Function In Healthy Older Adults Research Articles

Applicability of the decomposed theory of planned behavior for the evaluation of community-dwelling older adults' acceptance in continuous usage of robot-assisted board games for cognitive training.

Improving cognitive function in healthy older adults is a global concern. Cognitive training delays mental deterioration. The utilization of robots and board games for aiding older adults in cognitive training represents a prominent technological trend and is a subject of meriting investigation. This study evaluates the acceptability and factors influencing the continuous usage intention of a robot-assisted board game (RABG) for cognitive training in community-dwelling older adults based on the decomposed theory of planned behavior (DTPB). In this explanatory study, we developed an RABG with six educational modules. The experiences of 126 older adults recruited from northern Taiwan who completed the program were assessed using a DTPB-based questionnaire. Partial least-squares structural equation modeling was used to examine the correlations. The results demonstrate the DTPB's sufficient fitness and 79.9% explanatory power for the continuous usage intention of the RABG, confirming the effectiveness of the proposed structural model. Perceived usefulness positively affected attitude and continuous usage intention, indicating that perceived usefulness is critical in promoting older adults' continuous usage intention. The interpersonal influence was a major antecedent of subjective norms. Self-efficacy affects perceived behavioral control. Attitudes and perceived behavioral control affected users' intentions to use the RABG. Our findings support the applicability of the DTPB in evaluating RABGs for cognitive training in older adults, suggesting its potential integration in future interventions.

The Brain Tissue Properties Within the Cerebellum Play Role in Executive Functioning and Memory Performance in Healthy Older Adults

The Brain Tissue Properties Within the Cerebellum Play Role in Executive Functioning and Memory Performance in Healthy Older Adults

Levels of plasma ADAM10, education, and cognitive performance of healthy older adults and persons living with Alzheimer’s disease from a middle‐income country

Levels of plasma ADAM10, education, and cognitive performance of healthy older adults and persons living with Alzheimer’s disease from a middle‐income country

Multivariate sleep health and cognitive functions in healthy older adults: results from partial least square correlation analysis

Multivariate sleep health and cognitive functions in healthy older adults: results from partial least square correlation analysis

Factors associated with the cognitive performance of healthy older adults and persons living with Alzheimer’s disease from a middle‐income country in Latin America

Factors associated with the cognitive performance of healthy older adults and persons living with Alzheimer’s disease from a middle‐income country in Latin America

Effect of transcranial direct current stimulation with cognitive training on executive functions in healthy older adults: a secondary analysis from the ACT trial.

Cognitive aging has become a public health concern as the mean age of the population is ever-increasing. It is a naturalistic and common process of degenerative and compensatory changes that may result in neurocognitive disorders. While heterogeneous, cognitive aging mostly affects executive functions that may be associated with functional losses during activities of daily living. Cognition-oriented treatments like cognitive training and transcranial direct current stimulation (tDCS) have garnered considerable attention in the past few decades while the exact picture regarding their efficacy in healthy older adults has not been determined yet. The present paper aimed to evaluate the effects of a 3-month intervention of tDCS over the dorsolateral prefrontal cortex (DLPFC) with multimodal cognitive training on the Stroop test and Trail Making Tests A and B performance. One hundred and ninety-three healthy older adults from 2 sites were administered repeated sessions of active/sham tDCS with cognitive training. Baseline, post-intervention, and 1-year performance results between groups were compared using multiple linear regressions. Active tDCS resulted in better Stroop test performance at post-intervention (p = 0.033) but not at 1-year follow-up while no differences between groups were observed in TrailMakingTests A & B performance. The present results may correspond to a modest improvement in conflict monitoring, potentially due to modulation of prefrontal regions, without changing shifting performance. Further investigation is warranted to draw an interference regarding the subdomain-specific impact of repeated tDCS with multimodal cognitive training on executive functions.

