Older Adults Age Research Articles

Healthy Aging: Interaction of Cognition, Lifestyle, and Instrumental Activities of Daily Living.

Background: The increasing elderly population highlights the importance of comprehending healthy aging by examining the interactions among cognition, daily activities, and lifestyle. This study aims to address this by investigating these relationships within the World Health Organization's Healthy Aging Model. Methodology: A cross-sectional study was conducted with 178 older adults from southern Iran, representing various cognitive levels. Participants underwent assessments to measure cognitive functions, lifestyle preferences, and independence in instrumental activities of daily living (IADL) using the Mini-Mental State Examination, the Lifestyle Assessment Questionnaire for the Iranian Elderly, and the Lawton IADL Scale. Findings: The relationships between the studied variables were identified. Lower cognitive function was found to be associated with decreased engagement in IADL and less-favorable lifestyle choices. Conclusion: Integrating cognition, IADL, and lifestyle into assessments and interventions align with both the domain and process of occupational therapy, thereby enhancing well-being and promoting healthy aging in older adults.

Effects of activity participation and cognitive levels on depression in middle-aged and older adults with chronic illness: a national cross-sectional study.

The world population is rapidly aging, and depression mainly affects middle-aged and older adults with chronic diseases and cognitive impairments. The sample for this study was obtained from the China Health and Retirement Longitudinal Study (CHARLS) public database. The sample size for inclusion was 12,767. There were 6,773 females and 5,994 males, with an overall low level of education. This study aims to provide a theoretical and practical reference basis for the clinical non-pharmacological treatment of depression in middle-aged and older adults (age ≥ 50 years) with chronic diseases. Additionally, the study seeks to promote the development of mental health interventions for middle-aged and older adults (age ≥ 50 years) with chronic diseases, ultimately enhancing the sense of well-being and quality of life for this demographic. Cognitive functioning and depressive symptoms of the study participants were assessed using the Mini-Mental State Examination Scale (MMSE) and the short version of the Center for Epidemiological Studies Depression Scale (CESD-10). Binary logistic regression results showed that among middle-aged and older adults (age ≥ 50 years) with chronic diseases, participation in physical activity [OR = 1.397; 95% CI (1.181-1.651); p < 0.05] was more effective than participation in social activities [OR = 0.997; 95% CI (0.924-1.076); p < 0.05] for preventing depression. Those with cognitive impairment [OR = 1.206; 95% CI (1.089-1.335); p < 0.05] were more likely to experience depression than those without cognitive impairment. Activity participation (physical activity and social activity) had a more significant effect on mild and moderate depression compared to no depression, and cognitive level had a more pronounced effect on moderate depression [OR = 1.491; 95% CI (1.278-1.740); p < 0.05] and major depression [OR = 2.231; 95% CI (1.282-3.884); p < 0.05]. Within the specific cohort of middle-aged and older adults (age ≥ 50 years) with chronic diseases, both activity participation and cognitive level exert a significant influence on the prevention and intervention of depression. Engagement in physical activity, participation in social activities, and enhanced cognitive functioning emerged as protective factors against depression. Therefore, the policy-maker should strengthen the prevention and treatment of depression in a comprehensive manner through the promotion of physical and social activities and the enhancement of cognitive level, so as to safeguard the mental health of middle-aged and older adults with chronic diseases.

Are depressive symptoms associated with biological aging in a cross-sectional analysis of adults over age 50 in the United States.

Major depressive disorder accelerates DNA methylation age, a biological aging marker. Subclinical depressive symptoms are common, but their link to DNA methylation aging in older adults remains unexplored. This study analyzed the cross-sectional relationship between depressive symptoms and accelerated DNA methylation aging, considering gender and race/ethnicity in U.S. adults aged over 50. We used data from 3,882 diverse participants in the 2016 Health and Retirement Study wave, measuring blood DNA methylation age against chronologic age for acceleration. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Multiple linear regression evaluated the association between depressive symptoms and DNA methylation age acceleration, adjusting for sociodemographic factors, blood cell proportions, and health behaviors (physical activity, alcohol use, smoking, and chronic conditions). Gender and race/ethnicity modifications were also tested. Depressive symptoms, measured by continuous CES-D score, high depressive symptoms (CES-D ≥ 4), or any symptoms (CES-D ≥ 1), significantly correlated with increased GrimAge DNA methylation age acceleration (all p ≤ .001) in unadjusted and sociodemographic-adjusted models but were nonsignificant in fully adjusted models. No significant gender or race/ethnicity effect modifications were found in fully adjusted models. Health behaviors significantly influence DNA methylation age acceleration and depressive phenotypes, underscoring the need to understand their roles in assessing psychological factors related to DNA methylation age acceleration. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Views and experiences of older people taking part in a safe-falling training program: Lessons learned from the FAlling Safely Training (FAST) trial

