Risk In Older Adults Research Articles

Relationship between social activities and cognitive impairment in Chinese older adults: the mediating effect of depressive symptoms

BackgroundThe differential impacts of various social activities on dementia prevention and the mediating role of depression in this relationship remain unclear.ObjectivesThis study aimed to identify the effects of different social activities on cognitive function, examine the mediating role of depression, and provide evidence for targeted interventions to prevent cognitive decline.MethodsUsing data from CHARLS, we employed RCS analysis and Structural Equation Modeling to examine the relationships between social activities, depression, and cognitive function in older adults.ResultsSocial activity participation is non-linearly inversely related to both cognitive impairment and depression risk. Cognitive function and social activities were significantly mediated by depression. Cognitively stimulating and physically stimulating activities had the greatest positive effects on mental health.ConclusionOur findings highlight the complex interplay between social engagement, depression, and cognitive health in aging. They support developing targeted interventions promoting physical and cognitive social activities to maintain cognitive function and reduce depression risk in older adults, potentially alleviating the burden of cognitive impairment in aging populations.

Attitudes of German General Practitioners Toward eHealth Apps for Dementia Risk Reduction: Qualitative Interview Study.

eHealth interventions constitute a promising approach to disease prevention, particularly because of their ability to facilitate lifestyle changes. Although a rather recent development, eHealth interventions might be able to promote brain health and reduce dementia risk in older adults. This study aimed to explore the perspective of general practitioners (GPs) on the potentials and barriers of eHealth interventions for brain health. Understanding the perspective of GPs allows us to identify chances and challenges for implementing eHealth apps for dementia risk reduction. We conducted semistructured expert interviews with 9 GPs working in an outpatient setting in and near Leipzig, Germany. Data were fully transcribed and analyzed using a process model of qualitative content analysis with codes and categories being constructed inductively and deductively. We found generally favorable but balanced views of eHealth apps for brain health. Eight themes were identified and elaborated on in the data as follows: "addressing dementia," "knowledge about dementia," "need for information," "potential for prevention," "chances for apps for prevention," "development of apps for prevention," and "barriers of apps for prevention." GPs talked mostly about how and when to address dementia and the requirements for their use of eHealth apps for dementia prevention. GPs stated that they only addressed dementia once abnormalities were already present or less frequently when a patient or relative expressed a direct wish, while individual dementia risk or standardized diagnostic during routine check-ups were mentioned much less frequently. According to GPs, knowledge about dementia in patients was low; therefore, patients expressed little need for information on dementia risk factors and prevention in GP practices. Most patients wished for quick information regarding diagnostics, treatment options, and progression of the disease. GPs mentioned a lack of overview of the available eHealth apps and their content. They also expressed a fear of inducing health anxiety when talking to patients about risk factors and prevention. GPs want patients to receive relevant and individualized information. Prerequisites for the use of eHealth apps for dementia prevention were app characteristics related to design and content. GPs need to address dementia more routinely, assess relevant risk factors, and aid patients in a preventive role. Concerns were expressed over limited effectiveness, overwhelming patients, limited use in clinical practice, and only targeting patients with an already low risk of dementia.

Cardiovascular risk profiling among South Asian adults in Hong Kong: a latent class analysis

BackgroundSouth Asians living in urbanized settings are facing disproportionate cardiovascular burden largely attributable to modifiable risk factors. Given the rapid surge in South Asian population in Hong Kong, this study aims to identify and distinguish clusters of cardiovascular risk profiles among community-dwelling South Asian adults.MethodsBetween June 2022 and December 2023, 1181 South Asian adults were recruited through territory-wide outreach health assessments on lifestyle, psychological distress, obesity, clinical cardiovascular conditions, and sociodemographic factors. Latent class analysis was performed to classify the cardiovascular profiles, followed by multinomial logistic regression to identify the sociodemographic characteristics across classes.ResultsFive latent classes were identified: low risk (19.6%), lifestyle risk plus distress (8.9%), obesity risk (33.4%), lifestyle risk plus distress with obesity (26.6%), and high clinical risk (11.4%). Apart from the higher clinical risk in older adults, women tended to cluster into classes with obesity, while men and the economically active were more likely in classes with poorer lifestyles and stress. Pakistani and Nepalese consistently exhibited higher risks compared to Indians, whereas the less educated tended to cluster into the high clinical risk class.ConclusionThis study revealed distinct cardiovascular risk patterns and sociodemographic features within the South Asian community in Hong Kong. The heavy burden on obesity especially in women, lifestyle and psychological risks especially in men, and low overall physical activity level may be translated into a tremendous cardiovascular disease burden in the forthcoming decades, in particular among Pakistani and Nepalese as well as the socioeconomically disadvantaged.

