Feeling younger buffers older adults from stress, protects against health decline

May 6, 2021

Science Daily/American Psychological Association

People who feel younger have a greater sense of well-being, better cognitive functioning, less inflammation, lower risk of hospitalization and even live longer than their older-feeling peers. A study published by the American Psychological Association suggests one potential reason for the link between subjective age and health: Feeling younger could help buffer middle-aged and older adults against the damaging effects of stress.

In the study, published in Psychology and Aging, researchers from the German Centre of Gerontology analyzed three years of data from 5,039 participants in the German Ageing Survey, a longitudinal survey of residents of Germany age 40 and older. The survey included questions about the amount of perceived stress in peoples' lives and their functional health -- how much they were limited in daily activities such as walking, dressing and bathing. Participants also indicated their subjective age by answering the question, "How old do you feel?"

The researchers found, on average, participants who reported more stress in their lives experienced a steeper decline in functional health over three years, and that link between stress and functional health decline was stronger for chronologically older participants.

However, subjective age seemed to provide a protective buffer. Among people who felt younger than their chronological age, the link between stress and declines in functional health was weaker. That protective effect was strongest among the oldest participants.

"Generally, we know that functional health declines with advancing age, but we also know that these age-related functional health trajectories are remarkably varied. As a result, some individuals enter old age and very old age with quite good and intact health resources, whereas others experience a pronounced decline in functional health, which might even result in need for long-term care," said study lead author Markus Wettstein, PhD, who is now at University of Heidelberg. "Our findings support the role of stress as a risk factor for functional health decline, particularly among older individuals, as well as the health-supporting and stress-buffering role of a younger subjective age."

The results suggest that interventions that aim to help people feel younger could reduce the harm caused by stress and improve health among older adults, according to the researchers -- though further study is needed to help determine what kind of interventions would work best. For example, Wettstein said, messaging campaigns to counteract ageism and negative age stereotypes and to promote positive views on aging could help people feel younger. In addition, more general stress-reduction interventions and stress management training could prevent functional health loss among older adults, according to Wettstein.

Finally, more research is needed to figure out the ideal gap between subjective and chronological age, according to Wettstein, as previous research has suggested that it's helpful to feel younger up to a point but that benefits decrease as the gap between subjective and chronological age increases. "Feeling younger to some extent might be adaptive for functional health outcomes, whereas 'feeling too young' might be less adaptive or even maladaptive," he said.

https://www.sciencedaily.com/releases/2021/05/210506163628.htm

Do people aged 105 and over live longer because they have more efficient DNA repair?

May 4, 2021

Science Daily/eLife

Researchers have found that people who live beyond 105 years tend to have a unique genetic background that makes their bodies more efficient at repairing DNA, according to a study published today in eLife.

This is the first time that people with 'extreme longevity' have had their genomes decoded in such detail, providing clues as to why they live so long and manage to avoid age-related diseases.

"Aging is a common risk factor for several chronic diseases and conditions," explains Paolo Garagnani, Associate Professor at the Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy, and a first author of the study. "We chose to study the genetics of a group of people who lived beyond 105 years old and compare them with a group of younger adults from the same area in Italy, as people in this younger age group tend to avoid many age-related diseases and therefore represent the best example of healthy aging."

Garagnani and colleagues, in collaboration with several research groups in Italy and a research team led by Patrick Descombes at Nestlé Research in Lausanne, Switzerland, recruited 81 semi-supercentenarians (those aged 105 years or older) and supercentenarians (those aged 110 years or older) from across the Italian peninsula. They compared these with 36 healthy people matched from the same region who were an average age of 68 years old.

They took blood samples from all the participants and conducted whole-genome sequencing to look for differences in the genes between the older and younger group. They then cross-checked their new results with genetic data from another previously published study which analysed 333 Italian people aged over 100 years old and 358 people aged around 60 years old.

They identified five common genetic changes that were more frequent in the 105+/110+ age groups, between two genes called COA1 and STK17A. When they cross-checked this against the published data, they found the same variants in the people aged over 100. Data acquired from computational analyses predicted that this genetic variability likely modulates the expression of three different genes.

The most frequently seen genetic changes were linked to increased activity of the STK17A gene in some tissues. This gene is involved in three areas important to the health of cells: coordinating the cell's response to DNA damage, encouraging damaged cells to undergo programmed cell death and managing the amount of dangerous reactive oxygen species within a cell. These are important processes involved in the initiation and growth of many diseases such as cancer.

The most frequent genetic changes are also linked to reduced activity of the COA1 gene in some tissues. This gene is known to be important for the proper crosstalk between the cell nucleus and mitochondria -- the energy-production factories in our cells whose dysfunction is a key factor in aging.

Additionally, the same region of the genome is linked to an increased expression of BLVRA in some tissues -- a gene that is important to the health of cells due to its role in eliminating dangerous reactive oxygen species.

"Previous studies showed that DNA repair is one of the mechanisms allowing an extended lifespan across species," says Cristina Giuliani, Senior Assistant Professor at the Laboratory of Molecular Anthropology, Department of Biological, Geological and Environmental Sciences, University of Bologna, and a senior author of the study. "We showed that this is true also within humans, and data suggest that the natural diversity in people reaching the last decades of life are, in part, linked to genetic variability that gives semi-supercentenarians the peculiar capability of efficiently managing cellular damage during their life course."

The team also measured the number of naturally occurring mutations that people in each age group had accumulated throughout their life. They found that people aged 105+ or 110+ had a much lower burden of mutations in six out of seven genes tested. These individuals appeared to avoid the age-related increase in disruptive mutations, and this may have contributed in protecting them against diseases such as heart disease.

"This study constitutes the first whole-genome sequencing of extreme longevity at high coverage that allowed us to look at both inherited and naturally occurring genetic changes in older people," says Massimo Delledonne, Full Professor at the University of Verona and a first author of the study.

"Our results suggest that DNA repair mechanisms and a low burden of mutations in specific genes are two central mechanisms that have protected people who have reached extreme longevity from age-related diseases," concludes senior author Claudio Franceschi, Professor Emeritus of Immunology at the University of Bologna.

https://www.sciencedaily.com/releases/2021/05/210504112619.htm

People with familial longevity show better cognitive aging

Exhibit better cognitive performance at baseline and show slower decline in processing speed

May 4, 2021

Science Daily/Boston University School of Medicine

If you come from a family where people routinely live well into old age, you will likely have better cognitive function (the ability to clearly think, learn and remember) than peers from families where people die younger. Researchers affiliated with the Long Life Family Study (LLFS) recently broadened that finding in a paper published in Gerontology, suggesting that people who belong to long-lived families also show slower cognitive decline over time.

The Long Life Family Study has enrolled over 5,000 participants from almost 600 families and has been following them for the past 15 years. The study is unique in that it enrolls individuals belonging to families with clusters of long-lived relatives. Since 2006, the LLFS has recruited participants belonging to two groups: the long-lived siblings (also called the proband generation) and their children. Since they share lifestyle and environmental factors, the spouses of these two groups have also been enrolled in the LLFS as a referent group.

To assess cognitive performance, the researchers administered a series of assessments to the study participants meant to test different domains of thinking, such as attention, executive function and memory, over two visits approximately eight years apart. This allowed researchers to ask whether individuals from families with longevity have better baseline cognitive performance than their spouses do and whether their cognition declines more slowly than does that of their spouses.

To study this question, LLFS researchers used a model to determine the change in score on several neuropsychological tests from one visit to the next. "This model allows us to assess both the cross-sectional effect of familial longevity at baseline visit and the longitudinal effect over follow-up time," says co-lead author Mengtian Du, a doctoral student in biostatistics at Boston University School of Public Health.

