Cross-Sectional Associations Between Personal and General Views on Aging and Future Care Preparation in Individuals Aged 50 and Over and Living in the United Kingdom.

Human ageing involves several physiological impairments—in particular, a decrease in sensorimotor function and changes in the nervous system reduce muscle strength, power, balance, and functional capacity performance. Preventive strategies are essential to ensure the quality of life of the elderly. High-speed resistance training (HSRT) may be an effective approach to muscle power development in this population, with significant short-term effects on neural adaptations and muscle power production. Therefore, the present study intends to analyze and systematize the studies focused on HSRT interventions and their effects on health outcomes in independent older adults. Four electronic databases (PubMed, Web of Science, EBSCO, and Scielo) were used for the purposes of searching randomized controlled trials that measured at least one key outcome measure focusing on velocity-based training and health outcomes in older adults on 7 March 2022 and identified 1950 studies. At the end of the process, fourteen studies were included in this systematic review and ten studies were included in the quantitative analysis. The main results showed that HSRT interventions would improve health measures, mostly cognitive function (large effects, p = 0.001, SMD = 0.94), neuromuscular function (moderate effects, p = 0.003, SMD = 0.70), and physical function (moderate effects, p = 0.04, SMD = 0.55 and p = 0.009, SMD = −0.59). Additionally, the results suggested that interventions with ten weeks or more, performed three times a week, provide significant improvements in neuromuscular function. In this sense, HSRT is effective for improving overall health outcomes in older adults. Future studies should include proper follow-ups (e.g., minimum six months) to assess the durability of HSRT intervention effects on all health-related variables.

This symposium focuses on the wellbeing of older adults with disability/cognitive impairment and their family caregivers. More specifically, it aims to understand how familly support, community resources utilization, internal migration, and immigrant status impact older adults’ caregiving arrangement, health outcomes and end-of-life preferences and family caregivers’ caregiving burden in China and the U.S. The first study explored how perceived spousal relationships and support impact dyadic experiences of living with cognitive impairment through a person-centered care lens during a three-year period. The second presentation examined the association between adult children’s support and the trajectories of depressive symptom level among Chinese older adults with disabilities. The third investigated how family relationship and immigrant status matter in advanced care planning (ACP) engagement and end-of-life preferences over burial plan among US-born and foreign-born older Chinese Americans living in Honolulu, Hawaii. The fourth study study explored family caregivers’ caregiving burden for community-dwelling patients with dementia and its associated factors. The last study conducted an inventory of longitudinal aging survey datasets to stimulate research on intersection of migration and caregiving arrangement. It paved the way to use existing high-quality datasets to examine the significant impact of massive rural-to-urban migration on caregiving arrangement among Chinese older adults. This symposium presents empirical evidence of the impact of family, migration and culture-related factors on caregiving arrangement and health outcomes of Chinese older adults. The presenters emphasize the importance of providing family-centered care and design culturally sensitive interventions to improve the health outcomes of older adults.

Loss of muscle mass and strength are associated with long-term adverse health outcomes in older adults. Urine creatinine concentrations (Ucr; mg/dl) are a measure of muscle tissue mass and turnover. This study assessed the associations of a spot Ucr level with muscle mass and with risk of hospitalization, mortality, and diabetes mellitus in older adults. We examined 3424 participants from the Cardiovascular Health Study who provided spot urine samples in 1996-1997 and who were followed through June 2015. All participants underwent baseline measurement of grip strength. In a sub-cohort, 1331 participants underwent dual energy X-ray absorptiometry (DEXA) scans, from which lean muscle mass was derived. Participants were followed for a median of 10 years for hospitalizations and mortality, and 9 years for diabetes mellitus. In linear regression analysis, a one standard deviation higher Ucr concentration (64.6mg/dl) was associated with greater grip strength (kg force) β=0.44 [0.16, 0.72]; p=0.002) and higher lean muscle mass (kg) (β=0.43 [0.08, 0.78]; p=0.02). In Cox regression analyses, each standard deviation greater Ucr concentration was associated with lower rates of hospitalizations (0.94 [95% confidence interval, 0.90, 0.98]; p < 0.001) and lower mortality risk (0.92 [0.88, 0.97]; p < 0.001), while a one standard deviation increase in muscle mass derived from DEXA had no such significant association. Ucr levels were not associated with incident diabetes mellitus risk (0.97 [0.85, 1.11]; p=0.65). A higher spot Ucr concentration was favorably associated with muscle mass and strength and with health outcomes in older community-living adults. The ease of obtaining a spot Ucr makes it an attractive analyte to use for gauging the health of older adults.

