Status In Older Adults Research Articles

Combining motivational and exercise intervention components to reverse pre-frailty and promote self-efficacy among community-dwelling pre-frail older adults: a randomized controlled trial

BackgroundExercise is effective in preventing frailty status in older adults, but the effect of an exercise program based on Wellness Motivation Theory (WMT) on the frailty status, self-efficacy for exercise, and quality of life for older adults with pre-frailty remains unclear. Our objective was to examine the efficacy of a multicomponent exercise program based on WMT on frailty status, self-efficacy, and quality of life among pre-frail older adults.MethodsThis was a randomized controlled trial of pre-frail older adults aged from 60 years to 85 years. Participants in the intervention group performed exercise three times a week for 24 weeks, once at a community health service station instructed by two researchers and two times at home. Participants in the control group were given one-time advice on physical activity. The assessor was the only one blinded. The primary outcome was the reversal rate of pre-frailty. The secondary outcomes included self-efficacy and quality of life.ResultsOne hundred and forty-four participants were randomized into two groups (n = 72 in the intervention group and n = 72 in the control group) and analyzed. After 24 weeks, the proportion of pre-frailty was significantly lower in the intervention group than in control (31.8% versus 74.6%, P < 0.001). The absolute risk reduction was 42.8% [95% CI, 25.1–57.1]. In the 8th week and the 24th week, the frailty score of the intervention group was significantly lower than that of the control group. There were significant improvements in self-efficacy at week 2, week 8, and week 24. In weeks 8 and 24, participants in the intervention group reported a higher quality of life than the control group. There were no exercise-related injuries or falls among the participants.ConclusionsThe exercise intervention based on WMT for pre-frail older adults could reverse pre-frailty, increase self-efficacy for exercise, and improve the quality of life in older Chinese.Study registration detailsThis study was registered in www.ClinicalTrials.gov on the 25th of July, 2024, with the identifier NCT06519695.Reporting methodThe Consolidated Standards of Reporting Trials (CONSORT) checklist was used in this study for properly reporting how the randomized trial was conducted.

High cotinine levels as an associated factor with frailty status in older adults: evidence from the NHANES study

IntroductionSmoking has been recognized as a contributing factor to frailty in older adults. Nevertheless, it remains uncertain whether the degree of smoking has a discernible impact on frailty among older smokers. This cross-sectional study was conducted to investigate the correlation between serum cotinine levels, a biomarker reflecting tobacco exposure, and the presence of frailty within a nationally representative cohort of older adults.MethodA total of 1626 individuals aged ≥ 60 who identified as smokers were included in the analysis. Participants were selected based on self-reported current smoking status. According to the Fried Phenotype, frailty is assessed through five dimensions: unintentional weight loss, slow walking speed, weakness, self-reported exhaustion, and low physical activity. Participants with three or more of these conditions were categorized as frailty, those with at least one but less than three as pre-frailty, and those with none as robust. Multinomial logistic regression models were employed to explore the relationship between serum cotinine level quartiles, with the lowest quartile as the reference group, and the various frailty statuses, with robustness as the reference category. These models were adjusted for covariates, including age, sex, race/ethnicity, alcohol drinking, daily protein intake, systolic blood pressure, serum albumin level, depressive symptoms, and cognitive function. The data used for this analysis were sourced from the National Health and Nutrition Examination Survey for the years 2011 to 2014.ResultsThe median age of the participants was 69.0 years. The majority were male (62.2%) and non-Hispanic White (49.0%). The distribution of frailty statuses among the participants revealed that the highest proportion had pre-frailty (50.7%), followed by robustness (41.1%), and frailty (8.2%). Multinomial logistic regression showed that participants in the 4th quartile of serum cotinine level exhibited a higher probability of pre-frailty versus robustness (Odds ratio [OR] 1.599, 95% confidence interval [CI] 1.017, 2.513, P = 0.042). Participants in the 3rd quartile of serum cotinine level had higher odds of frailty versus robustness (OR 2.403, 95% CI 1.125, 5.134, P = 0.024). Moreover, participants whose serum cotinine levels were higher than the literature cutoffs (≥ 15 ng/ml) were more likely to be pre-frail (Odds ratio [OR] 1.478, 95% confidence interval [CI] 1.017, 2.150, P = 0.035) or frail (Odds ratio [OR] 2.141, 95% confidence interval [CI] 1.054, 4.351, P = 0.041).ConclusionsA higher serum cotinine level is linked to an elevated probability of pre-frailty and frailty among older smokers. Initiatives geared towards assisting older smokers in reducing or quitting their smoking habits might possibly play a crucial role in preventing pre-frailty and frailty.