Application of Orofacial Muscle Strength Measurement to Screen for Penetration/Aspiration Risk in Older Adults With Sarcopenia: A Diagnostic Accuracy Study.

Early identification of penetration/aspiration (P/A) risk in older adults with sarcopenia is crucial to prevent complications and maintain quality of life. To evaluate the diagnostic utility of orofacial muscle strength measurements for predicting the risk of P/A in older adults with sarcopenia. In this observational and prospective study, we collated consecutive data from community-dwelling older adults diagnosed with sarcopenia at a musculoskeletal disorder clinic. Altogether, 54 participants underwent orofacial muscle strength measurements (the index test) using the Iowa Oral Performance Instrument and a videofluoroscopic swallowing study (VFSS) (the reference test) to evaluate for the presence of P/A. Receiver operating characteristic (ROC) curve analysis was performed to determine orofacial muscle strength based on P/A. Overall, 34 patients showed penetration in the VFSS, although none of the patients showed signs of aspiration. The cut-off for tongue strength to identify the risk of P/A was ≤ 20.5 kPa, with a sensitivity and specificity of 0.75 and 0.74, respectively; the area under the curve (AUC) was 0.88. The cut-off for buccinator strength was ≤ 19.5 kPa, with a sensitivity and specificity of 0.65 and 0.68, respectively, with an AUC of 0.69. The cut-off for lip muscle strength was ≤ 18.5 kPa, with a sensitivity and specificity of 0.65 and 0.71, respectively, with an AUC of 0.69. The evaluation of buccinator and lip muscle strength did not demonstrate sufficient diagnostic utility for detecting the risk of P/A in older patients with sarcopenia; however, tongue strength showed reliable diagnostic utility for identifying the risk of P/A.

The Influence of Lifestyle Modifications on Cardiovascular Outcomes in Older Adults: Findings from a Cross-Sectional Study.

Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among older adults. Lifestyle modifications, including diet, physical activity, and smoking cessation, are key to reducing cardiovascular risk. This study examines the combined effects of these behaviors on cardiovascular outcomes and their mediating mechanisms. Methods: A cross-sectional study was conducted among older adults (aged ≥ 60 years) in Riyadh, Saudi Arabia. Data on dietary quality, physical activity, and smoking status were collected using validated questionnaires. Cardiovascular outcomes, including low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), and body mass index (BMI), were measured. A composite cardiovascular risk score was computed. Path analysis was employed to assess direct and indirect effects of lifestyle factors on cardiovascular outcomes. Results: Participants adhering to a healthy diet, engaging in regular physical activity, and avoiding smoking had significantly lower composite cardiovascular risk scores. Non-smoking status showed the strongest direct effect (β = -0.20, p = 0.006), while dietary quality and physical activity exhibited significant indirect effects mediated by LDL, SBP, and BMI. Combined adherence to multiple healthy behaviors resulted in the greatest reductions in cardiovascular risk. The path analysis highlighted dietary quality and physical activity as critical mediators of cardiovascular health improvements. Conclusions: Lifestyle modifications significantly reduce cardiovascular risk in older adults, with cumulative benefits observed for combined adherence to healthy behaviors. These findings emphasize the importance of comprehensive lifestyle interventions targeting diet, physical activity, and smoking cessation to promote cardiovascular health in aging populations.

Sex differences in the association between age-related decline in blood pressure and decline in cognition: A prospective cohort study.