Nutritional risk and adverse health outcomes in Chinese community-dwelling older adults: A study based on the Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA)

BACKGROUND Introduction: Type 2 diabetes is a major public health concern in older adults. Healthy lifestyles such as engaging in physical activity and adopting healthy eating are effective strategies in diabetes self-management for controlling glucose and improving physical function. Increasing evidence shows that health technologies could promote healthy lifestyles for type 2 diabetes management. However, few such studies have been conducted in older adults. Given the low digital literacy among older adults, this study assessed the feasibility of using health technology to self-monitor lifestyles for diabetes management, test the preliminary efficacy of lifestyle self-monitoring on health outcomes in older adults with type 2 diabetes, and Explore participants’ experiences with health technologies and identify strategies needed to support lifestyle changes for diabetes management. OBJECTIVE Given the low digital literacy among older adults, this study aimed to assess the feasibility of using health technology to self-monitor lifestyles for diabetes management, test the preliminary efficacy of lifestyle self-monitoring on health outcomes in older adults with type 2 diabetes, and explore participants’ experiences with health technologies and identify strategies needed to support lifestyle changes for diabetes management. METHODS This 12-week pilot study used a pre- and post-test design. Fitbit fitness trackers paired with smart phone applications were used to track physical activity and food intake over 12 weeks in 15 overweight/obese older adults with type 2 diabetes (Mean age=70.5±4.8). Baseline and 12-week health outcomes (e.g., HbA1c and physical function) were compared using paired t-tests; effect sizes were calculated using Cohen’s D. The associations with HbA1c and physical function (assessed by the Short Physical Performance Battery) of percentage of days with tracked steps (PDWTS), average daily steps, and percentage of days with food logs (PDWFL) were examined using Pearson Correlation analysis. Semi-structured qualitative interviews were conducted with participants at the end of the study. Facilitators and barriers of self-monitoring and lifestyle behaviors were collected and analyzed using thematic analysis. RESULTS HbA1c decreased significantly from baseline to 12-weeks (effect size=-0.49, p=0.036). Weight (effect size=-0.83), BMI (effect size=-0.61), and physical function (effect size=0.20) trended toward improvement (p&gt;0.05). PDWFL showed a significant inverse correlation with HbA1c (r=-0.53, P&lt;0.05) at 12-week follow-up. Qualitative data revealed that barriers and facilitators of self-monitoring of lifestyle and diabetes management through lifestyle modifications exist across multiple levels, including the individual, interpersonal, organizational/community, and societal levels in older adults with type 2 diabetes. Factors at one level could influence those at another level. For example, health technology not tailored to older adults may present challenges due to limited technological proficiency, while support from others can help mitigate these difficulties. CONCLUSIONS Technology-assisted self-monitoring of lifestyle behaviors may support glycemic control and related health outcomes in older adults with type 2 diabetes. In designing future diabetes management interventions, it is essential to address interconnected factors at multiple levels that address older adults’ unique needs and capacities in diabetes self-management.

The population of older adults in the United States is steadily growing and identifying factors that contribute to healthy aging is a public health priority. Changes in body composition are a hallmark of the aging process and have been implicated in the loss of physical function among older adults. In particular, age-related declines in muscle strength and power occur at a faster rate than the loss of muscle mass (sarcopenia), and this suggests a decrease in muscle quality of older adults. Muscle quality has traditionally been defined as muscle function (strength or power) per unit of muscle size (mass or cross-sectional area) and a growing body of literature suggests that lower body muscle quality may be critical for maintaining functional independence with age. However, the literature regarding the definition of muscle quality and its relationship with health outcomes in older adults has not been adequately reviewed. Thus, the aim of this report is to highlight the contemporary literature regarding age-related changes in muscle quality and its relationship with health outcomes in community-dwelling older adults.

BackgroundAlthough it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements.MethodsIn the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 13,738 community-dwelling older adults (≥65 years) were included for analyses. Living arrangements and loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The effect modificaitons of loneliness on adverse health outcomes by living arrangements were estimated using logistic regression or Cox proportional hazards regression models.ResultsLiving alone older adults were significantly more likely to be lonely at baseline (52% vs 29.5%, OR = 1.90, 95% CI = 1.67–2.16, P < 0.001), compared with those living with others. Loneliness in older adults was a significant risk factor for prevalent cognitive impairment and frailty, and 3-year mortality, especially among those who lived with others (OR = 1.32, 95% CI = 1.15–1.52, P < 0.001; OR = 1.39, 95% CI = 1.24–1.57, P < 0.001; HR = 1.14, 95% CI = 1.05–1.24, P = 0.002, respectively). In contrast, among the living alone older adults, loneliness was only significantly associated with higher prevalence of frailty (OR = 1.42, 95% CI = 1.07–1.90, P = 0.017). Living arrangement significantly modified the associations of loneliness with prevalent cognitive impairment and 3-year mortality (P values for interaction = 0.005 and 0.026, respectively).ConclusionsLiving arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population and more social services should be developed to reduce adverse health outcomes, in order to improve their quality of life and promote successful aging.

The interplay of nutritional status and physical function on health outcomes in older adults: a longitudinal study in Singapore.

