The Irish Longitudinal Study On Ageing Research Articles

A network analysis of depressive symptoms in adults with and without diabetes: findings from the Irish longitudinal study on ageing.

This study aimed to estimate networks of depressive symptoms among Irish adults with and without diabetes at two time points and compare between the two groups at each time point using data from the Irish Longitudinal Study on Ageing (TILDA). Participants were from Wave 1 (2009-2011) and Wave 4 (2016) of TILDA, with n = 639 participants with diabetes and n = 7,837 without diabetes at Wave 1, and n = 1,151with diabetes and n = 4,531 without diabetes at Wave 4. Depressive symptoms were measured using the 8 items of the Center for Epidemiologic Studies Depression Scale. Network psychometric analysis was used to examine symptom centrality, symptom-level associations, and network comparisons at each time point. Stable, strongly connected networks emerged for people with and without diabetes at both time points. The symptoms of feeling depressed, feeling like everything's an effort, not enjoying life, feeling sad, and couldn't get going were the most central nodes in all networks, which did not differ between people with and without diabetes. However, for people with diabetes, the network was more densely connected at Wave 4, when the sample was predominately people with newly diagnosed diabetes. Furthermore, the relationship between 'felt lonely' and 'couldn't get going' and between 'not enjoying life' and 'sad' was significantly stronger for people with diabetes than for those without. This study provides a more detailed understanding of the structure of depressive symptoms at two time points in older Irish adults with and without type 1 or type 2 diabetes.

Impact of sociodemographic patient factors on prescriber adherence to antihypertensive prescription guidelines: a cross-sectional study using data from The Irish Longitudinal Study on Ageing

Abstract Introduction Uncontrolled hypertension causes significant morbidity and mortality worldwide. Several international prescribing guidelines have been created to address this. However, prescriber adherence to these guidelines may be influenced by sociodemographic patient factors such as socio-economic status, gender and age. Aim To examine the effects of gender and other patient factors, including age, geographical location, educational attainment, duration of disease, socio-economic status, smoking status, and previous history of cardiovascular diseases on prescriber adherence to hypertension prescription guidelines. Achievement of blood pressure goals (<140/90 mmHg) with adherence to prescription guidelines was also assessed. Methods This study is a secondary analysis of cross-sectional data from the first wave (2009-2011) of The Irish Longitudinal Study on Ageing (TILDA), which included 8,175 Irish adults ≥50 years of age. Participants were included in the present study if they reported a previous doctor diagnosis of hypertension. Antihypertensive medication regimens were compared and categorised according to the 2011 National Institute for Health and Clinical Excellence (NICE)[1] prescription guidelines, which included the use of angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, and thiazide diuretics in the treatment of hypertension. In this study, the antihypertensive medication regimens of participants were categorised based on age categories (<55, ≥55, and all age groups), and compared to the 2011 NICE Guidelines which differentiate treatment in those ≥55, and <55 years of age. The effects of patient sociodemographic factors on prescriber adherence to the guidelines, and the effects of guideline adherence on blood pressure control, (defined as blood pressure<140/90 mmHg), were determined using multinomial logistic regression models. The mlogit, RRR code in STATA 17 SE was used to report relative risks (RRs). Results A total of 2,992 participants were included, of whom 54.9% were women. The mean age of participants was 65.69 years (±9.23). Male gender, older age and lower socioeconomic status among participants were associated with increased prescriber guideline adherence. Prescribers were less likely to adhere to guidelines in female patients ≥55 years (RR 0.75 [0.62 to 0.91]), and female patients across all age groups (RR 0.80 [0.67 to 0.95]). Better blood pressure control was seen with medication regimens adherent to prescription guidelines with a mean of 140.38 (±18.98)/83.09 (±11.02) mmHg compared to a mean of 141.66 (±19.86)/84.77 (±11.71) mmHg in those non-adherent to guidelines. Conclusion This study highlights the effects of patient gender on prescriber adherence to antihypertensive prescription guidelines. A study strength is the use of a large, nationally representative cohort that used a standardised protocol of data collection within the Irish population. A potential limitation is the inclusion of self-reported data, including doctor diagnosis of hypertension. The results of this study may emphasise a larger issue of the systemic undertreatment of women within healthcare; however, these results should be interpreted in the context of 2011 guidelines, which have since been superseded by 2019 NICE guidelines. Further research may seek to determine possible reasons for such differences in hypertensive care. Reference 1. Linden B. NICE guidance on primary hypertension National Institute for Health and Clinical Excellence (2011) Hypertension: Clinical Management of Primary Hypertension in Adults. NICE Clinical Guideline 127. British journal of cardiac nursing. 2011;6:582-584.

