Function In Elderly Individuals Research Articles

Cardiac structure and function across the glycemic spectrum in elderly men and women free of prevalent heart disease: the Atherosclerosis Risk In the Community study.

Individuals with diabetes mellitus and pre-diabetes mellitus are at particularly high risk of incident heart failure or death, even after accounting for known confounders. Nevertheless, the extent of impairments in cardiac structure and function in elderly individuals with diabetes mellitus and pre-diabetes mellitus is not well known. We aimed to assess the relationship between echocardiographic measures of cardiac structure and function and dysglycemia. We assessed measures of cardiac structure and function in 4419 participants without prevalent coronary heart disease or heart failure who attended the Atherosclerosis Risk In the Community (ARIC) visit 5 examination (2011-2013) and underwent transthoracic echocardiography (age, 75±6 years; 61% women, 23% black). Subjects were grouped across the dysglycemia spectrum as normal (39%), pre-diabetes mellitus (31%), or diabetes mellitus (30%) based on medical history, antidiabetic medication use, and glycated hemoglobin levels. Glycemic status was related to measures of cardiac structure and function. Worsening dysglycemia was associated with increased left ventricular mass, worse diastolic function, and subtle reduction in left ventricular systolic function (P≤0.01 for all). For every 1% higher glycated hemoglobin, left ventricular mass was higher by 3.0 g (95% confidence interval, 1.5-4.6 g), E/E' by 0.5 (95% confidence interval, 0.4-0.7), and global longitudinal strain by 0.3% (95% confidence interval, 0.2-0.4) in multivariable analyses. In a large contemporary biracial cohort of elderly subjects without prevalent cardiovascular disease or heart failure, dysglycemia was associated with subtle and subclinical alterations of cardiac structure, and left ventricular systolic and diastolic function. It remains unclear whether these are sufficient to explain the heightened risk of heart failure in individuals with diabetes mellitus.

Role of Auditory Training in Intervention of Individuals With Cognitive Decline and Hearing Impairment

The role of auditory training in enhancement of auditory and cognitive function in aging individuals with hearing loss and cognitive decline is discussed in this article. Results of previous controlled studies and the current pilot (Angel Sound) support value for auditory training for these individuals.

Effects of enteric-coated lactoferrin supplementation on the immune function of elderly individuals: A randomised, double-blind, placebo-controlled trial

A randomised, double-blind, placebo-controlled trial was performed to investigate the effects of enteric-coated lactoferrin (LF) supplementation on the immune function of healthy, elderly individuals. Sixty-two healthy men and women were randomly divided into LF (300 mg of bovine LF intake per day) and placebo groups, who consumed the assigned supplements once daily for 3 months. The blood cell count, peripheral blood lymphocyte subset ratios, neutrophil phagocytic function, natural killer (NK) cell cytotoxicity, and serum granulysin and lysozyme concentrations were measured every month. By the third month of treatment, significant inter-group differences were observed in peripheral blood lymphocyte subset ratios, neutrophil phagocytic function, and NK cell cytotoxicity. Our findings suggest that immune competent cells of the innate immune system in elderly individuals are specifically activated by LF intake; therefore, enteric LF supplementation may have beneficial effects on immune function in elderly individuals.

Abstract T P160: Influence of Polyunsaturated Fatty Acids on Cognition in Elderly Alzheimer's Disease Patients

Background: Many genes and environmental factors linked to Alzheimer’s disease (AD) risk affect lipid metabolism or the cardiovascular system, strongly implicating cerebrovascular and metabolic dysfunction in AD pathogenesis. Although some PUFAs may improve cognitive function in aging individuals, it is still unclear how different PUFAs influence AD neuropathology and cognitive function. Objective: To examine the influence of polyunsaturated fatty acid (PUFA) metabolism on AD-associated cognitive decline, we investigated the relationship between serum PUFA profile and neuropsychological test performance. Methods: Cognitive functioning in patients with probable AD (n = 174, mean age 77.6 years) was examined using the Mini-Mental State Exam (MMSE) and clock drawing test (CDT). Serum samples were obtained for PUFA profile, including the eicosapentaenoic acid/arachidonic acid (EPA/AA) ratio, and measurement of brain natriuretic peptide (BNP) concentration. In the follow-up study, 47 subjects repeated MMSE and CDT after 1 year, According to the second MMSE score, the subjects were divided into the following 2 groups: those with unchanged or improved MMSE score and those with lower MMSE score. A receiver operating characteristic curve was used to evaluate the relationship between the EPA/AA ratio and 1-year cognitive stability. Results: In the cross-sectional study, total MMSE score correlated positively with the EPA/AA ratio and systolic blood pressure (SBP), and negatively with age and diastolic blood pressure (DBP) (p < 0.05). In the follow-up study, the MMSE score was lower than baseline in 20 subjects, whereas it was improved or unchanged in 29 patients. The EPA/AA ratio in the stable group was significantly greater than that in the deteriorating group, suggesting an association between higher EPA/AA ratio and cognitive stability over 1 year. The EPA/AA ratio predicted stability of cognitive performance with a sensitivity of 66% and specificity of 70% (odds ratio = 4.43) when the cut-off was 0.67. Conclusion: Our results suggest that serum EPA concentration strongly influences cognitive performances in AD patients. The EPA/AA ratio was a sensitive indicator of cognitive stability in this patient group.

