Knowledge Of Age-related Changes Research Articles

Hematopoietic stem cells through the ages: A lifetime of adaptation to organismal demands.

Hematopoietic stem cells (HSCs), which govern the production of all blood lineages, transition through a series of functional states characterized by expansion during fetal development, functional quiescence in adulthood, and decline upon aging. We describe central features of HSC regulation during ontogeny to contextualize how adaptive responses over the life of the organism ultimately form the basis for HSC functional degradation with age. We particularly focus on the role of cell cycle regulation, inflammatory response pathways, epigenetic changes, and metabolic regulation. We then explore how the knowledge of age-related changes in HSC regulation can inform strategies for the rejuvenation of old HSCs.

Mechanobiological implications of age-related remodelling in the outer retina

The outer retina consists of the light-sensitive photoreceptors, the pigmented epithelium, and the choroid, which interact in a complex manner to sustain homeostasis. The organisation and function of these cellular layers are mediated by the extracellular matrix compartment named Bruch's membrane, situated between the retinal epithelium and the choroid. Like many tissues, the retina experiences age-related structural and metabolic changes, which are relevant for understanding major blinding diseases of the elderly, such as age-related macular degeneration. Compared with other tissues, the retina mainly comprises postmitotic cells, making it less able to maintain its mechanical homeostasis over the years functionally. Aspects of retinal ageing, like the structural and morphometric changes of the pigment epithelium and the heterogenous remodelling of the Bruch's membrane, imply changes in tissue mechanics and may affect functional integrity. In recent years, findings in the field of mechanobiology and bioengineering highlighted the importance of mechanical changes in tissues for understanding physiological and pathological processes. Here, we review the current knowledge of age-related changes in the outer retina from a mechanobiological perspective, aiming to generate food for thought for future mechanobiology studies in the outer retina.

Distinct neural activation patterns of age in subcomponents of inhibitory control: A fMRI meta-analysis.

Inhibitory control (IC) is a fundamental cognitive function showing age-related change across the healthy lifespan. Since different cognitive resources are needed in the two subcomponents of IC (cognitive inhibition and response inhibition), regions of the brain are differentially activated. In this study, we aimed to determine whether there is a distinct age-related activation pattern in these two subcomponents. A total of 278 fMRI articles were included in the current analysis. Multilevel kernel density analysis was used to provide data on brain activation under each subcomponent of IC. Contrast analyses were conducted to capture the distinct activated brain regions for the two subcomponents, whereas meta-regression analyses were performed to identify brain regions with distinct age-related activation patterns in the two subcomponents of IC. The results showed that the right inferior frontal gyrus and the bilateral insula were activated during the two IC subcomponents. Contrast analyses revealed stronger activation in the superior parietal lobule during cognitive inhibition, whereas stronger activation during response inhibition was observed primarily in the right inferior frontal gyrus, bilateral insula, and angular gyrus. Furthermore, regression analyses showed that activation of the left anterior cingulate cortex, left inferior frontal gyrus, bilateral insula, and left superior parietal lobule increased and decreased with age during cognitive inhibition and response inhibition, respectively. The results showed distinct activation patterns of aging for the two subcomponents of IC, which may be related to the differential cognitive resources recruited. These findings may help to enhance knowledge of age-related changes in the activation patterns of IC.

An Interprofessional Yearlong Geriatrics Fellowship Program for Advanced Practice Nursing and Social Work Students.

The care of older adults with complex medical conditions requires effective team-based care. Nursing and social work students need a curriculum that provides them with immersive experiences in geriatrics to prepare them for competent practice. This Geriatric Workforce Enhancement Program supported 5 advanced practice nursing (APN) and 5 master of social work (MSW) student fellows in a 2-semester program, with 3 cohorts completing the fellowship over 3 years (N = 30). By the completion of the fellowship, students had (1) demonstrated increased knowledge of age-related changes and health problems experienced by older adults, (2) developed clinical competencies in providing patient-centered health care for older adults, and (3) assessed the fellowship as helpful in preparing for interprofessional team care. An interprofessional gerontology fellowship for APN and MSW students can develop knowledge and skills in team-based care for older adults. Recommendations for creating a fellowship curriculum are provided.

