Older Adults Research Articles

Ethically challenging situations in eldercare: A cross-sectional study.

Ethically challenging situations are one of the many stressors that strain eldercare employees. The study aimed to examine (1) the mean levels of ethically challenging situations among eldercare employees in different Finnish eldercare service types and (2) the associations between organizational constraints and poor work-unit collaboration with ethically challenging situations. Cross-sectional survey in 2020 including 4,347 Finnish eldercare employees (response rate 67%). These employees provide care and support to older adults, such as assist with daily activities and manage medical needs. Employees were classified into four categories based on the eldercare service type: home care (n = 1,683), service housing (n = 1,649), outpatient and ward care (n = 650), and guidance and activity services (n = 365). The data was analyzed with variance analysis, t-tests, and linear regression analysis. The study was approved by the ethical board of the Finnish Institute of Occupational Health. Respondents' provided informed consent for participation. Analyses showed that the level of ethically challenging situations was highest in service housing, among nurses, and among practical nurses. Organizational constraints-job strain and organizational injustice-had the strongest positive association with ethically challenging situations. Poor work-unit collaboration, instead, had a minor positive association with ethically challenging situations. Organizational constraints, especially job strain and organizational injustice, are important to identify to alleviate ethically challenging situations among eldercare workers.

Selenium and Episodic Memory: The Moderating Role of Apolipoprotein E ε4

Background: Selenium (Se), a vital trace element, plays a neuroprotective role by mitigating oxidative stress through selenoproteins and regulating metal balance. The apolipoprotein E ε4 allele (APOE4), a significant genetic risk factor for Alzheimer’s disease (AD), has been linked to reduced Se levels and weakened antioxidant capacity. This research explores the association between serum Se concentrations and cognitive performance, with an emphasis on how APOE4 status influences this relationship. Methods: This study included 196 older adults from community and memory clinic settings, who underwent assessments for episodic memory, global cognition, and non-memory functions using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery, with serum selenium levels analyzed via inductively coupled plasma–mass spectrometry (ICP-MS) and APOE genotyping conducted to determine allele status. Results: Higher serum Se levels were associated with better episodic memory score (EMS) (B = 0.065, 95% CI = 0.020–0.110, p = 0.005) and CERAD total score (TS) (B = 0.119, 95% CI = 0.046–0.193, p = 0.002). However, the interaction between Se and APOE4 status significantly affected EMS (B = −0.074, 95% CI = −0.109 to −0.039, p < 0.001), with significant benefits observed in APOE4-negative participants. Conclusions: This study highlights the genotype-specific impact of Se on cognitive health, emphasizing the need for personalized nutritional interventions targeting Se levels, particularly for APOE4-negative individuals. Future research should further elucidate the mechanisms of Se’s effects and assess its therapeutic potential in aging populations.

Evaluating the efficacy of AI-enhanced 3D human pose estimation in telerehabilitation for older adults with sarcopenia

Evaluating the efficacy of AI-enhanced 3D human pose estimation in telerehabilitation for older adults with sarcopenia

Normative Beliefs for Older Adults and Volunteering Intentions

Introduction: The idea that older adults should contribute to the common good has become a social normative belief (i.e., social activation). Younger and – even more so – older adults prescribe social activation to the group of older adults. Older adults are assumed to behave in line with what is socially expected of them. However, previous studies did not establish a link between the old-age norm of social activation and older adults’ social engagement. Following the reasoning of stereotype embodiment theory, we investigated the role of self-endorsement of social activation for older adults’ social engagement (i.e., formal volunteering). Method: We conducted two preregistered experiments in which older participants (60 – 90 years, N = 1,463) reflected on agreeing or disagreeing with the norm of social activation. We then assessed endorsement of social activation and intention to engage in formal volunteering. Results: Replicating our previous studies, participants who reflected on agreement with the norm of social activation reported higher endorsement of this norm compared to participants who reflected on disagreement. Endorsing the norm of social activation for (other) older adults translated into endorsing social activation for oneself (internalization). Furthermore, reflecting on agreement with social activation was indirectly related to volunteering intention via endorsement of self-related social activation (embodiment). Conclusion: Our findings elucidate the role of societal normative beliefs for older adults’ behavior and offer insights into the discourse on the continued social participation of older adults.

Effect of Medication Management at Home via Pharmacist-Led Home Televisits: Protocol for a Cluster Randomized Controlled Trial.

