Professor Andrew Steptoe

Perceived weight discrimination in England: a population-based study of adults aged ⩾50 years

Abstract OBJECTIVE: To investigate the influence of social network characteristics on subjective well-being over 6 years in a population sample of older adults. METHOD: A total of 4,116 participants in the English Longitudinal Study of Aging provided baseline data on social network characteristics and potential confounding factors, and complete follow-up data on 2 measures of subjective well-being. RESULTS: Social network size and network contact frequency were positively and independently associated with future life satisfaction and quality of life after controlling for confounding factors, including demographic characteristics, socioeconomic factors, and long-standing illness. In contrast, social network diversity was not independently related to future subjective well-being. CONCLUSION: Different aspects of people's social networks may help sustain levels of subjective well-being in older age. The role of close relationships and frequent contact in later life may be particularly important. These results highlight the need for examining different aspects of social networks for promoting well-being of older people.

Abstract STUDY OBJECTIVES: Hypertension and inflammation may contribute to the increased risk of cardiovascular disease in individuals with suboptimal sleep, but large prospective studies are lacking. This study tested whether sleep duration and disturbance were predictive of incident hypertension and inflammation four years later. METHODS: Participants were men and women aged 50 years and older from the English Longitudinal Study of Ageing. Sleep was assessed by self-report, incident hypertension (N = 3068) was defined by clinical examination and C-reactive protein and fibrinogen (N = 3768) were measures of inflammation. RESULTS: Both men (odds ratio, OR:1.73, confidence interval, C.I. 1.08-2.76) and women (OR: 1.44, C.I. 1.00-2.07) reporting short sleep at baseline had increased odds of incident hypertension 4 years later, after adjustment for covariates. Age-stratified analyses revealed that short sleep was predictive of incident hypertension in men (OR: 2.27, C.I. 1.01-5.11) and women (OR: 2.10, C.I. 1.08-4.09) younger than 60 years but not in older people. Disturbed sleep also predicted incident hypertension in men (OR: 1.20, C.I. 1.02-1.41). In women, disturbed sleep was associated with elevated C-reactive protein (B = 0.030, C.I. 0.00-0.06) and fibrinogen (B = 0.030, C.I. 0.01-0.05) at follow-up controlling for baseline inflammation and other covariates. Sleep duration was unrelated to inflammatory markers in either sex. CONCLUSIONS: This study of older men and women adds to growing evidence that aberrant sleep patterns may increase the risk of cardiovascular outcomes through its adverse impact on blood pressure and inflammation.

The influence of partner's behavior on health behavior change: the English Longitudinal Study of Ageing

Abstract IMPORTANCE: Couples are highly concordant for unhealthy behaviors, and a change in one partner's health behavior is often associated with a change in the other partner's behavior. However, no studies have explicitly compared the influence of having a partner who takes up healthy behavior (eg, quits smoking) with one whose behavior is consistently healthy (eg, never smokes). OBJECTIVE: To examine the influence of partner's behavior on making positive health behavior changes. DESIGN, SETTING, AND PARTICIPANTS: We used prospective data from married and cohabiting couples (n, 3722) participating in the English Longitudinal Study of Ageing, a large population-based cohort of older adults (≥50 years). Studying men and women who had unhealthy behaviors in 3 domains at baseline (ie, smoking, physically inactive, or overweight/obese), we used logistic regression analysis to examine the influence of the partner's behavior in the same domain on the odds of positive health behavior change over time. MAIN OUTCOMES AND MEASURES: Smoking cessation, increased physical activity, and 5% weight loss or greater. RESULTS: Across all domains, we found that when one partner changed to a healthier behavior (newly healthy), the other partner was more likely to make a positive health behavior change than if their partner remained unhealthy (smoking: men 48% vs 8%, adjusted odds ratio [OR], 11.82 [95% CI, 4.84-28.90]; women 50% vs 8%, OR, 11.23 [4.58-27.52]) (physical activity: men 67% vs 26%, OR, 5.28 [3.70-7.54]; women 66% vs 24%, OR, 5.36 [3.74-7.68]) (weight loss: men 26% vs 10%, OR, 3.05 [1.96-4.74]; women 36% vs 15%, OR, 3.08 [1.98-4.80]). For smoking and physical activity, having a consistently healthy partner also predicted positive change, but for each domain, the odds were significantly higher in individuals with a newly healthy partner than those with a consistently healthy partner (smoking: men OR, 3.08 [1.43-6.62]; women OR, 5.45 [2.44-12.16]) (physical activity: men OR, 1.92 [1.37-2.70]; women OR, 1.84 [1.33-2.53]) (weight loss: men OR, 2.28 [1.36-3.84]; women OR, 2.86 [1.55-5.26]). CONCLUSIONS AND RELEVANCE: Men and women are more likely to make a positive health behavior change if their partner does too, and with a stronger effect than if the partner had been consistently healthy in that domain. Involving partners in behavior change interventions may therefore help improve outcomes.

