Public Health最新文献

{"title":"Social inequality in rehabilitation after stroke: a health care gap approach","authors":"Authors Marie Kruse ,&nbsp;Maja Søndergård Worm ,&nbsp;Kim Rose Olsen","doi":"10.1016/j.puhe.2025.105835","DOIUrl":"10.1016/j.puhe.2025.105835","url":null,"abstract":"<div><h3>Objectives</h3><div>Stroke remains one of the largest burdens of disease in the world. Rehabilitation is an essential component of the treatment, with the potential to remedy the individual consequences and societal costs.</div><div>Much effort has been put into securing timely assessment of rehabilitation needs and providing information to patients and professionals about the importance. Despite this, less than half of stroke patients participate in rehabilitation and little is known about why. This study aims to investigate patient and provider triggers for this potential inequality.</div></div><div><h3>Study design</h3><div>Register-based study on population-based data.</div></div><div><h3>Methods</h3><div>This study includes all stroke patients in Denmark between 2014 and 2018 (N ∼ 70,000), for which we conduct individual-level linkage to register data on patient characteristics, health service utilisation, as well as sociodemographic information. Provider-side rehabilitation is signalled by the issuing of a rehabilitation plan, while demand (compliance) is defined as units of rehabilitation services utilized by the patient. The Danish Stroke Register holds information on injury-related factors, e.g. severity, and allows us to derive a measure of the need for rehabilitation. Thus, we can estimate the expected need for rehabilitation and apply the health care gap (HCG) approach to analyse the socioeconomic patient-level and provider-level drivers of potential inequality in rehabilitation.</div></div><div><h3>Results</h3><div>There were 70,173 stroke events during the five years of study, of which 41 % received a rehabilitation plan upon discharge. In the group who received a rehabilitation plan, 81 % attended rehabilitation. High severity, Danish origin, living outside the capital area, and being an age pensioner increased the provider health care gap; while young age, male gender, longer length of stay, living in the capital area and employment increased the attendance-gap.</div></div><div><h3>Conclusions</h3><div>We find that age and severity along with sociodemographic characteristics (education and place of residence) impact both provider-health care gap and attendance-health care gap. There appears to be a potential for improving both provision and participation in rehabilitation after a stroke. Some sociodemographic characteristics may act as barriers to rehabilitation and should be focused on in the planning of rehabilitation services.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105835"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health disparities in the impact of prenatal temperature exposure on birth outcomes: A nationwide population-based study in the Netherlands.","authors":"L Burgos-Ochoa, P Garcia-Gomez, E A P Steegers, T G M Van Ourti, L C M Bertens, J V Been","doi":"10.1016/j.puhe.2025.105819","DOIUrl":"https://doi.org/10.1016/j.puhe.2025.105819","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the impact of prenatal temperature exposure on birth outcomes and related health disparities across socioeconomic status (SES) levels.</p><p><strong>Study design: </strong>Retrospective study, based on birth registry national data comprising the years 2003-2017.</p><p><strong>Methods: </strong>Data on singleton births from the Dutch perinatal registry (N = 2,472,352) were analysed. We measured exposure as the number of days during gestation when mean ambient temperature fell into specific, mutually exclusive bins, using the 8-12 °C range as a reference. A robust method based on a temperature-bin regression model was employed to capitalize on the unpredictability of daily temperature fluctuations, assessing the impact on birth outcomes while accounting for seasonal and other underlying trends. This method also enabled an exploration of effect heterogeneity across variables such as household income, neighbourhood SES, and maternal education levels.</p><p><strong>Results: </strong>In-utero exposure to an additional hot day (with a mean temperature exceeding 20 °C), relative to the reference range, led to increased odds of low birth weight (LBW) (OR [95 % CI] = 1.007 [1.005, 1.009]), small for gestational age (SGA) (OR [95 % CI] = 1.004 [1.003, 1.005]), and preterm birth (PTB) (OR [95 % CI] = 1.006 [1.005, 1.007]). Exposure during the second trimester to an additional cold day led to increased odds of LBW and PTB. The observed impact was the most detrimental for births in low-SES households.