Older adults are more likely to have multiple chronic conditions, be prescribed multiple medications, and be more susceptible to adverse drug reactions (ADRs) to their medications. In addition, older adults often use over-the-counter medications and supplements, further complicating their medication regimens. Complex medication regimens are potentially harmful to older adults. Interventions aimed at reducing medication discrepancy in the ambulatory clinic setting, such as reviews of medication lists and the implementation of "brown bag" reconciliation, continue to be challenging, with limited success. Pharmacist-led interventions to improve appropriate medication use in older adults have demonstrated effectiveness in reducing ADRs. Video visits have the potential to provide direct visualization of medications in older adults' homes, thereby reducing medication discrepancy and increasing medication adherence. Pharmacist-led management of older adults' medication regimens may improve appropriate medication use in older adults. The objective of this study is to examine the effect of pharmacist-led medication through home televisits compared to usual care on appropriate medication use, medication discrepancies, medication adherence, and ADRs. We will conduct a 2-site cluster randomized controlled trial (RCT). The intervention will be a pharmacist-led home televisit including medication reconciliation and assessment of actual medication use. The cluster RCT was iteratively adapted after a pilot test. The primary outcome of medication appropriateness of the intervention will be measured using the STOPP (Screening Tool of Older Persons' Prescriptions) criteria for potentially inappropriate medications (PIMs) at 6 months. Medication lists obtained will be compared against electronic medical records (EMRs) by a clinician to establish discrepancies in medications. The clinician will review medications using the validated Medication Appropriateness Index (MAI). This project has been peer-reviewed and selected for support by the Veterans Affairs (VA) Health Services Research Service. The pilot phase of the study was completed December 2021 with 20 veterans and was primarily informed by the Steinman model of the prescribing process adapted to include system- and provider-level factors. The last date of enrollment was August 6, 2021. We anticipate the completion of the ongoing trial in spring 2025. The first results are expected to be submitted for publication in 2025. The cluster RCT will provide evidence on medication management through televisits. If found effective in improving the use of medications, the intervention has the potential to impact older adults with multiple chronic conditions and polypharmacy. ClinicalTrials.gov NCT04340570; https://clinicaltrials.gov/study/NCT04340570. PRR1-10.2196/65141.

Enhancing Older Adults’ Lives Through Positive Aging Perception, Quality-of-Life Enhancement, and Social Support to Drive Acceptance and Readiness Toward Indoor Assistive Technology: Cross-Sectional Study

Background The growing aging population faces increasing mobility limitations, highlighting the need for assistive technologies as potential solutions. These technologies support the independence and well-being of older adults and individuals with mobility challenges. Indoor mobility is essential for daily activities and significantly impacts their lives. Limited indoor mobility can reduce quality of life and heighten the risk of falls. Objective This study explores how positive aging perceptions, quality-of-life enhancements, and social support influence the acceptance and readiness of indoor assistive technologies among older adults. Methods A cross-sectional study was conducted at a gerontechnology laboratory, requiring participants to visit the facility in person. Each 60-minute session included demonstrations of various indoor assistive technologies and the completion of a questionnaire. The assistive technologies showcased encompassed a wide range of devices. Participants’ positive aging perceptions, quality-of-life enhancements, social support, technology acceptance, and readiness were measured using validated scales. Data were analyzed with AMOS (version 28; IBM Corp) and SPSS (version 28; IBM Corp), using structural equation modeling and multivariate analysis of covariance to assess the effects of predictors while controlling for demographic factors. Results A total of 104 older adults aged 60 years and older participated, with a mean age of 67.92 (SD 5.68) years. Structural equation modeling indicated that positive aging perception has a significant influence on older adults’ control beliefs (P=.095), comfort (P=.047), and confidence (P<.001) in gerontechnology. Multivariate analysis revealed significant combined effects of quality-of-life enhancement (P=.01) and social support (P=.03) on technology acceptance and readiness, wherein quality-of-life enhancement (P=.001) and social support (P=.008) negatively impacted security perception. Among demographic variables, educational level significantly impacted gerontechnology confidence (P=.004) while ethnicity influenced optimism (P=.003). Conclusions This study sheds light on key factors affecting older adults’ acceptance and readiness to adopt indoor assistive technologies. Findings highlight the importance of fostering positive aging perceptions through these technologies. Addressing issues related to control beliefs, comfort, and confidence in gerontechnology is essential to enhance technology acceptance and readiness among older adults. Future research should investigate the underlying mechanisms and create targeted interventions to support successful technology adoption in this population.

