Community-dwelling Adults Research Articles

The Wako Cohort Study: Design and Profile of Participants at Baseline

We launched the Wako Cohort Study in 2023 to identify individual and socio-environmental factors related to the extension of healthy life expectancy and the reduction of health disparities among community-dwelling adults and to develop health promotion and care prevention strategies. This study profile aims to describe the study design and participants' profile at baseline. The Wako Cohort Study is a prospective study of community-dwelling adults aged ≥ 40 years living in Wako City, Saitama Prefecture, Japan. The Wako Cohort Study consists of two surveys: a mail-in survey for persons aged ≥ 40 years and a face-to-face assessment (on-site survey) for those aged ≥ 65 years. The survey items were designed considering the following points: 1) life course perspective (transition from middle to old age in the life course), 2) health indifference, and 3) employment in older age. A total of 8,824 individuals participated in the mail-in survey (2,395 persons aged 40-64 years and 6,429 aged ≥ 65 years). Of those aged ≥ 65 years who returned the mail survey, 1,004 participated in the subsequent on-site survey. Men aged ≥ 65 years tended to have higher health interests than those aged 40-64 years; however, this was not true for women. In the mail-in survey, 30.4 % of those aged ≥ 65 years were employed. The Wako Cohort Study is expected to provide new insights into the development of strategies to extend healthy life expectancy and reduce health disparities in Japan.

Protocol for the implementation and referral of the ecofit physical activity intervention within Diabetes Alliance Program Plus among regional, rural and remote people with type 2 diabetes in a primary care setting

This paper outlines the protocol for the ecofit implementation-effectiveness trial, a multi-component mobile Health (mHealth) intervention that aims to increase resistance and aerobic physical activity in primary care-based adults with type 2 diabetes (T2D). This study will be conducted as part of the Diabetes Alliance Program Plus (DAP+), a large-scale integrated health service intervention in a large health district in Australia. The ecofit program has previously demonstrated efficacy and effectiveness in insufficiently active people with (or at risk of) T2D and community dwelling-adults, respectively. The aim of this study is to assess the reach (primary outcome), adoption, appropriateness, feasibility and fidelity of the implementation of ecofit and the overall effectiveness of the intervention. Prospective participants are adults diagnosed with T2D, who attend primary care settings enrolled in DAP+, and are identified and referred to ecofit by a primary care clinician. To support the implementation of ecofit a host of strategies will be utilised, which includes the education and upskilling of primary care clinicians enrolled in DAP+ using brief training sessions, the supply of an information package and access to professional development. The co-primary outcomes of reach will be defined as the number of participant registrations on the ecofit platform and the number of primary care clinicians who have been introduced to ecofit. This study will evaluate the implementation of ecofit among adults with T2D within the primary care setting. The results may help improve T2D lifestyle interventions in primary care settings across Australia.

Associations between 6-min walk distance and cardiopulmonary parameter in non-obese older adults: An observational study.

The 6-min walk test (6MWT) has established itself as a classical field-test for assessing exercise capacity across diverse populations, including older adults. Despite its widespread use, the specific contribution of cardiopulmonary factors to the 6-min walk distance (6MWD) remains relatively unexplored. The primary objective of this investigation was to examine any potential associations between 6MWD and various cardiopulmonary parameters in older adults. Ninety-two non-obese older adults (66.9±4.1 years) were recruited for this study. Real-time assessments of cardiohemodynamic parameters were conducted using impedance cardiography, while cardiopulmonary parameters were evaluated using a gas analyzer during the administration of the 6MWT. Our findings revealed mild-to-strong positive correlations between 6MWD and several cardiohemodynamic parameters, including left cardiac work index, heart rate, cardiac output, and cardiac index, as well as cardiopulmonary parameters such as oxygen consumption (V˙˙O2), carbon dioxide consumption (V˙˙CO2), minute ventilation, oxygen pulse, tidal volume, respiratory exchange ratio (RER), and breath frequency at the end of walking task (p<0.05). Additionally, a negative moderate association was observed between 6MWD and systemic vascular resistance index (SVRi), while no significant correlation was found between stroke volume and 6MWD. Furthermore, a combination of SVRi, V˙˙O2, V˙˙CO2, and RER appeared to predict 6MWD with reasonable accuracy (R2=0.567, p<0.001). Our investigation highlights a robust association between cardiopulmonary parameters and 6MWD among non-obese older adults. These results also emphasize the potential impact of systemic vascular health on submaximal exercise capacity evaluation within the community-dwelling older adults.

