Part Of Healthy Aging Research Articles

The Impact of an Outdoor Motor-Cognitive Exercise Programme on the Health Outcomes of Older Adults in Community Settings: A Pilot and Feasibility Study.

Physical and cognitive exercises can prevent or at least mitigate the symptoms of certain diseases and help older adults perform a range of daily functions. Yet, most seniors do not meet the World Health Organisation's recommended guidelines for physical activity. The objective of this study is to promote and maintain the physical and cognitive capacity of older adults by implementing a feasible and effective low-threshold, age-appropriate, motor-cognitive training outdoors. In the German city of Chemnitz, citizens aged 60 years and older participated in a quasi-randomised intervention trial. Exercises to train coordination, strength, endurance, and cognition were integrated into a 12-week outdoor motor-cognitive exercise programme. Both the physical (e.g., 6MWT) and cognitive skills (e.g., TMT B) of the intervention group (n = 41) and control group (no intervention, n = 58) were measured before (T1) and after (T2) completion of the exercise programme. Some of the participants' physical and all their cognitive measures improved. Neurocognitive performance (DSST) showed a significant time × group interaction effect (F(1,95) = 6.943, p = 0.010, ηp2 = 0.068). Sex and age were found to be influencing factors. We consider our exercise programme to be successfully implemented, well received by the participants, and feasible and useful to promote the continued exercise of daily functions as part of healthy aging in community-dwelling older adults.

Do Not Go Gentle into That Deaf Night: A Holistic Perspective on Cochlear Implant Use as Part of Healthy Aging

Research suggests that cochlear implant (CI) use in elderly people improves speech perception and health-related quality of life (HRQOL). CI provision could also prevent dementia and other comorbidities and support healthy aging. The aim of this study was (1) to prospectively investigate potential changes in HRQOL and speech perception and (2) to identify clinical action points to improve CI treatment. Participants (n = 45) were CI recipients aged 60–90 with postlingual deafness. They were divided into groups, according to age: Group 1 (n = 20) received a CI between the age of 60–70 years; group 2 (n = 25) between the age of 71–90 years. HRQOL and speech perception were assessed preoperatively, and three and twelve months postoperatively. HRQOL and speech perception increased significantly within one year postoperatively in both groups. No difference between groups was found. We conclude that CI treatment improves speech perception and HRQOL in elderly users. Improvement of the referral process for CI treatment and a holistic approach when discussing CI treatment in the elderly population could prevent auditory deprivation and the deterioration of cognitive abilities.

MO588: Is The ‘Short-Form 12 Health Survey’ A Valid Assessment of Physical Function in People Living with Chronic Kidney Disease?

