Middle-aged Individuals Research Articles

Overview of Achilles Tendon Injury Treatment

Achilles tendon rupture is a prevalent injury, particularly among middle-aged individuals who participate in high-demand athletics. This article reviews the anatomy, risk factors, diagnosis, and current treatment strategies for Achilles tendon rupture, with a focus on surgical and non-surgical approaches. The traditional open repair technique is still a widespread surgical approach that uses a large incision to reconnect the tendon directly. However, complications and infections may occur, so percutaneous or mini-open techniques can be changed depending on the patient's condition. Various suture techniques, such as Bunnell, Modified Kessler, and Tsuge, have been evaluated in clinical settings, with braided polyester sutures demonstrating superior biomechanical performance over monofilament polydioxanone sutures. Despite the effectiveness of surgical intervention, non-surgical treatment remains an option for specific patient populations, though it is associated with a slightly higher re-rupture rate. Postoperative rehabilitation is crucial for restoring function, with early weight-bearing and mechanical stimulation playing key roles in successful recovery.

Smoking status and edentulism among older Chinese: a cohort study.

The harmful impact of tobacco smoke on health is widely recognized, linking it to various diseases. However, the link between tobacco smoke and edentulism in China's population hasn't been fully investigated. This study aims to fill this gap by exploring smoking habits and the possible connection between tobacco smoke and edentulism in a nationally representative Chinese cohort. This study used data from the 2011 China Longitudinal Study of Health and Retirement (CHARLS) and included 17,705 participants aged 45years and older, and linked with follow-up data (2018). Smoking status (non-smoker, ex-smoker, smoker, pack-years of smoking, age at starting and ceasing smoking) was used as an independent variable, and edentulism was used as a dependent variable. Multivariable logistic regression analysis and curve fitting were used to evaluate the association between smoke status and edentulism. Subgroup analyses were then employed to examine the impact of subgroup factors on the link between smoking status and edentulism. A total of 13,720 people were included in the study, 2,029 of whom were edentulism patients. The association between smoking duration (OR = 1.038, 95%CI = 1.031, 1.045) /Age at quitting smoking (OR = 1.026, 95%CI = 1.013, 1.039)/Smoking pack years (OR = 1.005, 95%CI = 1.002, 1.007) and risk of edentulism was significant, while Age start smoking (OR = 1.003, 95%CI = 0.995, 1.012) and Cigarettes consumed per day (OR = 0.998, 95%CI = 0.991, 1.006) was not associated with risk of edentulism. Compared with non-smokers, current smoker had a higher risk of edentulism (OR 1.274, 95% CI = 1.108, 1.465). Additionally, our results also revealed that there was a nonlinear trend between Smoking duration/Cigarettes consumed per day/Age at quitting smoking/ Age at starting smoking/pack-years of smoking and edentulism (P > 0.05). The research found a significant link between smoking habits and edentulism in nationally representative Chinese population. This study in China found a complex link between tobacco use and tooth loss among middle-aged and elderly individuals, highlighting the need for personalized smoking cessation strategies to improve dental health in this population.

Nonlinear and synergistic effects of demographic characteristics on urban polycentric structure using SHAP

Polycentric urban development is promoted by urban planners and policy makers for its perceived benefits of alleviating urban issues. Theoretically, a polycentric urban structure is formed when different demographic groups present a collection of diverse and unique housing location preferences. Yet, only limited empirical studies have fully captured the complex effects of demographic characteristics on urban polycentric structures. Our study utilizes detailed demographic data and employs interpretable machine learning models to elucidate the nonlinear and synergistic relationship between demographic characteristics and the urban polycentric structure in the context of a city of 10 million population in China. When characterizing urban centers, the three most important demographic groups are young females, senior married couples, and middle-aged single individuals with basic education. Each urban center presents distinctive demographic compositions; for instance, middle-aged married individuals exerting a stronger influence in certain contexts, whereas in senior resident groups, married individuals have a more pronounced impact. Spatial heterogeneity is observed in the demographic profiles of urban centers; for instance, primary central cores are predominantly young, single females, whereas peripheral and secondary centers have stronger presence of highly educated residents.