BackgroundWhile falls are the leading cause of accidental injury among older people, the current fall prevention strategies have not resulted in a remarkable reduction in fall rates. An alternative novel approach, teaching older adults how to fall safely to prevent injury, has been recently implemented in the FAlling Safely Training (FAST) trial. The current study aimed to explore the views and perceptions of older people about their participation in the safe-falling training program.MethodsFocus groups were conducted with eight community-dwelling older adults (age range: 66 to 76 years, five females) at risk of falling who completed the FAST program. Two focus groups involving four participants each were conducted. Recordings were transcribed verbatim and analyzed using thematic analysis.ResultsThree themes were identified following the analysis: (1) Before the training; with subthemes: Previous fall prevention strategies and Motivation to participate. Motivations to take part in the training included worries about falling, an awareness of an increased risk of falling, and a desire to decrease the chances of sustaining an injury. (2) Training itself; with subthemes: General impressions of the training and Learning the techniques. Older people highlighted that the training was well-designed and executed. (3) Going forward; with subthemes: Training increased confidence, Incorporating in a community setting, and Proposing improvements to the study. It was reported that the training enhanced participants’ confidence about falling without injury. Incorporating the training into a community context was discussed, and suggestions for program enhancements were made. The individual nature of the training was valued, but participants also provided suggestions for how they would see the program taking place successfully in small groups.ConclusionsThe results indicated that the safe-falling training was acceptable to older adults. The perceived ability to fall without injury was reported to have increased. Individuals who experienced a fall after the training ended reported being able to use the techniques learned in their daily life. The findings have implications for the training to be refined and implemented in the community.Trial registrationThe article is linked to a randomized controlled trial registered at http://ClinicalTrials.gov (NCT05260034).

The development of intrinsic capacity measures for longitudinal research: The Longitudinal Aging Study Amsterdam

BackgroundThe World Health Organization has introduced the construct of intrinsic capacity (IC) as an important component of healthy ageing and overall well-being in older adults The present study aimed to develop domain-specific and composite IC scores and to validate these scores by examining their longitudinal relation with functioning. MethodsWe used prospective data on participants aged 57 to over 90 years, with a 10-year follow-up, from the Longitudinal Aging Study Amsterdam, an ongoing cohort study of older Dutch men and women Using a formative, stepwise approach, we identified indicators across the different domains of IC, i.e. vitality, sensory, cognition, psychology, and locomotion, using a combination of unidimensional factor analyses and Partial Least Squares Structural Equation Modelling (PLS-SEM). Next, domain-specific and composite IC scores were generated, and the construct validity (score across age groups) and criterion validity (relationship with change in functional limitations) were assessed. ResultsThe multiple unidimensional factor analyses and PLS-SEM identified a total of 18 indicators, covering the five domains of IC. The mean composite IC score was 70.9 (SD = 0.9) in men and 69.7 (0.8) in women. The domain-specific and composite IC scores all showed good construct validity, with known-group validation results indicating age-related declines. A higher composite IC score was associated with less functional limitations over time (B = 0.20, 95%CI [0.19, 0.22]). ConclusionThe developed domain-specific IC scores and the composite IC score effectively discriminated age-related declines in IC. Additionally, the composite IC score was longitudinally associated with functional limitations. By creating this comprehensive and reliable tool for tracking IC, we aim to provide valuable insights into the dynamics of ageing and support more effective strategies for promoting health and well-being throughout later life. These scores establish a foundation for future research to track longitudinal changes across various IC domains and relate these changes to key age-related outcomes.

Vitamin D Deficiency as a Contributing Factor to Chronic Rhinitis in Middle-Aged and Older Adults: An Epidemiological Study.

