Age Dependence Research Articles

Factors Associated With Caregiver Burden in Family Caregivers of Older Adults: A Cross-Sectional Study.

This study aimed to assess caregiver burden and identify factors associated with caregiver burden among family caregivers of older adults. This cross-sectional study included 140 older adults and their family caregivers. The study was conducted between February and November 2020 at a hospital in İstanbul. Data were collected using the Zarit Burden Interview (ZBI), Multidimensional Scale of Perceived Social Support (MSPSS), General Health Questionnaire-12 (GHQ-12), and Katz Activities of Daily Living Scale (Katz ADL). The mean age of the caregivers was 49.20 ± 10.75 years, and 72.9% were female. The mean ZBI score was 30.65 ± 9.31. Katz Activities of Daily Living Scale (β = -.579, p < .001), older adults' age (β = -.462, p < .001), caregiver's gender (β = .250, p < .001), MSPSS (β = -.195, p < .01), whether the caregiver had regular health check-ups (β = -.156, p < .05), and GHQ-12 (β = .147, p < .05) were found to be significant predictors of caregiver burden respectively. These variables explain 56.3% of the total variance for the caregiver burden (R2 = .563, p < .001). Being a female caregiver and experiencing poor mental health were associated with a higher caregiver burden. Regular health check-ups received by caregivers and good social support were associated with a lower caregiver burden. Older age and higher dependency of older adults were associated with a lower caregiver burden. Based on these findings, there is a need for interventions and social policies aimed at reducing caregiver burden among family caregivers of older adults.

COVID-19 latent age-specific mortality in US states: a county-level spatio-temporal analysis with counterfactuals

During the COVID-19 pandemic, which spanned much of 2020–2023 and beyond, daily case and death counts were recorded globally. In this study, we examined available mortality counts and associated case counts, with a focus on the estimation missing information related to age distributions. In this paper, we explored a model-based paradigm for generating age distributions of mortality counts in a spatio-temporal context. We pursued this aim by employing Bayesian spatio-temporal lagged dependence models for weekly mortality at the county level. We compared three US states at the county level: South Carolina (SC), Ohio, and New Jersey (NJ). Models were developed for mortality counts using Bayesian spatio-temporal constructs, incorporating both dependence on current and cumulative case counts and lagged dependence on previous deaths. Age dependence was predicted based on total deaths in proportion to population estimates. This latent age field was generated as counterfactuals and then compared to observed deaths within age groups. The optimal retrospective space–time models for weekly mortality counts were those with lagged dependence and a function of caseload. Added random effects were found to vary across states: Ohio favored a spatially correlated model, while SC and NJ favored a simpler formulation. The generation of age-specific latent fields was performed for SC only and compared to a 15-month, 13-county data set of observed &amp;gt;65 age population. It is possible to model spatio-temporal variations in mortality at the county level with lagged dependencies, spatial effects, and case dependencies. In addition, it is also possible to generate latent age-specific fields based on estimates of death risk (using population proportions or more sophisticated modeling approaches). More detailed data will be needed to make more calibrated comparisons for future epidemic monitoring. The proposed discrepancy tool could serve as a useful resource for public health planners in tailoring interventions during epidemic situations.

Is the age pension in Australia sustainable and fair? Evidence from forecasting the old-age dependency ratio using the Hamilton-Perry model

The age pension aims to assist eligible elderly Australians who meet specific age and residency criteria in maintaining basic living standards. In designing efficient pension systems, government policymakers seek to satisfy the expectations of the overall aging population in Australia. However, the population’s unique demographic characteristics at the state and territory level are often overlooked due to the lack of available data. We use the Hamilton-Perry model, which requires minimum input, to model and forecast the evolution of age-specific populations at the state and territory level. We also integrate the obtained sub-national demographic information to determine sustainable pension ages up to 2051. We also investigate pension welfare distribution in all states and territories to identify the disadvantaged residents under the current pension system. Using the sub-national mortality data for Australia from 1971 to 2021 obtained from AHMD (2023), we implement the Hamilton-Perry model with the help of functional time series forecasting techniques. With the forecasts of age-specific population sizes for each state and territory, we compute the old age dependency ratio to determine the nationwide sustainable pension age.