</p><p><strong>Conclusions: </strong>Prenatal exposure to extreme temperatures has a detrimental impact on birth outcomes in the Netherlands. Projected increases in extreme temperatures may further exacerbate health inequalities in early life. These findings underscore the need for targeted public health policy strategies such as heat-health guidance during pregnancy to protect vulnerable populations.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":" ","pages":"105819"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professionalism under pressure: which factors influence community pharmacists' practice? A scoping review","authors":"Francielly Lima da Fonseca ,&nbsp;Lara Joana Santos Caxico-Vieira ,&nbsp;Rafaella de Oliveira Santos Silva ,&nbsp;Fernando de Castro Araújo-Neto ,&nbsp;Thaís Maria Araújo Tavares ,&nbsp;Mayara de Almeida Lima Ribeiro ,&nbsp;Divaldo Pereira de Lyra Jr.","doi":"10.1016/j.puhe.2025.105825","DOIUrl":"10.1016/j.puhe.2025.105825","url":null,"abstract":"<div><h3>Objectives</h3><div>Several factors can influence the professionalism of pharmacists in community pharmacies. Due to the growing role in providing patient-centered care, pharmacists need to develop a strong sense of professionalism to ensure the quality of services. However, there is a lack of research that explores the challenges faced by pharmacists in community pharmacies. Thus, this study aimed to identify factors that influence the professionalism of community pharmacists.</div></div><div><h3>Study design</h3><div>Scoping review.</div></div><div><h3>Methods</h3><div>A scoping review was conducted via the PubMed/Medline, Scopus, Web of Science, ERIC, EMBASE, and LILACS databases. The search was carried out on July 1, 2024. The identified factors were classified into four domains following the APOTECA framework: Attitudinal, Political, Technical, and Administrative.</div></div><div><h3>Results</h3><div>Twelve studies were included in the review. From these studies, 11 factors that influence professionalism of community pharmacists were identified, with emphasis on academic training, infrastructure, knowledge, social skills, ethics, and human resources. The factors were unequally distributed across domains, with the Technical domain being the most frequently cited.</div></div><div><h3>Conclusions</h3><div>The review identified significants barriers to professionalism in community pharmacy settings, particularly related to Technical and Attitudinal challenges. Improvements in academic training, enhancement of socioemotional skills, and stronger administrative support are critical for fostering professional development and improving the quality of care provided in community pharmacies.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105825"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on maternal health and birth outcomes: A network analysis in Alabama","authors":"Haneen Ali ,&nbsp;Sa'd Hamasha ,&nbsp;Yasin Fatemi ,&nbsp;Rebecca Turochy ,&nbsp;John Duah","doi":"10.1016/j.puhe.2025.105838","DOIUrl":"10.1016/j.puhe.2025.105838","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the effects of COVID-19 on birth outcomes for women in Alabama by comparing data from pre-pandemic years (2018 and 2019) to post-pandemic years (2021 and 2022).</div></div><div><h3>Study design</h3><div>Retrospective cohort study with network analysis.</div></div><div><h3>Methods</h3><div>The study used a retrospective cohort design to compare maternal and birth outcomes before and after the COVID-19 pandemic, with network analysis employed to evaluate changes in the complexity of multimorbidity interactions during these two periods.</div><div>Maternal health metrics, including maternal age, number of prenatal visits, weight at delivery, number of morbidities, BMI, gestational diabetes, hypertension, premature births, and NICU admissions, were analyzed to assess changes between pre-pandemic (2018–2019) and post-pandemic (2021–2022) periods. Ethnicity disparities, particularly among American Indian or Alaska Native and Black mothers, were evaluated in relation to BMI, comorbidities, and previous cesarean rates.</div></div><div><h3>Results</h3><div>The analysis revealed significant changes in maternal health metrics during the pandemic. Post-pandemic, average maternal age increased from 27.45 to 27.80 years (p &lt; 0.001), prenatal visits decreased from 10.44 to 10.27 (p &lt; 0.001), and BMI rose from 27.72 to 28.24 kg/m² (p &lt; 0.001). Gestational diabetes increased from 5.53 % to 6.54 %, hypertension from 10.45 % to 12.72 %, premature births from 4.65 % to 6.52 %, and NICU admissions from 8.93 % to 10.24 % (all p &lt; 0.001). Network analysis demonstrated that the complexity of the multimorbidity network worsened after COVID-19, indicating more intricate and interconnected disease interactions. Ethnicitydisparities were also evident, with American Indian or Alaska Native and Black mothers disproportionately affected, showing substantial increases in BMI, age, weight, and previous cesarean rates.