Level In Older Adults Research Articles

Ophiocephalus striatus Extract Supplementation Decreases Serum IL-6 Levels in Older People with Sarcopenia-A Single-Center Experience.

Sarcopenia, a condition characterized by muscle loss and decreased function in older adults, is a growing public health concern. This study aimed to investigate the effects of Ophiocephalus striatus extract on insulin-like growth factor-1 serum, interleukin-6 serum levels, and sarcopenia-related parameters in older adults with sarcopenia. This double-blind randomized controlled trial included 80 older adults with sarcopenia. Participants were randomly assigned to receive Ophiocephalus striatus extract or a placebo for two weeks. The IGF-1 serum and IL-6 serum levels were assessed as primary outcomes. The Ophiocephalus striatus extract intervention resulted in a significant reduction in serum IL-6 levels. Although the IGF-1 levels did not show significant changes, there was an increase for the intervention group. This study demonstrated that a 2-week intervention with Ophiocephalus striatus extract positively impacted the serum IL-6 levels in older adults with sarcopenia. While the IGF-1 levels did not change significantly in this short intervention period, the observed improvements in IGF-1, calf circumference, muscle mass, and muscle strength are promising. The findings suggest that Ophiocephalus striatus extract may offer a valuable intervention for managing sarcopenia, particularly in regions with abundant Ophiocephalus striatus production, such as South Sumatera. This study was registered with trial number NCT05869383.

The relationship between childhood socioeconomic status and depression level in older adults: the mediating role of adult socioeconomic status and subjective well-being

BackgroundThere is a causal link between childhood socioeconomic status and health status in adulthood and beyond. It's vital to comprehend the relationship between childhood socioeconomic status and mental health among older Chinese individuals from the current generation who have undergone significant social changes in China. This understanding is critical to foster healthy demographic and social development in China.MethodsUsing data from the 2020 China Family Panel Studies, we investigate the relationship between childhood socioeconomic status and depression in older adults. Additionally, we examine the mediating role of adult socioeconomic status and subjective well-being.Results1) Childhood socioeconomic status of Chinese older adults differences by region of residence, while depression levels differences by gender, region of residence, and marital status. 2) Adult socioeconomic status mediated the relationship between childhood socioeconomic status and depression in older adults. 3) Adult socioeconomic status and subjective well-being had a chain-mediated role in the relationship between childhood socioeconomic status and depression in older adults.ConclusionsIn terms of childhood socioeconomic status, older adults in urban regions were significantly higher than those in rural regions. As for depression level, female older adults were more depressed than males; married older people have the lowest depression levels, while unmarried and widowed older people have higher depression levels; older adults in rural regions had higher depression levels than those in urban regions. Evidence from our study further suggests that childhood socioeconomic status can suppress the depression level in older adults through adult socioeconomic status; it can also further reduce the depression level in older adults through the chain mediation of adult economic status affecting subjective well-being. As depression is more prevalent among older individuals with a lower childhood socioeconomic status, it is vital to prioritize the extensive impact of childhood socioeconomic status as a distal factor and investigate "upstream" solutions to enhance childhood socioeconomic status and reduce the gap during the early years of life.