Abstract BACKGROUND AND AIMS Compromised physical function is well-recognised in chronic kidney disease (CKD) and is associated with reduced quality of life (QoL) and poor outcome. CKD is often considered to be the model of ‘accelerated aging,’ thus quick and reliable measurements of physical function are essential as part of healthy aging in the CKD population. However, monitoring physical function via objective assessments can be impractical in clinical and some research settings. The ‘Short-Form 12 Health Survey’ (SF-12) is a commonly used self-report instrument to assess the quality of life, and it has also been used to assess physical health and function through its physical component subscale (PCS), and the physical function domain (PF). However, the validity of the SF-12 against objective physical function tests is unknown. In this analysis, we aimed to validate the SF-12 against multiple objective physical function measures. METHOD Forty-six non-dialysis CKD non-dialysis patients (21 men, mean age: 66.8 (±11.7) years, eGFR 42.8 (±19.6) mL/min/1.73 m2) completed the SF-12 and performed objective physical function tests [short physical performance battery (SPPB), sit to stand 60 (STS60), sit to stand 5 (STS5), timed up and go (TUAG), gait speed and handgrip strength (HGS)]. Based on these tests, patients were categorised into having ‘low’ and ‘normal’ physical function via previously established reference points. To establish construct validity, partial correlation adjusted for age, eGFR and sex were conducted. The predictive ability of the SF-12 was assessed by receiver operating curves (ROC) and the area under curve (AUC), as well as sensitivity (%) and specificity (%). RESULTS The PF domain and PCS subscale had moderate to strong correlation with the SPPB (r = 0.455, P = 0.010 and r = 0.432, P = 0.012), and the STS60 (r = 0.659, P = 0.000 and r = 0.729, P < 0.000) tests and a moderate negative correlation with the STS5 (r= −0.431, P = 0.022 and r = −0.471, P = 0.009). PCS was also associated with gait speed (r = 0.369, P = 0.41). The ability of the PF domain and PCS subscale to predict physical function was ‘Fair’ (P = 0.03) and ‘Good’ (P = 0.01) based on the STS60 test but not the other tests (Table 1). A cut off score, for the PF domain, using Youden's J statistics was determined at a 0.343 with a score of 75 (sensitivity: 76% and specificity: 58%). A cut off score for the PCS component, was determined at Youden's J of 0.400 with score of ≤41.04 (sensitivity: 65% and specificity: 75%). CONCLUSION These data demonstrate that the SF-12 PF domain and PCS component have adequate construct validity when compared with lower body functional tests such as the STS60, STS5 or the SPPB. The PF domain demonstrated a fair accuracy while the PCS component showed good accuracy to predict ‘low’ and ‘normal’ functional status based on the STS60 test. These data also confirm previously assumed cut off point of 75 scores on the SF-12 PF domain, and it also introduces a cut-off point of ≤41.04 scores for the SF-12 PCS subscale to predict low physical function in this population. Thus, the SF-12 may be an adequate tool to measure perceived functional status in nondialysis CKD patients. Therefore, it could be a useful instrument to measure physical function as well as QoL as core components of healthy aging in this population.

A personalized approach empowering successful aging: Patient perspective on fall prevention education.

Falls are the leading cause of fatal injury, and the most common cause of nonfatal trauma, among older adults. However, patient perspectives on preferences for obtaining fall education are not well reported. To identify components of successful fall prevention education. Prospective qualitative study. Tertiary care center; institutional. Adults aged 65 years or older with a history of falls who received services from inpatient trauma or outpatient geriatric services. One-hour face-to-face semistructured interview. Semistructured interviews sought to determine participants' history of fall education and perceived strengths and weaknesses of various formats of fall education. Nearly all participants (9/10) indicated they had not received fall prevention education of any kind. Many participants (6/10) reported that, despite not receiving any formal education about falls, they had either given or received information about falls from other older adults in their communities. Participants indicated that framing fall education as a part of healthy aging would be more desirable and mentioned involving participants' families as part of the education. The majority of participants (7/10) suggested fall education be delivered through in-person discussion with providers, and most (9/10) indicated this would provide a personalized approach with opportunity for questions. Participants specified fall education should consist of both environmental modifications (5/10) and awareness of one's surroundings (4/10). Despite histories of falls, nearly all participants reported they had not received formal fall education. However, many indicated they received fall information informally through their communities. Participants agreed successful fall prevention education would be delivered in an empowering way by a trusted member of the care team.

Ancianos en la investigación de medicamentos

En las últimas décadas se viene produciendo un envejecimiento de la población que es foco de atención de instituciones de ámbito mundial con objeto de promover un envejecimiento saludable. Las enfermedades crónicas forman parte del envejecimiento y la población geriátrica es la mayor consumidora de medicamentos. Limitar la participación de esta población en la investigación clínica puede resultar en la falta de información sobre la eficacia y seguridad. Es necesario definir acciones que incluyan la investigación clínica como parte del envejecimiento saludable ya que promueve el envejecimiento activo y proporciona información relevante para un mejor uso de los medicamentos en esta población.

