Ability Of Older Adults Research Articles

Effects of repetitive peripheral magnetic stimulation on knee joint extensor strength in older persons receiving day services.

To verify the effects of repetitive peripheral magnetic stimulation (rPMS) on knee joint extensor strength and motor ability in older adults receiving day services. Thirty Hz rPMS using Talent Pro® was applied to the bilateral vastus lateralis, vastus medialis, and rectus femoris of 12 older persons (mean age 83.8 ± 4.5 years) attending a day service center and receiving functional training by a physical therapist. The intervention was performed for 20 minutes per day, three times per week, for a total of 4 weeks. Evaluations before and after the intervention included maximum voluntary contraction (MVC), knee extensor torque induced by rPMS (rPMS-induced torque), pain (visual analog scale: VAS), thigh circumference, comfortable 5-m walking time, 30-second chair-stand test (CS-30), Timed-Up-and-Go Test (TUG), and Functional Reach Test (FRT). MVC and rPMS-induced torque were measured using the μ-Tas F-1®. MVC significantly increased in both lower limbs after the intervention (right/left: 72.4 ± 23.5 Nm/72.9 ± 23.0 Nm) compared with immediately before the intervention (right/left: 59.9 ± 17.2 Nm/64.5 ± 21.0 Nm). No significant changes were observed in MVC between one month before the intervention and immediately before the start of the intervention, and between the end of the intervention and one month after the end of the intervention. rPMS-induced torque, TUG, and CS-30 improved significantly after the intervention compared with immediately before the intervention. Intervention using rPMS increases MVC- and rPMS-induced torque and improves motor ability in older adults. Because rPMS is a simple means of increasing muscle strength, it is expected to be widely used in the future.

The facilitation effect of audiovisual perceptual training on the cognitive ability in older adults and its mechanisms

The facilitation effect of audiovisual perceptual training on the cognitive ability in older adults and its mechanisms

The effects of shared decision-making informed dietary intervention based on digital health technology in older adults with type 2 diabetes mellitus: A randomized controlled trial.

To evaluate the effectiveness of shared decision-making informed dietary intervention based on digital health technology, for older adults with type 2 diabetes mellitus and determine its impact on patients' glycemic control (hemoglobin A1c (HbA1c) and fasting plasma glucose), physical indicators (blood pressure and body mass index), self-management behavior, and self-efficacy. A double-arm-randomized controlled trial using a parallel group design was conducted. 124 older adults with type 2 diabetes mellitus recruited from the endocrinology department or diabetes clinics were randomly assigned to the intervention (n = 64) or control group (n = 60). Patients in the intervention group received shared decision-making informed dietary intervention through the digital health system and those in the controlled group received routine dietary management. The primary outcome was HbA1c, and the secondary outcomes were fasting plasma glucose, blood pressure, body mass index, self-management ability, and self-efficacy. After 3 months of intervention, compared to the control group, the intervention group showed a statistically significant decrease in HbA1c, diastolic blood pressure, and fasting plasma glucose (P < 0.05). After the intervention, there were time, group main effects, and interaction effects on diabetes self-management ability and diabetes self-efficacy scores of older adults with type 2 diabetes mellitus (P < 0.05). The intervention program based on a digital health system significantly improved glycemic control and enhanced self-care ability in older adults with type 2 diabetes mellitus. Clinicians can integrate digital health technology in behavior change intervention, especially in older adults with chronic disease. It was registered and approved by the China Clinical Trials Center (ChiCTR2300071455).

The use of a digital life story to support person-centred care of older adults with dementia: A scoping review.