Circulating medium- and long-chain acylcarnitines are associated with plasma P-tau181 in cognitively normal older adults.

Alzheimer's disease (AD) pathogenesis involves dysregulation in diverse biochemical processes. Nevertheless, plasma tau phosphorylated at threonine 181 (P-tau181), a recognised AD biomarker, has been described to reflect early-stage cortical amyloid-β (Aβ) deposition in cognitively normal (CN) adults. Therefore, identifying changes in plasma metabolites associated with plasma P-tau181 at the pre-clinical stage may provide insights into underlying biochemical mechanisms to better understand initial AD pathogenesis. In the current study, plasma P-tau181, quantified via single molecule array (Simoa) technology, and plasma metabolites, quantified via targeted-mass spectrometry, were investigated for associations in CN older adults and upon stratification by positron emission tomography (PET)-Aβ load. In addition, the P-tau181-linked metabolites were evaluated for cognitive performance and neuroimaging markers of AD and the potential to distinguish between CN Aβ- and CN Aβ+ individuals. Significant positive associations of medium- and long-chain acylcarnitines (ACs) were observed with P-tau181 in the entire cohort, CN Aβ- and CN Aβ+, suggesting a link between initial Aβ pathology and fatty acid oxidation-mediated energy metabolism pathways. However, in CN Aβ-, additional linear associations of P-tau181 were observed with muscle metabolism and nitric oxide homeostasis-associated metabolites. Upon investigating the P-tau181-linked metabolites for cognitive performance, significant inverse correlations of the verbal and visual episodic memory and the global composite score were noted in CN Aβ+ with medium- and long-chain ACs, suggesting prognostic value of ACs accompanying weaker cognitive performance. While investigating neuroimaging markers, ACs had positive associations with PET-Aβ load and inverse associations with hippocampal volume in CN Aβ+, indicating connections of ACs with initial AD pathogenesis. Furthermore, based on receiver operating characteristics analysis, the associated ACs potentially classified PET-Aβ status in older adults. Therefore, plasma P-tau181-linked circulating ACs may serve as potential prognostic markers for initial AD pathogenesis in CN older adults. However, further cross-sectional and longitudinal research in highly characterised AD cohorts is needed to validate current findings.

Creatinine Filtration as an Indicator of Muscle Mass and Functional Status in Older Adults

Creatinine Filtration as an Indicator of Muscle Mass and Functional Status in Older Adults

The mitochondrial function of peripheral blood mononuclear cells in frail older patients

BackgroundFrailty increases the incidence of geriatric syndromes and even the risk of death in old adults. However, the diagnostic criteria for frailty are inconsistent because of complex pathological processes and diverse clinical manifestations. To determine the effective biomarker and recognize frail status early, we investigated the correlation of mitochondrial morphology and function of human peripheral blood mononuclear cells (PBMCs) with frailty status in older adults. MethodsThis Cross-sectional study followed 393 participants (aged 25–100 years, female 31.04 %) from the First Affiliated Hospital of Nanjing Medical University. The frailty status of subjects was assessed by the physical frailty phenotype (PFP) scale. We analyzed mitochondria functions including mitochondria copy number (mtDNAcn), the mRNA expressions of mitochondrial dynamics-related genes mitofusin 1(MFN1), mitofusin 2(MFN2), optic atrophy protein-1(OPA1), fission protein-1(FIS1) and dynamin-related protein 1(DRP1), mitochondrial oxidative respiration and reactive oxygen species(ROS) levels in PBMCs. Mitochondria morphology, size, and number were observed by transmission electron microscopy (TEM). ResultsAfter adjustment for sex and BMI, mtDNAcn, the mRNA expression of FIS1, mitochondrial respiratory function (proton leak, maximum oxygen consumption, and respiratory reserve) and ROS level were significantly correlated with age (P = 0.031, 0.030, 0.042, 0.003, 0.002, 0.022, respectively). After correcting for age, sex, and BMI, mtDNAcn and the mRNA expression of OPA1 were correlated with 4 m gait speed respectively (P = 0.003, 0.028, respectively). Compared with non-frail people, mtDNAcn, the mRNA expression of MFN1, mitochondrial basal respiration, proton leak, maximum oxygen consumption, ATP production and space capacity were significantly decreased in frail older adults (P = 0.013, 0.036, 0.026, 0.024, 0.012, 0.032, 0.020, respectively). ROS levels were significantly increased in the frail group (P = 0.016). Compared with non-frail people, the number, length, and perimeter, area of mitochondria were reduced in frail group under TEM (all P < 0.001). ConclusionMitochondrial dysfunctions (decreased mtDNAcn, impaired mitochondrial morphology, imbalanced mitochondrial dynamic, impaired mitochondrial respiratory function, and increased ROS levels) were significantly correlated with frail status.