Cortical pencil lining on SWI MRI in NBIA and healthy aging

BackgroundNeurodegeneration with brain iron accumulation (NBIA) is characterized by pathological iron accumulation in the subcortical nuclei and the cortex. As age-related iron accumulation studies in these structures are lacking in healthy aging, we aimed to characterize the dynamics of age-dependent iron accumulation in subcortical nuclei in healthy aging and selected NBIA cases. This is fundamental to understand the natural age-related iron deposition in the healthy brain prior to using this marker as a potential prognostic or diagnostic tool in neurodegenerative disorders.MethodsSusceptibility-weighted imaging (SWI) scans from 81 healthy volunteers (0-79 years) and four genetically confirmed patients suffering from NBIA (2-14 years) were obtained. We scored the presence or absence of pencil lining of the motor cortex and putamen and analyzed the normalized SWI signal intensity ratio (NSIR) in five subcortical nuclei.ResultsIn healthy subjects, an age-dependent increase of pencil lining occurred starting from the second decade of life and was present in all cases at the age of 50. In their first decade, NBIA patients showed no cortical pencil lining, but we did observe putaminal pencil lining at this stage. In healthy subjects, age and NSIR of all nuclei correlated positively and was particularly dynamic in early childhood until young adulthood in the globus pallidus, dentate nucleus and red nucleus, but not in the caudate nucleus and putamen. NBIA patients showed an increased NSIR in the globus pallidus only and not in the other subcortical nuclei compared to age-matched healthy subjects.ConclusionsCortical pencil lining is part of healthy aging. This should be considered when assessing this as a potential marker in NBIA diagnosis and prognosis. Putaminal pencil lining has the potential to become a specific marker for some subtypes of NBIA in the first decade of life, as it was only observed in NBIA and not in age-matched healthy subjects. NSIR in the subcortical nuclei during healthy aging was shown to be dynamic, accentuating the importance of having an age-dependent baseline.

Executive Functioning in Healthy Aged Population in comparison to Young Adults Using Cognitive Estimation Test

Abstract Background and objective: Cognitive estimation is an important task in which people engage themselves in estimating the environment in different aspects of their life, such as; distance, quantity, size, weight etc The study was taken up to evaluate the cognitive estimation skills in Healthy Aged Population in comparison to Young Adults. Methodology: A total of 40 healthy young and old adults participated in the study. The participants were divided into two groups. Cognitive Estimation Test (CET) was administered for both the groups. The CET, was modified to suit Indian population consisted of 18 questions under the domains of distance, quantity, size, weight, temperature and time. Responses were scored for Under-estimation (UE), Over-estimation (OE), Approximate answer (AA), and No answer (NA). Number of UE, OE, AA, and NA were calculated. Independent t-test was employed to find out the significant differences between the means of both the groups. Results: Results revealed that young adults were better in estimating the environment when compared to healthy aged population, which was significant .Distance and size dimensions were remarkably affected in comparison to all other dimensions. Instances of No answers (NA) were higher in healthy aged population in comparison to young adults. Conclusion: The results indicate that, the decline in cognitive estimation abilities is a part of healthy aging rather than a pathological condition. Thus CET can be used as a tool in the assessment and management of cognitive disorders.

The Use of Problem-Solving Therapy for Primary Care to Enhance Complex Decision-Making in Healthy Community-Dwelling Older Adults.

Some older adults who are cognitively healthy have been found to make poor decisions. The vulnerability of such older adults has been postulated to be the result of disproportionate aging of the frontal lobes that contributes to a decline in executive functioning abilities among some older adults. The purpose of this study was to investigate whether decision-making performance in older adults can be enhanced by a psychoeducational intervention. Twenty cognitively and emotionally intact persons aged 65 years and older were recruited and randomized into two conditions: psychoeducational condition [Problem-Solving Therapy for Primary Care (PST-PC)] and no-treatment Control group. Participants in the psychoeducational condition each received four 45-min sessions of PST-PC across a 2-week period. The Iowa Gambling Task (IGT) was administered as the outcome measure to the treatment group, while participants in the Control group completed the IGT without intervention. A significant interaction effect was observed between group status and the trajectory of score differences across trials on the IGT. Particularly, as the task progressed to the last 20% of trials, participants in the PST-PC group significantly outperformed participants in the Control group in terms of making more advantageous decisions. These findings demonstrated that a four-session problem-solving therapy can reinforce aspects of executive functioning (that may have declined as a part of healthy aging), thereby enhancing complex decision-making in healthy older adults.