Multiple Sclerosis and Aging: The Dynamics of Demyelination and Remyelination

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) leading to demyelination and neurodegeneration. Life expectancy and age of onset in MS patients have been rising over the last decades, and previous studies have shown that age affects disease progression. Therefore, age appears as one of the most important factors in accumulating disability in MS patients. Indeed, the degeneration of oligodendrocytes (OGDs) and OGD precursors (OPCs) increases with age, in association with increased inflammatory activity of astrocytes and microglia. Similarly, age-related neuronal changes such as mitochondrial alterations, an increase in oxidative stress, and disrupted paranodal junctions can impact myelin integrity. Conversely, once myelination is complete, the long-term integrity of axons depends on OGD supply of energy. These alterations determine pathological myelin changes consisting of myelin outfolding, splitting, and accumulation of multilamellar fragments. Overall, these data demonstrate that old mature OGDs lose their ability to produce and maintain healthy myelin over time, to induce de novo myelination, and to remodel pre-existing myelinated axons that contribute to neural plasticity in the CNS. Furthermore, as observed in other tissues, aging induces a general decline in regenerative processes and, not surprisingly, progressively hinders remyelination in MS. In this context, this review will provide an overview of the current knowledge of age-related changes occurring in cells of the oligodendroglial lineage and how they impact myelin synthesis, axonal degeneration, and remyelination efficiency.

Nutrition and Healthy Aging: Prevention and Treatment of Gastrointestinal Diseases.

Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly. It is estimated that at least half of non-institutionalized elderly people need nutritional intervention to improve their health and that 85% have one or more chronic diseases that could improve with correct nutrition. Although prevalence estimates are highly variable, depending on the population considered and the tool used for its assessment, malnutrition in the elderly has been reported up to 50%. Older patients are particularly at risk of malnutrition, due to multiple etiopathogenetic factors which can lead to a reduction or utilization in the intake of nutrients, a progressive loss of functional autonomy with dependence on food, and psychological problems related to economic or social isolation, e.g., linked to poverty or loneliness. Changes in the aging gut involve the mechanical disintegration of food, gastrointestinal motor function, food transit, intestinal wall function, and chemical digestion of food. These alterations progressively lead to the reduced ability to supply the body with adequate levels of nutrients, with the consequent development of malnutrition. Furthermore, studies have shown that the quality of life is impaired both in gastrointestinal diseases, but especially in malnutrition. A better understanding of the pathophysiology of malnutrition in elderly people is necessary to promote the knowledge of age-related changes in appetite, food intake, homeostasis, and body composition in order to better develop effective prevention and intervention strategies to achieve healthy aging.

Comprehensive analysis of male ejaculate from infertile couples in the age aspect

Introduction. According to Russian Association of Urology a number of infertile couples ranges from 8 to 17.2 % in various regions of Russia. One of the causes of which is the male factor. Raising the age of the father reduces the chance of conception, increases the risk of early termination of pregnancy and the risk of certain diseases of the child. In this regard the existing knowledge of age-related changes in ejaculate parameters needs to be de veloped. This is particularly true for men of infertile couples.The study objective – to investigate the age patterns of change in the spermological status of infertile men and identify the most age-related variations.Materials and methods. Research design – observation, retrospective, crossection. Analysis of the medical records of 517 Novosibirsk male residents from couples with infertility in marriage was made. The sampling is divided into 5 age groups: 1st group (n = 108) – men of ≤29.9 years old; 2nd group (n = 171) – 30.0–34.9 years old; 3rd group (n = 130) – 35.0–39.9 years old; 4th group (n = 68) – 40.0–44.9 years old; 5th group (n = 40) – ≥45.0 years old.Results. Median of male age in total sample – 34 years, frequency of persons over 40 years – 21 %. Overall sample shows a decline in reference values of proportion of morphologically normal forms – 3.0 (1.5–5.0) % and increase in sperm DNA fragmentation index (SDFI) – 16.0 (11.0–22.2) %. In groups from 1st to 5th there is an age-specific decrease in ejaculate volume (3.5 (2.5–4.8) ml; 3.3 (2.4–4.2) ml; 3.2 (2.4–4.5) ml; 3.0 (1.7–4.9) ml; 2.7 (1.9–3.5) ml, р1–5 <0.005) and sperm count (127.1 (58.8–264.0) million; 122.5 (62.4–214.0) million; 118.5 (52.8–217.5) million; 98.0 (58.5–199.5) million; 81.0 (36.5–137.9) million, р1–5, 2–5 <0.005). SDFI has an age-associated increase in the value of the indicator (14.4 (10.8–19.5) %; 15.0 (10.0–21.0) %; 17.2 (11.0–22.0) %; 18.5 (14.0–24.2) %; 19.2 (13.2–29.6) %, р1–4 <0.005).Conclusion. It was first time shown for the male population of Novosibirsk of Siberian Federal District that a reduction in the proportion of morphologically normal sperm below the reference values observed in the total sample and it did not depend on the age of the men examined. Only three of the examined indicators of sperm status studied infertile males had a significant age dependency: ejaculate volume decrease, reduction of total sperm, increased DNA fragmentation of sperm. The lack of a reliable influence of age on HBA-test indicators was first shown. However the trends identified require further study. The results show that age-associated increase in DNA fragmentation of sperm starts with young men under 30, and underscores the need to define SDFI in actual clinical practice. And negative processes of age influence on the quantitative, morphological and ultrastructural characteristics of sperm occur most frequently in men after 40 years.

