Interventions For Older Adults Research Articles

Impact of Frailty on Antihypertensive Treatment in Older Adults.

The association between systolic blood pressure and all-cause mortality differs between frail and nonfrail individuals, highlighting uncertainties about the effectiveness of antihypertensive treatments in frail populations. Using data from the SHEP trial (Systolic Hypertension in the Elderly Program), a baseline frailty index (FI), including 55 variables, was constructed. Fine-Gray subdistribution hazard models and Cox proportional hazards regression models were used to explore the association between baseline FI and the risks of stroke, cardiovascular disease, and all-cause death, as well as to examine whether the impact of antihypertensive treatment on these outcomes was modified by baseline FI. A total of 4692 participants (mean age, 72.1 years; 56.7% women) were included, with a mean (SD) FI of 0.134 (0.061). During a median follow-up period of 4.4 years, FI was associated with a higher risk of stroke (subdistribution hazard ratio, 1.24 [95% CI, 1.10-1.39]; per SD higher FI), cardiovascular disease (subdistribution hazard ratio, 1.18 [95% CI, 1.09-1.26]), and all-cause death (hazard ratio, 1.37 [95% CI, 1.26-1.50]), after adjustment for age, sex, race, and treatment group. Although those with higher levels of frailty were at higher risk for all outcomes, there was no evidence of an interaction between baseline FI and antihypertensive treatment (P for interaction >0.05 for all outcomes). In individuals with isolated systolic hypertension, antihypertensive treatment improved associated outcomes even among those with a higher degree of frailty. These findings from the SHEP trial reinforce evidence from other seminal antihypertensive trials, which collectively inform the appropriate treatment of frail individuals with hypertension. URL: https://www.clinicaltrials.gov; Unique identifier: NCT00000514.

Development of the Revised Entry-Level Essential Competencies in the Care of Older Adults: Linking Domains of Competence, Commission on Accreditation in Physical Therapy Education Standards, and the Geriatric 5Ms.

Geriatric physical therapy (PT) has evolved since 2011, when the Essential Competencies (ECs) in the Care of Older Adults at the Completion of the Entry-level Physical Therapy Professional Program of Study were published. The purpose of the ECs was to ensure that all entry-level physical therapists were prepared to meet the unique needs of the growing older adult population. Changes in population demographics, medical and research advances, coupled with advancements in the profession of PT, necessitate a revision of the ECs. The Academic Education Committee of APTA Geriatrics was convened to revise the original ECs. Participation was solicited and obtained from experts in clinical and academic geriatric PT; committee work lasted from 2021 to 2024. The committee recognized the intersection of the Domains of Competence Framework developed by the American Physical Therapy Association (APTA), American Council of Academic Physical Therapy, and the Academy of Education partnership, the geriatric medicine 5Ms model, and the Commission on Accreditation in Physical Therapy Education (CAPTE) standards in guiding entry-level PT education. The committee determined that the Domains of Competence, Geriatric 5Ms, and CAPTE standards could synergistically enhance the establishment of contemporary ECs. Input from a nonresearch-based informational survey of APTA Geriatrics members, supported by feedback from discussion at a platform presentation at the APTA's Combined Section Meeting San Diego 2023, informed the revised ECs presented in the current manuscript. This manuscript presents the revised ECs and describes how each EC links to the Domains of Competence, the Geriatric 5Ms, and CAPTE standards. The updated ECs aim to promote best practices in entry-level PT education by providing all stakeholders clear and concise competency statements for the physical therapy examination and treatment of older adults.

Efficacy and safety of osteoporosis treatment in older adults. approach for the secondary prevention of fractures in older populations. a proposal by SEFRAOS

Efficacy and safety of osteoporosis treatment in older adults. approach for the secondary prevention of fractures in older populations. a proposal by SEFRAOS

A Scoping Review of Interventions Aimed at Reducing Fear of Falling in Older Adults With Orthopedic Conditions.

