Level In Older Adults Research Articles

Antibody levels versus vaccination status in the outcome of older adults with COVID-19.

BACKGROUNDDespite the currently prevailing, milder Omicron variant of COVID-19, older adults remain at elevated risk of hospital admission, critical illness, and death. Loss of efficacy of the immune system, including reduced strength, quality, and durability of antibody responses, may render generalized recommendations on booster vaccinations inadequate. There is a lack of data on the efficacy of antibody levels in older adults and on the utility of vaccination status versus antibody levels as a correlate of protection. It is further unclear whether antibody levels may be used to guide the timing of booster vaccinations in older adults.METHODSWe conducted a prospective multicenter cohort study comprising hospitalized patients with COVID-19. Anti-SARS-CoV-2 spike antibodies were measured on hospital admission. The primary endpoint was in-hospital mortality. Patients were stratified by age, antibody levels, and vaccination status. Multiple logistic regression and Cox regression analyses were conducted.RESULTSIn total, 785 older patients (≥60 years of age [a]) and 367 controls (<60a) were included. After adjusting for confounders, risk of mortality, ICU admission, endotracheal intubation, and oxygen administration was 4.9, 2.6, 6.5, and 2.3 times higher, respectively, if antibody levels were < 1,200 BAU/mL (aOR, 4.92 [95%CI, 2.59-9.34], P < 0.0001; aOR, 2.64 [95%CI, 1.52-4.62], P = 0.0006; aOR, 6.50 [95%CI, 1.48-28.47], P = 0.013; aOR, 2.34 [95%CI, 1.60-3.343], P < 0.0001). Older adults infected with the Omicron variant were approximately 6 times more likely to die if antibody levels were < 1,200 BAU/mL (aOR, 6.3 [95% CI, 2.43-16.40], P = 0.0002).CONCLUSIONAntibody levels were a stronger predictor of in-hospital mortality than vaccination status. Monitoring antibody levels may constitute a better and more direct approach for safeguarding older adults from adverse COVID-19 outcomes.

Psychological and physiological benefits of horticultural therapy for Chinese older adults

Background Gardening as a leisure activity has been shown to be potentially beneficial for older adults, this study aimed to assess the physiological and psychological impacts of a specific horticultural activity, watering indoor plants, compared with playing a computer game - the Klondike Solitaire Card Game. Methods This crossover study included 100 older adults recruited from a nursing care facility for older people in Shanghai, China. They were allocated to either engage in watering indoor plants (horticultural group) or playing a computer game (control group). For the inclusion criteria, screening for cognitive function was conducted to exclude those with severe cognitive impairments, thereby focusing on those capable of participating fully in the study activities. Brainwave activities, blood pressure, and psychological states were measured through pre- and post-test questionnaires to evaluate the physiological and psychological effects. Results The activity of watering indoor plants was associated with significant reductions in both systolic and diastolic blood pressure, in contrast to the computer game activity. Additionally, participants in the horticultural group showed increased brainwave mean values, indicating heightened relaxation and focus, while decreases were observed in the control group. The experimental group reported reduced anxiety scores, along with increased feelings of comfort and relaxation, and also exhibited significantly higher meditation levels, which indicates a profound mental relaxation effect. Conclusion Our findings suggest that engaging in indoor horticultural activities, such as watering houseplants for 10 minutes, can reduce mental and physical stress levels in older adults.

Effect of Curcumin Intake on Skeletal Muscle Oxygen Saturation Parameters in Older Participants.

