child (1 year < age ≤10 years), adolescent (10 years < age ≤ 25 years), and adult (age > 25 years). Results: Over the 30-day period, 5,268 patients were seen in the FMS seeking medical care (average 188.1 patients per day), spending less than five hours in the facility. The distribution of patients’ age was bimodal: the first peak at one year and the second at age 50. The most common patient complaint was infection (38.8%), then musculoskeletal (MSK) complaints (11.8%) and management of chronic medical conditions (11.8%). The proportion of patients presenting with chronic disease complaints declined over the course of the period of observation (21.4% on Day 4 to 8.0% on Day 30) while the proportion of patients presenting with infection increased (31.0% on Day 4 to 48.6% on Day 30). Infection complaints were highest in all age groups, but most in infxants (80.2%), while MSK and chronic disease complaints were highest in adults (14.9% and 14.9%, respectively). Conclusion: Infection treatment and chronic disease management were important medical needs facing patients seeking care at FMS Manatí after Hurricane Maria. These findings suggest that basic needs related to sanitation and shelter remained important weeks after the hurricane, and a focus on access to medications, infection control, and injury prevention/management after a disaster needs to be prioritized during disaster response.

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Trends in COVID-19 vaccination intent, determinants and reasons for vaccine hesitancy: results from repeated cross-sectional surveys in the adult general population of Greece during November 2020-June 2021

10.1101/2021.06.23.21259376 ◽

2021 ◽

Author(s):

Vana Sypsa ◽

Sotirios Roussos ◽

Vasiliki Engeli ◽

Dimitrios Paraskevis ◽

Sotirios Tsiodras ◽

...

Keyword(s):

General Population ◽

Large Scale ◽

Multinomial Logistic Regression ◽

Multivariable Analysis ◽

Age Groups ◽

Female Gender ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Major Barrier ◽

Over Time

Background: Vaccine hesitancy is a major barrier to achieve large-scale COVID-19 vaccination. We report trends in vaccination intention and associated determinants from surveys in the adult general population in Greece. Methods: Four cross-sectional phone surveys were conducted in November 2020, February, April and May 2021 on nationally representative samples of adults in Greece. Multinomial logistic regression was used on the combined data of the surveys to evaluate independent predictors of vaccination unwillingness/uncertainty. Results: Vaccination intention increased from 67.6% in November 2020 to 84.8%. in May 2021. Individuals aged 65 years or older were more willing to get vaccinated (May 2021: 92.9% vs. 79.5% in 18-39 years, p<0.001) but between age-groups differences decreased over time. Vaccination intention increased substantially in both sexes, though earlier among men than women and was higher in individuals with postgraduate studies (May 2021: 91.3% vs. 84.0% up to junior high). From multivariable analysis, unwillingness and/or uncertainty to get vaccinated was associated with younger age, female gender (in particular in the April 2021 survey), lower educational level and living with a child ≤12 years old. Among those with vaccine hesitancy, concerns about vaccine effectiveness declined over time (21.6% in November 2020 vs. 9.6% in May 2021, p=0.014) and were reported more often by men; safety concerns remained stable over time (66.3% in November 2020 vs. 62.1% in May 2021, p=0.658) and were reported more often by women. Conclusions: Vaccination intention increased substantially over time. Tailored communication is needed to address vaccine hesitancy and concerns regarding vaccine safety.

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Differential Effect of Vaccine Effectiveness and Safety on COVID-19 Vaccine Acceptance across Socioeconomic Groups in an International Sample

Vaccines ◽

10.3390/vaccines9091010 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1010

Author(s):

Stefania Kerekes ◽

Mengdi Ji ◽

Shu-Fang Shih ◽

Hao-Yuan Chang ◽

Harapan Harapan ◽

...