RNA sequencing comparing centenarian and middle-aged women lymphoblastoid cell lines identifies age-related dysregulated expression of genes encoding selenoproteins, heat shock proteins, CD99, and BID.

Women typically live longer than men, and constitute the majority of centenarians. We applied RNA-sequencing (RNA-seq) of blood-derived lymphoblastoid cell lines (LCLs) from women aged 60-80 years and centenarians (100-105 years), validated the RNA-seq findings by real-time PCR, and additionally measured the differentially expressed genes in LCLs from young women aged 20-35 years. Top RNA-seq genes with differential expression between the age groups included three selenoproteins (GPX1, SELENOW, SELENOH) and three heat shock proteins (HSPA6, HSPA1A, HSPA1B), with the highest expression in LCLs from young women, indicating that young women are better protected from oxidative stress. The expression of two additional genes, BID encoding BH3-interacting domain death agonist and CD99 encoding CD99 antigen, showed unique age dependence, with similar expression levels in young and centenarian women while exhibiting higher and lower expression levels, respectively, in LCLs from women aged 60-80 years compared with the two other age groups. This age-related differential expression of BID and CD99 suggests elevated inflammation susceptibility in middle-aged women compared with either young or centenarian women. Our findings, once validated with human peripheral blood mononuclear cells and further cell types, may lead to novel healthy aging diagnostics and therapeutics.

Impact of the Extent of Population Aging on Economic Development and Countermeasure

With the comprehensive prosperity and development of human society, human life expectancy shows a rising trend, fertility rate shows a declining trend, the world is facing a severe problem of population aging, the ensuing economic impact is the focus we need to pay attention to. Taking various countries and regions in the world from 1960 to 2019 as samples, this paper conducted an empirical test on transnational panel data and found that old age dependency would significantly hinder economic growth. The conclusion remained valid after the robustness test of replacing explanatory variables, instrumental variable method and changing sample interval. Further study found that old-age dependency ratio will also significantly reduce consumption expenditure. Based on this, this paper gets inspiration and puts forward corresponding policy suggestions to mitigate the adverse impact of population aging on China's social and economic development.

Different copula types and reliability applications for a new fisk probability model

In this research endeavor, the authors introduce a novel lifetime probability model. This distribution is meticulously examined and characterized, offering insights into its behavior and applicability in various contexts. The proposed new density function of this distribution has various heavy tail forms that are useful in the field of reliability, insurance and statistical modeling. This allows for the representation and modeling of a wide range of data sets that are diverse in their form and nature. The new distribution is characterized by having different patterns of risk or failure rates. The researchers extend the new distribution to the bivariate domain through different methods, including the Morgenstern-Farley-Gumbel distribution, the modified Morgenstern-Farley-Gumbel distribution, the famous Clayton mathematical versions, and the Rennie versions. These extensions enhance the usefulness of the proposed distribution in modeling multivariate age and reliability data and dependencies between variables. The study presents some statistical modeling experiments on reliability data and some important comparisons are presented within the framework of some statistical comparison criteria.

An inquiry into the causes of income differences among high-income countries

Within high-income countries, there is a notable income inequality spectrum, with certain nations positioned close to a predefined economic threshold, while others within this cohort simultaneously embark on substantial economic growth. This study investigates the influence of critical factors on economic growth and the transition from lower-high and middle-high income to upper-high income. Between 1990 and 2019, 25 of the 28 nations successfully advanced to upper-high income levels. Several key factors contribute to overcoming the barriers associated with lower-high income or middle-high income to upper-high income status. These factors include labor force participation, labor productivity, life expectancy, high-tech exports, reduction in unemployment rates, age dependency ratio, and poverty. The regression discontinuity analysis reveals a positive impact on the experimental group, as economic globalization surpasses the threshold of 78 % facilitating the achievement of upper-high income status.