They showed that individuals from long-lived families performed better than their spouses on two tests: a symbol coding test, which has participants match symbols to their corresponding numbers and provides insight into psychomotor processing speed, attention, and working memory, and a paragraph recall test, which asks participants to remember a short story and assesses episodic memory. The researchers from the LLFS also found that individuals in the younger generation (participants born after 1935) exhibited a slower rate of cognitive decline on the symbol coding test than did their spouses.

"This finding of a slower decline in processing speed is particularly remarkable because the younger generation is relatively young at an average age of 60 years and therefore these differences are unlikely to be due to neurodegenerative disease," explains corresponding author Stacy Andersen, PhD, assistant professor of medicine at Boston University School of Medicine. "Rather we are detecting differences in normal cognitive aging."

According to Andersen this suggests that people with familial longevity demonstrate resilience to cognitive aging. "By studying the LLFS families we can learn about the genetics, environmental factors, and lifestyle habits that are essential in optimizing cognitive health throughout the lifespan."

https://www.sciencedaily.com/releases/2021/05/210504112437.htm

New mothers twice as likely to have post-natal depression in lockdown

May 11, 2021

Science Daily/University College London

Almost half (47.5%) of women with babies aged six months or younger met the threshold for postnatal depression during the first COVID-19 lockdown, more than double average rates for Europe before the pandemic (23%), finds a new study led by UCL researchers.

Women described feelings of isolation, exhaustion, worry, inadequacy, guilt, and increased stress. Many grieved for what they felt were lost opportunities for them and their baby, and worried about the developmental impact of social isolation on their new little one.

Those whose partners were unable or unavailable to help with parenting and domestic tasks, particularly where they were also dealing with the demands of home schooling, felt the negative impacts of lockdown most acutely.

Researchers surveyed 162 mums in London between May and June 2020 using a unique social network survey designed in response to lockdown. Participants listed up to 25 people who were important to them and shared who they had interacted with and how, whether in person, by phone, video call or messaging on social media.

The women also reported on their well-being with researchers basing depression ratings on the Edinburgh Postnatal Depression Scale, the most commonly used tool. This allowed them to capture the full range of mothers' social interactions, as well as their mental health.

The findings are published today (11 May 2021) in the journal Frontiers in Psychology.

The more contact new mums had with people, either remotely or face-to-face, the fewer depressive symptoms they reported, suggesting reduced social contact during lockdown may have increased the risk of postnatal depression.

However, where women had maintained some face-to-face contact with family members, they were actually more likely to have depressive symptoms than women who saw fewer of their relatives. Researchers think this reflects family responding to mums who were struggling with their mental health, potentially breaking lockdown rules to help them.

Many mothers felt that lockdown created a 'burden of constant mothering' without anyone around to help, and that while virtual contact (video calls/phone calls/texts/social media messages) helped, it was still inadequate. Virtual contact meant women had to actively ask for help, because friends and family couldn't see them struggling, which they felt amplified the stresses of motherhood.

Dr Sarah Myers (UCL Anthropology) said: "Caring for a new baby is challenging and all new mothers suffer some level of mental, physical and emotional exhaustion. Low social support is one of the key risk factors for developing postnatal depression. Social distancing measures during lockdown created so many barriers to having practical help and meaningful support from others in the weeks and months after their baby's arrival, leading many new mothers to feel totally overwhelmed.

"It really does take a village to raise a child, especially in a crisis when everyone is dealing with increased demands, stresses and significant life events. Our survey shows that lockdowns leave new mothers more vulnerable to postnatal depression, and that digital solutions might help but they are not the answer. Policy makers must take this into account as we continue to deal with COVID-19, for the sake of mums, babies and whole families."

Not everything new mums experienced as a result of lockdown was negative. Some felt it 'protected' family time, leading to better bonding. Other benefits included partners being around more to co-parent and help out than if the UK had not been in lockdown.

Dr Emily Emmott (UCL Anthropology) said: "New mothers with more than one child were hardest hit, left to deal with newborns on top of multiple demands like home schooling. First-time mothers often felt cheated out of precious time spent together with their babies and family or friends, making coming to terms with the change of identity and isolation that new mothers often feel even harder.

"But, where partners were at home more because of lockdown, and able to share the relentless tasks and household chores or take care of existing children, new mums felt the benefits. Some reported that it helped everyone develop closer relationships and that the family benefited overall from spending this time together. This should also be food for thought when we look at support for parents with new babies, not just in a pandemic."

Comments from new mothers surveyed about their experiences included: "It has definitely made me more anxious -- am I doing enough for my baby, is she ok, is she healthy and happy, should I be doing more, do people think I'm a good mother? Much of this is because it's hard to communicate online."

A first-time mother said, "I feel I'm making it up as I go along and have no one to guide me," while another mum said, "I worry that my child isn't getting the development they deserve as they are not getting enough stimulus."

One mum described how, "We haven't had anyone come over to give us a break since before lockdown and it's exhausting."

Another said: "I think lockdown has made me feel like I'm not a person in my own right anymore. Not having anyone to hold him or to help out a bit makes me feel it's all me and it's a lot of pressure, which I can resent. I feel like I don't have any time to rest." While another mum said, "I am an exhausted mum not able to concentrate on either of my children and this is taking a toll on everyone."

https://www.sciencedaily.com/releases/2021/05/210511123619.htm

Sugar-sweetened drinks linked to increased risk of colorectal cancer in women under 50

Sugary beverage consumption in adolescence, young adulthood associated with increased risk

May 6, 2021

Science Daily/Washington University School of Medicine

Colorectal cancer diagnoses have increased among people under age 50 in recent years and researchers are seeking reasons why. A new study led by Washington University School of Medicine in St. Louis has found a link between drinking sugar-sweetened beverages and an increased risk of developing colorectal cancer in women under age 50. The findings suggest that heavy consumption of sugary drinks during adolescence (ages 13 to 18) and adulthood can increase the disease risk.

The study, published online May 6 in the journal Gut, provides more support for public health efforts that encourage people to reduce the amount of sugar they consume.

"Colorectal cancer in younger adults remains relatively rare, but the fact that the rates have been increasing over the past three decades -- and we don't understand why -- is a major public health concern and a priority in cancer prevention," said senior author Yin Cao, ScD, an associate professor of surgery and of medicine in the Division of Public Health Sciences at Washington University. "Due to the increase in colorectal cancer at younger ages, the average age of colorectal cancer diagnosis has gone down from 72 years to 66 years. These cancers are more advanced at diagnosis and have different characteristics compared with cancers from older populations.

"Our lab is funded by the National Cancer Institute (NCI) and the National Comprehensive Cancer Network to identify risk factors, the molecular landscapes, and precision screening strategies for these cancers so that they can be detected earlier and even prevented," said Cao, who also has a master's of public health. "In past work, we have shown that poor diet quality was associated with increased risk of early-onset colorectal cancer precursors, but we have not previously examined specific nutrients or foods."

Compared with women who drank less than one 8-ounce serving per week of sugar-sweetened beverages, those who drank two or more servings per day had just over twice the risk of developing early-onset colorectal cancer, meaning it was diagnosed before age 50. The researchers calculated a 16% increase in risk for each 8-ounce serving per day. And from ages 13 to 18, an important time for growth and development, each daily serving was linked to a 32% increased risk of eventually developing colorectal cancer before age 50.

Sugar-sweetened drink consumption has been linked to metabolic health problems, such as type 2 diabetes and obesity, including in children. But less is known about whether such high-sugar beverages could have a role in the increasing incidence of colorectal cancer in younger people. Like early-onset colorectal cancer rates, consumption of such drinks has increased over the past 20 years, with the highest consumption level found among adolescents and young adults ages 20 to 34.

The researchers analyzed data from the Nurses' Health Study II, a large population study that tracked the health of nearly 116,500 female nurses from 1991 to 2015. Every four years, participants answered surveys that included questions about diet, including the types and estimated amounts of beverages they drank. Of the total participants, over 41,000 also were asked to recall their beverage habits during their adolescence.