Disparities in COVID-19-Related Mortality Among Older Adults With Alzheimer's Disease and Related Dementias: Variations Over Time.

Older adults with Alzheimer's disease and related dementias (ADRD) had a high risk of COVID-19-related mortality. Racial and ethnic minorities were disproportionally impacted by the pandemic. The variations in disparities, including racial and ethnic disparities and disparities across communities, in COVID-19-related mortality across the different stages of the COVID-19 pandemic among the ADRD population are unknown. This observational study estimated linear probability models for community-dwelling older adults with ADRD who were diagnosed with COVID-19 in 2020 and 2021 using multiple national data (e.g., Medicare data), accounting for individual and community characteristics. Disparities in 30-day mortality were compared between 2020 and 2021. The socioeconomic disparity in COVID-19-related mortality across communities became insignificant during the later stage of the pandemic, ethnic differences in COVID-19-related mortality decreased but persisted, and racial disparity remained largely unchanged. The study provides insights into interventions to mitigate lingering disparities in health outcomes among the vulnerable population.

Changes in Cerebral Hemodynamics and Progression of Subclinical Vascular Brain Disease: A Population-Based Cohort Study.

Cerebral hypoperfusion is associated with vascular brain injury and neurodegeneration, but their longitudinal relationship is largely unknown, especially in healthy older adults. We investigated the longitudinal relationship between cerebral hemodynamics and subclinical vascular brain disease in community-dwelling older adults without stroke or dementia at baseline. Participants underwent brain magnetic resonance imaging scans every 3 to 4 years between 2005 and 2016. Cerebral blood flow (CBF) was measured through 2-dimensional phase-contrast magnetic resonance imaging; the cerebrovascular resistance index (CVRi) was defined as the ratio of mean arterial blood pressure to total CBF. Simultaneous progression in subclinical brain disease was evaluated through repeated magnetic resonance imaging assessment of white matter hyperintensities (WMH), cerebral microbleeds, lacune, and brain atrophy. The longitudinal relationship was estimated using generalized estimating equations, with adjustment for age, sex, smoking habits, body mass index, systolic blood pressure (for CBF measures), lipid level, history of diabetes and cardiovascular disease, and the baseline burden of magnetic resonance imaging markers. Among 3623 older adults (mean age, 61.4±9.3 years; 54.6% women), large decreases and increases in CBF and increases in CVRi over time were associated with white matter hyperintensity progression. The risk ratios for white matter hyperintensity progression were 1.36 (95% CI, 1.19-1.55) for large decreases in total CBF (lowest quartile), 1.02 (95% CI, 0.91-1.14) for moderate decreases (second quartile), and 1.28 (95% CI, 1.14-1.45) for large increases (highest quartile), compared with stable CBF (third quartile). The corresponding risk ratios for changes in CVRi were 1.13 (95% CI, 1.00-1.30), 1.25 (95% CI, 1.09-1.43), and 1.33 (95% CI, 1.16-1.52) for the second to fourth (versus lowest) quartiles, respectively, showing a dose-response relationship. The changes in CBF also demonstrate a similar U-shaped association with the progression of brain atrophy and incident microbleeds, whereas increases in CVRi were associated with lower microbleed risk. Longitudinal changes in CBF and CVRi may capture distinct pathophysiologies linking cerebral hemodynamics to subclinical brain disease, extending beyond single-time point measurements.

The association between functional social support, marital status and memory in middle-aged and older adults: An analysis of the canadian longitudinal study on aging.