7280 Pituitary Dysfunction Following Mild Traumatic Brain Injury in Female Athletes: Neuropsychological and Psychological Functioning

Abstract Disclosure: L.Ó. Eggertsdóttir Claessen: None. M.K. Jónsdóttir: None. H. Kristjánsdóttir: None. S.H. Lund: None. I. Unnsteinsdóttir Kristensen: None. H.Á. Sigurjónsdóttir: None. Background: Pituitary dysfunction (PD), as well as neuropsychological and psychological symptoms, have been reported following mild traumatic brain injury (mTBI). These symptoms may be due to the brain injury itself or PD as hypopituitarism (HP) can have neuropsychological and psychological effects. To the best of our knowledge, this study is the first to report neuropsychological and psychological outcomes in female athletes with PD following sport-related mTBI. Subjects: Female athletes aged 18 to 45 years currently active in or retired from soccer, team handball, basketball, ice hockey, and martial arts who answered an online questionnaire regarding mTBI history and mental health were included (n = 508). Of the 308 women who reported one or more mTBI, 166 (53.8%) accepted to participate in a further interview and neuropsychological tests. All 166 women were subsequently invited to participate in a medical interview. Of those 151 accepted (90.9%) and 131 (86.7%) of them participated in pituitary hormone screening blood tests (SBT). Methods: The online questionnaire included a post-concussion symptom scale, and mental health scales evaluating symptoms of anxiety, depression, stress, and quality of life. Sleep disturbances were evaluated, and neuropsychological tests were performed in the psychological interview. The Sustained Attention to Response Task (SART). Executive functioning, visual search, motor and processing speed, divided attention, working memory, and intellectual abilities were also measured. The SBT were taken at 8 a.m. and included S-IGF1 (age dependant reference range), S-cortisol (values &amp;lt; 350 nmol/L were considered abnormal), S-prolactin (reference range 4.79 - 23.3 μg/L), S-TSH (reference range 0.270 - 4.20 mIU/L), S-fT4 (reference range 12 - 22 pmol/L), S-FSH, S-oestrogen, and S-progesterone measurements. If SBT were repeatedly O-RV, detailed endocrinological tests were performed for each axis as indicated. Results: Following a detailed endocrinological evaluation, 16 women were diagnosed with PD (HP n = 6, hyperprolactinemia n = 10) following mTBI. Women with PD had a significantly higher mean SART error score than women with normal pituitary function (PF) (16.7 and 12.8 respectively; p = 0.04). No other significant differences in neuropsychological outcome were found between the two groups. Moreover, there was not a significant difference with regards to mTBI symptoms, anxiety, depression, stress, QOL or insomnia between women with PD and those with normal PF. Conclusions: Sustained attention or inhibitory performance may be affected in women with PD following mTBI as they had a higher mean SART error score than women with normal PF. No other significant difference in neuropsychological or psychological outcome was demonstrated. Presentation: 6/3/2024

