Decline In Age Research Articles

Contributions of loneliness to cognitive impairment and dementia in older adults are independent of other risk factors and Alzheimer's pathology: a narrative review.

Loneliness significantly contributes to cognitive impairment and dementia in older adults. Loneliness is a distressing feeling resulting from a perceived lack of social connection (i.e., a discrepancy between desired and actual social relationships), while social isolation is a related term that can be defined by number and type of social relationships. Importantly, loneliness is distinct from social isolation in that it is associated with a distressing self-perception. The primary focus of this narrative review is the impact of chronic loneliness on cognitive impairment and dementia among older adults. Loneliness has a significant association with many factors that are related to worse cognition, and therefore we include discussion on health, mental health, as well as the physiological effects of loneliness, neuropathology, and potential treatments. Loneliness has been shown to be related to development of dementia with a hazard ratio (HR) risk comparable to having a single APOE4 gene. The relationship of dementia to loneliness appears to be at least partially independent of other known dementia risk factors that are possibly associated with loneliness, such as depression, educational status, social isolation, and physical activity. Episodic memory is not consistently impacted by loneliness, which would be more typically impaired if the mild cognitive impairment (MCI) or dementia was due to Alzheimer's disease (AD) pathology. In addition, the several longitudinal studies that included neuropathology showed no evidence for a relationship between loneliness and AD neuropathology. Loneliness may decrease resilience, or produce greater cognitive change associated with the same level of AD neuropathology. Intervention strategies to decrease loneliness in older adults have been developed but need to consider key treatment targets beyond social isolation. Loneliness needs to be assessed in all studies of cognitive decline in elders, since it significantly contributes to the variance of cognitive function. It will be useful to better define the underlying mechanism of loneliness effects on cognition to determine if it is similar to other psychological factors related to excessive stress reactivity, such as neuroticism or even depression, which are also associated with cognitive decline. It is important from a health perspective to develop better strategies to decrease loneliness in older adults.

Cretan Aging Cohort-Phase III: Methodology and Descriptive Characteristics of a Long-Term Longitudinal Study on Predictors of Cognitive Decline in Non-Demented Elderly from Crete, Greece.

Identifying modifiable factors that may predict long-term cognitive decline in the elderly with adequate daily functionality is critical. Such factors may include poor sleep quality and quantity, sleep-related breathing disorders, inflammatory cytokines and stress hormones, as well as mental health problems. This work reports the methodology and descriptive characteristics of a long-term, multidisciplinary study on modifiable risk factors for cognitive status progression, focusing on the 7-year follow-up. Participants were recruited from a large community-dwelling cohort residing in Crete, Greece (CAC; Cretan Aging Cohort). Baseline assessments were conducted in 2013-2014 (Phase I and II, circa 6-month time interval) and follow-up in 2020-2022 (Phase III). In total, 151 individuals completed the Phase III evaluation. Of those, 71 were cognitively non-impaired (CNI group) in Phase II and 80 had been diagnosed with mild cognitive impairment (MCI). In addition to sociodemographic, lifestyle, medical, neuropsychological, and neuropsychiatric data, objective sleep was assessed based on actigraphy (Phase II and III) and home polysomnography (Phase III), while inflammation markers and stress hormones were measured in both phases. Despite the homogeneity of the sample in most sociodemographic indices, MCI persons were significantly older (mean age = 75.03 years, SD = 6.34) and genetically predisposed for cognitive deterioration (APOE ε4 allele carriership). Also, at follow-up, we detected a significant increase in self-reported anxiety symptoms along with a substantial rise in psychotropic medication use and incidence of major medical morbidities. The longitudinal design of the CAC study may provide significant data on possible modifiable factors in the course of cognitive progression in the community-dwelling elderly.