Haptoglobin genotype modulates the relationships of glycaemic control with cognitive function in elderly individuals with type 2 diabetes.

The purpose of this study was to investigate whether the association of glycaemic control with cognitive function is modulated by the haptoglobin 1-1 (Hp 1-1) genotype in cognitively normal elderly individuals with type 2 diabetes. In this cross-sectional study, we examined 793 participants who were genotyped for Hp (80 Hp 1-1 carriers and 713 Hp 1-1 non-carriers) enrolled in the Israel Diabetes and Cognitive Decline (IDCD) study. Glycaemic control was operationally defined by HbA1c level. The outcome measures were performance in four cognitive domains (episodic memory, attention/working memory, language/semantic categorisation, executive function) and overall cognition, a composite of the domains. Effect sizes were obtained from hierarchical linear regression analyses for each outcome measure, controlling for demographics, type 2 diabetes-related characteristics, cardiovascular risk factors, and their interactions with Hp genotype. Interaction analyses showed significantly stronger associations of HbA1c with poorer cognitive function among Hp 1-1 carriers than non-carriers; attention/working memory (p < 0.001) and overall cognition (p = 0.003). For these two cognitive domains, associations were significant for Hp 1-1 carriers despite the small sample size (p < 0.00001 and p = 0.001, respectively), but not for non-carriers. Our findings suggest that patients with type 2 diabetes and poor glycaemic control carrying the Hp 1-1 genotype may be at increased risk of cognitive impairment, particularly in the attention/working memory domain. The association of glycaemic control with this domain may indicate cerebrovascular mechanisms.