Association of adipose tissue inflammation and physical fitness in older adults

An active lifestyle is of key importance for reduction of obesity and inflammation, as well as circulating levels of adipokines. Therefore, the aim of our study was to assess the relationship of physical fitness with chronic inflammatory status, and to evaluate biomarkers useful in the analysis of adipose tissue dysfunction. Sixty-three older adults (69.6 ± 5.1 years) were allocated to a high n = 31 (women n = 23 and men n = 8 male) or low physical fitness n = 32 (women n = 29 and men n = 3) group based on gait speed values (1.4–1.8 m/s or ≤ 1.3 m/s). The gait speed correlated with hand grip strength (rs = 0.493, p = 0.0001) and with leptin level (R = -0.372, p = 0.003), which shows the benefits of physical activity on muscle strength and circulating adipokines. In low physical fitness group, 58.1% individuals had adiponectin to leptin ratio (Adpn/Lep) < 0.5 revealing dysfunction of adipose tissue and high cardiometabolic risk; 20% of the group were obese with BMI ≥ 30 kg/m2. In high physical fitness group, 25.8% of individuals had Adpn/Lep ≥ 1.0 i.e., within the reference range. Markers of systemic inflammation were significantly related to physical fitness: CRP/gait speed (rs = -0.377) and HMGB-1/gait speed (rs = -0.264). The results of the ROC analysis for Adpn (AUC = 0.526), Lep (AUC = 0.745) and HMGB-1 (AUC = 0.689) indicated their diagnostic potential for clinical prognosis in older patients. The optimal threshold values corresponded to 1.2 μg/mL for Adpn (sensitivity 74.2%, specificity 41.9%, OR = 1.4, 95%Cl 0.488–3.902), 6.7 ng/mL for Lep (sensitivity 56.2%, specificity 93.5%, OR = 14.8, 95%Cl 3.574–112.229), 2.63 mg/L for CRP (sensitivity 51.6%, specificity 84.3%, OR = 4.4, 95% Cl 1.401- 16.063) and 34.2 ng/mL for HMGB-1 (sensitivity 62.0%, specificity 86.6%, OR = 12.0, 95%Cl 3.254—61.614). The highest sensitivity and specificity were observed for Leptin and HMGB-1. The study revealed changes in inflammatory status in older adults at various levels of physical fitness and demonstrated diagnostic usefulness of adipokines in the assessment of adipose tissue inflammation.

The Short Physical Performance Battery does not correlate with daily life gait quality and quantity in community-dwelling older adults with an increased fall risk