The Acute Effects of Moderate-Intensity Aerobic Exercise on Core Executive Functions in Healthy Older Adults: A Systematic Review

There is growing interest in examining acute effects of exercise on cognitive functions and neurocognitive outcomes. These behavioral and neurocognitive outcomes have been most frequently investigated in healthy young individuals, but relatively few studies have examined healthy older adults. This study aimed to systematically review the effects of acute moderate-intensity aerobic exercise (MIAE) on core executive functions, including inhibition, working memory, and cognitive flexibility, in healthy older adults. A database search of PubMed, Scopus, and Web of Science was conducted using a systematic search strategy. Acute MIAE interventions assessing core executive functions using randomized or stratified controlled trials investigating healthy older adults were reviewed. Eleven studies were identified, and the behavioral results from all included studies revealed that acute MIAE can improve core executive functions in healthy adults. However, incompatible results were observed in activated areas of the prefrontal cortex following MIAE in older adults. The limited number of studies investigating the effects of MIAE on core executive functions in older healthy adults with moderate overall quality restricts the conclusions. Therefore, more robust quality studies using neuroimaging techniques to investigate core executive functions, especially working memory and cognitive flexibility, are needed to explain the neural and behavioral mechanisms.

Immunogenicity and Safety of the Higher Valent Pneumococcal Conjugated Vaccine Compared to the 13-Valent Pneumococcal Conjugated Vaccine in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract Introduction The immunogenicity of PCV15 and PCV20 in older adults was approved based on comparative data with PCV13, though their relative immunogenicity and safety in this population remain undetermined. A systematic review and meta-analysis were conducted to provide insights, addressing the lack of large-scale efficacy studies. Methods A phrase 2 or 3 randomized controlled trials evaluating immunogenicity of a single dose of either PCV15 or PCV20 in older adults by the opsonophagocytic assay (OPA) geometric mean titer (GMT) response at 1-month postvaccination compared to PCV13 were included in analysis. Results In total, eight trials were eligible. PCV15 group demonstrated superior immunogenicity compared to PCV13 among older adults (GMTR: 1.11, 95% CI: 1.02–1.20). The PCV20 group demonstrated non-inferiority (exceeded 0.5 at one-month post-vaccination) in immunogenicity compared to PCV13 (GMTR: 0.84, 95% CI: 0.81–0.87). The incidence of local and systemic reactions was higher in the PCV15 group compared to the PCV13 group, with risk ratios (RR) of 1.23 (95% CI: 1.14, 1.32) and 1.15 (95% CI: 1.02, 1.29), respectively. PCV20 are well tolerated and exhibit a comparable rate of local and systemic reactions to PCV13 group. Conclusions These findings support the immunogenicity and safety of PCV15 and PCV20 for pneumococcal vaccination in older adults. Given its superior immune response, PCV15 may address the gaps left by PCV13. Despite higher antibody levels, the clinical effectiveness of these vaccines remains uncertain. Ongoing surveillances are essential to evaluate both vaccines impact on remaining vaccine-type pneumococcal disease.

Perceived stress and death-related distress in older adults: Exploring the role of social support and emotional loneliness.

The purpose of this study was to examine whether emotional loneliness and social support mediated the association between perceived stress and death distress in older adults. The sample consisted of 524 older adults, aged between 65 and 88, living in an urban area in Türkiye (M = 70.05, SD = 5.01). Mediation analyses revealed that perceived stress is positively associated with death distress and emotional loneliness, and negatively associated with social support. Both social support and emotional loneliness mediate the relationship between perceived stress and death-related distress. Additionally, social support mediates the association between emotional loneliness and perceived stress with death distress in older adults. These findings underscore the importance of social resources in promoting mental health and well-being, and in mitigating the adverse effects of stress and loneliness on death-related feelings and thoughts in older adults. By providing emotional and practical assistance, social support can significantly enhance the mental health and well-being of older adults.

Internet use and self-rated health among Chinese older adults: the role of social engagement and social support

This study examines how social engagement and social support affect association between internet use and older adults' self-rated health in Kunming. An analysis of 518 community-dwelling older adults reveals that internet use significantly enhances their self-rated health. Social engagement mediates this relationship, while social support strengthens the beneficial impact of social engagement on self-rated health. Additionally, social support amplifies the mediating role of social engagement, suggesting that greater social support enhances the benefits of social engagement on health outcomes. Our findings emphasize the significance of fostering social engagement and providing robust social support to improve older adults' health.

