study aimed to evaluate whether leisure activities causally mediate these associations.
METHODS
This longitudinal study included 42,246 participants aged over 65 years from the Chinese Longitudinal Healthy Longevity Survey. The Mini-Mental State Examination and a self-reported scale were used to measure cognitive status and leisure activities, respectively. We examined the associations of cognitive function and leisure activities with mortality using Cox proportional hazards models. Causal mediation analysis was used to assess whether leisure activities mediated the association between cognitive function and mortality.
RESULTS
Cognitive function and leisure activities were inversely associated with mortality. Leisure activities accounted for 28.3% (95% confidence interval [CI], 25.6 to 31.1) of the total effect of cognitive function and mortality. A higher mediated proportion (PM) was observed for physical leisure activities (PM, 20.1%; 95% CI, 18.0 to 22.3) than for social leisure activities (PM, 17.7%; 95% CI, 15.7 to 19.7). The mediating effect was higher among participants at younger ages (PM, 41.5%; 95% CI, 21.3 to 65.4), those with higher education levels (PM, 30.5%; 95% CI, 25.3 to 36.2), and residents of rural China (PM, 42.5%; 95% CI, 25.4 to 62.5).
CONCLUSIONS
Cognitive function was associated with inverse mortality. Leisure activities significantly mediated this association. Participation in leisure activities at the early stages of mild cognitive impairment could reduce the risk of mortality, which has a major impact on interventional strategies for healthy aging.
Summary
Korean summary
Key Message
Both cognitive function and leisure activities were associated with inverse mortality. Leisure activities were an important mediator of the association between cognitive function and mortality. A planned intervention for leisure activities, at an early stage of mild cognitive impairment, could promote health outcomes and optimally reduce the risk of mortality.
OBJECTIVES Open and supportive communication between parents and children is known to reduce adolescents’ delinquent behavior. Recently, the risk of Internet gaming disorder (IGD) has been increasing in adolescents. The purpose of this study was to investigate the mediating effects of parent-child communication styles on the relationship between adolescent aggressiveness and risk of IGD.
METHODS
Participants in this study were 402 first-year students from 4 middle schools in Seoul who enrolled in the Internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE) and completed baseline assessment in 2016. The structural equation model was constructed based on an aggression questionnaire, the Internet game use-elicited symptom screen, a mother-child communication inventory, and a father-child communication inventory.
RESULTS
Adolescents’ aggressiveness was found to be related to their risk of IGD. The father-child communication style mediated the relationship between aggression and risk of IGD. However, the mother-child communication style had no mediating effect.
CONCLUSIONS
Our findings suggest that fathers should make an effort to improve open and positive communication skills with their children, because the father-child communication style plays an important role in the relationship between adolescent aggressiveness and risk of IGD.
Summary
Korean summary
본 연구는 청소년기의 공격성과 인터넷 게임장애 위험과의 연관성에서 부모와의 의사소통 방식의 매개효과를 알아보고자 하였다. 연구대상자는 인터넷 사용자 코호트 연구(the Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence, iCURE)에 등록된 중학교 1학년 402명을 대상으로 단면조사 연구를 실시하여 구조방정식 모형분석을 하였다. 청소년 시기의 공격성은 인터넷 게임중독과 연관성이 있었고, 이러한 연관성은 아버지와 자녀간의 의사소통을 통해 매개되고 있었다. 아버지가 청소년과 개방적이고 긍정적 의사소통을 하는 경우 청소년의 공격성과 인터넷 게임장애 위험의 연관성을 낮추는 매개효과가 있었다.
Key Message
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In recent years, mediation analysis has emerged as a powerful tool to disentangle causal pathways from an exposure/treatment to clinically relevant outcomes. Mediation analysis has been applied in scientific fields as diverse as labour market relations and randomized clinical trials of heart disease treatments. In parallel to these applications, the underlying mathematical theory and computer tools have been refined. This combined review and tutorial will introduce the reader to modern mediation analysis including: the mathematical framework; required assumptions; and software implementation in the R package medflex. All results are illustrated using a recent study on the causal pathways stemming from the early invasive treatment of acute coronary syndrome, for which the rich Danish population registers allow us to follow patients’ medication use and more after being discharged from hospital.