Fear of falling (FoF) is a persistent anxiety regarding the risk of falling, which can even impact individuals without a history of falls. Fear of falling has been associated with decreased physical functioning and increased risk of falls. Most interventions have focused on reducing FoF in healthy older adults. This study aimed to review the literature's scope, nature, and content related to FoF interventions in older adults with orthopedic conditions. A scoping literature review was conducted. The method steps included identifying the research question, identifying relevant studies, selecting the studies, charting the data, and synthesizing, summarizing, and reporting the results. Cochrane Library, Medline, PsycINFO, Embase, ProQuest, and Google Scholar were searched. The search strategy used a set of key concepts, including "Fear of Falling," "Orthopedic conditions," "Interventions," and "Older adults." Out of the 33 articles that fulfilled the inclusion criteria, 21 were randomized control trials (RCTs), 5 were RCT protocols, 3 were quasi-experimental studies, 2 employed pre-post designs, 1 was a prospective cohort study, and 1 was an experimental study. The review revealed 7 distinct categories of interventions: exercise training, cognitive behavioral therapy, enhanced occupational or physical therapy (OT or PT), motivational interviews, interdisciplinary interventions, education, and mind-body intervention. The Falls Efficacy Scale (FES) was the most frequently used outcome measure for assessing FoF. Other measures were the Fear of Falling Questionnaire (FoFQ), the International Physical Activity Questionnaire (IPAQ), and the Perceived Ability to Manage Fall (PAMF). The studies varied in their reasoning, content, and how they reported findings, posing challenges for healthcare professionals in choosing and applying FoF intervention programs specific to various orthopedic conditions. This review highlighted the need for adopting more comprehensive approaches for assessing and addressing FoF in older adults with orthopedic conditions.

Mindfulness interventions in older adults for mental health and well-being: A meta-analysis.

Mindfulness interventions are consistently associated with beneficial effects in younger adults. In this meta-analysis, we seek to quantify the effectiveness of mindfulness interventions for the mental health and well-being of older adults. We include 46 studies that implemented a mindfulness intervention (MBSR = 20; MBCT = 9; ad hoc protocol = 17) with older adults (samples with an average age of 60 or older; healthy adults = 20; adults with underlying symptoms = 26), examining a wide range of outcome measures (e.g., stress, quality of life, sleep). Mindfulness interventions in older adults yielded an estimated Hedges' g of 0.25. Moderator analyses revealed three significant effects. Type of intervention mattered, with the effect size for MBSR not significantly different from zero (Hedges' g = 0.12) while the effect sizes for MBCT (Hedges' g = 0.33) and "other" interventions (Hedges' g = 0.36) were. Outcome measure mattered, with significant beneficial effect sizes for mental functioning (Hedges' g = 0.59), depression (Hedges' g = 0.35), sleep (Hedges' g = 0.39), anxiety (Hedges' g = 0.32), "other" (Hedges' g = 0.24), stress (Hedges' g = 0.22) and mindfulness (Hedges' g = 0.23). Finally, whether the outcome was targeted (e.g., measures of depression in a population suffering from major depressive disorder) mattered: variables that measured targeted outcomes yielded stronger effects (Hedges' g = 0.30). Mindfulness interventions with older adults are effective, but modestly so. The extant literature is limited by reliance on modified interventions that have not been evaluated for effectiveness.

An innovative model of behavioral healthcare for older adults with serious mental illness, substance use disorders, and dementia.