</div></div><div><h3>Conclusions</h3><div>These findings underscore the exacerbation of health disparities during the pandemic, highlighting the need for targeted interventions and continued research on COVID-19's long-term effects.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105838"},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clean fuels and cognitive protection: a robustness analysis of the impact of declining self-care ability on cognitive function in middle-aged and older adults","authors":"Ling Zhang ,&nbsp;Junzhou Xu","doi":"10.1016/j.puhe.2025.105817","DOIUrl":"10.1016/j.puhe.2025.105817","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the impact of different types of cooking fuels (solid fuel vs. clean fuel) on cognitive function in middle-aged and older adults, with particular attention to the moderating role of self-care ability. To enhance the credibility of the findings, robustness checks using Bootstrap, quantile regression, and weighted analysis were employed.</div></div><div><h3>Study design</h3><div>This study employs a cross-sectional design. Data were sourced from the 2020 from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey covering the health and living conditions of middle-aged and older adults. The final sample included 18,715 participants, with 4,927 households using solid fuels and 13,788 households using clean fuels.</div></div><div><h3>Methods</h3><div>Cognitive function was assessed using standardized tests, and the type of cooking fuel and self-care ability were recorded. Multivariate regression models were used to analyze the relationship between fuel type and cognitive function, including interaction terms to explore the moderating effect of self-care ability. Multiple robustness checks were conducted to validate the main findings.</div></div><div><h3>Results</h3><div>The study found that, even after controlling for various confounding factors, the use of clean fuels was associated with better cognitive function. However, as self-care ability declined, the negative impact of solid fuels on cognitive function increased, and the protective effect of clean fuels diminished. Specifically, individuals who required partial or complete assistance had significantly lower cognitive function scores than those who were fully independent. Robustness analyses supported these findings, indicating the stability and reliability of the results.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that the choice of cooking fuel has significant implications for cognitive health in middle-aged and older adults, with the effect moderated by self-care ability. For individuals with poorer self-care ability, the use of clean fuels may be particularly important to reduce the risk of cognitive decline. These findings provide scientific evidence for public health interventions targeted at different levels of self-care ability.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105817"},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of hypertension, diabetes, and hypercholesterolemia in relation to social and behavioral health determinants: Insights from the 2018 Bangladesh STEPS survey","authors":"Mohammad Meshbahur Rahman ,&nbsp;Zaki Farhana ,&nbsp;Abdullah Al Noman ,&nbsp;Nazmul Hossain ,&nbsp;Anton Abdulbasah Kamil ,&nbsp;Baizid Khoorshid Riaz","doi":"10.1016/j.puhe.2025.105832","DOIUrl":"10.1016/j.puhe.2025.105832","url":null,"abstract":"<div><h3>Objectives</h3><div>Bangladesh is experiencing a significant shift in its epidemiological landscape, moving from a predominance of communicable diseases to an increasing burden of non-communicable diseases (NCDs). This study aims to identify the risk factors for hypertension, diabetes, and hypercholesterolemia based on the recent STEPS survey in Bangladesh.</div></div><div><h3>Study design</h3><div>Secondary cross-sectional study.</div></div><div><h3>Methods</h3><div>This study analyze the publicly available “National STEPS Survey for Non-communicable Diseases Risk Factors in Bangladesh 2018” dataset. The sample size was 6875, after cleaning the three phases of dataset. Frequency distribution, Spatial distribution, Chi-square test, and Logistic regression models were employed in data analysis.</div></div><div><h3>Results</h3><div>The nationwide prevalence of NCDs revealed 27.3 % for hypertension, 9.8 % for diabetes, and 30.2 % for hypercholesterolemia. The NCDs prevalence significantly varied across divisions in Bangladesh, with Barisal having the highest hypertension (25 %) and Sylhet the lowest (18.1 %). Chittagong led in diabetes prevalence (12.0 %), while Rangpur had the lowest (4.8 %). For hypercholesterolemia, Barisal topped (34.9 %), and Mymensingh had the lowest (20.9 %). The significant risk factors of NCDs included age, occupational status, physical activity, and BMI category. Older age and obesity notably increased significantly (p &lt; 0.05) the odds of hypertension, diabetes, and hypercholesterolemia, while urban residence increased the odds of diabetes.