BackgroundBoth the Short Physical Performance Battery (SPPB) and daily life gait quality and quantity obtained from wearable sensors are used to measure functional status in older adults. It is generally assumed that they are interrelated and exchangeable, but this has not yet been established. Interchangeability of these measures would pave the way for remote monitoring of functional status. Research QuestionAre the SPPB and daily life gait quality and quantity measures correlated in community-dwelling older adults? MethodsThe SPPB and gait quality and quantity data of 229 community-dwelling adults of 65 years or older were collected. The SPPB is a combined score of the Three Stage Balance test, Four Meter Walk test, and Five Times Sit to Stand test and ranges from 0 to 12. Participants wore a tri-axial inertial sensor for one week to assess gait quality (e.g. gait stability and smoothness) and quantity (e.g. number of strides). Correlation coefficients between SPPB scores and gait quality and quantity measures were assessed using Spearman’s correlation. ResultsThe median age of the study population was 76.2 years (IQR 72.6–81.0), and 76 % were women (n=175). The median SPPB score was 10 (IQR 8–11). Spearman's correlation coefficients between the SPPB and gait quality and quantity measures were all below 0.3. SignificanceA possible explanation for the observed weak correlations is that the SPPB reflects one’s maximal capacity, while gait quality and quantity reflect the submaximal performance in daily life. The SPPB and gait quality and quantity seem therefore distinct constructs with complementary value, rather than interchangeable. A more comprehensive understanding of functional status might be achieved by combining the SPPB assessment of standardized activities with the evaluation of inertial sensor measurements obtained during daily life activities.

The association of calligraphy activities with peace of mind, stress self-management, and perceived health status in older adults.

Calligraphy, as a form of mindful practice, encourages focus, creativity, and relaxation, which collectively contribute to a more peaceful mental state. Through regular engagement in calligraphy, older adults can develop better coping mechanisms for stress, leading to more effective self-management of daily stressors. This enhanced ability to manage stress can reduce the overall burden on their mental and physical health, promoting a more positive outlook on life. This study employed convenience sampling and snowball sampling to select 246 older adults aged 60-70 from Changsha, China, in March 2024 as valid samples. AMOS v.23 was used to construct a structural equation model to validate the hypotheses. The study found a significant positive correlation between calligraphy activities and peace of mind/stress self-management. There is also a significant positive correlation between peace of mind/stress self-management and perceived health status. Additionally, peace of mind and stress self-management act as mediators between calligraphy activities and perceived health status. This indicates that calligraphy activities not only contribute to the psychological well-being of older adults but also indirectly enhance their positive perception of their own health by improving their mental state. Consequently, such activities can be an integral part of holistic health interventions aimed at enhancing the quality of life and overall health of older adults.

Family transition and older adults: does age still matter?

Purpose In the current scenario, with rapid socioeconomic transformation occurring in all aspects of society, the adversities experienced by older adults have come to the forefront. The lived experiences within joint families are making it harder for the elderly to adjust to the changed familial setup. In such a situation, they undergo many problems which are most often overlooked and considered not worthy of serious attention. Loneliness and isolation are the most crucial and serious issues experienced by the elderly within the nuclear family. After spending a significantly larger part of their lives within large families, with caring people, interdependent, adjusting to the changing familial setup has become hard and strenuous. Moreover, lack of emotional support is yet another major concern of the elderly. As they grow older, care and emotional support become necessary to maintain an effective and active life in old age. However, such emotional support and care that the joint family offered is missing in the changing familial setup. Now, in light of these issues, this paper aims to explore the multidimensional concerns of the elderly (60 years and above) who, on account of familial transitioning from joint to nuclear in Kashmir, are experiencing isolation and other, hard to adjust, life changes. The paper is based on 20 oral narratives conducted, over time, with elderly people undergoing life changes due to family transition from joint to nuclear. The finding of the study revealed that the elderly experience a greater degree of change in their lifestyle due to the family transition from joint to nuclear. Design/methodology/approach This is a qualitative study that describes the multidimensional concerns of the older adults. The study was conducted in the union territory of Jammu and Kashmir using in-depth face-to-face interviews with 20 respondents aged 60 years and above who have witnessed a transition in family from joint to nuclear and have undergone many problems during this transition. Apart from this, two interviews with the sons of older persons were also included in the study to know the status of age in the current situation. After the data was collected from the first 10 respondents, the study witnessed a data saturation, as the same set of results were obtained. Meanwhile, 3 more respondents were included in the study to make sure that no data was left behind; however, again same results were witnessed. This led the investigator to halt the data collection process. Thereafter, the data was then analyzed using Braun and Clarke's (2006) thematic analysis technique, which involved familiarizing oneself with the data, looking for themes, validating and refining themes, identifying and labeling themes and finally creating the report. Findings The traditional joint family is undergoing rapid transformation in the current scenario. With a trend toward the nuclearization of families, which resulted in the diminishing status of the elderly, the vulnerabilities of the elderly have come to the forefront (Kumar et al., 2014). The transition of the family from joint to nuclear can be difficult for the elderly as it involves the elderly having to adjust and adapt to a new social milieu, which can be quite complex as it involves major changes in their lifestyle and daily routine. The elderly may also experience difficulty with increased social isolation and reduced family interaction. Such problems may seem insignificant and trivial to the younger ones, but stepping into the shoes of the elderly would help us understand the intensity and vulnerability of such problems. This cultural shift is quickly making changes, in part due to the rise of individualism in modern societies and the existence of a consumerist perspective among the younger generations. Such situations lead to greater alienation and isolation among the elderly from society in general and the members of the family in particular. Originality/value The is an empirical study conducted to know the status of older adults in nuclear families.