Older adults with serious mental illness (SMI) experience higher rates of medical comorbidities, mortality, hospital readmissions, and total healthcare spending when compared with Medicare beneficiaries without SMI. Although telehealth provides an opportunity to overcome barriers to behavioral healthcare access, older adults face unique challenges when accessing and utilizing telehealth services. We present Author Health's care model, which integrates virtual-first behavioral health care with an interdisciplinary approach to health-related social needs (HRSN) screening and intervention in older adults. We launched an innovative behavioral healthcare delivery model in collaboration with primary care for Medicare Advantage recipients with SMI, substance use disorders (SUD), and dementia. All patients completed an intake with an MD/NP and were offered screening for HRSN at entry using the Accountable Health Communities HRSN tool. Primary diagnosis was assigned and categorized into SMI/SUD/dementia and non-SMI. Logistic regression was used to quantify the odds of food, housing, and transportation insecurity explained by SMI/SUD/dementia versus non-SMI behavioral health conditions. A total of 2301 patients completed an intake from January 2023 to March 2024. Moderate/severe depression (40%) was the most common primary target condition at intake, followed by dementia/Alzheimer's disease (12%) and bipolar disorder (5%). The rates of housing insecurity, food insecurity, and transportation insecurity were 27%, 30%, and 21%, respectively. Within our sample of Medicare Advantage participants in Florida, patients with SMI/SUD/dementia were 1.42 times (p < 0.05) and 1.58 times (p < 0.01) more likely to report housing insecurity and food insecurity, respectively, when compared with those with mild/moderate behavioral health conditions. Author Health provides a blueprint for behavioral health services that remove barriers and provide tenacious, consistent, and whole-person virtual-first behavioral health care tailored to the unique needs of older adults. Our sample of Medicare Advantage participants in Florida suggests SMI/SUD/dementia may be a predictor for HRSN independent of socioeconomic status and race/ethnicity.

Examining Share plus-A Continuous Glucose Monitoring Plus Data-Sharing Intervention in Older Adults and Their Care Partners: Protocol for a Randomized Control Study.

Older adults with type 1 diabetes (T1D) are increasingly turning to care partners (CPs) as resources to support their diabetes management. With the rise in diabetes technologies, such as continuous glucose monitoring (CGM), there is great potential for CGM data sharing to increase CP involvement in a way that improves persons with diabetes' glucose management and reduces distress. The specific aims of this paper are to (1) evaluate the feasibility, usability, and acceptability of the Share plus intervention compared to the CGM Follow app plus diabetes self-management education and support; (2) evaluate the effect of the Share plus intervention on time-in-range (TIR; primary outcome) and diabetes distress (secondary outcome); and (3) explore differences between groups in person with diabetes and CP dyadic appraisal and coping, quality of life, diabetes self-care, and CP burden at 12 and 24 weeks and associations of dyadic variables on outcomes. This is a protocol for a feasibility, pilot randomized controlled trial. Older adults with T1D and their CP (N=80 dyads) will be randomized 1:1 to the Share plus intervention or Follow app plus diabetes self-management education. The trial will include a 12-week active intervention to determine the change in primary (TIR) and secondary (diabetes distress) outcomes, followed by a 12-week, observation-only phase to examine maintenance effects. The evaluation is guided by the Dyadic Coping Model. Patient-level effectiveness outcomes (TIR, hemoglobin A1c [HbA1c], diabetes distress, diabetes appraisal, coping, quality of life, diabetes self-care behaviors, and CP burden) will be assessed, using patient-reported outcomes measures and a home HbA1ctest kit. Patient- and CP-level acceptability and feasibility will be assessed using surveys and interviews. Quantitative feasibility, acceptability, and usability data will be described using frequencies and percentages. Acceptability will be summarized based on Likert questions and open-ended questions. Usability will be examined separately for the intervention and control groups based on the System Usability Scale, with a study benchmark of ≥68 indicating good usability. TIR will be computed based on 2 weeks' worth of data at baseline (prior to intervention) and 2 weeks each after the intervention (week 12) and at follow-up (week 24). Recruitment started in August 2023 and enrollment began inNovember 2023. To date, 24 participants have been enrolled in this study. We expect to conclude this study in March 2026 and expect to disseminate results in March 2026. To our knowledge, this will be the first pilot randomized controlled trial to evaluate both feasibility and effectiveness outcomes for the web-based, platform-delivered Share plus intervention for older adults with T1D and their CP. This research has implications for CGM data sharing in other age groups with T1D and type 2 diabetes. ClinicalTrials.gov NCT05937321; https://clinicaltrials.gov/study/NCT05937321. DERR1-10.2196/60004.