Both high and declining blood pressure (BP) are associated with cognitive decline risk in older adults. In late-life, women have higher rates of hypertension, experience faster cognitive decline, and represent two-thirds of individuals with Alzheimer's disease dementia. However, sex differences in the association between BP decline and cognitive decline are unknown. Data were analyzed from 4719 older adults without known baseline dementia (mean age = 76.7 [SD = 7.7] years; 74% women) enrolled in one of five US-based prospective community-based cohort studies, followed annually for up to 31 years (mean = 8.7 [SD = 5.7] years). A 19-test cognitive battery, yielding composite global and five domain-specific scores, and BP were assessed annually. Bivariate mixed-effects models simultaneously estimated change in BP and cognition, for the total group and by sex. Systolic BP, diastolic BP, and cognition all declined over time (ps <0.01). Bivariate mixed-effect models revealed a sex difference in the correlation of decline in systolic BP and decline in global cognition (women: r = 0.26, 95%CI: 0.17 - 0.37; men: r = 0.01, 95%CI: -0.13 - 0.11), such that women exhibited a stronger correlation than men. Decline in systolic BP was related to decline in global and all five cognitive domains in women but none in men, with another sex difference identified in the working memory domain. An increase of diastolic BP was related to decline in working memory in men, and no other associations with diastolic BP were significant for either sex. Systolic BP decline in late-life is related to decline in global and domain-specific cognition in women but not men, with sex differences in global cognition and the working memory domain. These findings suggest that in older women, declining systolic BP - a routinely-used clinical measure - may be an important marker of concurrent cognitive decline.

Early detection and management of hearing loss to reduce dementia risk in older adults with mild cognitive impairment: findings from the treating auditory impairment and cognition trial (TACT).

Age-related hearing loss and mild cognitive impairment (MCI) independently increase dementia risk. The Ageing and Cognitive Health Evaluation in Elders randomised controlled trial (RCT) found hearing aids reduce cognitive decline in high-risk older adults with poor hearing. This pilot RCT in London memory clinics randomised people with MCI (aged ≥55, untreated hearing loss defined as Pure Tone Average 0.5-4KHz between 25-70dB) into two groups. The intervention group received 4 sessions of hearing aid fitting and support. The control group received healthy ageing education and a GP letter recommending audiological referral. Both were followed for 6months. Primary outcomes were recruitment (feasibility target: 50%; 95% CI: 39%-61%) and retention (feasibility target: 80%; 95% CI: 71%-89%); intervention completion (≥2 visits) and hearing aid use (acceptability target: 80%; 95% CI: 71%-89%) for the intervention group and 50% difference between arms (95% CI: 31%-69%). Secondary outcomes included hearing aid fitting, cognition and other measures. From October 2018 to March 2020, 58 participants were recruited (29 per group, 95% [86%-99%]). Twenty-four participants were fitted with hearing aids in the intervention arm, and 6 in the control arm (difference: 62% [42%-82%]). At 6months, retention was 81% [69%-90%]. Hearing intervention completion (≥2 visits) was achieved by 24 (83%). Daily hearing aid use was reported by 18 (75%) intervention versus 5 (22%) control participants, a difference of 53% [29%-77%]. Randomisation of people with MCI to a personalised hearing intervention versus control is feasible. These findings support proceeding to a fully-powered multicentre RCT.

Co-exposure to polycyclic aromatic hydrocarbons and nicotine and their associations with cognitive impairment risk in older adults from southern China.