The researchers identified 109 diagnoses of early-onset colorectal cancer among the nearly 116,500 participants.

"Despite the small number of cases, there is still a strong signal to suggest that sugar intake, especially in early life, is playing a role down the road in increasing adulthood colorectal cancer risk before age 50," said Cao, also a research member of Siteman Cancer Center. "This study, combined with our past work linking obesity and metabolic conditions to a higher risk of early-onset colorectal cancer, suggests that metabolic problems, such as insulin resistance, may play an important role in the development of this cancer in younger adults."

With the increasing rates in mind, the American Cancer Society has recently lowered the recommended age for a first screening colonoscopy to 45, down from the previously recommended age 50 for people at average risk. Those with additional risk factors, such as a family history of the disease, should start even earlier, according to the guidelines.

Since the study only included female nurses, most of whom were white, more work is needed to examine this link in people of more diverse races, ethnicities and genders.

While sugar-sweetened beverages were linked to an increased risk of early-onset colorectal cancer, some other drinks -- including milk and coffee -- were associated with a decreased risk. This observational study can't demonstrate that drinking sugary beverages causes this type of cancer or that drinking milk or coffee is protective, but the researchers said that replacing sweetened beverages with unsweetened drinks, such as milk and coffee, is a better choice for long-term health.

"Given this data, we recommend that people avoid sugar-sweetened beverages and instead choose drinks like milk and coffee without sweeteners," Cao said.

https://www.sciencedaily.com/releases/2021/05/210506183353.htm

Thin and brittle bones strongly linked to women's heart disease risk

Thinning lower spine, top of thigh bone and hip predictive of raised heart attack/stroke risk

May 6, 2021

Science Daily/BMJ

Thin and brittle bones are strongly linked to women's heart disease risk, with thinning of the lower (lumbar) spine, top of the thigh bone (femoral neck), and hip especially predictive of a heightened heart attack and stroke risk, suggests research in the journal Heart.

Osteoporosis, often dubbed brittle bone disease, is common, particularly among women after the menopause. It is characterised by thinning and weakened bones and a heightened fracture risk.

Previously published research indicates that people with osteoporosis often have atherosclerosis (artery hardening and narrowing), suggesting that both conditions may be linked.

The risk of a cardiovascular death is higher in women (21%) than it is in men (15%), and the predictive risk framework for heart disease is skewed towards men, so factors that better identify women at higher risk of a heart attack or stroke are needed, say the researchers.

Millions of women are screened for osteoporosis using a DXA scan, so this assessment might provide an ideal opportunity to identify any potential associations between thinning bones and atherosclerosis, and those women most at risk of heart disease, without incurring any additional costs or further exposure to radiation, they add.

To test this out, the researchers reviewed the medical records of 50-80 year old women who had had a DXA scan to check for osteoporosis at Seoul National University Bundang Hospital between 2005 and 2014.

After excluding those who already had heart disease and other serious illness at the time of the scan, the final analysis included 12,681 women whose health was tracked for an average of 9 years, using national registry data.

In all, 468 women (around 4%) had a heart attack or stroke during the monitoring period. Some 237 (2%) died.

Thinning/weakened bones, expressed as a low bone mineral density score at the lumbar spine, femoral neck, and hip, were independently associated with a heightened (16% to 38%) risk of heart attack or stroke after taking account of potentially influential factors, such as age, high blood pressure, high cholesterol, smoking, and a previous bone break.

And a formal diagnosis of osteoporosis was also independently associated with a 79% higher risk of cardiovascular disease.

Adding bone mineral density score or a clinical diagnosis of osteoporosis or osteopenia (precursor to osteoporosis) to clinical risk factors more effectively predicted risk than clinical risk factors alone.

It's not clear exactly how osteoporosis and atherosclerosis might be linked, but long term inflammation and cumulative oxidative stress have key roles in both age-related bone loss and atherosclerosis, while sex hormones, particularly oestrogen, help regulate bone turnover and the vascular system, explain the researchers.

This is an observational study, and as such can't establish cause, only correlation. And the researchers acknowledge several limitations to their findings: the study included women from one medical centre in South Korea so the results might not be more widely applicable.

And they weren't able to gather potentially important information on physical activity levels or steroid use, both of which affect bone mineral density and cardiovascular disease risk.

Nevertheless, they conclude: "Considering that [DXA scanning] is widely used to screen for osteopenia and osteoporosis in asymptomatic women, the significant association between [bone mineral density] and higher risk of [cardiovascular disease] provides an opportunity for large-scale risk assessment in women without additional cost and radiation exposure."

In a linked editorial, Drs Dexter Canoy and Kazem Rahimi of the Nuffield Department of Women's and Reproductive Health, University of Oxford, agree, adding that further research in different settings is warranted.

But they suggest: "Perhaps it is high time to establish how bone health affects vasculature and understand the underlying pathophysiology that links osteoporotic and atherosclerotic conditions. In doing so, we might just discover new ways to improve the treatment of, and care for, the hearts and minds of women, as well as of men."

https://www.sciencedaily.com/releases/2021/05/210506183351.htm

Men with chest pain receive faster, more medical attention than women

Women with possible heart attack wait longer and undergo less testing, study finds

May 6, 2021

Science Daily/American College of Cardiology

Among younger adults visiting the emergency department for chest pain, women may be getting the short end of the stick. Compared with men of similar age, women were triaged less urgently, waited longer to be seen, and were less likely to undergo basic tests or be hospitalized or admitted for observation to diagnose a heart attack, according to new research being presented at the American College of Cardiology's 70th Annual Scientific Session.

The study is the first to examine emergency room management of chest pain specifically among younger adults (age 18-55 years). Heart disease is the leading cause of death in women and is becoming more common in younger adults. About one-third of women who were hospitalized for a heart attack in the past two decades were under the age of 55, a proportion that has grown in recent years.

"Women should trust their instincts," said Darcy Banco, MD, an internal medicine resident at NYU Langone Health and the study's lead author. "Women should seek care right away if they experience new chest discomfort, difficulty breathing, nausea, vomiting, fatigue, sweating or back pain, as these could all be signs of a heart attack. The most important thing a woman can do is to seek medical care if she is worried and to ask specific questions of her doctor."

Chest discomfort is the most common symptom of a heart attack in both men and women, but research shows that women can have a broader range of accompanying symptoms that may not initially be recognized as a sign of a heart attack. Chest discomfort caused by a heart attack can be perceived as pain, pressure, tightness or another uncomfortable sensation.

The study is based on data collected by the National Hospital Ambulatory Medical Care Survey between 2014-2018. Researchers extrapolated the data to represent an estimated 29 million emergency department visits for chest pain in the U.S. among adults aged 18-55; women comprised nearly 57% of those visits.

Researchers found that women reporting chest pain were equally likely to arrive at the hospital by ambulance but significantly less likely than men to be triaged as emergent. On average, women waited about 11 minutes longer to be evaluated by a clinician. Women were also significantly less likely to undergo an electrocardiogram (EKG), the standard initial test used to diagnose a heart attack, or to receive cardiac monitoring or be seen by a consultant, such as a cardiologist.

Medical guidelines recommend that all patients with possible heart attack symptoms receive an EKG within 10 minutes of arrival in the emergency department to minimize the time to treatment.

"Time is very important when you're treating heart attacks," Banco said. "The longer people wait, the worse their outcomes can be."

The study did not examine the reasons why women with chest pain were treated differently than men. Banco suggested that pre-conceived notions of risk--rather than overt discrimination--likely play a role. Historically, heart attacks have been most common in older men, and clinicians may be less likely to suspect a heart attack among patients outside of that demographic. Banco suggested clinicians should appreciate that younger women represent a growing portion of heart attack patients.

