Establishing Automated Analysis Systems in the Animal Fluency Task Reflecting Korean-specific Clustering Criteria

The sympathetic nervous system is an important regulator of coronary blood flow. The cold pressor test (CPT) is a powerful sympathoexcitatory stressor. We tested the hypotheses that: (1) CPT-induced sympathetic activation elicits coronary vasodilatation in young adults that is impaired with advancing age and (2) combined α- and β-adrenergic blockade diminishes/abolishes these age-related differences. Vascular responses of the left anterior descending artery to the CPT were determined by transthoracic Doppler echocardiography before (pre-blockade) and during (post-blockade) systemic co-administration of α- and β-adrenergic antagonists in young (n = 9; 26 ± 1 years old, mean ± SEM) and older healthy men (n = 9; 66 ± 2 years old). Coronary vascular resistance (CVR; mean arterial pressure/coronary blood velocity) was used as an index of vascular tone. CPT decreased CVR (i.e. coronary vasodilatation occurred) in young ( -33 ± 6%), but not older men ( -3 ± 4%; P < 0.05 vs. young) pre-blockade. Adrenergic blockade abolished CPT-induced coronary vasodilatation in young men ( -33 ± 6% vs. 0 ± 6%, pre-blockade vs. post-blockade, respectively; P < 0.05) such that responses post-blockade mirrored those of older men ( -3 ± 4% vs. 8 ± 9%; both P > 0.05 compared to young pre-blockade). Impaired CPT-induced coronary vasodilatation could not be explained by a reduced stimulus for vasodilatation as group and condition effects persisted when CVR responses were expressed relative to myocardial oxygen demand (rate-pressure product). These data indicate that the normal coronary vascular response to sympathetic activation in young men is pronounced vasodilatation and this effect is lost with age as the result of an adrenergic mechanism. These findings may help explain how acute sympathoexcitation may precipitate angina and coronary ischaemic events, particularly in older adults.

Verbal fluency impairments among middle-aged and older outpatients with schizophrenia are characterized by deficient switching

(169) Comparison of Temporal Stability of Conditioned Pain Modulation and Temporal Summation of Pain in Healthy Older and Younger Adults

Speechreading and Aging

PurposeEstablish bedside biomarkers of myosteatosis for sarcopenia and cachexia. We compared ultrasound biomarkers against MRI-based percent fat, histology, and CT-based muscle density among healthy adults and adults undergoing treatment for lung cancer.MethodsWe compared ultrasound and MRI myosteatosis measures among young healthy, older healthy, and older adults with non-small cell lung cancer undergoing systemic treatment, all without significant medical concerns, in a cross-sectional pilot study. We assessed each participant's rectus femoris ultrasound-based echo intensity (EI), shear wave elastography-based shear wave speed, and MRI-based proton density fat-fraction (PDFF). We also assessed BMI, rectus femoris thickness and cross-sectional area. Rectus femoris biopsies were taken for all older adults (n = 20) and we analyzed chest CT scans for older adults undergoing treatment (n = 10). We determined associations between muscle assessments and BMI, and compared these assessments between groups.ResultsA total of 10 young healthy adults, 10 older healthy adults, and 10 older adults undergoing treatment were recruited. PDFF was lower in young adults than in older healthy adults and older adults undergoing treatment (0.3 vs. 2.8 vs. 2.9%, respectively, p = 0.01). Young adults had significantly lower EI than older healthy adults, but not older adults undergoing treatment (48.6 vs. 81.8 vs. 75.4, p = 0.02). When comparing associations between measures, PDFF was strongly associated with EI (ρ = 0.75, p < 0.01) and moderately negatively associated with shear wave speed (ρ = −0.49, p < 0.01) but not BMI, whole leg cross-sectional area, or rectus femoris cross-sectional area. Among participants with CT scans, paraspinal muscle density was significantly associated with PDFF (ρ = −0.70, p = 0.023). Histological markers of inflammation or degradation did not differ between older adult groups.ConclusionPDFF was sensitive to myosteatosis between young adults and both older adult groups. EI was less sensitive to myosteatosis between groups, yet EI was strongly associated with PDFF unlike BMI, which is typically used in cachexia diagnosis. Our results suggest that ultrasound measures may serve to determine myosteatosis at the bedside and are more useful diagnostically than traditional weight assessments like BMI. These results show promise of using EI, shear wave speed, and PDFF proxies of myosteatosis as diagnostic and therapeutic biomarkers of sarcopenia and cachexia.