Age-related changes in size, bone microarchitecture and volumetric bone mineral density of the mandible in the harbor seal (Phoca vitulina).

Detailed knowledge of age-related changes in the structure and mineralization of bones is important for interpreting osseous changes in wild mammals caused by exposure to environmental contaminants. This study analyzed mandibular size, microarchitecture and volumetric bone mineral density (vBMD) in harbor seals (n = 93, age range 0.5 months to 25 years) from the German North Sea. Bone microarchitecture and vBMD were assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT). Significant differences were observed between the analyzed age classes (i) young juveniles (0.5–10 months), (ii) yearlings (12–23 months), and (iii) adults (12–25 years) for several of the variables, indicating an overall increase in cortical and trabecular area, cortical thickness and total and cortical vBMD with age. Furthermore, for juvenile animals (≤ 23 months), significant positive correlations with age were observed for mandible length and perimeter, cortical area, cortical thickness, trabecular separation, and total and cortical vBMD. The findings demonstrate a rapid increase in overall size, cortical dimensions and the degree of mineralization of the harbor seal mandible during the first two years after birth. Negative correlations with age existed for trabecular number and thickness as well as for trabecular bone volume fraction in the juveniles. The findings suggest a reduction in trabecular bone volume fraction with age, due to the bone trabeculae becoming thinner, less numerous and more widely spaced. Given the strong age dependence of most analyzed parameters, it is recommended to standardize samples with respect to age in future studies comparing microarchitecture and mineralization of harbor seal mandibles from different populations or different collection periods.

Age-related morphological changes in the pancreas and their association with pancreatic carcinogenesis.

Age-related pathological changes in the pancreas have been unclear because they are often minor and nonspecific. However, recent studies have shown that they are closely related to various pathological conditions such as pancreatic cancer and diabetes mellitus. Knowledge of age-related changes is important to determine appropriate prevention, detection, and treatment strategies for various diseases observed in elderly patients. We present a review of the pathological age-related non-neoplastic changes in the exocrine pancreas such as pancreatic fatty replacement, lobulocentric pancreatic atrophy, pancreatic duct ectasia, and metaplasia of exocrine pancreas, as well as changes in islet cells. We have discussed common pancreatic neoplasms in elderly patients, such as pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasms (IPMNs), and pancreatic ductal adenocarcinoma (PDAC). Age-related pathological changes play a key role in pancreatic carcinogenesis via telomere dysfunction. Further studies are warranted to clarify molecular mechanisms of pancreatic carcinogenesis in elderly patients.

Spontaneous Age-Related Histopathological Changes in Microminipigs.

Microminipigs have become an attractive animal model for toxicology and pharmacology studies and for human disease models, owing to their manageable size. Although there are numerous reports of spontaneous age-related lesions in mice, rats, dogs, and monkeys, those in minipigs are scarce. In the present study, spontaneous age-related histopathological changes were investigated using 37 microminipigs (20 males and 17 females) that were 6 months to 10 years of age. Abnormal deposits of materials were evident in several animals from 6 years of age, and these deposits included amyloid in the renal medulla, thyroid gland, and adrenal gland, hyaline droplets in glomeruli, and fibrillar inclusions in neurons. Arterial sclerosing changes (intimal thickening, intimal proliferation, and medial mineralization) and proliferative lesions (hyperplasia of hepatocytes, follicular cells, Leydig cells, and uterine endometrial glands) were present at 4 years of age and beyond. Renal adenoma, uterine leiomyoma, and Leydig cell tumor were observed in several microminipigs. Moreover, glomerulosclerosis, renal interstitial fibrosis, thymic involution, and adrenocortical cell vacuolation were common in aging microminipigs. Since knowledge of age-related changes is helpful for pathologists, the basic information obtained in this study will be a useful reference for all future toxicity evaluations in microminipigs.