Population age structure dependency of the excess mortality P-score

BackgroundSince the outbreak of the COVID-19 pandemic, the excess mortality P-score has gained prominence as a measure of pandemic burden. The P-score indicates the percentage by which observed deaths deviate from expected deaths. As the P-score is regularly used to compare excess mortality between countries, questions arise regarding the age dependency of the measure. In this paper we present formal and empirical results on the population structure bias of the P-score with a special focus on cross-country comparisons during the COVID-19 pandemic in Europe.MethodsP-scores were calculated for European countries for 2021, 2022, and 2023 using data from the 2024 revision of the United Nations’ World Population Prospects and the HMDs Short Term Mortality Fluctuations data series. The expected deaths for 2021, 2022, and 2023 were estimated using a Lee–Carter forecast model assuming pre-pandemic conditions. P-score differences between countries were decomposed using a Kitagawa-type decomposition into excess-mortality and structural components. To investigate the sensitivity of P-score cross-country rankings to differences in population structure we calculated the rank-correlation between age-standardized and classical P-scores.ResultsThe P-score is an average of age-specific percent excess deaths weighted by the age-distribution of expected deaths. It can be shown that the effect of differences in the distribution of deaths only plays a marginal role in a European comparison. In most cases, the excess mortality effect is the dominant effect. P-score rankings among European countries during the COVID-19 pandemic are similar under both age-standardized and classical P-scores.ConclusionsAlthough the P-score formally depends on the age-distribution of expected deaths, this structural component only plays a minor role in a European comparison, as the distribution of deaths across the continent is similar. Thus, the P-score is suitable as a measure of excess mortality in a European comparison, as it mainly reflects the differences in excess mortality. However, this finding should not be extrapolated to global comparisons, where countries could have very different death distributions. In situations were P-score comparisons are biased age-standardization can be applied as a solution.

Clinical structure and features of the course of pain and non-specific somatoform disorders in adolescent children

Annotation. The research is devoted to the study of clinical signs of painful and nonspecific somatoform disorders in children of early and late adolescence, depending on sex, place of residence, and study. The study examined 56 adolescent children with pain and non-specific syndromes who were treated in the MNP “Khmelnytskyi Regional Children's Hospital” of the Khmelnytskyi Regional Council and in the MP “Khmelnytskyi City Children’s Hospital” of the Khmelnytsky City Council. The average age of the children was 14,0±4,53 years. Among them, children of early adolescence (10-14 years) accounted for 57.2%, and late adolescence (15 years 11 months 28 days) – 42.8%. The clinical signs of pain and nonspecific somatoform disorders in the children we examined were as follows: headache, thermoregulation disorder, fibromyalgia and arthralgia syndrome, nonspecific back pain, asthenic syndrome with decreased work capacity, increased meteorological sensitivity, and impaired concentration. Nonspecific persistent pain syndrome occurred in 56 children, in particular, cephalic pain – in 77.4 %, polyarthralgia – in 8.9%, fibromyalgia syndrome – in 8.5%, nonspecific back pain – in 13.4% of children; thermoregulatory disorders were identified in 42.7%, asthenic syndrome – in 35.3% of children. It shows that among pain somatoform disorders, headache, in particular, tension headache and migraine, occupies the first rank in children. Stress, tension, and sleep disturbances were predominant among the triggering factors. Therefore, among adolescent children with painful and non-specific somatoform disorders, cephalalgia, with a predominance of tension headaches, and long daytime low fevers are most often diagnosed, as a manifestation of autonomic somatoform dysfunctions with impaired thermoregulation. At the same time, migraine, episodic symptoms associated with migraine, as well as trigeminal variants of headache and long-term pain of other localization were found in isolated cases. The age dependence of primary headache has been revealed: tension headaches occur more often in children of early adolescence, and migraines in children of older adolescence, which is important to consider in the differential diagnosis of headaches, since the treatment and prevention of attacks of these forms of headache are completely different.

Not the average farmer: Heterogeneity in Dutch arable farmers’ intentions to reduce pesticide use

Ambitious environmental policies and regulations in Europe aim to reduce pesticide use, yet their implementation faces significant obstacles. Effective strategies that gain support within the farming community require a deeper understanding of the underlying intentions, considering that farmers are a heterogeneous group with diverse beliefs related to socio-demographic characteristics. Using an existing dataset with theory of planned behaviour data from 359 Dutch arable farmers (Bakker et al., 2021), we examined the heterogeneity in intentions and beliefs regarding pesticide reduction. Expanding the analysis with quantile regression models, we show that the influence of attitude becomes increasingly important as farmers' aspirations to reduce pesticide use grow. Additionally, we observed a small positive effect of injunctive norms at the 25th quantile and a small negative effect at the 75th quantile of intention. These findings indicate that the relative impact of these constructs varies across the intention distribution, emphasising the need for more nuanced quantitative analyses of heterogeneity in TPB studies. Using moderation models, we observed variations in the relative impact of attitude, injunctive and descriptive norms on intention across different segments of the farming community, particularly concerning age, educational level, and farm income dependencies. Younger, higher-educated farmers, and those less reliant on farm income demonstrated greater openness towards reducing pesticide usage and adopting alternative crop protection practices. These findings suggest that different farmer segments may respond differently to interventions and incentives. Policymakers can leverage this knowledge to develop more nuanced and targeted strategies that promote pesticide reduction while aligning with the diverse motivations and beliefs present among farmers.