Association between chronic pain and cognitive frailty among middle-aged and elderly individuals: evidence from the China Health and Retirement Longitudinal Study

BackgroundFrailty, particularly cognitive frailty, is an escalating public health issue. Cognitive frailty is defined by the simultaneous presence of physical frailty and cognitive impairment, without a confirmed diagnosis of dementia, and has become a significant geriatric syndrome. This study aimed to explore the association between chronic pain and the risk of cognitive frailty.MethodsWe utilized data from two waves (2011 and 2015) of the China Health and Retirement Longitudinal Study (CHARLS), conducting both cross-sectional and longitudinal analyses involving 17,705 Chinese adults aged 45 years and older. Chronic pain was defined as pain reported at both time points. Cognitive function was evaluated using a questionnaire adapted from the Telephone Interview for Cognitive Status. The frailty index (FI) was derived from a 30-item assessment. Cognitive frailty was characterized by the co-occurrence of cognitive impairment and physical frailty.ResultsAmong the 14,285 participants, 5.39% exhibited cognitive frailty at baseline. Both cross-sectional and longitudinal analyses indicated that individuals suffering from chronic pain faced a higher likelihood of developing cognitive frailty compared to those without pain. After adjusting for potential confounders, multivariate models also indicated a higher odds of cognitive frailty for participants with chronic pain.ConclusionChronic pain is significantly associated with an elevated risk of cognitive frailty among middle-aged and elderly individuals. These findings highlight the importance of managing chronic pain to mitigate the risk of cognitive frailty, thereby potentially enhancing the quality of life for the aging population and alleviating the economic burden on families and society.

Phenological multivariance of Betula pendula Roth in an anthropogenically transformed environment

Abstract The article presents the results of long-term biomonitoring based on the phenology of the arboreal species Betula pendula of the city of Yoshkar-Ola, Russia. The phenological multivariance of B. pendula was studied for the first time at different stages of the ontogenesis of the generative period, in the gradient of atmospheric air pollution by industrial and automotive toxicants. The rhythm of seasonal development of B. pendula depends on both individual and age characteristics, as well as on the influence of conditions of a specific urban microclimate and environmental pollution. Middle-aged generative individuals of B. pendula are characterized by earlier periods of the onset of phenophases, rapid leaf unfolding, prolonged flowering, yellowing of leaves and, in general, the growing season, compared with young and old generative trees. The asynchrony of seasonal development is characteristic mainly for trees located in the zone of medium pollution. Under conditions of a specific microclimate and air pollution, heterogeneity within ontogenetic groups B. pendula increases. The adaptation of B. pendula individuals to adverse weather factors and urban conditions is determined by the diversity of phenorhythmogroups in the generative period of ontogenesis.

Features of chronic urticaria after COVID-19 mRNA vaccine over time

BackgroundNew onsets of chronic urticaria (CU) have been reported after repeated immunizations, mainly with the Moderna mRNA-1273 vaccine (Spikevax). This study aims to evaluate patients with CU after COVID-19 mRNA vaccination. The contribution of SARS-Cov2 infection, atopy and IgE against the vaccine was analyzed.MethodsWe monitored the features of patients who developed CU after vaccination through two surveys conducted in 2022 and 2023. Fifty individuals with CU underwent blood tests, and their results were compared with individuals without a history of urticaria (N = 135). The presence of anti-vaccine IgE was tested in 185 individuals with basophil activation tests (BAT). We assessed anti-SARS-Cov2 humoral response, and the presence of IgEs against common respiratory allergens (Phadiatop) as a surrogate for atopy.ResultsPost-vaccination CU occurs after a median interval of 10 days and significantly more after the Spikevax booster, affecting middle-aged individuals (median 41, 66% females). In 2023, CU was still active in 53% of the cases. Inducible forms of CU, primarily dermographism, are reported in 54% (2022) and 61% (2023) of the cases. BAT positivity is not specific to CU, anti-nucleocapsid positivity, or atopy but is significantly associated with higher anti-spike neutralizing activities and younger age. Four CU patients tolerate an additional dose of mRNA vaccine with no disease exacerbation/recurrence.ConclusionsThe spikevax booster induces anti-vaccine IgE independently of CU, the latter being not directly associated with COVID-19 infection nor atopy. The tolerance to a new booster in 4/4 patients suggests that the Spikevax vaccine indirectly triggers CU in predisposed individuals.