</div></div><div><h3>Conclusion</h3><div>Several factors, mostly age, occupational status, physical activity, and BMI category are responsible for higher prevalence of NCD diseases. The study explores common factors in NCDs and offers regional comparisons, aiding policymakers in focused interventions for specific regions.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105832"},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in the impact of social isolation and loneliness on mortality","authors":"Alexandre Vallée","doi":"10.1016/j.puhe.2025.105831","DOIUrl":"10.1016/j.puhe.2025.105831","url":null,"abstract":"<div><h3>Objective</h3><div>Social isolation and loneliness are increasingly recognized as risk factors for mortality, but their sex-specific effects remain unclear.</div></div><div><h3>Study design</h3><div>This study examines the impact of social isolation and loneliness and their combined association with all-cause, cardiovascular disease (CVD), and cancer mortality.</div></div><div><h3>Methods</h3><div>322,558 participants were analyzed from the UK Biobank cohort (51.3 % female, mean age: 55.66 ± 7.99 years; 48.7 % male, mean age: 56.53 ± 8.16 years). Social isolation and loneliness were assessed using validated measures. Mortality data were obtained from national death registries over a median follow-up of 11.83 years. Cox proportional hazards models estimated hazard ratios (HRs) and 95 % confidence intervals for mortality, adjusting for socioeconomic, behavioral, and health-related confounders.</div></div><div><h3>Results</h3><div>Social isolation was consistently associated with increased all-cause and CVD mortality in both sexes, with higher effect sizes in males (HR all-cause: 1.41 [95 % CI: 1.37–1.49]; CVD: 1.61 [1.45–1.80]) compared to females (HR all-cause: 1.25 [1.16–1.34]; CVD: 1.31 [1.08–1.58]). Loneliness was associated with increased all-cause mortality in females (HR: 1.12 [1.01–1.24]) but not in males (HR: 1.01 [0.94–1.10]). The combination of loneliness and social isolation yielded the highest mortality risks, particularly for CVD mortality. A significant interaction by sex was observed for all-cause mortality (p = 0.012), but not for CVD or cancer mortality.</div></div><div><h3>Conclusions</h3><div>Social isolation is a strong and independent predictor of mortality in both sexes, particularly for CVD-related deaths, while loneliness exerts a significant impact on overall mortality in females but not in males.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105831"},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of change in psychological resilience on subsequent all-cause and cause-specific mortality in community-dwelling older adults: a nationwide cohort study","authors":"Chi Zhang ,&nbsp;Anying Bai ,&nbsp;Wenyu Li ,&nbsp;Qingqing Wang ,&nbsp;Siwei Liu ,&nbsp;Miao Miao","doi":"10.1016/j.puhe.2025.105833","DOIUrl":"10.1016/j.puhe.2025.105833","url":null,"abstract":"<div><h3>Objective</h3><div>Psychological resilience, commonly conceptualized as the capacity to rebound or surmount various forms of adversity, reflects the dynamic adaptability to the aging process. This study examines the impact of change in psychological resilience on all-cause and cause-specific mortality in older adults.</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>7311 older individuals (mean age 79.61 ± 10.66 years, 53.39 % female) were enrolled from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Psychological resilience was assessed using a 7-item scale in two consecutive waves (2002 and 2005), and survival information was collected in subsequent four follow-up waves (2008, 2011, 2014, and 2018). Participants were classified based on change patterns of psychological resilience: sustained high resilience (n = 3140), resilience decrease (n = 1690), resilience increase (n = 1149), and sustained low resilience (n = 1332). Cox proportional hazards models adjusted for demographic characteristics, health behaviors, and health conditions were employed to assess mortality risk.</div></div><div><h3>Results</h3><div>Over 34946.58 person-years of follow-up [median: 3.5 (1.51–6.59) years], 4238 deaths were documented including 987 from cardiovascular diseases (CVD). Compared to sustained low resilience group, fully adjusted hazard ratios (HRs) for all-cause mortality were 0.76 (95 % CI: 0.70–0.83) for sustained high resilience group, 0.98 (95 % CI: 0.90–1.08) for resilience decrease group, and 0.80 (95 % CI: 0.72–0.88) for resilience increase group. Similar trends were observed for CVD and non-CVD mortality risks in all participants. Sensitivity and subgroup analyses consistently supported these findings.