The effects of a short exercise bout on executive functions in healthy older adults

Regular physical activity is associated with healthier brains and improved cognition among older adults. Yet, the impact of a short bout of exercise on older adults’ cognition still is not fully clarified. The present study explored the effects of 20 min of moderate-intensity aerobic exercise (on a cycle ergometer) on cognition. Forty-eight healthy older adults were randomly assigned to an exercise or a control group and completed four cognitive tests: Affective Go/No-Go (AGN), Simple Reaction Time (SRT), Spatial Working Memory (SWM) and a Backward Counting task. Tests were administered prior to and immediately after 20 min of cycling (exercise group) or rest (control group). Mixed-design 2 × 2 ANOVAs indicated a significant interaction of Group x Session, for commission errors on the positive valence of the Affective Go/No-go task, indicating that the exercise group performed better on one aspect of this inhibition test after cycling (p = 0.004), while the control group’s performance declined after rest. A similar pattern was found for the SWM, with the exercise group showing a significantly better performance after the exercise both for total error (p = 0.027) and the strategy (p = 0.002), while no improvement was observed after rest (controls). The study suggests that inhibitory control functions and working memory may be improved by a single relatively short bout of moderate exercise. However, the null effects of exercise on the other cognitive measures indicate that the neurocognitive benefits of acute exercise for older adults may be selectively sensitive to exercise parameters and to specific aspects of cognition.

Cholinergic neurotransmission in the anterior cingulate cortex is associated with cognitive performance in healthy older adults: Baseline characteristics of the Improving Neurological Health in Aging via Neuroplasticity-based Computerized Exercise (INHANCE) trial.

Aging is associated with dysfunction in the cholinergic system, including degeneration of basal forebrain cholinergic terminals that innervate the cortex, which directly contributes to age- and disease-related cognitive decline. In this study, we used [18F]fluoroethoxybenzovesamicol ([18F]FEOBV) positron emission tomography (PET) imaging to assess the effect of age on cholinergic terminal integrity in predefined regions of interest and its relationship to cognitive performance in healthy older adults who underwent neuropsychological assessment and FEOBV PET brain imaging. Our results showed age-related reductions in FEOBV binding, particularly in the anterior cingulate cortex-our primary region of interest-as well as in the striatum, posterior cingulate cortex, and primary auditory cortex. Notably, FEOBV binding in the anterior cingulate cortex was positively correlated with cognitive performance on the NIH EXAMINER Executive Composite Score. These findings suggest that [18F]FEOBV PET imaging can be used as a reliable biomarker to assess cholinergic changes in the human brain and indicate that preserving the cholinergic integrity of the basal forebrain may help maintain cognitive function and protect against age-related cognitive decline.

Incidental Physical Activity and Physical Fitness Associate with Sustained Attention and Impulse Control in Older Adults

Age-related changes have been observed in sustained attention and impulse control. Deficits in these functions are related to pathological aging. However, research suggests that an active lifestyle may exert a protective effect on cognition in aging. While the association between physical activity and cognitive functioning in older adults has been previously described, few studies have explored the relationship between incidental physical activity and fitness with sustained attention and impulse control in this population. Therefore, this study aimed to evaluate the association between incidental physical activity and various components of fitness and sustained attention and impulsivity in older adults. Fifty-four older adults were recruited (41 females and 13 males) with a mean age of 76.76 years (SD = 8.94). Physical activity levels were assessed using the Yale Physical Activity Survey (YPAS), physical function in healthy older adults was evaluated with the Senior Fitness Test, and sustained attention and impulsivity were measured using a computerized continuous performance task. Significant correlations were found between higher energy expenditure during housework and yardwork activities, and fewer commission errors and shorter reaction times during sustained attention task, and higher sensitivity during impulse control task (rho between 0.35 and 0.40, p < .01, β = 0.80). Additionally, higher scores between agility and balance were associated with better accuracy during the sustained attention task, and faster speed processing correlated to better performance impulse control task (rho between 0.33 and 0.36, p < .05, β = 0.80). Our study highlights the importance of incidental physical activity and various components of fitness on sustained attention and impulse control in aging.