The thyroid gland and the process of aging

The endocrine organs, including the thyroid gland, undergo important functional changes during aging. It is known that the prevalence of thyroid disorders increases with age. Importantly, subclinical disturbances of thyroid function are more frequent than overt diseases in the elderly. Moreover, the clinical course of thyroid diseases in elderly people differs from that observed in younger subjects; namely, symptoms are more subtle and are often attributed to normal aging, and therefore, require special attention in elderly individuals. One of the subclinical thyroid function disturbances is subclinical hypothyroidism, which is characterized by normal free thyroxine (FT4) and increased thyrotropin (TSH) levels. The prevalence of subclinical hypothyroidism increases with aging and ranges from 3 to 16 % in individuals aged 60 years and older [1]. In contrast to overt hypothyroidism, the subclinical hypothyroidism in elderly subjects is not associated with impairment of physical and cognitive function, depression, metabolic disturbances or poor quality of life [2,3]. Subclinical hypothyroidism is also not associated with the increased overall mortality risk [2]. Moreover, there is not association between subclinical hypothyroidism and incident coronary heart disease (CHD), heart failure (HF) or cardiovascular (CV) mortality [4]. Similarly, total mortality was not increased in subjects with subclinical hypothyroidism, although the risk of CHD events and of CHD mortality increased with TSH levels 10 mU/L or higher [5]. Importantly, a quite high rate of reversion of subclinical hypothyroidism to euthyroidism in individuals aged at least 65 years with lower baseline TSH levels (4.5-6.9 mU/L) and antithyroid peroxidase antibody (TPOAb) negativity (≤ 37 IU/L) was observed [6]. In turn, higher TSH levels and TPOAb positivity were independently associated with lower chance of reversion to euthyroid status; TSH levels ≥10 mU/L were independently associated with progression to overt hypothyroidism [6]. There are obvious indications for overt hypothyroidism treatment. In turn, indications for treatment of subclinical hypothyroidism are still quite controversial. Nevertheless, the replacement therapy with L-thyroxine is not uniformly recommended in elderly people with subclinical hypothyroidism. For example, L-thyroxine replacement therapy did not improve cognitive function in elderly individuals with subclinical hypothyroidism [7]. Moreover, despite improvement of lipid profile due to treatment of L-thyroxine in subclinical hypothyroidism, there is no clear evidence that this beneficial effect can be associated with decreased cardiovascular or all-cause mortality in elderly patients [8]. Intriguingly, thyroid hypofunction, as well as elevated thyrotropin (TSH) levels may contribute to the extended lifespan. A potential contribution of TSH and thyroid hormones to lifespan regulation was observed in the studies performed on thyroid disease-free population of Ashkenazi Jews, characterized by exceptional longevity (centenarians). For example, the higher serum TSH level in these individuals in comparison with the control groups was observed [9]. Thus, increased serum TSH level seems to be associated with extreme longevity [9]. Moreover, two single nucleotide polymorphisms (SNPs) in TSH receptor (TSHR) gene (namely rs10149689 and rs12050077) were associated with increased TSH level in Ashkenazi Jewish centenarians and their offspring [10]. Also, an inverse correlation between FT4 and TSH levels in centenarians was reported [9] which may suggest a potential role of decreased thyroid function in lifespan regulation, leading to extended longevity. The findings obtained in the Leiden Longevity Study actually show the associations between low thyroid activity and exceptional familial longevity [11]. Also in animals, a reduced thyroid function with low levels of T4 seems to be associated with extended longevity [12-14]. A very severe thyroid hypofunction was observed in Ames dwarf (df/df) mice. These animals are characterized by mutations at the Prop-1 (Prophet of pituitary factor 1) gene and demonstrate a lack of growth hormone (GH), prolactin and TSH. These features may unexpectedly contribute to remarkable longevity in Ames dwarf mice [12]. Furthermore, severe hypothyroid Ames dwarfs and mice with targeted disruption of the growth hormone (GH) receptor/GH binding protein gene (GH receptor knockout; GHRKO) with mild thyroid hypofunction, have decreased thyroid follicle size which may explain decreased thyroid hormone levels in these long-lived mutants [15]. In conclusion, the altered thyroid function may play, via different mechanisms [16], a relevant role in lifespan regulation. Namely, decreased thyroid function may lead to extended longevity.

The common functional FKBP5 variant rs1360780 is associated with altered cognitive function in aged individuals.

The common single nucleotide polymorphism (SNP) rs1360780 (C/T) of the FK506 Binding Protein 5 (FKBP5) gene has been reported to be associated with an altered response of the hypothalamic-pituitary-adrenal (HPA) axis and the development of stress-related psychiatric disorders such as posttraumatic stress disorder (PTSD). In the present study, we examined whether this SNP is associated with cognitive function in a non-clinical population. The full versions of the Wechsler Memory Scale-Revised and Wechsler Adult Intelligence Scale-Revised were administered to 742 and 627 Japanese individuals, respectively, followed by genotyping of rs1360780 by the TaqMan 5′-exonuclease allelic discrimination assay. For both cognitive tests, we found significantly poorer attention/concentration (working memory) in aged (>50 years old) individuals carrying the T allele compared with their counterparts. This finding accords with an altered HPA axis and vulnerability to stress-related psychiatric disorders.

Age-associated changes of nitric oxide concentration dynamics in the central nervous system of Fisher 344 rats.