John Huxtable Elliott (1930–2022)

John Huxtable Elliott (1930–2022)

신학생 급감 시대에서 신학생 유치와 양성 방안에 대한 연구 : 고려신학대학원 모델의 비판적 성찰을 중심으로

본 논문은 신학생이 급감하는 현실 가운데 그 원인을 해석하고, 어떻게 하면 신학대학원이 신학생을 효과적으로 유치하면서 그들을 바르게 양성할 수 있는지를 다룬다. 좋은 방안을 모색하기 위하여 특정 학교인 고려신학대학원을 사례로 선택하여, 이 학교가 지금까지 이행해온 신학생 유치 활동 및 사역자 양성 교육의 실제를 소개할 뿐 아니라 이를 비판적으로 재고한다. 나아가 이를 통해 다른 신학교들이 선택하여 앞으로 나아가야 할 방안을 제안한다. 특별히 본 논문은 학생 유치 위원회, 선발 방식 및 학위 과정의 다양화, 장학금 신설 및 확충, 목사 후보생 양성 전략, 노회 및 총회와의 협력 등을 다룬다.

Structural Network Efficiency Predicts Resilience to Cognitive Decline in Elderly at Risk for Alzheimer's Disease.

Introduction: Functional imaging studies have demonstrated the recruitment of additional neural resources as a possible mechanism to compensate for age and Alzheimer’s disease (AD)-related cerebral pathology, the efficacy of which is potentially modulated by underlying structural network connectivity. Additionally, structural network efficiency (SNE) is associated with intelligence across the lifespan, which is a known factor for resilience to cognitive decline. We hypothesized that SNE may be a surrogate of the physiological basis of resilience to cognitive decline in elderly persons without dementia and with age- and AD-related cerebral pathology.Methods: We included 85 cognitively normal elderly subjects or mild cognitive impairment (MCI) patients submitted to baseline diffusion imaging, liquor specimens, amyloid-PET and longitudinal cognitive assessments. SNE was calculated from baseline MRI scans using fiber tractography and graph theory. Mixed linear effects models were estimated to investigate the association of higher resilience to cognitive decline with higher SNE and the modulation of this association by increased cerebral amyloid, liquor tau or WMHV. Results: For the majority of cognitive outcome measures, higher SNE was associated with higher resilience to cognitive decline (p-values: 0.011–0.039). Additionally, subjects with higher SNE showed more resilience to cognitive decline at higher cerebral amyloid burden (p-values: <0.001–0.036) and lower tau levels (p-values: 0.002–0.015).Conclusion: These results suggest that SNE to some extent may quantify the physiological basis of resilience to cognitive decline most effective at the earliest stages of AD, namely at increased amyloid burden and before increased tauopathy.

Incidental Brain Magnetic Resonance Imaging Findings and the Cognitive and Motor Performance in the Elderly: The Shanghai Changfeng Study

BackgroundThe frequently discovered incidental findings (IFs) from imaging observations are increasing. The IFs show the potential clues of structural abnormalities underlying cognitive decline in elders. Detecting brain IFs and their relationship with cognitive and behavioral functions helps provide the information for clinical strategies.MethodsFive hundred and seventy-nine participants were recruited in the Shanghai Changfeng Study. All participants performed the demographic, biochemical, and cognitive functions and gait speed assessment and underwent the high-resolution multimodal magnetic resonance imaging scans. We calculated the detection rate of brain IFs. The association between cardiovascular risk factors and IFs and the associations between IFs and cognitive and motor functions were assessed using regression models. The relationships among gray matter volume, cognitive function, and gait speed were assessed with/without adjusting the IFs to evaluate the effects of potential IFs confounders.ResultsIFs were found in a total of 578 subjects with a detection rate of 99.8%. Age and blood pressure were the most significant cardiovascular risk factors correlated with IFs. IFs were found to be negatively associated with Montreal Cognitive Assessment, Mini-Mental State Examination, and gait speed. The gray matter volume was found to be positively correlated with the cognitive function without adjusting the white matter hyperintensity but not if adjusted.ConclusionIFs are commonly found in the elderly population and related to brain functions. The adequate intervention of IFs related cardiovascular risk factors that may slow down the progression of brain function decline. We also suggest that IFs should be considered as confounding factors that may affect cognitive issues on the structural neuroimaging researches in aging or diseases.

Portable Ultrasound-Based Device for Detecting Older Adults' Sit-to-Stand Transitions in Unsupervised 30-Second Chair-Stand Tests.

