Health Of Elderly Population Research Articles

Facial aging, cognitive impairment, and dementia risk

BackgroundFacial aging, cognitive impairment, and dementia are all age-related conditions. However, the temporal relation between facial age and future risk of dementia was not systematically examined.ObjectivesTo investigate the relationship between facial age (both subjective/perceived and objective) and cognitive impairment and/or dementia risk.MethodsThe study included 195,329 participants (age ≥ 60 y) from the UK Biobank (UKB) with self-perceived facial age and 612 participants from the Nutrition and Health of Aging Population in China Project (NHAPC) study (age ≥ 56 y) with objective assessment of facial age. Cox proportional hazards model was used to prospectively examine the hazard ratios (HRs) and their 95% confidence intervals (CIs) of self-perceived facial age and dementia risk in the UKB, adjusting for age, sex, education, APOE ε4 allele, and other potential confounders. Linear and logistic regressions were performed to examine the cross-sectional association between facial age (perceived and objective) and cognitive impairment in the UKB and NHAPC, with potential confounders adjusted.ResultsDuring a median follow-up of 12.3 years, 5659 dementia cases were identified in the UKB. The fully-adjusted HRs comparing high vs. low perceived facial age were 1.61 (95% CI, 1.33 ~ 1.96) for dementia (P-trend ≤ 0.001). Subjective facial age and cognitive impairment was also observed in the UKB. In the NHAPC, facial age, as assessed by three objective wrinkle parameters, was associated with higher odds of cognitive impairment (P-trend < 0.05). Specifically, the fully-adjusted OR for cognitive impairment comparing the highest versus the lowest quartiles of crow’s feet wrinkles number was 2.48 (95% CI, 1.06 ~ 5.78).ConclusionsHigh facial age was associated with cognitive impairment, dementia and its subtypes after adjusting for conventional risk factors for dementia. Facial aging may be an indicator of cognitive decline and dementia risk in older adults, which can aid in the early diagnosis and management of age-related conditions.

A case for the use of deep learning algorithms for individual and population level assessments of mental health disorders: Predicting depression among China's elderly

BackgroundWith the continuous advancement of age in China, attention should be paid to the mental well-being of the elderly population. The present study uses a novel machine learning (ML) method on a large representative elderly database in China as a sample to predict the risk factors of depression in the elderly population from both holistic and individual level. MethodsA total of participants met the inclusion criteria from the fourth waves of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed with ML algorithms. The level of depression was assessed by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). ResultsThe current study found top 5 factors that were important for predicting depression in the elderly population in China, including average sleep time, gender, age, social activities and nap time during the day. The results also provide reliable diagnostic likelihood at the individual level to support clinicians identify the most impactful factors contributing to patient depression. Our findings also suggested that activities such as interacting with friends and play ma-Jong, chess or join community clubs may have a positive collaborative effect for elderly's mental health. ConclusionsHolistic approaches are an effective method of deriving and interpreting sophisticated models of mental health in elderly populations. More detailed information about a patient's demographics, medical history, sleeping patterns and social/leisure activities can help to inform policy and treatment interventions on a population and individual level. Large scale surveys such as CHARLS are effective methods for testing the most accurate models, however, further research using professional clinical input could further advance the field.

Can tissue-specific PD-1/PD-L1 targeting combined with other immune checkpoint blockades enhance immune clearance?

Age-related disorders are exacerbated by senescent cells (SnCs) due to their secretion of proinflammatory molecules, yet current therapeutic strategies have limited success in preclinical settings and clinical trials. A novel approach is needed to enhance SnCs clearance by targeting immune checkpoints, particularly the PD-1/PD-L1 axis, combined with tissue-specific delivery of therapeutic agents. This strategy is critical in reducing the chronic inflammation and improving tissue health in aging populations. However, challenges such as immune evasion by SnCs and potential autoimmune responses must be addressed. The aim of this manuscript is to propose a combined approach to improve the efficacy of senolytic therapy.