ABSTRACTMeaningful intergenerational interactions between older and younger adults are rare outside of family relationships. Interventions to increase positive intergenerational interactions are growing, but finding appropriate measures of attitudes toward both younger and older age groups is difficult. Many measures assessing attitudes toward older adults can remind participants of negative stereotypes of aging and are rarely used to assess attitudes toward younger adults. We adapted Pittinsky, Rosenthal, and Montoya’s allophilia measure to assess attitudes toward younger (18–25 years old) and older (over age 65) adults. In the first study, 94 traditional college age and 52 older adults rated older and younger adults. The allophilia measure distinguished between younger and older adults’ attitudes toward each age group. In the second study, we compared the age-related allophilia measures with seven traditional measures of attitudes toward older adults. Forty-seven traditional college age students completed measures. As predicted, correlations between allophilia toward older adults and the traditional semantic differential measures were weak (i.e., r = |0.15|or less), whereas correlations with general attitudes toward older adults were more moderate (r = 0.59 or less). Correlations between allophilia toward younger adults and the traditional measures were primarily non-significant as predicted. The allophilia measure differentiated between the five domains of positive attitudes toward younger and older adults and was not highly correlated with measures of more negative attitudes toward older adults. Results suggest that the allophilia measure can fill a need for a measure of positive attitudes toward older and younger adults.

The Role of Oxytocin in Older Adults’ Facial Emotion Recognition Difficulties

Functional Assessment in Younger and Older Adults with Sickle Cell Disease

Cognitive function depends on adequate cerebrovascular perfusion and control. However, it is unknown whether acutely-reduced cerebral blood flow (CBF) impairs cognition in healthy adults. In the present study, we used a placebo-controlled, single-blinded, randomized cross-over design to test the hypothesis that acutely-reduced CBF (using a pharmacological aid; indomethacin) would impair cognition in young and older healthy adults. At baseline, older adults had lower cognitive performance and CBF, but similar cerebrovascular reactivity to CO2 and dynamic cerebral autoregulation compared to young adults. In both young and older adults, cognitive performance on a mental switching task was slightly (7%) reduced after indomethacin, but not significantly associated with reductions in CBF (∼31%). These results indicate that cognitive performance is broadly resilient against a ∼31% reduction in CBF per se in healthy young and older adults. Cognitive function depends on adequate cerebrovascular perfusion and control. However, it is unknown whether acutely-reduced cerebral blood flow (CBF) impairs cognition in healthy adults. Using a placebo-controlled, single-blinded, randomized cross-over design, we tested the hypothesis that acutely-reduced CBF (using indomethacin [1.2mgkg-1 oral dose]) would impair cognition in young (n=13; 25±4years) and older (n=12; 58±6years) healthy adults. CBF and cerebrovascular control were measured using middle cerebral artery blood velocity (MCAvmean ) and its reactivity to hypercapnia (CVRHYPER ) and hypocapnia (CVRHYPO ), respectively. Cognitive function was assessed using a computerized battery including response time tasks. Baseline comparisons revealed that older adults had 14% lower MCAvmean and 15% lower cognitive performance (all P≤0.048), but not lower CVRHYPER/HYPO (P≥0.26). Linear and rank-based mixed models revealed that indomethacin decreased MCAvmean by 31% (95% confidence interval=-35 to -26), CVRHYPER by 68% [interquartile range (IQR)=-94 to -44] and CVRHYPO by 50% (IQR=-83 to -33) (treatment-effect; all P<0.01), regardless of age. Baseline CVRHYPER/HYPO values were strongly associated with their indomethacin-induced reductions (r=0.70 to 0.89, P<0.01). Mental switching performance was impaired 7% (IQR=0-19) after indomethacin (P=0.04), but not significantly associated with reductions in MCAvmean (Young: rho=-0.31, P=0.30; Older: rho=0.06, P=0.86). In conclusion, indomethacin reduced MCAvmean and impaired cognition slightly; however, no clear association was evident in younger or older adults. Older adults had poorer cognition and lower MCAvmean , but similar CVRHYPER/HYPO .