Staying Active Is Part of Healthy Aging

Staying Active Is Part of Healthy Aging

Age-Related Imbalance Is Associated With Slower Walking Speed: An Analysis From the National Health and Nutrition Examination Survey.

Walking speed is an important dimension of gait function and is known to decline with age. Gait function is a process of dynamic balance and motor control that relies on multiple sensory inputs (eg, visual, proprioceptive, and vestibular) and motor outputs. These sensory and motor physiologic systems also play a role in static postural control, which has been shown to decline with age. In this study, we evaluated whether imbalance that occurs as part of healthy aging is associated with slower walking speed in a nationally representative sample of older adults. We performed a cross-sectional analysis of the previously collected 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) data to evaluate whether age-related imbalance is associated with slower walking speed in older adults aged 50 to 85 years (n = 2116). Balance was assessed on a pass/fail basis during a challenging postural task-condition 4 of the modified Romberg Test-and walking speed was determined using a 20-ft (6.10 m) timed walk. Multivariable linear regression was used to evaluate the association between imbalance and walking speed, adjusting for demographic and health-related covariates. A structural equation model was developed to estimate the extent to which imbalance mediates the association between age and slower walking speed. In the unadjusted regression model, inability to perform the NHANES balance task was significantly associated with 0.10 m/s slower walking speed (95% confidence interval: -0.13 to -0.07; P < .01). In the multivariable regression analysis, inability to perform the balance task was significantly associated with 0.06 m/s slower walking speed (95% confidence interval: -0.09 to -0.03; P < .01), an effect size equivalent to 12 years of age. The structural equation model estimated that age-related imbalance mediates 12.2% of the association between age and slower walking speed in older adults. In a nationally representative sample, age-related balance limitation was associated with slower walking speed. Balance impairment may lead to walking speed declines. In addition, reduced static postural control and dynamic walking speed that occur with aging may share common etiologic origins, including the decline in visual, proprioceptive, and vestibular sensory and motor functions.

Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults: The Atherosclerosis Risk in Communities Study.

Although age-associated changes in left ventricular diastolic function are well recognized, limited data exist characterizing measures of diastolic function in older adults, including both reference ranges reflecting the older adult population and prognostically relevant values for incident heart failure (HF), as well as their associations with circulating biomarkers of HF risk. Among 5801 elderly participants in the ARIC study (Atherosclerosis Risk in Communities; age range, 67-90 years; mean age, 76±5 years; 42% male; 21% black), we determined the continuous association of diastolic measures (tissue Doppler imaging [TDI] e', E/e', and left atrial size) with concomitant N-terminal pro-brain natriuretic peptide and subsequent HF hospitalization or death. We also determined sex-specific 10th and 90th percentile limits for these measures using quantile regression in 401 participants free of prevalent cardiovascular disease and risk factors. Each measure of diastolic function was robustly associated with N-terminal pro-brain natriuretic peptide and incident HF or death. ARIC-based reference limits for TDI e' (4.6 and 5.2 cm/s for septal and lateral TDI e', respectively) were substantially lower than guideline cut points (7 and 10 cm/s, respectively), whereas E/e' and left atrial size demonstrated good agreement with guideline cut points. TDI e' was nonlinearly associated with incident HF or death, with inflection points for risk supportive of ARIC-based limits. ARIC-based limits for diastolic function improved risk discrimination over guideline-based cut points based on the integrated discrimination improvement (P<0.001) and continuous net reclassification improvement (P<0.001), reclassifying 42% of the study population as having normal diastolic function. We replicate these findings in the Copenhagen City Heart Study. With these limits, 46% had normal diastolic function and were at low risk of HF hospitalization or death (1%/y over a mean 1.7-year follow-up), 49% had 1 or 2 abnormal measures and were at intermediate risk (2.4%/y), and all 3 diastolic measures were abnormal in 5% who were at high risk (7.5%/y). Our findings suggest that left ventricular longitudinal relaxation velocity declines as a part of healthy aging and is largely prognostically benign. The use of age-based normative values when considering an elderly population improves the risk discrimination of diastolic measures for incident HF or death.