Impact of physical activity on mental health in elderly population

Impact of physical activity on mental health in elderly population

Prevention of Dementia Through Physical Exercise and Cognitive Training: A Narrative Review

Background: Dementia reduces the ability to live independently, thus deteriorating the patient’s quality of life and caregivers' mental health. Consequently, dementia indirectly affects economic and social growth. Dementia is also a major contributor to death worldwide. There is no effective treatment for dementia, but preventing physical and cognitive inactivity among the elderly could help. Studies show that the risk of dementia increases in the elderly with mild cognitive impairment (MCI). Methods: This review set out to compare the effects of physical exercise (PE) and cognitive training (CT) on cognitive performance among the elderly with MCI, by examining the evidence from published literature between 2013-2023. Four major electronic databases were used to search the relevant studies, resulting in 2782 articles. A total of fourteen articles were included in the review. Results: The findings showed that interventions with naturally combined cognitive and physical training not only improved cognitive performance, but also prevented the elderly from stress and fatigue. Integrating physical exercise and cognitive training interventions with the best combination method is crucial to ensure participant adherence. Therefore, the intervention can be incorporated effectively into healthcare policies and programs to support cognitive health in aging populations. Conclusion: Future studies should also explore the optimal duration of training sessions to maximise cognitive benefits and ensure participant adherence and motivation.

The impact of age-related hearing loss on cognitive decline: The mediating role of brain age gap

In recent years, the relationship between age-related hearing loss, cognitive decline, and the risk of dementia has garnered significant attention. The significant variability in brain health and aging among individuals of the same chronological age suggests that a measure assessing how one’s brain ages may better explain hearing-cognition links. The main aim of this study was to investigate the mediating role of Brain Age Gap (BAG) in the association between hearing impairment and cognitive function.This research included 185 participants aged 20–79 years. BAG was estimated based on the difference between participant’s brain age (estimated based on their structural T1-weighted MRI scans) and chronological age. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test while hearing ability was measured using pure-tone thresholds (PTT) and words-in-noise (WIN) perception. Mediation analyses were used to examine the mediating role of BAG in the relationship between age-related hearing loss as well as difficulties in WIN perception and cognition.Participants with poorer hearing sensitivity and WIN perception showed lower MoCA scores, but this was an indirect effect. Participants with poorer performance on PTT and WIN tests had larger BAG (accelerated brain aging), and this was associated with poorer performance on the MoCA test. Mediation analyses showed that BAG partially mediated the relationship between age-related hearing loss and cognitive decline.This study enhances our understanding of the interplay among hearing loss, cognition, and BAG, emphasizing the potential value of incorporating brain age assessments in clinical evaluations to gain insights beyond chronological age, thus advancing strategies for preserving cognitive health in aging populations.

Musculoskeletal Failure.

Osteoarthritis, osteoporosis, and sarcopenia are prevalent musculoskeletal disorders that significantly impact the aging population's health and quality of life. Osteoarthritis, characterized by joint inflammation, leads to pain, stiffness, and reduced mobility. Osteoporosis, a condition marked by bone density loss, increases fracture susceptibility, especially in postmenopausal women and older adults. Sarcopenia, the age-related loss of muscle mass and function, contributes to frailty and an increased risk of falls. Combined, osteoarthritis, osteoporosis and sarcopenia constitute "Musculoskeletal Failure." These 3 conditions share common risk factors like aging, genetics, and hormonal changes, as well as unhealthy lifestyle behaviors resulting in systemic chronic inflammation. Healthy lifestyle behaviors, including regular physical activity and a nutritious diet across the lifespan play a crucial role in the prevention and management of musculoskeletal failure. Awareness of the relationship between lifestyle behaviors, systemic chronic inflammation and the development and progression of these 3 common conditions is a key step in prevention, early detection and are essential for addressing the complex interplay of these musculoskeletal disorders. As the global population ages, understanding and effectively preventing and managing osteoarthritis, osteoporosis, and sarcopenia become paramount for promoting healthy aging and mitigating the societal and economic burden associated with these conditions.

Association of dietary selenium intake and all-cause mortality of Parkinson’s disease and its interaction with blood cadmium level: a retrospective cohort study

BackgroundParkinson’s disease (PD) is a slowly progressive neurodegenerating disease that may eventually lead to disabling condition and pose a threat to the health of aging populations. This study aimed to explore the association of two potential risk factors, selenium and cadmium, with the prognosis of Parkinson’s disease as well as their interaction effect.MethodsData were obtained from the National Health and Nutrition Examination Survey (NHANES) 2005–2006 to 2015–2016 and National Death Index (NDI). Participants were classified as Parkinson’s patients by self-reported anti-Parkinson medications usage. Cox regression models and restricted cubic spline models were applied to evaluate the association between PD mortality and selenium intake level as well as blood cadmium level. Subgroup analysis was also conducted to explore the interaction between them.ResultsA total of 184 individuals were included. In full adjusted cox regression model (adjusted for age, gender, race, hypertension, pesticide exposure, smoking status and caffeine intake), compared with participants with low selenium intake, those with normal selenium intake level were significantly associated with less risk of death (95%CI: 0.18–0.76, P = 0.005) while no significant association was found between low selenium intake group and high selenium group (95%CI: 0.16–1.20, P = 0.112). Restricted cubic spline model indicated a nonlinear relationship between selenium intake and PD mortality (P for nonlinearity = 0.050). The association between PD mortality and blood cadmium level was not significant (95%CI: 0.19–5.57, P = 0.112). However, the interaction term of selenium intake and blood cadmium showed significance in the cox model (P for interaction = 0.048). Subgroup analysis showed that the significant protective effect of selenium intake existed in populations with high blood cadmium but not in populations with low blood cadmium.ConclusionModerate increase of selenium intake had a protective effect on PD mortality especially in high blood cadmium populations.