</div></div><div><h3>Conclusion</h3><div>Maintaining and enhancing resilience is linked to reduced mortality risks among older adults. These findings underscore the potential benefits of integrating resilience-focused interventions into public health initiatives to promote healthy aging.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105833"},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of firearm injury survivors’ views on contributing factors and solutions to community violence","authors":"Damaris Ortiz ,&nbsp;Lauren Magee ,&nbsp;Hanna Durbin ,&nbsp;Anthony W. Beverly ,&nbsp;Beatrice Beverly ,&nbsp;Clark J. Simons","doi":"10.1016/j.puhe.2025.105791","DOIUrl":"10.1016/j.puhe.2025.105791","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to elucidate reasons for and solutions to community firearm violence from firearm injury survivors after the COVID-19 pandemic.</div></div><div><h3>Study design</h3><div>This was a qualitative study secondary analysis. The original study question focused on participant engagement with medical and mental health services after their firearm injuries.</div></div><div><h3>Methods</h3><div>Individual in-depth interviews were completed with participants who were community-dwelling survivors of firearm injury using an interview facilitator guide. The interviews were analyzed using narrative content analysis and were coded independently by two researchers.</div></div><div><h3>Results</h3><div>Eighteen interviews were completed. Reasons for violence included prevalence of guns, flexing, stealing/robbery, beefs, COVID, and drugs, gangs, and music. Solutions to decrease community violence included limiting gun access, unknown, increase community cohesion, replacing rap music with positive role models, increasing policing and criminal penalties for violent acts, and people minding their own business.</div></div><div><h3>Conclusions</h3><div>This qualitative study of firearm injury survivors after the increase in violence surrounding the COVID-19 pandemic support a multifaceted approach for community violence prevention with limiting firearm access and strengthening community connectedness as top priorities.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105791"},"PeriodicalIF":3.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early identification of cognitive impairment in older adults from Advanced Activities of Daily Living (AADL): A scoping review","authors":"H. Gao ,&nbsp;J. Harris ,&nbsp;D. Maupin ,&nbsp;S. Schneider ,&nbsp;R. Hernandez ,&nbsp;H. Jin","doi":"10.1016/j.puhe.2025.105822","DOIUrl":"10.1016/j.puhe.2025.105822","url":null,"abstract":"<div><h3>Objectives</h3><div>Rapid technological advancements and societal shifts have reshaped older adults’ daily lives. Emerging evidence suggests that Advanced Activities of Daily Living (AADL)—complex tasks beyond basic Activities of Daily Living (ADL) and Instrumental ADL (IADL)—may signal cognitive impairment earlier than traditional measures. This scoping review aims to identify AADL that could serve as early indicators of cognitive impairment.</div></div><div><h3>Study design</h3><div>Scoping review.</div></div><div><h3>Methods</h3><div>This review followed Arksey and O'Malley's framework and adhered to the PRISMA-ScR guideline. We systematically searched Web of Science, PubMed, and PsycINFO for relevant studies published between 2013 and 2023.</div></div><div><h3>Results</h3><div>From 16,185 initially identified articles, 45 studies conducted across 11 countries were included after thorough screening and eligibility assessment. These studies examined eight domains of AADL (e.g., digital technology use, social engagement, cultural activities, naturalistic driving), across cognitive impairment stages from mild cognitive impairment (MCI) to dementia. Findings highlighted that frequent engagement in certain leisure, social, and intellectually stimulating activities (e.g., reading, playing board games, volunteering) was consistently associated with a reduced risk of cognitive decline. Digital behavioural indicators (e.g., computer usage patterns, naturalistic driving metrics, survey response times) showed promising predictive potential for early cognitive impairment identification, with several studies reporting good predictive accuracy (e.g., AUC &gt;0.80).</div></div><div><h3>Conclusions</h3><div>AADL indicators hold promise for early detection and potential prevention of cognitive impairment among older adults. Future research should explore the feasibility, acceptability, and clinical integration of AADL assessments into routine geriatric care and public health practice, particularly in low- and middle-income countries.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"246 ","pages":"Article 105822"},"PeriodicalIF":3.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}