Keyword(s):

Age Groups ◽

Mainland China ◽

Vaccine Safety ◽

Vaccine Effectiveness ◽

Effective Vaccine ◽

Lower Income ◽

Cross Sectional ◽

Vaccine Acceptance ◽

The Us ◽

Over Time

Controlling the spread of SARS-CoV-2 will require high vaccination coverage, but acceptance of the vaccine could be impacted by perceptions of vaccine safety and effectiveness. The aim of this study was to characterize how vaccine safety and effectiveness impact acceptance of a vaccine, and whether this impact varied over time or across socioeconomic and demographic groups. Repeated cross-sectional surveys of an opt-in internet sample were conducted in 2020 in the US, mainland China, Taiwan, Malaysia, Indonesia, and India. Individuals were randomized into receiving information about a hypothetical COVID-19 vaccine with different safety and effectiveness profiles (risk of fever 5% vs. 20% and vaccine effectiveness 50% vs. 95%). We examined the effect of the vaccine profile on vaccine acceptance in a logistic regression model, and included interaction terms between vaccine profile and socioeconomic/demographic variables to examine the differences in sensitivity to the vaccine profile. In total, 12,915 participants were enrolled in the six-country study, including the US (4054), China (2797), Taiwan (1278), Malaysia (1497), Indonesia (1527), and India (1762). Across time and countries, respondents had stronger preferences for a safer and more effective vaccine. For example, in the US in November 2020, acceptance was 3.10 times higher for a 95% effective vaccine with a 5% risk of fever, vs a vaccine 50% effective, with a 20% risk of fever (95% CI: 2.07, 4.63). Across all countries, there was an increase in the effect of the vaccine profile over time (p < 0.0001), with stronger preferences for a more effective and safer vaccine in November 2020 compared to August 2020. Sensitivity to the vaccine profile was also stronger in August compared to November 2020, in younger age groups, among those with lower income; and in those that are vaccine hesitant. Uptake of COVID-19 vaccines could vary in a country based upon effectiveness and availability. Effective communication tools will need to be developed for certain sensitive groups, including young adults, those with lower income, and those more vaccine hesitant.

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Socioeconomic Characteristics and Trends in the Consumption of Ultra-Processed Foods in Korea from 2010 to 2018

Nutrients ◽

10.3390/nu13041120 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1120

Author(s):

Jee-Seon Shim ◽

Sun-Young Shim ◽

Hee-Jeung Cha ◽

Jinhee Kim ◽

Hyeon Chang Kim

Keyword(s):

Food Consumption ◽

Economic Status ◽

Age Groups ◽

Income Level ◽

Korean Population ◽

Processed Foods ◽

Processed Food ◽

Cross Sectional ◽

Socioeconomic Characteristics ◽

Over Time

There is growing evidence for a global transition to a more highly processed diet. While the dietary share of ultra-processed foods depends on a country’s economic status, food choice and consumption are also influenced by the socioeconomic situation of individuals. This study investigated whether ultra-processed food consumption differed across socioeconomic subgroups and over time (2010–2018) in Korea. Cross-sectional data from the Korea National Health and Nutrition Examination Survey 2010–2018 were analyzed. Food and beverages reported in a one-day 24 h recall were classified according to the NOVA food classification criteria. The dietary energy contribution of ultra-processed foods was high among men and urban residents, and increased with education and income level; additionally, it reached its peak in adolescents and thereafter decreased with increasing age. After adjusting the socioeconomic variables, such associations remained significant, except for income level. The overall contribution of ultra-processed foods increased from 23.1% (2010–2012) to 26.1% (2016–2018), and the same trend over time was observed in all age groups and socioeconomic strata. In the Korean population, ultra-processed food consumption differed by individual socioeconomic characteristics, but gradually increased over time, and this trend was consistently found in all socioeconomic subgroups. Future strategies to promote healthy food choices are needed for the Korean population.