Effect of moderate-intensity aquatic treadmill exercise on cognitive function and cerebral blood flow for healthy older adults

To compare the effect of moderate-intensity aquatic treadmill exercise (ATM) on cerebral blood flow (CBF) and cognitive function in healthy older adults to that of moderate-intensity land-based treadmill exercise (LTM). This randomized controlled trial study was conducted between May 2023 and Oct 2023. Twenty-eight participants aged 60–80 were randomly assigned to either ATM group (N = 14) or LTM group (N = 14). Cognitive function and cerebral blood flow were assessed before and after the exercise. The outcome measures used in this study were the Digit Symbol Substitution Test (DSST) and the Digit Span Test (DST) to assess cognitive performance, and the mean middle cerebral artery blood velocity (MCAvmean) to evaluate CBF. A mixed effects model was used to analyze the within-group and between-group differences in cognitive function and CBF outcomes pre-to-post treadmill by SPSS. The DSST demonstrated a statistically significant improvement within both the ATM [β ± SE: −13.643 ± 2.407, 95 % CI: −18.749, −8.537] and LTM [β ± SE: −19.25 ± 3.66, 95 % CI: −26.424, −12.076] groups, indicating clinical significance in both groups. Both ATM and LTM groups exhibited post-exercise improvements within their respective groups for forward Digit Span Test (FDST) [ATM β ± SE: −0.143 ± 0.362, 95 % CI: −0.92, 0.634; LTM β ± SE: −0.286 ± 0.37, 95 % CI: −1.078, 0.506] and backward Digit Span Test (BDST) (ATM β ± SE: −1.741 ± 5.377, 95 % CI: −13.27, 9.792; LTM β ± SE: −6.729 ± 5.370, 95 % CI: −4.788, 18.24). In terms of MCAvmean, there is a higher improvement of CBF in ATM group [β ± SE: −138.669 ± 67.9217, 95 % CI: −288.164, 10.826] than LTM group [β ± SE: −9.305 ± 70.076, 95 % CI: −153.617, 135.007]. Hence, a single bout of moderate-intensity ATM and LTM can enhance cognitive function and CBF in healthy older adults, suggesting their potential as preventive strategies against age-related declines.

Dietary Protein in a Challenge Meal Does Not Alleviate Postprandial Impairments in Vascular Endothelial Function in Healthy Older Adults with Cardiometabolic Risk: A Randomized Crossover-Controlled Trial

BackgroundPostprandial vascular endothelial dysfunction is an early marker of atherosclerosis. Meal protein has been reported to reduce endothelial dysfunction in adults, and the effect could be mediated by the amino acid content. ObjectivesThis trial aims to assess the effect of a specifically designed plant-protein blend that contains high leucine, arginine, and cysteine on postprandial endothelial function in the elderly. MethodsIn a randomized, double-blind, 3-period crossover (2-wk washout), controlled trial, we compared the vascular effects of 3 high-saturated-fat high-sucrose (HFHS) meals containing either our specific plant-protein blend, or milk protein, or without added protein. The trial was conducted on 29 healthy adults aged >65 y presenting ≥2 cardiometabolic risk factors. Postprandial vascular function was evaluated at fasting, 3 h, and 5 h postprandially, using brachial flow-mediated dilation (FMD), hand microvascular reactivity (using Flowmetry Laser Doppler, FLD), and finger reactive hyperemia index (using Peripheral Arterial Tonometry, RHI). Immune cell count and gene expression in peripheral blood mononuclear cells (PBMCs) were also assessed postprandially. Data were analyzed using mixed linear models with repeated measurements on participants for meal composition and time of sampling. This trial was registered at clinicaltrials.gov as NCT04923555. ResultsFMD incremental AUC value decreased after meals (time effect P < 0.01), with no significant differences between meals. RHI also decreased with time (P < 0.01). PBMC count and monocyte chemoattractant protein-1 (MCP1), IL-1β, and IL-6 expression increased after meals showing postprandial endothelial activation (P < 0.05). Overall, meal composition had no effect on any of the postprandial changes (Ps>0.10). ConclusionsIn healthy adults aged >65 y presenting cardiometabolic risk, adding protein to an HFHS challenge meal does not mitigate postprandial impairments in vascular endothelial function and inflammatory activation. Further studies are needed to explore the potential differences with younger adults.