The increase in life expectancy is accompanied by an increased risk of developing neurodegenerative disorders and age is the most relevant risk factor for the appearance of cognitive decline. While decreased neuronal count has been proposed to be a major contributing factor to the appearance of age-associated cognitive decline, it appears to be insufficient to fully account for the decay in mental function in aged individuals. Nitric oxide ((•)NO) is a ubiquitous signaling molecule in the mammalian central nervous system. Closely linked to the activation of glutamatergic transmission in several structures of the brain, neuron-derived (•)NO can act as a neuromodulator in synaptic plasticity but has also been linked to neuronal toxicity and degenerative processes. Many studies have proposed that changes in the glutamate-(•)NO signaling pathway may be implicated in age-dependent cognitive decline and that the exact effect of such changes may be region specific. Due to its peculiar physical-chemical properties, namely hydrophobicity, small size, and rapid diffusion properties, the rate and pattern of (•)NO concentration changes are critical determinants for the understanding of its bioactivity in the brain. Here we show a detailed study of how (•)NO concentration dynamics change in the different regions of the brain of Fisher 344 rats (F344) during aging. Using microelectrodes inserted into the living brain of anesthetized F344 rats, we show here that glutamate-induced (•)NO concentration dynamics decrease in the hippocampus, striatum, and cerebral cortex as animals age. performance in behavior testing of short-term and spatial memory, suggesting that the impairment in the glutamate:nNOS pathway represents a functional critical event in cognitive decline during aging.

Global Transcriptional Profiling Reveals Distinct Functions of Thymic Stromal Subsets and Age-Related Changes during Thymic Involution

Age-associated thymic involution results in diminished T cell output and function in aged individuals. However, molecular mediators contributing to the decline in thymic function during early thymic involution remain largely unknown. Here, we present transcriptional profiling of purified thymic stromal subsets from mice 1, 3, and 6 months of age spanning early thymic involution. The data implicate unanticipated biological functions for a subset of thymic epithelial cells. The predominant transcriptional signature of early thymic involution is decreased expression of cell-cycle-associated genes and E2F3 transcriptional targets in thymic epithelial subsets. Also, expression of proinflammatory genes increases with age in thymic dendritic cells. Many genes previously implicated in late involution are already deregulated by 3-6 months of age. We provide these thymic stromal data sets, along with thymocyte data sets, in a readily searchable web-based platform, as a resource for investigations into thymocyte:stromal interactions and mechanisms of thymic involution.

P177: The influence of lower-extremity function in elderly individuals’ quality of life: An analysis of the correlation between SPPB and EQ-5D

P177: The influence of lower-extremity function in elderly individuals’ quality of life: An analysis of the correlation between SPPB and EQ-5D

LOW GLUCOSE UTILIZATION AND HIGH LACTATE PRODUCTION IN THE ALZHEIMER'S DISEASE BRAIN

Background: Age-related changes in the cerebral white matter (WM) have been demonstrated in cognitively intact elderly, and are associated with cognition. The etiology of microstructuralWMdegeneration and its relation to cerebral blood flow (CBF) and white matter hyperintensities (WMH) are uncertain.Methods: 61 cognitively intact elderly volunteers (mean age 85, CDR 0) underwent 3T MRI Q2TIPS pulsed arterial spin labeling (PASL), diffusion tensor imaging (DTI), and cognitive assessment. Voxelwise Tract-Based Spatial Statistics (TBSS) was performed. A general linear model using permutation-based nonparametric testing (FSLRANDOMIZE) examined regional associations betweenWMCBF,WMHs, and microstructural measures. WMHs and WM CBF were examined in relation to fractional anisotropy using both voxel-based and mean WMH volume and WM CBF values. Region of interest (ROI) analyses included atlas-based segmentation of the corpus callosum (CC), limited to the TBSS-derived WM skeleton, and examined CC integrity in relation to cognitive function. Analyses were corrected for partial volume effects and adjusted for age and gender. Matched pairs t-test examined differences in anterior and poster WM integrity.Results: In TBSS voxel-based analysis, associations between WM integrity and WMHs were observed in regions commonly associated with small vessel ischemic disease, along the periventricular WM tracts. WM integrity was significantly decreased in relation to lowerWMperfusion in similar regions. Findings were largely replicated when WMH and WM CBF were entered into the model as mean values, rather than voxel-wise analysis. In addition, clusters of decreased WM integrity were seen in areas of normal appearing white matter in the anterior and posterior cc and WM tracts in the frontal and parietal lobes. ROI analyses showed greater WM integrity disruption in the anterior compared with posterior CC. Anterior CC integrity was associated with performance on executive and memory function tests. Conclusions: Greater WMH and lower WM perfusion are independently associated with decreased WM integrity both within and outside of commonly observedWMlesions.Anterior> poster cc involvement may represent greater susceptibility of this region to hypoperfusion.WMCBF may serve as a potentiallymodifiable target in trials aimed at preserving cognitive function in elderly individuals, prior to cognitive impairment.