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Increasing false positive diagnoses may lead to overestimation of stroke incidence, particularly in the young: a cross-sectional study

BMC Neurology ◽

10.1186/s12883-021-02172-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abhinav J. Appukutty ◽

Lesli E. Skolarus ◽

Mellanie V. Springer ◽

William J. Meurer ◽

James F. Burke

Keyword(s):

Older Adults ◽

False Positive ◽

Age Groups ◽

Cross Sectional Study ◽

Primary Diagnosis ◽

Sectional Study ◽

Cross Sectional ◽

Stroke Incidence ◽

Ed Visits ◽

Over Time

Abstract Background Stroke incidence is reportedly increasing in younger populations, although the reasons for this are not clear. We explored possible reasons by quantifying trends in neurologically focused emergency department (ED) visits, classification of stroke vs. TIA, and imaging use. Methods We performed a retrospective, serial, cross-sectional study using the National Hospital Ambulatory Medical Care Survey to examine time trends in age-stratified primary reasons for visit, stroke/TIA diagnoses, and MRI utilization from 1995 to 2000 and 2005–2015. Results Five million eight hundred thousand ED visits with a primary diagnosis of stroke (CI 5.3 M–6.4 M) were represented in the data. The incidence of neurologically focused reason for visits (Neuro RFVs) increased over time in both the young and in older adults (young: + 111 Neuro RFVs/100,000 population/year, CI + 94 − + 130; older adults: + 70 Neuro RFVs/100,000 population/year, CI + 34 − + 108). The proportion of combined stroke and TIA diagnoses decreased over time amongst older adults with a Neuro RFV (OR 0.95 per year, p < 0.01, CI 0.94–0.96) but did not change in the young (OR 1.00 per year, p = 0.88, CI 0.95–1.04). Within the stroke/TIA population, no changes in the proportion of stroke or TIA were identified. MRI utilization rates amongst patients with a Neuro RFV increased for both age groups. Conclusions We found, but did not anticipate, increased incidence of neurologically focused ED visits in both age groups. Given the lower pre-test probability of a stroke in younger adults, this suggests that false positive stroke diagnoses may be increasing and may be increasing more rapidly in the young than in older adults.

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Prevalence and treatment of atrial fibrillation in UK general practice from 2000 to 2016

Heart ◽

10.1136/heartjnl-2018-312977 ◽

2018 ◽

Vol 105 (1) ◽

pp. 27-33 ◽

Cited By ~ 20

Author(s):

Nicola Jaime Adderley ◽

Ronan Ryan ◽

Krishnarajah Nirantharakumar ◽

Tom Marshall

Keyword(s):

Atrial Fibrillation ◽

Stroke Risk ◽

Age Groups ◽

Poor Agreement ◽

Cross Sectional ◽

Stroke Treatment ◽

Current Prevalence ◽

Practice Performance ◽

The Uk ◽

Over Time

ObjectiveAtrial fibrillation (AF) is the most common cardiac arrhythmia and an important risk factor for stroke. Treatment with anticoagulants substantially reduces risk of stroke. Current prevalence and treatment rates of AF in the UK as well as changes in recent years are not known. The aim of this analysis was to determine trends in age–sex specific prevalence and treatment of AF in the UK from 2000 to 2016.Methods17 sequential cross-sectional analyses were carried out between 2000 and 2016 using a large database of electronic primary care records of patients registered with UK general practitioners. These determined the prevalence of patients diagnosed with AF, the stroke risk of those with AF and the proportion of AF patients currently receiving anticoagulants. Stroke risk was assessed using CHA2DS2-VASc score.ResultsAge–sex standardised AF prevalence increased from 2.14% (95% CI 2.11% to 2.17%) in 2000 to 3.29% (95% CI 3.27% to 3.32%) in 2016. Between 2000 and 2016, the proportion of patients with AF prescribed anticoagulants increased from 35.4% (95% CI 34.7% to 36.1%) to 75.5% (95% CI 75.1% to 75.8%) in those with high stroke risk (p for change over time <0.001) and from 32.8% (95% CI 30.5% to 35.2%) to 47.1% (95% CI 45.4% to 48.7%) in those with moderate stroke risk (p<0.001). In patients with low risk of stroke, the proportion decreased from 19.9% (95% CI 17.8% to 22.2%) to 9.7% (95% CI 8.4% to 11.1%) (p<0.001). Anticoagulant prescribing performance varied between practices; in 2016, the proportion of eligible patients treated was 82.9% (95% CI 82.2% to 83.7%) and 62.0% (95% CI 61.0% to 63.0%) in the highest-performing and lowest-performing practice quintiles, respectively. There was poor agreement in individual practice performance over time from 2006 to 2016: linear-weighted κ=0.10 (95% CI 0.02 to 0.19).ConclusionsFrom 2000 to 2016, the prevalence of recorded AF has increased in all age groups and both sexes. Anticoagulant treatment of eligible patients with AF has more than doubled, with marked improvements since 2011, alongside a reduction in the use of anticoagulants in ineligible patients with AF.

