Gerontology最新文献

Introduction: MindCrowd is an online cognitive health platform that engages adults in a 10-min experience, including the paired-associates learning (PAL) test, a demographic survey, and an option to be contacted for future research. This study's objective was to identify factors associated with consent to research studies.

Methods: Adults from US zip codes, who joined MindCrowd from June 17, 2022 to December 31, 2024 and agreed to be contacted for future research, were eligible for the study. Outcomes included consent to online cognitive health surveys (MindCrowd-Expanded) and genetic testing for AD risk via mailed self-collection kit. Variables of interest included age, sex, race, ethnicity, education, socioeconomic vulnerability, family history of AD, and PAL test score. Consent was modeled using multivariable logistic regression, generating adjusted odds ratios (aOR), and 95% confidence intervals (CIs).

Results: A total of 52,113 MindCrowd participants were study eligible - 19.1% consented to MindCrowd-Expanded and 9.5% to genetic testing. Compared with white individuals, black individuals had 58% and 75% lower odds of consenting to MindCrowd-Expanded [aOR = 0.42 (95% CI = 0.37-0.48)] and genetic testing [aOR = 0.25 (95% CI = 0.20-0.32)], respectively. Compared with non-Hispanic individuals, Hispanic individuals had 26% and 37% lower odds of consenting to MindCrowd-Expanded [aOR = 0.74 (95% CI = 0.68-0.80)] and genetic studies [aOR = 0.63 (95% CI = 0.56-0.71)], respectively.

Conclusion: Despite previous research demonstrating that black and Hispanic MindCrowd participants were more willing to be contacted for future research than white participants, findings from this study suggest hesitancy to consent to online cognitive aging research and genetic testing. A more intentional approach may be necessary to retain MindCrowd participants from underrepresented communities in cognitive research studies.

Background: Comprehensive "senior-friendly hospital" (SFH)-programs have been developed to counteract negative health outcomes in hospitalized older adults. The aim of this narrative review was to provide an overview of published SFH-programs and their elements and to summarize evidence of their effect on quality of care and patient satisfaction.

Summary: A search of the databases Pubmed/Medline from inception to July 2023 and of governmental, regional, and hospital websites was performed. Programs were earmarked as SFH-programs if they primarily focused on the hospital setting, and comprised a hospital wide, multilevel approach and consisted of multiple elements. Articles and reports were included if participants were hospitalized and aged 60 years and older, and described the effect on quality of care or patient satisfaction. Articles focusing on specific patient groups or wards or on a health system or network were excluded. Ten SFH-programs were identified, with mutual elements like "organizational support," "social climate and services," "processes of care," and "physical environment." Only for the "Acute Care for Elders" program (USA), evidence was found showing positive effects on functional abilities, falls, delirium, length of stay, and patient satisfaction; effectiveness of other SFH-programs could not be found.

Key message: Elements of SFH-programs may improve care for hospitalized older adults, but the evidence of their effectiveness is scarce.

Background: Comprehensive "senior-friendly hospital" (SFH)-programs have been developed to counteract negative health outcomes in hospitalized older adults. The aim of this narrative review was to provide an overview of published SFH-programs and their elements and to summarize evidence of their effect on quality of care and patient satisfaction.

Summary: A search of the databases Pubmed/Medline from inception to July 2023 and of governmental, regional, and hospital websites was performed. Programs were earmarked as SFH-programs if they primarily focused on the hospital setting, and comprised a hospital wide, multilevel approach and consisted of multiple elements. Articles and reports were included if participants were hospitalized and aged 60 years and older, and described the effect on quality of care or patient satisfaction. Articles focusing on specific patient groups or wards or on a health system or network were excluded. Ten SFH-programs were identified, with mutual elements like "organizational support," "social climate and services," "processes of care," and "physical environment." Only for the "Acute Care for Elders" program (USA), evidence was found showing positive effects on functional abilities, falls, delirium, length of stay, and patient satisfaction; effectiveness of other SFH-programs could not be found.

Key message: Elements of SFH-programs ma

Introduction: Remnant cholesterol (RC) is an important contributor to cardiovascular disease development. We aimed to investigate the effect of physical activity (PA) type on serum RC levels in Korean adults.

Methods: We used data from the 2016-2021 Korea National Health and Nutrition Examination Survey, and included 32,877 adults. Serum RC was calculated by subtracting the low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels from the total cholesterol level. Hyper-remnant cholesterolemia was defined as a serum RC level of ≥30 mg/dL. PA was classified into aerobic, resistance, and walking exercises, which involved practicing 150 min of moderate, 75 min of high-intensity PA, or a combination of the 2, per week; doing resistance exercise more than 2 days per week; walking more than 150 min per week, respectively. Multivariate logistic regression analysis was performed to examine the association between serum RC and PA type.

