Young-old Adults Research Articles

Is There a Link Between Older Adults' Frequency of (Face-to-Face and Remote) Contact with Grandchildren and Cognitive Functioning over 12 Years?

Past research has linked more frequent social contacts with better cognition and slower cognitive decline in older adults. An open question is whether face-to-face and remote contact with one's grandchildren can be beneficial. We analyzed data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) covering a span of 12 years and two age cohorts (young-old < 78, N = 1100; old-old ≥ 78 years, N = 705). We used latent growth curve models, to examine whether frequency of face-to-face or remote grandchild contact was associated with cognitive levels and decline and applied (random intercept) cross-lagged models to investigate if these associations were reciprocal. Face-to-face contact with grandchildren was positively linked to levels of cognition in young-old adults only. We found no associations with cognitive decline. Results of cross-lagged models suggested that grandparents with better cognition had more face-to-face (for young-old adults only) or remote (for old-old adults only) grandchild contact at subsequent waves. However, more grandchild contact was not associated with later cognition. Our findings suggest that grandparents with better cognition engage more with their grandchildren, but that frequency of grandchild contact is not a protective factor against later cognitive decline in older adults.

DiaBetter Together: Clinical trial protocol for a strengths-based Peer Mentor intervention for young adults with type 1 diabetes transitioning to adult care

BackgroundType 1 diabetes (T1D) management is challenging for young adults, who are expected to transfer from the pediatric to adult T1D healthcare system while also managing typical developmental demands (e.g., social, financial, work/school, residential). Many young adults have extended gaps in care before following up in adult care, increasing risk for poor health outcomes. There are few evidence-based programs to support young adults with T1D to promote a timelier transition during this period. This paper reports on the design of DiaBetter Together, a randomized controlled trial to evaluate a 12-month Peer Mentor-delivered intervention compared to usual care among young adults with T1D during the transfer from pediatric to adult care. MethodsOne-hundred young adults (age 17–25) with T1D and 29 Peer Mentors enrolled in this randomized clinical trial. Peer Mentors are experienced, older young adults with T1D, trained by the study team to share transition experiences and strategies to successfully navigate the adult healthcare system, help young adults prepare for the first adult care visit, and use strengths-based support strategies to teach and model skills for managing T1D-related challenges. ResultsThe primary outcome of the trial is HbA1c, and secondary outcomes include time to adult care, engagement in diabetes self-management behaviors, and psychosocial well-being. ConclusionThe goal of this research is to evaluate a developmentally appropriate, supportive intervention that can improve T1D self-management and successful transfer of care during the difficult young adult years and promote optimal T1D health outcomes.

Characteristics of falls in Japanese community-dwelling older adults.

Understanding the characteristics of falls among older adults is necessary to prevent them. These characteristics include questions such as when (month and time), where (places), who (age), what (injury), why (trigger), and how (direction) the falls occur. The objective of this study was to identify the characteristics of falls in individuals aged 65-74 years (young-old), 75-84 years (old-old), and ≥85 years (oldest-old). We conducted an observational mail survey among community-dwelling older adults in Japan and collected detailed information on the incidence of falls over the past 3 years. The month, time, location, trigger, direction, and resulting trauma of each fall were analyzed and compared across the different age groups (young-old, old-old, and oldest-old). A total of 1695 falls among 1074 community-dwelling older adults were analyzed in this study. Falls were frequent during May and October as well as during the winter season from December to February, especially between 10:00 a.m. and 11:00 a.m. These fall characteristics were consistent across all the age groups. There was a higher incidence of outdoor falls among relatively young older adults, which were typically caused by tripping or slipping. However, as one progresses with age, there is a higher incidence of falls indoors, typically due to loss of balance or leg entrapment. Approximately 60% of older fallers experience some form of injury due to falls, with fractures considered the most serious, occurring in ≈10% of all falls. We clarified the characteristics of falls including the "when, where, who, what, why, and how" of the fall. A future challenge is to use this valuable information to develop effective fall prevention programs for older populations worldwide. Geriatr Gerontol Int 2024; ••: ••-••.