Aging is associated with increased reactive oxygen species (ROS) and reduced bioavailability of nitric oxide (NO). Curcumin has been shown to increase NO bioavailability due to its ability to neutralize ROS, preventing oxidative stress. The present study aimed to investigate the effect of curcumin intake on skeletal muscle oxygen parameters and exercise tolerance in response to exercise in older people. Changes in circulating levels of NO metabolites were also investigated. Older subjects consumed 10 g of turmeric root extract from Curcuma longa L. (containing 95.33% of the total curcuminoids) or placebo in a randomized, double-blind, crossover study. A time of 2 h after ingestion, the participants performed one set of rhythmic handgrip exercise until the limit of tolerance, followed by 5 min of recovery. During exercise and exercise recovery, skeletal muscle oxygen saturation parameters were recorded. During exercise, the amplitude of deoxyhemoglobin was greater after curcumin intake compared to placebo (CUR: 13.11 ± 9.52 vs. PLA: 10.22 ± 8.39 μM, p = 0.030). Furthermore, a faster skeletal muscle oxygen resaturation during exercise recovery was observed after curcumin compared to placebo (CUR: 1.01 ± 0.65 vs. PLA: 0.32 ± 0.20%.s-1, p = 0.004). These results were associated with significant changes in plasma nitrite (CUR: 6.82 ± 11.68 vs. PLA: -4.94 ± 17.28%, p = 0.028). There was no statistical difference in the total hemoglobin, exercise time until fatigue, and plasma nitrate between groups. The present study suggests that curcumin improves muscle oxygenation status at the capillary level in older adults by possibly improving muscle oxygen extraction and/or delivery, with no effect on exercise tolerance.

Effects of a 12-week training program in outdoor gym equipment in morphological and functional parameters, quality of life, and physical activity levels in older adults.

This study aimed to investigate the effectiveness of a supervised physical training program with controlled cadence on functional fitness parameters, quality of life perception, and physical activity level in older adults. Sixty physically independent older adults were randomly divided into three groups: Supervised Training (ST, n = 20), Unsupervised Training (UT, n = 20), and a Control Group (C, n = 20). The ST and UT groups participated in a 12-week program, performing exercises three times a week for 30 min. The ST group had structured weekly sessions consisting of a 5-minute warm-up (walking at 60% of max heart rate), 20 sets of 30 s at a moderate pace controlled by a metronome with 30 s of passive recovery, and a 5-minute cool-down on non-consecutive days. The UT group trained spontaneously using senior gym equipment, including elliptical machines, rowing machines, air skiers, and leg press machines. The control group maintained their usual daily routines throughout the study. Parameters evaluated included body mass, body mass index (BMI), muscle thickness (biceps brachii, triceps brachii, and vastus lateralis), and functional capacity tests (walking 10 m [W10 m], rising from a sitting position [RSP], rising from the prone position [RVDP], sitting and rising from a chair and moving around the house [SRCW]). Quality of life was assessed across physical, psychological, environmental, and social domains, and physical activity levels were also measured. No significant changes (p > 0.05) in body mass, BMI, or muscle thickness were observed between groups before and after the intervention. However, significant time effects in functional fitness tests were found only in the ST group for W10 m (p = 0.0469), RVDP (p < 0.0004), RSP (p < 0.0001), and SRCW (p < 0.0001). Quality of life improved significantly over time in the ST and UT groups across all domains (p < 0.0001). Both ST and UT groups also showed significant increases in weekly physical activity time (p > 0.0001). 12 weeks of training improved quality of life perception and physical activity levels in older adults.

Estimated cardiorespiratory fitness level and utilization of antidepressants among older adults before and after the COVID-19 lockdown: Findings from the HUNT4 Trondheim 70+ study

BackgroundCardiorespiratory fitness (CRF) refers to the capacity of the cardiovascular and respiratory system to process oxygen. CRF is associated with depressive symptoms and findings suggest that CRF decreased significantly in older adults during the COVID-19 pandemic. However, purchase of prescribed antidepressants before and after the pandemic lockdown by CRF level in older adults has not yet been described. MethodsThis longitudinal study included 1221 community-dwelling older adults ≥70 years old participating in the Norwegian HUNT4 Trondheim 70+ study (2018–2019). Data on estimated CRF (eCRF) were linked to the Norwegian Prescribed Drug Registry and utilized defined daily doses (DDDs) of antidepressants from January 2019 throughout December 2021. Paired t-tests were performed to assess changes in DDDs before and after the Norwegian COVID-19 lockdown in March 2020. ResultsParticipants had a mean (M) and standard deviation (SD) age of 76.5 (5.2) years, 53.6% were women. In the total sample, the results showed a significant rise in purchase of antidepressants from before (M = 1.25, SD = 7.17) compared to after the lockdown (M = 1.52, SD = 7.86); t (1220) = −2.47, p = 0.014). The number of participants purchasing antidepressants also increased in the total sample and within each of the eCRF groups. In the different eCRF groups, only individuals in the highest eCRF tertile showed a significant higher purchase of antidepressants after the lockdown (M = 1.44, SD = 6.65); t (413) = −2.63, p = 0.009) compared to the year before (M = 0.99, SD = 5.21). ConclusionsCompared to before the COVID-19 pandemic lockdown, the utilization of antidepressants increased in community-dwelling older adults, with the steepest increase observed among those with the highest eCRF levels.