Results: Among those aged <65 years, the odds ratio (OR) of hyper-remnant cholesterolemia was 1.23 times higher in the group that did not perform resistance exercise than in the group that performed more than 2 resistance exercises per week (95% confidence interval [CI] 1.12-1.36, p < 0.0001). Among those aged ≥65 years, the OR of hyper-remnant cholesterolemia was 1.31 times higher in the group that did not practice walking exercise than in the group that walked for more than 150 min per week (95% CI: 1.11-1.55, p < 0.01).

Conclusion: This study revealed that resistance exercise in those aged <65 years and walking exercise in those aged ≥65 years were significantly associated with low RC levels in Korean adults.

Background: Epidemiological data of populations living at moderate altitudes between 1,000 and 2,000 m suggest healthier aging when compared to people living in lower regions. Besides social determinants of health, lifestyle and cardiovascular risk factors, environmental conditions such as ambient temperature, air pollution and aeroallergens, solar radiation and in particular hypobaric hypoxia may modify the risk of disease development and mortality. The present study was aimed at (1) evaluating altitude-dependent overall and age-specific mortality rates of the most prevalent diseases using mortality registries and (2) link them to differences in lifestyle and risk factors from a population-based survey in Austria. We analyzed altitude-dependent mortality data of the entire Austrian population over a 10-year period (2013-2022, including the COVID-19 pandemic) and the distribution of cardiovascular risk factors such as hypertension, hypercholesterolemia and diabetes, lifestyle factors such as the amount of regular physical activity and dietary habits based on a representative Austrian-wide survey from 2019.

Summary: Mortality was reduced in both sexes when living between 1,000 and 2,000 m compared to those living lower: by 15% (13-18%) in men and by 22% (20-24%) in women (p < 0.05). People aged between 50 and 89 years, particularly benefited from living at higher altitudes. Women lived a healthier lifestyle than men, especially at an age of above 50 years, only women older than 74 benefited from a higher located residence regarding COVID-19 mortality.

Key messages: The present study confirms mortality benefits at moderate altitudes. We propose that besides lifestyle and other environmental conditions, episodically occurring hypoxic periods and related hypoxia conditioning effects represent major underlying mechanisms.

Background: Minor and major neurocognitive disorders, depression, and anxiety are common in older adults. The brain, and specifically the aging brain, relies heavily on oxygen and is highly sensitive to reductions in oxygen availability. Hypoxia occurs during both acute and prolonged exposure to altitude. While the negative effects of very low oxygen levels at high altitudes (above 3,500 m) on cognition and symptoms of depression as well as anxiety are well documented, we propose that moderate altitudes (1,000-2,500 m) may have potential benefits for brain health by promoting stress tolerance and adaptability.

Summary: This narrative review summarizes the impact of environmental oxygen availability on cognitive function and symptoms of depression and anxiety, considering the hypoxic dose (severity and duration of hypoxia). Given the limited data on moderate altitude and older adults, we also included results from studies involving younger populations and higher altitudes for comparison, alongside theoretical perspectives that still require experimental validation. We propose that mild hypoxia at moderate altitudes may enhance the brain's stress tolerance and adaptability, potentially through mechanisms involving metabolic and redox homeostasis as well as neurotransmitter regulation. However, the evidence remains inconclusive due to the influence of multiple confounding factors in most studies, complicating the ability to reach firm conclusions.

Key messages: Severe hypoxia at very high or extreme altitudes has detrimental effects on brain health, particularly in the aging brain, resulting in cognitive impairment and triggering or aggravating symptoms of depression and anxiety. In contrast, the potential benefits of prolonged exposure to moderate altitudes on brain and mental health, especially in aging populations, remain a topic of debate. The limited number of studies, coupled with the presence of multiple confounding factors, makes it difficult to draw definitive conclusions.

Background: Sirtuin 3 (SIRT3), a NAD+-dependent deacetylase localized in the mitochondrial matrix, has emerged as a central regulator of aging and age-related pathologies.

Summary: This review synthesizes evidence demonstrating SIRT3's tripartite anti-senescence mechanisms: (1) enhancement of mitophagy via p53 deacetylation-mediated mitochondrial quality control, (2) reinforcement of antioxidant defenses through SOD2/IDH2 activation, and (3) optimization of metabolic homeostasis by coordinating fatty acid β-oxidation and glucose metabolism. In neurodegenerative models, SIRT3 ameliorates proteotoxic stress by promoting ketogenesis and reducing amyloid-β/tau pathology. SIRT3 mediates cardiovascular protection through dual modulation of fibrotic signaling cascades and nitric oxide biosynthesis. Paradoxically, SIRT3 exhibits context-dependent roles in oncology, suppressing tumor metabolism via HIF1α destabilization while potentially enabling chemoresistance through ferroptosis regulation. Within metabolic disorders, SIRT3 preserves β-cell function by neutralizing oxidative stress and SASP-driven inflammation, significantly delaying diabetes progression. Current therapeutic strategies leverage SIRT3's pleiotropic functions through natural compounds: gastrodin (mitochondrial membrane stabilization), cocoa polyphenols (FOXO3-mediated antioxidant enhancement), and baicalein (anti-fibrotic signaling blockade).