The POINTER Imaging baseline cohort: Associations between multimodal neuroimaging biomarkers, cardiovascular health, and cognition.

The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) is evaluating lifestyle interventions in older adults at risk for cognitive decline and dementia. Here we characterize the baseline data set of the POINTER Imaging ancillary study. Participants underwent health and cognitive assessments and neuroimaging with multimodal positron emission tomography (PET) (beta-amyloid [Aβ] and tau) and magnetic resonance imaging (MRI). Framingham risk score (FRS) was used to quantify cardiovascular disease (CVD) risk. A total of 1052 participants (31% from underrepresented ethnoracial groups) were enrolled. Compared to Aβ-, Aβ+ (29%) participants were older, had higher apolipoprotein E (APOE) ε4 carriage rate and white matter hyperintensity volume, and greater temporal tau. FRS was related to MRI measures, but not AD biomarkers. FRS and tau had independent effects on cognition. In this heterogenous, at-risk cohort, CVD risk was related to more abnormal brain structure and poorer cognition, representing a putative non-AD (Alzheimer's disease) pathway to brain injury and cognitive decline. ·The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) cohort is enriched for cardiovascular disease (CVD) and poor lifestyle ·POINTER Imaging collected multimodal neuroimaging data in this unique, at-risk cohort ·Amyloid burden was related to age, apolipoprotein E (APOE) ε4 carriage, and measures of disease progression ·Associations between amyloid and tau, and tau and cognition, were relatively weak ·CVD risk and tau pathology were independently related to memory.

Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Hospitalization: Randomized Clinical Trial.

Reduced physical function following hospitalization places older adults at risk of adverse health events. Many older adults receive home health physical therapy to reverse their deconditioning; however, optimal approaches to improve physical function are currently not known. This study aimed to evaluate the effectiveness of a home health care approach comprised of high-intensity exercise, enhanced care transition, and protein supplementation. Eligible participants included adults aged 65years or older referred to home health care following hospitalization. Two hundred older adults who are medically complex were enrolled and were randomized 1:1 to (1) a high-intensity progressive, multi-component (PMC) intervention or (2) enhanced usual care (UC) comparison group. All participants received 12 visits over 60days. The primary study outcome was change in the Short Physical Performance Battery (SPPB) from baseline to 60days. Secondary outcomes included gait speed (usual, fast), modified Physical Performance Test, grip strength, Fatigue Severity Scale, Falls Efficacy Scale-International, physical activity (step count), and adverse events (falls, emergency department visits, hospitalizations). All outcomes were collected at baseline, then 30, 60, 90, and 180 days post baseline. There was no difference in 60-day SPPB change between groups with both groups experiencing significant improvements (PMC = 1.53 [95% CI: 1.00-2.05]; enhanced UC = 1.39 [95% CI = 0.89-1.88]). Differences were also not observed in secondary measures or adverse events at any time point. An intervention consisting of high-intensity exercise, enhanced care transition, and protein supplementation was not associated with greater functional improvement at 60days compared to enhanced UC in older adults receiving home health physical therapy. The findings of this study demonstrate that a high-intensity progressive, multi-component intervention results in similar physical functional changes as an enhanced UC intervention in older adults who are medically complex and receiving home health care following hospital-associated deconditioning.

Remote Monitoring of Tai Chi Balance Training Interventions in Older Adults Using Wearable Sensors and Machine Learning.