Exposure to polycyclic aromatic hydrocarbons (PAHs) and tobacco smoke is widespread and linked to various adverse health outcomes. Their potential to disturb the neurological system has raised much concern, particularly among older adults. Thus, we conducted a case-control study to assess the associations between co-exposure to PAHs and nicotine, and the risk of cognitive impairment and oxidative stress in older adults. A total of 384 adults aged 60 years and older were recruited from 2017 to 2018 in Shenzhen, China. Morning spot urine samples were collected for the analysis of 6 mono-hydroxylated PAHs, 8 nicotine metabolites, and a typical biomarker for oxidative stress, 8-hydroxy-2'-deoxyguanosine (8-OHdG). The Mini-Mental State Examination was used to assess the cognitive function of participants. Quantile-based g-computation (QGC), weighted quantile sum regression, and Bayesian kernel machine regression were used to analyze the associations between the exposure mixture and outcomes. QGC showed co-exposure to PAHs and nicotine were positively associated with cognitive impairment risk (OR: 1.66, 95% CI: 1.36-2.03, P<0.001) and 8-OHdG (β:11.19, 95% CI: 3.90-18.48, P<0.001). The primary contributors to cognitive impairment risk were (S)-nicotine-N-β-glucuronide (NicGluc), cotinine N-β-D-glucuronide (CotGluc) and (S)-cotinine N-oxide (CNO) and Cotinine (Cot), with no-linear dose-response relationships. However, 8-OHdG did not mediate the association between PAHs, nicotine and cognitive impairment risk.

MUSCLE QUALITY AND REACTIVE BALANCE CONTROL IN OLDER ADULTS

Abstract Falls are a predominant cause of morbidity and mortality in older adults. Muscle quality is associated with mobility and fall risk in older adults. Echo intensity (EI), obtained via ultrasonography, offers a method to quantify muscular fat infiltration and has become increasingly popular as an objective measure of morphological muscle quality. This study aimed to determine the relationship between lower limb EI and reactive balance control (RBC) in community-dwelling older adults. We analyzed EI and muscle thickness in the biceps femoris (BF), vastus lateralis (VL), and medial gastrocnemius (MG) across 18 participants (12 older adults, age: 65 ± 4.1; 6 younger controls, age: 25 ± 3.4) before administering specific assessments of RBC including the Choice Stepping Reaction Test and the Lean and Release Test. BF and MG EI were associated with LRT performance (t=3.112, p&amp;lt;0.001; t=-3.597, p&amp;lt;0.01), and BF EI was associated with CSRT performance (t=-4.281, p&amp;lt;0.001). However, these associations were characterized by small effect sizes (d=-0.17, d=-0.19 and, d=0.12 respectively) and were not significant after controlling for age. Although muscle quality is important for functional mobility it was not associated with RBC in the present study. This is supported by previous research that balance recovery appears to depend on the ability to generate efficiently coordinated neuromotor responses rather than on general qualities such as muscle force or muscle quality and thickness alone and underscores the importance of specific training to improve balance recovery. Further research, with larger sample sizes, is needed to understand the influence of EI on RBC.

The interplay between lying, sitting, standing, moving, and walking on obesity risk in older adults: a compositional and isotemporal substitution analysis

IntroductionObesity in older adults is linked to various chronic conditions and decreased quality of life. Traditional physical activity guidelines often overlook the specific postures and movements that older adults engage in daily. This study aims to explore the compositional associations between posture-specific behaviours and obesity risk in younger (M = 67.35 ± 2.03 years) and older (M = 75.73 ± 4.17 years) groups of older adults and investigate the differences in body mass index (BMI) associated with replacing time spent in lying, sitting and standing with moving or walking.MethodsThis cross-sectional study involved 309 older adults aged 65 and above from Czech Republic. Participants’ movement behaviours, including lying, sitting, standing, moving, and walking, were measured using accelerometers. The data were analysed using compositional data analysis (CoDA) and isotemporal substitution models to assess the impact of reallocating time between different activities on self-reported (BMI).ResultsThe younger group engaged in more overall movement (193.84 min/day vs. 172.41 min/day) and walking (92.15 min/day vs. 76.62 min/day) than the older group. Significant estimated increases in BMI were associated with reallocating 30 min from movement to lying, sitting, or standing (up to + 3.31 kg/m²), while reallocating the same amount of time from lying, sitting, or standing to movement was associated with estimated reductions in BMI (up to − 2.54 kg/m²). In the older group, reallocating time from slow walking to lying or sitting was associated with estimated increases in BMI (up to + 1.86 kg/m²), while increasing time spent slow walking at the expense of lying or sitting theoretically reduced BMI (up to − 0.95 kg/m²).ConclusionsThe findings suggest that promoting movement and walking, including both slow and fast walking, may play a role in managing obesity risk in older adults. This study highlights the potential benefits of reducing sedentary time and encouraging low-intensity physical activity tailored to the capabilities of seniors, especially those aged 70+, as a possible strategy to mitigate obesity risk. However, further longitudinal studies are needed to confirm these associations and explore causal relationships.