Impact of an oral nutritional supplement on nutritional status in older adults with malnutrition: A randomized controlled trial

Background: The aging population is expanding at an unprecedented rate, leading to a significant increase in the prevalence of malnutrition among older adults. Oral Nutritional Supplements (ONS) have emerged as a widely accepted strategy to address the nutritional needs of this demographic. Objective: This study aimed to evaluate the impact of an ONS on the nutritional status of malnourished older adults. Methods: This was an open-label, randomized-controlled, parallel-group, single-centered study. Recruitment criteria were age ≥60 years, and mini nutrition assessment-short form (MNA-SF) score ≤11. A total of 50 participants were randomly assigned to the intervention (IG) and control (CG) groups (1:1 ratio). The IG received 200 mL of ONS as a bedtime drink for 12 weeks, while the CG received 200 mL of water. Nutrition status, biochemical analysis, and dietary assessment were performed at the beginning and end of the study. Results: Forty-two participants (IG: n=20, and CG: n=22) completed the study. After 12 weeks, the IG showed a significant improvement in the MNA-SF score (p&lt;0.001) compared to the CG (p=0.118). The IG experienced a substantial increment in the vitamin D level (p=0.002). No significant improvements were found in the serum albumin and haemoglobin levels in either group. The intervention led to significant increases in daily intake of energy (p&lt;0.001), carbohydrate (p=0.013), protein (p&lt;0.001), and fat (p&lt;0.001) in comparison to the control group. Conclusion: Supplementing with an ONS, along with a regular diet, significantly improved nutritional status, some biochemical parameters, and daily intake of energy and macronutrients in older adults with malnutrition.

Predicting physical functioning status in older adults: insights from wrist accelerometer sensors and derived digital biomarkers of physical activity.

Conventional physical activity (PA) metrics derived from wearable sensors may not capture the cumulative, transitions from sedentary to active, and multidimensional patterns of PA, limiting the ability to predict physical function impairment (PFI) in older adults. This study aims to identify unique temporal patterns and develop novel digital biomarkers from wrist accelerometer data for predicting PFI and its subtypes using explainable artificial intelligence techniques. Wrist accelerometer streaming data from 747 participants in the National Health and Aging Trends Study (NHATS) were used to calculate 231 PA features through time-series analysis techniques-Tsfresh. Predictive models for PFI and its subtypes (walking, balance, and extremity strength) were developed using 6 machine learning (ML) algorithms with hyperparameter optimization. The SHapley Additive exPlanations method was employed to interpret the ML models and rank the importance of input features. Temporal analysis revealed peak PA differences between PFI and healthy controls from 9:00 to 11:00 am. The best-performing model (Gradient boosting Tree) achieved an area under the curve score of 85.93%, accuracy of 81.52%, sensitivity of 77.03%, and specificity of 87.50% when combining wrist accelerometer streaming data (WAPAS) features with demographic data. The novel digital biomarkers, including change quantiles, Fourier transform (FFT) coefficients, and Aggregated (AGG) Linear Trend, outperformed traditional PA metrics in predicting PFI. These findings highlight the importance of capturing the multidimensional nature of PA patterns for PFI. This study investigates the potential of wrist accelerometer digital biomarkers in predicting PFI and its subtypes in older adults. Integrated PFI monitoring systems with digital biomarkers would improve the current state of remote PFI surveillance.