Key messages: These advances position SIRT3 as a critical interface between mitochondrial energetics and systemic aging, offering a unified framework for developing precision gerotherapeutics.

Introduction: Intrinsic capacity, encompassing locomotion, vitality, cognition, psychology, and sensory function, is a critical determinant of healthy aging, yet its association with inflammatory markers remains poorly understood due to confounding factors in observational studies. We aimed to investigate the bidirectional causal relationships between chronic inflammation and intrinsic capacity decline by using Mendelian randomization (MR).

Methods: We conducted a bidirectional MR analysis using summary-level data from large-scale genome-wide association studies (GWAS). Genetic variants significantly associated with five inflammatory markers (C-reactive protein [CRP], interleukin-1 receptor antagonist [IL-1RA], interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], and white blood cell count [WBC]), and intrinsic capacity domains were used as instrumental variables. The inverse-variance weighted method was employed as the primary analysis, supplemented by sensitivity analyses such as MR-Egger, weighted median, and weighted mode methods.

Results: Higher CRP levels were negatively associated with anxiety, hand grip strength, malnutrition, and usual walking pace but positively associated with macular degeneration. Elevated IL-1RA levels were associated with reduced cognitive performance, while higher WBC levels were linked to decreased hand grip strength and usual walking pace. Better cognitive performance, hand grip strength, and the usual walking pace were associated with lower CRP and WBC levels. The robustness of these findings was confirmed by sensitivity analyses.

Conclusion: Our study provides robust evidence for bidirectional causal relationships between chronic inflammation and intrinsic capacity decline, highlighting inflammation as a potential target for interventions to promote healthy aging. Future research is required to explore these relationships in more diverse populations and investigate therapeutic strategies to mitigate inflammation-related declines in intrinsic capacity.

Introduction: Cognitive decline is cross-sectionally associated with frailty in older adults. However, the longitudinal associations between cognitive performance in late midlife and subsequent frailty are less well understood.

Methods: Participants of the Helsinki Birth Cohort Study (n = 1,279) were assessed for cognitive performance in late midlife and a 41-item frailty index on up to three occasions from late midlife into old age. The CogState assessment assessed reaction time, response accuracy, choice reaction time (CRT), working memory (WM), divided attention (DA), and associated learning. Generalized linear mixed models estimated the association between baseline cognitive performance and the rate of change in frailty and were adjusted for sex, education, and smoking.

Results: Each standard deviation (SD) slower reaction time was associated with a 1.02-1.07-fold higher level of frailty in late midlife in all domains except for simple reaction time. Each SD higher response accuracy in CRT was associated with a lower level of frailty (0.95-fold) in late midlife; better WM response accuracy was associated with lower levels of frailty (0.94-fold) in women only. Longitudinally, each SD higher reaction time response accuracy was associated with a slower increase in frailty from late midlife into old age; the annual rate of change was 0.97-fold. Furthermore, each SD higher DA response accuracy was associated with an equally slower annual increase in frailty among men only.

Conclusion: Poorer cognitive performance is associated with higher levels of frailty in late midlife. The association between cognitive performance and frailty from late midlife into old age was less consistent and varied by the cognitive trait being measured.

Introduction: Maximizing the benefits of physical activity (PA) is important to prevent physical frailty for a measure of this public health issue. This study aimed to investigate the association of timing of PA with the conversion to physical frailty.

Methods: This longitudinal observational study enrolled a total of 1,310 community-dwelling Japanese older adults who enrolled in the National Center for Geriatric and Gerontology-Study of Geriatric Syndromes remained as the examined population. A health checkup was conducted to measure baseline characteristics. Subsequently, objectively measured PA was recorded for ≥7 days (≥10 h per day) for 30 days. Daily steps and the morning (6:00-12:00), afternoon (12:00-18:00), and evening (18:00-24:00) steps were calculated. A 2-year follow-up survey was administered to determine the frailty conversion, defined by newly acquired Kihon Checklist scores of 7 or higher. A logistic regression model was constructed with timing of PA and covariates as explanatory variables and frailty conversion as the dependent variable.

Results: The number of conversions to frailty was 121 (9.2%). A significant association were observed between evening steps and frailty conversion (log(OR) = -0.44; 95% confidence interval [CI] = -0.87 to 0.03; p = 0.037). No significant associations were observed in the PA of morning (log(OR) = -0.03; 95% CI = -0.51 to 0.55; p = 0.906) and afternoon (log(OR) = -0.36; 95% CI = -0.78 to 0.13; p = 0.117).

Conclusions: Evening PA could be advantageous in preventing frailty conversion among community-dwelling older adults. Maximizing the impact of PA may be effective against this public health concern, physical frailty.