Cannabis and Driving in Older Adults

Epidemiological studies have found that cannabis increases the risk of a motor vehicle collision. Cannabis use is increasing in older adults, but laboratory studies of the association between cannabis and driving in people aged older than 65 years are lacking. To investigate the association between cannabis, simulated driving, and concurrent blood tetrahydrocannabinol (THC) levels in older adults. Using an ecologically valid counterbalanced design, in this cohort study, regular cannabis users operated a driving simulator before, 30 minutes after, and 180 minutes after smoking their preferred legal cannabis or after resting. This study was conducted in Toronto, Canada, between March and November 2022 with no follow-up period. Data were analyzed from December 2022 to February 2023. Most participants chose THC-dominant cannabis with a mean (SD) content of 18.74% (6.12%) THC and 1.46% (3.37%) cannabidiol (CBD). The primary end point was SD of lateral position (SDLP, or weaving). Secondary outcomes were mean speed (MS), maximum speed, SD of speed, and reaction time. Driving was assessed under both single-task and dual-task (distracted) conditions. Blood THC and metabolites of THC and CBD were also measured at the time of the drives. A total of 31 participants (21 male [68%]; 29 White [94%], 1 Latin American [3%], and 1 mixed race [3%]; mean [SD] age, 68.7 [3.5] years), completed all study procedures. SDLP was increased and MS was decreased at 30 but not 180 minutes after smoking cannabis compared with the control condition in both the single-task (SDLP effect size [ES], 0.30; b = 1.65; 95% CI, 0.37 to 2.93; MS ES, -0.58; b = -2.46; 95% CI, -3.56 to -1.36) and dual-task (SDLP ES, 0.27; b = 1.75; 95% CI, 0.21 to 3.28; MS ES, -0.47; b = -3.15; 95% CI, -5.05 to -1.24) conditions. Blood THC levels were significantly increased at 30 minutes but not 180 minutes. Blood THC was not correlated with SDLP or MS at 30 minutes, and SDLP was not correlated with MS. Subjective ratings remained elevated for 5 hours and participants reported that they were less willing to drive at 3 hours after smoking. In this cohort study, the findings suggested that older drivers should exercise caution after smoking cannabis.

Objectively measured prolonged sleep is associated with plasma cytokines in older adults with mild cognitive impairment.

This study aimed to determine whether objective sleep time is associated with the concentrations of various plasma cytokines in older adults with mild cognitive impairment (MCI). In total, 118 adults with MCI (66 women; mean age: 75.7 years) participated in this prospective cohort study. All participants were required to wear a wristband sensor for 7.8 days, on average, every 3 months for 1 year and undergo measurement of 27 plasma cytokines using multiplex immunoassays. After adjusting for potential confounders, the associations of total sleep time with cytokine concentrations were assessed by multiple linear regression analysis. The total sleep time was significantly correlated with plasma interleukin (IL)-9 and macrophage inflammatory protein (MIP)-1β levels (r = 0.239, p = 0.009, and r = 0.242, p = 0.008, respectively). Moreover, these associations remained significant after adjusting for covariates, including demographic characteristics, lifestyle-related diseases, and apolipoprotein E status (β = 0.272, 95% confidence interval: 0.095-0.448, p = 0.003, and β = 0.27, 95% confidence interval: 0.092-0.449, p = 0.003, respectively). Thus, this study is the first to demonstrate the association between objective prolonged sleep and higher plasma IL-9 and MIP-1β levels in older adults with MCI.

Relationships Among Health Literacy, Self-Efficacy, Self-Management, and HbA1c Levels in Older Adults with Diabetes in South Korea: A Cross-Sectional Study.

This study investigated the levels of health literacy, self-efficacy, self-management, and glycated hemoglobin (HbA1c) levels in older adults with diabetes to identify the relationships between these factors. This descriptive study consisted of 162 elderly outpatients with diabetes at the departments of endocrinology of three general hospitals in J Province, South Korea. Data were collected using a structured self-report questionnaire between October 21 and November 16, 2019. The data were analyzed using SPSS/WIN version 23.0. Health literacy was positively correlated with self-efficacy (rs=0.64, p<0.001) and self-management (rs=0.44, p<0.001) and significantly negatively correlated with HbA1c levels (rs=-.42, p<0.001). Self-efficacy showed a significantly positive correlation with self-management (rs=0.65, p<0.001) and a significantly negative correlation with HbA1c levels (rs=-.30, p<0.001). Moreover, a significant negative correlation was found between self-management and HbA1c levels (rs=-.35, p<0.001). Hence, health literacy and patient self-management levels were associated with HbA1c levels in older adults with DM. Health education for community-dwelling older adults with diabetes should consider their health literacy levels. Moreover, measures to improve self-management abilities may be needed when developing educational programs for older adults with diabetes.

Decrease in the usual walking speed and body fat percentage associated with a deterioration in long-term care insurance certification levels.