A life story (LS) is a tool healthcare professionals (HCPs) use to help older adults with dementia preserve their identities by sharing their stories. Applied health technology can be considered a niche within welfare technology. Combining technology and nursing, such as using life stories in digital form, may support person-centred care and allow HCPs to see the person behind the disease. The study's objective was to summarise and describe the use of life stories in digital form in the daily care of older adults with dementia. A scoping review was conducted in five stages. Database searches were conducted in Cinahl, PubMed, Scopus, Web of Science, and Google Scholar; 31 articles were included. A conventional qualitative content analysis of the collected data was conducted. The qualitative analysis resulted in three categories: (1) benefits for older adults, (2) influence on HCPs' work, and (3) obstacles to implementing a digital LS in daily care. Older adults with dementia can receive person-centred care through a digital LS based on their wishes. A digital LS can enable symmetric communication and serve as an intergenerational communication tool. It can be used to handle behavioural symptoms. Using a digital LS in the later stages of dementia may differ from using it earlier in dementia. However, it may compensate for weakening abilities in older adults by enhancing social interaction.

The Effects of Cognitive Ability, Mental Health, and Self-Quarantining on Functional Ability of Older Adults During the COVID-19 Pandemic: Results From the Canadian Longitudinal Study on Aging.

Determine whether levels of anxiety and depression, cognitive ability, and self-quarantining during and prior to the pandemic predict decreases in perceived functional ability. Longitudinal data collected from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study (2020) and core CLSA study (Follow-Up 1; 2014-2018). 17541 CLSA participants. Self-quarantining behaviours from questionnaires administered at Baseline (April 2020), Monthly, and Exit (December 2020) time points of the CLSA COVID-19 Questionnaire Study, levels of anxiety and depression at Baseline, perceived change in functional ability at Exit, and performance on neuropsychological tests (Rey Auditory Verbal Learning Task, Mental Alternation Task, Animal Fluency Test) and functional ability (Older Americans Resources and Services [OARS] Multidimensional Assessment Questionnaire) from the core CLSA study. Greater cognitive ability pre-pandemic (B = -.003, P < .01), higher levels of anxiety (B = -.024, P < .01) and depressive symptoms (B = -.110, P < .01) at Baseline, and higher frequency of engaging in self-quarantining throughout the COVID-19 survey period (B = -.098, P < .01) were associated with perceived loss in functional ability at Exit. Self-quarantining behaviour was associated with perceived loss in functional ability only at average and high levels of depressive symptoms (B = -.013, P < .01). Older adults with higher cognitive and lower functional ability prior to the pandemic were at greater risk of decreased perceived functional ability during the first year of the pandemic, as were those who experienced greater levels of anxiety and depressive symptoms during the pandemic. Strategies/interventions to preserve functional ability in older adults with cognitive independence prior to future pandemics are warranted.

Motivations Behind Dog Walking in Older Adults: Insights From Guided Walks and Interviews.

For many older adults, physical activity declines with age, contributing to chronic disease and social isolation. Companionship from dogs can help mitigate isolation and promote physical activity. Outdoor environments aligned with the abilities of older adults can encourage walking habits and socialization. To understand how neighborhood features influence dog walking, we adapted a Photovoice approach and photographed 12 older adults walking their dog. Photographs were presented during in-person interviews to facilitate discussions about environmental features. Thematic coding revealed that interactions with nature were key. Participants valued choices in walking path type and conveniently placed dog waste stations. Opportunities to socialize with neighbors were also important. Safety from falling, other animals, and motorized traffic were concerns but were not enough to prevent walking. Our findings suggest that walking environments intended for older adults with dogs should include experiences with nature, diverse path designs, and dog-specific amenities.

Association of subjective and objective cognitive performance to self‐rated driving ability in older adults