The acute effects of coffee ingestion on postural control and physical function in older adults: A randomised crossover trial

Caffeine consumption can elicit improvements in aspects of physical function in older adults but also, negatively modify standing balance, potentially increasing fall risk. However, balance alterations and changes in physical function induced by commonly consumed caffeine vehicles such as coffee have not been investigated. Therefore, this study investigated coffee ingestion providing 3 mg·kg BW−1 caffeine on balance performance and physical function, in a group of older adults. In a randomised, crossover design, 22 older adults (Male n = 10, Age: 68 ± 6 years) completed bipedal standing balance and physical function assessments (Senior Fitness Test) under one of the following conditions: caffeinated coffee (COF), decaffeinated coffee (DEC), placebo (PLA) or a control (CON) (no fluid ingestion). Centre of pressure (COP) root mean square and power frequency were calculated to characterise postural performance and strategy, respectively. The complexity (i.e., regularity) of the COP signal was also determined by calculating sample entropy. Caffeinated coffee had limited effects on COP outcomes. Frequency of the COP in the anteroposterior direction was greater following COF compared to DEC (P = 0.047;g = 0.29) but there were no statistical differences between COF and PLA or CON (P > 0.05). Furthermore, there were no significant performance differences between any conditions in all tests of physical function (P > 0.05). This suggests that coffee has limited effects on balance performance or physical function but may influence both balance complexity and the strategy utilised to maintain upright stance. Overall, a strong cup of coffee does not significantly influence balance and measures of functional performance in healthy older adults.

A meta-analysis of the effects of transcranial direct current stimulation combined with cognitive training on working memory in healthy older adults.

Working memory (WM) loss, which can lead to a loss of independence, and declines in the quality of life of older adults, is becoming an increasingly prominent issue affecting the ageing population. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, is emerging as a potential alternative to pharmacological treatments that shows promise for enhancing WM capacity and May enhance the effects of cognitive training (CT) interventions. The purpose of this meta-analysis was to explore how different tDCS protocols in combination with CT enhanced WM in healthy older adults. Randomized controlled trials (RCTs) exploring the effects of tDCS combined with CT on WM in healthy older adults were retrieved from the Web of Science, PubMed, Embase, Scopus and the Cochrane Library databases. The search time period ranged from database inception to January 15, 2024. Methodological quality of the trials was assessed using the risk-of-bias criteria for RCTs from the Cochrane Collaboration Network, and RevMan 5.3 (Cochrane, London, United Kingdom) was used for the meta-analysis of the final literature outcomes. Six RCTs with a total of 323 participants were ultimately included. The results of the meta-analysis show that tDCS combined with CT statistically significantly improves WM performance compared to the control sham stimulation group in healthy older adults [standard mean difference (SMD) = 0.35, 95% CI: 0.11-0.59, I 2 = 0%, Z = 2.86, p = 0.004]. The first subgroup analysis indicated that, when the stimulus intensity was 2 mA, a statistically significant improvement in WM performance in healthy older adults was achieved (SMD = 0.39, 95% CI: 0.08-0.70, I 2 = 6%, Z = 2.46, p = 0.01). The second subgroup analysis showed that long-term intervention (≥ 10 sessions) with tDCS combined with CT statistically significantly improved WM compared to the control group in healthy older adults (SMD = 0.72, 95% CI: 0.22-1.21, I 2 = 0%, Z = 2.85, p = 0.004). tDCS combined with CT statistically significantly improves WM in healthy older adults. For the stimulus parameters, long-term interventions (≥ 10 sessions) with a stimulation intensity of 2 mA are the most effective.

Investigation of Pharyngeal Swallow Function of Healthy Older Adults Using Visual Analysis of Swallowing Efficiency and Safety Scale.

To assess the pharyngeal swallow function of older adults in terms of safety and efficiency using the VASES scale. Twenty healthy individuals aged 60-80 years were included. They were evaluated using the EAT-10K and VVST, followed by the FEES assessment. VASES was used to assess the residue in the oropharynx, hypopharynx, Epiglottis, Laryngeal vestibule, Vocal folds, and Sub glottis, and the aspiration and penetration during swallowing. Residue was present in the oropharynx, hypopharynx, epiglottis, and laryngeal vestibule for 95%, 85%, 45%, and 15% of the swallowing trials. The median residue amount was found to be 2% in the oropharynx and 1% in the hypopharynx. 70% of swallows yielded a score of PAS score of 1, followed by PAS 3 for 20% and PAS 2 for 10%. VASES facilitated the quantification of the residue across anatomical sites. Older adults did have compromised swallow safety and efficiency.