In Japan, the number of older adults requiring long-term care insurance (LTCI) is increasing and the cost is becoming a social problem. In these fields, the role of geriatric rehabilitation includes maintaining the physical function and LTCI certification levels. The prevalence of sarcopenia is high among older adults requiring LTCI certification, and there are many opportunities to assess the handgrip strength, walking speed, and muscle mass. This study aimed to identify sarcopenia-related assessments sensitive to transitions in LTCI certification levels and determine cut-off values to predict them. This prospective cohort study analyzed 98 daycare users (mean age±standard error: 78.5±0.8 years) between March 2019 and 2023. The participants received LTCI certification before the study, and their levels were renewed between baseline and follow-up (six months later). The measurements included handgrip strength, usual walking speed, body composition, and SARC-F score. Participants were classified into maintenance, deterioration, and improvement groups according to the changes in their LTCI certification levels. We identified factors contributing to the deterioration of LTCI certification levels using baseline and before and after comparisons, multivariate analyses, and receiver operating characteristic analyses. No significant differences were observed in the baseline data among the groups. Only the deterioration group showed significant changes in the usual walking speed (baseline: 0.64±0.25 m/s, follow-up: 0.53±0.21 m/s, P = 0.008) and body fat percentage (baseline: 29.2±9.9%, follow-up: 27.7±10.3%, P = 0.047). Binomial logistic regression showed that changes in usual walking speed (P = 0.042) and body fat percentage (P = 0.011) were significantly associated with the deterioration of LTCI certification levels, even after adjustment. The cutoff values of change to discriminate the deterioration of LTCI certification levels were -0.14 m/s at the usual walking speed (P = 0.047) and -1.0% for body fat percentage (P = 0.029). Decreases in usual walking speed and body fat percentage may predict worse certification levels in older adults requiring LTCI.

Fall risk and frailty level in older adults admitted to the emergency department with a complaint of falling

Introduction and aim. Falls are the second leading cause of unintentional death in the world. The study was conducted to examine the risk of falls and levels of frailty in older adult patients admitted to the emergency department due to fractures, as well as to identify the factors that influence fall risk and frailty levels. Material and methods. This cross-sectional and correlational study conducted with 155 older patients. Data collected by the patient information form, Itaki Fall Risk Scale and Edmonton Frail Scale. Results. Patients diagnosed with fracture in the emergency department had a high risk of falling with a mean score of 9.55±3.84.70.3% of the patients were frail. The one-third (30.3%) had severe frailty. There was a moderate positive correlation between the risk of falling and the mean frailty score of the older adult patients (p&lt;0.001). Conclusion. The study showed that older adults admitted to the emergency department due to falls are at high risk of falling and the majority of them are frail. Early determination of fall risk and frailty levels in the older adults with a history of falling, prevention of falls and fractures due to falls will be beneficial in increasing the quality of life of the older adults.

A STUDY ON THE TYPES OF CHANGES IN DEPRESSION AND COVID-19 AMONG OLDER ADULTS IN KOREA

Abstract This study focuses on the long-term trends in depression levels in older adults, with a particular focus on the period following the onset of COVID-19. While previous studies have examined depression levels in older adults, this study aims to complement those studies by providing a longitudinal perspective. This study used data from the Korea Welfare Panel Study(KoWePS), which included 2,716 data of older adults aged 65 and above, from 2017 to 2021. The study variables included gender, age, income, educational background, residential area, living alone, and disability status. The results of this study identified two types of changes in depression levels in older adults: the ’rapidly rising’ type and the ’steadily increasing’ type. The study found that those who were more likely to belong to the ’rapidly rising’ type were those with lower equalized annual income, women, those with lower education, those living in urban areas, and those living alone. These findings suggest that those who are already at risk for depression are at even higher risk during and after the COVID-19 pandemic. Given these findings, it is crucial to provide timely and effective guidelines to prevent depression in older adults during outbreaks of infectious diseases such as COVID-19. Policymakers should consider the findings of this study when implementing policies aimed at preventing depression in older adults. Overall, this study provides important insights into the long-term trends in depression levels in older adults and highlights the importance of addressing this issue in response to the ongoing COVID-19 pandemic.