Although several studies have reported positive associations between functional social support (FSS) and memory, few have explored how other social variables, such as marital status, may affect the magnitude and direction of this association. We examined whether marital status modifies the association between FSS and memory in a sample of community-dwelling, middle-aged and older adults. Data at three timepoints, spanning six years, were analyzed from the Tracking Cohort of the Canadian Longitudinal Study on Aging (n = 10,318). Linear mixed models were used to regress memory onto FSS across all three timepoints, adjusting for multiple covariates. The moderating effect of marital status was assessed by adding its interaction with FSS in the model. Separate regression models were built for overall FSS and four subtypes (positive interactions, affectionate, emotional/informational, and tangible support). We found significant and positive adjusted associations for overall FSS (β: 0.07; 95 % CI: 0.01, 0.13), positive interactions (β: 0.06; 95 % CI: 0.01, 0.11), and affectionate support (β: 0.05; 95 % CI: 0.00, 0.11) with memory. However, the interaction between marital status and FSS (overall and subtypes) was not statistically significant (likelihood ratio test p-value = 0.75), indicating that FSS does not have differing effects on memory depending on marital status. Our findings do not provide evidence to suggest that marital status affects the association between FSS and memory in middle-aged and older adults. Nonetheless, policymakers and practitioners should take a comprehensive approach when exploring how various dimensions of social relationships may uniquely influence cognitive trajectories.

Baseline nutrition risk as measured by SCREEN-8 predicts self-reported 12-month healthcare service use of older adults 3 years later.

This study investigated whether nutrition risk, as measured by SCREEN-8 at baseline, was associated with self-reported healthcare service use in the past 12 months among community-dwelling older adults who were interviewed 3 years later. Data from the Canadian Longitudinal Study on Aging were used. SCREEN-8 assessed nutrition risk among community-dwelling persons ages 55+. Multivariable logistic regression determined if baseline SCREEN-8 score was associated with the following healthcare services reported to occur in the 12 months preceding the 3-year follow-up period: (i) overnight hospital admission (n=13 623), (ii) emergency room visit (n=13 614), (iii) contacting a family doctor (n=13 616), (iv) visiting dental professional (n=13 288), and (v) visiting a doctor due to an infection (n=13 171) after adjusting for demographic and health variables. Those with higher SCREEN-8 scores (lower nutrition risk) had significantly lower odds of reporting: (i) an overnight hospital admission (χ2 (27, 13 587)=10.59, p<0.001); (ii) visiting a hospital emergency room (χ2 (27, 13 578)=9.64, p<0.001); and (iii) visiting a doctor due to an infection (χ2 (27, 13 135)=10.32, p<0.001) at 3-year follow-up. Less nutrition risk was significantly associated with higher odds of reporting visiting a dental professional (χ2 (27, 13 252)=17.88, p<0.001). Baseline nutrition risk was not significantly associated with visiting a family doctor at the 3-year follow-up. SCREEN-8 predicted future self-reported 12-month healthcare service use among older adults in expected directions.

The relationship between trajectories of intrinsic capacity and differences in the risk of functional ability decline in community-dwelling older adults: A socio-ecological approach.

Functional ability (FA), a key determinant of healthy aging, is determined by intrinsic capacity (IC), environmental factors, and their interactions. IC is a composite of physical and mental capacities that undergo constant change. Therefore, understanding the factors that influence IC requires a multi-level analysis of individuals to optimize its trajectory. Individuals aged ≥ 65 were included in the Korean Longitudinal Study of Aging (2012-2020). Impaired IC (IIC) scores were tracked over eight years using latent class growth modeling to classify trajectory patterns. Determinants were identified through multinomial logistic regression. The relationship between IIC trajectory and FA decline was assessed using Kaplan-Meier analysis and the Cox proportional hazards model. Of the 7486 subjects, 2268 (mean age 72.26 [SD 5.31] years; female 56.4 %) were included after excluding those who were underage, had lost independence, or were missing baseline data. The IIC trajectories were categorized into four classes: low-persistent (Class 1, 48.46 %); low-increasing (Class 2, 17.46 %); high-decreasing (Class 3, 20.37 %); and high-stable (Class 4, 13.71 %). Over a mean follow-up of 7.21 years, 536 individuals experienced a decline in FA. After adjusting for confounders, the hazard ratios (HRs) were 1.95 (95 % CI 1.51-2.50) for class 2, 1.93 (1.50-2.46) for class 3, and 3.41 (2.64-4.39) for class 4 compared to class 1. Additionally, age, gender, marital status, employment, social participation, and living status had overlapping effects on both IC and FA. Understanding the heterogeneity of IC, combined with multidomain interventions, can enable FA maintenance and promote healthy aging.

Arterial Stiffness and Subsequent Incidence of CKD and Kidney Function Decline in a Large Longitudinal Community Cohort: The Atherosclerosis in Communities (ARIC) Study.