Sense of belonging and its positive association with physical activity levels and negative association with sedentary behaviors in residential aged care facilities in COVID-19 pandemic: a longitudinal study

IntroductionThe COVID-19 pandemic reduced physical activity levels and increased sedentary behavior among older adults in residential care facilities. Another effect of this crisis was that facilitating a sense of social belonging through in-person social activities, such as group exercises or communal meals, became difficult. This study examines the relationship between physical activity, sedentary behavior, and sense of social belonging in older adults.MethodsThis longitudinal study, which lasted 10 months, involved 57 older adults in residential care facilities. Participants completed the Échelle de mesure du Sentiment d’Appartenance Sociale (ESAS) questionnaire three times and wore an accelerometer on their waists for 1 week each time to measure sedentary time and physical activity levels. The ESAS questionnaire, a validated tool for evaluating social belonging in older adults, measures social belonging through a series of questions that assess an individual’s feelings of acceptance and intimacy within their social group.ResultsParticipants were predominantly sedentary (7.30 h/day) and engaged in low-intensity physical activities (2.9 h/day). They did not meet the recommended 150 min/week of moderate-to-vigorous physical activity. The sense of social belonging was high, with mean scores of 6.75 (ESAS), 7.08 (Acceptance), and 6.43 (Intimacy). Light physical activity was negatively associated with sedentary time. The sense of social belonging was positively associated with light physical activity and negatively correlated to sedentary time.ConclusionThis study underscores the importance of light physical activity and a sense of social belonging in reducing sedentary behavior among older adults in residential care facilities. By promoting social interactions and light physical activity, we can enhance the well-being of this population, especially during pandemic conditions. The study’s findings should inspire future interventions to focus on these aspects, thereby improving health outcomes in residential care facilities for older adults.

Inverse association between dietary flavonoid intake and nocturia in middle-aged and older adults from NHANES 2007–2010

Nocturia is an increasingly prevalent chronic disease that affects the quality of an individual’s life. The prevalence of nocturia exceeds 50% among older adults in the U.S. Inflammation and oxidative stress are considered potential factors affecting nocturia, according to prior research. Flavonoids have attracted considerable interest due to their anti-inflammatory, antioxidant, and anti-aging properties. The association between flavonoid consumption and nocturia has been rarely investigated. For this cross-sectional study, we selected 5926 middle-aged and older adults over 40 from the 2007–2010 National Health and Nutrition Examination Survey (NHANES). Daily dietary flavonoid consumption was assessed through two 24-hour dietary recall interviews and the principal outcome was assessed based on a standardized questionnaire administered by trained interviewers. Weighted multivariate logistic regression and stratified analysis were employed to evaluate the impact of dietary total flavonoid consumption on nocturia. Restricted cubic spline (RCS) was utilized to explore whether there is a non-linear association between total flavonoid intake and nocturia. In addition, we performed weighted logistic regression and weighted quantile sum (WQS) regression by six flavonoid species (isoflavones, anthocyanins, flavan-3-ols, flavanones, flavonoids and flavonols) to estimate a combined mixture sum effect as well as the contribution of each mixture component. Subgroup analysis help us identify heterogeneity in these relationships and enhances the applicability of the research findings across different groups. After fully adjusting for confounders, weighted logistic regression models indicated that dietary flavonoid intake was significantly associated with a decreased prevalence of nocturia (OR: 0.93; 95% CI: 0.88-1.00, P-value = 0.036). This trend remained significant in the analysis stratified by quartile level of flavonoid intake. RCS analysis demonstrated an inverse linear correlation between total flavonoid consumption and nocturia. Analysis conducted through quartile stratification of six flavonoid species and WQS regressions showed that anthocyanins, flavan-3-ols, and flavonols were crucial elements. Within these subclasses, Peonidin in anthocyanins, Catechin and Theaflavin-3,3’-digallate in flavan-3-ols, and Isorhamnetin, Kaempferol, and Quercetin in flavonols were also investigated and may have contributed significantly. Our study revealed an inverse association between dietary flavonoid intake and nocturia in middle-aged and older adults, and anthocyanins, flavan-3-ols and flavonols were protectively associated with nocturia.