NEIGHBORHOOD ENVIRONMENT AND DEPRESSIVE SYMPTOMS OF OLDER ADULTS IN URBAN AND RURAL CHINA : A MODEL OF SOCIAL CAPITAL

Abstract Depression is a significant mental health issue among older adults worldwide. This study aimed to examine the mechanisms linking neighborhood environment to depressive symptoms among Chinese older adults and how other levels of social environment influence this relationship. Using data from the China Family Panel Studies, mediation and moderated mediation models were tested among 3,483 urban and 3,812 rural adults aged 60+ years. Results showed that community-level social capital (trust, reciprocity, belonging) partially mediated the association between built neighborhood environment and depressive symptoms in both urban and rural areas. The indirect pathway linking neighborhood environment to fewer depressive symptoms through community social capital was more evident when older adults reported less society social capital, suggesting a compensatory relationship between these two types of social capital. However, this relationship was significant only for urban older adults. The findings highlight the importance of distinguishing different levels of older adults’ social environment. Fostering community social capital through improving neighborhood walkability, safety, and amenities could benefit older adults’ mental health. Community development efforts may play a compensatory role for urban older adults lacking societal-level social resources.

FAITH IS SIGNIFICANTLY ASSOCIATED TO SOCIODEMOGRAPHIC AND CLINICAL CHARACTERISTICS IN BRAZILIAN OLDER ADULTS

Abstract Religiosity is a strong factor related to health in older adults, which could positively affect physical and mental health. We aimed to observe the association between sociodemographic and clinical factors and the religiosity level in older adults. This is a secondary analysis of the Brazilian Older-adults Health Longitudinal Study (ELSI-Brazil) run by Fiocruz Institute in 2015 using a national sample of older adults (60+ year-old) population. The dependent variable was “How much the religious faith give meaning to your life?” and the independent were: sociodemographic (age-group, sex, race, marital status, and scholarly) and clinical (auto perception of health and non-transmittable chronic diseases diagnose - NTCD) characteristics, tested by Chi-Square with p&amp;lt;0.05 significant level. The total sample accounted for 4,669 participants, 4,080 (87.4%) answered that faith gives a lot of meaning to their lives. This percentage was significantly higher in women (91.2% vs 81.8% in men, p=0.003), indigenous race (95%, p=0.003), lower scholarly (p&amp;lt;0.001) and better auto perception of health (p=0.021). NTCD significantly related to higher importance of religiosity were hypertension (88.3%), dyslipidemia (90.0%), angina (93.9%), arthritis (90.5%), osteoporosis (91.0%), depression (88.7%), and cancer (90.4%). Participants with Diabetes (86.1%), pneumopathies (85.9%), and Parkinson (86.7%) had significant lower levels of religiosity. Religiosity had a significant association with sex, race, scholarly, health auto perception and NTCD, including cancer. The results evidence the important role of religious faith in the Brazilian older adult’s health. We concluded that religion and spiritual approach should always be considered to older adults.

Is education level, as a proxy for socio-economic position, related to device-measured and self-reported sedentary behavior in European older adults? A cross-sectional study from the SITLESS project.

Sedentary behavior (SB) is a determinant of health in older adult people. Educational level is a primary driver of health disparities and is demonstrated to be a reliable measure of socioeconomic position. We aimed to examine the associations between educational level and self-reported along with device-measured SB in older adults living in Europe and the association of mentally active and passive SB domains with the educational level and gender in these associations. The design is cross-sectional. One thousand three hundred and sixty participants aged 65 and over (75.3±6.3 years old, 61.8% women) participated. Inclusion criteria were scored with the Short Physical Performance Battery. Variables that describe the sample were assessed with an interview, and device-measured SB was assessed with an accelerometer. SB was assessed with the Sedentary Behavior Questionnaire and an accelerometer. Multiple linear regression models were used to study the association between the level of education and SB. Participants self-reported an average of 7.82 (SD: 3.02) daily waking hours of SB during weekend days, and the average of device-measured SB was 11.39 (1.23) h. Total mentally active SB (weekdays and weekends) was associated with the education level (p < 0.000). Participants were more sedentary during the week than during weekends, regardless of level of education (p < 0.000). Education level was significantly associated with self-reported mean hours per day in 46SB (p = 0.000; R=0.026; 95%CI). Low education level in older adults is associated with self-reported SB but not with objective SB measures.

