Author: admin

Welcome to NeurologyLive^® Brain Games! This weekly quiz series, which goes live every Sunday morning, will feature questions on a variety of clinical and historical neurology topics, written by physicians, clinicians, and experts in the fields of neurological care and advocacy.

Test your mettle each week with 3 questions that cover a variety of aspects in the field of neurology, with a focus on dementia and Alzheimer disease, epilepsy and seizure disorders, headache and migraine, movement disorders, multiple sclerosis, neuromuscular disorders, sleep disorders, and stroke and cerebrovascular disease.

This week’s questions include the theme of Stroke triage

Click here to check out the prior iterations of Brain Games.

Interested in submitting quiz questions? Contact our editor, Marco Meglio, via email: mmeglio@neurologylive.com.

Please click here after selecting answer

Please click here after selecting answer

Please click here after selecting answer

How did you do on this week’s quiz? Let us know with a response to the poll below. Don’t forget to share and compare your results with your friends!

Middle-aged and older women who say they feel lonely are likely to spend more hours in front of the television a few years later, according to a new longitudinal study published in the Journal of Affective Disorders. In contrast, men in the same age range showed no comparable pattern, and watching additional television did not predict becoming lonelier over time for either gender.

The research team, led by Zijun Liu and Liye Zou at Shenzhen University’s Body-Brain-Mind Laboratory, set out to clarify how social disconnection and sedentary leisure might be linked. The World Health Organization recently identified loneliness among older adults as a growing public-health issue, while public-health bodies also warn about the health risks that accompany prolonged sitting and screen time.

Although snapshots of data have linked both issues—people who sit more often report feeling lonelier—previous studies could not determine which tends to come first. The authors wanted to know whether feeling lonely drives people toward the television or whether long hours on the couch quietly erode social ties over the years. Untangling that timeline could help guide interventions that aim to improve emotional wellbeing and reduce passive screen habits later in life.

“Sedentary behavior research is a newly emerging but rapidly growing field, partly because the 2020 guidelines on physical activity and sedentary behavior issued by the World Health Organization (WHO) did not specify a quantitative threshold for sedentary behavior,” explained Zou, a full professor of psychology. “Given its correlates of adverse outcomes such as cardiovascular disease, mental disorders, and obesity, sedentary behavior has increasingly been recognized as a critical public health concern. Meanwhile, the WHO has declared loneliness in ageing populations to be a significant and growing social-economic burden.”

“As a key marker of leisure-time sedentary behavior, watching TV is the most prevalent sedentary behavior in ageing populations. In the context of healthy ageing policies, a deeper understanding of the temporal relationship between loneliness and TV viewing is crucial. This could help us determine whether sedentary behavior or loneliness should be prioritized for the targeted intervention, thus optimising the allocation of public health resources and improving the efficiency of interventions.”

To answer these questions, the researchers drew on the English Longitudinal Study of Ageing, a nationally representative cohort that has tracked the health and lifestyles of adults aged fifty and older since the early 2000s. The present analysis focused on three survey waves collected between 2008 and 2013. After excluding respondents with missing data or implausibly high viewing times, the final sample included 6,788 participants—3,684 women and 3,104 men—with an average baseline age in the early sixties.

Each participant answered two straightforward questions about weekday and weekend television viewing, from which the researchers calculated daily hours. Feelings of social disconnection were measured with the three-item University of California Los Angeles Loneliness Scale, which asks how often someone lacks companionship, feels left out, or feels isolated. Scores can range from three to nine, with higher numbers reflecting more frequent loneliness.

The team also collected a broad set of background characteristics that could muddy the picture: age bracket, marital status, educational attainment, employment, body-mass index, physical-activity frequency, and symptoms of depression. Including these factors in the statistical models helped isolate the unique contribution of loneliness and television habits to one another.

To track influence across time rather than at one moment, Liu and colleagues used random-intercept cross-lagged panel models. This method separates two kinds of patterns: stable differences between people (for example, the fact that some individuals are both lonelier and more sedentary than their peers across the entire study) and within-person changes (for example, whether a spike in loneliness in one wave predicted a later increase in personal viewing hours). Models were run separately for women and men so any sex-specific effects would be visible.

Several descriptive trends emerged before the directional tests began. At baseline, women reported slightly higher loneliness scores than men and also watched about half an hour more television per day, on average. Across the full six-year span, television time and loneliness were positively related at the between-person level for both sexes. People who generally spent longer in front of the screen also tended to rate themselves as lonelier, suggesting a stable link between the two traits across the population.