중년기 성인의 자기결정적 고독동기와 삶의 만족도의 관계: 적극적 대처와 걱정의 매개효과

The aim of this study was to explore the relationship between self -determined loneliness motivation and life satisfaction in middle-age d adults, with a focus on the mediating effects of active coping and worry. To achieve this, an survey was conducted with 753 adults. Th e collected data were analyzed using SPSS 23.0 and AMOS 23.0, yiel ding the following results: First, Self-determined loneliness motivatio n showed a significant positive association with life satisfaction, acti ve coping, and worry. Additionally, life satisfaction was positively rel ated to active coping and negatively related to worry, while active c oping and worry exhibited a negative relationship with each other. Second, Active coping and worry were found to fully mediate the rel ationship between self-determined loneliness motivation and life sati sfaction. Specifically, a sequential mediation effect was observed, wh erein active coping influenced worry, which in turn affected life sati sfaction. This study offers valuable insights into the psychological tr aits of middle-aged individuals with self-determined solitary motivati on.

Cardiorespiratory Fitness in Adolescence and Risk of Type 2 Diabetes in Late Adulthood: A Nationwide Sibling-Controlled Cohort Study.

The importance of adolescent cardiorespiratory fitness for long-term risk of type 2 diabetes (T2D) remains poorly investigated, and whether the association is influenced by unobserved familial confounding is unknown. We conducted a sibling-controlled cohort study based on all Swedish men who participated in mandatory military conscription examinations from 1972 to 1995 around the age of 18, and who completed standardized cardiorespiratory fitness testing. The outcome was T2D, defined as a composite endpoint of diagnosis in inpatient or specialist outpatient care, or dispensation of antidiabetic medication, until 31 December 2023. 1 124 049 men, of which 477 453 were full siblings, with a mean age of 18.3 years at baseline were included. During follow-up, 115 958 men (48 089 full siblings) experienced a first T2D event at a median age of 53.4 years. Compared to the first decile of fitness, higher fitness levels were associated with a progressively lower risk of T2D. In cohort analysis, the hazard ratio (HR) in the second decile was 0.83 (95% CI, 0.81 to 0.85), with a difference in the standardized cumulative incidence at age 65 of 4.3 (3.8 to 4.8) percentage points, dropping to a HR of 0.38 (0.36 to 0.39; incidence difference 17.8 [17.3 to 18.3] percentage points) in the tenth decile. When comparing full siblings, and thus controlling for all unobserved behavioral, environmental, and genetic confounders that they share, the association replicated, although with attenuation in magnitude. The HR in the second decile was 0.89 (0.85 to 0.94; incidence difference 2.3 [1.3 to 3.3] percentage points), and in the tenth decile it was 0.53 (0.50 to 0.57; incidence difference 10.9 [9.7 to 12.1] percentage points). Hypothetically shifting everyone in the first decile of fitness to the second decile was estimated to prevent 7.2% (6.4 to 8.0) of cases at age 65 in cohort vs. 4.6% (2.6 to 6.5) in full-sibling analysis. The association was similar in those with overweight as in those without. Higher levels of adolescent cardiorespiratory fitness are associated with lower risk of T2D in late adulthood, with clinically relevant associations starting already from very low levels of fitness, and similarly in those with overweight compared to those without. The association replicates, but becomes weaker, after adjusting for unobserved familial confounders shared between full siblings. This suggests that adolescent cardiorespiratory fitness is a robust marker of long-term T2D risk, but that conventional observational analysis may yield biased estimates. None. Evidence before this study: Type 2 diabetes is a growing public health issue, affecting at least half a billion people globally. Modifiable factors such as physical activity and the closely related trait cardiorespiratory fitness, which are inversely associated with type 2 diabetes, are declining, particularly among youth. Since these traits track from youth into adulthood, early-life interventions might have important implications for prevention. However, previous studies have typically focused on middle-aged individuals, leaving gaps in understanding whether fitness in youth is associated with type 2 diabetes in the long-term. Moreover, they have not been designed to adequately account for unobserved confounders. Triangulating the evidence across different methods, such as using sibling comparison analysis, would be important to obtain more accurate and reliable estimates of the causal relationship.Added value of this study: In this nationwide sibling-controlled cohort study encompassing more than 1 million young men, of which half a million were full siblings, higher levels of adolescent cardiorespiratory fitness were associated with a substantially lower risk of developing type 2 diabetes up to five decades later. The association was clinically relevant already from low levels of fitness, and it appeared similar in those with overweight as in those without overweight. While the association replicated after adjusting for unobserved familial confounders shared between full siblings, the magnitude of association attenuated by an amount that appeared clinically relevant. For example, the incidence differences between deciles of fitness were about 40% smaller in sibling-comparison analyses as compared to cohort analysis, and the preventable share of type 2 diabetes associated with hypothetical interventions shifting the population-level of fitness was reduced by about one-third.Implications of all the available evidence: Adolescent cardiorespiratory fitness is a strong marker of long-term risk of type 2 diabetes, both in those with and without overweight. These findings render support to large-scale surveillance of fitness from a prevention perspective, and if the findings are confirmed using other lines of causal analysis, they may render support to interventions targeting fitness already from a young age. Yet, these findings also highlight the importance of triangulation for obtaining more reliable evidence of the magnitude of association, and shed light on the pitfalls of conventional observational analysis which may yield biased estimates.