Salivary Cortisol and Melatonin, Sleep, and Behavioral Patterns in Older Adults Living With Dementia.

Over half of the older adults living with dementia have behavioral and psychological symptoms of dementia (BPSD), including sleep disturbance; however, little is known about physiological markers. Salivary cortisol and melatonin have been identified as potential biomarkers of BPSD, with evidence suggesting a relationship between these biomarkers and various behavioral factors, as well as sleep and activity patterns. The aim of this study was to investigate the time-dependent changes in salivary cortisol and melatonin levels in older adults with dementia, their relationship with the sleep-wake cycle, and their correlation with BPSD symptoms and behavioral factors. This observational study conducted in Seoul and Gyeonggi-do, South Korea, used data from 172 older adults with dementia, measuring sleep and activity patterns for 2 weeks using a wearable device, in addition to administering questionnaires for neuropsychiatric and psychological symptoms-the Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory, and Cornell Scale for Depression in Dementia. Salivary cortisol and melatonin levels were measured at four time points and divided into four groups based on a dual-trajectory model. Differences among the groups were analyzed using one-way analysis of variance. The participants showed normal but heterogeneous patterns of salivary cortisol and melatonin levels. Dual-trajectory pattern analysis showed that higher levels of melatonin during the daytime were correlated with poor nighttime sleep efficiency and decreased disinhibited behaviors, and higher levels of cortisol at all four time points were associated with decreased physical activity. Measuring and analyzing periodic changes in cortisol and melatonin levels can predict various behavioral symptoms (e.g., sleep disturbances, activity counts, and disinhibition) in older adults with dementia. A study with an experimental design is needed to discover the direct physiological interactions between cortisol, melatonin, and these symptoms.

Caregiving for a spouse with cognitive impairment: Effects on serum homocysteine level

AbstractBackgroundAmong older adults, being a spousal caregiver (SCG) for a patient with cognitive impairment is well known to be associated with increased risk for cognitive decline and cardiovascular disease. It is important to understand the caregiving‐related risk factor for caregiver’s health outcome. Elevated total serum homocysteine also has been linked to cognitive impairment and is a risk factor for cardiovascular disease. Therefore, this study aims to examine the relationship between caregiver burden with serum homocysteine level in older adults couples.MethodFrom May 2020 to December 2022, clinical evaluation and blood tests were conducted for patients who visited Chungnam National University Geriatric Neuropsychiatric clinic with their spouse. A total of 92 individuals were included in the analysis. As clinical assessment, we evaluated the care burden using Zarit burden interview and blood samples were collected from the subjects after overnight fasting.ResultIn linear regression analysis adjusted for age, sex, care‐recipient’s clinical diagnosis, vascular risk score and apolipoprotein E ε4 positivity. The SCG’s burden was significantly associated with the level of homocysteine (β = 0.289, t = 2.670, p = 0.009). As SCG’s burden increased, the serum homocysteine level also increased. The results were unchanged after excluding care‐recipient with normal cognition (n = 8) (β = 0.266, t = 2.432, p = 0.018)ConclusionThis finding suggest that SCG’s burden for patients with cognitive impairment might raise homocysteine levels among SCGs which can further affect cardiovascular disease and cognitive decline. As such, homocysteine level should be well monitored among SCGs for patient with cognitive impairment.

The influence of widowhood on amyloid positivity status in cognitively normal older adults