"We, as health care providers, should continue to learn about how best to triage and diagnose patients with heart attacks, particularly among those who have historically been under-diagnosed or under-treated," Banco said. "We are learning that heart attacks take many forms. We need to continue to raise awareness and make sure all patients are diagnosed and treated properly, even if they're not the 'classic' demographic for a heart attack. [This knowledge] will help us improve care for all."

https://www.sciencedaily.com/releases/2021/05/210506105435.htm

Exercise aids the cognitive development of children born preterm

May 6, 2021

Science Daily/University of Basel

A premature start in life can cause problems even into teenage years. A study by the University of Basel and the University Children's Hospital Basel (UKBB) indicates that training motor skills in these children helps even when they are older.

Children that are born before the 37th week of pregnancy remain under close medical supervision while they are young. Any cognitive limitations often disappear after a few years. However, children who come into the world even before the 32nd week of gestation still exhibit differences even into their teenage years. In a new study, researchers led by Dr. Sebastian Ludyga and Professor Uwe Pühse have demonstrated that these children have weaker impulse control compared with children born at term (after the 37th week of pregnancy). This can, for example, have disadvantages in school performance and is linked to behavioral problems and a higher susceptibility to addiction.

As the research team reports in the journal Developmental Cognitive Neuroscience, these differences in impulse control can be fully explained by the children's motor skills. "In other words, premature children who had very well-developed motor skills were practically equal to children born at term when it came to impulse control," explains Ludyga.

In their study, the researchers compared a group of 54 very preterm children aged 9 to 13 years with a control group of children of the same age who had been born at term. To test impulse control, the sports scientists conducted a "go/no go" test with the children. When given a signal, the young study participants had to push a button as quickly as possible. When given a different signal, they were not allowed to push the button -- in other words, they had to suppress their impulse to move.

During the experiment, the researchers monitored certain brain activity parameters using an EEG (electroencephalogram) to determine how the children processed the stimulus. A comparison of the two groups showed that on average, the premature children found it more difficult to suppress the impulse to move due to impaired attention processes.

In further experiments, the researchers tested gross and fine motor skills, as well as ball handling. They found that the greater the deficit in motor skills, the more limited the impulse control in the children born very preterm.

"We conclude from these findings that targeted motor skills training could also reduce cognitive limitations," explains Ludyga. The researchers now want to test this in a follow-up study.

Ludyga says that there are few support options for very premature children as they grow into teenagers unless they come under scrutiny for a different reason, such as ADHD or another illness: "Limited impulse control at this age, even if it sorts itself out later, can have negative consequences and restrict these children's educational opportunities."

In younger children in particular, the development of motor and cognitive skills are closely linked. The time window from 9 to 13 years is therefore a promising period in which to reduce cognitive deficits in children born very preterm.

https://www.sciencedaily.com/releases/2021/05/210506105422.htm

Risk of developmental difficulties remains high among children born early

Preterm birth continues to pose a large burden for families, healthcare, and educational systems, say researchers

April 28, 2021

Science Daily/BMJ

Children born preterm (before 37 weeks of pregnancy) remain at high risk of developmental difficulties that can affect their behaviour and ability to learn, finds a study published by The BMJ today.

These difficulties were found not only in children born extremely preterm (22-26 weeks) but also in those born very and moderately preterm (between 27 and 34 weeks), say researchers.

Survival of preterm babies has increased worldwide. Children born early often have developmental issues, but studies have mainly focused on those born extremely preterm (22-26 weeks' gestation) and less is known about children born very and moderately preterm (27-34 weeks' gestation).

Given how important it is to identify children most at risk of developmental difficulties, researchers in France set out to describe neurodevelopment among children born before 35 weeks compared with children born at full term.

Their findings are based on 3,083 French children aged 5½ born after 24-26, 27-31, and 32-34 weeks gestation who were taking part in the EPIPAGE-2 study (designed to investigate outcomes of preterm children over the past 15 years) and a comparison group of 600 children born at full term.

Neurodevelopmental outcomes such as cerebral palsy, sensory impairments (blindness and deafness), and brain function (cognition), as well as behavioural difficulties and movement disorders, were assessed using recognised tests.

To further assess the family and social burden of prematurity, measures such as the need for extra support at school, visits to a psychiatrist, speech therapist or physiotherapist, and parental concerns about development, were also recorded.

After adjusting for other potentially influential factors, the researchers found that rates of neurodevelopmental disabilities increased as gestational age decreased.

For example, among the 3,083 children assessed, rates of severe to moderate neurodevelopmental disabilities were 28%, 19% and 12% and rates of mild disabilities were 39%, 36%, and 34% among children born at 24-26, 27-31 and 32-34 weeks, respectively.

Assistance at school was used by 27%, 14% and 7% of children born at 24-26, 27-31, and 32-34 weeks, respectively. And about half of children born at 24-26 weeks received at least one developmental intervention which fell to 26% for those born at 32-34 weeks.

Behaviour was the concern most commonly reported by parents.

Rates of neurodevelopmental disabilities were also higher in families with low socioeconomic status.

This is an observational study, so can't establish cause, and the researchers point to some limitations that may have affected their results. However, by assessing a wide range of developmental and behavioural issues, they were better able to reflect the complexity of difficulties faced by these children and their families.

As such, they say their findings indicate that preterm birth "continues to pose a large burden for families, healthcare, and educational systems."

Although rates of severe to moderate neurodevelopmental disabilities decreased with increasing gestational age, they point out that around 35% of the moderately to extremely preterm born children had mild disabilities requiring special care or educational services.

And a considerable proportion of parents had concerns about their child's development, particularly about behaviour, which warrant attention, they add.

"Difficulties faced by these groups of children and their families should not be underestimated," they conclude.

https://www.sciencedaily.com/releases/2021/04/210428192712.htm

Childhood psychiatric symptom risk strongly linked to adverse exposures during gestation

April 28, 2021

Science Daily/Massachusetts General Hospital

Harmful exposures during pregnancy, including some that occur even before pregnancy is recognized, appear to significantly increase a child's risk for psychiatric or behavioral problems early in life, researchers from Massachusetts General Hospital report.

In their study of 9,290 children from the ages of 9 to 10 living in 21 communities in the United States, the researchers found that children subjected during pregnancy to two or more of six adverse exposures were significantly more likely to have clinically significant scores on the Child Behavior Checklist (CBCL), indicating a higher level of problems such as depression, attention difficulties or anxiety.

The adverse prenatal exposures are unplanned pregnancy; maternal use of alcohol, tobacco or marijuana before pregnancy was recognized; complications during pregnancy (such as high blood pressure or gestational diabetes); and complications during labor and delivery. Pre-term birth or Caesarean delivery were not associated with increased risk.

"While individually these factors had previously been associated with similar risks in prior, often smaller studies, this is the first time that we were able to gauge the effect of cumulative exposures, which were fairly dramatic," says lead author Joshua L. Roffman, MD, MMSc, director of the Mass General Early Brain Development Initiative.

For example, while children with none of the exposures during their mother's pregnancy had only a 7% chance of developing clinically significant psychiatric symptoms, this risk increased steeply and in a linear fashion, such that those with four or more of the exposures had a 29% chance of clinically significant symptoms.

As the researchers report in their study, published in the open-access journal PLOS ONE, they saw similar patterns across a range of specific symptoms, from mood and anxiety to attention and thought disturbances.

The associations between prenatal exposures and psychiatric symptoms in childhood held up even when the researchers accounted for other factors that might skew the results, such as the mother's socioeconomic status, or exposures after birth that are known to increase a child's risk for psychiatric disorders, such as a traumatic life event.