Recent studies suggest a critical role for vitamin D in respiratory diseases, including asthma and allergic rhinitis. However, the relationship between vitamin D deficiency and chronic rhinitis, particularly in middle- and older-aged populations, remains underexplored. This study aimed to investigate the association between vitamin D deficiency and chronic rhinitis in middle- and older-aged adults while controlling for lifestyle and physical status factors. Data from 12,654 participants aged 40 years and older were analyzed from the fifth Korean National Health and Nutrition Examination Survey (2010-2012). The prevalence of chronic rhinitis and its association with serum vitamin D levels were assessed using multiple logistic regression models, adjusting for demographic, lifestyle, and physical characteristics. The prevalence of chronic rhinitis was 21.1%. Participants with chronic rhinitis had a higher prevalence of vitamin D deficiency (69.9% vs. 65.2%) and lower mean vitamin D levels (17.73 ng/mL vs. 18.19 ng/mL) compared to those without chronic rhinitis. After adjusting for confounding factors, vitamin D deficiency remained significantly associated with an increased likelihood of chronic rhinitis (OR = 1.21, 95% CI, 1.082-1.348, p = 0.001). This study identifies a significant association between vitamin D deficiency and chronic rhinitis in middle- and older-aged adults, suggesting that maintaining adequate vitamin D levels may be important in managing chronic rhinitis.

8303 Analysis of Over 2.2 Million Anti-Mullerian Hormone Patient Results Across Lifespan From Birth to Over 80 Years Using a Lab Developed Chemiluminescent Immunoassay

Abstract Disclosure: C. Cheng: None. D. Alfego: None. K.Y. Chun: None. Introduction: Anti-Mullerian hormone (AMH) is a glycoprotein produced by granulosa cells of the ovarian follicle in females and by Sertoli cells of the testes in males. AMH is best known to correlate with ovarian reserve in females. As such, AMH is among the most frequently ordered tests in reproductive age females. The clinical utility of AMH beyond ovarian reserve assessment, especially in males, pediatric and postmenopausal populations, is less commonly examined. As a national reference laboratory that serves approximately 50% of providers across the country, our large database provides an opportunity to examine the clinical utility of AMH testing in other areas of health besides fertility. Objective: To examine AMH test utilization across lifespan of males and females in the US. Methods: Retrospective AMH tests performed at Labcorp® endocrine specialty lab from year 2012 to 2023 of 2,229,845 female patients and 10,362 male patients have been analyzed. Patients with unspecified sex were excluded. Serum AMH levels from birth to 80 plus years for males vs females were compared. For clinical utility assessments, female results are separated into four age groups: pediatric (age 0-17), adult (age 18-39), perimenopausal (age 40-59), and postmenopausal (age &amp;gt;60), and males into pediatric (age 0-17), adult (age 18-59), and older adult (age &amp;gt;60). ICD-10 codes associated with testing order were reviewed for each subgroup based on age and sex Results: In postmenopausal females, AMH is most frequently ordered for evaluation of ovarian cancer, whereas menstrual disorders and PCOS make up the most frequent clinical entities associated with AMH orders in females &amp;lt;18 years. Fertility testing is the most common ICD-10 associated with AMH orders, particularly in reproductive age and perimenopausal females. The most common ICD-10s associated with AMH in pediatric males include delayed puberty, hypoplasia of penis, and childhood short stature. In the adult and older adult male groups, AMH is surprisingly found to also most commonly associate with fertility testing and hypogonadism, although the clinical significance of post pubertal AMH is less defined. Conclusion: AMH testing has most often been used for female fertility testing, but our data show that significant fraction (10-20%) of AMH testing is used to evaluate and manage other suspected endocrine disorders and malignancies including intersex conditions at birth, pubertal development disorder, polycystic ovarian syndrome, male gonadal disfunction at all ages and granulosa cell tumors. Analysis of our large database underscores a need for clinical study to better define AMH levels that are relevant for non-fertility-related conditions. Presentation: 6/2/2024

Weight loss rather than weight gain has a detrimental effect on successful aging in older adults: A 4-year longitudinal study in China

This study explored the effect of weight change on successful aging in older adults. A total of 1865 adults (≥65 years) were divided into the weight gain group (weight gain ≥5 %), the weight loss group (weight loss ≥5 %), and the weight stable group (weight change <5 %) according to weight changes over 4 years. Results showed that compared to the stable weight, the weight loss is associated with a lower rate of successful aging (OR=0.64, 95 % CI: 0.49-0.83), and the association was found greater in women (OR=0.61, 95 % CI: 0.43-0.86) and young-old adults (OR=0.66, 95 % CI: 0.41-0.88) than their counterparts. However, no significant association was found between weight gain and successful aging. The findings suggest that weight loss rather than weight gain in older adults has a detrimental impact on successful aging, and this detrimental impact is greater in women and young-old adults.