Higher Circulating Resistin Levels Linked to Increased Sarcopenia Risk in Older Adults

Abstract Context Experimental evidence indicates that resistin, an adipokine, negatively impacts muscle metabolism by hindering myogenesis. Objective To explore resistin's potential as a biomarker of muscle health in humans by examining the relationship between circulating resistin levels and sarcopenia in older adults. Design and Setting A case-control study conducted in a geriatric clinical unit. Participants The study included 247 individuals aged 65 and older who underwent comprehensive geriatric evaluations. Main Outcome Measures Sarcopenia was defined based on Asian-specific thresholds, with serum resistin concentrations measured using an enzyme-linked immunosorbent assay. Results After adjusting for sex, age, fat mass, smoking, osteoarthritis, and diabetes, participants with sarcopenia, low muscle mass, and weak muscle strength exhibited at least 27.0% higher circulating resistin concentrations than controls (P = 0.002 to 0.003). Elevated serum resistin levels were inversely associated with skeletal muscle mass, gait speed, and the short physical performance battery score, and positively associated with the time to complete five chair stands (P = 0.019 to 0.048). Higher serum resistin levels were linked to an increased risk of sarcopenia, low muscle mass, and weak muscle strength (all P = 0.005). Finally, participants in the highest resistin quartile had at least three times higher odds of having adverse muscle outcomes compared to those in the lowest quartile (P = 0.007 to 0.029). Conclusion This study is to establish a link between blood resistin levels and sarcopenia, suggesting that circulating resistin may serve as a potential biomarker reflecting poor muscle health in humans.

Effects of Longer-Term Mixed Nut Consumption on Lipoprotein Particle Concentrations in Older Adults with Overweight or Obesity.

Recently, we reported that longer-term mixed nut intake significantly reduced serum total and low-density lipoprotein (LDL)-cholesterol, but these markers may not fully capture lipoprotein-related cardiovascular disease (CVD) risk. This randomized, controlled, single-blinded, crossover trial in older adults with overweight or obesity examined the effects of longer-term mixed nut consumption on lipoprotein particle size, number, and lipid distribution. Twenty-eight participants (aged 65 ± 3 years; BMI 27.9 ± 2.3 kg/m2) completed two 16-week periods (control [no nuts] vs. mixed nuts (60 g/day: 15 g of walnuts, pistachios, cashews, and hazelnuts), separated by an 8-week washout. Plasma lipoprotein particle numbers, sizes, and lipid distributions across subclasses were analyzed using high-throughput nuclear magnetic resonance (NMR) spectroscopy. Mixed nut consumption significantly reduced Apolipoprotein B (ApoB) concentrations (-0.07 g/L; p = 0.009), total cholesterol (-0.27 mmol/L; p = 0.047), non-HDL cholesterol (-0.28 mmol/L; p = 0.022), and total triacylglycerol (TAG) (-0.27 mmol/L; p = 0.008). Total very large-density lipoprotein (VLDL) particle numbers decreased by 24 nmol/L (p < 0.001), with reductions observed across all VLDL subclasses. Total LDL particle numbers (p = 0.044), specifically intermediate-density lipoprotein (IDL) (p = 0.002) and large LDL particles (p = 0.015), were also reduced, while HDL particle numbers and sizes were unaffected. The mixed nut intervention significantly reduced cholesterol concentrations across all VLDL subclasses and IDL (all p < 0.01), with no changes in LDL or HDL subclasses. TAG concentrations showed reductions across all lipoprotein subclasses (all p < 0.05). Longer-term mixed nut consumption may lower CVD risk in older adults and favorable shifts in apoB-containing lipoprotein subclasses towards a less atherogenic profile.