Aging of bovine spinal cord: an alteration of myelinated nerve fibers in the white matter

To gain more knowledge of age-related changes in the spinal cord of the bovine species, the structure of 15 clinically normal aged cattle (Holstein-Friesian cows 8–13 years of age) was histopathologically examined. In 12 (80%) of the 15 animals, the common histopathological features identified were alteration of a small number of myelinated nerve fibers in the white matter, with less than 4 nerve fibers affected per cross-sectional area of the spinal cord. Alteration of nerve fibers was characterized by dilation of myelin sheaths with loss of axons or macrophage infiltration, resembling features of Wallerian axonal degeneration. The occurrence of this nerve fiber alteration had a predilection for the lateral and ventral white matter funiculi. In eight cattle, so-called axonal spheroids were rarely present in the white matter. There was little evidence of glial reaction against nerve fiber alteration. Gray horn neurons were unremarkable. Lipofuscin granules were recognized in neurons, glial cells, and neuropil of the medulla oblongata examined in six cows. The changes observed in the spinal cord white matter of the present cows were similar to those described previously in aged human beings and domestic and laboratory animals, and thus were likely to have been a phenomenon which was closely related to aging. The strict clinical significance of the histopathological changes in the spinal cord white matter remains undetermined.

Age-Related Changes in Glucose Metabolism, Hyperglycemia, and Cardiovascular Risk.

Aging and diabetes mellitus are 2 well-known risk factors for cardiovascular disease (CVD). During the past 50 years, there has been an dramatic increase in life expectancy with a simultaneous increase in the prevalence of diabetes mellitus in the older population. This large number of older individuals with diabetes mellitus is problematic given that CVD risk associated with aging and diabetes mellitus. In this review, we summarize epidemiological data relating to diabetes mellitus and CVD, with an emphasis on the aging population. We then present data on hyperglycemia as a risk factor for CVD and review the current knowledge of age-related changes in glucose metabolism. Next, we review the role of obesity in the pathogenesis of age-related glucose dysregulation, followed by a summary of the results from major randomized controlled trials that focus on cardiovascular risk reduction through glycemic control, with a special emphasis on older adults. We then conclude with our proposed model of aging that body composition changes and insulin resistance link possible dysregulation of physiological pathways leading to obesity and diabetes mellitus-both forms of accelerated aging-and risks for CVD.

Comparison of computed tomography and high-field (3.0\xa0T) magnetic resonance imaging of age-related variances in selected equine maxillary cheek teeth and adjacent tissues

BackgroundModern imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) have the advantage of producing images without superimposition. Whilst CT is a well-established technique for dental diagnostics, MRI examinations are rarely used for the evaluation of dental diseases in horses. Regarding equine endodontic therapies which are increasingly implemented, MRI could help to portray changes of the periodontal ligament and display gross pulpar anatomy. Knowledge of age-related changes is essential for diagnosis, as cheek teeth and surrounding structures alter with increasing age. The aim of the present study was to highlight the advantages of CT and MRI regarding age-related changes in selected equine cheek teeth and their adjacent structures.ResultsThe CT and MRI appearances of the maxillary 08 s and 09 s and adjacent structures were described by evaluation of post-mortem examinations of nine horses of different ages (Group A: <6 years, B: 6–15 years, C: ≥16 years). Most of the tissues selected were imaged accurately with MRI and CT. Magnetic resonance imaging gives an excellent depiction of soft endo- and periodontal units, and CT of hard dental and bony tissues. Negative correlation between dental age and pulpar sizes was found: 71.3% of the changes in pulp dimensions can be explained by teeth aging. Pulpar sizes ranged from 14.3 to 1.3 mm and were significantly smaller in older horses (p < 0.05). A common pulp chamber was present in 33% of the teeth with a mean dental age of 2.25 years. Ninety-four percent of the 08 and 09 alveoli of all groups were in direct contact with the maxillary sinus. An age-related regression was found (R2 = 0.88) for the distance between alveoli and the infraorbital canal.ConclusionsThe present study provides information about the dental and periodontal age-related morphology and its visibility using different imaging techniques. These results aid in evaluating diagnostic images and in deciding which is the superior imaging modality for clinical cases.