Weight loss rather than weight gain has a detrimental effect on successful aging in older adults: A 4-year longitudinal study in China

This study explored the effect of weight change on successful aging in older adults. A total of 1865 adults (≥65 years) were divided into the weight gain group (weight gain ≥5 %), the weight loss group (weight loss ≥5 %), and the weight stable group (weight change <5 %) according to weight changes over 4 years. Results showed that compared to the stable weight, the weight loss is associated with a lower rate of successful aging (OR=0.64, 95 % CI: 0.49-0.83), and the association was found greater in women (OR=0.61, 95 % CI: 0.43-0.86) and young-old adults (OR=0.66, 95 % CI: 0.41-0.88) than their counterparts. However, no significant association was found between weight gain and successful aging. The findings suggest that weight loss rather than weight gain in older adults has a detrimental impact on successful aging, and this detrimental impact is greater in women and young-old adults.

Transition of Physical, Psychological, and Cognitive Frailty and Its' Associated Determinants in Malaysian Older Adults: A 5-Year Follow-up Study.

Frailty, a multifaceted syndrome, affects approximately 26% of older adults globally, yet there are limited data on the prevalence and longitudinal impact of frailty subtypes. Therefore, in this study, we aim to determine the prevalence of physical, psychological, and cognitive frailty, transitions between subtypes, and associated health determinants among Malaysian community-dwelling older adults. This study is part of the longitudinal aging study in Malaysia (LRGS Ageless and TUA). We assessed 815 older adults in 2014, with successful follow-up of 402 participants (mean age: 67.08 ± 5.38 years) after 5 years. Frailty subtypes were assessed at baseline, and transitions were evaluated at the 5-year mark. At baseline, the prevalence of older adults categorized as robust, physical frailty, cognitive frailty, and psychological frailty was 26.7%, 36.3%, 12.1%, and 16.7%, respectively, with 8.1% exhibiting concurrent psychological and cognitive frailty. Follow-up results showed that 22.9% remained robust, 46.8% experienced no change, 24.9% deteriorated (adversed), and 5.5% improved (reversed). Logistic regression analysis identified living alone (p < 0.001), increased body fat percentage (p < 0.05), increased waist circumference (p < 0.05), reduced fat-free mass (p < 0.05), decreased lower limb flexibility (p < 0.05), and declined cardiorespiratory fitness (p < 0.05) as significant predictors of frailty deterioration. Higher Mini Mental State Examination (MMSE) scores and improved Timed Up and Go and Chair Stand test results (p < 0.05) were significantly associated with the reversal of frailty subtypes (p < 0.05). Younger older adults (p < 0.001), males (p < 0.05), those with lower WHO Disability Scale scores (p < 0.05), and higher MMSE scores (p < 0.05) were significantly less likely to develop frailty subtypes. Intervention strategies that focus on combined physical, cognitive, and psychosocial functions are crucial for both reversing and preventing the progression of frailty subtypes in older adults.

Association between the Kihon Checklist and Working Status among Young-Old Citizens: A Cross-Sectional Study.

Owing to increasing super-aging societies, older adults will be encouraged to continue working. Although demand exists for older adults to continue working in Japanese society, the enabling factors have not been clarified. This study aimed to clarify (1) the life functions that affect the working status among younger-older adults who continue to work and those who do not via the Kihon Checklist (KCL) and (2) examine whether the number of areas of difficulties in daily functions of the KCL affected older adults' employment status. This cross-sectional study involved 5386 older men and women aged 65 years or older in one city in Japan. Employment status and the seven domains of the Kihon Checklist (KCL) were analyzed. The KCL items related to employment status were the physical (odds ratio = 2.46, p < 0.01), socialization (odds ratio = 1.95, p < 0.01), and mood domains (odds ratio = 1.29, p < 0.01). Furthermore, the odds ratio increased to 2.06 when three or more domains were applicable. To remain employed, one must be physically and mentally healthy. Furthermore, since the risk of non-employment increased when one KCL domain was applicable, a broader assessment of life functions is necessary.

The Life-Space Mobility of Community-Dwelling Older Adults is Associated With Personality Traits.