Examining mental health and autonomic function as putative mediators of the relationship between sleep and trajectories of cognitive function: findings from the Irish longitudinal study on ageing (TILDA)

Objectives This study investigates the mediating roles of autonomic function and mental health in the association between sleep and cognitive decline in adults aged 50 and above. Method A total of 2,697 participants with observations on sleep and mediators at baseline and repeated measures of cognitive function (MMSE) were included. Clusters of individuals with similar cognitive trajectories (high-stable, mid-stable and low-declining) were identified. Multinomial logistic regressions were used to estimate the likelihood of membership to each trajectory group based on sleep duration and disturbance. Finally, mediation analysis tested potential mediating effects of autonomic function and mental health underpinning the sleep–cognition relationship. Results Short (p = .028), long (p =.019), and disturbed sleep (p =.008) increased the likelihood of a low-declining cognitive trajectory. Mental health measures fully attenuated relationships between cognitive decline and short or disturbed sleep but not long sleep. No autonomic function mediation was observed. Conclusion Older adults with short or disturbed sleep are at risk of cognitive decline due to poor mental health. Individuals with long sleep are also at risk, however, the acting pathways remain to be identified. These outcomes have clinical implications, potentially identifying intervention strategies targeting mental health and sleep as prophylactic measures against dementia.

The Impact of Type 2 Diabetes on Peripheral and Cerebral Hemodynamic Responses to Active Stand.

Although type 2 diabetes mellitus (T2DM) is an established risk factor for cognitive impairment, the underlying mechanisms remain poorly explored. One potential mechanism may be through effects of T2DM on cerebral perfusion. The current study hypothesized that T2DM is associated with altered peripheral and central hemodynamic responses to orthostasis, which may in turn be associated with cognitive impairment in T2DM. A novel use of function-on-scalar regression, which allows the entire hemodynamic response curve to be modeled, was employed to assess the association between T2DM and hemodynamic responses to orthostasis. Logistic regression was used to assess the relationship between tissue saturation index (TSI), T2DM, and cognitive impairment. All analyses used cross-sectional data from Wave 3 of The Irish Longitudinal Study on Ageing (TILDA). Of 2984 older adults (aged 64.3 ± 8.0; 55% female), 189 (6.3%) had T2DM. T2DM was associated with many features that are indicative of autonomic dysfunction including a blunted peak heart rate and lower diastolic blood pressure. T2DM was associated with reduced TSI and also with greater odds of impaired performance on the Montreal Cognitive Assessment (odds ratio [OR]: 1.62; confidence interval [CI: 1.07, 2.56]; p = .019). Greater TSI was associated with lower odds of impaired performance (OR: 0.90, CI [0.81-0.99]; p = .047). T2DM was associated with impaired peripheral and cerebral hemodynamic responses to active stand. Both T2DM and reduced cerebral perfusion were associated with impaired cognitive performance. Altered cerebral perfusion may represent an important mechanism linking T2DM and adverse brain health outcomes in older adults.

Nutrition is associated with differences in multisensory integration in healthy older adults

