The acquisition of tonal hierarchies in western music during school years: A re-analysis of 40 years of research

To determine the influence of in vivo dehydration and rehydration on color and whiteness variations in maxillary anterior teeth of younger, middle-aged, and older individuals. The spectrophotometric shade of maxillary anterior teeth from younger (20 to 30 years, n=20), middle-aged (50 to 60 years, n=20) and older (65 to 80 years, n=20) participants were assessed at baseline and every 10 minutes for 30 minutes after rubber dam isolation (dehydration). The teeth were then allowed to rehydrate, and shade values were assessed every 10 minutes for 30 minutes, after 24 hours, and after 48 hours. Data were collected as International Commission on Illumination (CIE) L*a*b* color coordinates. Color differences (ΔE*ab) and whiteness differences (ΔWID) were evaluated. Statistical analysis was performed using one-way analysis of variance with the Tukey Honest Significant Difference test. The color and whiteness changes of maxillary anterior teeth in older individuals after dehydration for 30 minutes were significantly lower than that of younger and middle-aged individuals. In younger participants, after 10 minutes of dehydration, mean ΔE*ab values of maxillary anterior teeth were above the acceptability threshold (AT), while mean ΔWID values were above AT only in maxillary canines. In middle-aged participants, mean ΔE*ab values were above AT, and mean ΔWID values were above the perceptibility threshold (PT) and below AT after 10 minutes of dehydration. In older participants, mean ΔE*ab values were above PT and below AT at 20 minutes of dehydration, while mean ΔWID values were above PT at 10 minutes of dehydration, and both were above AT at 30 minutes of dehydration. The mean ΔE*ab values were above AT after 20 minutes of rehydration in younger and middle-aged participants, while they were below AT in older participants after 10 minutes of rehydration. Mean ΔWID values were below AT for older participants after 20 minutes of rehydration. All mean ΔWID values were below AT and above PT after 30 minutes of rehydration except central incisors of younger participants. After 24 hours of rehydration, mean ΔE*ab and mean ΔWID values of participants in all age groups were below AT. After 48 hours of rehydration, mean ΔE*ab and ΔWID values of participants in all age groups were below PT except mean ΔE*ab values of canines and mean ΔWID values of central incisors in younger participants. L*, a*, and b* values were significantly different between age groups at 30 minutes of dehydration and after 48 hours of rehydration (p<0.05). Color and whiteness changes due to dehydration were less pronounced in older participants. Dehydration for 10 minutes in most maxillary anterior teeth of younger and middle-aged participants led to perceptible and clinically unacceptable color and whiteness changes. Maxillary anterior teeth of older participants showed color and whiteness changes that were perceptible at 10 minutes of dehydration but clinically acceptable up to 30 minutes of dehydration. After 30 minutes of dehydration, a 10- and 20-minute rehydration was needed, respectively, for color and whiteness changes to be clinically acceptable in maxillary anterior teeth of older individuals, while a 30-minute rehydration was recommended for the middle aged group and for maxillary laterals and canines of the younger group. Color and whiteness changes in most maxillary anterior teeth were imperceptible only after 48 hours of rehydration.

The nature of increased-age-related dual-task interference was examined during a driving-like dual task in the laboratory. Previous research revealed age-related deficits in dual tasks especially when cognitive and motor demands are involved. The specific contributions of sensory input, working memory demands, and/or coordination of motor responses to dual-task interference are not clear and should be clarified in the present study. Younger and older participants performed a driving-like tracking task and a visually cued attention task within a dual task. Behavioral and electrophysiological data were recorded during task performance. Overall tracking performance was lower for the older versus younger participants. This age-related decline was particularly pronounced in the time interval after the stimulus when the attention task demanded a motor response. In contrast, older participants tracked relatively better than the younger participants in the time interval preceding the stimulus. In the attention task, the older versus younger participants showed increased responses times and rates of false alarms and misses, suggesting a deficit in retaining the context in the cue-stimulus interval. The electroencephalogram data suggest that the older participants invested more resources than the younger participants in dual-task management during the cue-stimulus interval. Evidence was found for increased motor interference and a deficient context processing as well as for an increased investment of processing resources in the older compared with the younger group. The results suggest that in-vehicle information systems for older drivers should be designed to support cue maintenance and that simultaneous motor demands should not be required.