The Longitudinal Evidence on Social Ties and Fruit and Vegetable Intake among Aging Adults: A Systematic Review.

Social ties are associated with the mortality and morbidity of aging populations; however, the role of social ties in healthy eating practices or gender differences in this link is less understood. The objective of this study was to examine the longitudinal evidence for the impact of changes in social ties on fruit and vegetable (FV) intakes among aging adults, with attention to gender differences. Medline, Embase, Scopus, CINAHL, and ProQuest databases were searched until December 2022. Longitudinal studies evaluating changes in living arrangement, marital status, social network, or social participation and changes in FV intake among middle- and older-age adults were included. Data from the included studies were extracted using a standardized template and analyzed using a narrative approach. A total of 4956 titles were eligible after deduplication, and 75 full texts were screened. Seven studies met the inclusion criteria, and all examined marital transitions only. Five marital transitions were assessed: staying married, becoming widowed, becoming divorced, remaining unmarried, and becoming married. Both the quantity and variety of fruit and/or vegetables eaten were studied. Three of the included studies had only male or only female populations. The studies found that marital dissolution (divorce or widowhood), and remaining unmarried, were associated with reduced FV intakes in older women or men, compared with staying married. The associations were stronger in men than in women. Two studies showed that becoming married was associated with increased vegetable intakes, but 3 reported null results. The included studies were of medium quality. There is a paucity of longitudinal research on whether changes in social ties are associated with changes in FV intakes among aging adults. This review showed that specific marital transitions may influence healthy eating habits, especially in older men. No evidence exists on whether changes in other social ties might alter healthy eating. PROSPERO registration No. CRD42022365795.

Child Sexual Abuse and Boundary Violating Behaviors in Youth Serving Organizations: National Prevalence and Distribution by Organizational Type.

Many youth serving organizations (YSOs) implement child sexual abuse (CSA) prevention strategies. We examined the potential impact of those strategies by retrospectively estimating the prevalence of CSA and boundary violating behaviors experienced in five broad organizational settings: organized sports, religious organizations, music or arts programs, K-12 schools, and the "Big 6 settings" (i.e., 4-H, Big Brothers Big Sisters of America, Boys and Girls Clubs of America, Boy Scouts of America, Girl Scouts of the USA, and the YMCA of the USA). We compared victimization rates between nationally representative cohorts of younger adults (age 18-22; N = 3174) and slightly older adults (age 32-36, N = 3237). Across all participants and settings, 3.75% (n = 363) experienced CSA in YSOs. Among survivors, younger adults reported experiencing a lower proportion of CSA within Big 6 settings than older adults (29.1% vs. 44.5%; p < .05), suggesting that prevention efforts may be having the desired effects in Big 6 settings.

Frailty, Body Composition, and Glycemic Control in Older Adults with Type 2 Diabetes.

The relationship between frailty and glycemic control in older adults with diabetes remains uncertain, mainly due to the fact that previous studies have not accounted for measures of body composition. In older adults with diabetes, we examined the association between three types of frailty measures and glycemic control, while accounting for fat-free mass (FFM) and waist circumference (WC). Eighty older adults (age ≥65, 27 women and 53 men, mean age 80.5±0.6 years) had gait speed, Cardiovascular Health Study Index (CHSI), Rockwood Clinical Frailty Scale (RCFS), and glycosylated hemoglobin (HgA1C) measured. HgA1C showed a negative association only with CHSI (standardized β=-0.255±0.120, p=0.038), but no association with gait speed or the RCFS. Even after accounting for FFM and WC, we demonstrated a negative association between glycated hemoglobin and increasing frailty in older adults with diabetes.