Associations Between Food Insufficiency, SNAP Participation Status, and Variability of Nutritional Status in Older Adults: A 10-Year Longitudinal Study

Associations Between Food Insufficiency, SNAP Participation Status, and Variability of Nutritional Status in Older Adults: A 10-Year Longitudinal Study

Factors Influencing Low Muscle Strength among Community-Dwelling Older Adults with Non-Communicable Diseases

Introduction The presence of low muscle strength serves as a major indicator of sarcopenia and health status in older adults with non-communicable diseases (NCDs), leading to increased morbidity and mortality among them. Objective 1) To describe the prevalence of low muscle strength, and 2) To investigate personal and health factors predicting low muscle strength in community-dwelling older adults with NCDs Design This study employed a correlational predictive design, guided by physiological theory and literature as its conceptual framework. Methodology The participants consisted of 192 community-dwelling older adults diagnosed with non-communicable diseases in Samut Prakan province. Purposive sampling was employed according to the inclusion and exclusion criteria. Data were collected using the Global Physical Activity Questionnaire (GPAQ) version 2, the Thai Geriatric Depression Scale (TGDS-15), and nutritional and muscle strength assessments. Data were then analyzed using descriptive statistics and logistic regression analysis. Results Most of the participants were female (65.1%), with a mean age of 69.60 years (SD = 7.60). The prevalence of low muscle strength among older adults with non-communicable diseases was 54.17%. Personal and health factors including age (OR= 3.47, 95% CI = 1.91-6.33), weight loss (OR= 4.05, 95% CI = 1.11-14.70), physical activity (OR= 0.37, 95% CI = .19-.73), and depression (OR= 3.06, 95% CI = 1.16-8.03) were significantly predicted low muscle strength. Multiple logistic regression analysis revealed that age (OR= 3.02, 95%CI = 1.63-5.59) and physical activity (OR= 0.48, 95%CI = 0.24-0.97) together could predict low muscle strength among older adults with NCDs, accounting for 14.3% of the variance. Recommendation This study demonstrates that age and physical activity significantly predict low muscle strength among older adults with NCDs in the community. Therefore, health promotion programs addressing physical activity should be developed to reduce risk factors and to prevent and delay sarcopenia particularly in older adults of advanced age with NCDs.

Incidence of Fear of Fall and Stairs Climbing Status in Older Adults After Total Knee Arthroplasty

Background: This research aimed to assess factors influencing the frequency and fear of falls, and the anxiety related to climbing stairs in patients undergoing total knee arthroplasty (TKA). Fall-related injuries are common complications after TKA, affecting daily activities and overall quality of life. Objective: To evaluate the incidence of falls, fear of falling, and stair climbing abilities in patients post-TKA. Methods: The study included 183 patients who had undergone unilateral or bilateral TKA between 6 months to 1 year prior, encompassing both genders. Data were collected using the Fall Efficacy Scale (FES) and the Timed Up and Go (TUG) scale through structured questionnaires. Results: The mean age of participants was 68.78 years (SD=6.828, range 60-89). The mean total FES score was 64.11 (SD=10.712, range 37-91). Approximately 65% of patients had a high fear of falling and poor stair climbing status. Conclusion: The study found that 65% of patients experienced fear of falling and difficulties in stair climbing post-TKA. Continued risk of falls necessitates providing physical therapy and comprehensive discharge training to mitigate fall risk and improve functional outcomes.

CHIPing away at immunity: the role of clonal hematopoiesis of indeterminate potential in bacterial pneumonia.

The occurrence of clonal hematopoiesis of indeterminate potential (CHIP), in which advantageous somatic mutations result in the clonal expansion of blood cells, increases with age, as do an increased risk of mortality and detrimental outcomes associated with CHIP. However, the role of CHIP in susceptibility to pulmonary infections, which also increase with age, is unclear. In this issue of the JCI, Quin and colleagues explored the role of CHIP in bacterial pneumonia. Using characterization of immune cells from human donors and mice lacking tet methylcytosine dioxygenase 2 (Tet2), the authors mechanistically link myeloid immune cell dysfunction to CHIP-mediated risk of bacterial pneumonia. The findings suggest that CHIP drives inflammaging and immune senescence, and provide Tet2 status in older adults as a potential prognostic tool for informing treatment options related to immune modulation.