'Fine-tuning' blood flow to the exercising muscle with advancing age: an update.

What is the topic of this review? This review focuses on age-related changes in the regulatory pathways that exist at the unique interface between the vascular smooth muscle and the endothelium of the skeletal muscle vasculature, and how these changes contribute to impairments in exercising skeletal muscle blood flow in the elderly. What advances does it highlight? Several recent in vivo human studies from our group and others are highlighted that have examined age-related changes in nitric oxide, endothelin-1, alpha adrenergic, and renin-angiotensin-aldosterone (RAAS) signaling. During dynamic exercise, oxygen demand from the exercising muscle is dramatically elevated, requiring a marked increase in skeletal muscle blood flow that is accomplished through a combination of systemic sympathoexcitation and local metabolic vasodilatation. With advancing age, the balance between these factors appears to be disrupted in favour of vasoconstriction, leading to an impairment in exercising skeletal muscle blood flow in the elderly. This 'hot topic' review aims to provide an update to our current knowledge of age-related changes in the neural and local mechanisms that contribute to this 'fine-tuning' of blood flow during exercise. The focus is on results from recent human studies that have adopted a reductionist approach to explore how age-related changes in both vasodilators (nitric oxide) and vasoconstrictors (endothelin-1, α-adrenergic agonists and angiotensinII) interact and how these changes impact blood flow to the exercising skeletal muscle with advancing age.

Principal component and factor analysis to study variations in the aging lumbar spine.

Human spine is a multifunctional structure of human body consisting of bones, joints, ligaments, and muscles which all undergo a process of change with the age. A sudden change in these features either naturally or through injury can lead to some serious medical conditions which puts huge burden on health services and economy. While aging is inevitable, the effect of aging on different areas of spine is of clinical significance. This paper reports the growth and degenerative pattern of human spine using principal component analysis. Some noticeable lumbar spine features such as vertebral heights, disc heights, disc signal intensities, paraspinal muscles, subcutaneous fats, psoas muscles, and cerebrospinal fluid were used to study the variations seen on lumbar spine with the natural aging. These features were extracted from lumbar spine magnetic resonance images of 61 subjects with age ranging from 2 to 93 years. Principal component analysis is used to transform complex and multivariate feature space to a smaller meaningful representation. PCA transformation provided 2-D visualization and knowledge of variations among spinal features. Further useful information about correlation among the spinal features is acquired through factor analysis. The knowledge of age related changes in spinal features are important in understanding different spine related problems.

Stem Cell Ageing and Apoptosis

Ageing has been defined as the process of deterioration of many body functions over the lifespan of an individual. In spite of the number of different theories about ageing, there is a general consensus in identifying ageing effects in a reduced capacity to regenerate injured tissues or organs and an increased propensity to infections and cancer. In recent years the stem cell theory of ageing has gained much attention. Adult stem cells residing in mammalian tissues are essential for tissue homeostasis and repair throughout adult life. With advancing age, the highly regulated molecular signalling necessary to ensure proper cellular, tissue, and organ homeostasis loses coordination and leads, as a consequence, to a compromised potential of regeneration and repair of damaged cells and tissues. Although a complete comprehension of the molecular mechanisms involved in stem cell ageing and apoptosis is far to be reached, recent studies are beginning to unravel the processes involved in stem cell ageing, particularly in adult skeletal muscle stem cells, namely satellite cells. Thus, the focus of this review is to analyse the relationship between stem cell ageing and apoptosis with a peculiar attention to human satellite cells as compared to haematopoietic stem cells. Undoubtedly, the knowledge of age-related changes of stem cells will help in understanding the ageing process itself and will provide novel therapeutic challenges for improved tissue regeneration.