ITRAQ-Based Proteomic Analysis of Spontaneous Achilles Tendon Rupture.

Spontaneous Achilles tendon rupture (SATR) predominantly affects middle-aged and elderly individuals with chronic injuries. However, the exact cause and mechanism of SATR remain elusive, and potential therapeutic intervention or prevention is still insufficient. The present study aimed to uncover the key pathological molecules by using iTRAQ proteomics. The results identified 2432 candidate proteins in SATR patients using iTRAQ proteomic analysis. A total of 307 differentially expressed proteins (DEPs) were identified and linked to 211 KEGG signaling pathways including Coronavirus disease (COVID-19), focal adhesion, and ribosomes. GO enrichment analysis highlighted significant enrichment in processes such as biological adhesion, ossification, lipid (APOA4) processes, and extracellular matrix (ECM) organization (collagen). PPI network analysis identified hub genes such as serum albumin (ALB), fibronectin (FN1), and actin cytoplasmic 1. The WB analysis confirmed that FN1 and the receptor for activated C kinase (RACK1) were downregulated in the SATR tendon. Immunohistochemical staining revealed that collagen I and III were suppressed, while collagen II and APOA4 expression were higher in the SATR pathological tissue (P < 0.05). However, the primary cultured tenocytes (PCTs) from SATR patients showed enhanced proliferation and, consistent with tissue staining, reduced collagen I and III and increased collagen II. Our findings reveal vital targets and pathways in SATR's etiological progression, offering a new perspective on the diagnosis, treatment, and prognosis of this complex disorder.

Influence of Information and Communication Technology-Based Training on Livestock Production Efficiency in Bwari Area Council, Abuja

This study examines the influence of ICT-based training on livestock production efficiency among farmers in Bwari Area Council, with a focus on socio-economic characteristics, ICT knowledge post-training, productivity impact, effectiveness factors, and preferred ICT tools. Using a multi-stage sampling approach, 250 livestock farmers were selected. Primary survey were collected and analyzed with descriptive and inferential statistics to meet the research objectives. The socio-economic analysis reveals a farming population primarily composed of middle-aged individuals (mean age 41.7 years), with 72% male and 64% married. Education levels varied, with 38% having secondary education. Post-training evaluations indicated that 80% of farmers were proficient in SMS alerts for disease management, 72% confident in mobile applications, and 70% experienced productivity gains using ICT tools. ICT training was found to positively impact areas like increasing awareness of government programs and subsidies (3.4), scheduling vaccinations accurately (3.3), disease prevention (3.2), and record-keeping (3.1) and feeding practices (3.0), preparing and storing livestock feeds (2.9), etc. Logit regression analysis identified significant factors influencing ICT effectiveness, including educational level (p=0.010), cooperative membership (p = 0.012), household size (p=0.032), contact with extension agents (p=0.011), and access to credit (p = 0.002), while gender, marital status, and farm size were non-significant. Kendall’s Coefficient of Concordance analysis ranked mobile applications, SMS alerts, and radio broadcasts as the most effective ICT tools, demonstrating high consensus. Partnerships with telecommunication companies and government initiatives is recommended to address connectivity barriers, ensuring that all farmers can fully utilize digital tools in their livestock management practices.