Allostatic load measures in older adults with subjective cognitive decline and mild cognitive impairment: A cross-sectional analysis from the Brazilian Memory and Aging Study

IntroductionAn increasing body of research suggests that stress and allostatic load are related to cognitive dysfunction and neurodegeneration. Objectivesto determine the relationship between allostatic load (AL) and cognitive status in older adults classified with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). MethodologyUsing the Brazilian Memory and Aging Study (BRAMS) database, we analyzed data from 57 older adults with SCD and MCI. Blood neuroendocrine (cortisol, DHEA-s), inflammatory (C-reactive protein, fibrinogen), metabolic (HbA1c, HDL-cholesterol, total cholesterol, creatinine), and cardiovascular (blood pressure, waist/hip ratio) were transformed into an AL index. ResultsDespite a significant difference in the univariate analysis between waist/hip ratio (0.94 in the MCI group vs. 0, 88 in the SCD group, p = 0.03), total cholesterol levels (194 vs. 160, p = 0.02), and AL index (36.9 % in the MCI group vs. 27.2 % in the SCD group, p = 0.04), AL was not associated with SCD or MCI in the multivariate analysis. ConclusionOur data suggest that different profiles of AL in MCI compared to individuals with SCD could be due to cofounding factors. These findings need to be confirmed in longitudinal studies investigating profiles of AL changes at preclinical and prodromal stages of Alzheimer’s disease.

An event-related potential investigation of the influence of bilingualism on disambiguating homonyms in older adults.

Ambiguity is ubiquitous in language; lexical ambiguity refers to instances where a single word has multiple meanings. The current investigation examined homonyms, words that have the same orthography and pronunciation in English but multiple meanings (e.g., BANK, meaning "financial institution" or "river's edge"). The processing of homonyms requires the engagement of executive control processes, for example, to select the appropriate meaning of the homonym while reducing interference from other meanings. Executive function processes are known to change over the lifespan and may be impacted by experiential factors such as bilingualism. The present study uses event-related brain potentials as an index of lexical access to examine whether bilingualism influences homonym processing in older adults. The results indicate that patterns of lexical access differ as a function of bilingual status in older adults and compared to young adults, suggesting that language experience may moderate language processing in both young and older adults, at least in situations where language processing is demanding on executive function, such as in the processing of homonyms. Importantly, we show that older bilinguals show a somewhat similar pattern of ambiguity processing as their younger counterparts, while age differences were observed in monolinguals when comparing across studies. This suggests that bilingual language experience may have a mitigating impact on age-related changes in ambiguity processing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association between oral health and cognitive impairment in older adults: Insights from a Six-year prospective cohort study

ObjectiveThis study aims to investigate the relationships between four baseline oral conditions (periodontal status, dental caries, tooth wear, and dentition) and repeated global cognition or domain-specific cognition (memory, executive function, attention, and verbal fluency) in non-demented older adults over time. MethodsThis prospective cohort study (2011–2019) enrolled 516 non-demented community-dwelling older adults (age ≥ 65) to explore the association between oral health and cognitive function. Global and domain-specific cognition were assessed biennially (four repeats) using a battery of neuropsychological tests. The baseline oral health conditions were examined, including periodontal status, dental caries, tooth wear, and dentition. The association of these oral conditions with cognition was evaluated by generalized linear mixed models. Stratified analyses were performed by important covariates. ResultsOver time, dental caries was associated with poor memory in two different logical memory tests (β^= -0.06 and β^= -0.04). Incomplete dentition with less than 28 teeth was associated with poor performance in attention (β^= -0.05) and verbal fluency (β^= -0.03). These associations became more evident in those with an elevated inflammatory marker (IL-6, β^= -0.11 to -0.08). In contrast, tooth wear was associated with better memory in two different logical memory tests (β^= 0.33 and β^= 0.36) and better executive function (β^= 0.06) over time, and this association became more evident in those with the lowest inflammatory marker (IL-6, β^= 0.10). ConclusionsDental caries and incomplete dentition were associated with poor memory, attention, and verbal fluency performance. Conversely, tooth wear was associated with better memory performance and executive function. Clinical SignificanceFor early prevention of dementia, an evaluation of multiple dental and periodontal status in older adults helps predict the risk of dementia in the preclinical phase. Maintaining intact tooth structure without caries progression and eventually tooth loss may help prevent the worsening of memory, attention, and verbal fluency over time.