Physiology-inspired bifocal fronto-parietal tACS for working memory enhancement

Aging populations face significant cognitive challenges, particularly in working memory (WM). Transcranial alternating current stimulation (tACS) offer promising avenues for cognitive enhancement, especially when inspired by brain physiology. This study (NCT04986787) explores the effect of multifocal tACS on WM performance in healthy older adults, focusing on fronto-parietal network modulation. Individualized physiology-inspired tACS applied to the fronto-parietal network was investigated in two blinded cross-over experiments. The first experiment involved monofocal/bifocal theta-tACS to the fronto-parietal network, while in the second experiment cross-frequency theta-gamma interactions between these regions were explored. Participants have done online WM tasks under the stimulation conditions. Network connectivity was assessed via rs-fMRI and multichannel electroencephalography. Prefrontal monofocal theta tACS modestly improved WM accuracy over sham (d = 0.30). Fronto-parietal stimulation enhanced WM task processing speed, with the strongest effects for bifocal in-phase theta tACS (d = 0.41). Cross-frequency stimulations modestly boosted processing speed with or without impairing task accuracy depending on the stimulation protocol. This research adds to the understanding of physiology-inspired brain stimulation for cognitive enhancement in older subjects.

Noninvasive neurostimulation promotes working memory performance in older adults: a systematic review

Working memory is a core component of high-level cognitive functions. A key feature of cognitive decline in older adults is the impairment of working memory capacity, which is also observed in many clinical conditions. In recent years, noninvasive neurostimulation techniques have garnered extensive research attention for their potential to enhance human cognitive function, particularly in older adults. This review focuses on several advanced noninvasive neurostimulation techniques for working memory in older adults. A systematic search of the PubMed and Google Scholar literature databases was conducted, covering research papers published from 2013 to 2023. This review identified 19 articles on transcranial electrical stimulation, 6 on transcranial magnetic stimulation, and 2 on transcranial photobiomodulation techniques that met the inclusion criteria. These results suggest that transcranial electrical stimulation, especially transcranial alternating current stimulation and transcranial direct current stimulation, can improve working memory performance in healthy older adults. Transcranial direct current stimulation combined with cognitive training improves functional connectivity between relevant brain regions in addition to performance gains. Transcranial random noise stimulation, transcranial magnetic stimulation, and transcranial photobiomodulation also have the potential to improve working memory. Further research is needed to understand the neural mechanisms involved and optimize stimulation parameters. In addition, emerging techniques such as transcranial focused ultrasound may offer promising solutions for future studies on working memory enhancement in older adults.

Blood-Brain Barrier Permeability Is Associated With Cognitive Functioning in Normal Aging and Neurodegenerative Diseases.

The purpose of this study was to investigate the relationship between blood-brain barrier (BBB) permeability and cognitive functioning in healthy older adults and individuals with neurodegenerative diseases. A total of 124 participants with Alzheimer disease, cerebrovascular disease, or a mix Alzheimer's and cerebrovascular diseases and 55 controlparticipants underwent magnetic resonance imaging and neuropsychological testing. BBB permeability was measured with dynamic contrast-enhanced magnetic resonance imaging and white matter injury was measured using a quantitative diffusion-tensor imaging marker of white matter injury. Structural equation modeling was used to examine the relationships between BBB permeability, vascular risk burden, white matter injury, and cognitive functioning. Vascular risk burden predicted BBB permeability (r=0.24, P<0.05) and white matter injury (r=0.38, P<0.001). BBB permeability predicted increased white matter injury (r=0.34, P<0.001) and increased white matter injury predicted lower cognitive functioning (r=-0.51, P<0.001). The study provides empirical support for a vascular contribution to white matter injury and cognitive impairment, directly or indirectly via BBB permeability. This highlights the importance of targeting modifiable vascular risk factors to help mitigate future cognitive decline.

Brain metabolites are associated with sleep architecture and cognitive functioning in older adults.

