Time at home during the COVID-19 pandemic: a prospective examination of psychosocial health in people with and without type 2 diabetes using digital phenotyping

Abstract Introduction Societal restrictions due to COVID-19 have had a profound effect on our ability to connect with one another and limited our personal mobility. There is evidence that loneliness, social isolation, and psychological distress increased during restrictions for people with diabetes. Fluctuating restrictions provide a unique opportunity to utilise continuous GPS data from personal smartphones (digital phenotypes) to explore the relationship between time-at-home and psychosocial health for people with diabetes. This study aims to (1) describe the digital phenotypes of time-at-home during varying societal COVID-19 restrictions for people with and without type 2 diabetes and (2) to explore associations between these digital phenotypes and loneliness, social support, and other psychosocial factors and compare for people with and without type 2 diabetes. Methods Data come from a longitudinal observational study in the Republic of Ireland that ran between March and August 2021. Participants are seventy-four adults (64.8% female; median age-group = 50-54) with (N = 40) and without (N = 34) diabetes. Continuous GPS data were recorded for 2 months through the Beiwe smartphone application. Loneliness (UCLA-3), social support (MSPSS), diabetes stigma (DSAS-2; diabetes cohort only) as well as other demographic, psychosocial, and lifestyle questionnaires were assessed at baseline, 1 month, and 2 months follow-up. Analysis GPS data are being processed. The GPS-derived features of time-at-home, overall movement, and location variance will be computed. Associations between these digital phenotypes and psychosocial factors will be explored and changes over time examined using multilevel modeling. Conclusions We expect this study to be the first to describe and compare the digital phenotypes of people with and without diabetes during varying societal COVID-19 restrictions, providing new insights into the effects of such policies on the psychosocial health of people with diabetes.


Background:
Depression is a common co-morbidity in diabetes.The mechanisms underlying the association between depression and diabetes are poorly understood.Although risk factors, such as poor lifestyle behaviours, obesity, and stress have been identified, emerging evidence suggests that systemic inflammation may play an important role in the pathogenesis and recurrence of depression in people with diabetes.The aim of the present study was to evaluate if the inflammatory marker C-reactive protein (CRP) is associated with an increased risk of major depression episodes in people with type 2 diabetes.Methods: A prospective, community-based study was conducted in Quebec, Canada.Individuals were recruited from the CARTaGENE (CaG) cohort, a population-based survey of Quebec residents aged 40 to 69 years.Our sample included 719 individuals with type 2 diabetes and 1423 individuals without diabetes.Individuals were assessed at baseline and 5 years after baseline.Major depression disorders were assessed using a clinical interview (CIDI).Inflammatory markers were assessed from blood samples.Elevated CRP levels were defined as 3 mg/L.

Results:
Participants with both diabetes and elevated CRP levels had the highest risk of major depressive episodes (adjusted OR = 1.90, 95% CI 1.45, 2.50), compared to those without diabetes and without elevated CRP levels.The risk of major depressive episodes in individuals with diabetes without elevated CRP episodes was lower (adjusted OR = 1.21, 95% CI 0.85, 1.73) and similar to the risk of those without diabetes and elevated CRP levels (adjusted OR = 1.15, 95% CI 0.94, 1.39).

Discussion:
The study highlights the interaction between diabetes, inflammatory makers, and depression in a community sample.Early identification, monitoring, and management of elevated inflammation levels might be an important depression prevention strategy in people with type 2 diabetes.

Background:
Individuals who ultimately receive a diagnosis of dementia typically have an observable accelerated cognitive decline (ACD) many years prior to diagnosis.Depression in combination with diabetes is an emerging risk factor that is associated with cognitive problems.Using data from the Canadian Longitudinal Study on Aging, the objective of the present study was to investigate the longitudinal association between depression, diabetes, and cognitive decline in an elderly cohort.

Methods:
Baseline and follow-up data from a population-based study in Canada were used.The sample consisted of 18161 adults between 45 and 85 years of age without diabetes.Cognitive functioning was assessed at baseline and after 4 years using six measures: the Rey Auditory Verbal Learning Test (RAVLT), the Mental Alternation Test (MAT), the Animal Fluency Test (AF), the Controlled Oral Word Association Test (COWAT), the Stroop Test, and the Prospective Memory Test.Depression was assessed using the CES-D10.Regression analysis was conducted to evaluate interactions between depression, diabetes and cognitive decline.

Results:
The mean age of participants was 61 years.Participants with a comorbidity of depression and diabetes had an accelerated cognitive decline (g-factor) compared to those with depression without diabetes and those with diabetes without depression (regression coefficients ß = -0.145(0.036), ß = -0.076(0.011), and ß = -0.053(0.021), respectively).

Conclusions:
This study suggests that depression and diabetes might increase the risk of cognitive decline in a synergistic way.