To validate their findings, Roffman and colleagues also tested them in a separate group of non-twin siblings who differed in their exposures during pregnancy, and here too the data showed that the sibling with the higher number of exposures was at greater risk for more severe symptoms.

A limitation of the results is that they are based on the mother's recall of events during pregnancy, although the frequency of adverse events closely followed national trends. The study did not measure the effects of maternal infections or stress during pregnancy, although each of these has also been associated with increased risk in previous studies.

Given the additive effects of the common exposures they studied, Roffman and colleagues speculate that the "floor" of risk for psychiatric symptoms may have been raised for children born during the COVID-19 pandemic.

"Our findings reinforce the importance of the prenatal environment for brain health and for reducing risk of psychiatric symptoms in childhood. This brings increased urgency to the need to discover, develop and implement early life interventions that mitigate some of these risks," says Roffman, who is also an associate professor of Psychiatry at Harvard Medical School (HMS).

Improving child brain development and psychiatric health is the main goal of the Mass General Early Brain Development Initiative, a multidisciplinary collaboration among staff in the Departments of Psychiatry, Obstetrics, Pediatrics and Medicine.

https://www.sciencedaily.com/releases/2021/04/210428140901.htm

Breastfeeding linked to higher neurocognitive testing scores in offspring

April 27, 2021

Science Daily/University of Rochester Medical Center

New research finds that children who were breastfed scored higher on neurocognitive tests. Researchers in the Del Monte Institute for Neuroscience at the University of Rochester Medical Center (URMC) analyzed thousands of cognitive tests taken by nine and ten-year-olds whose mothers reported they were breastfed, and compared those results to scores of children who were not.

"Our findings suggest that any amount of breastfeeding has a positive cognitive impact, even after just a few months." Daniel Adan Lopez, Ph.D. candidate in the Epidemiology program who is first author on the study recently published in the journal Frontiers in Public Health. "That's what's exciting about these results. Hopefully from a policy standpoint, this can help improve the motivation to breastfeed."

Hayley Martin, Ph.D., a fourth year medical student in the Medical Scientist Training Program and co-author of the study, focuses her research on breastfeeding. "There's already established research showing the numerous benefits breastfeeding has for both mother and child. This study's findings are important for families particularly before and soon after birth when breastfeeding decisions are made. It may encourage breastfeeding goals of one year or more. It also highlights the critical importance of continued work to provide equity focused access to breastfeeding support, prenatal education, and practices to eliminate structural barriers to breastfeeding."

Researchers reviewed the test results of more than 9,000 nine and ten-year-old participants in the Adolescent Brain Cognitive Development (ABCD) study. Variations were found in the cumulative cognitive test scores of breastfed and non-breastfed children. There was also evidence that the longer a child was breastfed, the higher they scored.

"The strongest association was in children who were breastfed more than 12 months," said Lopez. "The scores of children breastfed until they were seven to 12 months were slightly less, and then the one to six month-old scores dips a little more. But all scores were higher when compared to children who didn't breastfeed at all." Previous studies found breastfeeding does not impact executive function or memory, findings in this study made similar findings.

"This supports the foundation of work already being done around lactation and breastfeeding and its impact on a child's health," said Ed Freedman, Ph.D., the principal investigator of the ABCD study in Rochester and lead author of the study. "These are findings that would have not been possible without the ABCD Study and the expansive data set it provides."

https://www.sciencedaily.com/releases/2021/04/210427110611.htm

Even when they include them, gifted programs aren't serving Black or low-income kids

May 10, 2021

Science Daily/University of Florida

After years of criticism for their lack of diversity, programs for high achievers may not be adequately serving their Black and low-income students, a new study shows.

"The potential benefits aren't equally distributed," said lead author and University of Florida College of Education professor Christopher Redding, Ph.D., who evaluated data from gifted programs in elementary schools nationwide. "The conversation up to this point has been about access, with less emphasis on how students perform once in gifted programs."

While academic achievement gains for students overall were modest -- going from the 78th to 80th percentile in reading and rising only a third as much in math -- low-income and Black gifted students, on average, saw no achievement gains. When the researchers looked at factors beyond scores, including engagement, attendance, and whether a student left or stayed in a school, they found little evidence to suggest gifted participation influenced those measures for any group.

"We're not saying these programs don't have benefits," Redding said. "But as states and school districts evaluate them, we need to ask, 'How can we do this best both for all gifted students and for diverse student populations?'"

A barrier to effectively serving a diverse gifted population could be the programs' content. If the curriculum only reflects the affluent, predominantly white population that gifted has traditionally served, it might not meet the needs of its other students, Redding says. As a success story, he points to the example of Illinois' second-largest school district, which diversified its curriculum -- but the impetus for that shift was a federal class-action suit.

"Unfortunately, unless there's this strong pressure from the courts, lots of districts aren't taking these steps that could be taken," Redding said.

Another culprit could be the structure of the programs. While some students receive all-day gifted instruction, others might only get an hour every other week. In "light touch" programs like those, a better option might be what education researchers call acceleration: skipping a grade or taking fifth grade math while in fourth grade, for example.

Redding doesn't want to see gifted programs go away, but he wants educators to take a hard look at how their curriculum meshes with the students they're trying to reach -- and for policymakers to have a better understanding of what the programs are actually achieving.

"It's not just about access," he said.

https://www.sciencedaily.com/releases/2021/05/210510161515.htm

Managing children's weight, blood pressure and cholesterol protects brain function mid-life

May 10, 2021

Science Daily/American Heart Association

Managing weight, blood pressure and cholesterol in children may help protect brain function in later life, according to new research published today in the American Heart Association's flagship journal Circulation. This is the first study to highlight that cardiovascular risk factors accumulated from childhood through mid-life may influence poor cognitive performance at midlife.

Previous research has indicated that nearly 1 in 5 people older than 60 have at least mild loss of brain function. Cognitive deficits are known to be linked with cardiovascular risk factors, such as high blood pressure, obesity, type 2 diabetes, smoking, physical inactivity and poor diet, as well as depression and low education level.

Many diseases that cause neurological deficits, such as Alzheimer's, have a long preclinical phase before noticeable symptoms begin, so finding links between childhood obesity and other cardiovascular risk factors is important for cognitive health. The researchers noted that there are currently no cures for major causes of dementia, so it is important to learn how early in life cardiovascular risk factors may affect the brain.

"We can use these results to turn the focus of brain health from old age and midlife to people in younger age groups," said the study's first author Juuso O. Hakala, M.D., a Ph.D. student at the Research Centre of Applied and Prevention Cardiovascular Medicine at the University of Turku, in Turku, Finland. "Our results show active monitoring and prevention of heart disease and stroke risk factors, beginning from early childhood, can also matter greatly when it comes to brain health. Children who have adverse cardiovascular risk factors might benefit from early intervention and lifestyle modifications."

The Cardiovascular Risk in Young Finns Study is a national, longitudinal study on cardiovascular risk from childhood to adulthood in Finland. Researchers followed the participants' cardiovascular risk factor profiles for 31 years from childhood to adulthood. Baseline clinical examinations were conducted in 1980 on approximately 3,600 randomly selected boys and girls, ranging in ages from 3 to 18, all of whom were white. More than 2,000 of the participants, ranging in ages from 34 to 49, underwent a computerized cognitive function test in 2011. The test measured four different cognitive domains: episodic memory and associative learning; short-term working memory; reaction and movement time; and visual processing and sustained attention.

Researchers found:

• Systolic blood pressure, total blood cholesterol and low-density lipoprotein (LDL) cholesterol, as well as body mass index, from childhood to midlife are associated with brain function in middle age.

• Consistently high systolic blood pressure or high blood total cholesterol and LDL cholesterol were linked to worse memory and learning by midlife when compared with lower measures.

• Obesity from childhood to adulthood was associated with lower visual information processing speed and maintaining attention.