ABSTRACT Diet can influence cognitive functioning in older adults and is a modifiable risk factor for cognitive decline. However, it is unknown if an association exists between diet and lower-level processes in the brain underpinning cognition, such as multisensory integration. We investigated whether temporal multisensory integration is associated with daily intake of fruit and vegetables (FV) or products high in fat/sugar/salt (FSS) in a large sample (N = 2,693) of older adults (mean age = 64.06 years, SD = 7.60; 56% female) from The Irish Longitudinal Study on Ageing (TILDA). Older adults completed a Food Frequency Questionnaire from which the total number of daily servings of FV and FSS items respectively was calculated. Older adults’ susceptibility to the Sound Induced Flash Illusion (SIFI) measured the temporal precision of audio-visual integration, which included three audio-visual Stimulus Onset Asynchronies (SOAs): 70, 150 and 230 ms. Older adults who self-reported a higher daily consumption of FV were less susceptible to the SIFI at the longest versus shortest SOAs (i.e. increased temporal precision) compared to those reporting the lowest daily consumption (p = .013). In contrast, older adults reporting a higher daily consumption of FSS items were more susceptible to the SIFI at the longer versus shortest SOAs (i.e. reduced temporal precision) compared to those reporting the lowest daily consumption (p < .001). The temporal precision of multisensory integration is differentially associated with levels of daily consumption of FV versus products high in FSS, consistent with broader evidence that habitual diet is associated with brain health.

The lived experience of frailty: beyond classification and towards a holistic understanding of health

Key summary pointsAimWe cross-sectionally described measured characteristics and lived experiences of older adults classified as frail by three different scales in The Irish Longitudinal Study on Ageing (TILDA).FindingsDespite being classified as frail, more than 60% rated their health positively, and over 77% engaged in active leisure activities at least once a month.MessageThis study challenges the excessively negative perceptions of frailty, underscoring the need for a holistic understanding of frailty beyond classification scales.

Physical activity dose for generalized anxiety disorder & worry: Results from the Irish longitudinal study on ageing

The lowest moderate-to-vigorous physical activity (MVPA) dose that conveys protection for Generalized Anxiety Disorder (GAD) and worry is unknown. This study quantified associations of weekly accumulated MVPA doses with GAD and worry across 10 years using data from The Irish Longitudinal Study on Ageing (TILDA). Continuous MVPA (metabolic equivalent of task [MET] minutes per week [MET.min.week−1]; e.g., moderate-intensity brisk walking = 4METs), three-dose and, more precise, five-dose MVPA categories were examined. Worry symptoms and GAD status were measured using the Penn State Worry Questionnaire-Abbreviated and the Composite International Diagnostic Interview. Multivariable negative random effect binomial regression and logistic models adjusted for relevant covariates quantified associations across time. Among the 7,650 participants, compared to no MVPA (0 MET.min.week−1), 18 % (OR: 0.82; 95 %CI: [0.69–0.98]), 22 % (OR: 0.78; [ 0.64–0.95]) and 31 % (OR: 0.69; [0.59–0.79]) lower odds of GAD were found for the doses of 1-<600, 600-<1,200 and ≥2,400 MET.min.week−1 respectively. Post-hoc analysis demonstrated 47 % lower odds (OR: 0.53; (0.36–0.78) of GAD for 1-<200 MET.min.week1 compared to inactivity. Compared to no activity, engaging in even minimal physical activity equivalent of 10 min/day for five days/week of moderate-intensity activity (e.g., brisk walking), may lower the risk of GAD over time among older adults.

Slower speed of blood pressure recovery after standing is associated with accelerated brain ageing: Evidence from The Irish Longitudinal Study on Ageing (TILDA)

BackgroundImpaired recovery of blood pressure (BP) in response to standing up is a prevalent condition in older individuals. We evaluated the relationship between the early recovery of hemodynamic responses to standing and brain health in adults over 50. MethodsParticipants from The Irish Longitudinal Study on Ageing (TILDA) (n=411; age 67.6 ± 7.3 years; 53.4 % women) performed an active stand challenge while blood pressure and heart rate were continuously monitored. The recovery of these parameters was determined as the slope of the BP and HR response, following the initial drop/rise after standing. We have previously reported a novel and validated measure of brain ageing using MRI data, which measures the difference between biological brain age and chronological age, providing a brain-predicted age difference (brainPAD) score. ResultsSlower recovery of systolic and diastolic BP was found to be significantly associated with higher brainPAD scores (i.e., biologically older brains), where a one-year increase in brainPAD was associated with a decrease of 0.02 mmHg/s and 0.01 mmHg/s in systolic and diastolic BP recovery, respectively, after standing. Heart rate (HR) recovery was not significantly associated with brainPAD score. ConclusionThese results demonstrate that slower systolic and diastolic BP recovery in the early phase after standing is associated with accelerated brain ageing in older individuals. This suggests that the BP response to standing, measured using beat-to-beat monitoring, has the potential to be used as a marker of accelerated brain ageing, relying on a simple procedure and devices that are easily accessible.