Use and Discontinuation Rates of Long-Acting Injectable Antipsychotics Between Race/Ethnicity in Older Adults Using Medicaid Databases.

The primary objective of this study was to assess the prescribing patterns of long acting injectable (LAI) antipsychotics in an older adult population. Secondary objectives were to determine if there were differences in treatment discontinuation rates between different LAI agents and race/ethnicity. Merative MarketScan Multi-State Medicaid Databases (2017-2021) were used to identify patients 65 years or older who were prescribed a LAI antipsychotic. Pharmacy claims for LAI antipsychotics were referenced via National Drug Code (NDC) by brand/generic name and dose. International Classification of Diseases, 10th edition (ICD-10) codes were used to identify older adults diagnosed with schizophrenia, schizotypal or schizoaffective disorders. Those with dementia or related disorders were censored. Conditional associations between race/ethnicity and generation of LAI antipsychotics were investigated using logistic regression controlling for age, sex, and health plan. Cox proportional hazard regression was used to compare the distribution of time until treatment discontinuation among older adults across LAI antipsychotics. A total of 526 older adults (59% female) with an average age of 70.4 ± 5.5 years met inclusion for analysis. The most commonly used LAI antipsychotics included paliperidone palmitate-1 month formulation (~35%), haloperidol decanoate (~24%), and risperidone microspheres (~15%). Overall, approximately 32% received LAI first-generation antipsychotics and 68% received LAI second generation antipsychotics. Blacks (n = 204) received LAI first-generation antipsychotics more often than Whites (n = 283); (OR: 1.74, 95% [1.18, 2.56], p < 0.01). When controlling for age, sex, and race/ethnicity, LAI first-generation antipsychotics showed earlier discontinuation rates compared to LAI second-generation antipsychotics (HR: 2.12, 95% CI [1.45, 3.10], p < 0.001). LAI first-generation antipsychotics showed treatment discontinuation significantly earlier compared to LAI second-generation antipsychotics. Furthermore, Blacks were prescribed LAI first-generation antipsychotics at a higher rate than Whites, which may contribute to poorer health outcomes. Futures studies are needed to establish a causal relationship.

Associations of Accelerometer-Measured Physical Activity With Dementia, Anxiety, and Depression Among Older Adults.

Higher physical activity (PA) is associated with better neuropsychiatric health, but prior studies have been limited by cross-sectional designs, self-reported PA measures, and small numbers of older individuals. We examined associations between baseline and changes in accelerometer-measured moderate-vigorous PA (MVPA) with neuropsychiatric health among individuals aged ≥ 70 years in the National Health and Aging Trends Study. We used the average daily minutes of accelerometer-measured MVPA above a validated threshold of 2184 counts per minute as a continuous measure at baseline for the exposure variable. For longitudinal analyses, we categorized change in MVPA as follows: an increase of > 20 min/day over 1 year, a decrease of > 20 min/day over 1 year, and staying within 20 min/day over 1 year. Our outcomes were possible/probable dementia and anxiety or depression. Associations were estimated using confounder-adjusted logistic regressions. In our survey-weighted analytic sample of 639 individuals aged ≥ 70 years, 56% were ≥ 75 years, and 53% were female. After adjusting for confounders, a 20-min/day higher baseline MVPA was significantly associated with lower odds of possible/probable dementia 1 year later (odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.83-0.96) but not with depression and anxiety symptoms. Compared to no change in PA over 1 year, an increase in MVPA by > 20 min/day was associated with decreased odds of depression and anxiety symptoms (OR = 0.06, 95% CI = 0.03-0.14) but not with possible/probable dementia. Compared to no change in MVPA over 1 year, a decrease in MVPA by > 20 min/day was associated with higher odds of possible/probable dementia (OR = 3.82, 95% CI = 1.34-10.87) but not with depression and anxiety symptoms. Higher and increasing MVPA over time is associated with better neuropsychiatric health in individuals aged ≥ 70 years. Future studies should prioritize evaluating detailed PA trajectories to better understand how different doses, intensities, and modalities of PA impact neuropsychiatric decline in older adults.

Adverse childhood experiences and elder abuse victimization nexus: A systematic review and meta-analysis.