Age-related changes in swallowing. Physiology and pathophysiology

The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness in itself but contributes to a more pervasive naturally diminished functional reserve, making older adults more susceptible to dysphagia. If disorders in swallowing occur in the elderly as a comorbidity of a specific disease, for example stroke or neurodegenerative disorders, this is called secondary presbyphagia. Increasing age has an impact on each stage of deglutition. In the oral preparatory phase a diminished input for smell and taste as well as a usually multifactorial cause of dry mouth are the most important influencing factors. Sarcopenia, the degenerative loss of skeletal muscle mass, strength and quality associated with aging, interferes in particular with the oropharyngeal phase. A decreased sensory feedback from the oropharyngeal mucosa leads to a delayed triggering of the swallowing reflex. Finally, a reduction in connective tissue elasticity and changes of the axial skeleton lead to various modifications of the swallowing pattern with advanced age.

Understanding the reasons why Chinese older people do not wish to tell their life stories.

To explore the reasons why older Chinese people decline to tell their life stories. Promoting the telling of life stories by older people, as part of healthy ageing, may develop their sense of unity and meaning in life. However, not all older adults seem to review their past and tell others about it. Understanding is lacking about how 'healthy' older adults experience the meanings of not telling. A descriptive phenomenology with Giorgi's analysis. Data were collected from June 2010-August 2011 through unstructured individual interviews. A potential sample of 36 older people were identified through convenience sampling from 17 daycare and senior centres, of whom 19 participated in this study. Our findings suggest that the reasons why these older people declined to tell their life stories relate to an understanding of the self and to the perception that the older people had of their audience's response and their family's support. Older people seemed to be naturally inclined to reminiscence, but their accumulated personal and interpersonal experiences might have caused them to feel disinclined to talk about what they no longer considered to be important. An understanding about the tension existing in cultural/generational narratives of the older people may help health professionals to provide them with a supportive environment for their continuous construction of social identities. This may contribute to their better social health. Equally important is to provide an opportunity for them to share their stories and engage in family and cross-generational dialogues.

Nutrition as a part of healthy aging and reducing cardiovascular risk: improving functionality in later life using quality protein, with optimized timing and distribution.

Aging is associated with many physiological changes, which may in time lead to numerous pathophysiological outcomes, including adverse vascular events. For example, senescence of the immune system and cellular senescence both contribute to rising inflammation with age, potentially induced by the overall burden of comorbid illness, adipose tissue mass, diet, socioeconomic status, and physical activity. In turn, this chronic inflammation decreases physical and cognitive performance, and promotes sarcopenia and the syndrome of frailty. These events and others decrease the functionality of life as we age and include an increased risk of thrombosis and adverse cardiovascular outcomes. In this review, we aim to overview the aging process primarily as related to functional impairment, and provide evidence for the role of protein, and specifically differential quality protein, in particular whey protein, and timing and distribution of intake, to help reduce some of the morbid effects of aging, including reducing obesity, improving glycemic control, and improving vascular function.

Interactive CaringTV® supporting elderly living at home

Interactive CaringTV® is a Finnish innovation that was developed by Laurea University of Applied Sciences in 2006. CaringTV was developed through action research during three research projects. The aim of interactive CaringTV is to support the health and well-being of elderly people living in their own homes. The Safe Home project was based on action research, userdriven methods, and a case study. User-driven methods were applied in planning, implementing and evaluating the programme and eServices e.g. testing and evaluating peer support, including eConsultation as the methods for supporting clients´ coping with life in their own homes. Costeffectiveness and process modelling were studied through the case study. The user-driven approach and the collected data formed the basis for the interactive programme. The online CaringTV programme included content to: support everyday life for the elderly, safety, and activities of daily living, support social relationships, participate in rehabilitation and physical exercises, manage self-care, and health issues. Active participation in the CaringTV programme provided functional ability and everyday coping as well as a meaningful activity in everyday life. CaringTV is an interactive platform to support elderly in their everyday life and help them cope at home. User-driven methods enable participants´ active involvement in planning interactive and online programmes and eServices via CaringTV. The ultimate goal of the CaringTV is to support elderly´s health, wellbeing and interaction. CaringTV empowers elderly people to take responsibility for their own health care as part of healthy ageing.