Lower-limb strength is a marker of functional decline in elders. This work studies the feasibility of using the quasi-periodic nature of the distance between a subjects’ back and the chair backrest during a 30-s chair–stand test (CST) to carry out unsupervised measurements based on readings from a low-cost ultrasound sensor. The device comprises an ultrasound sensor, an Arduino UNO board, and a Bluetooth module. Sit-to-stand transitions are identified by filtering the signal with a moving minimum filter and comparing the output to an adaptive threshold. An inter-rater reliability (IRR) study was carried out to validate the device ability to count the same number of valid transitions as the gold-standard manual count. A group of elders (age: mean (m) = 80.79 years old, SD = 5.38; gender: 21 female and seven male) were asked to perform a 30-s CST using the device while a trained nurse manually counted valid transitions. Ultimately, a moving minimum filter was necessary to cancel the effect of outliers, likely produced because older people tend to produce more motion artefacts and, thus, noisier signals. While the intra-class correlation coefficient (ICC) for this study was good (ICC = 0.86, 95% confidence interval (CI) = 0.73, 0.93), it is not yet clear whether the results are sufficient to support clinical decision-making.

AGE of DECLINE – From Stage to Page Mahmoud Gewaily

AGE of DECLINE – From Stage to Page Mahmoud Gewaily

Pope Francis: a new way of looking at the world

ABSTRACTFrom the very beginning, Francis knew he would be seen as a pope far from Europe and from what is commonly understood to be the West. Many of the criticisms and much of the opposition to his papacy hark back to this ‘foreignness’. Trump and Francis appear on opposite positions, but they are creatures of the same age: the age of decline of West. If the main horizon of the Benedict XVI’s papacy was secularization, Francis’s papacy looks at globalization, which he views above all from the viewpoint of the poorest. This pope combined action for peace (Cuba and Colombia) with major ecumenical initiatives (the meeting with Patriarch Kiril). His first intercontinental journey was to Asia (South Korea): the Asian world is less penetrated by and more culturally distant from Christianity. In this sense, the agreement with China is an historic event and a great success of Pope Francis.

노년기의 인지 저하가 활동참여와 사회적 관계망에 미치는 영향

목적 : 지역사회에 거주하는 경도인지장애 노인들의 인지수준이 여가나 일상생활활동 뿐만 아니라 활동에 대한 참여와 사회적 관계망에 어떤 영향을 미치는지에 대해 살펴보고자 하였다. 연구방법 : 지역사회에 거주중인 65세 이상 노인을 대상으로, MMSE-K의 점수가 15점 이상 23점 이하인 경도인지장애 노인들을 대상으로 선별하였다. 대상자들의 영역별 인지능력을 알아보기 위하여 MoCA-K를, 활동참여 수준 및 사 회관계망 지수를 확인하기 위하여 K-ACS와 LSNS-18을 각각 적용하였다. 결과 : 인지와 활동 참여의 관계를 살펴본 결과 인지의 다양한 하위 능력(시공간능력, 어휘능력, 주의력, 추상력, 지남력) 이 수단적 일상생활, 여가활동, 사회활동에 유의한 영향을 주고 있었다. 또한 인지의 모든 하위 능력이 사회적 관계 망의 하위 요소들과 유의한 상관관계를 보이는 것으로 나타났다. 결론 : 본 연구를 통하여 인지의 전반적 요소들이 경도인지장애 노인들의 다양한 영역의 활동참여 및 사회적 관계망에 영향을 주고 있는 것을 알 수 있었다. 후속 연구들을 통하여 경도인지장애 노인들의 활동 참여와 사회적 참여를 높이는 방안들이 마련되기를 제언하는 바이다.

Atrophy of hippocampal subfield CA2/3 in healthy elderly men is related to educational attainment

A higher education level is a protective factor against cognitive decline in elders; however, the underlying neural mechanisms remain unclear. Modulated by both aging and education, the hippocampus is a starting point for understanding the long-lasting effect of education on the aging of human brain. Because the hippocampus possesses functionally heterogeneous subfields and exhibits sex differences, we examined hippocampal subfields in men and women separately. We performed both cross-sectional (n = 143) and longitudinal (n = 51) analyses on healthy participants aged 65–75 years, who underwent structural magnetic resonance imaging. Volumes of the hippocampi and their subfields were estimated by automated segmentation. We found significantly positive correlations between educational attainment and the volume of hippocampal CA2/3 in men but not in women. The longitudinal analysis focusing on this region validated the above results by showing that a higher education level attenuated the progression of atrophy during a 15-month follow-up period in the CA2/3 region in men. These findings suggest that, in men, education plays a role in the aging of specific hippocampal subfields.