Tai Chi, an Asian martial art, is renowned for its health benefits, particularly in promoting healthy aging among older adults, improving balance, and reducing fall risk. However, methodological challenges hinder the objective measurement of adherence to and proficiency in performing a training protocol, critical for health outcomes. This study introduces a framework using wearable sensors and machine learning to monitor Tai Chi training adherence and proficiency. Data were collected from 32 participants with inertial measurement units (IMUs) while performing six Tai Chi movements evaluated and scored for adherence and proficiency by experts. Our framework comprises a model for identifying the specific Tai Chi movement being performed and a model to assess performance proficiency, both employing Random Forest algorithms and features from IMU signals. The movement identification model achieved high accuracy (micro F1: 90.05%). Proficiency assessment models also achieved high accuracy (mean micro F1: 78.64%). This study shows the feasibility of using IMUs and machine learning for detailed Tai Chi movement analysis, offering a scalable method for monitoring practice. This approach has the potential to objectively enhance the evaluation of Tai Chi training protocol adherence, learnability, progression in proficiency, and safety in Tai Chi programs, and thus inform training program parameters that are key to achieving optimal clinical outcomes.

Tissue‐specific methylomic responses to a lifestyle intervention in older adults associate with metabolic and physiological health improvements

AbstractAcross the lifespan, diet and physical activity profiles substantially influence immunometabolic health. DNA methylation, as a tissue‐specific marker sensitive to behavioral change, may mediate these effects through modulation of transcription factor binding and subsequent gene expression. Despite this, few human studies have profiled DNA methylation and gene expression simultaneously in multiple tissues or examined how molecular levels react and interact in response to lifestyle changes. The Growing Old Together (GOTO) study is a 13‐week lifestyle intervention in older adults, which imparted health benefits to participants. Here, we characterize the DNA methylation response to this intervention at over 750 thousand CpGs in muscle, adipose, and blood. Differentially methylated sites are enriched for active chromatin states, located close to relevant transcription factor binding sites, and associated with changing expression of insulin sensitivity genes and health parameters. In addition, measures of biological age are consistently reduced, with decreases in grimAge associated with observed health improvements. Taken together, our results identify responsive molecular markers and demonstrate their potential to measure progression and finetune treatment of age‐related risks and diseases.

Surrogate Decision‐Making Regarding Life‐Sustaining Treatments for Older Adults with Dementia Admitted to Long‐Term Care Hospitals

Surrogate Decision‐Making Regarding Life‐Sustaining Treatments for Older Adults with Dementia Admitted to Long‐Term Care Hospitals

Maintenance with 5-FU/LV-aflibercept after induction with FOLFIRI-aflibercept versus FOLFIRI-aflibercept until progression as second-line treatment in older adults with metastatic colorectal cancer: the AFEMA phase II randomized trial

The combination chemotherapy i.v. 5-fluorouracil (5-FU), irinotecan, and aflibercept (FOLFIRI-A) is a standard second-line treatment of metastatic colorectal cancer (mCRC). The aim was to assess maintenance treatment in second-line setting in older patients (aged ≥70 years) with mCRC. We evaluated FOLFIRI-A given for six cycles followed by maintenance with 5-FU/leucovorin (LV)-A (arm A) or FOLFIRI-A (arm B) until progression in older adults with mCRC in the AFEMA randomized, open-label, non-inferiority phase II trial (EudraCT2016-004076-21/NCT03279289). Patients aged ≥70 years who previously failed oxaliplatin-fluoropyrimidine were randomly allocated (1 : 1) to either arm A (experimental) or arm B (control). After enrolling 35 patients, the FOLFIRI dose was reduced to level 1 in both arms due to toxicity. The primary endpoint was median progression-free survival (PFS); and secondary endpoints were median overall survival, objective response rate, and safety. Non-inferiority required the upper confidence interval (CI) limit to not exceed a hazard ratio (HR) of 1.5 (one-sided α= 0.075, 80% power). A total of 170 patients were randomly allocated to arm A or arm B (n= 85 each). The median follow-up was 12.2 versus 10.9 months in arm A versus arm B. Most patients died (83.5% versus 88.2% in arm A versus arm B), mainly from disease progression. PFS non-inferiority was met (HR= 0.78, 95% CI 0.566-1.076, P= 0.131) with a median PFS of 6.1 versus 5.5 months in arm A versus arm B. Median overall survival was similar in arms A and B (12.2 and 11.5 months, respectively) (HR= 0.89, 95% CI 0.640-1.227, P= 0.467). During the maintenance phase, severe asthenia (4.5% versus 21.6%, P= 0.038), serious adverse events (SAEs) (17.8% versus 37.8%, P= 0.049), and treatment-related SAEs (6.7% versus 10.8%, P= 0.695) were reduced in arm A versus arm B. In older adults, induction with six cycles of FOLFIRI-A plus maintenance with 5-FU/LV-A was non-inferior to FOLFIRI-A until progression. Severe asthenia, SAEs, and treatment-related SAEs were reduced with 5-FU/LV-A maintenance.