Abstract AIM: To examine the medium-term stability of anthropometric and cardio-metabolic parameters in the general population. MATERIALS & METHODS: Participants were 5160 men and women from the English Longitudinal Study of Ageing (age ≥50 years) assessed in 2004 and 2008. Anthropometric data included height, weight, BMI and waist circumference. Cardio-metabolic parameters included blood pressure, serum lipids (total cholesterol, HDL, LDL, triglycerides), hemoglobin, fasting glucose, fibrinogen and C-reactive protein. RESULTS: Stability of anthropometric variables was high (all intraclass correlations >0.92), although mean values changed slightly (-0.01 kg weight, +1.33 cm waist). Cardio-metabolic parameters showed more variation: correlations ranged from 0.43 (glucose) to 0.81 (HDL). The majority of participants (71-97%) remained in the same grouping relative to established clinical cut-offs. CONCLUSION: Over a 4-year period, anthropometric and cardio-metabolic parameters showed good stability. These findings suggest that when no means to obtain more recent data exist, a one-time sample will give a reasonable approximation to average levels over the medium-term, although reliability is reduced.

Feeling old vs being old: associations between self-perceived age and mortality

Self-perceived age reflects appraisals of health, physical limitations, and well-being in later life.1 Older people typically feel younger than their chronologic age, and it is thought that those who feel younger than their actual age have reduced mortality.2,3 We sought to confirm this relationship in a large representative population sample, and to understand the role of existing health problems, poor physical function, depression, sociodemographic factors, social isolation, impaired cognitive function, and health behaviors in explaining the association.

BACKGROUND: Obesity is a risk factor for cancer incidence and survival, but data on patterns of weight change in cancer survivors are scarce and few stratify by pre-diagnosis weight status. In two population-based cohorts of older adults, we examined weight change in cancer survivors and cancer-free controls in relation to baseline weight status.

Abstract OBJECTIVE: The role of social relationships in determining well-being may be particularly salient in ageing populations. There is only limited longitudinal research examining the relationship between different dimensions of social relationships and change in well-being over time. The present analysis explores the association between isolation, loneliness and two measures of subjective well-being over six years using data from the English Longitudinal Study of Ageing. DESIGN: Measures of social relationships were obtained at baseline and associations with well-being over the following six years were analysed using mixed models. MAIN OUTCOME MEASURES: Hedonic and evaluative well-being assessed every two years over the six-year period. RESULTS: Levels of well-being showed a U-shaped relationship with time. At baseline, higher isolation and loneliness were associated with lower levels of hedonic and evaluative well-being. Individuals with high levels of isolation and loneliness initially showed a smaller decrease in evaluative well-being. The subsequent rise in well-being was, however, also diminished in this group. In contrast, loneliness was not associated with rate of change in hedonic well-being, while high levels of isolation were associated with a sustained decrease in hedonic well-being. CONCLUSION: Social isolation and loneliness show different associations with changes in evaluative and hedonic well-being over time.

Background: Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Methods: Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010–2011). Height and weight were measured at wave 4 (2008–2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Results: Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53–2.40) in those who were overweight, 8.86 (4.65–16.88) in those with class I obesity, 35.06 (18.30–67.16) in class II obese and 56.43 (27.72–114.87) in class III obese. Conclusions: Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public policy and highlight the need for effective interventions to promote equality.

Grip Strength across the Life Course: Normative Data from Twelve British Studies

Socioeconomic and lifestyle factors related to instrumental activity of daily living dynamics: results from the English Longitudinal Study of Ageing

Psychological changes following weight loss in overweight and obese adults: a prospective cohort study.

Enjoyment of life and declining physical function at older ages: a longitudinal cohort study

Linking stable and dynamic features of positive affect to sleep