Passing Rhetoric’s Kaleidoscope

Passing Rhetoric’s Kaleidoscope

Association of serum albumin levels with kidney function decline and incident chronic kidney disease in elders.

Previous studies in HIV-infected individuals have demonstrated serum albumin to be strongly associated with kidney function decline, independent of urine albumin and inflammatory markers. Lower serum albumin concentrations may be an under-appreciated risk factor for kidney function decline in elders. We performed a cohort analysis in the Health Aging and Body Composition Study, a cohort of well-functioning, bi-racial, community-dwelling elders between the age of 70 and 79 years. We examined the associations of serum albumin concentration with longitudinal kidney function decline by estimated glomerular filtration rate (eGFR). Outcomes included linear eGFR decline, rapid kidney function decline defined as >30% decrease in eGFR, defined as a final eGFR <60 mL/min/1.73 m2 in those with an eGFR >60 mL/min/1.73 m2 at baseline. Cystatin C-based eGFR was calculated at baseline, Year 3 and Year 10. Mean age was 74 years, and mean eGFR was 73 mL/min/1.73 m2 at baseline. The mean rate of eGFR change was 1.81 mL/min/1.73 m2 per year. After multivariate adjustment, lower serum albumin concentrations were strongly and independently associated with kidney function decline (-0.11 mL/min/1.73 m2 per year for each standard deviation decrease serum albumin; -0.01 to - 0.20) with no attenuation after adjustment for urine albumin and inflammatory markers (-0.12, -0.03 to - 0.22). When divided into quartiles, serum albumin levels ≤3.80 g/dL were associated with increased odds of rapid kidney function decline (odds ratio 1.59; 1.12-2.26) and increased risk of incident chronic kidney disease (incident rate ratio 1.29; 1.03-1.62) relative to levels >4.21g/dL. Urine albumin to creatinine ratio (ACR) was also significantly and independently associated with kidney function decline (-0.08 mL/min/1.73 m2 per year for urine ACR >30 mg/g; -0.82 to - 0.13). Lower serum albumin levels are strongly and independently associated with kidney function decline in elders, independent of clinical risk factors, urine albumin and measured inflammatory markers.

Effect of Educational Program, Based on PRECEDE and Trans-Theoretical Models, on Preventing Decline in Regular Physical Activity and Improving it among Students.

Adolescents especially middle school girls do not follow 60 min of regular physical activity (RPA), recommended by WHO, and endure physical activity decline. Using theory-based interventional program, considering the age of decline in RPA, seems to be effective. The aim of this study was to determine the effects of educational program, based on PRECEDE and Trans-Theoretical models, on preventing decline in RPA and improving it among 7th grade girl students. Randomized controlled trial. This study was conducted on 7th grade girl students in Hamadan, west of Iran from 2015-16. Participants were divided into intervention (N=179) and control (N=165) groups by random assignment. Physical activity questionnaire for adolescents and the model-based questionnaire were used before and after intervention. Intervention included two months education and six months follow up. The effects of intervention were determined by statistical test and analysis of covariance using SPSS version 16. The higher change in the mean scores was observed in self-efficacy (0.86), counter condition (0.66) and helping relationship (0.57) in the intervention group (P≤0.001). In addition, a significant difference (P ≤0.001) was observed between the two groups 6 months after the intervention in all constructs of model. The mean score of doing physical activity in the intervention group increased from 2.50 to 3.17 that it was differed significantly from the control group (P≤0.001). CONCLUSIONS: School based intervention using PRECEDE and Trans-Theoretical models might prevent girl students' RPA decline and improve their RPA.