BackgroundChoose to Move (CTM), an effective health-promoting intervention for older adults, was scaled-up across British Columbia, Canada. Adaptations that enable implementation at scale may lead to ‘voltage drop’—diminished positive effects of the intervention. For CTM Phase 3 we assessed: i. implementation; ii. impact on physical activity, mobility, social isolation, loneliness and health-related quality of life (impact outcomes); iii. whether intervention effects were maintained; iv) voltage drop, compared with previous CTM phases.MethodsWe conducted a type 2 hybrid effectiveness-implementation pre-post study of CTM; older adult participants (n = 1012; mean age 72.9, SD = 6.3 years; 80.6% female) were recruited by community delivery partners. We assessed CTM implementation indicators and impact outcomes via survey at 0 (baseline), 3 (mid-intervention), 6 (end-intervention) and 18 (12-month follow-up) months. We fitted mixed-effects models to describe change in impact outcomes in younger (60–74 years) and older (≥ 75 years) participants. We quantified voltage drop as percent of effect size (change from baseline to 3- and 6-months) retained in Phase 3 compared with Phases 1–2.ResultsAdaptation did not compromise fidelity of CTM Phase 3 as program components were delivered as intended. PA increased during the first 3 months in younger (+1 days/week) and older (+0.9 days/week) participants (p<0.001), and was maintained at 6- and 18-months. In all participants, social isolation and loneliness decreased during the intervention, but increased during follow-up. Mobility improved during the intervention in younger participants only. Health-related quality of life according to EQ-5D-5L score did not change significantly in younger or older participants. However, EQ-5D-5L visual analog scale score increased during the intervention in younger participants (p<0.001), and this increase was maintained during follow-up. Across all outcomes, the median difference in effect size, or voltage drop, between Phase 3 and Phases 1–2 was 52.6%. However, declines in social isolation were almost two times greater in Phase 3, compared with Phases 1–2.ConclusionBenefits of health-promoting interventions—like CTM—can be retained when implemented at broad scale. Diminished social isolation in Phase 3 reflects how CTM was adapted to enhance opportunities for older adults to socially connect. Thus, although intervention effects may be reduced at scale-up, voltage drop is not inevitable.

Choose to Move (CTM), an effective health-promoting intervention for older adults, was scaled-up across British Columbia, Canada. Adaptations that enable implementation at scale may lead to 'voltage drop'-diminished positive effects of the intervention. For CTM Phase 3 we assessed: i. implementation; ii. impact on physical activity, mobility, social isolation, loneliness and health-related quality of life (impact outcomes); iii. whether intervention effects were maintained; iv) voltage drop, compared with previous CTM phases. We conducted a type 2 hybrid effectiveness-implementation pre-post study of CTM; older adult participants (n = 1012; mean age 72.9, SD = 6.3 years; 80.6% female) were recruited by community delivery partners. We assessed CTM implementation indicators and impact outcomes via survey at 0 (baseline), 3 (mid-intervention), 6 (end-intervention) and 18 (12-month follow-up) months. We fitted mixed-effects models to describe change in impact outcomes in younger (60-74 years) and older (≥ 75 years) participants. We quantified voltage drop as percent of effect size (change from baseline to 3- and 6-months) retained in Phase 3 compared with Phases 1-2. Adaptation did not compromise fidelity of CTM Phase 3 as program components were delivered as intended. PA increased during the first 3 months in younger (+1 days/week) and older (+0.9 days/week) participants (p<0.001), and was maintained at 6- and 18-months. In all participants, social isolation and loneliness decreased during the intervention, but increased during follow-up. Mobility improved during the intervention in younger participants only. Health-related quality of life according to EQ-5D-5L score did not change significantly in younger or older participants. However, EQ-5D-5L visual analog scale score increased during the intervention in younger participants (p<0.001), and this increase was maintained during follow-up. Across all outcomes, the median difference in effect size, or voltage drop, between Phase 3 and Phases 1-2 was 52.6%. However, declines in social isolation were almost two times greater in Phase 3, compared with Phases 1-2. Benefits of health-promoting interventions-like CTM-can be retained when implemented at broad scale. Diminished social isolation in Phase 3 reflects how CTM was adapted to enhance opportunities for older adults to socially connect. Thus, although intervention effects may be reduced at scale-up, voltage drop is not inevitable.