Influence of Information and Communication Technology-Based Training on Livestock Production Efficiency in Bwari Area Council, Abuja

This study examines the influence of ICT-based training on livestock production efficiency among farmers in Bwari Area Council, with a focus on socio-economic characteristics, ICT knowledge post-training, productivity impact, effectiveness factors, and preferred ICT tools. Using a multi-stage sampling approach, 250 livestock farmers were selected. Primary survey were collected and analyzed with descriptive and inferential statistics to meet the research objectives. The socio-economic analysis reveals a farming population primarily composed of middle-aged individuals (mean age 41.7 years), with 72% male and 64% married. Education levels varied, with 38% having secondary education. Post-training evaluations indicated that 80% of farmers were proficient in SMS alerts for disease management, 72% confident in mobile applications, and 70% experienced productivity gains using ICT tools. ICT training was found to positively impact areas like increasing awareness of government programs and subsidies (3.4), scheduling vaccinations accurately (3.3), disease prevention (3.2), and record-keeping (3.1) and feeding practices (3.0), preparing and storing livestock feeds (2.9), etc. Logit regression analysis identified significant factors influencing ICT effectiveness, including educational level (p=0.010), cooperative membership (p = 0.012), household size (p=0.032), contact with extension agents (p=0.011), and access to credit (p = 0.002), while gender, marital status, and farm size were non-significant. Kendall’s Coefficient of Concordance analysis ranked mobile applications, SMS alerts, and radio broadcasts as the most effective ICT tools, demonstrating high consensus. Partnerships with telecommunication companies and government initiatives is recommended to address connectivity barriers, ensuring that all farmers can fully utilize digital tools in their livestock management practices.

The association between ozone exposure and blood pressure in a general Chinese middle-aged and older population: a large-scale repeated-measurement study

BackgroundThe relationship between ozone (O3) exposure and blood pressure (BP) remains inconclusive. Given the scarcity of Chinese epidemiological data, more research on this association is of paramount importance, particularly among middle-aged and older Chinese populations.MethodsThis study involved 10,875 participants (median age: 60.0 years) in Xiamen, China, from 2013 to 2019, with 34,939 repeated BP measurements. Air pollutant exposure data, including O3, particulate matter, nitrogen dioxide, sulfur dioxide, and carbon monoxide were derived from China High Air Pollutants and High-resolution Air Quality Reanalysis datasets using a k-nearest neighbor algorithm. The relationship between mixed air pollutant exposure and BP was evaluated using Bayesian kernel machine regression model. The effects of daily-specific O3 exposure on BP were assessed by distributed lag models integrated into a linear mixed-effects framework. The mediating role of total cholesterol (TC), serum total bilirubin (STB), triglyceride (TG), and low-density lipoprotein (LDL) were examined using multilevel mediation analysis with a fully adjusted model.ResultsMixed air pollutant exposure was positively correlated with BP, with O3 being a predominant contributor exhibiting an inverse effect. O3 exposure had immediate effects on pulse pressure (PP), while systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) showed delayed responses, with 3-, 14-, and 8-day lags, respectively. During the study period of up to 30 days, each 10 μg/m3 increase in maximum daily 8-h average O3 concentration was associated with reductions in SBP (β = − 1.176 mm Hg), DBP (− 0.237 mm Hg), PP (β = − 0.973 mm Hg), and MAP (β = − 0.544 mm Hg). Stronger correlations were observed in the older participants (aged ≥ 65 years), overweight/obese individuals, smokers and alcohol consumers, and those with hypertension or type 2 diabetes mellitus. STB and LDL mediated these effects, while TC and TG played mitigating roles.ConclusionsShort-term O3 exposure is negatively associated with BP in middle-aged and older Chinese individuals. The findings provide preliminary evidence for the impact of O3 exposure on BP regulation and underscore the urgent need to reassess public health policies in response to O3 pollution.