AbstractBackgroundWidowhood and associated spousal bereavement is a life event that may lead to stress, loneliness, and depression. Previous research found associations between widowhood and an elevated risk of dementia. However, no direct relationship has been evidenced between widowhood and beta‐amyloid (Aβ) pathology, which is a hallmark of Alzheimer’s disease. Additionally, little is known about whether particular demographic or background factors might contribute to potential influences of widowhood on Aβ levels in older adults. Our objective was to evaluate the relationship between widowhood and Aβ positivity status in older adults, and to determine whether subgroups based on age, gender, educational attainment, or APOE ε4 status are driving effects.MethodCognitively normal (CN) subjects (n = 182) who were either widowed (including widows and widowers) or married from the Alzheimer’s Disease Neuroimaging Initiative were included in this study that underwent [18F]Florbetapir PET imaging on the baseline study visit. Multivariable logistic regression interrogated associations between widowhood status and Aβ positivity classification based on a global standardised uptake value ratio threshold of 1.11. This analysis included age, gender, APOE ε4 allele possession, education, and MMSE score as covariates. Regressions were also run in subgroups of CN subjects based on gender (male vs. female), APOE ε4 allele possession (carriers vs. non‐carriers), age (youngest, middle, oldest tertiles), and education (at least an undergraduate degree vs. no undergraduate degree).ResultIn CN subjects, there was overall no significant association between widowhood status and Aβ positivity (p = 0.114). When examining subgroups, widowhood was significantly associated with an increased risk of Aβ positivity in CN individuals with an undergraduate degree or higher (p = 0.025) or in the oldest age tertile (ages ranging from 76.3 to 89) (p = 0.024).ConclusionFindings from this cross‐sectional study indicated that a positive relationship between widowhood and in vivo Aβ neuropathology measured by PET exists specifically in those that are highly educated or undergoing advanced ageing. Whereas cognitive reserve is often hypothesised to mediate links between social isolation, depression and dementia risk, these results suggest that there may also be a direct effect on Alzheimer’s disease neuropathology.

Association of mild cognitive impairment, dementia and vitamin B12 levels in older adults

AbstractBackgroundVitamin B12 deficiency has been associated with the development of multiple pathologies. However, it is still controversial if the deficiency is associated with cognitive impairment. Objective: To determine the association between cognitive performance and the vitamin B12 levels.MethodCross‐sectional study including 241 adults aged 60 or older, treated as an outpatient at a tertiary care hospital, who had serum levels of vitamin B12. Participans underwent a cognitive assessment and assigned to one of three groups: normal cognition (NC), mild cognitive impairment (MCI), and dementia. Vitamin B12 levels were classified in three categories: sufficiency (&gt;400 pg/ml), subclinical deficiency (201‐400 pg/ml), and absolute deficiency (≤200 pg/ml). Univariate and multivariate linear regression analyzes were used to assess the association between cognitive performance and vitamin B12 levelsResultMean age was 81.4 ± 8.0 years and 68% were women. The prevalence of absolute and subclinical B12 deficiency was 17.8% and 39.8%, respectively. Eigthy participants (33%) had MCI and 70 (29%) dementia. Those with MCI and dementia had lower vitamin B12 levels compaired with NC after adjusting for age, sex and education level (p = 0.019).ConclusionThis study suggests a statistically significant association between global cognitive performance and serum levels of vitamin B12 in older adults

Low-Density-Lipoprotein Cholesterol and Mortality Outcomes Among Healthy Older Adults: A Post Hoc Analysis of ASPREE Trial.

The prognostic implication of cholesterol levels in older adults remains uncertain. This study aimed to examine the relationship between low-density-lipoprotein cholesterol (LDL-c) and mortality outcomes in older individuals. This post hoc analysis examined the associations of LDL-c levels with mortality risks from all-cause, cardiovascular disease (CVD), cancer, and combined non-CVD/noncancer conditions in a cohort of individuals aged ≥65 years from the ASPirin in Reducing Events in the Elderly trial (NCT01038583). At baseline, participants had no diagnosed dementia, physical disability, or CVD, and were not taking lipid-lowering agents. Outcome analyses were performed using multivariable Cox models. We analyzed 12334 participants (mean age: 75.2 years). Over a median 7-year follow-up, 1250 died. Restricted cubic splines found a U-shaped relation for LDL-c and all-cause mortality, cancer mortality, and noncancer/non-CVE mortality (nadir: 3.3-3.4 mmol/L); the risk of CVD mortality was similar at LDL-c below 3.3 mmol/L and increased above 3.3 mmol/L. Similar trends were observed in analyses modeling LDL-c by quartiles. When modeling LDL-c as a continuous variable, the risk of all-cause mortality, cancer mortality, and noncancer/non-CVD mortality was decreased by 9%, 16%, and 18%, respectively, per 1-mmol/L higher LDL-c, and the risk of CVD mortality was increased by 19% per 1-mmol/L higher LDL-c. Reduced all-cause and non-CVD/noncancer mortality risks were only significant in males but not females (pinteraction < .05). There were U-shaped relationships between LDL-c and all-cause mortality, cancer mortality, and noncancer/non-CVD mortality in healthy older adults. Higher LDL-c levels were associated with an increased risk of CVD mortality. Future studies are warranted to confirm our results.