Arterial stiffness is associated with prevalent chronic kidney disease (CKD). Whether arterial stiffness is prospectively associated with incident CKD is inconclusive. Longitudinal cohort study. Using data from the Atherosclerosis Risk in Communities (ARIC) Study, the primary analysis included 3,161 participants without prevalent CKD at visit 5; a secondary analysis studied 4,341 participants with any estimated glomerular filtration rate (eGFR) record across visits 5 to 7. Carotid-femoral pulse wave velocity (cfPWV), heart-femoral PWV (hfPWV), heart-ankle PWV (haPWV), brachial-ankle PWV (baPWV), heart-carotid PWV (hcPWV), and femoral-ankle PWV (faPWV). Primary analysis - incident CKD, defined as an eGFR <60 ml/min/1.73m2 accompanied by >25% decline eGFR or CKD hospitalization. Secondary analysis - eGFR slope. Primary analysis - Cox regression models to calculate hazard ratio (HR). Secondary analysis - multilevel mixed effects models to estimate the eGFR slope across visits. Median follow-up was 6.6 years. 460 participants developed incident CKD (incidence rate 22.0/1,000 person-years). The highest quartiles (Q4) of cfPWV, hfPWV, and haPWV were associated with an increased risk of incident CKD compared to the lowest quartile (Q1) (HRs, 1.53 [95% CI, 1.15 to 2.04] and 1.49 [95% CI, 1.12 to 1.99], and 1.56 [95% CI, 1.16 to 2.08], respectively). The results were consistent in subgroups. In the secondary analysis, the Q4s of cfPWV, hfPWV, haPWV, baPWV, and hcPWV were significantly associated with a faster eGFR decline compared to Q1 (e.g., for cfPWV, -0.44 mL/min/1.73 m2/year [95% CI, -0.56 to -0.33] in Q4 versus -0.37 [95% CI, -0.48 to -0.26] in Q1). All p-value <0.05. faPWV was not associated with incident CKD or eGFR slope. Residual confounding. Greater arterial stiffness, especially higher cfPWV, hfPWV, and haPWV, was prospectively associated with a higher risk of incident CKD and faster decline in eGFR among community-dwelling older adults, supporting a pathophysiological contribution of arterial stiffness to the development of CKD.

Substantial Impact of Later-Life Depression Among Community Older Adults on the Family Caregivers' Burden in the Home Care Setting of Chiang Mai, Northern Thailand.

Background and Objectives: Depression is a common geriatric problem globally. It is particularly burdensome in low- and middle-income countries, where care for older people mainly relies on the family in the absence of long-term care facilities. This study aimed to assess the level of caregivers' burden among family caregivers who are taking care of older persons with depression in the home care setting within the communities of Chiang Mai, Northern Thailand. Materials and Methods: This cross-sectional study investigated 867 pairs of community-dwelling older adults and their family caregivers in Chiang Mai, Thailand. The depression of older people was screened using the 15-item Geriatric Depression Scale. The family caregivers' burden and quality of life were measured using the Caregiver Burden Inventory (CBI) and the European Quality of Life (EQ) Five Dimension Five Level scales. The analysis applied was multivariable regression. Results: Two-thirds of the family caregivers were female. The mean age was 55.3 ± 13.8 years. The family caregivers caring for older persons with depression experienced significantly higher levels of burden in terms of the CBI total score (Coefficient: 10.60, 95% CI: 8.60, 12.60) and lower quality of life in terms of the EQ visual analogue scale (Coefficient: -5.52, 95% CI: -8.41, -2.62). They were more likely to take sick leave from their jobs (adj. OR 4.00, 95% CI: 1.73, 9.24) and more often to get sick (adjusted OR 7.26, 95% CI: 2.68, 19.64) than the caregivers of older adults without depression. Conclusions: Urgent interventions to prevent depression among older adults and systematic support to relieve family caregiver burden are necessary. The measures to relieve family caregiver burden include care capacity building, psychological support, respite care service, financial support, and other health promotion activities.

Psychometric evaluation of the elderly mobility scale in Indonesia.