52495 Elevated C-reactive protein levels in older adults with itch is associated with incident comorbidities and mortality: a multicenter cohort study

52495 Elevated C-reactive protein levels in older adults with itch is associated with incident comorbidities and mortality: a multicenter cohort study

Medical database analysis of the association between kidney function and achievement of glycemic control in older Japanese adults with type 2 diabetes who started with oral antidiabetic drugs.

Despite the emergence of new drugs with novel mechanisms of action, treatment options for older people and those with chronic kidney disease are still limited. Using a medical database compiled from Diagnostic Procedure Combination hospitals, we retrospectively analyzed treatment status, glycemic control and kidney function over 3 years after the first oral antidiabetic drugs in Japanese adults with type 2 diabetes who were aged ≥65 years. Among 5,434 study participants, 3,246 (59.7%) were men, the median age was 72.0 years, the baseline median hemoglobin A1c was 7.1% and the baseline median estimated glomerular filtration rate was 66.6 mL/min/1.73 m2. Treatment was intensified in 40.0% of people during the 3-year observation period, and the median time to the first treatment intensification was 198 days. Insulin was the most commonly used agent for treatment intensification (36.9%, 802/2,175). Hemoglobin A1c of <7.0% was achieved in 3,571 (65.7%) at 360 ± 90 days. Multivariable logistic regression analysis found that baseline age, hemoglobin A1c and estimated glomerular filtration rate were negatively associated with achieving hemoglobin A1c of <7.0% at 360 ± 90 days. In older Japanese adults with type 2 diabetes, those with a lower estimated glomerular filtration rate were more likely to achieve hemoglobin A1c of <7.0%. To safely manage blood glucose levels in older adults with chronic kidney disease, physicians should remain vigilant about the risk of iatrogenic hypoglycemia.

Correlation between Muscle Mass and Physical Activity Level in Older Adults at Risk of Falling: The FITNESS Study

BackgroundThe study investigates the correlation between muscle mass and physical activity level measured objectively and subjectively in older adults who fall or are at high risk of falling.MethodsFITNESS (Fall Interest to Target Newly Sarcopenic Society) is a multi-center (French university hospitals of Angers, Lille, Limoges and Orléans), cross-sectional, observational study of routine care within a French multidisciplinary hospital consultation. Inclusion criteria were ≥ 75 years old, living at home and consulting for fall or gait disorder. A standardized geriatric assessment, muscle mass evaluation by impedancemetry, physical activity by continuous actimetry (5 days) and Incidental and Planned Exercise Questionnaire (IPEQ) were performed at patient inclusion.Results170 people aged 75 and over were included in the FITNESS study (mean age 82.9 ± 4.7 years, women 72.9%). Muscle mass (whole body and lower limbs) correlated with active energy expenditure (AEE, ρ whole body = 0.32, p-value < 0.001; ρ lower limbs = 0.25, p-value = 0.003), but not with number of daily steps, nor with IPEQ score. Multivariate analysis of whole-body muscle mass showed a positive and significant association with AEE and albumin levels and for lower limb muscle mass, a positive association with AEE and Charlson.ConclusionThis study suggests that in the particular population of older adults who fall and/or are at high risk of falling, loss of muscle mass correlates with reduced physical activity. So subjects who fall or at high risk of falling constitute a special group for whom the fight against sedentary lifestyles and the maintenance of physical activity should be a dual priority.

High serum Cholesterol and Triglyceride levels in older adults: associations with sleep and nighttime behavior disorders at baseline and a prediction analysis of incidental cases at 12 months follow-up.