This study aimed to elucidate the effect of aging on shear-mediated dilation of the common and internal carotid arteries (CCA and ICA, respectively). Hypercapnia-induced shear-mediated dilation in the CCA and ICA were assessed in 10 young (5 women and 5 men, 23 ± 1 yr) and 10 older (6 women/4 men, 68 ± 1 yr) healthy adults. Shear-mediated dilation was induced by two levels of hypercapnia (target end-tidal Pco2, +5 and +10 mmHg from individual baseline values) and was calculated as the percent rise in peak diameter from baseline diameter. There were no differences in shear-mediated dilation between young and older adults in either artery under lower levels of hypercapnia (CCA: 2.8 ± 0.6 vs. 2.0 ± 0.3%, P = 0.35; ICA: 4.6 ± 0.8 vs 3.6 ± 0.4%, P = 0.37). However, shear-mediated dilation in response to higher levels of hypercapnia was attenuated in older compared with young adults in the ICA (4.5 ± 0.5 vs. 7.9 ± 1.2%, P < 0.01) but not in the CCA (3.7 ± 0.6 vs. 4.5 ± 0.8%, P = 0.35). Shear-mediated dilation was significantly correlated to the percent change in shear rate in the ICA (young: r = 0.55, P = 0.01; older: r = 0.49, P = 0.03) but not in the CCA in either young or older adults (young: r = -0.30, P = 0.90; older: r = 0.16, P = 0.50). These data indicate that aging attenuates shear-mediated dilation of the ICA in response to higher levels of hypercapnia, and shear rate is an important stimulus for hypercapnic vasodilation of the ICA in both young and older adults. The present results may provide insights into age-related changes in the regulation of cerebral circulation in healthy adults. NEW & NOTEWORTHY We explored the effect of aging on shear-mediated dilation in the common and internal carotid arteries (CCA and ICA, respectively) in healthy adults. Our findings suggest that 1) aging attenuates shear-mediated dilation of the ICA but not the CCA and 2) shear rate is an important stimulus for hypercapnic vasodilation of the ICA in young and older adults. These findings may provide insights into the age-related changes in cerebrovascular regulation of healthy adults.

Complaints of xerostomia and salivary hypofunction are common in older adults. However, recent studies reported that dehydration-induced salivary hypofunction caused fewer xerostomic complaints in older compared with young adults. This may predispose older adults to developing oral problems that will subsequently not receive attention from health care providers. Since many medications are known to inhibit salivation, this study attempted to determine if an anticholinergic drug (glycopyrrolate) had a differential effect on xerostomic complaints in young vs. older adults. Eighteen young (age 20-38 yrs) and 18 older (age 60-77 yrs) healthy adults were given a 4.0 micrograms/kg dose of i.v. glycopyrrolate. For 6 hrs after drug administration, stimulated parotid salivary flow was collected, and an eight-item Visual Analogue Scale (VAS) subjective xerostomia test was given. At several time points post-i.v. glycopyrrolate, salivary flow rates were consistently lower in older compared with young adults. For some measures of xerostomic complaint (time to first complaint; time to maximum complaint; mean maximum complaint), there were no age-related differences for all VAS items. However, a trend for increased xerostomic complaints in older adults was demonstrated (time to recovery; total duration of complaint; number xerostomic at 6 hrs). These findings suggest that, given equal doses of an anti-sialogogue, salivary hypofunction is greater in healthy older adults, while increased complaints of xerostomia are not as consistent.

Increased central arterial stiffness and enhanced arterial wave reflections may contribute to increased risk of cardiovascular disease development with advancing age. Omega-3 polyunsaturated fatty acid (n-3) ingestion may reduce cardiovascular risk via favorable effects exerted on arterial structure and function. We determined the effects of n-3 supplementation (4 g/day for 12 weeks) on important measures of central arterial stiffness (carotid-femoral pulse wave velocity; PWV) and arterial wave reflection (central augmentation index) in young (n = 12; 25 ± 1-year-old, mean ± SE) and older (n = 12; 66 ± 2) healthy adults. We hypothesized that n-3 supplementation would decrease carotid-femoral PWV and central augmentation index in older adults. Our results indicate that carotid-femoral PWV and central augmentation index were greater in older (988 ± 65 cm/sec and 33 ± 2%) than in young adults (656 ± 16 cm/sec and 3 ± 4%: both P < 0.05 compared to older) before the intervention (Pre). N-3 supplementation decreased carotid-femoral PWV in older (Δ-9 ± 2% Precompared to Post; P < 0.05), but not young adults (Δ2 ± 3%). Central augmentation index was unchanged by n-3 supplementation in young (3 ± 4 vs. 0 ± 4% for Pre and Post, respectively) and older adults (33 ± 2 vs. 35 ± 3%). Arterial blood pressure at rest, although increased with age, was not altered by n-3 supplementation in young or older adults. Collectively, these data indicate that 12 weeks of daily n-3 supplementation decreases an important measure of central arterial stiffness (carotid-femoral PWV) in older, but not young healthy adults. The mechanism underlying decreased central arterial stiffness with n-3 supplementation is unknown, but appears to be independent of effects on arterial blood pressure or arterial wave reflections.