Adverse childhood experiences (ACEs) are important life course events that can influence elder abuse victimisation (EAV) among older adults. This systematic review and meta-analysis aimed to provide synthesised and consolidated evidence on the existing associations between ACEs and EAV. A systematic search was conducted across six databases, including PubMed, PsycINFO, CINAHL Complete, Scopus, Google Scholar, and the Web of Science. All studies that addressed associations between ACEs, in singular or multiple form, and EAV were included in the review. Meta-analysis of the extracted odds ratios (ORs) and confidence intervals (CIs) was conducted using the common-effect inverse-variance model. Nine studies (cross-sectional design = 7; cohort design = 2) met the inclusion criteria. Included studies examined multiple ACEs and multiple EAVs associations (N = 3); at least single ACE and multiple EAVs (N = 3); any single form of ACE and multiple EAVs (N = 3); multiple ACEs-any single form of EAV nexus (N = 2); multiple ACEs-financial elder abuse association (N = 2); and multiple ACEs-physical elder abuse nexus (N = 2). Pooled ORs and CIs showed statistically significant results for all ACEs and EAVs associations whether in singular or multiple form. The results indicate that interventions designed to reduce ACEs, in singular or multiple form, early in life targeting residential and community-dwelling older adults may be relevant in reducing the incidence of EAV. The life course perspective s be integrated into the planning for support services for children, families, and older adults to prevent EAV in singular or multiple forms in later life.

The promises and perils of a free rural inter-city transportation scheme: A mixed-methods study from Northern Saskatchewan

Abstract Objective Transportation is a critical health determinant, yet the last decade has witnessed rapid disinvestment across Canada (particularly in rural contexts) with negative health consequences. We sought to explore and describe the benefits and challenges faced in operating the first community-driven free-transportation scheme in Saskatchewan that emerged in response to widespread unavailability of public transportation due to budget cuts (austerity). Methods We conducted a mixed-methods community-based participatory research study involving 22 interviews with bus riders and service administrators. We also performed descriptive statistics and chi-squared analyses on bus rider data (data on 1185 trips routinely collected between July 2023 and December 2023) to explore sociodemographic characteristics and trip purposes of bus riders. Results All trips were completed by 616 community members using the free bus service between July 2023 and December 2023. Community members took an average of 5 trips (median = 2.0) with a maximum of 22 trips being taken by one community member (1.9% of all trips). Most trips were by women (53%), and older adults mostly used the free bus for medical purposes (22% of riders were older adults and 34% of these used the bus for medical reasons). Qualitatively, the bus service has increased access to care and promotes social participation and autonomy, especially for older adults. The service however faces some challenges, including funding disruptions and difficulty recruiting and retaining drivers. Conclusion Free inter-community transportation (i.e. transportation across cities and municipalities) promotes health equity and access. In contexts without access to public transportation, governments could support community-driven initiatives through increased funding.

Montefiore Einstein Robust Geriatric Normative Project: Robust Age- and Regression-Based Demographic Norms for the Repeatable Battery for Neuropsychological Status and Select Neuropsychological Tests in Older Adults.

This study introduces the Montefiore Einstein Robust Geriatric Normative Project (MERGER-NP), which provides robust normative data for older adults on the Repeatable Battery for Neuropsychological Status (RBANS) and other select neuropsychological tests. Age-stratified and regression-based demographic norms were derived from a robust sample of older adults (n = 420, mean age = 75.55, 68% female). The study included assessments using the RBANS, Trail Making Test, Digit-Symbol Coding, a 15-item version of the Boston Naming Test, and verbal fluency tests, along with word reading measures. Regression-based norms were generated by analyzing predictors of test performance, integrating demographic variables and measurable social determinants of health (SDOH), specifically word reading ability and occupational attainment. Normative data include convenient look-up tables for the RBANS and other tests. Findings indicate that word reading measures significantly predict neuropsychological performance, accounting for up to 41% of the variance when included with demographic variables. Notably, our analyses revealed that race often did not contribute unique variance when controlling for reading ability. Additionally, occupation was identified as a significant predictor of test performance, with Job Zone scores retained in approximately 60% of regression models. The MERGER-NP enhances existing normative data by integrating robust norms with regression-based methods, facilitating more precise assessments for older adults. The findings underscore the utility of including SDOH such as reading ability and occupation into normative approaches, with important implications for improving diagnostic accuracy and patient care in clinical settings. Future research should explore the generalizability of these norms to more diverse populations.