Dietary nutrient intake study among older adults: baseline Malaysian pure study

IntroductionThe older adults (OA) is vulnerable to malnutrition, which may affect their health and quality of life. This study assesses the prevalence of deficiencies in dietary nutrients among the Malaysian OA stratified by residency, genders, socioeconomic status (SES) and body mass index (BMI).MethodologyA cross-sectional study was conducted, utilizing purposive sampling, recruiting 2,299 Malaysian people aged 60 years old and above who agreed to be interviewed via a comprehensive semi-quantitative food frequency questionnaire. The nutrients intake was calculated based on the Malaysian food composition and US Department of Agriculture food composition databases. Then, the nutrients intake was compared with the Malaysian Recommended Nutrients Intake guidelines, and the prevalence of deficiencies in dietary nutrients were calculated. The median (interquartile ranges) intakes of nutrients were compared between residency (urban and rural), genders (male and female), and SES (low and middle-high) using the Mann-Whitney U test. The differences in nutrient intake between BMI categories (underweight, normal, and overweight) were identified using the Kruskal-Wallis test followed by Dunn’s post hoc test.ResultsThe response rate was 70.3% (n = 2,299), predominantly were females (50.8%), received primary education (76.6%), were currently married (84.3%), were middle–high SES (57.7%), and had a normal BMI (59.8%). There was a notable inadequate intake prevalence of magnesium (100.0%), manganese (97.9%), zinc (95.6%), vitamin B6 (98.4%), potassium (91.0%), calcium (89.3%), vitamin B12 (80.2%), vitamin E (91.2%), and vitamin K (81.5%) among Malaysian OA. Additionally, significant differences were observed in nutrients intake levels across gender, residency, SES, and BMI within this population.ConclusionsThis study shows a high prevalence of dietary nutrients deficiency (> 80%) among the Malaysian OA, particularly for magnesium, manganese, potassium, zinc, vitamin B6, vitamin E, calcium, vitamin B12, and vitamin K. To improve the nutritional status of OA and safeguard against adverse health effects, it is necessary to formulate and execute strategies to enhance their dietary nutrient intakes. The strategies may involve intervention such as nutrient supplementation and promotion of consuming nutrient-rich foods.

Glucose Targets Using Continuous Glucose Monitoring Metrics in Older Adults With Diabetes: Are We There Yet?

The older population is increasing worldwide and up to 30% of older adults have diabetes. Older adults with diabetes are at risk of glucose-related acute and chronic complications. Recently, mostly in type 1 diabetes (T1D), continuous glucose monitoring (CGM) devices have proven beneficial in improving time in range (TIR glucose, 70-180 mg/dL or glucose 3.9-10 mmol/L), glycated hemoglobin (HbA1c), and in lowering hypoglycemia (time below range [TBR] glucose <70 mg/dL or glucose <3.9 mmol/L). The international consensus group formulated CGM glycemic targets relating to older adults with diabetes based on very limited data. Their recommendations, based on expert opinion, were aimed at mitigating hypoglycemia in all older adults. However, older adults with diabetes are a heterogeneous group, ranging from healthy to very complex frail individuals based on chronological, biological, and functional aging. Recent clinical trial and real-world data, mostly from healthy older adults with T1D, demonstrated that older adults often achieve CGM targets, including TIR recommended for non-vulnerable groups, but less often meet the recommended TBR <1%. Existing data also support that hypoglycemia avoidance may be more strongly related to minimization of glucose variability (coefficient of variation [CV]) rather than lower TIR. Very limited data are available for glucose goals in older adults adjusted for the complexity of their health status. Herein, we review the bidirectional associations between glucose and health status in older adults with diabetes; use of diabetes technologies, and their impact on glucose control; discuss current guidelines; and propose a new set of CGM targets for older adults with insulin-treated diabetes that are individualized for health and living status.