Immobility and diminished skeletal muscle recovery with age: the sedentary myoblast.

People smile in various emotional contexts, for example, when they are amused or angry or simply being polite. We investigated whether younger and older adults differ in how well they are able to identify the emotional experiences accompanying smile expressions, and whether the age of the smiling person plays a role in this respect. With this aim, we produced 80 video episodes of three types of smile expressions: positive-affect smiles had been spontaneously displayed by target persons as they were watching amusing film clips and cartoons. Negative-affect smiles had been displayed spontaneously by target persons during an interaction in which they were being unfairly accused. Affectively neutral smiles were posed upon request. Differences in the accompanying emotional experiences were validated by target persons' self-reports. These smile videos served as experimental stimuli in two studies with younger and older adult participants. In Study 1, older participants were less likely to attribute positive emotions to smiles, and more likely to assume that a smile was posed. Furthermore, younger participants were more accurate than older adults at identifying emotional experiences accompanying smiles. In Study 2, both younger and older participants attributed positive emotions more frequently to smiles shown by older as compared to younger target persons, but older participants did so less frequently than younger participants. Again, younger participants were more accurate than older participants in identifying emotional experiences accompanying smiles, but this effect was attenuated for older target persons. Older participants could better identify the emotional state accompanying smiles shown by older than by younger target persons. Taken together, these findings indicate that there is an age-related decline in the ability to decipher the emotional meaning of smiles presented without context, which, however, is attenuated when the smiling person is also an older adult.

Multisensory integration appears to be enhanced in older age (e.g., Laurienti et al., 2006; Maguinness et al., 2011). Given that motion perception declines with ageing, we examined whether multisensory integration may enhance motion perception in older adults. Calabro et al. (2011) recently showed that the detection of object motion in the context of self-motion is facilitated by the presentation of a co-localized and directionally congruent auditory stimulus. We compared performance of younger (mean age: 26 years) and older (mean age: 68 years) participants on this task. On each trial, nine identical spheres were randomly distributed within 10 degrees of fixation and 8 spheres expanded outward for 1 s, simulating forward translation at a constant speed. One sphere (the target) had independent motion either expanding or receding at one of three different speeds. A response screen prompted the participants to report which of four highlighted spheres was the target. The task was presented with no sound and with a co-localized sound that simulated motion congruent with the target’s direction. Older participants showed overall poorer target detection than younger participants. Consistent with Calabro et al. (2011), the auditory stimulus improved target detection in younger participants, however, it had less of an effect on older participants’ performance. A control experiment confirmed that both groups were able to localize the auditory stimulus, however localization was poorer in the older group. Future studies equating unisensory performance in younger and older participants are needed to determine whether multisensory integration in motion is affected in older age.