Life-space mobility (LSM) in older adults is influenced by physical, cognitive, and psychological states. However, the relationship between LSM and personality traits remains unclear. Thus, our cross-sectional study investigated this correlation, which included 144 participants aged ≥60years. LSM was assessed using the life-space assessment (LSA), and personality traits were evaluated using the Japanese version of the Ten-Item Personality Inventory (TIPI-J). Physical data were also collected. Univariate analyses revealed that among young-older adults, extroversion in the TIPI-J showed a significant association with LSA scores in addition to handgrip strength. Among old-older adults, openness to experience in the TIPI-J demonstrated a significant association with LSA scores in addition to quadriceps strength. This study revealed correlations between personality traits (extroversion and openness to experience) and LSM, in addition to physical function. Considering older adults' personality traits is crucial for designing support and interventions to maintain and expand LSM.

Neuropsychological and psychiatric outcomes among community-dwelling young Chinese older adults affected by falls in the past year with and without vision impairment.

This study was to investigate the differences between young older adults with and without vision impairment on neuropsychological and psychiatric outcomes following falls during the past year and to identify predictors of cognitive decline or mental distress. A secondary analysis of 668 young older Chinese adults aged 65 ∼ 79 years old with a history of falls was conducted from the cross-sectional survey data in the 2018 wave of the Chinese Longitudinal Health Longevity Survey (CLHLS). Participants with vision impairment scored significantly higher on anxiety and depression and lower on cognitive function and SWB than those without vision impairment. And vision impairment was a significant predictor of adverse outcomes for all four neuropsychological and psychiatric measures. Neurocognitive deficits, psychological problems, and decreased self-sufficiency are quite common among community-dwelling older adults with visual impairment who have a history of falls within a year.

Synergistic impact of plasma albumin and cognitive function on all-cause mortality in Chinese older adults: a prospective cohort study.

Hypoalbuminemia and cognitive impairment (CI) each independently increase the mortality risk in older adults. However, these two geriatric syndromes can occur simultaneously. In community-dwelling older adults, is the combination of hypoalbuminemia and CI linked to a higher mortality risk than either condition alone? We aimed to investigate the association between plasma albumin, cognitive function, and their synergistic effect on mortality in Chinese community-dwelling older adults. Data from the Chinese Longitudinal Healthy Longevity Survey (2012) included 1,858 participants aged ≥65. Baseline assessments comprised albumin levels and cognitive status. All-cause mortality was confirmed through 2014-2018 surveys. Cox proportional hazards models assessed associations, and restricted cubic splines explored albumin-mortality relationship. During a median follow-up of 48.85 months, 921 deaths. Albumin≥35 g/L vs < 35g/L [HR: 1.33 (95%CI, 1.10, 1.62)] and CI vs normal cognition [HR: 1.69 (95%CI, 1.43, 1.99)] independently predicted mortality. A dose-response relationship with mortality was observed for albumin quartiles (p < 0.001). Each SD increase in MMSE or albumin correlated with 22% and 15% lower mortality risk, respectively. Combined hypoproteinemia and CI increased the mortality risk by 155%, with a notably higher risk in males, those aged <85 years, and individuals living in rural areas. Interaction effects of albumin and CI on mortality were observed (p < 0.001). In the single CI group, older adults had a 61% increased risk of mortality in the hypoproteinaemia group compared with the albumin-normal group. Restricted cubic spline revealed a reverse J-shaped association, particularly for participants without CI. For individuals with CI, albumin levels were inversely associated with mortality risk. Hypoproteinemia and CI, individually and combined, increased all-cause mortality risk in Chinese older adults, with stronger effects observed in males, younger older adults, and those living in rural areas. These findings emphasize the importance of targeted adjustments and early nutrition programs in health prevention and clinical care for older adults.

Younger Older Americans and Sarcopenic Obesity: The Moderating Role of Living Alone.