Predictors of Cognitive Function Decline of Elderly : Using Living Conditions and Welfare Needs of Older Korean Persons Panel Data

Predictors of Cognitive Function Decline of Elderly : Using Living Conditions and Welfare Needs of Older Korean Persons Panel Data

THE MEDIATING EFFECTS OF STRESS ON DYNAMIC CHANGE IN PHYSICAL ACTIVITY AND COGNITIVE DECLINE IN AGING

THE MEDIATING EFFECTS OF STRESS ON DYNAMIC CHANGE IN PHYSICAL ACTIVITY AND COGNITIVE DECLINE IN AGING

Citizen-Protectors: The Everyday Politics of Guns in an Age of Decline

Citizen-Protectors: The Everyday Politics of Guns in an Age of Decline, by Jennifer Carlson. New York: Oxford University Press, 2015. 248 pp. $29.95 cloth. ISBN: 9780199347551. It is easier for an average citizen in Dodge City or Tombstone to carry a concealed firearm in public today than it was in the nineteenth century, the heyday of the Wild West. The expansion of shall issue concealed carry laws in the United States over the past three decades represents the greatest liberalization of laws in the nation's history. Consequently, many more ordinary citizens are legally permitted to carry firearms for self-defense in public. Reasonable estimates suggest 8 to 12 million Americans have permits to carry concealed weapons nationally, with over 10 percent of the population licensed to carry in some states. Jennifer Carlson calls this a gun carry revolution, and she is right. And yet sociologists have been oddly silent about it. Carlson steps into this void with a case study of individuals who legally carry guns, either openly or concealed, in southeastern Michigan. In addition to interviews with 60 mostly white, middle-aged male carriers, Carlson did 150 hours of participant observation at shooting ranges, activist events, and training classes. In the process she also obtained a concealed carry license, carried a during her fieldwork, and became a National Rifle Association (NRA) certified firearms instructor. In the best tradition of ethnography, Carlson is a critical observer analyzing this aspect of American culture from the inside out. Carlson begins Citizen-Protectors with the stories of two individuals that illustrate the complex race, class, gender, and other social dynamics that influence carry. The first involves Corey, a white clerk at a corner store in Flint, who shoots and kills a black man in self-defense during … Language: en

Comparative postcolonial ruralities and English heritage: Julian Barnes’s England, England and Kiran Desai’s The Inheritance of Loss

This article argues for the vastly different ways in which English heritage is celebrated as a legacy of the British Empire in rural spaces located both in England and in India. Comparing Julian Barnes’s satirical novel England, England (1998) with Kiran Desai’s The Inheritance of Loss (2006) affords disparate images of English heritage in postimperial Britain and in postcolonial India. Barnes parodies efforts by the English heritage industry, in an age of decline, to revivify English nationalism and to recollect erstwhile imperial glory. In a globalized world, he underscores the desire for nostalgia preoccupied with a mythic English agrarian past, its historical icons, and its social order as anachronistic instead of inspirational. At best, it appears historically ignorant; at worst, he suggests, it serves as a perversion of reality. For Barnes, the English heritage industry is self-indulgent and largely motivated by profit. In contrast, Desai’s novel represents the damage caused by a class structure forged from India’s colonial inheritance and a persistent privileging of English culture and heritage. Desai suggests economic power and social prestige, even in an obscure hill village in India, are articulated through material displays and personal knowledge of English heritage, reflecting the different classes’ uneven access to capital and knowledge. Her novel simultaneously depicts those at the bottom end of India’s class hierarchy who are compelled to acts of desperation in pursuit of better lives.

Benzodiazepine Use and Cognitive Decline in Elderly With Normal Cognition.

Benzodiazepine (BZD) use may be associated with dementia. However, differing opinions exist regarding the effect of BZDs on long-term changes in cognition. We evaluated the association between BZD use and cognitive decline in the elderly with normal cognition from the National Alzheimer's Disease Coordinating Center's Uniform Data Set. The study exposure, BZD use, was classified 2 ways: any-use [reported BZD use at a minimum of 1 Alzheimer's disease center (ADC) visit] and always-use (reported BZD use at all ADC visits). The reference group included participants without any declared BZD use at any Alzheimer's Disease Center (ADC) visit. The main outcome measures were Clinical Dementia Rating Sum of Boxes score and Mini-Mental State Examination score. We observed a decline in cognitive status over time in the 2 comparison groups. All participants who reported taking BZDs had poorer cognitive performance at all visits than nonusers. However, cognitive decline was statistically similar among all participants. We found no evidence of an association between BZD use and cognitive decline. The poor cognitive performance in BZD users may be due to prodromal symptoms caused by preclinical dementia processes.

Vitamin-D Deficiency May Play Role in Cognitive Decline in Elderly

Vitamin-D Deficiency May Play Role in Cognitive Decline in Elderly