Difficulty in turning is prevalent in older adults and results in postural instability and risk of falling. Despite this, the mechanisms of turning problems have yet to be fully determined, and it is unclear if different speeds directly result in altered posture and turning characteristics. The aim of this study was to identify the effects of turning speeds on whole-body coordination and to explore if these can be used to help inform fall prevention programs in older adults. Forty-two participants (21 healthy older adults and 21 younger adults) completed standing turns on level ground. Inertial Measurement Units (XSENS) were used to measure turning kinematics and stepping characteristics. Participants were randomly tasked to turn 180° at one of three speeds; fast, moderate, or slow to the left and right. Two factors mixed model analysis of variance (MM ANOVA) with post hoc pairwise comparisons were performed to assess the two groups and three turning speeds. Significant interaction effects (p < 0.05) were seen in; reorientation onset latency of head, pelvis, and feet, peak segmental angular separation, and stepping characteristics (step frequency and step size), which all changed with increasing turn speed. Repeated measures ANOVA revealed the main effects of speeds within the older adults group on those variables as well as the younger adults group. Our results suggest that turning speeds result in altered whole-body coordination and stepping behavior in older adults, which use the same temporospatial sequence as younger adults. However, some characteristics differ significantly, e.g., onset latency of segments, peak head velocity, step frequency, and step size. Therefore, the assessment of turning speeds elucidates the exact temporospatial differences between older and younger healthy adults and may help to determine some of the issues that the older population face during turning, and ultimately the altered whole-body coordination, which lead to falls.

Aging is associated with detrimental changes in sleep physiology, a process accelerated in Alzheimer's disease. Fine-tuned temporal interactions of non-rapid eye movement slow oscillations and spindles were shown to be particularly important for memory consolidation, and to deteriorate in healthy older adults. Whether this oscillatory interaction further decline in early stages of Alzheimer's disease such as mild cognitive impairment has not been investigated to date, but may have important therapeutic implications. Here, we assessed differences in sleep architecture and memory-relevant slow oscillation, sleep spindles and their functional coupling during a 90-min nap between healthy young and older adults, and in older patients with mild cognitive impairment. Furthermore, associations of nap-sleep characteristics with sleep-dependent memory performance change were evaluated. We found significant differences between young and older healthy adults, and between young adults and patients with mild cognitive impairment, but not between healthy older adults and patients for several sleep metrics, including slow oscillation-spindle coupling. Moreover, sleep-dependent retention of verbal memories was significantly higher in young healthy adults versus older adults with and without mild cognitive impairment, but no difference between the two older groups was observed. Associations with sleep metrics were only found for pre-nap memory performances. In conclusion, our results indicate changes in nap sleep physiology and sleep-related memory consolidation in older adults with and without mild cognitive impairment. Thus, interventions targeted at improving sleep physiology may help to reduce memory decline in both groups, but our study does not indicate additional benefits for patients with mild cognitive impairment. Effects of Brain Stimulation During Daytime Nap on Memory Consolidation in Younger, Healthy Subjects: https://clinicaltrials.gov/ct2/show/NCT01840865; NCT01840865. Effects of Brain Stimulation During a Daytime Nap on Memory Consolidation in Older Adults; https://clinicaltrials.gov/ct2/show/study/NCT01840839?term=01840839&draw=2&rank=1; NCT01840839. Effects of Brain Stimulation During a Daytime Nap on Memory Consolidation in Patients With Mild Cognitive Impairment; https://clinicaltrials.gov/ct2/show/NCT01782365?term=01782365&draw=2&rank=1; NCT01782365.

High Diagnostic Uncertainty and Inaccuracy in Adult Emergency Department Patients With Dyspnea: A National Database Analysis.