Egg consumption and bone mass density among the elderly: A scoping review.

Eggs offer a range of essential nutrients that could support skeletal health as individuals age. Maintaining bone density is crucial for reducing the risk of fractures and improving overall mobility and quality of life in later years. Understanding the potential benefits of habitual egg consumption on bone mass density among older people is essential, given that the natural decline in bone mass density occurs with age. This area of research has not garnered sufficient attention basically because of the mixed reactions and conflicting reports about the safety of egg consumption especially among the older adults. This scoping review aims to systematically examine the existing literature to map the evidence regarding the association between habitual egg consumption and bone mass density in older adults' individuals. The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines to ensure methodological rigor and transparency. Five electronic databases were searched for published pieces of literature. While high egg intake has been linked to increased mortality and dyslipidemia, eggs contain compounds like Ovo transferrin and carotenoids that may benefit bone health. As aging increases vulnerability to bone fragility and fractures, it's crucial to provide comprehensive dietary recommendations. The complex relationship between egg consumption, cholesterol, and health highlights the need for nuanced assessment. Overall, eggs present a potentially valuable dietary component for promoting bone health in aging populations. Limited research on the link between egg consumption and bone mass density in older adults highlights the need for further investigation. Concerns about cholesterol have overshadowed potential benefits. Given aging populations and bone health challenges, exploring eggs' role in preventing falls and fractures is essential for a proactive approach to older adults' well-being.

Advancing Cognitive Health in Aging Populations by Leveraging Digital Assessment

Advancing Cognitive Health in Aging Populations by Leveraging Digital Assessment

Brief virtual intervention associated with increased social engagement and decreased negative affect among people aging with HIV

ABSTRACT Virtual Villages—online communities that deliver supports to promote aging in place—are proposed to mitigate isolation and support the health of aging populations. Using a community-engaged approach, we developed and pilot-tested a Virtual Village intervention tailored for people living with HIV (PLWH) aged 50+ . The intervention employed a Discord server featuring social interaction, regional and national resources, expert presentations, and mindful meditation exercises. In 2022, a sample of PLWH aged 50+ from three U.S. study sites participated in a four-week pilot. Pre- and post-intervention surveys assessed participants’ demographic characteristics; degree of loneliness, social connectedness, HIV-related stigma, and technology acceptance; mental wellbeing and physical health outcomes; and user experience. Participants (N = 20) were socioeconomically and racially/ethnically diverse, aged 51–88 years, and predominantly identified as gay or bisexual men (75%). Paired t-tests revealed a significant increase in participants’ mean social engagement scores and a significant decrease in participants’ mean negative affect scores, following the intervention. User experience scores were acceptable and participants reported a positive sense of connectedness to the Virtual Village community. Results suggest that a virtual community can be accessible to older PLWH and may enhance social engagement and improve aspects of mental wellbeing.

Adaptative computerized cognitive training decreases mental workload during working memory precision task - A preliminary fNIRS study

With the growing concern for the health of ageing populations, much research continues to look at the impact of cognitive training, particularly in relation to cognitive decline. We sought to use novel techniques, including augmented reality and portable neurotechnology, to evaluate the impact of a dynamically adjusting cognitive training programme, in comparison to a statically challenging alternative. Before and after an 8-week training period, and at a 5-week follow-up, we used portable functional Near Infrared Spectroscopy to examine mental workload in a mixed battery of cognitive and transfer tasks. A recently developed tablet-based task was used to identify changes in cognitive misbinding. Augmented Reality was used to create a supermarket shopping experience, as a more ecologically valid and realistic transfer task relating to an everyday task relating to independence that quickly becomes difficult with cognitive decline. The analyses showed a decreased mental workload within the dorsolateral prefrontal cortex and that participants considerably increased their performance in the trained task. Some results were maintained at the 5-week follow-up assessment. In terms of transfer, we observed reliable group differences immediately after training completion, which were mainly driven by distinct conditions. Some behavioural memory gains were maintained during the follow-up. The use of novel technologies brought new insights into the effects produced by the dynamic computerised cognitive training programme, which has potential future applications in cognitive decline screening and prevention.