Oncological outcomes of stage I–II breast cancer treatment after subcutaneous/skin-sparing mastectomies with reconstruction

Aim. To study the recurrence of stage I–II breast cancer after subcutaneous/skin-sparing mastectomies with reconstruction with or without radiation therapy. Materials and methods. From 2013 to 2022, 984 patients diagnosed with breast cancer underwent 1020 subcutaneous/skin-sparing mastectomies with reconstruction at the P.A. Herzen Moscow State Medical Institute. Histological types are presented: cancer in situ – 7, invasive cancer without signs of specificity – 818, invasive lobular cancer – 105, combined cancer – 40, rare forms – 50. Subcutaneous mastectomy with reconstruction was performed in 617 (60.5 %), skin-sparing mastectomy in 403 (39.5 %) cases. Reconstruction with own tissues was performed in 5.7 %, expanders/implants in 94.3 % of patients. Patients with diagnosed mutations in the genes ВRCА1, 2, СНЕК2 amounted to 208 (21.1 %), while among patients with primary multiple synchronous cancer, the percentage with mutations was 25 %. Results. In the studied group of patients, recurrence of breast cancer was diagnosed in 40 (4.1 ± 0.1 %) cases, distant metastases – in 52 (5.3 ± 0.1 %) cases. The minimum time to relapse was 36 months, and the maximum was 108 months. In a single-factor analysis of the stage of the disease: at stage I, relapse was diagnosed in 25 (5.8 %) cases, at stage IIA (T2N0M0) – in 5 (2.0 %), at stage IIA (T1N1M0) – in 6 (4.2 %), at stage IIB T2N1M0 – in 4 (2.1 %) (p &gt; 0.05). The recurrence in the group with radiation therapy was 2.5 ± 0.6 (odd ratio 0.98, 95 % confidential interval 1.52–3.48), without radiation therapy 5.1 % (odd ratio 2.13, 95 % confidential interval 0.92–5.18) regardless of the stage of breast cancer (t-criterion &gt;2, p &gt; 0.05). In our study, the recurrence of breast cancer at the edge of R1 was 6.8 ± 2.5 %, at R0 – 3 ± 0.6 % (p &gt; 0.05). When analyzing age and risk of recurrence, we did not identify age dependence, up to 40 years the probability of recurrence is 4.3 ± 1 %, after 40 years – 3.3 ± 0.7 % (t-criterion 0.44, p &gt; 0.05). The dependence of the degree of malignancy of the tumor node and the frequency of recurrence is as follows: G1 – 2. 3 ± 2.3 %, G2 – 3 ± 0.7 %, G3 – 3.9 ± 1 %, when compared G3 c G1 (t-criterion 0.52, p&gt;0.05), when comparing G3 from G2 (t-criterion 0.49, p &gt; 0.05). Recurrence of breast cancer with triple negative type was diagnosed in 2.5 ± 0.9 % relative to other molecular biological types (t-criterion 1.49, p &gt; 0.05). We analyzed the dependence of relapse on the non-luminal and luminal HER2 positive types; the relapse was 5.4 ± 1.5 % (p &gt; 0.05); the dependence on the level of Ki-67; at a level of 40 %, the probability of recurrence is 4 ± 0.8 %, at a level &gt; 40 %, recurrence is 2 ± 0.8 % (t-criterion 1.77, p &gt; 0.05). A statistically significant difference in our study was revealed, in addition to radiation therapy, during neoadjuvant polychemotherapy, so in the group with neoadjuvant polychemotherapy, the recurrence was 2 ± 0.8 %, without neoadjuvant polychemotherapy – 4.1 ± 0.7 % (t-criterion 2.16, р &lt; 0.05). Conclusion. A link between breast cancer recurrence and morphological features (R1 resection margin, lymphovascular invasion, lymphatic tumor emboli, luminal and non-luminal HER2+ subtype, G3) and clinical characteristics (presence of mutations, location of a lesion in the gland, stages) was found. Further search for predictors of breast cancer recurrence after combination or integrated treatment is necessary.