Maternal Gut Microbiome-Mediated Epigenetic Modifications in Cognitive Development and Impairments: A New Frontier for Therapeutic Innovation.

Cognitive impairment in various mental illnesses, particularly neuropsychiatric disorders, has adverse functional and clinical consequences. While genetic mutations and epigenetic dysregulations of several genes during embryonic and adult periods are linked to cognitive impairment in mental disorders, the composition and diversity of resident bacteria in the gastrointestinal tract-shaped by environmental factors-also influence the brain epigenome, affecting behavior and cognitive functions. Accordingly, many recent studies have provided evidence that human gut microbiota may offer a potential avenue for improving cognitive deficits. In this review, we provide an overview of the relationship between cognitive impairment, alterations in the gut microbiome, and epigenetic alterations during embryonic and adult periods. We examine how various factors beyond genetics-such as lifestyle, age, and maternal diet-impact the composition, diversity, and epigenetic functionality of the gut microbiome, consequently influencing cognitive performance. Additionally, we explore the potential of maternal gut microbiome signatures and epigenetic biomarkers for predicting cognitive impairment risk in older adults. This article also explores the potential roles of nutritional deficiencies in programming cognitive disorders during the perinatal period in offspring, as well as the promise of gut microbiome-targeted therapeutics with epigenetic effects to prevent or alleviate cognitive dysfunctions in infants, middle-aged adults, and older adults. Unsolved challenges of gut microbiome-targeted therapeutics in mitigating cognitive dysfunctions for translation into clinical practice are discussed, lastly.

Baroreflex Sensitivity and Long-Term Dementia Risk in Older Adults.

Increased blood pressure (BP) variability is linked to dementia risk, but the relationship between baroreflex sensitivity (BRS), a fundamental mechanism for maintaining stable BP, and dementia risk is undetermined. We tested the hypothesis that impaired BRS is associated with increased dementia risk in 1819 older adults (63% women; age, 71.0±6.3 years) from the community-based Rotterdam Study. Cardiac BRS was determined from a 5-minute beat-to-beat BP recording at supine rest between 1997 and 1999. Cardiac BRS measures the correlation between changes in consecutive beat-to-beat systolic BP and subsequent responses in heartbeat intervals, with a higher value indicating better BRS. The primary outcome was incident dementia ascertained from baseline through January 1, 2020; the secondary outcome was all-cause mortality. During a median follow-up of 14.8 years, 421 participants developed dementia. The association of cardiac BRS with dementia risk differed by antihypertensive medication use (Pinteraction=0.03) and was only observed in participants not taking antihypertensives. Specifically, in those not taking antihypertensive medication, reduced BRS was associated with a higher risk of dementia (adjusted hazard ratio comparing bottom versus top quintiles, 1.60 [95% CI, 1.07-2.40]; Ptrend=0.02). Reduced BRS was also associated with an increased risk of death (corresponding hazard ratio, 1.76 [95% CI, 1.32-2.35]). The association remained after adjusting for average BP and BP variability. Impaired BRS partly explains hypertension-related brain damage and excessive dementia risk beyond conventional BP measures, making it a potential novel biomarker for early detection and prevention of dementia.

Meeting 24-hour movement guidelines and mortality risk in older adults: cross-sectional and longitudinal pooled analysis in the Seniors-ENRICA cohorts.