EE335 A Systematic Review of Health Economic Evaluations of Oral Nutritional Supplements as a Single-Component or Multi-Component Intervention in Older Adults With or at Risk of Malnutrition

EE335 A Systematic Review of Health Economic Evaluations of Oral Nutritional Supplements as a Single-Component or Multi-Component Intervention in Older Adults With or at Risk of Malnutrition

From burden to benefits: new promises of glucose-lowering treatments in older adults.

From burden to benefits: new promises of glucose-lowering treatments in older adults.

Psychotherapeutic treatments for depression in older adults.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of psychotherapeutic interventions in the treatment of older adults with depression and whether the effects of different types of psychotherapeutic treatments vary for older adults with depression.

Frailty integration in medical specialties: Current evidence and suggested strategies from the Clin-STAR frailty interest group.

Frailty is a syndrome that can inform clinical treatments and interventions for older adults. Although implementation of frailty across medical subspecialties has the potential to improve care for the aging population, its uptake has been heterogenous. While frailty assessment is highly integrated into certain medical subspecialties, other subspecialties have only recently begun to consider frailty in the context of patient care. In order to advance the field of frailty-informed care, we aim to detail what is known about frailty within the subspecialties of internal medicine. In doing so, we highlight cross-disciplinary approaches that can enhance our understanding of frailty, focusing on ways to improve the implementation of frailty measures, as well as develop potential interventional strategies to mitigate frailty within these subspecialties. This has important implications for the clinical care of the aging population and can help guide future research.

The REGENERATE Study: A Non-Randomized Feasibility Study of an Intervention to REduce anticholinerGic burdEN in oldER pATiEnts.

Background: Anticholinergic burden (ACB) from medications has been associated with adverse outcomes in older adults. Aim: The aim was to conduct a non-randomized feasibility study of an intervention to reduce the anticholinergic burden in older patients (REGENERATE) to inform a subsequent definitive trial. Methods: The development and evaluation of an ACB reduction intervention was guided by the Medical Research Council framework. Findings from preliminary studies, two systematic reviews, and two qualitative studies informed the design of a mixed-method feasibility study. The study was conducted in one UK primary care site. The clinical pharmacist identified and invited potentially eligible patients, reviewed their medications, and made recommendations to reduce the ACB as needed. Patients completed surveys at baseline and 6 and 12 weeks post-intervention. A purposive sample of patients and healthcare professionals was interviewed. Results: There was a response of 16/20; 14/16 attended the pharmacist-led consultation and completed the baseline questionnaire, and 13/14 completed both follow-up questionnaires. The sustainability of deprescribing was confirmed. The results suggest the potential of the intervention to reduce side effects from medications and improve quality of life (EQ-5D-5L). The interviews showed patients were happy with the study processes and the medication changes and were satisfied with the pharmacist's consultation. Conclusions: This feasibility study demonstrated that a deprescribing/reducing ACB intervention in older adults is feasible in a primary care setting and may benefit patients. Well-designed RCTs and cost-effectiveness studies should be undertaken to confirm the benefits of ACB deprescribing in primary care settings.