Social Vulnerability, Frailty and Self-Perceived Health: Findings from The Irish Longitudinal Study on Ageing (TILDA).

Social vulnerability interacts with frailty and influences individuals' health status. Although frailty and social vulnerability are highly predictive of adverse outcomes, their relationship with self-perceived health(SPH) has been less investigated. Data are from the Irish Longitudinal Study on Ageing(TILDA), a population-based longitudinal study of ageing. We included 4,222 participants aged ≥50 years (age 61.4±8.5 years;women 56%) from Wave 1 (2009-2011) followed over three longitudinal waves (2012,2014-2015,2016). Participants responded to single questions with five response options to rate their 1)physical health, 2)mental health, and 3)health compared to peers. 30-item Frailty (FI) and Social Vulnerability (SVI) indices were calculated using standardised methods. Multivariable regression analyses were performed to establish the association between FI and SVI cross-sectionally and longitudinally over 6 years. Cross-sectionally, SVI (mean:0.40±0.08; range:0.14-0.81) and FI (mean: 0.13±0.08; range:0.10-0.58) were modestly correlated (r=0.256), and independently associated with poor physical health (SVI: OR 1.43, 95%CI 1.15-1.78; FI: OR 3.16, 95%CI 2.54-3.93), poor mental health (SVI: OR 1.65, 95%CI 1.17-2.35; FI: OR 3.64, 95%CI 2.53-5.24), and poor health compared to peers (SVI: OR 1.41,95%CI 1.06-1.89; FI: OR 3.86, 95%CI 2.9-5.14). Longitudinally, FI and SVI were independently and positively associated with poor physical health (SVI: β 1.08, 95%CI 0.76-1.39; FI: β 1.97, 95%CI 1.58-2.36), poor mental health (SVI: β 1.18, 95%CI 0.86-1.5; FI: β 1.58, 95%CI 1.2-1.97), and poor overall health compared to peers (SVI: β 0.78, 95%CI 0.89-1.33; FI: β 1.74, 95%CI 0.47-1.1). In a large cohort of community-dwelling older adults, frailty and social vulnerability were associated with poor SPH and with risk of SPH decline over six years.

‘Ageing well’: Discursive constructions of ageing and health in the public reach of a national longitudinal study on ageing

Established in 2006, the Irish Longitudinal Study on Ageing (TILDA) investigates the health, economic and social circumstances of a nationally-representative sample of people aged fifty years and older in a series of biennial data collection waves. Irish newspapers have been reporting the results of TILDA for over a decade and a half, and their texts represent reports of scientific research distilled through the pen of journalists. In their totality, their texts constitute a public discourse on ageing and health. Using critical discourse analysis, we examined the discourse within the texts of a purposive sample of two national daily newspapers. As sites of public discourse, newspapers reflect social life and are influential in forming and legitimating public attitudes. Like other sites of discourse, their language-in-use is contextually located, is rarely neutral and may employ strategies to discursively construct, sustain and privilege particular social identities, including ageing identities.Discursively constructed as ‘ageing well’, our analysis of newspaper texts revealed a discernible meta-discourse on ageing and health in which ageing was framed as a life course stage that may be cultivated, diligently self-nurtured and exploited for its positive aspects. When considered in light of literature on health and social inequalities, the consequences of this broadly positive ageing discourse can, somewhat perversely, frame older adults in unintended negative ways, including homogenising them and attributing to them capacities for ageing well that they may not possess. Discursively constructing older adults as a social and economic resource can also impose unrealistic expectations on them and may legitimise exploitation and demonstrate how normative ideologies of ageism and ableism are conveyed through legitimising language. Despite these potentially unintended consequences, the available media resources associated with TILDA may represent one of the most important contributions of the study, in terms of informing positive public attitudes towards ageing.