Analysis of Housing Topics for Middle-Aged Adults in Online News Articles Using Text-Mining Techniques

Middle-aged adults face social isolation and economic insecurity due to limited institutional support, and despite government efforts, their financial, housing, and health challenges persist. This study explored housing welfare support strategies for middle-aged individuals through an analysis of major topics related to "middle-aged housing" in online news articles using text mining techniques. For this purpose, data from Naver articles published between February 2020 and July 2023 were collected and analyzed. The key findings were as follows: term frequency (TF) and term frequency-inverse document frequency (TF-IDF) comparisons revealed that TF focused on social and policy aspects ("support," "youth," "project," "region," "household," "policy," "housing," and "welfare"), highlighting government support characteristics, while TF-IDF emphasized economic aspects ("move-in," "market," "region," "housing," "price," "rise," "subscription," "apartment," "Jeonse," and "sale"), highlighting issues related to the housing market. This suggests that policies to improve housing welfare for middle-aged individuals should consider both social and economic aspects. Network analysis identified six major categories: housing support, support targets, housing economy, job support, housing infrastructure, and health and well-being. Each category was further divided into the following detailed topics: policy support, residential services, economic activities, employment creation, living environment improvement, and personalized health management. These findings indicate the need for comprehensive support that addresses various aspects of middle-aged housing welfare, including family considerations, economic support, social engagement, health, and digital adaptation.

Predicting Depression in Middle-Aged Individuals in Tehran Based on Socioeconomic Status, Loneliness, Spiritual Well-Being, and Marital Satisfaction in 2023

Introduction: Information related to the amount of the most significant risk factors identified in relation to depression in middle-aged Iranian individuals is insufficient. Accordingly, the aim of this study was to predict depression in middle-aged residents of Tehran based on their socioeconomic status, feelings of loneliness, spiritual well-being, and marital satisfaction. Methods: This cross-sectional study employed a quantitative descriptive-correlational approach and regression analysis. A total of 216 middle-aged individuals visiting health centers in Tehran in 2023 were selected through convenience sampling. Participants completed questionnaires assessing marital satisfaction (Hudson), social-emotional loneliness in adults, spiritual well-being (Dehshiri et al.), socioeconomic status (SES), and the Beck Depression Inventory (BDI-II). Multiple linear regression analysis was conducted using SPSS version 24 to examine the relationship between predictor variables and depression. Rusults: Among the 216 middle-aged participants in Tehran, aged between 40 and 60 years, 47/68% were male (103 individuals) and 52/31% were female (113 individuals). The prevalence of depression among middle-aged individuals in Tehran was found to be 46/3% (100 individuals). Notably, only spiritual well-being significantly predicted the variability in depression among middle-aged individuals in Tehran (B=0/19, p&lt; 0/01). Conclusion: Contrary to previous studies, socioeconomic status, loneliness, and marital satisfaction did not statistically predict the variability in depression among middle-aged individuals in Tehran. It is recommended that further research be conducted to identify the most significant risk factors associated with depression in this demographic.