Just feeling a naked body close to you: Men, sexuality and intimacy in later life

Despite an increasing emphasis on sexuality as lifelong and part of healthy ageing, the voices of older men and women are seldom heard. Based on qualitative interviews with Swedish heterosexual men aged 67–87, this article discusses how men make sense of later life sexuality through narratives of intimacy. In the interviews, intimacy is described as something more or other than sexual intercourse, involving both touch and feelings of love and closeness in a committed relationship. Inspired by the work of Ahmed ( The Cultural Politics of Emotion, 2004) the article discusses how narratives of intimacy shape the sexual subjectivities and bodies of older men. Intimacy is discussed as making sexual subjectivities and bodies possible beyond a coital imperative. As such, intimacy is of potential use to anti-ageist and feminist theorizing. However, intimacy is also discussed as a possible reinforcement of respectable heterosexuality. The article concludes that intimacy may be a way for older heterosexual men to navigate between current binary discourses of asexual old age and ‘sexy seniors’.

Accelerating Cortical Thinning: Unique to Dementia or Universal in Aging?

Does accelerated cortical atrophy in aging, especially in areas vulnerable to early Alzheimer's disease (AD), unequivocally signify neurodegenerative disease or can it be part of normal aging? We addressed this in 3 ways. First, age trajectories of cortical thickness were delineated cross-sectionally (n = 1100) and longitudinally (n = 207). Second, effects of undetected AD on the age trajectories were simulated by mixing the sample with a sample of patients with very mild to moderate AD. Third, atrophy in AD-vulnerable regions was examined in older adults with very low probability of incipient AD based on 2-year neuropsychological stability, CSF Aβ(1-42) levels, and apolipoprotein ε4 negativity. Steady decline was seen in most regions, but accelerated cortical thinning in entorhinal cortex was observed across groups. Very low-risk older adults had longitudinal entorhinal atrophy rates similar to other healthy older adults, and this atrophy was predictive of memory change. While steady decline in cortical thickness is the norm in aging, acceleration in AD-prone regions does not uniquely signify neurodegenerative illness but can be part of healthy aging. The relationship between the entorhinal changes and changes in memory performance suggests that non-AD mechanisms in AD-prone areas may still be causative for cognitive reductions.

Life course vaccination and healthy aging

The authors notice the low vaccine coverage rate among European citizens and inventory the multiple reasons leading to the non-use of preventable infectious diseases vaccines in adults whose mortality consequences represent an important and unexpected burden of diseases. These facts are in close relation with the disruption of vaccine recommendations after the childhood vaccine program, the poor literacy knowledge concerning vaccines among the general population, but also unfortunately among physicians and other health care workers. Popular beliefs, fear of side-effects, fear of needles facilitated the constitution of active non-vaccine groups which conduct to the reappearance in non-vaccinated adults and with dramatic consequences of preventable childhood infectious diseases. This careful analysis of the current preventable infectious disease vaccine coverage in old adults leads to propose a life course vaccine programme including adult vaccinations as part of healthy aging as well as old adults' vaccine guidelines integrated in health prevention programs.

Is selection required for the accumulation of somatic mitochondrial DNA mutations in post-mitotic cells?

Mitochondrial DNA (mtDNA) mutations accumulate in the skeletal muscle of patients with mtDNA disease, and also as part of healthy ageing. Simulations of human muscle fibres suggest that, over many decades, the continuous destruction and copying of mtDNA (relaxed replication) can lead to dramatic changes in the percentage level of mutant mtDNA in non-dividing cells through random genetic drift. This process should apply to both pathogenic and neutral mutations. To test this hypothesis we sequenced the entire mitochondrial genome for 20 muscle fibres from a healthy elderly 85-year-old individual, chosen because of the low frequency of cytochrome c oxidase negative fibres. Phenotypically neutral single base substitutions were detected in 15% of the healthy fibres, supporting the hypothesis that positive selection is not essential for the clonal expansion of mtDNA point mutations during human life. Treatments that enhance mtDNA replication, such as vigorous excercise, could amplify this process, with potentially detrimental long-term consequences.