The heart of the study lay in the lagged paths that connected one wave to the next. For women, feeling lonelier during one survey wave predicted an uptick in daily television viewing—about a 9-minute increase for each one-point rise on the loneliness scale—by the time the next survey rolled around two years later. That association held after the researchers accounted for physical activity, marital changes, and the other covariates.

No evidence suggested that heavier viewing later made women feel lonelier. In men, neither direction reached statistical significance, even though they showed the same between-person link. Both women and men displayed strong stability in loneliness itself: those who felt isolated at one survey tended to report similar feelings two years on.

“This study provides new evidence suggesting that loneliness may be a predictor of TV viewing time,” Zou told PsyPost. “No evidence was found for a converse effect, meaning that loneliness and TV viewing were not bidirectionally related. An observed sex difference indicates that loneliness may predict increased time spent viewing TV in middle-aged and older women, but not men. This highlights the need for targeted interventions to address loneliness in ageing women.”

Taken together, the findings paint a picture in which loneliness in women, but not men, sets the stage for more time spent watching television as the years go by. Because the analysis controlled for depressive symptoms and exercise frequency, the effect of loneliness appears to stand somewhat apart from these related influences.

One interpretation is that television provides a convenient and socially acceptable way to fill time and attention when face-to-face interaction feels out of reach. The set may serve as an emotional companion or simply a distraction that is easier to access than community activities. The absence of a similar pattern in men raises questions about how older men manage feelings of isolation—some may under-report loneliness due to social expectations, or they may seek different outlets such as hobbies away from screens.

“This study reveals an important connection between loneliness and a specific type of sedentary behavior, TV viewing, particularly among middle-aged and older women,” Zou explained. “We found that increased TV viewing time can be predicted by levels of loneliness. This highlights the importance of raising awareness of the phenomenon of loneliness for the general public, and the need for relevant innovations and support services. Our study adds to the current body of evidence indicating that loneliness can predict subsequent TV viewing time and elevated sedentary behavior in women. Therefore, loneliness should be monitored and addressed early on, as this may help to effectively prevent time spent TV viewing.”

But the researchers are cautious about over-extending their conclusions. “First, due to the limitations of the database, our study utilized self-reported assessment of sedentary behavior and loneliness, which may introduce recall bias,” Zou noted. “Device-based measures, such as accelerometers and inclinometers, can provide more objective data. Second, as our study was observational and epidemiological, our findings demonstrate the correlations rather than causal relationships.”

“Third, our focus was exclusively on TV viewing without including other types of sedentary behavior. In fact, an increasing number of researchers highlight that different contexts of sedentary behavior have different impacts on mental health. For example, mentally active sedentary behavior, such as reading, may show a different impact than mentally passive sedentary behavior, such as watching TV.”

“Thus, future studies should employ more complex methods in order to offer a more comprehensive understanding of the relationship between sedentary behavior and mental health. Additionally, more laboratory-based study designs (e.g., randomized controlled trials and sedentary behavior interventions) could be constructed to explore the relationship between sedentary behavior and human well-being, with a particular focus on the context of sedentary behavior (e.g., watching TV versus reading) and the underlying potential neurobiological mechanisms.”

Despite these limitations, the study has several strengths, including its large sample size and use of a robust statistical model that accounts for stable individual differences. By analyzing the data separately for men and women, the researchers were able to identify important sex-specific patterns that might otherwise have been missed.

“My long-term goal is to develop a comprehensive understanding of the dynamic relationships between sedentary behavior and human well being across the lifespan, with a particular focus on modifiable lifestyle factors,” Zou explained. “Previous sedentary behavior-mental health studies still lack systematic summarization. The absence of a synthesized framework significantly impedes and limits the development of high-quality studies. Collectively, building upon the current investigation of TV viewing and loneliness, our plan is to propose a sedentary behavior-mental health model that accounts for the context and the type of sedentary behavior.”

The study, “Bidirectional relationships between television viewing and loneliness in middle-aged and older men and women,” was authored by Zijun Liu, Andre Oliveira Werneck, Fabian Herold, Cassandra J. Lowe, Mats Hallgren, Boris Cheval, Benjamin Tari, Brendon Stubbs, Markus Gerber, Ryan S. Falck, Arthur F. Kramer, Neville Owen, and Liye Zou.