Correlation between blood pressure control status and cognitive impairment in older adults: A national cross-sectional study.

Hypertension is closely related to cognitive impairment; however, the correlation between blood pressure control and cognitive impairment in the hypertensive population is unclear. We aimed to explore the relationship between blood pressure control and cognitive impairment in older adults with hypertension. Using the cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, 5,860 people with self-reported history of hypertension were divided into the hypotension, intermediate blood pressure, and hypertension groups. Cognitive impairment was defined as a score of < 18 on the Chinese version of the Mini-Mental State Examination. Demographics of the population were also collected. Bivariate Logistic regression analysis and restricted cubic spline (RCS) model were used to analyze the relationship between blood pressure control and cognitive impairment. After adjusting for confounding factors, binary logistic regression analysis showed that the intermediate group was significantly associated with an increased risk of cognitive impairment than the hypotension group, whereas the hypertension group was significantly correlated with a reduced risk of cognitive impairment. No significant correlation was found between blood pressure control and cognitive impairment in patients aged <80 years, with hearing impairment, or with cerebrovascular diseases, whether in the hypotension or hypertension groups. There was a significant correlation between hypotension and cognitive impairment, and no correlation between hypertension and cognitive impairment in people aged ≥ 80 years, Han ethnicity and those who used antihypertensive drugs. Furthermore, RCS model analysis showed that there was a non-linear relationship between systolic blood pressure and cognitive impairment in individuals aged ≥ 80 years and those using antihypertensive drugs. There was a linear relationship between diastolic blood pressure and cognitive impairment. Blood pressure control in the hypertensive group was significantly associated with a lower risk of cognitive impairment.

The relationship between visceral adipose tissue and osteoarthritis among older adults: evidence from the NHANES 1999–2018

ObjectivesThis study aimed to assess any possible links between visceral fat accumulation and an elevated prevalence of osteoarthritis (OA) in the elderly.Methods3,779 subjects aged 65 years or older from the National Health and Nutrition Examination Survey (NHANES) 1999–2018 were finally included, of whom 516 had OA. The identification of patients diagnosed with OA was conducted using questionnaire data. The visceral adiposity index (VAI) was computed utilizing body mass index (BMI), waist circumference (WC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). To investigate the relationship between VAI and OA, weighted multivariable logistic regression analysis, restricted cubic spline (RCS), subgroup analyses, and interaction tests were carried out.ResultsMultivariate logistic regression analysis showed that the increase in VAI is accompanied by an increased prevalence of OA after fully correcting for variables. The top quartile of VAI had a prevalence that was 110% higher than the lowest quartile. A non-linear positive correlation between VAI and OA was found in the RCS.ConclusionThis study suggests a potential correlation between elevated VAI and increased prevalence of OA in older adults, and that lowering VAI may have an impact on the prevalence of OA.

Frequency and Intensity of Depressive Symptoms and Frequency of Prescribed Opioid Use Among Older Adults in the United States: Results of a National Survey.

As part of the opioid crisis, opioid overuse is increasing in U.S. older adults. However, research on granular measures of depressive symptoms and opioid use exclusively in this population are limited. Using data from the 2020 National Health Interview Survey, we constructed multivariate logistic and multinomial logistic regression models to examine the association of frequency and intensity of depressive symptoms with frequency of prescribed opioid use. The study population consisted of 8,637 participants with a mean age of 74.3 (SD = 6.4) years. Sixteen percent of the participants used prescribed opioids. Compared with participants who never felt depressed, those who felt depressed daily (OR = 1.796, 95% CI [1.371, 2.337]), weekly (OR = 1.579, 95% CI [1.236, 2.003]), or a few times a year (OR = 1.237, 95% CI [1.077, 1.418]) had increased odds of prescribed opioid use. Compared with participants who felt a little depressed, those who felt depressed somewhere in between a little and a lot (OR = 1.538, 95% CI [1.283, 1.842]) and those who felt depressed a lot (OR = 1.784, 95% CI [1.336, 2.274]) had increased odds of prescribed opioid use. Compared with participants who never felt depressed, those who felt depressed weekly (OR = 2.295, 95% CI [1.012, 5.204]) and those who felt depressed monthly (OR = 2.385, 95% CI [1.051, 5.409]) had increased OR of using prescribed opioid every day from using prescribed opioid some days. Frequency and intensity of depressive symptoms were independently and positively associated with prescribed opioid use.