Brain Iron in signature regions relating to cognitive aging in older adults: the Taizhou Imaging Study

BackgroundRecent magnetic resonance imaging (MRI) studies have established that brain iron accumulation might accelerate cognitive decline in Alzheimer’s disease (AD) patients. Both normal aging and AD are associated with cerebral atrophy in specific regions. However, no studies have investigated aging- and AD-selective iron deposition-related cognitive changes during normal aging. Here, we applied quantitative susceptibility mapping (QSM) to detect iron levels in cortical signature regions and assessed the relationships among iron, atrophy, and cognitive changes in older adults.MethodsIn this Taizhou Imaging Study, 770 older adults (mean age 62.0 ± 4.93 years, 57.5% women) underwent brain MRI to measure brain iron and atrophy, of whom 219 underwent neuropsychological tests nearly every 12 months for up to a mean follow-up of 2.68 years. Global cognition was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Domain-specific cognitive scores were obtained from MoCA subscore components. Regional analyses were performed for cortical regions and 2 signature regions where atrophy affected by aging and AD only: Aging (AG) -specific and AD signature meta-ROIs. The QSM and cortical morphometry means of the above ROIs were also computed.ResultsSignificant associations were found between QSM levels and cognitive scores. In particular, after adjusting for cortical thickness of regions of interest (ROIs), participants in the upper tertile of the cortical and AG-specific signature QSM exhibited worse ZMMSE than did those in the lower tertile [β\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\:\\beta\\:$$\\end{document} = -0.104, p = 0.026; β\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\:\\beta\\:$$\\end{document} = -0.118, p = 0.021, respectively]. Longitudinal analysis suggested that QSM values in all ROIs might predict decline in ZMoCA and key domains such as attention and visuospatial function (all p < 0.05). Furthermore, iron levels were negatively correlated with classic MRI markers of cortical atrophy (cortical thickness, gray matter volume, and local gyrification index) in total, AG-specific signature and AD signature regions (all p < 0.05).ConclusionAG- and AD-selective iron deposition was associated with atrophy and cognitive decline in elderly people, highlighting its potential as a neuroimaging marker for cognitive aging.

Moderate physical activity and higher frequency are inversely associated with incidence of frailty in middle-aged and older population: a 4-year longitudinal study in Europe.

Global aging is leading to an increase in frailty patients, and physical activity (PA) may have an impact on frail in middle-aged and older population. This study aimed to explore the relationship between the frequency of different PA intensities and the incidence and prevalence of frailty in middle-aged and older adults based on the Survey of Health, Ageing, and Retirement in Europe (SHARE). Self-reported questionnaires were used to obtain information on demographics and PA, and frailty was assessed using the SHARE Frailty Instrument (SHARE-FI). Cox regression and logistic regression models were used to explore the association between PA and frailty and stratified according to middle or old age. Among 6315 baseline non-frail participants aged 44-96years, 16.1% developed frailty over 4years, with higher incidence and prevalence in women (P < 0.05). Women accounting for 55.80% of the sample. The frequency of participants participating in sports decreased over 4years (P < 0.05). Compared with participants who engaged in PA more than once a week, participants who engaged in moderated PA less frequently had a higher risk of new-onset frailty (HR: 3.174-6.115), and participants who engaged in vigorous PA 1-3 times a month had a higher risk of new-onset frailty (HR: 1.335). Participation in low-frequency moderate PA and vigorous PA 1-3 times per month were positively associated with the prevalence of frailty (P < 0.05). Physical activity frequency decreases with age in middle-aged and older adults. Those adults who engage in moderate PA more than once a week have a lower risk of incidence of frailty, compared to those with more sedentary life-styles. Additionally, women need to pay more attention to frailty management.

Concern about falling is related to threat-induced changes in emotions and postural control in older adults

BackgroundConcern about falling is reportedly related to mobility and balance in older adults. While increased concern about falling may be directly related to balance deficits, establishing a causal relationship remains limited. This study aimed to investigate whether concern about falling affects threat-induced changes in emotions and postural control in older adults. Research questionHow does concern about falling affect threat-induced changes in emotions and postural control among older adults? MethodsSixty-two older adults (age; 78.8 ± 5.7 years, height; 152.7 ± 6.3 cm) were exposed to height-related fear while standing, leaning forward, and leaning backward on the floor and a higher surface. The mean position, root mean square, and mean velocity of the center of pressure (COP) displacement were measured during the standing task, as well as the forward and backward limits of stability (LOS) tasks. The degree of self-reported fear of falling (FoF) was also obtained during the standing and LOS tasks. The participants were categorized into lower and higher concerns about falling based on the short form of the Falls Efficacy Scale International (FESI). ResultsLower and higher concern about falling groups scored 10.2 ± 2.2 and 17.3 ± 3.3 in the short FESI. Both groups experienced increased FoF during the standing and forward LOS tasks on a higher surface. Leaning away from the edge of the surface resulted in increased COP velocity, decreased COP amplitude while standing, and decreased forward LOS. Participants with higher concern about falling had increased FoF during the backward LOS task and decreased backward LOS on a higher surface, while those with lower concern about falling did not. SignificanceConcern about falling can directly affect emotions and balance control owing to the occurrence of threat-related changes.