This study explored the association between dyslipidemia and sleep and nighttime behavior disorders (SNBD) in the elderly. ADNI population with complete Cholesterol, Triglyceride, SNBD, and neurocognitive data were included. Logistic regression was performed to study the association between dyslipidemia and SNBD at baseline and 12 months. Relevant confounders were adjusted for. Among the 2,216 included cases, 1,045 (47%) were females, and the median age was 73 (IQR: 68, 78). At baseline, 357 (16%) had SNBD, and 327 (18%) at 12 months; 187 were incident cases.There were more cases of baseline SNBD in the hypertriglyceridemia group than in those without (19% vs. 14%, p-value=0.003). Similarly, more follow-up SNBD cases had hypertriglyceridemia at baseline (21% vs. 16%, p-value=0.025). SNBD cases at baseline had significantly higher serum Triglyceride levels than those without (132 vs. 118mg/dL, p-value<0.001).Only hypertriglyceridemia was significantly associated with baseline SNBD (crude OR=1.43, 95%CI: 1.13,1.80, p-value=0.003), even after adjustment for confounding factors (adj.OR=1.36, 95%CI: 1.06,1.74, p-value=0.016) and (BMI-adj.OR=1.29, 95%CI: 1.00,1.66, p-value=0.048). None of the dyslipidemia forms did predict incident cases at 12 months. Hypertriglyceridemia, but not hypercholesterolemia, was associated with higher odds of SNBD. None of the dyslipidemia forms predicted incidental SNBD over 12 months.

Malondialdehyde and Zinc May Relate to Severity of Microvascular Complications in Diabetes: A Preliminary Study on Older Adults with Type 2 Diabetes Mellitus in Northeast China.

Serum trace elements and oxidative stress factors are related to diabetic microvascular complications. The study was to investigate the complex relationship between trace elements, oxidative stress factors, and the severity of microvascular complications of diabetes in older adults. The present study included patients with or without type 2 diabetes, and blood glucose, blood lipids, trace elements (iron, magnesium, zinc), oxidative stress factors (malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC)) were evaluated. Risk factors for the severity of diabetic microvascular complications in older adults with diabetes were also estimated. There were statistically significant differences in fasting blood glucose (FBG), triglycerides (TG), low density lipoprotein (LDL), glycated hemoglobin (HbAlc), MDA, NO, SOD, T-AOC, magnesium, and zinc between the two groups (P<0.05). Iron (rZinc = 0.147, rSOD = 0.180, rT-AOC = 0.193, P < 0.05) was positively correlated with zinc, SOD and T-AOC. Iron was negatively correlated with MDA (rMDA = -0.146, P < 0.05). Magnesium was positively correlated with SOD (rMagnesium = 0.147, P < 0.05). Zinc (rSOD = 0.616, rT-AOC = 0.575, P < 0.01) was positively correlated with SOD and T-AOC. Zinc (rMDA =-0.636, rNO=-0.616, P<0.01) was positively correlated with MDA and negatively correlated with NO. The course of disease (18.653, [5.726; 60.764], P <0.01), FBG (1.265, [1.059; 1.511], P <0.05), HbAlc (1.545, [1.431; 1.680], P <0.01), MDA (2.989, [1.900; 4.702], P <0.01) were risk factor for the severity of diabetic microvascular complications. Zinc (0.680, [0.503; 0.919], P < 0.05) and SOD (0.820, [0.698; 0.964], P < 0.05) were protective factors for the severity of diabetic microvascular complications. Serum trace elements are related to oxidative stress levels in older adults with type 2 diabetes. The more stable trace element in older adults with diabetes, the lower the oxidative stress and the fewer microvascular complications of diabetes.

Epigenetic age acceleration is associated with blood lipid levels in a multi-ancestry sample of older U.S. adults.