Introduction We investigated whether the relationship between daytime sleepiness and previous night’s sleep duration changes with age using a protocol in which individuals were studied both after habitual sleep duration and after multiple days with extended sleep opportunities. Methods 35 younger (18-32 years old, 18 F) and 18 older (60-76 years old, 6 F) healthy participants were studied using polysomnography in an in-lab protocol (Klerman and Dijk, Curr. Biol. 2008). During night 1 (SP1), participants were scheduled to sleep based on their at-home sleep schedules. On day 2, the 5 sessions of a MSLT (MSLT_pre) began 2 hours after SP1 ended .Participants then began a schedule with 16 hrs (12 hrs at night and 4 hrs during day) of sleep opportunity in bed per 24 hrs for 7 days, followed by a second set of MSLTs (MSLT-post). Total sleep time (TST) for the nighttime sleep episodes prior to both sets of MSLTs was calculated. The median sleep latency and percent of the MSLT sessions in which participants fell asleep (PctSlept) within MSLT_pre and MSLT_post were calculated. Results Total sleep time on SP1 ranged from 5.4-9.7hr; only Younger participants had a TST &amp;gt;8.0 hr. Therefore, for analyses comparing Younger and Older participants, only TST of &amp;lt; 8.0 hr was used (21 Younger, 18 Older). All participants fell asleep at least once during MSLT_pre. During MSLT_post, 32% of Younger and 8% of Older participants did not fall asleep during any of the MSLT sessions (i.e., PctSlept=0); therefore, latency-based analyses cannot be done for MSLT_post data. There was a negative correlation between SP1 TST and median sleep latency for MSLT_pre for Younger (Pearson R=0.35; p=0.049) but not Older participants. There was a negative correlation between SP1 TST and PctSlept for Younger (Pearson R=-0.47, p=0.006), but not Older participants. There was no relationship between TST before MSLT_post and the PctSlept for either Younger or Older participants. Repeated measures ANOVA testing (MSLT_pre vs MSLT_post) found a time (p&amp;lt; 0.001) and time*agegroup (p=0.008) effect for PctSlept. Conclusion The relationship between the prior night’s sleep and daytime sleepiness may change with age. Support (if any) NIH R01- HL166205, R01-HD107064

Substance misuse is increasing in the older population, which may have differing effects on behavior compared to younger substance participants. Differences in trait and state impulsivity were assessed in younger and older cocaine-dependent participants. Thirty-one younger cocaine-dependent participants (n = 31) and 21 older cocaine-dependent participants (n = 21) were assessed using the Barrett Impulsiveness Scale-11 and the Immediate Memory Task. Younger participants showed higher trait impulsivity than older participants (p =.027). However, older participants demonstrated higher state impulsivity than younger participants (p =.018). Higher state impulsivity in older cocaine participants suggests that cocaine use may have accelerating effects on the aging brain. This preliminary study adds the limited research on how cocaine use affects normal aging. Current treatments are based on younger adults, therefore the needs of older adults should be taken into consideration and studied more. (Am J Addict 2018;27:557-559).

This study was designed to identify age-related differences in the ability to understand and remember Spanish-accented and non-accented speech while participants were sitting and while they were walking, and to examine how listening to Spanish-accented and non-accented speech influences walking mechanics. Groups of younger, middle-aged, and older adult participants (n = 20/group) listened to and repeated back non-accented and Spanish-accented sentences while they sat and while they walked. They were also asked to recall the last word of each sentence at the end of blocks of five sentences. Walking mechanics (gait speed, step width, and mediolateral head acceleration-a measure of body sway) were assessed using a 14-camera motion capture system. Participants recognized the non-accented sentences with greater accuracy than the accented sentences, with no significant effects of age group or sitting versus walking on speech recognition performance. Older participants' ability to remember accented speech was better when sitting than while walking. Middle-aged and older (but not younger) participants walked more slowly when listening to accented speech, as compared with when walking while not listening. Mediolateral head acceleration was greater for older adults when they were listening to accented speech while walking versus when they were just walking. Middle-aged and older adults were able to understand accented speech while walking with accuracy similar to younger listeners, but their walking mechanics changed in ways that were not noted in younger participants. This cohort of middle-aged and older individuals slowed their walking in response to the greater listening demands imposed by Spanish-accented speech. These results suggest that reaching a high level of speech recognition performance was more effortful for middle-aged and older adults than for younger adults and that, in situations where middle-aged and older people are walking while engaged in a challenging listening task, walking mechanics are changed.