FRAILTY AND DEVELOPMENT ACROSS INDIAN STATES

Abstract Introduction Frailty, a common syndrome of vulnerability among older adults, provides insight into the overall health of aging populations. Life-course influences play an important role in late-life health, but the role of social and economic development has not been well-explored. We study these indicators at the state level in the Longitudinal Aging Study in India (LASI). Methods: Participants in LASI were adults aged 45 years or older from 2017-19 in 35 of 36 states and union territories. Frailty was assessed by a 48-item deficit accumulation frailty index (FI). Robust was defined as FI of 0 to 0.1, pre-frail was &amp;gt;0.1 – 0.2, mildly frail &amp;gt;0.2 – 0.3, moderately frail &amp;gt;0.3 – 0.4, and severely frail was &amp;gt;0.4. Development indicators were GDP per capita, infant mortality rate (IMR), and literacy rate in 1981 and 2018 (2011 for literacy), from the Reserve Bank of India. Associations were assessed using beta regression. Results IMR in 1981 had a small but significant association with frailty (OR 1.00 [1.00-1.00]). For GDP per capita and literacy, 1981 values were associated with greater frailty (1.15 [1.10-1.21] and 1.01 [1.01-1.01] respectively). However, 2018/2011 values were associated with lower frailty (0.94 [0.93-0.95] and 0.99 [0.99-1.00]). These associations were similar after stratifying by age group. Discussion Associations between frailty and state-level development varied both by indicator and by time of assessment. Sensitivity to the environment these indicators measure – such as IMR – may differ by age. Whether that sensitivity leads to protection or vulnerability may also change with age.

Enhancing Bone Health in Aging Populations to Prevent Fragility Fractures

Enhancing Bone Health in Aging Populations to Prevent Fragility Fractures

Profiles of tobacco smokers and ex-smokers in a large-scale random sample survey across Wales: an unsupervised machine-learning cluster analysis

BackgroundThe Welsh government recently set a target to be smoke-free by 2030, which means reducing the prevalence of tobacco smoking in adults to 5% by then. The goal is to improve health and population life expectancy. To support this strategy, we identified profile groups with different sets of socioeconomic and demographic characteristics within the population of smokers. We compared these profiles to those identified in the ex-smoker population to provide a broader understanding of smokers and inform targeting of interventions and policy. MethodsWe did a cross-sectional study using data from the National Survey for Wales. This survey is a random sample telephone survey of individuals aged 16 years and older across Wales carried out from Sept 1, 2021 to Jan 31, 2022, weighted to be representative of the Welsh population. For the smoking subgroup, we did a weighted hierarchical cluster analysis with multiple imputation to impute missing data and repeated it for ex-smokers. In total, 63 survey variables were used in the analysis. These variables included smoking history, e-cigarette use, sociodemographics, lifestyle factors, individual-level deprivation, general health and long-term conditions, mental health, and wellbeing. FindingsAmong the 6407 respondents (weighted proportions: 49% male, 51% female; 28% aged 16–34 years, 46% aged 35–44 years, 26% aged ≥65 years; 95% white, 5% other ethnicity), 841 (13%) smoked and 2136 (33%) were ex-smokers. Four distinctive profiles of smokers were identified, the groups were of relatively comparable size and characterised by similarities described as (1) high-risk alcohol drinkers and without children; (2) single, mostly in social housing, and poor health and mental health; (3) mostly single, younger, tried e-cigarettes, and poor mental health; (4) older couples and poor health; when comparing the groups with each other. Cluster quality and validation statistics were considered fair: silhouette coefficient=0·09, Dunn index (Dunn2)=1·06. Generally, ex-smoker clusters differed from smoking clusters because of themes related to increased sickness, better affluence, employment, and older age (≥75 years). InterpretationThis study suggests that not all smokers are the same, and they do not fall into one coherent group. Smoking cessation interventions to improve the health of ageing populations might need a different approach to consider a wider context or motivations to inform targeted quitting. It is acknowledged that smoking might be underreported because of perceived social unacceptability. FundingPublic Health Wales.

Hobby engagement boosts mental health in aging populations.

Hobby engagement boosts mental health in aging populations.