Dyslipidemia, which is characterized by an unfavorable lipid profile, is a key risk factor for cardiovascular disease (CVD). Understanding the relationships between epigenetic aging and lipid levels may help guide early prevention and treatment efforts for dyslipidemia. We used weighted linear regression to cross-sectionally investigate the associations between five measures of epigenetic age acceleration estimated from whole blood DNA methylation (HorvathAge Acceleration, HannumAge Acceleration, PhenoAge Acceleration, GrimAge Acceleration, and DunedinPACE) and four blood lipid measures (total cholesterol (TC), LDL-C, HDL-C, and triglycerides (TG)) in 3,813 participants (mean age = 70 years) from the Health and Retirement Study (HRS). As a sensitivity analysis, we examined the same associations in participants who fasted prior to the blood draw (n = 2,531) and in participants who did not take lipid-lowering medication (n = 1,869). Using interaction models, we also examined whether demographic factors including age, sex, and educational attainment modified the relationships between epigenetic age acceleration and blood lipids. After adjusting for age, race/ethnicity, sex, fasting status, and lipid-lowering medication use, greater epigenetic age acceleration was associated with lower TC, HDL-C, and LDL-C, and higher TG (p < 0.05), although the effect sizes were relatively small (e.g., < 7mg/dL of TC per standard deviation in epigenetic age acceleration). GrimAge acceleration and DunedinPACE associations with all lipids remained significant after further adjustment for body mass index, smoking status, and educational attainment. These associations were stronger in participants who fasted and who did not use lipid-lowering medication, particularly for LDL-C. We observed the largest number of interactions between DunedinPACE and demographic factors, where the associations with lipids were stronger in younger participants, females, and those with higher educational attainment. Multiple measures of epigenetic age acceleration are associated with blood lipid levels in older adults. A greater understanding of how these associations differ across demographic groups can help shed light on the relationships between aging and downstream cardiovascular diseases. The inverse associations between epigenetic age and TC and LDL-C could be due to sample limitations or non-linear relationships between age and these lipids, as both TC and LDL-C decrease faster at older ages.

Effects of a Nonlinear Program on Different Health Parameters in the Elderly.

The aim of this research was to evaluate the impact of a nonlinear training program on visceral adipose tissue (VAT) and systolic (SBP) and diastolic (DBP) blood pressure, as well as the response of biochemical parameters such as fasting plasma glucose (FPG), total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and triglycerides (TG). The nonlinear periodized program would produce greater improvements in outcomes than the linear periodized training program. Randomized cross-sectional design. Level 3. Older adults with no previous training experience (10 male and 8 female [age, 64 ± 2.1 years; height, 165.12 ± 7.5 cm; body mass, 72.5 ± 11.4 kg; body max index, 26.5 ± 3.2 kg/m2]) were randomized to linear (n = 9, TT) or undulating (n = 9, UT) periodization. After a 3-week familiarization period, all participants performed 3 sessions of resistance training per week; 8 weeks of training were conducted for each group. Dual x-ray absorptiometry was used to measure VAT, and SBP and DBP were measured using an OMRON M3 digital automatic blood pressure monitor. Blood samples were collected between 8:00 a.m. and 9:30 a.m. after 12-hour overnight fasting. Both interventions significantly (P < 0.05) decreased FPG, TC, LDL-C, and TG. A significant decrease in SBP and DBP was observed only in the UT group (P < 0.05). No significant between-group differences in outcomes were observed (P > 0.5). However, the effect size was marginally more pronounced for all outcomes in the UT group. An undulating periodization program was effective in improving VAT, TC, LDL-C, FPG, HDL-C, TG, and blood glucose levels in older adults. Resistance training can be programmed in an undulating or traditional way in older adults based on improvements in health parameters, considering adherence and individual preferences.