The Elderly Mobility Scale (EMS) is widely used to identify mobility limitations in older adults, though it has not been validated in Indonesia. To evaluate the reliability and validity of the Indonesian version of the EMS (EMS-I). A cross-sectional design involving 230 older adults in South Tangerang City, Indonesia, was used. The EMS was translated and culturally adapted following a multistage process. Psychometric testing included content validity, exploratory, and confirmatory factor analysis. The participants had a mean age of 70, with 65.7 % female. Results demonstrated high internal consistency (Cronbach's alpha = .942) and item content validity index (I-CVI > .75). Exploratory factor analysis confirmed a unidimensional structure, with confirmatory factor analysis supporting a good model fit. The EMS-I shows high reliability and validity, enabling healthcare professionals to monitor mobility status and facilitate targeted interventions for enhancing well-being in community-dwelling older adults in Indonesia.

PLAN—Dementia literacy education and navigation for Korean elders with probable dementia and their caregivers: Rationale, methods, and design of a community-based, randomized, controlled, multi-site clinical trial

Linkage to medical services is key to early detection, diagnosis, and care for dementia. Yet, racial and ethnic minoritized older adults and their caregivers are particularly vulnerable to inequity in dementia care due to limited dementia literacy. Mobilizing community resources such as community health workers (CHWs) can benefit older patients and their caregivers who are challenged by linguistic barriers and low health literacy. Preparing for healthy aging through dementia Literacy education And Navigation (PLAN), is a CHW-led intervention program designed to promote linkage to medical services for dementia and caregiver outcomes in a multi-site clinical trial in the Greater Washington and New York metropolitan areas. This protocol describes the rationale, design, and methods of the PLAN trial. We recruited 288 dyads of eligible Korean American older adults with undiagnosed dementia and their caregivers, totaling 576 participants. Data collection is ongoing. Findings from this trial will contribute to knowledge around identifying community-dwelling older adults with probable dementia with limited health resources as well as navigating appropriate medical evaluation and support. gov identifier: NCT03909347.

A 3-Month Dual-Task Exercise Randomized Pilot Trial Improves Dynamic Stability and Coordination in Community-Dwelling Older Adults.

Dual-task (DT) exercises combine both physical and cognitive activities and have the potential to efficiently enhance both physical and cognitive function. This study aimed to determine if, compared with exercise-only (EO) and control (C) groups, adults in a DT training program improved measures of cognitive and/or physical functioning. Thirty-five participants (Mage = 65.7 ± 8.5years; 74.3% female, 25.7% male) were randomly sorted into EO (n = 15), DT (n = 10), and C (n = 10). EO and DT participated in 3months of twice weekly, 50-min exercise. DT played cognitive games on a SMARTfit Cognitive-Motor Exercise System during exercise sessions. C did not participate in any supervised sessions. Cognition was assessed with a Cognivue Thrive program. Dynamic stability, coordination, and lower body strength were assessed. Linear mixed-effects models investigated effects for different groups. For outcomes showing significant (p < .05) differences, pairwise t tests were conducted between all treatment and time comparisons. Dynamic stability and coordination improved in DT and EO (p = .002 and .04, respectively), but not in C in the first 6weeks (p = .58). Cognition and memory did not change over time among the three groups. Healthy, independent-living older adults in either DT or EO improved dynamic stability and coordination over time and DT improved balance and functional mobility more than either EO or C. No improvements in several standard cognition or memory measurements were observed. Significance/Implications: A DT exercise program improved balance and coordination, but not cognition or memory, in healthy, independent-living older adults.

Predicting incident dementia in community-dwelling older adults using primary and secondary care data from electronic health records.