AbstractBackgroundOlder drivers often self‐regulate their driving behaviours to avoid more challenging situations that may lead to increased driving risk. However, other research also indicates that many older adults overestimate their driving ability, and therefore may be at risk of road traffic incidents due to not self‐regulating accurately. Understanding how self‐rated driving relates with cognitive performance can uncover markers for at‐risk driving behaviours. The present study therefore aimed to establish how self‐rated driving ability within a healthy older adult cohort relates to subjective and objective cognitive performance.Method925 cognitively healthy individuals were recruited to take part in an online cohort study (age: 71.07, % female = 55.56). Participants completed questionnaires examining driving behaviour and subjective cognitive performance. Subjective cognition was measured by a questionnaire examining spatial ability and memory performance across the lifespan and within the past 3 months. A subjective cognitive change measure was established by subtracting lifetime cognition ratings from recent cognition ratings. Participants then completed a cognitive battery in domains associated with driving performance. Hierarchical regression modelling was conducted to establish how self‐rated driving ability was associated with subjective and objective cognitive performance after controlling for age and gender effects.ResultWithin subjective cognition, individuals who rated their spatial ability and memory performance higher also rated their driving ability higher, and greater subjective cognitive change within both memory and spatial ability was predictive of lower self‐rated driving ability. Within objective cognitive performance, individuals with faster reaction speeds and faster Trail Making Test‐B completion time rated their driving abilities higher. Interestingly, when included in the same regression model, only subjective cognitive measures were predictive of self‐rated driving ability.ConclusionPrevious studies have found that self‐perceived driving ability is a more accurate indicator of self‐regulation behaviour than actual driving ability. Here, we show that subjective cognitive measures were more predictive of self‐rated driving ability than objective cognitive measures within a healthy older adult cohort. These findings add to the understanding in how cognition interacts with self‐regulation behaviour and provides an opportunity for comparison in self‐regulation driving behaviour within prodromal and clinical dementia.

Testing central auditory processing abilities in older adults with and without dementia using the consonant-vowel dichotic listening task.

Hearing loss and dementia are linked, although the roles of peripheral and central auditory dysfunction are not well defined. Many behavioral measures of hearing are confounded by the overlapping cognitive functions required to perform the tests. To collect pilot data to identify how central auditory function, measured using a dichotic listening test that indexes both auditory and cognitive components under different attentional conditions, differs among people with mild cognitive impairment (MCI), dementia and controls, and how performance relates to neuropsychological results. Fifty-eight participants (17 MCI, 11 dementia and 30 controls) undertook hearing screening, the Bergen consonant-vowel dichotic listening paradigm, and a short battery of neuropsychological tests chosen to index attention and executive control. Dichotic listening was assessed under three attentional conditions (non-forced, forced right ear and forced left) amongst older adults with normal cognitive function, MCI and dementia. We report two main findings: (a) The expected right ear advantage under non-forced conditions, was seen in controls and patients with dementia but not in people with MCI, who showed equal numbers of correct responses from both ears (i.e., a lack of asymmetry); (b) Performance under forced attentional conditions was significantly associated with disease progression (i.e., control > MCI > dementia) and performance on the cognitive tasks. The reduction in asymmetry on dichotic listening tasks may be a marker of MCI and reflect underlying compensatory mechanisms. Use of this test could aid stratification of patients with memory disorders. Whether abnormalities could predict dementia onset needs longitudinal investigation in a larger sample.

Associations between white matter hyperintensities, lacunes, entorhinal cortex thickness, declarative memory and leisure activity in cognitively healthy older adults: A 7-year study