#2493 Podocyturia: a novel biomarker of ageing

Abstract Background and Aims Urinary podocyte shedding (podocyturia) is a biomarker of glomerular injury in young and old individuals. Podocyturia is associated with diabetes and hypertension, and it is an early indicator of systemic cardiovascular disease. Importantly, podocyturia has also been noted in healthy adults and may indicate physiologic podocyte turnover. Whether age is a predictor of podocyte loss, independently of diabetes and hypertension, is still unclear. The aim of this study was to examine the association between age and urinary podocin levels. Method This was a secondary analysis of data from 5 studies, including 868 individuals, 18-90 years of age. Data on urinary podocin mRNA levels was present on all subjects, as measured by CFX96 Touch™ RT-PCR detection system (Biorad, USA). Descriptive statistics, Chi-square test, ANOVA, and post hoc analysis were performed. Linear regression was conducted with gender, diabetes status, and hypertension status as covariates. Significance was set at p &amp;lt; 0.05. Results The mean age of the total sample was 55.10 ± 14.84 years; 46% were female, 26.4% had diabetes, and 37.9% had hypertension. There were significant differences in mean podocin levels by age group (F = 25.27, p ≤ 0.001) as follows. Podocin levels were significantly lower in Group 1 (age 18-35 years; 0.79 ± 0.67 million copies), compared to Group 2 (36-55 years; 2.21 ± 2.15 million copies) and Group 3 (over 56 years; 2.86 ± 3.18 million copies). Moreover, mean podocin levels differed significantly between Group 2 and Group 3 (p = 0.003). Age was a predictor of podocyturia, independently of diabetes and hypertension (p &amp;lt; 0.001). Conclusion Podocyturia was present in younger adults. There was a significant rise in podocyturia in middle-aged adults (36-55 years), denoting a transitional phase. There were higher podocyturia levels in older adults compared to the youngest and middle-aged adults. These differences in podocin by age were observed while accounting for diabetes and hypertension.

Physical activity and functional social support in community-dwelling older adults: a scoping review

BackgroundGlobally, the population of older people is increasing and is estimated to reach nearly 2.1 billion by 2050. Physical activity (PA) is one of the key components for successful ageing. However, PA decreases with age and many older adults do not meet PA guidelines. Previous research has shown that social support (SOSU) is related to PA in older people. The aim of this scoping review is to identify and map all of the available evidence and to explore the association between functional SOSU and PA in older adults. Functional SOSU consists of emotional, informational, instrumental and companionship SOSU and social comparison.MethodsA scoping review was conducted using the Joanna-Briggs manual. Quantitative and qualitative studies investigating associations between functional SOSU and PA levels in older adults (mean age ≥ 60 years) were identified through a systematic search in seven electronic databases up to August 2023. After removing duplicates, 20,907 articles were screened for titles and abstracts. The results were analysed separately for different types of SOSU.Results116 articles met the inclusion criteria; 72% were quantitative studies and 28% were qualitative studies. Most studies used self-reported PA measures, only 23% of the studies used objective-reported PA measures. Most studies of SOSU for PA reported positive associations but the evidence is inconclusive when the source of support is considered. PA is positively associated with general, emotional, informational, and companionship SOSU, while instrumental support may occasionally be negatively associated. Companionship support is particularly influential on PA, especially in group settings, as it promotes social connectedness. Qualitative studies show that social comparison also supports PA. Different forms of SOSU generally show positive associations with PA.ConclusionsWhile the evidence on the association between functional SOSU and PA is mixed, most studies show that there is a positive association. PA may also be a strategy for improving social contact and social integration. This study offers a comprehensive overview of measures for SOSU and PA and thereby informs future research and policy-making.

Hepatic WDR23 proteostasis mediates insulin homeostasis by regulating insulin-degrading enzyme capacity

Maintaining insulin homeostasis is critical for cellular and organismal metabolism. In the liver, insulin is degraded by the activity of the insulin-degrading enzyme (IDE). Here, we establish a hepatic regulatory axis for IDE through WDR23-proteostasis. Wdr23KO mice have increased IDE expression, reduced circulating insulin, and defective insulin responses. Genetically engineered human cell models lacking WDR23 also increase IDE expression and display dysregulated phosphorylation of insulin signaling cascade proteins, IRS-1, AKT2, MAPK, FoxO, and mTOR, similar to cells treated with insulin, which can be mitigated by chemical inhibition of IDE. Mechanistically, the cytoprotective transcription factor NRF2, a direct target of WDR23-Cul4 proteostasis, mediates the enhanced transcriptional expression of IDE when WDR23 is ablated. Moreover, an analysis of human genetic variation in WDR23 across a large naturally aging human cohort in the US Health and Retirement Study reveals a significant association of WDR23 with altered hemoglobin A1C (HbA1c) levels in older adults, supporting the use of WDR23 as a new molecular determinant of metabolic health in humans.