Associations between NTproBNP and 10‐year cognitive decline in The Irish Longitudinal Study on Ageing (TILDA)

AbstractBackgroundNT‐proB‐type Natriuretic Peptide (NTproBNP) is a hormone released in response to changes in pressure inside the heart often related to heart failure and other cardiac problems. Early evidence shows significant correlations between brain structure and markers of heart failure including ejection fraction and NTproBNP. We sought to investigate if levels of this biomarker are related to cognitive decline over 10 years in older adults participating in the Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort of adults aged 50 years and older residing across Ireland.MethodLevels of NTproBNP were measured in 4,105 participants, mean age 61.5 years and 53.8% women, from blood drawn at baseline (Wave 1: 2009‐2011). Verbal memory (10‐word immediate and delayed recall) and verbal fluency/ executive function (animal naming) were measured every two‐years over a 10‐year follow‐up (Wave 1 – 6) and were used to create a composite score at each wave which served as a measure of global cognitive function. Linear mixed effect models with adjustment for covariates were performed. Model 1 included age, age^2, sex, education; Model 2 included Model 1 + cardiovascular diseases (heart failure, heart attack, stroke, tia, hypertension, diabetes), lifestyle factors (smoking, alcohol, physical activity, waist‐hip ratio) and depression.ResultNTproBNP was significantly and negatively associated with cognitive function at Wave 3 (B = ‐0.13, 95%CI = ‐0.20, ‐0.05), Wave 4 (B = ‐0.24, 95%CI = ‐0.31, ‐0.16), Wave 5 (B = ‐0.25, 95%CI = ‐0.32, ‐0.17) and Wave 6 (B = ‐0.26, 95%CI = ‐0.34, ‐0.17) (p&lt;.001) (Figure 1). After further adjustment, the associations remained significant.ConclusionThese results suggest that NTproBNP may be useful as an early indicator of cognitive decline in older adults for those with and without current cardiovascular diseases.

Metabolic syndrome accelerates epigenetic ageing in older adults: Findings from The Irish Longitudinal Study on Ageing (TILDA)

Metabolic syndrome (MetS) is a risk factor for the development of diabetes, cardiovascular disease, and all-cause mortality. It has an estimated prevalence of 40 % among older adults. Epigenetic clocks, which measure biological age based on DNA methylation (DNAm) patterns, are a candidate biomarker for ageing. GrimAge is one such clock which is based on levels of DNAm at 100 Cytosine-phosphate-Guanine (CpG) sites. This study hypothesised that those with MetS have ‘accelerated ageing’ (biological age greater than their chronological age) as indexed by GrimAge. This study examined MetS's association with GrimAge age acceleration (AA) using data from a subsample of 469 participants of the Irish Longitudinal Study on Ageing (TILDA). MetS was defined by National Cholesterol Education Program Third Adult Treatment Panel (ATP III) and International Diabetes Foundation (IDF) criteria, operationalised using the conventional binary cut-off, and as a count variable ranging from 0 to 5, based on the presence of individual components. This study also explored inflammation (as measured by C reactive protein) and metabolic dysfunction (as measured by adiponectin) as possible mediating factors between MetS and GrimAge AA. We found that MetS as defined by IDF criteria was associated with GrimAge AA of 0.63 years. When MetS was treated as a count, each unit increase in MetS score was associated with over 0.3 years GrimAge AA for both ATP III and IDF criteria. Inflammation mediated approximately one third of the association between MetS and GrimAge AA, suggesting that chronic subclinical inflammation observed in MetS has a relationship with DNAm changes consistent with a faster pace of ageing. Metabolic dysfunction mediated the association between MetS and GrimAge AA to a lesser extent (16 %). These data suggest that chronic subclinical inflammation observed in MetS has a relationship with DNAm changes consistent with a greater pace of ageing.