IntroductionCerebral small vessel disease (cSVD) is a growing epidemic that affects brain health and cognition. Therefore, a more profound understanding of the interplay between cSVD, brain atrophy, and cognition in healthy aging is of great importance. In this study, we examined the association between white matter hyperintensities (WMH) volume, number of lacunes, entorhinal cortex (EC) thickness, and declarative memory in cognitively healthy older adults over a seven-year period, controlling for possible confounding factors. Because there is no cure for cSVD to date, the neuroprotective potential of an active lifestyle has been suggested. Supporting evidence, however, is scarce. Therefore, a second objective of this study is to examine the relationship between leisure activities, cSVD, EC thickness, and declarative memory. MethodsWe used a longitudinal dataset, which consisted of five measurement time points of structural MRI and psychometric cognitive ability and survey data, collected from a sample of healthy older adults (baseline N = 231, age range: 64–87 years, age M = 70.8 years), to investigate associations between cSVD MRI markers, EC thickness and verbal and figural memory performance. Further, we computed physical, social, and cognitive leisure activity scores from survey-based assessments and examined their associations with brain structure and declarative memory. To provide more accurate estimates of the trajectories and cross-domain correlations, we applied latent growth curve models controlling for potential confounders. ResultsLess age-related thinning of the right (β = 0.92, p<.05) and left EC (β = 0.82, p<.05) was related to less declarative memory decline; and a thicker EC at baseline predicted less declarative memory loss (β = 0.54, p<.05). Higher baseline levels of physical (β = 0.24, p<.05), and social leisure activity (β = 0.27, p<.01) predicted less thinning of right EC. No relation was found between WMH or lacunes and declarative memory or between leisure activity and declarative memory. Higher education was initially related to more physical activity (β = 0.16, p<.05) and better declarative memory (β = 0.23, p<.001), which, however, declined steeper in participants with higher education (β = –.35, p<.05). Obese participants were less physically (β = –.18, p<.01) and socially active (β = –.13, p<.05) and had thinner left EC (β = –.14, p<.05) at baseline. Antihypertensive medication use (β = –.26, p<.05), and light-to-moderate alcohol consumption (β = –.40, p<.001) were associated with a smaller increase in the number of lacunes whereas a larger increase in the number of lacunes was observed in current smokers (β = 0.30, p<.05). ConclusionsOur results suggest complex relationships between cSVD MRI markers (total WMH, number of lacunes, right and left EC thickness), declarative memory, and confounding factors such as antihypertensive medication, obesity, and leisure activitiy. Thus, leisure activities and having good cognitive reserve counteracting this neurodegeneration. Several confounding factors seem to contribute to the extent or progression/decline of cSVD, which needs further investigation in the future. Since there is still no cure for cSVD, modifiable confounding factors should be studied more intensively in the future to maintain or promote brain health and thus cognitive abilities in older adults.

67 Cognitive Reserve, Depressive Symptoms, and Functional Ability in Older Adults

Objective:Cognitive reserve has been linked to functional ability, and depression has been shown to be associated with more functional impairment in older adults. While cognitive reserve and depression are associated and have each been shown to impact functional impairment, the independent impact of cognitive reserve on functional ability after accounting for depressive symptoms has not been explored. For the purpose of this study, years of education served as a proxy for cognitive reserve, which is consistent with the literature. It was predicted that higher levels of education would be associated with better functional ability regardless of age and severity of depressive symptoms.Participants and Methods:Participants (ages 55 to 90) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (N=3407); participants with major depression were not included. Subsyndromal depressive symptoms were measured using the Geriatric Depression Scale (GDS &lt; 6) and functional impairment was assessed using the Functional Activities questionnaire. A three-stage hierarchical regression was conducted with functional ability as the dependent variable.Results:Age, entered at stage one of the regression model, was a significant predictor (F(1,1427) =49.75, p&lt;.001) and accounted for 3.4% of the variance in functional ability. Adding depressive symptoms to the regression model led to a significant increase in variance explained (F(1,1426) = 64.57, p&lt;.001), accounting for an additional 4.2% of the variance in functional ability. Adding years of education to the regression model explained an additional 1.4% of variance in functional ability and this increase in variance explained was significant (F(1,1425) = 22.53, p&lt;.001).Conclusions:Cognitive reserve (operationalized as higher levels of education) was associated with higher functional ability even after accounting for age and depressive symptoms.