Comparison of Isokinetic Muscle Power and Physical Fitness by Using Body Mass Index in Women Over 70 Years of Age

The purpose of study was to compare isokinetic muscle power and senior fitness test in women over 70 years of age. Subjects were divided into 2 groups: normal-weight group (BMI < 18.5 - 24.9 kg/m2, n = 20, 72.4 ± 1.8yrs) and overweight group (BMI > 25 kg/m2, n = 20, 72.8 ± 1.8yrs). Main results were as follows: 1) Isokinetic peak torque was higher in the left extensor and right flexor at 60o/sec and in the left extensor, right extensor, and right flexor at 180o/sec in the normal-weight group than in the overweight group. 2) Peak torque %BW was higher in the normal-weight group than in the overweight group for all items. 3) Bilateral strength ratio of the quadriceps femoris muscle was higher in the overweight group than in the normal-weight group, which implies a greater susceptibility to injury. 4) SFT revealed greater physical function in the chair stand, 2-min step test, and 8-foot up-and-go test in the normal-weight group than in the overweight group. Therefore, high BMI decreases leg function and limits physical activity. Further studies on the characteristics of leg function in elderly individuals should be performed to ensure systematic health management.

Latent Toxoplasma gondii infection leads to deficits in goal-directed behavior in healthy elderly

Goal-directed behavior is well-known to show declines in elderly individuals, possibly because of alterations in dopaminergic neural transmission. The dopaminergic system is modulated by a number of other different factors. One of these factors, which has attracted a considerable amount of interest in neurobiology, but has only rarely been examined with respect to its possible modulatory role for cognitive functions in elderly individuals, is latent Toxoplasma gondii (T. gondii) infection. Latent T. gondii infection may be of relevance to goal-directed behavior as it alters dopaminergic neural transmission. We examine goal-directed behavior in T. gondii IgG positive and negative elderly subjects in auditory distraction paradigm. We apply event-related potentials to examine which cognitive subprocesses are affected by latent T. gondii infection on a neurophysiological level. We show that latent T. gondii infection compromises the management of auditory distraction in elderly by specifically delaying processes of attentional allocation and disengagement. The results show that latent T. gondii infection is neglected but an important neurobiological modulator of cognitive functions in elderly individuals.

The influence of lower-extremity function in elderly individuals’ quality of life (QOL): An analysis of the correlation between SPPB and EQ-5D

BackgroundIf an association between a decline in physical performance and subjective QOL is confirmed, the SPPB could be used as a predictor for declining QOL in older people. ObjectiveThis study aimed to elucidate the association between the short physical performance battery (SPPB) and QOL (EQ-5D) to determine the utility of the SPPB as a predictor of declining QOL. MethodsThe SPPB and the EQ-5D test were performed with a random sample of participants nested in the Korean Longitudinal Study of Aging (KLoSA) panel. Comparisons of the adjusted mean scores on the EQ-5D index between normal and abnormal SPPB groups were performed. We selected the quartiles of the EQ-5D index variables for the analysis. The association between the EQ-5D index and SPPB abnormality was examined using multinomial logistic regression analysis. Additionally, the associations between gait speed and chair stand time and the EQ-5D index were examined using the same analysis. ResultsFour hundred and twenty-two subjects were included in the analysis. The adjusted means for the EQ-5D index were significantly lower when the SPPB score was abnormal (p=0.022 for men, p=0.047 for women). An abnormal SPPB score was significantly associated with the lowest quartile of EQ-5D index score (adjusted OR 3.54 in the lowest quartile for men; adjusted OR 2.50 and 3.37 in the lowest and second quartiles for women). Gait speed was significantly associated with the EQ-5D index for participants of both sexes, but standup time was associated with the EQ-5D index only for men. ConclusionsAn abnormal SPPB score was associated with lower QOL. Thus, the SPPB has the potential to be used as an early predictor of declining QOL in clinical settings and epidemiological studies.