Impaired functional status attenuates the relationship of systolic blood pressure (SBP) with mortality in older adults but has not been studied in middle-aged populations. Among 10,264 stroke-free Atherosclerosis Risk in Communities participants (mean age 62.8 [5.7] years; 6,349 [62%] younger [<65 years]; 5,148 [50%] men; 2,664 [26%] Black), function was defined as good function (GF) for those self-reporting no difficulty performing functional tasks and basic or instrumental tasks of daily living; all others were defined as impaired function (IF). SBP categories were normal (<120 mmHg), prehypertension (120-139 mmHg), and hypertension (≥140 mmHg). Mortality risk associated with SBP was estimated using adjusted Cox proportional hazard models with a triple interaction between age, functional status, and SBP. Mean follow-up was 12.9 years with 2,863 (28%) deaths. Among younger participants, 3,017 (48%) had IF; 2,279 of 3,915 (58%) older participants had IF. Prehypertension (hazard ratio [HR] = 1.48 [1.03, 2.15] p = .04) and hypertension (HR = 1.97 [1.29, 3.03] p = .002) were associated with mortality in younger GF and older (≥65 years) GF participants (prehypertension HR = 1.21 [1.06, 1.37] p = .005; hypertension HR = 1.47 [1.36, 1.59] p < .001). Among IF participants, prehypertension was not associated with mortality in younger participants (HR = 0.99 [0.85, 1.15] p = .93) and was protective in older participants (HR = 0.87 [0.85, 0.90] p < .001). Hypertension was associated with mortality in younger IF participants (HR = 1.54 [1.30, 1.82] p < .001) but not in older IF participants (HR = 0.99 [0.87, 1.14] p = .93). Compared with younger and well-functioning persons, the additional contribution of blood pressure to mortality is much lower with older age and impaired function, particularly if both are present. Functional status and age could potentially inform optimal blood pressure targets.

Vitamin C and inorganic nitrate have been linked to enhanced nitric oxide (NO) production and reduced oxidative stress. Vitamin C may also enhance the conversion of nitrite into NO. We investigated the potential acute effects of vitamin C and inorganic nitrate co-supplementation on blood pressure (BP) and peripheral vascular function. The secondary aim was to investigate whether age modified the effects of vitamin C and inorganic nitrate on these vascular outcomes. Ten younger (age 18-40y) and ten older (age 55-70y) healthy participants were enrolled in a randomised double-blind crossover clinical trial. Participants ingested a solution of potassium nitrate (7mg/kg body weight) and/or vitamin C (20mg/kg body weight) or their placebos. Acute changes in resting BP and vascular function (post-occlusion reactive hyperemia [PORH], peripheral pulse wave velocity [PWV]) were monitored over a 3-h period. Vitamin C supplementation reduced PWV significantly (vitamin C:-0.70±0.31m/s; vitamin C placebo:+0.43±0.30m/s; P=0.007). There were significant interactions between age and vitamin C for systolic, diastolic, and mean arterial BP (P=0.02, P=0.03, P=0.02, respectively), with systolic, diastolic and mean BP decreasing in older participants and diastolic BP increasing in younger participants following vitamin C administration. Nitrate supplementation did not influence BP (systolic: P=0.81; diastolic: P=0.24; mean BP: P=0.87) or vascular function (PORH: P=0.05; PWV: P=0.44) significantly in both younger and older participants. However, combined supplementation with nitrate and vitamin C reduced mean arterial BP (-2.6mmHg, P=0.03) and decreased PWV in older participants (PWV:-2.0m/s, P=0.02). The co-administration of a single dose of inorganic nitrate and vitamin C lowered diastolic BP and improved PVW in older participants. Vitamin C supplementation improved PWV in both age groups but decreased systolic and mean BP in older participants only. Current Controlled Trials (ISRCTN98942199).