Longitudinal changes in plasma Cystatin C and all-cause mortality risk among the middle-aged and elderly Chinese population

ObjectiveElevated plasma Cystatin C levels are associated with an increased mortality risk among middle-aged and elderly Chinese individuals. This study explores whether tracking the longitudinal changes in Cystatin C can improve the prediction of mortality risk and allow better risk stratification, jointly with baseline measurements. Design & MethodsThis analysis includes 3,195 participants from the China Health and Retirement Longitudinal Study who completed plasma Cystatin C measurements in two waves (2011 and 2015) and were followed through 2020. To evaluate the association between Cystatin C levels/changes and mortality risk, multivariate Cox proportional hazard models were employed, adjusting for potential confounders. Survival probabilities were compared using Kaplan-Meier curves and log-rank tests, while restricted cubic splines were utilized to illustrate any nonlinear relationships between Cystatin C levels and hazard ratios. ResultsParticipants in the highest quartile of baseline Cystatin C show an increased risk of mortality compared to those in the lowest quartile (hazard ratio (HR): 1.51, 95 % CI: 1.02–2.24, p = 0.04). Including longitudinal changes in Cystatin C further strengthens this association (HR: 1.81, 95 % CI: 1.20–2.74, p < 0.001). Kaplan-Meier plots show that baseline levels effectively stratify both the entire cohort and gender-specific subgroups (p < 0.001). Moreover, integrating baseline levels with the longitudinal changes in Cystatin C levels provides additional stratification benefits. The predictive performance significantly improves by including longitudinal changes in Cystatin C in baseline-only models, with the concordance index increasing from 0.745 to 0.839 and the area under the receiver operator characteristic curve rising from 0.751 to 0.845. Additionally, significant nonlinear relationships between changes in Cystatin C and HR are observed in the entire population, the males and the females (p = 0.003, 0.018, 0.025). ConclusionsDynamic monitoring of changes in Cystatin C could enhance the prediction of mortality risk among middle-aged and elderly individuals.

Reduced neurovascular coupling is associated with increased cardiovascular risk without established cerebrovascular disease: A cross-sectional analysis in UK biobank.

Mid-life vascular risk factors predict late-life cerebrovascular diseases and poor global brain health. Although endothelial dysfunction is hypothesized to contribute to this process, evidence of impaired neurovascular function in early stages remains limited. In this cross-sectional study of 31,934 middle-aged individuals from UK Biobank without established cerebrovascular disease, the overall 10-year risk of cardiovascular events was associated with reduced neurovascular coupling (p < 2 × 10-16) during a visual task with functional MRI, including in participants with no clinically apparent brain injury on MRI. Diabetes, smoking, waist-hip ratio, and hypertension were each strongly associated with decreased neurovascular coupling with the strongest relationships for diabetes and smoking, whilst in older adults there was an inverted U-shaped relationship with DBP, peaking at 70-80 mmHg DBP. These findings indicate that mid-life vascular risk factors are associated with impaired cerebral endothelial-dependent neurovascular function in the absence of overt brain injury. Neurovascular dysfunction, measured by neurovascular coupling, may play a role in the development of late-life cerebrovascular disease, underscoring the need for further longitudinal studies to explore its potential as a mediator of long-term cerebrovascular risk.

Liver disease-linked metabolic and behavioral factors associated with cognitive performance in an observational study of community dwelling adults

Modifiable risk factors associated with cognitive functioning are important for identifying potential targets for intervention development. Although there are a few recognized modifiable risk factors (e.g., diabetes mellitus, diet, physical activity), there are limitations in the conclusions that can be drawn due to limited data. Therefore, this study examined the relationship between modifiable liver disease-linked metabolic and behavioral factors in a sample of community dwelling adults who do not currently experience functional limitations due to cognitive abilities. Individuals aged 19 to 69 were recruited to participate in this cross-sectional study in the Washington, DC area. Participants were assessed using anthropometric measures, ultrasound of the liver, glycated hemoglobin A1C, self-reported fatigue, clinical history, and 7 domains of cognitive function: processing speed, short- and long-term visual memory, working memory, inhibition, shifting, and abstract reasoning. The study included 104 participants (44% female, 51.1 ± 13.5 years old). The modifiable factors that were most consistently related to cognitive performance were waist-to-height ratio, which was related to a decrease in performance in 4 of the domains (short-term and long-term visual memory, working memory, and abstract reasoning), and the presence of nonalcoholic fatty liver disease, which was related to an increase in performance in the same 4 domains. This study suggests that liver disease-linked modifiable factors are associated with cognitive performance, even in middle-aged individuals without self-reported cognitive dysfunction. Further research is needed to explore the mechanisms that impact cognitive performance in relation to these factors to establish early intervention targets for reducing future cognitive deficits.