Central auditory functions in elderly individuals

AbstractElderly individuals often have more difficulty in understanding speech than younger adults, particularly in noisy environments. Three models that attempt to explain this are as follows: (a) deterioration in peripheral hearing; (b) structural changes to the central auditory system; and (c) changes in normal cognitive processes. The aim of this study was to assess the central auditory functions in an elderly population and compare them with those of an adult population. Participants and methods The study group included 60 elderly individuals; they were older than 60 years of age and were divided into two subgroups: the first subgroup A included 24 elderly individuals with normal peripheral hearing and the second subgroup B included 36 elderly individuals with presbycusis with a mild degree of hearing loss. The control group included 30 individuals ranging in age from 18 to 30 years. Both the study and the control group were subjected to an otological examination, immittancemetry, pure tone audiometry, speech audiometry, and central auditory processing assessment using the following selected few behavioral central auditory tests: synthetic sentence identification test with ipsilateral competing message (SSI-ICM), dichotic digits test (DDT), auditory fusion test-revised (AFT-R), and pitch pattern sequences test (PPT). Results There were elevated hearing thresholds at mostly all frequencies with statistically significant differences on comparing both study subgroups A and B with the control group. On using SSI-ICM, in the competition ratio (−15 dB), there were statistically significantly low scores in subgroups A and B compared with the control group. Results of DDT showed statistically significantly low scores on comparing the results between the left ear and the right ear in both subgroups A and B. There was a statistically significant elevated gap threshold for tonal stimuli in the AFT-R test on comparing both subgroups A and B with the control group. The results of PPT showed that subgroup B obtained a statistically significantly lower score compared with the control group. There was a statistically significant negative correlation between age and the results of SSI-ICM in the competition ratio 0 dB when presented to the left ear, DDT, and PPT. There was a statistically significant positive correlation between age and the results of AFT-R when presented at 4000 Hz. Conclusion Age-related changes to auditory processing will occur in most adults 60 years of age and older that may or may not be concomitant with peripheral hearing loss. Aging decreases the capacity of digit recognition and also increases interaural asymmetries. Many older listeners show reduced temporal resolution even when potential influences of hearing loss are absent. Temporal ordering abilities decrease with age. Recommendation It is important to include central auditory tests in the audiologic assessment protocol of the elderly. The utilization of these tests in assessment of the elderly enables us to improve the quality of therapeutic-rehabilitative interventions.

Neurovascular coupling, cerebral white matter integrity, and response to cocoa in older people

To investigate the relationship between neurovascular coupling and cognitive function in elderly individuals with vascular risk factors and to determine whether neurovascular coupling could be modified by cocoa consumption. Sixty older people (aged 72.9 ± 5.4 years) were studied in a parallel-arm, double-blind clinical trial of neurovascular coupling and cognition in response to 24 hours and 30 days of cocoa consumption. Cognitive measures included Mini-Mental State Examination and Trail Making Test A and B. Neurovascular coupling was measured from the beat-to-beat blood flow velocity responses in the middle cerebral arteries to the N-Back Task. In a subset of MRI-eligible participants, cerebral white matter structural integrity was also measured. Neurovascular coupling was associated with Trails B scores (p = 0.002) and performance on the 2-Back Task. Higher neurovascular coupling was also associated with significantly higher fractional anisotropy in cerebral white matter hyperintensities (p = 0.02). Finally, 30 days of cocoa consumption was associated with increased neurovascular coupling (5.6% ± 7.2% vs -2.4% ± 4.8%; p = 0.001) and improved Trails B times (116 ± 78 seconds vs 167 ± 110 seconds; p = 0.007) in those with impaired neurovascular coupling at baseline. There is a strong correlation between neurovascular coupling and cognitive function, and both can be improved by regular cocoa consumption in individuals with baseline impairments. Better neurovascular coupling is also associated with greater white matter structural integrity.

Effect of plasma lipids and APOE genotype on cognitive decline

A central tenet of brain aging is that "what is good for the heart is good for the brain." We examined the combined effect of plasma lipids and APOE genotype on cognitive function in elderly individuals. Plasma concentrations of high-density lipoprotein (HDL), low-density lipoprotein, triglyceride, total cholesterol, and apolipoprotein E (apoE) were evaluated in 622 community-dwelling individuals aged 65 years and older. We investigated the associations between plasma lipids and cognitive function in APOE4 carrier (E4+) and APOE4 noncarrier (E4-) groups using 3-year longitudinal data. At baseline and 3 years later, cognitive scores were correlated with plasma apoE levels in both E4- and E4+, and HDL level in E4-. Our findings suggest that an interaction between apoE and HDL is facilitated by APOE4, and is possibly linked with an enhancement of neuroplasticity and with resultant protective effects on cognitive function in later life. Preservation of higher plasma apoE and HDL from early life is proposed as a possible strategy for maintaining cognitive function in later life, especially for APOE4-positive individuals.