Factors linked to future care conversations with others in Ireland: Age and gender differences

Abstract Background Ireland needs evidence-based strategies for meaningful engagement in ACP activities. This study aimed to identify factors associated with conversations with trusted others among older adults in Ireland. Methods Data from the Irish Longitudinal Study on Ageing (TILDA), a nationally representative study of community-dwellers (≥50 years old), was used. Participants who consistently reported ACP conversations with trusted others at Waves 4 and 6 (n = 2764) were included. Binary logistic regression was carried out using these conversations as a dependent variable (categorised as engagement/non-engagement). The results of a mixed-research synthesis informed selection of explanatory variables; including age, gender, education, health literacy, pain, making a will, religiosity, wish to die, and marital status. Data were stratified by gender and aged groups. Results Although men (n = 1242) were 58% less likely to engage in conversations with trusted others, there was a 4% increase in odds of their engagement per year older. Younger participants (≤64) who made a will were 99% more likely to report ACP conversations. Those who were ≤74 years old and reported pain were 42% more likely to engage. Men and younger participants (50-64) who ever experienced a wish to die were over twice as likely to report ACP. Similarly, men and those &amp;gt;74 years old with a third level education were twice as likely to engage. For every additional score on the health literacy scale, women were 56% more likely to report ACP. Younger participants (50-64) for whom religion was somewhat important were 36% less likely to engage. While single women were 49% less likely to engage, separated, divorced, or widowed women were 43% more likely to report ACP. Conclusions This study identified theoretically important factors associated with ACP conversations with loved ones in Ireland and highlighted gender and age groups differentials. These findings will inform policy and ACP intervention development. Key messages • Increasing age, female gender, third level education, health literacy, having a will, pain, and a wish to die facilitate ACP conversations. Religiosity and being single impede these conversations. • The findings should inform the design of local ACP interventions. They suggest the need to tailor future ACP strategies to the requirements of specific gender and age groups.

Tooth loss is associated with prevalent diabetes and incident diabetes in a longitudinal study of adults in Ireland.

The aim of this study was to explore the relationship between periodontal status, tooth loss and diabetes among community-dwelling adults aged 50 years and over in Ireland. From respondents who attended a health assessment in Wave 3 of the Irish Longitudinal Study on Ageing (TILDA), an opportunistic sample was selected for an oral health examination. The oral health examination criteria were used in previous Irish surveys and WHO recommendations. For diabetes, the self-reported and objectively measured data on diabetes for the same cohort from Wave 3 to Wave 5 of TILDA was used. Multinomial regression analysis was used to evaluate the relationship between diabetes and tooth loss and tooth loss and incident diabetes, controlling for other covariates. Out of the 3111 people who were offered an oral health assessment 2539 were examined. For the purposes of analysis, the adults below 50 years of age (n = 31) and those with an incomplete oral health assessment (n = 4) were omitted from the sample. The final sample consisted of 2504 people, giving a response rate of 80.5%. Among the study sample, 9.9% (n = 249) were edentate; 35.7% (n = 895) had 1-19 teeth and 54.4% (n = 1360) had ≥20 teeth. From the sample of 2504 adults, 2358 had HbA1c results and 8.4% (n = 198) of these had diabetes according to the TILDA criteria. Multinomial regression analysis showed that diabetes was associated with tooth loss. Diabetes at Wave 3 was associated with a higher rate of being edentate (PR 2.12, 95% CI 1.27-3.52) relative to having ≥20 teeth while controlling for the effect of age, gender, education level, area of residence, body mass index (BMI) and smoking. Furthermore, having 1-19 teeth at Wave 3 was associated with incident diabetes over a 4-year follow-up (OR 1.94, 1.00-3.75). There was no evidence of an association between diabetes and periodontal status as measured in this sample. The results suggested that diabetes was associated with tooth loss and that this relationship may be bi-directional among community-dwelling adults aged 50 years and over in Ireland, but they do not support a relationship between diabetes and periodontal status in this sample.