Sarcopenia is associated with substantial health and economic consequences and is emerging as a major public health problem in the older population. The effects of sarcopenia may increase the risk for adverse health outcomes in older adults, and strategies need to be developed to maintain healthy aging. Although several intervention strategies have been proposed, resistance training (RT) has been suggested as the most effective stimulus for optimizing improvements in physical function and body composition with age. Although RT has been established as a safe and efficacious intervention for the prevention and treatment of sarcopenia, very few older adults regularly participate in RT programs. Community-based RT programs may be a feasible strategy because of their accessibility, cost-effectiveness, and lower-intensity training stimuli. However, the effects of these interventions on health outcomes in older adults have not been adequately reviewed. This report will describe the health effects associated with sarcopenia and summarize the major findings from community-based RT interventions on different health outcomes in older adults. Finally, it is suggested that all older adults who demonstrate the ability to safely participate in RT comply with the guidelines recommended by the American College of Sports Medicine.

Recent systematic reviews highlighted important relationships between combinations of movement behaviors (ie. sleep, sedentary behaviour, and physical activity) and health outcomes among children and adolescents. However, it is unclear whether similar relationships occur in older adults. Therefore, the purpose of this protocol was to describe the aims and methods for a systematic review to summarize the studies examining the relationships between movement behaviors and health outcomes in older adults. A systematic review will be developed based on searches of articles in seven electronic databases and references of retrieved articles, contact with authors, and study repositories. Eligibility criteria: observational or experimental studies examining the association of at least two movement behaviours (sleep, sedentary behaviour, and physical activity) with health outcomes in older adults (≥60 years old). Selection of the studies and extraction of the data will be carried out by two reviewers independently. Characteristics of the study, participants, methods of combinations, and main results will be extracted and described. Risk of bias and level of evidence in the studies will be assessed according to the study quality tool of the US National Heart, Lung, and Blood Institute and the GRADE guidelines. The data will be synthesized using random effects meta-analysis for results that are sufficiently homogeneous in terms of statistical, clinical, and methodological characteristics. If not, then a narrative synthesis will be conducted. The results of this review may provide insights to improve current guidelines on 24-hour cycle in older adults, as well as guide future studies in this research field.

Pet ownership (PO) has been linked to better health outcomes in older adults, particularly those with chronic health conditions. It is suggested that pets influence their owners lives both by encouraging social interaction and by interfering with owners’ willingness or ability to seek care for themselves. We use data from 6 questions about the positive and negative influence of pets on community dwelling older adults’ administered to pet owners (N=223, age >=50 years) in the Baltimore Longitudinal Study of Aging. We use principal components analysis (oblique rotation) to extract dimensions of owner’s perceptions of pet influences (PPI) and examine the relationship of these dimensions to owners’ cognitive, physical functional, and psychological status. Three dimensions of PPI include: fiscal/health challenges (F1: 3 items, alpha=0.70), wellness promotion (F2: 2 items, alpha=0.80); and reason for social/travel constraints (F3: 1 item). In regression analysis with all factors entered simultaneously, after controlling for age, higher magnitude of F1 significantly independently predicted poor physical quality of life (p=.0007), greater perceived stress (p=0.041), and lower happiness (p=0.014); F2 did not independently predict any health outcome; higher F3 significantly independently predicted lower emotional vitality (p=0.048). Controlling for age, all three factors were independent predictors of pet attachment (p’s=0.001, 0.010, 0.047, respectively). F1 and F3 were positively and F2 was negatively correlated with attachment. PPI was associated with owners’ physical and mental health. Perhaps older adults with higher attachment to pets are more likely to keep them despite higher challenges.

Self-disgust, loneliness and mental health outcomes in older adults: An eye-tracking study

Can resistance training improve mental health outcomes in older adults? A systematic review and meta-analysis of randomized controlled trials

Healthcare services and outcomes are often not evenly distributed across geographic regions. This study used the harmonized data from the Research on Early Life and Trends and Effects (RELATE) to compare the health outcomes of older adults across the North-South divide of Ghana and identify the factors underlying these differences. Although the literature indicates that the South has more health resources and better health indicators, the current study revealed that, for older adults, health outcome in the North was comparatively better than that in the South. The optimal health index scores show that older adults in the North are living at 86% of their optimal health compared with 82% in the South. Work-related physical activity and age substantially influenced optimal health in both regions. Additionally, healthcare use and gender were influential, particularly in the South. The results of the current study suggest that healthcare service availability can impact health outcomes, but so can behavioral and sociodemographic factors.

Unclean cooking fuels (ie, polluting fuels including kerosene/paraffin, and solid fuels) are a major contributor to diseases and mortality, specifically in low- and middle-income countries. This review aimed to identify potential mechanisms, public health implications, and future directions of unclean cooking fuel use and health outcomes in older adults. There is an expanding body of literature to demonstrate associations between unclean cooking fuel use and multiple mental and physical health outcomes in older adults. Two key mechanisms likely driving such associations include inflammation and oxidative stress. Considering that inflammation and oxidative stress have been implicated in multiple other health conditions (eg, arthritis and osteoporosis) in addition to those investigated to date on this topic it would be prudent to continue investigation of unclean cooking fuel use and with yet to be studied health outcomes. Moreover, future research is indeed now required to identify pathways to eliminating unclean cooking fuel globally to better the health of an aging global population and to support the implementation of Sustainable Development Goal 7.