BACKGROUND AND AIMS Age-adapted thresholds of estimated glomerular filtration rate (eGFR) have been proposed for the diagnosis of chronic kidney disease (CKD) [1] to acknowledge decline in kidney function with increasing age [2]. Proponents of age-adapted thresholds suggest that subjects over the age of 65 with eGFR 45–59 mL/min/1.73 m2 and without albuminuria appear to be at low risk of adverse outcomes [1]; however, the risks associated with CKD extend beyond kidney failure [3]. We evaluated whether cystatin C testing (eGFRcys) could improve risk stratification in CKD without adopting age-adapted thresholds. METHOD Data were from participants in the UK Biobank cohort with eGFR based on serum creatinine (eGFRcr) ≥45 mL/min/1.73 m2 and without albuminuria. Participants with a history of cardiovascular disease or kidney failure at baseline were excluded. CKD status was initially categorized by eGFRcr, then concordance of eGFRcys &amp;lt; 60 mL/min/1.73 m2 was determined. Multivariable-adjusted Cox proportional hazards models evaluated associations of CKD status with death, myocardial infarction (MI), stroke and kidney failure. Analyses were stratified by age: older (65–73 years) and younger (&amp;lt;65 years) participants. RESULTS Among 76 629 older and 351 773 younger participants, followed over median 11.5 (IQR 10.8–12.2) years, there were 24 251 deaths, 6983 MI, 4081 strokes and 209 kidney failure events. Of 2016 older participants with eGFRcr 45–59 mL/min/1.73 m2 37% had eGFRcys &amp;gt; 60 mL/min/1.73 m2. Furthermore, eGFRcr alone did not detect 6278 (8%) of older participants with eGFRcys &amp;lt; 60 mL/min/1.73 m2. In cross-sectional analyses, the median baseline eGFR was lower at higher age for all equations: this was most pronounced for eGFRcys (Figure 1). CKD by eGFRcys only or with both markers experienced higher absolute incidence of MI, stroke and mortality compared to those without CKD by either marker (Figure 2). Compared to those without CKD, older participants with concordant eGFRcr and eGFRcys &amp;lt; 60mL/min/1.73 m2 had elevated adjusted risks of death (HR 1.8, 1.6–2.0), MI (HR 1.9, 1.5–2.4), stroke (HR 1.7, 1.2–2.3) and kidney failure (HR 4.2, 1.2–14.1). Findings were similar in younger participants with concordant eGFRcr and eGFRcys &amp;lt; 60 mL/min/1.73 m2 for death (HR 2.2, 1.9–2.6) and stroke (HR 2.1, 1.4–3.2), though not MI (HR 1.2, 0.8–1.8). When CKD was not confirmed by eGFRcys, eGFRcr 45–59 mL/min/1.73 m2 was not associated with increased hazards of death (HR 1.1, 0.9–1.4), MI (HR 1.1, 0.7–1.7) or stroke (HR 1.1, 0.7–1.9) in older participants, nor in younger participants for the same outcomes: death (HR 1.1, 0.8–1.3), MI (HR 1.2, 0.8–1.9) and stroke (HR 0.8, 0.4–1.6). CONCLUSION Among persons with CKD, cardiovascular disease and mortality are important risks that should be considered when determining CKD status. CKD categorization by eGFRcr alone includes a large proportion of individuals who have similar risks to persons without CKD. eGFRcys detects a substantial number of high-risk individuals not identified to have CKD by eGFRcr. In the absence of cystatin C testing, lower, age-adapted thresholds for diagnosis of CKD may inadequately detect the broader risks associated with kidney disease in older people.