144 Personality’s association with the concordance of subjective and objective cholesterol measures: findings from the Irish longitudinal study on ageing (TILDA)

Abstract Background With Cardiovascular Disease (CVD) as a leading cause of death in older adults, examining risk factors for CVD is crucial. High cholesterol, often addressable by lifestyle changes and medication, is a main contributor to CVD. Despite a large portion of Ireland’s (and the world’s) population having high cholesterol, this chronic illness goes undiagnosed or untreated. Personality’s demonstrated associations with overall health, self-reported health, and health behaviours makes it a key facet to examine alongside cholesterol. Methods Through secondary analysis of data from Waves 1 and 3 of TILDA, this research explores the intricate relationships between personality, subjective (self-reported cholesterol), and objective (bloods-measured) cholesterol. The 5 domains of personality were first cross-sectionally and longitudinally examined in relation to each manner of cholesterol measure. Overall concordance between subjective and objective results was examined. Finally, personality’s association with levels of concordance was analysed. These analyses were conducted using bivariate analyses and multinomial logistic regression. Results Various personality traits were univariately associated with cholesterol, with associations varying by cholesterol measure. Neuroticism was higher in participants with high subjective cholesterol, and extraversion, openness, agreeableness, and conscientiousness were higher in those with high objective cholesterol. Overall agreement between objective and subjective high cholesterol was low and only partially explained by personality traits. While substantial percentage of participants improved their bloods-measured cholesterol over time, openness was the only trait that predicted any change in cholesterol status. Conclusion These findings demonstrate univariate effects of personality traits on cholesterol levels. There is also evidence of discordance between subjective and objective cholesterol levels, suggesting a vast amount of the population goes undiagnosed and untreated for high cholesterol. This study’s unique findings have crucial implications for the public health sphere, demonstrating the importance of diversifying healthcare approaches and laying the groundwork for exploring personality’s associations with other cardiometabolic risk factors.

216 The relationship between anxiety and physical functional decline in older Irish adults: analysis of the Irish Longitudinal Study on Ageing

Abstract Background Research has shown the prevalence of anxiety in the older adult population and its significant impact on physical health. The Irish population is ageing and will have an increasing proportion of the population experiencing physical functional decline. Both anxiety and physical functional decline are associated with reduced quality of life and increased healthcare costs. The aim of this study was to explore if there is an association between anxiety and physical functional decline in older Irish adults. Methods This study used data from the Irish Longitudinal Study on Ageing (TILDA). The sample cohort were derived from those who had completed the Hospital Anxiety and Depression Scale (HADS-A) and who reported having difficulty with Activities of Daily Living (ADL) at Wave 1. This cohort were analysed at Wave 2 for a possible association between anxiety, as measured by the HADS-A and physical functional decline, as measured by an ADL self-reporting questionnaire and a Timed Up and Go (TUG). Results The sample cohort consisted of 535 participants. The result of the logistic regression found that the odds of continuing to report an ADL difficulty at Wave 2 are 1.78 (95% Confidence Interval [CI]: 1.15, 2.76) times higher for those with anxiety compared to those without and is statistically significant at p = 0.029. The result of the logistic regression analysis found that those with anxiety are more likely to have a longer TUG time (12.4 sec) than those without (11.19 sec) and the result is statistically significant (p = 0.023). Conclusion Anxiety is a mental health condition that has a significant impact on physical health. This study has established that there is an association between anxiety and physical functional decline in the older adult population in Ireland. Further research is needed to establish the nature and directionality of the relationship.

180 Comparative performance of a new 3-item health index in predicting mortality: a seven-year follow-up study

Abstract Background The effectiveness of health measures in predicting mortality remains a critical aspect of clinical practice. This study aimed to evaluate the performance of a novel 3-item Health Index (HI) and compare it with existing frailty measures, the Frailty Index (FI) and Frailty Phenotype (FP), for predicting all-cause mortality in a cohort of older, community-dwelling adults. Methods Mortality data spanning seven years, encompassing multiple confounding variables, were analysed using Cox proportional regression. The 3-item HI was developed based on resting-state systolic blood pressure sample entropy (sBP SampEn), Sustained Attention Reaction Time (SART) performance, and gait speed. Hazard Ratios (HR) and Area Under the Curve (AUC) were derived for comparative analysis. Results In total, there were 4,265 participants (178 deceased) in the study (mean age = 61.6 ± 8.2 years; 54% female) from The Irish Longitudinal Study on Ageing (TILDA). The new 3-item HI demonstrated superior predictive ability for all-cause mortality compared to the FI and FP, with an AUC of 0.71, surpassing the AUC values of 0.68 and 0.62 for the FI and FP, respectively. Categorising individuals into ‘Low-Risk’, ‘Medium-Risk’, and ‘High-Risk’ groups, the High-Risk group of the HI exhibited a HR of 9.14 (95% CIs: 4.21, 19.86), while the Frail group of the FI and FP displayed HRs of 4.12 (95% CIs: 2.77, 6.12) and 6.87 (95% CIs: 3.58, 13.19), respectively. Furthermore, the 3-item HI remained a significant predictor of mortality even after comprehensively adjusting for confounding variables. Conclusion The objectively measured new 3-item HI demonstrated superior predictive ability for all-cause mortality compared to (mostly self-reported) count-based frailty measures currently employed in clinical practice. To facilitate wider utilisation, we have developed a user-friendly MATLAB App, freely available to researchers and clinicians, allowing easy calculation of the 3-item HI in various healthcare settings. The implementation of this innovative health assessment tool could advance risk prediction and inform decision-making in patient care.