• Having all three cardiovascular risk factors was linked to poorer memory and associative learning, worse visual processing, decreased attention span, and slower reaction and movement time.

These results are from observational findings, so more studies are needed to learn whether there are specific ages in childhood and/or adolescence when cardiovascular risk factors are particularly important to brain health in adulthood. Study limitations include that a definite cause-and-effect link between cardiovascular risk factors and cognitive performance cannot be determined in this type of population-based study; cognition was measured at a single point in time; and because all study participants are white, the results may not be generalizable to people from other racial or ethnic groups.

https://www.sciencedaily.com/releases/2021/05/210510085857.htm

How bullying and obesity can affect girls' and boys' mental health

May 7, 2021

Science Daily/Uppsala University

Depressive symptoms are more common in teenage girls than in their male peers. However, boys' mental health appears to be affected more if they suffer from obesity. Irrespective of gender, bullying is a considerably greater risk factor than overweight for developing depressive symptoms. These conclusions are drawn by researchers at Uppsala University who monitored adolescents for six years in a questionnaire study, now published in the Journal of Public Health.

"The purpose of our study was to investigate the connection between body mass index (BMI) and depressive symptoms, and to take a close look at whether being subjected to bullying affects this relationship over time. We also wanted to investigate whether any gender differences existed," says Sofia Kanders, a PhD student at Uppsala University's Department of Neuroscience.

In the study young people, born in Västmanland County, replied to questions about their height, weight and depressive symptoms on three separate occasions (2012, 2015 and 2018). The respondents' mean age was 14.4 years on the first occasion and 19.9 years on the last.

Based on BMI, the adolescents were divided into three groups: those with normal weight, overweight and obesity respectively. They were also grouped according to the extent of their depressive symptoms.

Overall, regardless of their weight, the girls stated more frequently that they had depressive symptoms. In 2012, 17 per cent of the girls and 6 per cent of the boys did so. By 2015, the proportions of adolescents with these symptoms had risen to 32 per cent for the girls and 13 per cent for the boys. The corresponding figures for 2018 were 34 and 19 per cent respectively.

A higher BMI did not, as far as the researchers could see, affect the girls' mental well-being to any great extent. Among the boys, however, the pattern observed was entirely different.

"When we analysed girls and boys separately, we saw that for boys with obesity in 2012, the risk for having depressive symptoms in 2015 was, statistically, five times higher than for normal-weight boys. In the girls we found no such connection," Kanders says.

The study has been unable to answer the question of what causes this gender difference, and the researchers think more research is needed in this area.

The young respondents were also asked about bullying -- for example, to state whether, in the past year, they had been physically exposed to blows and kicks, teased or excluded, subjected to cyberbullying (abusive texting or other electronic or web bullying), or bullied by an adult at school.

In every analysis, exposure to bullying was associated with a higher risk of depressive symptoms. This connection was also evident six years later, especially in overweight boys. The researchers believe that these results seem to indicate a gender difference in how BMI and bullying together drive development of future depressive symptoms.

"One key conclusion and take-home message from our study is that bullying can affect mental illness for a long time to come, which therefore makes preventive measures against bullying in schools extremely important," Kanders says.

Facts about the study 

This study is a sub-project in the much larger SALVe (Survey of Adolescent Life in Vestmanland) study. In SALVe, teenagers born in 1997 and 1999, and residing in Västmanland County (to the west of Uppsala), were asked in 2012 to answer questions about various ailments, well-being, sleep, computer habits, gaming, enjoyment of school and other aspects of their lives. The purpose is to follow this cohort for 20 years in order to gain knowledge of how inheritance and environment affect mental and physical health.

In this sub-project, 1,729 adolescents (962 girls and 767 boys) replied to the researchers' questions on the first occasion, in 2012. In 2015 there were 1,481 respondents, and in 2018 1,111. This decrease in numbers over time was due to drop-out, with slightly more boys than girls leaving the study.

The adolescents were grouped on the basis of their BMI and prevalence of depressive symptoms. Every answer to a question about the extent of their subjection to bullying was given a point score from 0 to 3. The researchers then compared the various groups' total scores; that is, they did not explore the results at individual level.

https://www.sciencedaily.com/releases/2021/05/210507112020.htm

Online learning doesn't improve student sleep habits

Students working/studying from home sleep later but not longer, according to new study

May 6, 2021

Science Daily/Simon Fraser University

New research from Simon Fraser University suggests that students learning remotely become night owls but do not sleep more despite the time saved commuting, working or attending social events.

The study, led by psychology professor Ralph Mistlberger, Andrea Smit and Myriam Juda, at SFU's Circadian Rhythms and Sleep Lab, compared self-reported data on sleep habits from 80 students enrolled in a 2020 summer session course at SFU with data collected from 450 students enrolled in the same course during previous summer semesters. The study results were recently published in the journal PLOS ONE.

"There is a widespread belief among sleep researchers that many people, especially young adults, regularly obtain insufficient sleep due to work, school, and social activities," says Mistlberger. "The move toward remote work and school during COVID-19 has provided a novel opportunity to test this belief."

The student participants kept daily sleep diaries over a period of two-to-eight weeks, completed questionnaires and provided written reports. Fitbit sleep tracker data was collected from a subsample of participants.

The team found that students learning remotely in the summer 2020 session went to bed an average of 30 minutes later than pre-pandemic students. They slept less efficiently, less at night and more during the day, but did not sleep more overall despite having no early classes and 44 per cent fewer work days compared to students in previous semesters.

"One very consistent finding is a collective delay of sleep timing -- people go to bed and wake up later," says Mistlberger. "Not surprisingly, there is also a marked reduction in natural light exposure, especially early in the day. The lack of change in sleep duration was a bit of a surprise, as it goes against the assumption that young adults would sleep more if they had the time."

Self-described night owls were more likely to report a greater positive impact on their sleep, getting to sleep in, instead of waking up early for that morning class, while morning types were more likely to report a negative response to sleeping later than usual.

Sleep plays an important role in immune functioning and mental health, which is why good sleep habits are crucial.

"My advice for students and anybody working from home is to try to get outside and be active early in the day because the morning light helps stabilize your circadian sleep-wake cycle -- this should improve your sleep, and allow you to feel more rested and energized during the day," says Mistlberger.

https://www.sciencedaily.com/releases/2021/05/210506163618.htm

Youngest children in class more likely to be diagnosed with learning disability

May 6, 2021

Science Daily/University of Turku

Children born in December, in school districts with a December 31 cut-off date, are almost twice as likely to be diagnosed with a learning disorder as those born in January. ADHD was found not to affect the association between month of birth and the likelihood of a learning disability diagnosis.

The new, register based study included children born in Finland between 1996 and 2002. Of nearly 400,000 children, 3,000 were diagnosed with a specific learning disorder, for example, in reading, writing or math by the age of ten.

"We were familiar with the effects of the relative age to the general school performance, but there were no previous studies on the association between clinically diagnosed specific learning disorders and relative age, which is why we wanted to study it," says Doctoral Candidate, MD Bianca Arrhenius from the Centre for Child Psychiatry at the University of Turku, Finland.

In previous studies, children born later in the year, and therefore younger than their classroom peers, have been found to be at increased risk of psychiatric disorders, low academic achievement, and being bullied.

ADHD does not affect learning disabilities

Many children with learning disabilities are diagnosed with ADHD. The study compared children with both learning disability diagnosis and ADHD separately from children with learning disabilities but without ADHD, and ADHD was found not to affect the association between month of birth and the likelihood of a learning disability diagnosis.

"This finding was surprising. In children referred to specialist care, the problems are typically complex. We did not expect the impact of relative age on "pure" learning disorder to be so significant, given previous research findings on relative age to ADHD," says Dr Arrhenius.