BACKGROUND AND AIMS Age-adapted thresholds of estimated glomerular filtration rate (eGFR) have been proposed for the diagnosis of chronic kidney disease (CKD) [1] to acknowledge decline in kidney function with increasing age [2]. Proponents of age-adapted thresholds suggest that subjects over the age of 65 with eGFR 45–59 mL/min/1.73 m2 and without albuminuria appear to be at low risk of adverse outcomes [1]; however, the risks associated with CKD extend beyond kidney failure [3]. We evaluated whether cystatin C testing (eGFRcys) could improve risk stratification in CKD without adopting age-adapted thresholds. METHOD Data were from participants in the UK Biobank cohort with eGFR based on serum creatinine (eGFRcr) ≥45 mL/min/1.73 m2 and without albuminuria. Participants with a history of cardiovascular disease or kidney failure at baseline were excluded. CKD status was initially categorized by eGFRcr, then concordance of eGFRcys &amp;lt; 60 mL/min/1.73 m2 was determined. Multivariable-adjusted Cox proportional hazards models evaluated associations of CKD status with death, myocardial infarction (MI), stroke and kidney failure. Analyses were stratified by age: older (65–73 years) and younger (&amp;lt;65 years) participants. RESULTS Among 76 629 older and 351 773 younger participants, followed over median 11.5 (IQR 10.8–12.2) years, there were 24 251 deaths, 6983 MI, 4081 strokes and 209 kidney failure events. Of 2016 older participants with eGFRcr 45–59 mL/min/1.73 m2 37% had eGFRcys &amp;gt; 60 mL/min/1.73 m2. Furthermore, eGFRcr alone did not detect 6278 (8%) of older participants with eGFRcys &amp;lt; 60 mL/min/1.73 m2. In cross-sectional analyses, the median baseline eGFR was lower at higher age for all equations: this was most pronounced for eGFRcys (Figure 1). CKD by eGFRcys only or with both markers experienced higher absolute incidence of MI, stroke and mortality compared to those without CKD by either marker (Figure 2). Compared to those without CKD, older participants with concordant eGFRcr and eGFRcys &amp;lt; 60mL/min/1.73 m2 had elevated adjusted risks of death (HR 1.8, 1.6–2.0), MI (HR 1.9, 1.5–2.4), stroke (HR 1.7, 1.2–2.3) and kidney failure (HR 4.2, 1.2–14.1). Findings were similar in younger participants with concordant eGFRcr and eGFRcys &amp;lt; 60 mL/min/1.73 m2 for death (HR 2.2, 1.9–2.6) and stroke (HR 2.1, 1.4–3.2), though not MI (HR 1.2, 0.8–1.8). When CKD was not confirmed by eGFRcys, eGFRcr 45–59 mL/min/1.73 m2 was not associated with increased hazards of death (HR 1.1, 0.9–1.4), MI (HR 1.1, 0.7–1.7) or stroke (HR 1.1, 0.7–1.9) in older participants, nor in younger participants for the same outcomes: death (HR 1.1, 0.8–1.3), MI (HR 1.2, 0.8–1.9) and stroke (HR 0.8, 0.4–1.6). CONCLUSION Among persons with CKD, cardiovascular disease and mortality are important risks that should be considered when determining CKD status. CKD categorization by eGFRcr alone includes a large proportion of individuals who have similar risks to persons without CKD. eGFRcys detects a substantial number of high-risk individuals not identified to have CKD by eGFRcr. In the absence of cystatin C testing, lower, age-adapted thresholds for diagnosis of CKD may inadequately detect the broader risks associated with kidney disease in older people.

As a group, older adults perform as well as younger adults on tasks that assess crystalized intelligence (CI), yet there is a negative effect for age on tasks that assess fluid intelligence (FI). It is important to note, however, that the negative impact of age on FI does not hold for all individuals. It has been suggested that physical fitness may be an important variable in explaining these individual differences. The primary purpose of this study was to examine performance on FI and CI tasks as a function of age and fitness. A secondary purpose was to examine the influence of age and fitness on the beneficial effects that practice has on performance and retention. Fitness was assessed in 41 older (60-80 yrs) and 42 younger (20-30 yrs) adults who were then randomly assigned to either experimental or control conditions. Participants performed repeated trials on two cognitive tasks during acquisition and retention with the experimental group practicing for 100 trials and the control group practicing for 20 trials. Results showed that older participants performed better than younger participants on the CI task: however, younger participants performed better than older participants on the FI task. Fitness influenced the results on the FI task such that older fit participants performed better than older unfit participants. As predicted, learning did not occur on the CI task. However, learning did occur on the FI task and differed as a function of age and fitness. Older unfit participants did not retain as much as older fit participants who were indistinguishable from younger fit participants. It is concluded that physical fitness may serve as a buffer to the normal age-related declines in cognitive function and in learning.