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Education and incident type 2 diabetes: quantifying the impact of differential exposure and susceptibility to being overweight or obese Jimmi Mathisen, Aksel K. G. Jensen, Ingelise Andersen, Gregers S. Andersen, Ulla A. Hvidtfeldt, Naja H. Rod Diabetologia.2020; 63(9): 1764. CrossRef
How polluted is your fat? What the study of adipose tissue can contribute to environmental epidemiology Vicente Mustieles, Juan P Arrebola Journal of Epidemiology and Community Health.2020; 74(5): 401. CrossRef
Analytical approaches to testing pathways linking greenspace to health: A scoping review of the empirical literature Angel M. Dzhambov, Matthew H.E.M. Browning, Iana Markevych, Terry Hartig, Peter Lercher Environmental Research.2020; 186: 109613. CrossRef
Association Between Chronic Hepatitis C Virus Infection and Myocardial Infarction Among People Living With HIV in the United States Jessica Williams-Nguyen, Stephen E Hawes, Robin M Nance, Sara Lindström, Susan R Heckbert, H Nina Kim, W Chris Mathews, Edward R Cachay, Matt Budoff, Christopher B Hurt, Peter W Hunt, Elvin Geng, Richard D Moore, Michael J Mugavero, Inga Peter, Mari M Kit American Journal of Epidemiology.2020; 189(6): 554. CrossRef
Associations Between Complementary and Alternative Medicine and Health Care Expenditures Among Adults With Chronic Back Pain R. Henry Olaisen Medical Care.2020; 58(8): 689. CrossRef
Inflammation, non-endothelial dependent coronary microvascular function and diastolic function—Are they linked? Hannah E. Suhrs, Jakob Schroder, Kira B. Bové, Naja D. Mygind, Daria Frestad, Marie M. Michelsen, Theis Lange, Ida Gustafsson, Jens Kastrup, Eva Prescott, Salvatore De Rosa PLOS ONE.2020; 15(7): e0236035. CrossRef
Direct and indirect pathways between low income status and becoming a high-cost health care user in Ontario, Canada: a mediation analysis of health risk behaviors Luke Mondor, Tristan Watson, Kathy Kornas, Catherine Bornbaum, Walter P. Wodchis, Laura C. Rosella Annals of Epidemiology.2020; 51: 28. CrossRef
Social bonds do not mediate the relationship between early adversity and adult glucocorticoids in wild baboons Stacy Rosenbaum, Shuxi Zeng, Fernando A. Campos, Laurence R. Gesquiere, Jeanne Altmann, Susan C. Alberts, Fan Li, Elizabeth A. Archie Proceedings of the National Academy of Sciences.2020; 117(33): 20052. CrossRef
No effect of plasma trimethylamine N-Oxide (TMAO) and plasma trimethyllysine (TML) on the association between choline intake and acute myocardial infarction risk in patients with stable angina pectoris Anthea Van Parys, Vegard Lysne, Jannike Øyen, Jutta Dierkes, Ottar Nygård Human Nutrition & Metabolism.2020; 21: 200112. CrossRef
Direct effect and indirect effect on an outcome under nonlinear modeling Kai Wang The International Journal of Biostatistics.2020;[Epub] CrossRef
The effect of early-life and adult socioeconomic position on development of lifestyle-related diseases Linda Ejlskov, Henrik Bøggild, Claus D Hansen, Jesper Wulff, Steen M Hansen, Liis Starkopf, Theis Lange, Thomas Gerds, Christian Torp-Pedersen European Journal of Public Health.2019; 29(3): 562. CrossRef
The Role of Genetic Variant rs13266634 in SLC30A8/ZnT8 in Postoperative Hyperglycemia After Major Abdominal Surgery Deborah Brunke-Reese, Paddy Ssentongo, Anna E Ssentongo, Brett E Phillips, Eric M Pauli, Arthur Berg, Shannon L Kelleher, David I Soybel The Journal of Clinical Endocrinology & Metabolism.2019; 104(9): 3877. CrossRef
Performance of methods to conduct mediation analysis with time‐to‐event outcomes Lizbeth Burgos Ochoa, Judith J.M. Rijnhart, Brenda W. Penninx, Klaas J. Wardenaar, Jos W.R. Twisk, Martijn W. Heymans Statistica Neerlandica.2019;[Epub] CrossRef
Hormone replacement therapy, mammographic density, and breast cancer risk: a cohort study Shadi Azam, Theis Lange, Stephanie Huynh, Arja R. Aro, My von Euler-Chelpin, Ilse Vejborg, Anne Tjønneland, Elsebeth Lynge, Zorana J. Andersen Cancer Causes & Control.2018; 29(6): 495. CrossRef
Disparidade racial na sobrevivência em 10 anos para o câncer de mama: uma análise de mediação usando abordagem de respostas potenciais Mário Círio Nogueira, Maximiliano Ribeiro Guerra, Jane Rocha Duarte Cintra, Camila Soares Lima Corrêa, Vívian Assis Fayer, Maria Teresa Bustamante-Teixeira Cadernos de Saúde Pública.2018;[Epub] CrossRef
Lorcaserin and metabolic disease: weight‐loss dependent and independent effects H. Bays, C. Perdomo, E. Nikonova, R. Knoth, M. Malhotra Obesity Science & Practice.2018; 4(6): 499. CrossRef
Angiopoietin-2: A Potential Mediator of the Glycocalyx Injury in Adult Nephrotic Patients Maria Chaves, Matheus Mendes, Maximilian Schwermann, Raquel Queiroz, Regina Coelho, Francisco Salmito, Gdayllon Meneses, Alice Martins, Ana Moreira, Alexandre Libório Journal of Clinical Medicine.2018; 7(11): 401. CrossRef