Effects of whey proteins and carbohydrates on the efficacy of resistance training in elderly people: double blind, randomised controlled trial

A few previous studies indicate that protein supplementation increases gains in muscle mass and strength during a resistance exercise program. The purpose of this study was to investigate whether whey protein supplementation results in greater increases in lean body mass, muscle strength and physical function in elderly individuals during 12 weeks of resistance exercise when compared to isocaloric carbohydrate supplementation. A total of 161 men and women, 65-91 years old, participated in a randomized, controlled, double-blind intervention study, involving dietary supplementation and a 12-week resistance exercise program, designed to increase muscle mass and strength of all major muscle groups. Participants exercised three times a week and received either 20 g of whey protein (n=83) or isocaloric carbohydrate (n=78) in liquid form immediately after each workout. Data were obtained at baseline and end point. The primary outcomes, lean body mass, strength and physical function increased significantly during the course of the study. Type of dietary supplementation did not influence gains in lean body mass (P=0.365), quadriceps strength (P=0.776) or performance during a 6-min walk (P=0.726) or a timed up-and-go test (P=0.151). Twenty participants discontinued the intervention. Ingestion of 20 g of whey protein immediately after resistance exercise three times per week, does not lead to greater gains in lean body mass, strength and physical function in elderly people with sufficient energy and protein intakes when compared to isocaloric carbohydrate.

Coffee, but not caffeine, has positive effects on cognition and psychomotor behavior in aging

The complex mixture of phytochemicals in fruits and vegetables provides protective health benefits, mainly through additive and/or synergistic effects. The presence of several bioactive compounds, such as polyphenols and caffeine, implicates coffee as a potential nutritional therapeutic in aging. Moderate (three to five cups a day) coffee consumption in humans is associated with a significant decrease in the risk of developing certain chronic diseases. However, the ability of coffee supplementation to improve cognitive function in aged individuals and the effect of the individual components in coffee, such as caffeine, have not been fully evaluated. We fed aged rats (19 months) one of five coffee-supplemented diets (0, 0.165, 0.275, 0.55, and 0.825% of the diet) for 8 weeks prior to motor and cognitive behavior assessment. Aged rats supplemented with a 0.55% coffee diet, equivalent to ten cups of coffee, performed better in psychomotor testing (rotarod) and in a working memory task (Morris water maze) compared to aged rats fed a control diet. A diet with 0.55% coffee appeared to be optimal. The 0.165% coffee-supplemented group (three cups) showed some improvement in reference memory performance in the Morris water maze. In a subsequent study, the effects of caffeine alone did not account for the performance improvements, showing that the neuroprotective benefits of coffee are not due to caffeine alone, but rather to other bioactive compounds in coffee. Therefore, coffee, in achievable amounts, may reduce both motor and cognitive deficits in aging.

The Effect of Garden Designs on Mood and Heart Output in Older Adults Residing in an Assisted Living Facility

The objective of this study is to trace short-term changes in mood and heart function in elderly individuals in response to exposure to different landscaped spaces. Nineteen elderly but cognitively intact residents of an assisted living facility participated in the study. They were exposed to three landscaped spaces: a Japanese style garden, an herb garden, and a simple landscaped area planted with a single tree. To assess the effect of different landscaped spaces on older adults, individuals were monitored for mood and cardiac function in response to short exposures to spaces. Mood state was assessed using Profile of Mood States (POMS) before and after viewing the spaces. Cardiac output was assessed using a portable electrocardiograph monitor before and during the viewing. We found that the structured gardens evoked greater responses in all outcome measures. Scores on the POMS improved after observation of the two organized gardens compared to responses to the simple landscaped space with a single tree. During the observation period, heart rate was significantly lower in the Japanese garden than in the other environments, and sympathetic function was significantly lower as well. We conclude that exposure to organized gardens can affect both the mood and cardiac physiology of elderly individuals. Our data further suggest that these effects can differ depending on the types of landscape to which an individual is exposed. Elderly, Japanese garden, herb garden, heart rate, mood, healing environmentPreferred Citation: Goto, S., Park, B-J., Tsunetsugu, Y., Herrup, K., & Miyazaki, Y. (2013). The effect of garden designs on mood and heart output in older adults residing in an assisted living facility. Health Environments Research & Design Journal 6(2), pp 27-42.