9 Connecting memory and functional brain networks in older adults: a resting state fMRI study

Objective:Nonpathological aging has been linked to decline in both verbal and visuospatial memory abilities in older adults. Disruptions in resting-state functional connectivity within well-characterized, higherorder cognitive brain networks have also been coupled with poorer memory functioning in healthy older adults and in older adults with dementia. However, there is a paucity of research on the association between higherorder functional connectivity and verbal and visuospatial memory performance in the older adult population. The current study examines the association between resting-state functional connectivity within the cingulo-opercular network (CON), frontoparietal control network (FPCN), and default mode network (DMN) and verbal and visuospatial learning and memory in a large sample of healthy older adults. We hypothesized that greater within-network CON and FPCN functional connectivity would be associated with better immediate verbal and visuospatial memory recall. Additionally, we predicted that within-network DMN functional connectivity would be associated with improvements in delayed verbal and visuospatial memory recall. This study helps to glean insight into whether within-network CON, FPCN, or DMN functional connectivity is associated with verbal and visuospatial memory abilities in later life.Participants and Methods:330 healthy older adults between 65 and 89 years old (mean age = 71.6 ± 5.2) were recruited at the University of Florida (n = 222) and the University of Arizona (n = 108). Participants underwent resting-state fMRI and completed verbal memory (Hopkins Verbal Learning Test - Revised [HVLT-R]) and visuospatial memory (Brief Visuospatial Memory Test - Revised [BVMT-R]) measures. Immediate (total) and delayed recall scores on the HVLT-R and BVMT-R were calculated using each test manual’s scoring criteria. Learning ratios on the HVLT-R and BVMT-R were quantified by dividing the number of stimuli (verbal or visuospatial) learned between the first and third trials by the number of stimuli not recalled after the first learning trial. CONN Toolbox was used to extract average within-network connectivity values for CON, FPCN, and DMN. Hierarchical regressions were conducted, controlling for sex, race, ethnicity, years of education, number of invalid scans, and scanner site.Results:Greater CON connectivity was significantly associated with better HVLT-R immediate (total) recall (ß = 0.16, p = 0.01), HVLT-R learning ratio (ß = 0.16, p = 0.01), BVMT-R immediate (total) recall (ß = 0.14, p = 0.02), and BVMT-R delayed recall performance (ß = 0.15, p = 0.01). Greater FPCN connectivity was associated with better BVMT-R learning ratio (ß = 0.13, p = 0.04). HVLT-R delayed recall performance was not associated with connectivity in any network, and DMN connectivity was not significantly related to any measure.Conclusions:Connectivity within CON demonstrated a robust relationship with different components of memory function as well across verbal and visuospatial domains. In contrast, FPCN only evidenced a relationship with visuospatial learning, and DMN was not significantly associated with memory measures. These data suggest that CON may be a valuable target in longitudinal studies of age-related memory changes, but also a possible target in future non-invasive interventions to attenuate memory decline in older adults.

32 Associations between Childhood Attention Deficit Hyperactivity Disorder and Learning Disabilities and Cognition in Late Adulthood.

Objective:There has been relatively little research on the effect of childhood attention difficulties/weaknesses and learning disabilities/differences on cognitive aging. This study examined associations between self-reported symptoms and diagnoses/concerns of childhood attention deficit hyperactivity disorder (ADHD) and reading or math learning disabilities (LD) and cognitive abilities in older adulthood. We hypothesized that cognitive weaknesses in childhood would be associated with cognitive abilities later in life.Participants and Methods:The 25 individuals with healthy cognition or MCI were recruited from the greater Philadelphia area (Mage= 74.4; SD= 5.34; 40% men; 84%white) and completed a self-report questionnaire of childhood ADHD and LD. Specifically, participants rated their experience of ADHD symptoms of inattention and hyperactivity/impulsivity and indicated whether they had a past diagnosis of (or concerns regarding past) ADHD, math LD or language/reading LD Participants also completed tests of language, attention, episodic memory, executive function, and processing speed. Pearson or point-biserial correlation coefficients (r-values) indicating a medium effect size (.30 or greater) were interpreted as meaningful.Results:On average, participants reported 3.48 symptoms of inattention and 2.56 symptoms of hyperactivity/impulsivity (i.e., at least six symptoms from either category are consistent with diagnostic criteria for ADHD). 16% of the sample reported childhood ADHD/attention difficulties, 48% reported childhood math LD/math difficulties, and 32% reported childhood language LD/difficulties. On cognitive tests, the sample performed in the average range, with considerable variability (i.e., norm-based, demographically adjusted T-scores ranged from 20-74). The relation between cognitive scores and report of childhood ADHD symptoms was weak and non-significant correlation (r&lt;.18). By contrast, report of childhood ADHD/attention difficulties was associated with lower scores attention tests (r=.33). Report of childhood language LD/difficulties was associated with a worse overall cognitive composite (r=-.35) and executive function ability (r=-.35). Childhood math LD/difficulties was not meaningfully associated with lower scores on any of the cognitive tests administered. Unexpectedly, report of childhood cognitive difficulties also were associated with higher scores on cognitive tests, such that childhood ADHD/attention difficulties was associated with better performance on tests of episodic memory (r=.39), and childhood math LD/difficulties were associated with better performance on tests of language (r=-.37).Conclusions:Current cognitive abilities in older adults may be influenced by lifelong cognitive weakness and academic difficulties. A history of ADHD and LD/difficulties should be considered in clinical neuropsychological assessment and future research on cognitive aging should consider ADHD/LD from a lifespan, developmental framework.