Longitudinal analysis of social and community factors effective in increasing the number of liver donors in the United States.

In this research, it was aimed to evaluate of social and community factors effective in increasing the number of liver donors. Descriptive and relational scanning models were used to conduct the research. Data on liver donors was gathered from the USA Health Resources & Services Administration's Organ Procurement and Transplantation Network between 1988 and 2023. The United States (USA) World Bank Country Reports provided the mortality rates. The data was analyzed using Spearman rho correlation, year-controlled partial correlation, and Generalized Linear Model-Logit analysis. Deceased donor numbers were significantly and negatively correlated with government health expenditure (r = -0.816; P < .01), current health expenditure (r = -0.768; P < .01), female education attainment (r = -0.804; P < .01) and Gini index (r = 0.434; P < .05). Living donor numbers were significantly and negatively correlated with government health expenditure (r = -0.731; P < .01), current health expenditure (r = -0.781; P < .01), male percentage (r = -0.786; P < .01), female education attainment (r = -0.640; P < .05), employment (r = 0.751; P < .01), GDP (r = -0.792; P < .01) and Gini index (r = -0.486; P < .01). Living donor numbers were significantly and positively correlated with age dependency (r = 0.815; P < .01). Generalized Linear Model-Logit (GLM-L) results showed that effect of female education attainment had significant contribution on deceased liver donor (B = -3290.605; P < .01). Effects of significantly correlated community factors on living liver donor numbers were found to be statistically insignificant (P > .05). Research findings reveal that among community factors, especially women's participation in education has a statistically significant effect on liver donors. These results show that the health expenditures made over the years do not provide any added value for liver donors, and role of women on liver donor is significantly dominant.

DNA Adductomics: A Narrative Review of Its Development, Applications, and Future.

DNA adductomics is the global study of all DNA adducts and was first proposed in 2006 by the Matsuda group. Its development has been greatly credited to the advances in mass spectrometric techniques, particularly tandem and multiple-stage mass spectrometry. In fact, liquid chromatography-mass spectrometry (LC-MS)-based methods are virtually the sole technique with practicality for DNA adductomic studies to date. At present, DNA adductomics is primarily used as a tool to search for DNA adducts, known and unknown, providing evidence for exposure to exogenous genotoxins and/or for the molecular mechanisms of their genotoxicity. Some DNA adducts discovered in this way have the potential to predict cancer risks and/or to be associated with adverse health outcomes. DNA adductomics has been successfully used to identify and determine exogenous carcinogens that may contribute to the etiology of certain cancers, including bacterial genotoxins and an N-nitrosamine. Also using the DNA adductomic approach, multiple DNA adducts have been observed to show age dependence and may serve as aging biomarkers. These achievements highlight the capability and power of DNA adductomics in the studies of medicine, biological science, and environmental science. Nonetheless, DNA adductomics is still in its infancy, and great advances are expected in the future.