Individual differences in seated resting heart rate are associated with multisensory perceptual function in older adults.

There is evidence that cardiovascular function can influence sensory processing and cognition, which are known to change with age. However, whether the precision of unisensory and multisensory temporal perception is influenced by cardiovascular activity in older adults is uncertain. We examined whether seated resting heart rate (RHR) was associated with unimodal visual and auditory temporal discrimination as well as susceptibility to the audio-visual Sound Induced Flash Illusion (SIFI) in a large sample of older adults (N = 3232; mean age = 64.17 years, SD = 7.74, range = 50-93; 56% female) drawn from The Irish Longitudinal Study on Ageing (TILDA). Faster seated RHR was associated with better discretization of two flashes (but not two beeps) and increased SIFI susceptibility when the audio-visual stimuli were presented close together in time but not at longer audio-visual temporal offsets. Our findings suggest a significant relationship between cardiovascular activity and the precision of visual and audio-visual temporal perception in older adults, thereby providing novel evidence for a link between cardiovascular function and perceptual function in aging.

218 An analysis of the impact of psychotropic medications on gait in the Irish longitudinal study on ageing (TILDA)

218 An analysis of the impact of psychotropic medications on gait in the Irish longitudinal study on ageing (TILDA)

Evaluation of a 3-Item Health Index in Predicting Mortality Risk: A 12-Year Follow-Up Study.

This study was carried out using a large cohort (N = 4265; 416 deceased) of older, community-dwelling adults from The Irish Longitudinal Study on Ageing (TILDA). The study compared the performance of a new 3-item health index (HI) with two existing measures, the 32-item frailty index (FI) and the frailty phenotype (FP), in predicting mortality risk. The HI was based on the objective measurement of resting-state systolic blood pressure sample entropy, sustained attention reaction time performance, and usual gait speed. Mortality data from a 12-year follow up period were analyzed using Cox proportional regression. All data processing was performed using MATLAB and statistical analysis using STATA 15.1. The HI showed good discriminatory power (AUC = 0.68) for all-cause mortality, similar to FI (AUC = 0.68) and superior to FP (AUC = 0.60). The HI classified participants into Low-Risk (84%), Medium-Risk (15%), and High-Risk (1%) groups, with the High-Risk group showing a significant hazard ratio (HR) of 5.91 in the unadjusted model and 2.06 in the fully adjusted model. The HI also exhibited superior predictive performance for cardiovascular and respiratory deaths (AUC = 0.74), compared with FI (AUC = 0.70) and FP (AUC = 0.64). The HI High-Risk group had the highest HR (15.10 in the unadjusted and 5.61 in the fully adjusted models) for cardiovascular and respiratory mortality. The HI remained a significant predictor of mortality even after comprehensively adjusting for confounding variables. These findings demonstrate the effectiveness of the 3-item HI in predicting 12-year mortality risk across different causes of death. The HI performed similarly to FI and FP for all-cause mortality but outperformed them in predicting cardiovascular and respiratory deaths. Its ability to classify individuals into risk groups offers a practical approach for clinicians and researchers. Additionally, the development of a user-friendly MATLAB App facilitates its implementation in clinical settings. Subject to external validation in clinical research settings, the HI can be more useful than existing frailty measures in the prediction of cardio-respiratory risk.