We assessed the association of adherence to the guidelines and subsequent changes over time in adherence with all-cause mortality. We used data from 3518 and 3273 older adults, aged 60-96 years at baseline, from Seniors-ENRICA-1 and 2 cohorts, respectively. Adherence to 24-hour movement guidelines was defined as ≥150 minutes/week of moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB) ≤8 hours/day (including ≤3 hours/day of recreational screen time), and 7-9 hours/day of sleep if aged 18-64y or 7-8 hours/day if aged ≥65y. All-cause mortality was ascertained up to January 31, 2024. Analyses were performed using Cox regression adjusted for the main confounders. Of the 6613 participants with complete data, 1353 died during a mean follow-up of 10.1 (SD = 4.0) years. Meeting MVPA (hazard ratio [HR] 0.73; 95% confidence interval [CI] 0.65-0.82), SB (HR 0.89; 95% CI 0.80-0.99), and sleep (HR 0.89; 95% CI 0.80-0.99) recommendations were associated with lower mortality. Also, we noticed a reduction in mortality in meeting MVPA combined with both SB (34%) and sleep (12%), sleep and SB combined (23%), and meeting all 24-hour movement guidelines (40%). Changes in meeting 24-hour movement guidelines occurred between a mean follow-up of 2.8 (0.6) years. Meeting 24-hour movement guidelines at baseline and follow-up is associated with lower mortality (HR 0.69; 95% CI 0.47-0.99), compared to not meet them at both examinations. This prospective cohort study underscores the critical impact of adhering to and maintaining adherence to the 24-hour movement guidelines in reducing mortality risk among older adults.

Age at First Fracture and Later Fracture Risk in Older Adults Undergoing Osteoporosis Assessment

Fragility fractures are often defined as those that occur after a certain age (eg, 40-50 years). Whether fractures occurring in early adulthood are equally associated with future fractures is unclear. To examine whether the age at which a prior fracture occurred is associated with future fracture risk. This observational, population-based cohort study included individuals from the Manitoba Bone Mineral Density Registry with a first bone mineral density (BMD) measurement between January 1, 1996, and March 31, 2018, with and without prior fracture in adulthood. Data analysis was completed between April 1, and May 31, 2023. Individuals with fractures before their first dual-energy x-ray absorptiometry were stratified by the age at first fracture (10-year intervals from 20-29 to ≥80 years of age). Incident fractures occurring after dual-energy x-ray absorptiometry (index date) and before March 31, 2021, were identified using linked provincial administrative health data. The cohort included 88 696 individuals (80 066 [90.3%] female; mean [SD] age, 64.6 [11.0] years) with a mean (SD) femoral neck T score of -1.4 (1.0). A total of 21 105 individuals (23.8%) had sustained a prior fracture at a mean (SD) age of 57.7 (13.6) years (range, 20.0-102.4 years) at the time of first prior fracture. During a mean (SD) of 9.0 (5.5) years of follow-up, incident fractures occurred in 13 239 individuals (14.6%), including 12 425 osteoporotic fractures (14.0%), 9440 major osteoporotic fractures (MOFs) (10.6%), and 3068 hip fractures (3.5%). The sex- and age-adjusted hazard ratios for all incident fractures, osteoporotic fractures, and MOFs, according to age at first fracture, were all significantly elevated, with point estimates ranging from 1.55 (95% CI, 1.28-1.88) to 4.07 (95% CI, 2.99-5.52). After adjusting for the additional covariates, the effect estimates were similar and remained significantly elevated, with point estimates ranging from fully adjusted hazard ratios of 1.51 (95% CI, 1.42-1.60) to 2.12 (95% CI, 1.67-2.71) across age categories. Sensitivity analyses examining age at last prior fracture and in those with multiple prior fractures showed similar results. In this cohort study, fractures in adulthood were associated with future fractures regardless of the age at which they occurred. Thus, fractures in early adulthood should not be excluded when assessing an individual's ongoing fracture risk.

Assessing a Digital Lifestyle Intervention to Reduce Dementia Risk in Older Adults

Assessing a Digital Lifestyle Intervention to Reduce Dementia Risk in Older Adults