Predicting risk of future dementia is essential for primary prevention strategies, particularly in the era of novel immunotherapies. However, few studies have developed population-level prediction models using existing routine healthcare data. In this longitudinal retrospective cohort study, we predicted incident dementia using primary and secondary care health records at 5, 10 and 13 years in 144 113 Scottish older adults who were dementia-free prior to 1st April 2009. Gradient-boosting (XGBoost) prediction models were trained on two feature subsets: data-driven (using all 171 extracted variables) and clinically supervised (22 curated variables). We used a random-stratified internal validation set to rank top predictors in each model, assessing performance stratified by age and socioeconomic deprivation. Predictions were stratified into 10 equally sized risk deciles and ranked by response rate. Over 13 years of follow-up, 11 143 (8%) patients developed dementia. The data-driven models achieved marginally better precision-recall area-under-the-curve scores of 0.18, 0.26 and 0.30 compared to clinically supervised models with scores of 0.17, 0.27 and 0.29 for incident dementia at 5, 10 and 13 years, respectively. The clinically supervised model achieved comparable specificity 0.88 [95% confidence interval (CI) 0.87-0.88] and sensitivity (0.55, 95% CI 0.53-0.57) to the data-driven model for prediction at 13 years. The most important model features were age, deprivation and frailty, measured by a modified electronic frailty index excluding known cognitive deficits. Model precision was consistent across socioeconomic deprivation quintiles but lower in younger-onset (<70 years) dementia cases. At 13 years, dementia was diagnosed in 32% of the population classified as highest risk with 40% of individuals in this group below the age of 80. Personalized estimates of future dementia risk from routinely collected healthcare data could influence risk factor modification and help to target brain imaging and novel immunotherapies in selected individuals with pre-symptomatic disease.

Combined effects of social isolation and loneliness on disability incidence in older adults.

Relationships among social isolation, loneliness, and disability onset remain unclear. We investigated the distinct patterns of disability development among Japanese older adults who experience social isolation and loneliness. This study applied a prospective observational approach. Data from 4,716 community-dwelling independent older adults were analyzed. The Japanese version of the University of California, Los Angeles Loneliness Scale Version 3 and the Social Isolation Scale were used to measure loneliness and social isolation, respectively. The long-term care insurer conducted monthly follow-ups with participants over two years to determine their care needs. Disability onset was defined as the point at which participants were certified by a care manager as requiring long-term care. During the follow-up period, 265 participants (5.6 %) required long-term care insurance certification due to disability onset. The incidence of disability in the lonely and not lonely groups was 8.0 % and 4.5 %, respectively. In the socially isolated and not socially isolated groups, it was 7.1 % and 4.4 %, respectively. The Cox proportional hazards regression model revealed a significantly higher risk of disability incidence in the lonely and socially isolated groups. The high-risk group experiencing both loneliness and social isolation exhibited significantly higher hazard ratios than the low-risk group without these symptoms. The results indicated that older adults experiencing both social isolation and loneliness were at high-risk for future disability incidence. This finding provides insight into the complex interplay between social factors and disability, which can contribute to the development of effective interventions to promote healthy aging and prevent disability.

Association of protein intake with discordance between cystatin C- and creatinine-based eGFR in community-dwelling Japanese adults.

Recent studies have reported the prognostic implications of the discordance between creatinine-based and cystatin C-based estimated glomerular filtration rates (eGFRcr and eGFRcys, respectively); however, the associations of protein intake with the eGFR discordance have not been investigated. The present study investigated whether protein intake was associated with the discordance between eGFRcr and eGFRcys. We cross-sectionally analyzed data from a Japanese community-based cohort including 6,143 participants (50.7% women; age range, 40-97 years). Protein intake was estimated by food groups derived from a validated food frequency questionnaire. As a measure of discordance, we modeled the ratio of eGFRcys and eGFRcr (eGFRcys divided by eGFRcr) continuously in multivariable linear regression models and categorically (<0.8, 0.8-1.1, and ≥1.2) in multinomial logistic regression models. We analyzed men and women separately given their distinct dietary patterns. The mean eGFR ratio was 1.15 in men and 1.19 in women. In multivariable linear regression analysis, total protein was positively associated with the eGFR ratio in men (regression coefficient, 0.005 [95% CI, 0.003, 0.007]). When animal and plant proteins were analyzed separately, a significant positive association was seen for animal protein only in men (0.005 [0.003, 0.007]). The results were similar when we modeled protein intake categorically by multinomial logistic regression. This study suggests intake of dietary protein, especially animal protein in men, as a determinant of eGFR discordance. Future studies exploring eGFR discordance and health outcomes should consider simultaneously assessing dietary protein intake.

Ethnicity predicts long-term depressive symptom patterns in older adults with type 2 diabetes.