Association between various insulin resistance indices and cardiovascular disease in middle-aged and elderly individuals: evidence from two prospectives nationwide cohort surveys

Association between various insulin resistance indices and cardiovascular disease in middle-aged and elderly individuals: evidence from two prospectives nationwide cohort surveys

Aberrant intra-network resting-state functional connectivity in chronic insomnia with or without cognitive impairment

Chronic insomnia (CI) is a common sleep disorder in middle-aged and elderly individuals. Long-term sleep deprivation can lead to physical, mental, and cognitive damage. Resting-state networks (RSNs) in the brain are closely linked to cognition and behavior. Therefore, we investigated changes in RSNs to explore behavioral and cognitive abnormalities in middle-aged and elderly CI patients. Resting state functional magnetic resonance imaging (rs-fMRI) and independent component analysis were used to study the intrinsic functional connectivity (FC) of the RSNs in 36 CI patients (20 CI with cognitive impairment (CI-I) patients and 16 CI without cognitive impairment (CI-N) patients) and 20 healthy controls (HC). Two-sample t-tests were used to compare RSNs differences between CI and HC groups and the RSNs differences between CI-I and CI-N groups. Partial correlation analysis was used to explore the relationship between the significant abnormal brain regions in RSN and clinical scales. Compared with HCs, CI patients showed significant differences in multiple RSNs, and FC values in two brain regions within RSNs were correlated with clinical scales. Furthermore, compared with CI-N group, CI-I group also showed significantly altered FC in multiple RSNs. Moreover, FC values in the right middle frontal gyrus within right frontal parietal network of CI-I patients were negatively correlated with the Mini-Mental State Examination scores. These results may explain hyperarousal, decreased attention and motor function impairments in CI patients. Furthermore, the aberrant alterations of RSNs in CI-I patients may play a crucial role in the onset and progression of cognitive impairment in CI patients.

Periodontitis associated with brain function impairment in middle-aged and elderly individuals with normal cognition.

The present study aimed to investigate changes in intranetwork functional connectivity (FC) and internetwork FC in middle-aged and elderly individuals with normal cognition (NC) and varying degrees of periodontitis to determine the effects of periodontitis on brain function. Periodontal findings and resting-state functional magnetic resonance imaging data were acquired from 51 subjects with NC. Independent component analysis and correlation analysis were used for the statistical analysis of the data. Differences in intranetwork FC were observed among groups in the anterior default-mode network (aDMN), dorsal attention network and dorsal sensorimotor network (dSMN). Compared with the nonperiodontitis (NP) group or the mild-periodontitis group, the analysis of internetwork FC showed increased FC between the auditory network and the ventral attention network (VAN), between the aDMN and the salience network (SN), and between the SN and the VAN and decreased FC between the posterior default-mode network and the right frontoparietal network in the moderate-to-severe periodontitis group. Additionally, internetwork FC between the dSMN and the VAN was also increased in the moderate-to-severe periodontitis group compared to the NP group. The altered intra- and internetwork FC were significantly correlated with the periodontal clinical index. Our results confirmed that periodontitis was associated with both intra- and internetwork FC changes even in NC. The present study indicates that periodontitis might be a potential risk factor for brain damage and provides a theoretical clue and a new treatment target for the early prevention of Alzheimer disease. Recent research has proposed that periodontitis is a potential risk factor for Alzheimer disease (AD). However, the relationship between periodontitis and the brain function of middle-aged and elderly individuals with normal cognition (NC) remains unclear. Analyzing the effect of periodontitis on brain function in the NC stage can provide clues to AD development and help achieve early prevention of dementia. The present study aimed to investigate changes in brain functional connectivity (FC) in NC with different severity of periodontitis to determine the effects of periodontitis on brain function. Both changed intranetwork FC and internetwork FC were found in the moderate-to-severe periodontitis group, and periodontitis was associated with brain network function impairment in NC. The present study indicates that periodontitis might be a potential risk factor for brain damage even in NC stage, and provides a theoretical clue and a new treatment target for the early prevention of AD.