Secondary solid malignancies in long-term survivors after total body irradiation

BackgroundTotal body irradiation (TBI)-based allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for selected patients with acute myeloid leukemia (AML). Yet, secondary malignancies contribute to long-term morbidity and mortality with TBI potentially influencing these risks.MethodsThis retrospective study analyzed the cumulative incidences of secondary solid malignancies and precancerous lesions of 89 consecutive AML patients after TBI-based conditioning before 1st allo-HSCT between 2000 and 2016. TBI was performed with an average dose rate of 4 cGy/min and a twice-daily fractionation. Cause-specific hazard models analyzed risk factors for secondary malignancies/precancerous lesions and the competing risks of dying before developing secondary malignancies/precancerous lesions.ResultsThe median patient age at TBI was 42.5 years (interquartile range, 32.5–51.2), while the median follow-up was 15.2 years (interquartile range, 13.0-18.2). Most patients received a myeloablative conditioning (MAC) containing 8 Gy (n = 47) and 12 Gy TBI (n = 11). Reduced-intensity regimens (RIC, 4 Gy TBI) were applied in 31 patients. Of note, patients receiving RIC were older than patients receiving MAC. The most common cancer types were non-squamous cell carcinomas (n = 14) after exclusion of a patient diagnosed with sarcoma within less than a year after TBI. The cumulative incidences of secondary malignancies and precancerous lesions were 8% (95%CI, 4–16), 14% (95%CI, 7–23), and 17% (95%CI, 9–27) at 10, 15 and 20 years, while the cumulative incidences of premature deaths were 59% (95%CI, 48–69), 59% (95%CI, 48–69), and 64% (95%CI, 49–76). In multivariate analyses, higher patient age at TBI was associated with lower rates of secondary malignancies/precancerous lesions, while higher patient age translated into a trend towards premature deaths (before patients could develop malignancies). Higher TBI doses, mainly applied in younger patients, translated into lower rates of secondary malignancies/precancerous lesions while lacking associations with mortality. Chronic GVHD requiring systemic immunosuppression was associated with premature deaths.ConclusionsAlthough this study indicates an inverse relationship between TBI doses applied and treatment-related malignancies, confounding by competing risks is present. The age dependency may be explained by the fact that older patients had a lower life expectancy independent of malignancies, illustrating the pitfalls of competing risks.Trial registrationThe study was retrospectively registered.

Age dependence of the average refractive index of the isolated human crystalline lens.

We measured the average group refractive index (RI) of 120 isolated lenses from 120 human donors (age: 0.03 to 61 years). The average group RI was calculated from a measurement of the optical thickness of the lens using optical coherence tomography and the apparent window shift of the test chamber caused by the lens. The estimated measurement uncertainty was ±0.004. The group RI at 880 nm was converted to phase RI at 589 nm using the dispersion equation of water and protein. From 2 to 61 years, the mean value of the RI was 1.415 ± 0.002 (group index at 880 nm) and 1.406 ± 0.002 (phase index at 589 nm) independent of age (p = 0.774). Two lenses from donors of age 0.33 and 3 months had significantly lower RI (group index: 1.405 and 1.403; phase index: 1.396 and 1.394). From age 2 to 61, the average lens RI is constant with age within the measurement uncertainty (±0.004).

The frailty among suburban elderly population after one-year COVID-19 pandemic in Cirebon Regency, Indonesia

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has had significant impacts worldwide, especially among older adults. Frailty is a determinant of susceptibility to morbidity and mortality due to COVID-19 in the elderly. This study aimed to determine frailty status and identify factors associated with the suburban elderly population in Cirebon Regency, Indonesia, after the one-year COVID-19 pandemic. Methods A cross-sectional study of community-dwelling individuals aged ≥ 60 years was conducted in Klangenan, Cirebon Regency, Indonesia, from March to June 2021. A questionnaire was used to determine the baseline characteristics of participants, healthcare access, comorbidity, and frailty status. The Ina-FRAIL scale was used to determine the frailty status (frail/non-frail). The chi-square test and logistic regression analysis were used to determine the association between independent variables and frailty. Results A total of 383 participants were recruited, with a median age of 67 (IQR 64-73) years. The prevalence of frailty in the present study was 10.2%. Multivariate analysis showed that age (OR 2.73; 95%CI 1.21-6.12), multimorbidity (OR 7.86; 95% CI 3.01-20.57) and financial dependence (OR 13.40, 95% CI 5.66-31.73) were significantly associated with frailty. Conclusion One-year COVID-19 pandemic has had a considerable burden on frailty among the suburban elderly population in Indonesia. The factors associated with frailty were age, multimorbidity, and financial dependence.