Sleep deficits are a possible risk factor for development of cognitive decline and dementia in older age. Research suggests that neuroinflammation may be a link between the two. This observational, cross-sectional study evaluated relationships between sleep architecture, neuroinflammation and cognitive functioning in healthy older adults. Twenty-two adults aged ≥60 years underwent whole-brain magnetic resonance spectroscopic imaging (in vivo method of visualizing increased brain temperatures as a proxy for neuroinflammation), supervised laboratory-based polysomnography, and comprehensive neurocognitive testing. Multiple regressions were used to assess relationships between magnetic resonance spectroscopic imaging-derived brain temperature and metabolites related to inflammation (choline; myo-inositol; N-acetylaspartate), sleep efficiency, time and % N3 sleep and cognitive performance. Choline, myo-inositol and N-acetylaspartate were associated with sleep efficiency and cognitive performance. Higher choline and myo-inositol in the bilateral frontal lobes were associated with slower processing speed and lower sleep efficiency. Higher choline and myo-inositol in bilateral frontoparietal regions were associated with better cognitive performance. Higher N-acetylaspartate around the temporoparietal junction and adjacent white matter was associated with better visuospatial function. Brain temperature was not related to cognitive or sleep outcomes. Our findings are consistent with the limited literature regarding neuroinflammation and its relationships with sleep and cognition in older age, which has implicated ageing microglia and astrocytes in circadian dysregulation, impaired glymphatic clearance and increased blood-brain barrier integrity, with downstream effects of neurodegeneration and cognitive decline. Inflammatory processes remain difficult to measure in the clinical setting, but magnetic resonance spectroscopic imaging may serve as a marker of the relationship between neuroinflammation, sleep and cognitive decline in older adults.

Impact of repetitive home-based galvanic vestibular stimulation on cognitive skills in healthy older adults

The human vestibular system is adversely affected by the aging process. Recent evidence indicates that vestibular information and cognitive functions are related, suggesting that age-related vestibular loss may contribute to cognitive impairment. In this study, we aimed to investigate the effects of repetitive, home-based galvanic vestibular stimulation (GVS) on cognitive functions in healthy older adults. Twenty-one participants (age = 64.66 ± 2.97 years, 12 females) were randomly allocated to either a home-based GVS or an active control group. The GVS intervention lasted 20 min per session, five times a week, for two weeks (10 sessions). Cognitive functions were assessed before and after the intervention using the Stroop Test, Trail Making Test A&B, and Dual-Task (digit recall and paper-pencil tracking test). Our findings revealed a significant group-by-time interaction effect for the tracking accuracy (F(1,18) = 7.713, p = 0.012, η p2 = 0.30), with only the home-based GVS group showing significant improvement (t = −2.544, p = 0.029). The proposed home-based GVS protocol offers a promising non-pharmacological avenue for enhancing visuospatial ability in healthy older adults. Further research is needed to investigate the effects of different GVS protocols on various cognitive functions, particularly in older individuals with different health conditions.

Cognitive and Emotional Effect of a Multi-species Probiotic Containing Lactobacillus rhamnosus and Bifidobacterium lactis in Healthy Older Adults: A Double-Blind Randomized Placebo-Controlled Crossover Trial.

As the population ages, cognitive decline becomes more common. Strategies targeting the gut-brain axis using probiotics are emerging to achieve improvements in neuropsychiatric and neurological disorders. However, the beneficial role of probiotics on brain function in healthy older adults remains unclear. Our aim was to evaluate a multi-species probiotic formulation as a therapeutic approach to reduce emotional and cognitive decline associated with aging in healthy adults. A randomized double-blind placebo-controlled crossover trial was conducted. The study involved a 10-week intervention where participants consumed the assigned probiotic product daily, followed by a 4-week washout period before the second condition started. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Psychological Experiments Construction Language Test Battery. At the emotional level, the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used. Thirty-three participants, recruited between July 2020 and April 2022, ingested a multispecies probiotic (Lactobacillus rhamnosus and Bifidobacterium lactis). After the intervention, noticeable enhancements were observed in cognitive function (mean difference 1.90, 95% CI 1.09 to 2.70, p < 0.005), memory (mean difference 4.60, 95% CI 2.91 to 6.29, p < 0.005) by MMSE and digit task, and depressive symptoms (mean difference 4.09, 95% CI 1.70 to 6.48, p < 0.005) by BDI. Furthermore, there were significant improvements observed in planning and problem-solving skills, selective attention, cognitive flexibility, impulsivity, and inhibitory ability. Probiotics administration improved cognitive and emotional function in older adults. Limited research supports this, requiring more scientific evidence for probiotics as an effective therapy for cognitive decline. This study has been prospectively registered at ClinicalTrials.gov (NCT04828421; 2020/July/17).