Previous studies have indicated that compared to older adults, younger older adults (e.g., baby boomers) are more susceptible to obesity, but their risk decreases as they age. However, there is a lack of research on how individuals experience sarcopenic obesity, which increases in later life and is a mortality risk factor. This study examined how younger cohorts of older Americans and their demographic traits are related to sarcopenic obesity. Generalized estimating equations were used to analyze participants aged 65 years and older, stratified by sex using data from the 2006-2016 Health and Retirement Study, with survey weights (n = 2,896 men and n = 4,268 women). The findings indicate that the youngest cohort (born between 1948 and 1953) had greater odds of sarcopenic obesity than older cohorts (born before 1931). However, the youngest cohort did not have significantly different risks from those born between 1931 and 1947. Unexpectedly, the youngest cohort of older women living alone tended not to have sarcopenic obesity compared to the older cohorts living alone. These results remained significant even after adjusting for various covariates, including marital status, race, education level, wealth, and other factors. This paper contributes to the existing literature on population health and demographic change in 2 ways. First, the risk of sarcopenic obesity is higher among younger cohorts of older Americans relative to older cohorts (born before 1931). Second, living alone may not necessarily be considered a worse health condition, particularly for younger female cohorts.

Psychometric Properties and Measurement Invariance of the Awareness of Age-Related Change Short Form in Older Adult Samples From Taiwan and Germany.

This study examined the psychometric properties and measurement invariance of the 10-item Awareness of Age-Related Change Short Form (AARC-SF) questionnaire in a Chinese-speaking sample of older adults in Taiwan. Data from 292 participants (Mage = 77.64 years) in the Healthy Aging Longitudinal Study in Taiwan cohort were used for Study 1, whereas data from young-old adult samples in Germany were used for Study 2. Study 1 showed that the AARC-SF had satisfactory reliability and validity for assessing adults' AARC in Taiwan. Analyses confirmed the 2-factor structure of AARC-gains and AARC-losses. Study 2 demonstrated strong measurement invariance across men and women, whereas direct comparisons of the item scores between young-old adults and old-old adults need to be made with caution. Noninvariance of loadings indicated that certain items were more closely linked to AARC-gains and AARC-losses in Taiwan than in Germany. Noninvariance of intercepts suggested potential biases in comparing item scores between Taiwanese and German older adults. The AARC-SF emerged as a reliable and valid instrument for capturing positive and negative subjective aging experiences among Taiwanese older adults. However, it is noteworthy that some items on the AARC-SF may solicit different responses from individuals of different ages and different countries of origin, requiring caution with age group and cross-cultural comparisons.

Older adults' online activities and cognition: Investigating the psychological mechanisms and age and gender differences

ObjectivesThis study aimed to investigate psychological mechanisms underlying the association between older adults' Internet use and cognition and examine potential age and gender group differences. Methods2064 older participants were extracted from the Waves 2012, 2013, and 2016 Health and Retirement Study. Internet use was measured by two sets of variables: Internet access and different types of online activities (i.e., informational use, social use, online shopping, and online banking). Path analyses were applied to test the proposed mechanisms via three mediators (i.e., loneliness, depressive symptoms, and perceived control). Multi-group analyses were conducted to examine the potential group differences. ResultsInternet use was positively associated with cognition. Despite the large direct effect, small but significant indirect effects via depressive symptoms and perceived control were identified across all online activities. Multi-group analyses revealed age-group differences in the mechanisms: depressive symptoms mediated the effects of all online activities on cognition among young-old adults, while perceived control mediated all the effects among old-old adults. Gender group differences were also identified: depressive symptoms mediated the effects of all online activities on cognition among older women and most online activities among older men, whereas perceived control mediated the associations between informational and instrumental (i.e., online shopping and banking) use and cognition among older men. DiscussionThis study highlights the mediating effect of depressive symptoms and perceived control and age and gender differences regarding the Internet use-cognition association. Internet-based cognitive interventions should consider these psychological mediators and age and gender differences for the best results.

Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach

ObjectivesThere is no precedent for the use of social media in preventing sarcopenia. The aim of this study is to develop a social media-based intervention programme for the young-old population in the community in China to improve their awareness and behaviours regarding sarcopenia prevention. Study designUsing guidelines for developing complex interventions, this study was divided into two main phases: a co-development phase and a preliminary test phase. Both were carried out in Changsha, China. The development phase employed co-design methodology with relevant stakeholders, including two rounds of consultation with patient and public involvement (12 members) and two rounds of focus groups (30 participants); this was followed by the three-week preliminary test phase (22 participants). Main outcome measuresThis study evaluated the consultation with patient and public involvement, and mainly collected qualitative data from the two rounds of focus group interviews and a final semi-structured interview following the preliminary test, so as to explore the participants' experiences, comments, and suggestions for revising the social media-based intervention. Handgrip strength was also evaluated. ResultsThe health education included seven videos of 4–6 min each related to sarcopenia, including information on the concept, influencing factors, adverse effects, manifestations, screening methods, and preventions. The exercise video consisted of four types of training (warm-up, aerobic, resistance, and flexibility training) and lasted 30 min, with a suggested engagement of at least 3 days/week. The specific contents and “dosage” of the final intervention were unanimously favourable to the diverse stakeholders involved (older adults with possible sarcopenia, experts, researchers). After the preliminary test, an improvement in handgrip strength was observed, from M15.92±SD5.22 kg to M19.13±SD5.44 kg (T = −5.44, P < 0.001). Subgroup analysis revealed that this improvement was evident in both men and women. ConclusionsThe social media-based intervention was universally endorsed by the participants and showed indications of a positive influence on sarcopenia. A feasibility study is now needed.

노인의 죽음 준비 잠재유형과 웰다잉 인식

Although social awareness of the importance of well-dying has increased, empirical evidence for well-dying policies and programs is very scarce. Additionally, there is limited research examining whether perceptions about dying well vary by the types of end-of-life preparation. Accordingly, this study sought to classify the end-of-life preparation among older Korean adults and verify differences in perceptions about well-dying according to subgroups. For this, older Korean adults aged 65 and above who participated in ‘2020 National Survey of Older Koreans’ were analyzed by dividing them into three groups: 5,977 young-old adults (65-74 years old), 3,333 old-old adults (75-84 years old), and 610 oldest-old adults (85 years old and above). End-of-life preparation was measured by four questions in the ritual aspect (e.g., preparing shrouds or funeral portraits), two questions in the psycho-social aspect (e.g., attending educational programs and writing a will), and two questions in the medical aspect (e.g., writing advance directives and pledging to donate organs). Perceptions about well-dying were measured using four items, assessing the importance of dying autonomously, without pain, in the company of family and acquaintances, and without burdening those around them. For statistical analysis, a three-stage latent class analysis and difference test which accounted for classification errors were conducted. As a result of the analysis, the young-old adults were classified into the ‘active preparation’ group, which showed a relatively active level of preparation, and the ‘no preparation’ group, which lacked preparation for end-of-life in all dimen sion s. The old-old and oldest-old adults were classified into the ‘active preparation’ group and the ‘passive preparation’ group, which was limited to end-of-life preparation only in the ritual aspect. In particular, the proportion of the ‘active preparation’ group in all generations was very low, ranging from 3 to 6%. The results of the difference test on perceptions of well-dying showed that among the young-old an d old-old adults classified into the ‘active preparation’ group, the scores for the importance of each item were significantly lower compared to those of the ‘no preparation’ or the ‘passive preparation’ groups. Among the oldest-old adults, the ‘active preparation’ group regarded end-of-life companionship with family and acquaintances as less important than the ‘passive preparation’ group. The results of this study suggest that the level of end-of-life preparation among older adults in Korea, from young-old to oldest-old, remains low and is predominantly focused on the ritual aspect. Furthermore, perceptions about well-dying vary according to the types of end-of-life preparation. The findings of this study underscore the need for tailored approaches in well-dying policies and programs, such as end-of-life preparation education, that consider the heterogeneity within the older population.

The prevalence and predictors of metabolic dysfunction-associated steatotic liver disease and fibrosis/cirrhosis among adolescents/young adults.