Predictive analysis between cytokine profile and Aβ42, p‐Tau, and p‐Tau/Aβ42 levels in the cerebrospinal fluid of older adults with and without cognitive impairment

AbstractBackgroundThe immune system activation observed in Alzheimer’s disease (AD) pathology contributes to its pathogenesis. It is proposed that ongoing interactions between β‐amyloid plaques, Tau protein, and neuroinflammatory mediators such as cytokines contribute to the maintenance of the inflammatory state in the brain. The aim was to evaluate whether cytokine profiles can predict variations in Aβ42, pTau, and pTau/Aβ42 cerebrospinal fluid (CSF) levels in older adults with and without objective cognitive impairment.MethodsEighty older adults were recruited, with a clinical diagnosis of AD dementia (36), with Mild Cognitive Impairment (MCI) (24), and without objective cognitive impairment (20). CSF levels of Aβ42, pTau, and 27 cytokines were assessed by the Luminex xMAP technique. Significant associations between Aβ42, p‐Tau, and p‐Tau/Aβ42 CSF levels and cytokines were explored in multiple linear regression analyses adjusted for age, education, and APOE ε4 carrier status.ResultsWe found that Granulocyte and Macrophage colony‐stimulating factors (GM‐CSF) (β = ‐.375; p = .010) and IL‐6 (β = ‐.370; p = .014) had a negative significant association with Aβ42, while IL‐8 (β = .452; p = .002) and IL‐4 (β = .488; p = .001) had positive significant association and higher magnitude of effect on Aβ42. For pTau, age (β = .240; p = .029), IL‐2 (β = .314; p = .012) and ε4 allele (β = 0.349; p = .002) had a positive significant association. The variable with the greatest magnitude of the effect was the presence of the ε4 allele. For the p‐Tau/Aβ42 ratio, G‐CSF (β = .423; p = .003) and GM‐CSF (β = .317; p = .019) had a significant positive association, while for IL‐8 (β = ‐.554; p = .001) and IL‐12 (β = ‐.334; p = .019) the association was significantly negative. IL‐8 had the greatest magnitude of effect on p‐Tau/Aβ42 ratio values.ConclusionThe higher levels of IL‐4 and the IL‐8 associated to a higher Aβ42 suggest their role at the beginning of the disease. On the other hand, the lower level of IL‐8 associated with a higher p‐Tau/Aβ42 suggests its inactivation as the disease progresses. Conversely, the higher levels of GM‐CSF associated with higher p‐Tau/Aβ42 suggests a more robust recruitment of the immune cell system at later stages.Reference: Aksnes, M., et al., (2021). Associations of cerebrospinal fluid amyloidogenic nanoplaques with cytokines in Alzheimer’s disease. Translational Neurodegeneration.

Functional fitness and risk factors of older patients with diabetes combined with sarcopenia and/or frailty: A cross-sectional study.

To learn the functional fitness levels in older adults with diabetes combined with sarcopenia and/or frailty. A cross-sectional investigation study. A total of 205 participants with type 2 diabetes were recruited from September 2019 to August 2020. All patients underwent diagnostic screening for sarcopenia and frailty, and were divided into combined group (the patients who had sarcopenia and/or frailty) and non-combined group (the patient who had no sarcopenia and/or frailty). The diagnostic criteria for sarcopenia applied was proposed by the Asian Working Group on Sarcopenia in 2019 and frailty status was assessed using FRAIL Scale. Functional fitness was measured using the Senior Fitness Test and compared between combined and non-combined groups. Biochemical data of blood routine, glycolipid, and hepatorenal function tests were acquired from medical records. Logistic regression analysis was applied to explore the factors associated with the sarcopenia and/or frailty in the older adults with diabetes. Compared with non-combined group, the participants in combined group exhibited shorter 6-min walk distance, fewer repetitions of arm curls and chair stands, smaller back scratch and chair sit-and-reach values, and longer time in the 8-ft up-and-go test. The patients in the combined group had significantly lower level of red blood cell, haemoglobin, haematocrit, and higher level of platelet and blood urea nitrogen. Apart from calf circumference, physical activity, and insulin injection treatment, 6-min walk distance was the factor associated with diabetes combined with sarcopenia and/or frailty.