Minimal short-term decline in functional performance and quality of life predicts better long-term outcomes for both in older Taiwanese adults after hip fracture surgery: a prospective study

BackgroundHip fracture can lead to long-term loss of mobility and self-care ability in older adults. Despite initial decreases in functional performance after hip fracture surgery, patients tend to gradually recover. However, recovery can vary, with some regaining their abilities quickly while others becoming functionally dependent. In this study, we investigated whether the level of short-term postoperative decline in activity of daily living (ADL) performance and quality of life (QoL) can predict the 1-year outcomes for both following hip fracture surgery in older Taiwanese adults.MethodsThis prospective cohort study included 427 older adults (≥ 60 years) who underwent hip fracture surgery at a single tertiary medical center in Taiwan between November 2017 and March 2021. We collected pre-fracture data, including the patients’ demographics, Charlson comorbidity index (CCI) scores, and responses to a questionnaire (Short Portable Mental State Questionnaire [SPMSQ]) for dementia screening. Moreover, their scores on the EuroQol-5D questionnaire (for evaluating QoL) and the Barthel Index (for assessing ADL performance) were collected at pre-fracture status and at 3- and 12-months following surgery. Changes in ADL and QoL three months post-surgery compared to pre-fracture status were evaluated, and the associations of these parameters (and other potential factors) with 1-year outcomes for ADL and QoL were investigated.ResultsWe analyzed the data of 318 patients with hip fracture and complete follow-up data regarding ADL performance and QoL at 3- and 12-months post-surgery. After adjusting for covariates, multivariate linear regression revealed that changes in ADL and QoL at 3 months post-surgery from pre-fracture status were positively and significantly associated with 1-year outcomes for both (p < .001 for both). Furthermore, pre-fracture CCI and SPMSQ scores were independent predictive factors associated with 1-year ADL outcomes (p = .042 and < .001, respectively).ConclusionsPatients who exhibit a smaller decline in functional performance and quality of life three months after hip fracture surgery from pre-fracture status are likely to have improved long-term ADL and QoL.Trial registration: TMU-JIRB N201709053.

Factors that predict hazard perception in older adult road-users: A systematic review

Background: Older adults are more likely to be at-fault and killed in road crashes, and this has been argued to be due to their declining hazard perception (HP). There has been no comprehensive review on what factors predict this decline in HP ability for older adults. Objectives: The aim of this systematic review is to identify any predictors of HP in older adults across all road-user types. Data Sources: The search was indexed in the Medline, PsycINFO, and Scopus during January 2022. Studies had to be peer reviewed and written in English language. Participants had to be road-users over the age of 60. Studies had to investigate a relationship between a predictor and HP. Results: 21 articles met the inclusion criteria, 20 for drivers and one for pedestrians. Seven predictors were examined. Results suggested that driving experience and auditory distraction were the most consistent predictors of HP. HP training for drivers significantly improved HP. Results were mixed for visual abilities, cognitive abilities, and age. Training for pedestrians was not a significant predictor of HP. Limitations: Grey literature was not reviewed. Conclusions: Whilst results related to age were mixed, most studies suggested that advancing age is associated with HP decline. Driving experience appeared to be a protective factor against decline in HP. Contrast and motion sensitivity may be important in identifying at-risk drivers. Cognitive function was not a consistent predictor of HP. Auditory distractors consistently negatively impacted HP. Results indicated that there could be potential benefits of HP training. There is a dearth of research into HP in vulnerable road user types. Implications: By identifying the predictors of HP, road safety strategies such as holistic training programs could be developed to assist with keeping older adult road-users safe. Future research is necessary to explore HP in older pedestrians, cyclists, and motorcyclists.