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Sentiment analysis of public perception on the use of digital contact tracing tools post COVID-19 lockdown (Preprint)

10.2196/preprints.33314 ◽

2021 ◽

Author(s):

Zhilian Huang ◽

Evonne Tay ◽

Dillon Wee ◽

Huiling Guo ◽

Hannah YeeFen Lim ◽

...

Keyword(s):

Sentiment Analysis ◽

Language Processing ◽

Public Perception ◽

Age Groups ◽

Contact Tracing ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Media ◽

Short Time ◽

Over Time

BACKGROUND Singapore’s national Digital Contact Tracing (DCT) tool—TraceTogether—attained an above 70% uptake by December 2020 after a slew of measures. Sentiment analysis can help policymakers to assess public sentiments on the implementation of new policy measures at a short time but there is a paucity of sentiment analysis studies on the usage of DCT tools. OBJECTIVE We sought to understand the public’s knowledge of and concerns with using TraceTogether, and their preferences for the type of TraceTogether tool. METHODS We conducted a cross-sectional survey one-month post-COVID-19 lockdown at a large public hospital in Singapore from July 2020 through February 2021. Four thousand and ninety-seven respondents aged 21 – 80 were sampled proportionately by gender and four age groups. The open-ended responses were processed and analyzed using natural language processing tools. We manually corrected the language and logic errors and replaced phrases with words available in the “Syuzhet” sentiment library without altering the original meaning of the phrases. The sentiment scores were computed by summing the scores of all the tokens (phrases split into smaller units) in the phrase. Stopwords (prepositions and connectors) were removed, followed by implementing the bag-of-words model to calculate the bigrams and trigrams occurrence in the dataset. Demographic and time filters were applied to segment the responses. RESULTS Respondents’ knowledge of and concerns with TraceTogether changed over time from a focus on “contact tracing” and “Bluetooth activation” in July-August 2020 to “QR code scanning” and “location check-ins” in January-February 2021. Younger males had the highest TraceTogether uptake (60%), while older females had the lowest uptake (23.5%) in the first half of July 2020. This trend was reversed in mid-October after the announcement on mandatory TraceTogether check-ins at public venues. Although their TraceTogether uptake increased over time, older females continued to have lower sentiment scores. The mean sentiment scores were the lowest in January 2021 when the media reported that data collected by TraceTogether were used for criminal investigations. Smartphone apps were initially preferred over tokens, but the preference for the type of the TraceTogether tool equalized over time as tokens became accessible to the whole population. The sentiments on token-related comments became more positive as the preference for tokens increased. CONCLUSIONS The public’s knowledge of and concerns with the use of a mandatory DCT tool varied with the national regulations and public communications over time with the evolution of the COVID-19 pandemic. Effective communications tailored to sub-populations and greater transparency in data handling will help allay public concerns with data misuse and improve trust in the authorities. Having alternative forms of the DCT tool can increase the uptake of and positive sentiments on DCT.

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