Frailty Index among Older Adults with Cancer at B.P. Koirala Memorial Cancer Hospital, Chitwan, Nepal

Introduction: The number of older adults is increasing day by day. This fact implies important health challenges. Frailty level in older adults having cancer is a globally important health issue. The concept of frailty has become gradually more accepted as one of the most important factors particularly in patients with cancer who are receiving treatment. The objective of the study was to find out the frailty index among older adults with cancer admitted for surgery at BPKMCH, Bharatpur, Nepal. Methods: An analytical cross-sectional study was conducted among 111 older adults. Nonprobability purposive sampling technique was used for data collection. Data were collected by face-to-face interview method using Carolina Frailty Index (CFI) developed from a cancer-specific geriatric assessment. Data was entered and analyzed by using SPSS-20, p-value &lt;0.05 was considered as statistically significant. Results: The age of the respondents ranged from 60 to 87 years with mean + SD: 67.46+6.11. Most common site of cancer was gastrointestinal system (47.7%) and the most prevalent co- morbidities in this study were diabetes mellitus (19.8%) and high blood pressure (18.0%). Based on the CFI score, 82.0% were robust, 11.7% were pre-frail and 6.3% were frail. Increasing age (P=0.033) and ethnicity (P=0. 042) were associated with frailty. Conclusion: CFI is a practical way to define oncologic frailty. Though it is only a descriptive study, frailty index revealed by this study would provide valuable baseline information for further researchers.

Short-term effects of ambient PM1, PM2.5, and PM10 on internal metal/metalloid profiles in older adults: A distributed lag analysis in China

There is limited evidence linking exposure to ambient particulate matter (PM) with internal doses of metals and metalloids (metal(loid)s). This study aimed to evaluate the effects of short-term exposure to ambient PM on urine metal(loid)s among Chinese older adults. Biological monitoring data of 15 urine metal(loid)s collected in 3, 970 community-dwelling older adults in Fuyang city, Anhui Province, China, from July to September 2018, were utilized. PMs with an aerodynamic diameter ≤ 1 µm (PM1), ≤ 2.5 µm (PM2.5), and ≤ 10 µm (PM10) up to eight days before urine collection were estimated by space–time extremely randomized trees (STET) model. Residential greenness was reflected by Normalized Difference Vegetation Index (NDVI). We used generalized additive model (GAM) combined with distributed lag linear/non-linear models (DLMs/DLNMs) to estimate the associations between short-term PM exposure and urine metal(loid)s. The results suggested that the cumulative exposures to PM1, PM2.5, or PM10 over two days (lag0-1 days) before urine collection were associated with elevated urine metal(loid)s in DLMs, while exhibited linear or “inverted U-shaped” relationships with seven urine metal(loid)s in DLNMs, including Gallium (Ga), Arsenic (As), Aluminum (Al), Magnesium (Mg), Calcium (Ca), Uranium (U), and Barium (Ba). Aforementioned results indicated robust rather than spurious associations between PMs and these seven metal(loid)s. After standardizations for three PMs, PM1 was the greatest contributor to U, PM2.5 made the greatest contributions to Ga, As, Al, and Ba, and PM10 contributed the most to Mg and Ca. Furthermore, the effects of three PMs on urine Ga, As, Al, Mg, Ca, and Ba were reduced when exposed to higher levels of NDVI. Overall, short-term exposures to ambient PMs contribute to elevated urinary metal(loid) levels in older adults, and three PMs exhibit various contributions to different urine metal(loid)s. Moreover, residential greenness may attenuate the effects of PMs on urine metal(loid)s.