Level of Depression in Older Adults Related to Functional Capacity

Introduction: It is expected that by the year 2050, the number of people aged 60 or over will be higher than that of adolescents and young people aged 15 to 24, and nearly 65 % of older people will live in low- and middle-income countries.1 In this regard aging will become a very important object of study. This process, combined with the lack of physical activity, become conclusive factors in the progressive loss or alteration of physical and mental abilities (for example, depression).2, 3 Hypothesis: Worse functionality is related to depressive levels in older adults. Objective: To determine the level of depression (geriatric depression scale Yesavage) related to the functionality (Barthel Index/scale) of the elderly patients. Methodology: A convenience sample of 40 elderly patients (&gt;60 years) was selected at the “Centro de Salud con Servicios Ampliados (CESSA) Romero Vargas” (Puebla, Mexico) who constantly attended follow-up consultations. During the period August-October 2023, the Yesavage and Barthel scale4 were applied. In addition, some additional data were also obtained from the identification sheet. Data analysis The final information was processed with Excel and Minitab software, the data were analyzed using simple descriptive statistics of frequencies, obtaining absolute and percentage distributions of the variable under study. For the relationship and significance of the variables level of depression and physical dependence, the variable correlation model (Spearman's Rho) was used, with a p &lt;0.05. Results: Of the total sample (n= 40), 78% were female and 23% were male. 37.5% of the patients were classified as without depression and independent, 2.5% without depression with moderate dependence, 12.5% with mild depression and independent, 5% with depression and mild dependence, 15% with mild depression and moderate dependence, 10% with mild depression and severe dependence, 7.5% with mild depression and total dependence, and finally 5% for the categories of “severe and independent depression” and “severe depression and severe dependence”. In addition, a statistically significant correlation (p &lt;0.05) was found with the following variables: economic dependency and health services, level of depression and health services and finally functional capacity and level of depression. Conclusion: Disability in the elderly encompasses functional deficiencies, limitations in activity and restrictions that transcend their autonomy, as well as the patient's own socialization; causing depression in the majority of this population. This is the reason why senile patients need to have close follow-up. In this study, it was demonstrated that the Barthel and Yesavage scale are useful tools for the assessment of depression and functionality. In addition, it was proven that there is a statistically significant correlation between the variables functional capacity and level of depression (p= 0.001).

Cluster analysis dissecting cognitive deficits in older adults with major depressive disorder and the association with neurofilament light chain

BackgroundCognitive impairment is a growing problem with increasing burden in global aging. Older adults with major depressive disorder (MDD) have higher risk of dementia. Neurofilament light chain (NfL) has been proven as a potential biomarker in neurodegenerative disease, including dementia. We aimed to investigate the association between cognitive deficits and NfL levels in older adults with MDD.MethodsIn this cross-sectional study, we enrolled 39 MDD patients and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer’s type, as controls, from a tertiary psychiatric hospital. Both groups were over age 65 and with matched Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and each cognitive domain.ResultsIn the MDD group, participants had higher rate of family psychiatry history and current alcohol use habit compared with controls. Control group of neurocognitive disorders showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits clustered with that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster.ConclusionsWe noted the negative correlation between NfL levels and cognition in MDD patients clustered with neurodegenerative disorder, Alzheimer’s type. NfL could be a promising candidate as a biomarker to predict subtype of patients in MDD to develop cognitive decline. Further longitudinal studies and within MDD cluster analysis are required to validate our findings for clinical implications.

Impaired erythropoietin response to hypoxia in type 2 diabetes.

Patients with type 2 diabetes have a 20% lower total blood volume than age- and weight-matched healthy adults, suggesting a reduced capacity to transport oxygen in this population. Intermittent hypoxia, consisting of alternating short bouts of breathing hypoxic and normoxic air, increases erythropoietin levels, the hormone regulating red blood cell production, in young and older adults. The objective of this study was to determine the effect of a single session of intermittent hypoxia on erythropoietin levels and hemoglobin mass, the absolute mass of hemoglobin contained in red blood cells, in patients with type 2 diabetes. Ten patients with type 2 diabetes were exposed to an intermittent hypoxia protocol consisting of eight 4-min cycles at a targeted oxygen saturation of 80% interspersed with normoxic cycles to resaturation. Erythropoietin and hemoglobin mass responses to intermittent hypoxia in patients with type 2 diabetes were compared to previously published data from an identical intermittent hypoxia protocol performed in age-matched older adults. Intermittent hypoxia increased erythropoietin levels in older adults but did not induce any change in erythropoietin levels in patients with type 2 diabetes (3.2 ± 2.2 vs. 0.2 ± 2.7mU/ml, p = 0.01). Hemoglobin mass indexed to body weight was 21% lower in patients with type 2 diabetes than in older adults (8.1 ± 1.7 vs. 10.2 ± 2.1g/kg, p < 0.01). These findings suggest an impaired erythropoietin response to decreased oxygen levels in patients with type 2 diabetes, which may contribute to the reduced oxygen transport capacity observed in this population.