A171: The Effects of Qigong on Balance and Fall Prevention in Older Adults

Background/Purpose: Falls are the second leading cause of unintentional injury deaths globally, with approximately 684,000 deaths from falls each year, and older adults are at the highest risk of death or serious injury due to imbalance, with risk increasing with age. Coupled with the accelerating global aging process, the safety of the elderly population due to fall imbalance should be taken seriously. Qigong, one of the classic traditional Chinese exercises, is beneficial for improving the physical fitness of the elderly. However, few studies have reported the effect of Qigong on fall risk in older adults. Therefore, we conducted this systematic review to investigate the effects of traditional Chinese Qigong on balance and fall-related factors in the elderly population. Method: Using keywords such as “falls,” “balance function,” “older adults,” and “Qigong,” RCTs related to the influence of Chinese traditional Qigong on balance function and fall prevention among older adults were searched from PubMed, Web of Science, SPORTDiscuss, CNKI, and Wanfang in Spring 2024. Subsequently, literature screening and quality assessment were performed. Results: Ten articles were included in this review. The intervention strategy consisted mainly of Qigong Baduanjin and Wuqinxi. A total of 925 healthy older adults aged 60–80 years were included. The duration of the intervention ranged from 1 to 12 months. The frequency of the intervention ranged from 30–60 minutes of exercise 2–7 times per week. Findings showed that nine studies demonstrated a significant effect on improvement of balance or fall prevention in older adults with traditional Chinese Qigong exercises (all p &lt; 0.05). The one study with no intervention effect on dynamic balance ability may be because of visual change interference in the open eye state. Conclusion/Discussion: Based on the studies reviewed, it seemed that traditional Chinese Qigong was effective in reducing the risk of falls in the elderly. Qigong is mainly used to prevent falls by improving static and dynamic balance, coordination, and lower limb muscle strength in older adults. However, existing studies mostly validate the application effects and lack in-depth mechanism investigation. There is also no clear harmonization of exercise time, frequency, intensity, and systematic regimen of Qigong interventions. Therefore, we recommend researchers conduct more studies to further clarify the potential mechanisms of Qigong for fall prevention and their exercise prescription.

Assessing a Digital Lifestyle Intervention to Reduce Dementia Risk in Older Adults

Assessing a Digital Lifestyle Intervention to Reduce Dementia Risk in Older Adults

Removable denture use, fit, and all-cause mortality in older adults with reduced occlusal support: The OHSAKA study

Statement of problemAs the global population ages, tooth loss among older adults has become increasingly prevalent, impacting oral function and overall health. Although removable dentures have been used to improve masticatory function, the long-term effects of denture conditions on mortality are unclear. PurposeThe purpose of this clinical study was to clarify the association between removable denture condition and the mortality rate in older adults with reduced occlusal support. Material and methodsThis longitudinal study analyzed survival data (up to 2022) for 186893 individuals aged ≥75 years who underwent dental examinations through public healthcare services between 2018 and 2020. The participants were categorized into 10 groups (A1 to A3, B1 to B4, and C1 to C3) based on their occlusal support status using the Eichner index. Denture conditions were assessed by private practice dentists and classified into 3 categories: well-fitting, poorly fitting, and not used. Cox proportional hazards regression analyses were conducted to examine the association between denture conditions and mortality by considering the following control variables: age, sex, history of chronic diseases (hypertension, diabetes, hyperlipidemia, and dementia), smoking habits, and body mass index for the entire study population and within each of the B1 to B4 and C1 to C3 groups. ResultsSignificantly higher hazard ratios (HRs) for mortality were observed with occlusal support deterioration, poorly fitting dentures, and nonusage, with the peak observed in the C3 group with no dentures. The HRs (with 95% confidence intervals) of well-fitting dentures were consistently the lowest across all groups as follows: 0.98 (0.90 to 1.06) in B1, 1.02 (0.95 to 1.10) in B2, 1.11 (1.03 to 1.19) in B3, 1.14 (1.07 to 1.22) in B4, 1.15 (1.05 to 1.26) in C1, 1.28 (1.21 to 1.37) in C2, and 1.58 (1.46 to 1.72) in C3, with the A1 to A3 group as the reference. Poorly fitting or no dentures were associated with increased HRs in the Eichner groups B3 to C3, compared with well-fitting dentures. ConclusionsThis large population-based cohort study found that well-fitting dentures were associated with lower mortality risk in older adults with reduced posterior occlusal support. Nonusage or poorly fitting dentures were associated with an increased risk of mortality as occlusal support deteriorated.