Depression is a chronic disorder that significantly affects functional decline in older adults, especially those with type 2 diabetes (T2D). Ethnic groups may experience different depression risks and severities, yet the effect of ethnicity on depression trajectories and specific dimensions in older adults with T2D remains largely unexamined. We examined the longitudinal associations of ethnicity with depression and its specific dimensions over time in older Ashkenazi and non-Ashkenazi Jews with T2D. Generalized estimating equations (GEE) models were employed to analyze the longitudinal associations of ethnicity with numbers of depressive symptoms and specific depression dimension, adjusting for sociodemographics, cognition, T2D characteristics, and cardiovascular risk factors. Community-dwelling older adults from the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study. 902 Ashkenazi and non-Ashkenazi Jews, mean age=72.3 years. The Geriatric Depression Scale-15 (GDS-15) and its five dimensions: Dysphoric Mood, Withdrawal Apathy-Lack of Vigor, Anxiety, Hopelessness, and Memory Complaint. At baseline, Ashkenazi Jews reported significantly lower GDS-15 scores compared to non-Ashkenazi Jews. They exhibited lower scores in Dysphoric Mood and Hopelessness dimensions. GEE models confirmed these findings, showing Ashkenazi Jews had significantly lower total GDS-15 scores (β=0.86, 95% CI 0.75-0.99; p=0.03), Dysphoric Mood (β=0.76 (0.52-0.90], p=0.006), Hopelessness (β=0.74 [0.58-0.95], p=0.017) and lower rates of clinical depression (OR= 0.68 [0.52-0.90], p=0.006). These data offered no evidence of a difference in trends between the Ashkenazi and non-Ashkenazi groups on depression trajectories. Ethnicity is associated with the longitudinal trajectories of depression and its specific dimensions in older adults with T2D. Further investigation of contributing factors, including social determinants of health, is essential.

Physical, Social, Psychological, and Environmental Predictors of Life Satisfaction Among Older Adults.

Life satisfaction is a multidimensional construct impacted by many variables and needs to be explored within that context. A correlational design was used to survey community-dwelling older adults to determine perceptions of life satisfaction and its association with physical, social, psychological, and environmental factors. The sample was primarily White (n = 474 [93%]) but balanced between male (n = 253 [50%]) and female (n = 258 [50%]). The mean age was 73.1 (SD, 4.8) years. Associations with life satisfaction were evaluated using linear regression models. In multivariable modeling, social isolation, living alone, depression, sleep disturbance, social vulnerability, and physical ability predicted life satisfaction. Physical ability was the only predictor of high life satisfaction. Findings underscore the importance of helping older adults with improvements in physical ability and addressing social, psychological, and environmental influences that may lead to low life satisfaction.

Association Between Kyphosis and Sleep Disturbance in Community-Dwelling Older Adults: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study

Association Between Kyphosis and Sleep Disturbance in Community-Dwelling Older Adults: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study

Association of ambient temperature with social isolation among the community-dwelling Chinese older adults: A cross-sectional study in Hong Kong.

The adverse health impacts of ambient temperature have been well-documented, encompassing not only the mortality and morbidity burden but also mood and mental health disorders. However, the relationship between temperature and social isolation remains unexplored. The objective of the current study was to investigate the potential associations between ambient temperature and social isolation among the aging population. We took advantage of a cross-sectional survey conducted between January 2017 and November 2018 from a community service program special for older adults aged ≥60 who lived in a central community of Hong Kong. The personal social isolation was assessed by the validated Lubben Social Network Scale-6 (LSNS-6), with a score ranging from 0 to 30 and score of less than 12 indicating social isolation. The environmental exposures, including ambient temperature, sunshine hours, rainfalls, and air pollution, were obtained from the nearby monitoring stations. The association of ambient temperature with LSNS-6 score or social isolation was examined by the generalized linear models while adjusting the potential confounding from other environmental exposures and personal sociodemographic factors. Among the 1616 participants, the distribution of LSNS-6 score was approximately normal and the mean score was a bit higher on cool days than on hot days (13.0 vs. 12.2). Compared with cool temperatures (14.4-19.5oC), the independent effect estimates of hot ambient temperatures (24.5-28.7oC) was associated with a 2.38 (95%CI: 1.63-3.13) decrease in LSNS-6 score. Meanwhile, we observed statistically significant associations of sunshine exposure, gender, health status, marital status, living alone, religion, and housing type with LSNS-6 score or social isolation. Our study revealed a clear association between ambient cool temperatures and reduced social isolation, as well as association between hot temperatures and social isolation among older Chinese adults residing in the urban community of Hong Kong.