88 Feasibility of a Home-based Physiotherapy Program to Increase Physical Activity Levels in Older Adults with Diabetes Mellitus

OBJECTIVES/GOALS: The objective of this study is to assess the feasibility and preliminary impact of a physiotherapy protocol for developing an individualized home-based physical activity program to increase physical activity (PA) levels in sedentary older adults with Type II Diabetes Mellitus (T2DM) living in Puerto Rico (PR). METHODS/STUDY POPULATION: This will be a pilot study with two phases. In phase 1, we will design a novel patient-centered home-based PA program protocol for adults ≥65 years with T2DM based on the Information-Motivation-Behavioral Skills model. Its content validity will be assessed through focus groups with 10 experts and 10 older adults and analyzed using a directed content analysis. Phase 2 we will be program implementation using a one-group, repeated measures design with 12 adults ≥65 years with T2DM. PA levels will be assessed by recording active minutes with a Fitbit. Risk of falls, balance, strength, and physical function will be assessed through standardized tests validated for this population. Statistical analysis will include descriptive statistics, comparisons via chi-square/Fisher’s exact test, and non-parametric tests. RESULTS/ANTICIPATED RESULTS: We expect to recruit a minimum of 12 participants and to administer the program for 12 weeks at a frequency of two visits per week. We anticipate that implementing and supervising the home-based PA protocol will be feasible as determined by recruitment and retention rates, patients’ satisfaction, and compliance with the program. We also expect that this protocol will increase physical activity levels, improve general strength, balance, physical function, and reduce the risk of falls in sedentary older adults with T2DM. DISCUSSION/SIGNIFICANCE: As the third cause of death in PR, T2DM represents a public health challenge. An effective home-based PA program may decrease morbidity and mortality rates in older adults by increasing PA and functional health. This study will provide data for planning a randomized controlled trial to assess its effectiveness in the outcomes of interest.

Effects of Exercise Intensity Differences in Forest Therapy Programs on Immunoglobulin A and Dehydroepiandrosterone Levels in Older Adults

The purpose of this study was to examine the effects of exercise intensity and the duration of an exercise-based forest therapy program on physiological changes in older adults. The forest therapy program consisted of 20 sessions over 10 weeks. Forty-one older adults aged 65 years and older were divided into no treatment (daily activity group) and experimental (forest therapy) groups. The experimental group was further divided into the medium-intensity forest exercise group and the high-intensity forest exercise group to analyze physiological changes according to exercise intensity and duration. The physiological changes were analyzed by collecting saliva and measuring changes in the levels of immunoglobulin A and dehydroepiandrosterone, a hormone used to predict aging. Changes within the daily activity group and the forest therapy group after their respective exercises were analyzed using paired t-tests. Saliva testing was performed before and in weeks 5 and 10 of the program and analyzed using a repeated measures analysis of variance to assess the effects of the forest therapy on the medium-intensity forest exercise group and the high-intensity forest exercise group based on the duration of exercise. As a result of the study, a significant increase in immunoglobulin A was observed in the medium-intensity forest exercise group. The daily activity group and the high-intensity forest exercise group showed an increase, but there was very little change and no significance. Changes in dehydroepiandrosterone decreased in the daily activity group and significantly increased in the moderate-intensity forest exercise group at 5 and 10 weeks, showing that regular moderate-intensity forest exercise has an effect on dehydroepiandrosterone. The high-intensity forest exercise group improved over time, but no significant level of change was observed. This study shows that forest exercise has a beneficial effect on immunoglobulin A and dehydroepiandrosterone levels in older adults.