Measurement of blood-brain barrier water exchange rate using diffusion-prepared and multi-echo arterial spin labelling: Comparison of quantitative values and age dependence.

Water exchange rate (Kw) across the blood-brain barrier (BBB) is an important physiological parameter that may provide new insight into ageing and neurodegenerative disease. Recently, two non-invasive arterial spin labelling (ASL) MRI methods have been developed to measure Kw, but results from the different methods have not been directly compared. Furthermore, the association of Kw with age for each method has not been investigated in a single cohort. Thirty participants (70% female, 63.8 ± 10.4years) were scanned at 3T with Diffusion-Prepared ASL (DP-ASL) and Multi-Echo ASL (ME-ASL) using previously implemented acquisition and analysis protocols. Grey matter Kw, cerebral blood flow (CBF) and arterial transit time (ATT) were extracted. CBF values were consistent; approximately 50 ml/min/100 g for both methods, and a strong positive correlation in CBF from both methods across participants (r = 0.82, p < 0.001). ATT was significantly different between methods (on average 147.7ms lower when measured with DP-ASL compared to ME-ASL) but was positively correlated across participants (r = 0.39, p < 0.05). Significantly different Kw values of 106.6±19.7min-1 and 306.8±71.7min-1 were measured using DP-ASL and ME-ASL, respectively, and DP-ASL Kw and ME-ASL Kw were negatively correlated across participants (r = -0.46, p < 0.01). Kw measured using ME-ASL had a significant linear relationship with age (p < 0.05). In conclusion, DP-ASL and ME-ASL provided estimates of Kw with significantly different quantitative values and inconsistent dependence with age. We propose future standardisation of modelling and fitting methods for DP-ASL and ME-ASL, to evaluate the effect on Kw quantification. Also, sensitivity and bias analyses should be performed for both approaches, to assess the effect of varying acquisition and fitting parameters. Lastly, comparison with independent measures of BBB water transport, and with physiological and clinical biomarkers known to be associated with changes in BBB permeability, are essential to validate the ASL methods, and to demonstrate their clinical utility.

Design, develop, and implement the strategic information system on health, dependence, and healthy aging: an analysis of the Mexican experience

BackgroundThe Decade of Healthy Aging (2021–2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging.MethodsThe system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information.ResultsA total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators.ConclusionsSIESDE is an effective system for providing an overall view of health, aging, and functional dependence.

Neurofilament Light Chain Serum Levels Mirror Age and Disability in Secondary Progressive Multiple Sclerosis: A Cross-Sectional Study.

To assess neurofilament light chain serum (sNfL) levels in patients with secondary progressive multiple sclerosis (SP-MS). Using a single molecule array, we analyzed sNfL levels in a cross-sectional cohort study of 153 patients with SP-MS hospitalized for rehabilitation in a clinic specialized in the care for patients with multiple sclerosis (MS). In addition, we investigated the correlation of disease activity with sNfL levels in 36 patients with relapsing-remitting MS (RR-MS). Mean sNfL levels in patients with SP-MS were consistently elevated when compared with age-matched controls and patients with RR-MS. In SP-MS, age dependency of sNfL levels was pronounced, whereas patients with RR-MS younger than 41 years without recent disease activity were not distinguishable from age-matched healthy controls. In a multivariate analysis, clinical disability was a risk factor for elevated sNfL levels in SP-MS, whereas no correlation with comorbidities, such as cardiovascular disease, diabetes mellitus, smoking status, or vitamin D serum levels, could be detected. These findings highlight that measurement of sNfL levels represents a useful tool to assess the extent of neuroaxonal damage as a surrogate for clinical progression in patients with SP-MS, when age and disease activity as major confounders are taken into account.