Regional White Matter Hyperintensities Relate to Specific Cognitive Abilities in Older Adults Without Dementia.

White matter hyperintensities (WMHs) are magnetic resonance imaging markers of small vessel cerebrovascular disease that are associated with cognitive decline and clinical Alzheimer disease. Previous studies have often focused on global or total WMH; less is known about associations of regional WMHs and cognitive abilities among older adults without dementia. A total of 610 older adults with normal cognition (n=302) or mild cognitive impairment (n=308) from the Alzheimer's Disease Neuroimaging Initiative underwent neuropsychological testing and magnetic resonance imaging. Linear regression models examined associations between regional WMH volumes and cognition, adjusting for age, sex, education, apolipoprotein E ε4 allele frequency, and pulse pressure. Among all participants, greater regional WMH volume in all lobes was associated with poorer performance on memory and speed/executive functioning. Among participants with normal cognition, greater temporal and occipital WMH volumes were associated with poorer memory, whereas no regional WMH volumes were associated with speed/executive function. Results show that greater regional WMH volume relates to poorer cognitive functioning-even among those with normal cognition. Together with results from previous studies, our findings raise the possibility that WMH may be a useful therapeutic target and/or important effect modifier in treatment or prevention dementia trials.

Enhancing Driving Ability in Older Adults through Health Exercises and Physical Activity: A Randomized Controlled Trial.

The global rise in the aging driving population has heightened concerns about traffic incidents involving this demographic. Beyond transportation, automobiles represent a vital lifeline for older adults, fostering social activities and influencing their health-related quality of life. This study explores improving and sustaining driving ability among older adults with anticipated declines through health-conscious exercises. Sixty-eight participants were randomly allocated into two groups. The exercise-oriented group (E-group) engaged in twelve 90 min health and exercise sessions over twelve weeks, while the control group (C-group) maintained their regular daily routines and did not receive any specific interventions during this period. The focal point of assessment was driving ability, as evaluated by a person using a real car on public roads without using a simulator. Driving ability and physical fitness were assessed before the intervention in both groups. Post-intervention measurements occurred twelve weeks after the initial gauging, encompassing both cohorts. Comparative analysis of pre- and post-intervention changes was executed between the two groups. The E-group demonstrated improved overall driving ability compared to the C-group. The results suggest that healthy exercise and physical activity may maintain and enhance driving ability for older adults.

Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial

ContextFalls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls.RationaleOlder people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls.ObjectiveThe aim is to assess the efficacy of an arm-in-arm gait-training program in older people.DesignThe arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial.ParticipantsWe will enroll 66 dyads of older people and their younger “gait instructors”. The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry.InterventionDyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks.OutcomesThe main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 – week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training.Expected resultsRecent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors.Trial registrationClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.

The effect of aerobic dancing on physical fitness and cognitive function in older adults during the COVID-19 pandemic-a natural experiment.