Mapping Age Differences in Brain Energy Metabolites and Metabolic Markers of Cellular Membrane Production and Degradation With 31P Magnetic Resonance Spectroscopy.

Using Phosphorus Magnetic Resonance Spectroscopy (31P MRS), we examined five metabolites associated with brain energy cycle, and cellular membrane production and degradation in 11 brain regions of 48 children (age 6-15), and 80 middle-aged and older adults (age 52-87). Levels of phosphomonoesters (PMEs) and phosphodiesters (PDEs), gamma plus alpha adenosine triphosphate (γαATP), phosphocreatine (PCr) and inorganic phosphate (Pi), were residualized on the total amplitude value. PMEs were greater in children compared to adults, whereas PDEs showed the opposite age difference. Higher γαATP and lower Pi were found in children compared to adults. The age group differences were particularly salient in the association cortices and anterior white matter. Among children, age correlated negatively with PMEs and positively with PDEs in association cortices. Compared to children, adults had lower intracellular pH. The results suggest reduction in membrane synthesis and increase in membrane degradation in adolescents and to a greater degree in adults compared to younger children. Concomitant reduction in γαATP and increase in Pi are consistent with reduced energy consumption in adolescents and further drop in middle-aged and older adults, although it is impossible to distinguish declines in energy supply from reduced demand due to shrinking neuropil, without longitudinal studies.

The association between age and functional disability in US adults with lifetime exposure to the criminal legal system, 2015–2019

ImportanceAs the global population ages, the proportion of individuals living with functional disability is increasing. Evidence suggests that functional disability is associated with worse health outcomes and is concentrated in populations with high rates of concurrent social risk factors such as criminal legal involvement (CLI), making it an increasingly important issue for advocates of health equity. ObjectiveTo determine whether age is associated with functional disability in a nationally representative sample of United States adults with lifetime exposure to the criminal legal system. DesignCross-sectional survey data from the National Survey of Drug Use and Health, 2015–2019. SettingNationally representative survey data. ParticipantsUS adults who reported lifetime history of arrest (N = 37,279). ExposureRespondents were categorized into age groups: younger adults (age 18–49); middle-aged adults (age 50–64); and older adults (age ≥ 65). Main outcome measureFunctional disability as measure by the World Health Organization Disability Assessment Score 2.0 (WHO-DAS 2.0). A higher score indicates a greater degree of functional disability. ResultsThe sample included 37,279 US adults with lifetime CLI of whom 60.0 % were younger adults, 28.5 % were middle-aged adults, and 11.5 % were older adults. The mean, unadjusted functional disability score for younger adults was 5.0 (95 % CI, 4.9, 5.1); for middle-aged adults it was 4.2 (95 % CI, 4.0, 4.4); and for older adults it was 3.2 (95 % CI, 2.9, 3.5). In models adjusted for sociodemographic and clinical confounders, differences were attenuated but remained statistically significant, indicating increased functional disability in the younger age groups. Conclusion and relevanceOur findings suggest that among adults with CLI, functional disability is distributed by age in a pattern distinct from the general population. A large number of young adults have CLI, and the findings suggest that prevalence of functional disability is exceedingly high in this marginalized group. Future studies should examine if substance use and mental health conditions contribute to these findings, and policy makers should examine if flexible interventions tailored to the needs of those with disability improve reentry outcomes for young adults with CLI.

Association Between Level of Pain and Depression Among Chronically Ill Older Adults in Rural Alabama: A Pilot Study

There is a paucity of research on pain and depression among older adults in rural communities. To address such a gap, this study examined the association between pain and depression among older rural-community-dwelling adults. Recruited from rural senior centers, 100 chronically ill older adults (age 55 or older) experiencing pain completed a cross-sectional survey. Data were collected on their level of depression (a five-item version of the Center for Epidemiologic Studies Depression scale), pain (the six-item Philadelphia Geriatric Center Pain scale), and sociodemographic factors. A multiple linear regression was conducted. With sociodemographic variables controlled, those reporting higher pain scores were significantly more likely to have higher depression scores (p &lt; .05). Older participants had lower depression scores than younger participants (p &lt; .05). In view of poorer health outcomes and limited health care access in rural areas, our findings warrant interventions to promote better access to pain management and mental health services for rural older adults.