We investigated the current prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and fibrosis/cirrhosis and identified at-risk populations for MASLD and MASLD-related fibrosis among US adolescents and young adults in the United States. Utilizing the National Health and Nutrition Examination Survey 2017-2020, the prevalence of MASLD and fibrosis/cirrhosis was assessed via controlled attenuation parameter (CAP) score and liver stiffness measurements by transient elastography in participants aged 12-29 years with at least one cardiometabolic criteria and absence of other chronic liver disease. Multivariable logistic regression was performed to determine predictors of MASLD and MASLD-related fibrosis. The overall prevalence of MASLD was 23.9% (95% CI: 21.3-26.5 for CAP ≥ 263 dB/m) and 17.3% (95% CI: 14.7-20.0 for ≥285 dB/m), respectively. The prevalence of fibrosis and cirrhosis in MASLD was 11.0% and 3.1%, respectively. When categorized by age, the prevalence of MASLD varied from 16.8% (of which 6.2% [fibrosis], 1.8% [cirrhosis]) in early and middle adolescents (12-17 years), to 25.5% (11.8% [fibrosis], 4.8% [cirrhosis]) in late adolescents and young adults (18-24 years), and to 30.4% (of which 13.2% [fibrosis] and 2.1% [cirrhosis]) in older young adults (25-29 years). The independent predictors for MASLD included male sex, Hispanic, non-Hispanic Asian, body mass index, and low HDL-cholesterol. In contrast, diabetes and body mass index were associated with an increased risk of fibrosis in individuals with MASLD. The prevalence of MASLD and related fibrosis in adolescents and young adults in the United States has reached a significant level, with a substantial proportion of cirrhosis.

Socioeconomic differences in digital inequality among Chinese older adults: Results from a nationally representative sample.

The current study seeks to investigate digital inequality among older adults in China, specifically examining two socially defined age groups: young-old adults (aged 60-74) and old-old adults (aged 75+). Descriptive statistics and multiple regression were used to examine the prevalence of and identify the factors associated with Internet access, usage (frequency and breadth containing 11 activities), skills, and social support. The study used data from the 2018 China Longitudinal Ageing Social Survey (CLASS) which consisted of 11,419 respondents aged 60 years and older. We found that 40.22% of older adults had access to the Internet, and 18.27% used it regularly. Socioeconomic factors played a crucial role in determining Internet access and usage, with young-old adults with higher education using the Internet more frequently, deliberately, and competently. Those with higher economic status had greater social support to use it, and the old-old adults with higher socioeconomic status were more likely to have Internet access. This study has implications for prioritizing targeted policies and interventions aimed at supporting socioeconomically disadvantaged older adults and ensuring equal opportunities for all to access and benefit from the digital world.

Impact of age and apolipoprotein E ε4 status on regional white matter hyperintensity volume and cognition in healthy aging.

White matter hyperintensity (WMH) volume is a neuroimaging marker of lesion load related to small vessel disease that has been associated with cognitive aging and Alzheimer's disease (AD) risk. The present study sought to examine whether regional WMH volume mediates the relationship between APOE ε4 status, a strong genetic risk factor for AD, and cognition and if this association is moderated by age group differences within a sample of 187 healthy older adults (APOE ε4 status [carrier/non-carrier] = 56/131). After we controlled for sex, education, and vascular risk factors, ANCOVA analyses revealed significant age group by APOE ε4 status interactions for right parietal and left temporal WMH volumes. Within the young-old group (50-69 years), ε4 carriers had greater right parietal and left temporal WMH volumes than non-carriers. However, in the old-old group (70-89 years), right parietal and left temporal WMH volumes were comparable across APOE ε4 groups. Further, within ε4 non-carriers, old-old adults had greater right parietal and left temporal WMH volumes than young-old adults, but there were no significant differences across age groups in ε4 carriers. Follow-up moderated mediation analyses revealed that, in the young-old, but not the old-old group, there were significant indirect effects of ε4 status on memory and executive functions through left temporal WMH volume. These findings suggest that, among healthy young-old adults, increased left temporal WMH volume, in the context of the ε4 allele, may represent an early marker of cognitive aging with the potential to lead to greater risk for AD.