Regional heterogeneity and age-related change in sub-regions of internal capsule evaluated by diffusion tensor imaging

The internal capsule (IC) includes various fiber tracts supporting sensory, motor and cognitive abilities. Diffusion tensor imaging (DTI) is useful for the diagnosis of brain diseases related to IC. However, there is some risk of misdiagnosis when measuring diffusion parameters throughout the whole IC without knowledge of age-related changes, as the thin structure and branching in multiple directions must be expected to produce sub-regional differences. In this study, regional heterogeneity and age-related changes in water diffusion parameters were evaluated in sub-regions of IC. The IC region-of-interest (ROI) was first thinned to reduce contamination from surrounding tissues and then morphologically divided into three regions: anterior limb (AL), genu and posterior limb (PL). To address the branching of PL, a procedure was applied to divide the thinned PL ROI into 10 equally-spaced positions. Estimates of fractional anisotropy (FA), mean diffusivity (MD), and longitudinal (λ L) and transversal (λ T) eigenvalues showed age-related and location-dependent variation in AL, genu and PL ROIs and at the 10 equally-spaced positions of PL. Simultaneous decrease of λ L and increase of λ T resulting in decrease of FA and steady MD with aging were observed. This might be caused by age-related atrophy of main fibers such as the pyramidal tract, possibly resulting in an increase in the relative signal contribution of some crossing fibers in each pixel. Evaluation using eigenvalues (λ L and λ T), as well as FA and MD, may provide important information towards understanding age-related changes and may also be useful for clinical diagnosis of diseased IC.

Age-Related Changes in Redox Signaling and VSMC Function

Epidemiological studies have shown that advancing age is associated with an increased prevalence of cardiovascular disease (CVD). Vascular smooth muscle cells (VSMC) comprise the major arterial cell population, and changes in VSMC behavior, function, and redox status with age contribute to alterations in vascular remodeling and cell signaling. Over two decades of work on aged animal models provide support for age-related changes in VSMC and/or arterial tissues. Enhanced production of reactive oxygen species (ROS) and insufficient removal by scavenging systems are hallmarks of vascular aging. VSMC proliferation and migration are core processes in vascular remodeling and influenced by growth factors and signaling networks. The intrinsic link between gene regulation and aging often relates directly to transcription factors and their regulatory actions. Modulation of growth factor signaling leads to up- or downregulation of transcription factors that control expression of genes associated with VSMC proliferation, inflammation, and ROS production. Four major signaling pathways related to the transcription factors, AP-1, NF-kappaB, FoxO, and Nrf2, will be reviewed. Knowledge of age-related changes in signaling pathways in VSMC that lead to alterations in cell behavior and function consistent with disease progression may help in efforts to attenuate age-related CVD, such as atherosclerosis.

Plasma Vasopressin Concentrations in Healthy Foals from Birth to 3 Months of Age

Arginine vasopressin (AVP) has received increased attention in equine critical care but there is minimal information of AVP concentration in foals. The clinical usefulness of measuring AVP in ill foals depends on knowledge of age-related changes in AVP concentrations in healthy foals. Plasma AVP concentrations will be significantly different when measured from birth to 3 months of age in healthy foals. Thirteen healthy university-owned foals. Prospective, observational study. Blood was collected from healthy foals at birth and 3, 5, 7, 10, 14, 21, 28, 42, 56, and 84 days of age. Plasma was harvested and plasma AVP concentrations were determined by radioimmunoassay. No statistically significant differences were detected in plasma AVP concentrations over the study period. Plasma AVP concentrations over the entire study period was 6.2+/-2.5 pg/mL. There was no age-related variation in plasma AVP concentrations detected in healthy foals from birth to 3 months of age suggesting that AVP concentrations are similar across foals of these ages.

Undergraduate Nursing Students' Knowledge of and Attitudes Toward Aging: Comparison of Context-Based Learning and a Traditional Program

The purpose of this study was to investigate nursing students' knowledge of and attitudes toward older adults in the first and fourth years of a baccalaureate program, following the introduction of a context-based learning (CBL) curriculum, and to compare the fourth-year CBL student findings to those of fourth-year students in the final year of the traditional, lecture-based baccalaureate program. The Facts on Aging Questionnaire was used to assess knowledge, and the Aging Semantic Differential was used to assess attitudes toward aging related to societal influences. Although there were differences in knowledge and attitudes between fourth-year CBL and fourth-year traditional students, the differences were not significant. These findings support earlier work that an integrated curriculum may not significantly improve knowledge of age-related changes nor positively influence attitudes that are already positive. The Reactions to Ageing Questionnaire was used to examine students' attitudes toward personal aging. There was a significant positive increase in CBL students' attitudes toward personal aging from the first to fourth years of the program. This suggests that CBL learning fosters an inner maturity toward personal aging.