Abstract 4122840: Patient activation improves with a multi-component personalized mHealth intervention in older adults at risk of cardiovascular disease

Background: Patient activation, a person’s level of confidence, comprehension, and autonomy toward their health, is an essential goal of cardiovascular disease therapy. Previous research has shown a link between high levels of patient activation and better patient outcomes and experiences. However, whether individualized interventions such as a text-based mobile health (mHealth), improve patient activation is unclear. Research on patient activation in people at risk for cardiovascular disease and influential factors is minimal. Aims: This study aimed to 1) determine the effect of a multi-component mHealth intervention on patient activation and 2) examine its predictors among older adults at risk for cardiovascular disease. Methods: In this pilot randomized controlled trial, community-dwelling older adults with poor eating behaviors and reduced physical activity (n=54) were randomly assigned to the GetFIT (control) or GetFIT+ (intervention) groups, with three- and six-month follow-up periods. The GetFIT group received healthy lifestyle counseling from a licensed health coach, a free commercial mHealth app with push alerts on physical activity, and an activity tracker for physical activity monitoring. The GetFIT + group received the same components but had personalized text messages instead of push alerts. The 13-item Patient Activation Measure assessed patient activation; higher scores indicate better activation. Linear mixed-effects models were used to investigate between-group changes in outcomes across time. Results: The mean age was 65.4 ± 6.0 years; 61% were females and 61% were married. Baseline characteristics were comparable between groups. Significant improvements were observed in the GetFIT+ group at three months (mean 3.53, 95% CI 0.11, 6.96; p=0.043) and six months (mean 4.37, 95% CI 0.91, 7.83; p=0.014), whereas improvements in the GetFIT group were non-significant. Adjusting for age, gender, education, employment, marital status, social support, smartphone confidence, and self-perceived health did not alter the results. Nevertheless, only social support was associated with higher patient activation overall (B=5.14, 95% CI 1.00, 9.27; p=0.015). Conclusions: People at risk for cardiovascular disease can improve their self-management abilities, knowledge, and confidence through personalized text messaging. Possessing social support is critical for maximizing the benefits of mHealth interventions.

Changes in senescence markers after a weight loss intervention in older adults with obesity

BackgroundUnderstanding how weight loss interventions in older adults with obesity impact aging biology can lay the foundation for targeted, ‘geroscience-based’ interventions. This study examines the association between changes in the senescence-associated secretory phenotypes (SASP) and changes in function in response to a weight loss intervention. MethodsWe conducted a post-hoc biomarker analysis on adults aged ≥ 65 years with body mass index [BMI] ≥30 kg/m2 enrolled in a six-month, non-randomized telemedicine-delivered weight loss intervention. We assessed 16 SASP cytokines using serum samples collected pre-and post-intervention. Clinical outcomes include anthropometric and physical function measurements. A weight loss responder was defined as a loss of ≥5 % of body weight. ResultsMean age was 73.2 ± 3.9 years (73 % female), and BMI was 36.5 ± 5.2 kg/m2. Responders lost 7.6 ± 2.5 %, while non-responders lost 2.0 ± 2.3 % of weight (n = 16 per group, p < 0.001). We observed several significant associations between SASP cytokines and physical function and anthropometric measurement outcomes in age- and sex-adjusted linear models. These included grip strength and Interleukin-8 (IL-8) (b = 9.07) and Insulin-like Growth Factor 1 (IGF-1) (b = 2.6); gait speed and Thymus and Activation-Regulated Chemokine (TARC) (b = 0.46) and IL-7(b = 61 0.11); weight IL-6 (b = -6.77) and IL-15 (b = -2.53); BMI and IL-15 (b = -0.95); waist-to-hip ratio and osteopontin (b = -0.07) (p < 0.05 for all). ConclusionsOur pilot data demonstrated an association between changes in select SASP biomarkers and increased functional ability with intentional weight loss in older adults with obesity. However, findings must be replicated in prospective randomized trials with a control group and additional SASP biomarkers.