Enhancing Mental Health in Aging Populations

Enhancing Mental Health in Aging Populations

Gut microbiome association with brain imaging markers, APOE genotype, calcium and vegetable intakes, and obesity in healthy aging adults.

Advanced age is a significant factor in changes to brain physiology and cognitive functions. Recent research has highlighted the critical role of the gut microbiome in modulating brain functions during aging, which can be influenced by various factors such as apolipoprotein E (APOE) genetic variance, body mass index (BMI), diabetes, and dietary intake. However, the associations between the gut microbiome and these factors, as well as brain structural, vascular, and metabolic imaging markers, have not been well explored. We recruited 30 community dwelling older adults between age 55-85 in Kentucky. We collected the medical history from the electronic health record as well as the Dietary Screener Questionnaire. We performed APOE genotyping with an oral swab, gut microbiome analysis using metagenomics sequencing, and brain structural, vascular, and metabolic imaging using MRI. Individuals with APOE e2 and APOE e4 genotypes had distinct microbiota composition, and higher level of pro-inflammatory microbiota were associated higher BMI and diabetes. In contrast, calcium- and vegetable-rich diets were associated with microbiota that produced short chain fatty acids leading to an anti-inflammatory state. We also found that important gut microbial butyrate producers were correlated with the volume of the thalamus and corpus callosum, which are regions of the brain responsible for relaying and processing information. Additionally, putative proinflammatory species were negatively correlated with GABA production, an inhibitory neurotransmitter. Furthermore, we observed that the relative abundance of bacteria from the family Eggerthellaceae, equol producers, was correlated with white matter integrity in tracts connecting the brain regions related to language, memory, and learning. These findings highlight the importance of gut microbiome association with brain health in aging population and could have important implications aimed at optimizing healthy brain aging through precision prebiotic, probiotic or dietary interventions.

Adherence to the dietary approaches to stop hypertension and bone health in the Chinese elderly.

Many studies have demonstrated the relationship between diet and bone health, but research on the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and bone health across populations is rare. The purpose of this study was to examine associations between the DASH dietary pattern and bone health outcomes in Chinese elders, to verify whether higher adherence to the DASH was associated with better bone health in elderly populations. A total of 839 Chinese adults aged 50years and above participated in this cross-sectional study. Bone mineral density (BMD) at calcaneus was measured via ultrasonic bone densitometer. A semiquantitative food frequency questionnaire (FFQ) was used to assess the usual dietary intake in the past 12months. The DASH score was calculated based on energy-adjusted intakes of nine dietary components, including whole grains, beans, vegetables, fruits, dairy, red meat, total fat, sodium, and sugar-sweetened beverages. In postmenopausal women, DASH score was significantly and positively correlated with BMD T-score after controlling potential covariates (β: 0.027 ± 0.012, P = 0.031) in multivariable linear regression models. In binary logistic regression analysis, male participants in the highest tertile of DASH score had lower risk of osteoporosis than those in the lowest tertile (odds ratio = 0.499; 95% confidence interval, 0.262-0.951; P = 0.035) after adjusting potential covariates. Adherence to the DASH dietary pattern was associated with better bone health in Chinese elderly adults.

The Protective Power of Cognitive Reserve: Examining White Matter Integrity and Cognitive Function in the Aging Brain for Sustainable Cognitive Health

Sustainable cognitive health is heavily influenced by cognitive reserve (CR), which delays cognitive decline or reduces its severity by enhancing cognitive function through life experiences. The main objective of this study is to explore whether CR moderates the relationship between white matter integrity and cognitive function in cognitively intact older adults. A cross-sectional analysis was conducted on 5004 cognitively normal individuals aged 48–80 years from the UK Biobank, utilizing hierarchical regression analysis to estimate CR through five CR proxies and five skeleton-based diffusion measures. The study’s findings revealed that early fluid intelligence had a significant independent and moderating impact on cognitive performance, demonstrating its suitability as an individual CR proxy. Moreover, the composite proxy composed of early fluid intelligence and physical activity showed promise in promoting sustainable cognitive health. Importantly, this study represents one of the most extensive MRI investigations to unveil the substantial moderating effect of CR on the intricate relationship between white matter integrity and cognitive function based on a complete model. Notably, this study employed the NODDI method, which proved more advantageous than DTI in examining this interaction. Overall, this research constitutes a noteworthy and substantive contribution to our current understanding of the complex and intricate relationship between CR, cognitive function, and aging-associated cognitive decline, highlighting the importance of considering CR proxies in promoting sustainable cognitive health in aging populations.