"Diagnosing learning disorders with psychological tests also takes the exact age of the child better into account compared with the methods used in diagnosing ADHD. For this reason, too, we expected more moderate differences between the months of birth. It seems that relatively young children are more easily sent to specialized health care," Arrhenius ponders.

Aiming for equality

Research shows that teachers, health care personnel, and parents need to be aware of the phenomenon of relative age, especially when assessing a child's learning ability.

"There is a risk of both over- and under-diagnosis, meaning that the youngest in the class are proportionately diagnosed so much more that the older students in the class may even be deprived of the diagnosis and rehabilitation they need. A more systematic screening for learning disabilities could be one approach that would even out the effect of relative age on referrals to specialized health care," says Arrhenius.

https://www.sciencedaily.com/releases/2021/05/210506104753.htm

Neighborhood disadvantage may be an environmental risk factor for brain development

Study suggests improving social and educational resources could alleviate risk

May 4, 2021

Science Daily/University of Southern California

A new USC study suggests that certain neighborhoods -- particularly those characterized by poverty and unemployment -- may pose an environmental risk to the developing brains of children, impacting neurocognitive performance and even brain size.

The research was published May 3 in the journal JAMA Pediatrics.

These findings highlight the importance of neighborhood environments for child and adolescent brain development, the researchers said, and suggest that policies, programs and investments that help improve local neighborhood conditions and empower communities could support children's neurodevelopment and long-term health.

"This is the first large, national study of neurodevelopment to determine that the role of neighborhood disadvantage is similar across all regions of the country, and we found that what mattered most were the local differences in neighborhood disadvantage within each city, rather than how cities differ from each other overall," said lead author Daniel Hackman, assistant professor at the USC Suzanne Dworak-Peck School of Social Work.

Researchers from the USC Suzanne Dworak-Peck School of Social Work and the Keck School of Medicine of USC used data from the Adolescent Brain and Cognitive Development (ABCD) Study, collected from October 2016 -- 2018. The ABCD Study is the largest long-term study of brain development and child health in the United States.

Neighborhood disadvantage, after accounting for family socioeconomic status and perceptions of neighborhood safety, showed associations with multiple aspects of neurocognition and smaller total cortical surface area, particularly in the frontal, parietal and temporal lobes.

"Our findings aren't specific to the child's home life, as we adjusted for socioeconomic factors at each child's home. But the research suggests neighborhoods may have different levels of social and educational resources and opportunities that can impact a child's neurodevelopment," said senior author Megan Herting, assistant professor at the department of preventive medicine at the Keck School of Medicine at USC.

In addition, the researchers said, disadvantaged neighborhoods may lack quality health services, access to nutritional foods, and well-maintained parks and rec facilities; they may also expose residents to more pollutants or social stressors.

"This research is important as it not only highlights that neighborhoods matter, but it also suggests that promoting neighborhood equity based on the unique local conditions within cities may improve short and long-term health and development of children and adolescents," said Hackman.

https://www.sciencedaily.com/releases/2021/05/210504191443.htm

Research delves into link between test anxiety and poor sleep

April 28, 2021

Science Daily/University of Kansas

College students across the country struggle with a vicious cycle: Test anxiety triggers poor sleep, which in turn reduces performance on the tests that caused the anxiety in the first place.

New research from the University of Kansas just published in the International Journal of Behavioral Medicine is shedding light on this biopsychosocial process that can lead to poor grades, withdrawal from classes and even students who drop out. Indeed, about 40% of freshman don't return to their universities for a second year in the United States.

"We were interested in finding out what predicted students' performance in statistics classes -- stats classes are usually the most dreaded undergrad class," said lead author Nancy Hamilton, professor of psychology at KU. "It can be a particular problem that can be a sticking point for a lot of students. I'm interested in sleep, and sleep and anxiety are related. So, we wanted to find out what the relationship was between sleep, anxiety and test performance to find the correlation and how it unfolds over time."

Hamilton and graduate student co-authors Ronald Freche and Ian Carroll and undergraduates Yichi Zhang and Gabriella Zeller surveyed the sleep quality, anxiety levels and test scores for 167 students enrolled in a statistics class at KU. Participants completed an electronic battery of measures and filled out Sleep Mood Study Diaries during the mornings in the days before a statistics exam. Instructors confirmed exam scores. The study showed "sleep and anxiety feed one another" and can hurt academic performance predictably.

"We looked at test anxiety to determine whether that did predict who passed, and it was a predictor," Hamilton said. "It was a predictor even after controlling for students' past performance and increased the likelihood of students failing in class. When you look at students who are especially anxious, it was almost a five-point difference in their score over students who had average levels of anxiety. This is not small potatoes. It's the difference between a C-minus abd a D. It's the difference between a B-plus and an A-minus. It's real."

Beyond falling grades, a student's overall health could suffer when test anxiety and poor sleep reinforce each other.

"Studies have shown students tend to cope with anxiety through health behaviors," Hamilton said. "Students may use more caffeine to combat sleep problems associated with anxiety, and caffeine can actually enhance sleep problems, specifically if you're using caffeine in the afternoon or in the evening. Students sometimes self-medicate for anxiety by using alcohol or other sedating drugs. Those are things that we know are related."

Hamilton said universities could do more to communicate to students the prevalence of test anxiety and provide them with resources.

"What would be really helpful for a university to do is to talk about testing anxiety and to talk about the fact that it's very common and that there are things that can be done for students who have test anxiety," she said. "A university can also talk to instructors about doing things that they can do to help minimize the effect of testing anxiety."

According to Hamilton, instructors are hindered by the phenomenon as well: Anxiety and associated sleep problems actually distort instructors' ability to measure student knowledge in a given subject.

"As an instructor, my goal when I'm writing a test is to assess how much a student understands," she said. "So having a psychological or an emotional problem gets in the way of that. It actually impedes my ability to effectively assess learning. It's noise. It's unrelated to what they understand and what they know. So, I think it behooves all of us to see if we can figure out ways to help students minimize the effects of anxiety on their performance."

The KU researcher said testing itself isn't the problem and suggested an increase in regular tests might reduce anxiety through regular exposure. However, she said a few small changes to how tests are administered also could calm student anxiety.

"In classes that use performance-based measures like math or statistics, classes that tend to really induce a lot of anxiety for some students, encouraging those students to take five minutes right before an exam to physically write about what they're anxious about can help -- that's cheap, that's easy," Hamilton said. "Also, eliminating a time limit on a test can help. There's just really nothing to be gained by telling students, 'You have an hour to complete a test and what you don't get done you just don't get done.' That's really not assessing what a student can do -- it's only assessing what a student can do quickly."

Hamilton said going forward she'd like research into the link between test anxiety and poor sleep broadened to include a more diverse group of students and also to include its influence on remote learning.

"The students in this study were mostly middle-class, Caucasian students," she said. "So, I hesitate to say these results would generalize necessarily to universities that have a more heterogeneous student body. I also would hesitate to say how this would generalize into our current Zoom environment. I don't know how that shakes out because the demands of doing exams online are likely to be very different."

https://www.sciencedaily.com/releases/2021/04/210428132955.htm

Childhood air pollution exposure linked to poor mental health at age 18

Risk factor is equivalent to lead exposure, study finds

April 28, 2021

Science Daily/Duke University

A multidecade study of young adults living in the United Kingdom has found higher rates of mental illness symptoms among those exposed to higher levels of traffic-related air pollutants, particularly nitrogen oxides, during childhood and adolescence.

Previous studies have identified a link between air pollution and the risk of specific mental disorders, including depression and anxiety, but this study looked at changes in mental health that span all forms of disorder and psychological distress associated with exposure to traffic-related air pollutants.

The findings, which will appear April 28 in JAMA Network Open,reveal that the greater an individual's exposure to nitrogen oxides across childhood and adolescence, the more likely they are to show any signs of mental illness at the transition to adulthood, at age 18, when most symptoms of mental illness have emerged or begin to emerge.

