Behavioral epidemiology of healthy aging

我们通过2005- 2006年美国20-85岁成年人全国健康与营养调查的横断面数据，研究了抑郁症状升高与抗氧化状态的关系。使用患者健康问卷测量抑郁症状，分界点为10分，以定义“抑郁症状升高”。血清抗氧化状态通过血清类胡萝卜素、视黄醇（游离和视黄醇酯）、维生素C和维生素e的水平来测定。考虑到抽样设计的复杂性，主要分析包括多元逻辑模型和零膨胀泊松回归模型。最后的样本包括1798名数据完整的美国成年人。较高的血清总类胡萝卜素水平与抑郁症状升高的可能性较低相关，每增加sd，总风险降低37%，女性风险降低34% （P< 0.05）。当血清总类胡萝卜素以四分位数表示时(Q4 (1.62-10.1 mumol/l) vs Q1 (0.06-0.86 mumol/l): OR 0.41；95% ci 0.23, 0.76, p < 0.001；P（趋势值= 0.035），但与其他抗氧化剂水平无显著相关性。在类胡萝卜素中，β -胡萝卜素（男性和女性结合）和叶黄素+玉米黄质（仅限女性，在控制了膳食叶黄素+玉米黄质摄入量和补充剂使用后）与美国成年人抑郁症状升高有独立的负相关。与总类胡萝卜素和其他协变量无关，其他血清抗氧化剂均与抑郁症状无显著关联。总之，在美国社区居住的成年人中，血清中总类胡萝卜素（主要是β -胡萝卜素和叶黄素+玉米黄质）与抑郁症状水平的降低有关。

We examined the relationship of elevated depressive symptoms with antioxidant status in cross-sectional data from the National Health and Nutrition Examination Surveys 2005-6 on US adults aged 20-85 years. Depressive symptoms were measured using the Patient Health Questionnaire with a score cut-off point of 10 to define 'elevated depressive symptoms'. Serum antioxidant status was measured by serum levels of carotenoids, retinol (free and retinyl esters), vitamin C and vitamin E. The main analyses consisted of multiple logistic and zero-inflated Poisson regression models, taking into account sampling design complexity. The final sample consisted of 1798 US adults with complete data. A higher total serum carotenoid level was associated with a lower likelihood of elevated depressive symptoms with a reduction in the odds by 37 % overall with each sd increase in exposure, and by 34 % among women (P< 0.05). A dose-response relationship was observed when total serum carotenoids were expressed as quartiles (Q4 (1.62-10.1 mumol/l) v. Q1 (0.06-0.86 mumol/l): OR 0.41; 95 % CI 0.23, 0.76, P< 0.001; P for trend = 0.035), though no significant associations were found with the other antioxidant levels. Among carotenoids, beta-carotene (men and women combined) and lutein+zeaxanthins (women only, after control for dietary lutein+zeaxanthin intake and supplement use) had an independent inverse association with elevated depressive symptoms among US adults. None of the other serum antioxidants had a significant association with depressive symptoms, independently of total carotenoids and other covariates. In conclusion, total carotenoids (mainly beta-carotene and lutein+zeaxanthins) in serum were associated with reduced levels of depressive symptoms among community-dwelling US adults. The sodium intake of participants of the Healthy Aging in Neighborhoods of Diversity across the Life Span study who were in three of the special population groups identified by the Dietary Guidelines for Americans, 2010 (those with hypertension, African Americans, and those >51 years) was analyzed to determine if they met sodium recommendations. The sample included 2152 African American and white subjects, aged 30-64 years. Major dietary sources of sodium for each group were determined from two 24-hour dietary recalls, and dietary intakes were compared with sodium recommendations. Dietary potassium was also evaluated. The intakes of the groups studied exceeded 1500 mg sodium while their potassium intakes were lower than the Adequate Intake of 4700 mg. The major contributors of sodium included "cold cuts, sausage, and franks," "protein foods," and yeast breads. Excessive sodium intake characterized the diet of an urban, socioeconomically diverse population who are hypertensive or at risk for having hypertension. These findings have implications for health professionals and the food industry. Reciprocal relations between weight and psychological factors suggest that there are deep connections between mind and body. Personality traits are linked to weight gain; weight gain may likewise be associated with personality change. Using data from two diverse longitudinal samples (N = 1,919) collected at two time points an average of 10 years apart, we showed that significant weight gain is associated with increases in both impulsiveness and deliberation: In both samples, middle-aged adults who gained 10% or more of their baseline body weight by follow-up increased in their tendency to give in to temptation, yet were more thoughtful about the consequences of their actions. The present research moves beyond life events to implicate health status in adult personality development. The findings also suggest that interventions focusing on the emotional component of impulse control may be more effective because even people who become more thoughtful about the consequences of their actions may have limited success at inhibiting their behavior. We examined the data quality and replicability of the Revised NEO Personality Inventory (NEO-PI-R) factor structure in a sample that varied in ethnicity, socioeconomic status, and literacy. Participants (N = 546), drawn from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, were African American (58%) and white (42%) urban dwellers living above (49%) and below (51%) 125% of the federal poverty line. The NEO-PI-R, administered via telephone, was evaluated for data quality (percent valid, acquiescence, internal consistency), congruence with the normative factor structure, and readability. All indices of data quality and factor congruence were excellent in the full sample. Literacy was the most consistent predictor of data quality. A slightly worse structure was found for the Openness to Experience and Extraversion factors among lower socioeconomic status African American and white participants. The overall index of factor congruence, however, supports replication of the normative structure well beyond chance levels even among those with lower literacy. Despite the challenges of low literacy, the present findings indicate that personality traits can be assessed reliably in socioeconomically diverse populations that include those living in poverty. Illicit substances increase risk of morbidity and mortality and have significant consequences for society. Personality traits are associated with drug use; we test whether these associations vary by socioeconomic status. Participants (N=412) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study completed the Revised NEO Personality Inventory and self-reported use of opiates and cocaine. 50% of participants were living below 125% of the federal poverty line. Mean-level personality differences across never, former, and current opiate/cocaine users were compared. Logistic regressions compared never versus current users and interactions between personality traits and poverty status tested whether these associations varied by socioeconomic status. High Neuroticism and low Agreeableness increased risk of drug use. The association between low Conscientiousness and drug use was moderated by poverty, such that low Conscientiousness was a stronger risk factor for illicit substance use among those with relatively higher SES. For every standard deviation decrease in Conscientiousness, there was a greater than 2-fold increase in risk of illicit substance use (OR=2.15, 95% CI=1.45-3.17). Conscientiousness was unrelated to drug use among participants living below 125% of the federal poverty line. Under favorable economic conditions, the tendency to be organized, disciplined, and deliberate is protective against drug use. These tendencies, however, matter less when financial resources are scarce. In contrast, those prone to emotional distress and antagonism are at greater risk for current drug use, regardless of their economic situation.