Trends in all-cause and cause-specific mortality in older adults with and without diabetes: A territory-wide analysis in one million older adults in Hong Kong

AimsDirect comparisons of population-level trends in all-cause and cause-specific mortalities among older adults with and without diabetes are lacking. MethodsWe performed a territory-wide analysis of 1,142,000 unique older adults aged ≥ 65 years (31.7 % with diabetes) with at least one attendance in the Hong Kong Hospital Authority in 2014–2018. We used Joinpoint regression to describe trends of age- and sex-standardised all-cause and cause-specific mortalities (cardiovascular disease [CVD], cancer, and non-CVD and non-cancer) in older adults with and without diabetes. ResultsAll-cause mortality decreased in older adults with (average annual percent change [AAPC] = -1.6, 95 % confidence interval [-2.7, -0.4]) and without (AAPC = -3.1 [-4.2, -2.1]) diabetes. Largest declines were seen for CVD-cause mortalities for people with and without diabetes (AAPC = -5.5 [-6.8, -4.1] vs AAPC = -5.8 [-8.6, -2.9], respectively). Cancer-cause mortalities were similar in both groups with no change. Men with diabetes showed less favourable improvements. An increasing mortality trend was seen only in the 65-69 age-group regardless of diabetes status. ConclusionsMortality continued to decline in older adults with and without diabetes, mainly driven by a decline in CVD deaths, with no narrowing of the mortality gap. Our findings call for continued actions to address excess mortalities especially in older men with diabetes and younger older adults.

The association of sleep duration and leukocyte telomere length in middle-aged and young-old adults: A cross-sectional study of UK Biobank

BackgroundThe relationships between sleep duration and aging-associated diseases are intricate. Leukocyte telomere length (LTL) is a biomarker of aging, while the association of sleep duration and LTL is unclear. MethodsThe 310,091 study participants from UK Biobank were enrolled in this cross-sectional study. Restricted cubic splines (RCS) analysis was firstly performed to assess the nonlinear relationship between sleep duration and LTL. Sleep duration was then categorized into three groups: <7 h (short sleep duration), 7–8 h (reference group), and >8 h (long sleep duration) and multiple linear regression was applied to analyze the association of short sleep and long sleep duration with LTL. We further performed subgroup analyses stratified by sex, age, chronotype and snoring. ResultsRCS showed an inverted J-shaped relationship between sleep duration and LTL. Compared with the reference group, the inverse association of long sleep duration and LTL was statistically significant in fully-adjusted model (P = 0.001). Subgroup analyses showed that this association was more apparent in people over 50 years (51–60 y: P = 0.002; >60 y: P = 0.005), in men (P = 0.022), and in people preferred evening chronotype (P = 0.001). ConclusionCompared with participants sleeping 7–8 h, those sleep longer than 8 h had shorter LTL in middle-aged and young-old adults. The negative association between long sleep duration and LTL was more apparent in older people, in men, and in people preferred evening chronotype.

Pitfalls and pearls in diagnosing inflammatory arthritis in older patients

Given current demographic shifts, the number of older adults continues to grow, with almost half of patients over 65 being diagnosed with some form of arthritis. Rheumatic diseases pose unique diagnostic challenges in older patients due to the convergence of physiologic changes of aging, confounding difficulties to care, and atypical disease manifestations. This review summarizes the current published evidence to guide clinicians in evaluating geriatric patients with rheumatologic concerns, focusing on inflammatory arthritis. Using the background of epidemiologic data on various musculoskeletal diseases, clinical presentations, current diagnostic tests, and known physiologic changes of aging, this review highlights five diagnostic pitfalls in inflammatory polyarthritis among older patients. The pitfalls include: 1) broader differential diagnosis; 2) atypical presentations; 3) communication, cognitive, and social impairments; 4) the role of chronological vs. biological age; and 5) anchoring bias by assuming older adults are simply “older young adults”. These pitfalls are discussed in the context of geriatric principles such as the “hallmarks of aging” and the expected pathophysiologic changes of organ systems. Furthermore, the review discusses the strengths and weaknesses of diagnostic tests used in arthritis and introduces some of the geriatric assessment tools that systematically evaluate multimorbidity and geriatric syndromes. With familiarity of the potential diagnostic pitfalls, knowledge of both normal and pathologic aging processes, awareness of the difference between biological and chronological age, and the ability to use geriatric assessment tools to better characterize older patients, clinicians will be better able to diagnose and manage rheumatic conditions in this population.