The temporal sequence and reciprocal relationships of frailty, social isolation and loneliness in older adults across 21years.

It is unclear whether social isolation and loneliness may precede frailty status or whether frailty may precipitate social isolation and loneliness. We investigated the reciprocal and temporal sequence of social isolation, loneliness, and frailty among older adults across 21years. We used seven waves of the Longitudinal Aging Study Amsterdam from 2302 Dutch older adults (M = 72.6years, SD = 8.6, 52.1% female) ages 55 or older. Using random intercept cross-lagged panel models, we investigated between- and within-person associations of social isolation and loneliness with frailty. Frailty was measured using the Frailty Index. Loneliness was measured using the 11-item De Jong Gierveld Loneliness Scale. Social isolation was measured using a multi-domain 6-item scale. Social isolation and loneliness were weakly correlated across waves. At the between-person level, individuals with higher levels of frailty tended to have higher levels of social isolation but not loneliness. At the within-person level, the cross-lagged paths indicated that earlier frailty status predicted future social isolation and loneliness over time. However, prior social isolation was not associated with subsequent frailty except at time point 5 (T5). Loneliness at specific time points (T1, T4 and T6) predicted greater frailty at later time points (T2, T5 and T7). The results also supported reciprocal and contemporaneous relations between social isolation, loneliness and frailty. Social isolation and loneliness are potential outcomes of frailty. Public health policies and health practitioners should prioritise interventions targeting social connection among older adults with pre-frailty or frailty.

Changes in Oral Frailty and Suggestions for Clinical Use according to Age and Sex

Objective: This study aimed to identify and report the changes in oral frailty diagnosis among older Korean adults according to age and sex. Methods: The study included 217 individuals aged 60 years or older who visited senior centers. The final analysis included 100 individuals with complete data on the diagnostic items of oral frailty. After subdividing by age and sex, the average of each age group for diagnostic items was analyzed. Results: The items with oral hypofunction tended to increase sequentially with oral dryness, tongue pressure, occlusal force, and chewing ability as the age group increased. Individuals aged 65-69 years old were considered pre-orally frail and those over 70 years old were determined to be orally frail. The diagnosis of oral frailty and decline in oral function in females was observed to be much faster than in males. Conclusions: This study confirmed that the number of items with decreased oral function increased sequentially with age in older adults and these characteristics also differ according to sex. These findings can be used to prevent deterioration into oral hypofunction and serve as primary data for the phased early detection of oral frailty.

Psychological Health Outcomes of Older Adult Volunteers: Findings from The Irish Longitudinal Study on Ageing

Abstract Background Volunteering has been shown to alleviate the feeling of loneliness and have indirect positive effects on the subjective quality of life of older adults. Volunteering post-retirement has been shown to have a positive effect on loneliness, quality of life, and depression. This research aimed to examine the relationship between volunteering and depression, loneliness, and quality of life among a nationally representative sample of older adults in the Republic of Ireland. These measures were also examined in the context of volunteering and retirement. Methods Through secondary analysis of five waves of data from the Irish Longitudinal Study on Ageing (TILDA), this research explored the relationships between volunteering, retirement, loneliness, depression and quality of life. To achieve this, both cross-sectional analyses using regression models and longitudinal analysis using mixed-effects modelling were utilised. Results Volunteering had a significant negative association with loneliness [Incident Rate Ratio (IRR)=0.87, 95% CI=0.80,0.95, p&amp;lt;0.01] and depression [IRR=0.88, 95% CI=0.81, 0.96, p&amp;lt;0.01], and a positive association with quality of life [Beta (B)=0.69, 95% CI=0.39, 1.00, p&amp;lt;0.05] at baseline. These associations were not significant over time. Volunteering in retirement was associated with increased quality of life [B=0.7, 95% CI=0.2, 1.1, p&amp;lt;0.05], while associations between depression and loneliness and retirement were not significant. Those who volunteered in retirement experienced less depression over time [IRR=0.90, 95% CI=0.83, 0.99]. Conclusion The findings of this study demonstrate the positive effects of volunteering on the psychological outcomes of older adults. This study also found evidence of the long-term effects of volunteering in retirement on depression, suggesting that continued participation in volunteer activities positively impacts depression. This research demonstrates the importance of increasing opportunities and promoting volunteer participation to contribute to the positive ageing of older adults.