Introduction:
Societal restrictions due to COVID-19 have had a profound effect on our ability to connect with one another and limited our personal mobility.There is evidence that loneliness, social isolation, and psychological distress increased during restrictions for people with diabetes.Fluctuating restrictions provide a unique opportunity to utilise continuous GPS data from personal smartphones (digital phenotypes) to explore the relationship between time-at-home and psychosocial health for people with diabetes.This study aims to (1) describe the digital phenotypes of time-at-home during varying societal COVID-19 restrictions for people with and without type 2 diabetes and (2) to explore associations between these digital phenotypes and loneliness, social support, and other psychosocial factors and compare for people with and without type 2 diabetes.Methods: Data come from a longitudinal observational study in the Republic of Ireland that ran between March and August 2021.Participants are seventy-four adults (64.8% female; median age-group = 50-54) with (N = 40) and without (N = 34) diabetes.Continuous GPS data were recorded for 2 months through the Beiwe smartphone application.Loneliness (UCLA-3), social support (MSPSS), diabetes stigma (DSAS-2; diabetes cohort only) as well as other demographic, psychosocial, and lifestyle questionnaires were assessed at baseline, 1 month, and 2 months follow-up.

Analysis:
GPS data are being processed.The GPS-derived features of time-at-home, overall movement, and location variance will be computed.Associations between these digital phenotypes and psychosocial factors will be explored and changes over time examined using multilevel modeling.

Conclusions:
We expect this study to be the first to describe and compare the digital phenotypes of people with and without diabetes during varying societal COVID-19 restrictions, providing new insights into the effects of such policies on the psychosocial health of people with diabetes.

11.E. Workshop: Urban Green Spaces, Built Environment and Urban -Mental -Environmental Health outcomes
Abstract citation ID: ckac129.704 Organised by: EUPHA-URB, EUPHA-PMH, EUPHA-ENV Chair persons: Stefano Capolongo (EUPHA-URB), Marija Jevtic (EUPHA-ENV) Contact: andrea.rebecchi@polimi.itEnvironmental sustainability, especially in an era of growth health inequality, is one of the most important challenges facing Public Health systems around the World.Environmental sustainability is responsibly interacting with the planet to maintain natural resources and not jeopardize the ability for future generations to meet their needs.The SDGs put environmental sustainability at the center of sustainable development.Environmental Health is the branch of Public Health concerning all aspects of the natural and built environment affecting human health.It is targeted towards preventing disease and creating health-supportive environments.It encompasses the assessment and control of those environmental factors that can potentially affect health, such as pollution, poverty and inadequate energy solutions.Urban Health is an intersectoral arena that links both the public health and the urban planning sectors, mainly captured by SDG3 (including Mental health) and SDG11.Both during the first waves of the Covid-19 pandemic period and in contemporary cities, urban environments were stressed; the resilience of our cities were tested, highlighting the strengths and weaknesses of the urban contexts, not always capable to pro-mote and protect the population health status.Urban Green Spaces (UGS) have proved essential role as ''tools'' to improve Urban Public and Mental Health.Unfortunately, the heterogeneous distribution of UGS inside the contemporary cities, together with the disparity in quality of such spaces, led to some exclusion phenomena.Evidence/experience-based research strongly demonstrated the positive effects on Public Health of the UGS, and for this reason, they are now becoming the strategic and challenging issue of many urban regeneration programs.The importance of UGS as a key infrastructure has generated the necessity of developing new health-centered design criteria able to conform to their new role in urban environments.The augmentation of UGS surface alone, does not necessarily make cities more livable.An increase in area and surfaces does not translate in ease of accessibility from all social groups or from all the cities' neighborhoods, or not does it give data on the qualities of such areas, like potential for social engagement or Physical Activity.
Aim of the Workshop -organized by the three EUPHA Section URB+MEN+ENV -it would like to be to build the capacity and knowledge between participants about the main topics and urban features capable to have relevant Urban Public, Mental and Environmental Health outcomes.Additional scope is to collected case studies and research experiences considered virtuous at the international level, analyzed in detail to highlight the main urban and architectural features of those healthy experiences and the related health outcomes, such as sedentary lifestyle reduction, increase of the attractiveness of places, reduction of air and noise pollution.

Key messages:
Promotion of healthy places -with particular reference to the green spaces -that enhance the experience and Mental Health needs to be part of green Referring to the Research Project ''Enhancing Healthcare and Well-Being Through the Potential of Big Data: An Integration of Survey, Administrative, and Open Data to Assess Health Risk in the City of Milan with Data Science'' the Authors present preliminary results regarding a survey distributed to a sample of citizens across all neighborhoods of Milano city.This survey sought to collect data regarding health risk factors of this population, including both individual (e. g. sociodemographic characteristics, behaviors, etc.) and community (e.g.environmental/morphological features, available social services, etc.) data.A digital survey was designed to collect 15th European Public Health Conference 2022