The link between air pollution exposure and young adult mental illness symptoms is modest, according to the study's first-author Aaron Reuben, a graduate student in clinical psychology at Duke University. But "because harmful exposures are so widespread around the world, outdoor air pollutants could be a significant contributor to the global burden of psychiatric disease," he said.

The World Health Organization (WHO) currently estimates that 9 out of 10 people worldwide are exposed to high levels of outdoor air pollutants, which are emitted during fossil fuel combustion in cars, trucks, and powerplants, and by many manufacturing, waste-disposal, and industrial processes.

In this study, air pollution, a neurotoxicant, was found to be a weaker risk factor for mental illness than other better-known risks, such as family history of mental illness, but was of equal strength to other neurotoxicants known to harm mental health, particularly childhood exposure to lead.

In a previous study in the same cohort, Helen Fisher of King's College London's Institute of Psychiatry, Psychology & Neuroscience, and coauthor and principal investigator for this study, linked childhood air pollution exposure to the risk of psychotic experiences in young adulthood, raising concern that air pollutants may exacerbate risk for psychosis later in life.

When combined with studies showing increased hospital admissions for many psychiatric illnesses during "poor" air quality days in countries like China and India, the current study builds on past findings to reveal that "air pollution is likely a non-specific risk factor for mental illness writ large," said Fisher, who noted that exacerbations of mental illness risk may show up differently in different children.

The subjects of this study are a cohort of 2,000 twins born in England and Wales in 1994-1995 and followed to young adulthood. They have regularly participated in physical and mental health evaluations and have provided information about the larger communities in which they live.

Researchers measured exposure to air pollutants -- particularly nitrogen oxides (NOx), a regulated gaseous pollutant, and fine particulate matter (PM2.5), a regulated aerosol pollutant with suspended particles below 2.5 microns in diameter -- by modeling air quality around study member's homes at ages 10 and 18 years using high-quality air dispersion models and data provided by the UK National Atmospheric Emissions Inventory and the Imperial College's UK road-traffic emissions inventory. Twenty-two percent of the study members were found to have had exposure to NOx that exceeded WHO guidelines, and 84% had exposure to PM2.5 that exceeded guidelines.

The research team, based at Duke and King's IoPPN, also assessed participant mental health at age 18. Symptoms associated with ten different psychiatric disorders -- dependence on alcohol, cannabis, or tobacco; conduct disorder and attention-deficit/hyperactivity disorder; major depression, generalized anxiety disorder, post-traumatic stress disorder, and eating disorder; and thought disorder symptoms related to psychosis -- were used to calculate a single measure of mental health, called the psychopathology factor, or "p-factor" for short.

The higher an individual's p-factor score, the greater the number and severity of psychiatric symptoms identified. Individuals can also differ on their mental health across sub-domains of psychopathology, which group together symptoms of distress or dysfunction that are manifested in outwardly visible ways (externalizing problems, like conduct disorder), experienced largely internally (internalizing problems, like anxiety), and via delusions or hallucinations (thought disorder symptoms). Air pollution effects on mental health were observed across these subdomains of psychopathology, with the strongest links to thought disorder symptoms.

Unique to this study, the researchers also assessed characteristics of children's neighborhoods to account for disadvantageous neighborhood conditions that associate with higher air pollution levels and greater risk of mental illness, including socioeconomic deprivation, physical dilapidation, social disconnection, and dangerousness. While air pollution levels were greater in neighborhoods with worse economic, physical, and social conditions, adjusting the study results for neighborhood characteristics did not alter the results, nor did adjustment for individual and family factors, such as childhood emotional and behavioral problems or family socioeconomic status and history of mental illness.

"We have confirmed the identification of what is essentially a novel risk factor for most major forms of mental illness," said Reuben, "one that is modifiable and that we can intervene on at the level of whole communities, cities, and or even countries."

In the future, the study team is interested in learning more about the biological mechanisms that link early life air pollution exposure to greater risk for mental illness at the transition to adulthood. Previous evidence suggests that air pollutant exposures can lead to inflammation in the brain, which may lead to difficulty regulating thoughts and emotions.

While the findings are most relevant to high-income countries with only moderate levels of outdoor air pollutants, like the US and the UK, there are also implications for low-income, developing countries with higher air pollution exposures, like China and India. "We don't know what the mental health consequences are of very high air pollution exposures, but that is an important empirical question we are investigating further," said Fisher.

https://www.sciencedaily.com/releases/2021/04/210428113756.htm

More sleep or more exercise: the best time trade-offs for children's health

April 28, 2021

Science Daily/University of South Australia

More sleep could offset children's excess indulgence over the school holidays as new research from the University of South Australia shows that the same decline in body mass index may be achieved by either extra sleep or extra exercise.

The striking new finding is part of a study that shows how children can achieve equivalent physical and mental health benefits by choosing different activity trade-offs across the 24-hour day.

Conducted in partnership with the Murdoch Children's Research Institute, and supported by the National Heart Foundation of Australia, the team examined the optimal balance between children's physical activity, sleep, and sedentary time across the 24-hour day to better inform tailored lifestyle choices.

On a minute-for-minute basis, moderate-to-vigorous physical exercise was shown to be 2-6 times more potent than sleep or sedentary time.

While exercise has a greater and faster impact on physical health and wellbeing, children may be able to achieve the same 7.4% reduction in body mass index (BMI) by either:

• exercising 17 more minutes (moderate-to-vigorous exercise) OR

• sleeping an extra 52 minutes OR

• reducing their sitting or sedentary time by an extra 56 minutes.

Similarly, children may significantly improve their mental health by either:

• exercising 35 minutes more (moderate-to-vigorous exercise), OR

• sleeping an extra 68 minutes OR

• reducing their sitting or sedentary time by 54 minutes.

The study assessed 1179 children aged 11-12 years, from the cross-sectional Child Health CheckPoint Study. Physical wellbeing was measured via BMI, waist girth and body fat; mental wellbeing was measured via self-reported responses on the Paediatric Quality of Life Inventory.

Lead researcher, UniSA's Dr Dot Dumuid, says that the findings provide options for busy families looking to get the most value out of their day.

"There are many competing time demands in modern families ¬- whether it's after school soccer, music lessons, or simply walking the family dog, finding the time to fit everything into a single day, can be a challenge," Dr Dumuid says.

"International guidelines suggest that children need 9-11 hours' sleep, 60 minutes of physical exercise, and no more than two hours of recreational screen time per day, yet only seven percent of children are regularly meeting these goals.

"With so many competing priorities and commitments, it's helpful to know which activities deliver the greatest 'bang for your buck'.

"In this research we calculated how much sleep, sedentary time, light exercise, and moderate-to-vigorous exercise was associated with the same improvements in mental health, physical health and academic achievement.

"For families with very little available time, small increases in moderate-to-vigorous exercise could be an option to improve children's health and wellbeing; alternatively an earlier night could equally deliver the same health benefits -- importantly, it's the flexibility that these findings offer that make them so valuable.

"Exploring trade-offs between children's activities is a promising way for families to make healthy choices that suit their regular family schedule."

The Heart Foundation's Director of Physical Activity, Adjunct Professor Trevor Shilton, said the Heart Foundation was happy to support such an innovative approach to investigating children's physical health and mental wellbeing.

"This study confirms that physical activity is the quickest and most effective way to deliver benefits for children's physical health and mental wellbeing. But the findings also offer some flexibility for families," Professor Shilton says.

"Helping young people make healthy choices and helping families create an environment that supports them in these choices can improve their quality of life in the future, as well as reducing their risk of chronic diseases, such as heart disease."

https://www.sciencedaily.com/releases/2021/04/210428100253.htm