During the Coronavirus disease (COVID-19), the physical activity of older adults is at a lower level. The study aimed to examine the effectiveness of aerobic dancing on physical fitness and cognitive function in older adults. We conducted a randomized controlled trial with 34 older adults who were assigned into an aerobic dancing group and a control group. Three dance sessions weekly for 60​min were scheduled for the aerobic dancing group for a total of 12 weeks. Physical fitness, blood pressure, lipids, glucose, cognitive function were assessed before and after the intervention. Baseline adjusted Analysis of Covariance (ANCOVA) was used to determine whether outcome variables varied between groups at pre-test and post-test. Effect size (Cohen's d) was calculated to determine the differences between groups from baseline to post-test. After 12 weeks, we found that the aerobic dancing group showed significant improvement in memory (portrait memory: F​=​10.45, p​=​0.003, d​=​1.18). The Limit of Stability (LOS) parameters in the aerobic dancing group displayed a significant increase after the intervention (right angle: F​=​5.90, p​=​0.022, d​=​0.60; right-anterior angle: F​=​4.23, p​=​0.049, d​=​0.12). Some beneficial effects were found on flexibility, grip strength, balance and subjective well-being (sit and reach: F​=​0.25, p​=​0.62, d​=​-0.40; grip strength: F​=​3.38, p​=​0.08, d​=​0.89; one-legged standing with eyes closed: F​=​1.26, p​=​0.27, d​=​0.50) in the aerobic dancing group. Aerobic dancing training was effective in improving memory and balance ability in older adults during the COVID-19 pandemic in China. In the future, aerobic dancing is a promising tool to encourage physical activity in older adults.

Tai Chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trials.

As the population ages, the health of older adults is becoming a public health concern. Falls are a significant threat to their health due to weakened balance. This study aims to investigate the beneficial effects of Tai Chi on fall prevention and balance improvement in older adults. We conducted a systematic review and meta-analysis of randomized controlled trials related to Tai Chi, falls, and balance ability, searching PubMed, Embase, and Cochrane Library databases from their establishment until December 31, 2022. Two independent reviewers performed the search, screening of results, extraction of relevant data, and assessment of study quality. This study followed the PRISMA guidelines for systematic review and meta-analysis. Totally 24 RCTs were included for meta-analysis, and the results showed that Tai Chi can effectively reduce the risk of falls in older adults (RR: 0.76, 95% CI: 0.71 to 0.82) and decrease the number of falls (MD [95% CI]: -0.26 [-0.39, -0.13]). Tai Chi can also improve the balance ability of older adults, such as the timed up and go test (MD [95% CI]: -0.69 [-1.09, -0.29]) and the functional reach test (MD [95% CI]: 2.69 [1.14, 4.24]), as well as other balance tests such as single-leg balance test, Berg balance scale, and gait speed (p < 0.05). Subgroup analysis showed that Tai Chi is effective for both healthy older adults and those at high risk of falls (p < 0.001), and its effectiveness increases with the duration and frequency of exercise. In addition, the effect of Yang-style Tai Chi is better than that of Sun-style Tai Chi. Tai Chi is an effective exercise for preventing falls and improving balance ability in older adults, whether they are healthy or at high risk of falling. The effectiveness of Tai Chi increases with exercise time and frequency. Yang-style Tai Chi is more effective than Sun-style Tai Chi. https://clinicaltrials.gov/, identifier CRD42022354594.

The retrogenesis of age-related decline in declarative and procedural memory.

The retrogenesis hypothesis proposes that the order of breakdown of cognitive abilities in older adults is the reverse of the developmental order of children. Declarative and procedural memory systems, however, have been empirically understudied regarding this issue. The current study aimed to investigate whether retrogenesis occurs in the developmental and decline order of the declarative and procedural memory systems. Besides, we further investigated whether retrogenesis occurs in declarative memory, which was tested through the recognition of familiar and unfamiliar items. Both questions were investigated by looking at 28 Chinese younger adults and 27 cognitively healthy Chinese older adults. The recognition memory task and the Serial Reaction Time Task were administered on two consecutive days in order to measure their declarative and procedural memory, respectively. The results showed older adults performed significantly worse than younger adults for both tasks on both days, suggesting a decline in both declarative and procedural memory. Moreover, older adults exhibited relatively preserved declarative memory compared to procedural memory. This does not follow the expectations of the retrogenesis hypothesis. However, older adults demonstrated superior performance and a steeper rate of forgetting for recognizing familiar items than unfamiliar items. This reverses the developmental order of different patterns in the declarative memory system. Overall, we conclude that retrogenesis occurs in the declarative memory system, while does not in the decline order of the two memory systems; this understanding can better help inform our broader understanding of memory aging.