GeroScience最新文献

Neuromuscular electrical stimulation (NMES) is a non-invasive therapeutic approach offering targeted muscle contraction without requiring voluntary effort. This pragmatic pilot study investigated the effects of integrating NMES into usual rehabilitation care on cognitive and mobility outcomes, as well as its acceptance among hospitalized older adults in rehabilitation settings. Twenty-nine older adults with a mean age of 81.7 years (SD = 9.0) participated in this study. Patients received either usual rehabilitation care alone (5 days/week) or NMES in addition to usual rehabilitation care (3 days/week) for three weeks. Cognitive function and mobility were assessed pre- and post-intervention, and NMES acceptability was measured using an 8-item questionnaire. Integrating NMES to usual rehabilitation care significantly improved cognitive flexibility, demonstrated by reduced task-switching errors (p = 0.03). No additional benefits were observed in other cognitive or mobility measures, although all participants showed mobility improvements over time. NMES was considered acceptable by older adults in the rehabilitation setting.Integrating NMES into usual rehabilitation is well accepted by hospitalized older adults, with preliminary evidence suggesting it may improve cognitive flexibility.

Dementia is a growing global public health concern, with an increasing number of individuals affected due to the aging population. Although chronic inflammation is implicated in cognitive impairment, studies on its association with autoimmune diseases, which are representative chronic inflammatory diseases, are lacking. This study aimed to investigate whether the onset of autoimmune diseases is associated with an increased risk of dementia or cognitive impairment. This study used data from the Korean National Health Insurance Service-Health Screening from 2002 to 2019, with 8,743,801 person-years. The risk of dementia according to the type of autoimmune disease was calculated using the Cox proportional hazards model. The status and risk of cognitive impairment, which were assessed using the Korean Dementia Screening Questionnaire-Prescreening related with autoimmune diseases also estimated. Among participants, 8.3% developed dementia. All autoimmune diseases significantly increased dementia risk (hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.29-1.35), particularly Alzheimer's disease (HR 1.36; 95% CI, 1.32-1.40), vascular dementia (HR, 1.21; 95% CI, 1.12-1.30), and unspecified dementia (HR, 1.25; 95% CI, 1.18-1.33). Autoimmune diseases also increased the risk of positive dementia screening (odds ratio [OR], 1.18; 95% CI, 1.12-1.24), particularly connective tissue disorders (OR, 1.24; 95% CI, 1.15-1.34). This large-scale cohort study demonstrates a significant association between autoimmune diseases and increased risk of dementia and cognitive impairment. These findings underscore the potential importance of chronic inflammation in dementia pathogenesis and highlight the need for early cognitive screening and intervention strategies in patients with autoimmune diseases.

Multimorbidity, frailty, and polypharmacy are associated with worse outcomes in patients with atrial fibrillation (AF), leading to 'clinically complex' patient phenotypes. Possible differences between European and Asian patients regarding these aspects have not been studied. We studied AF patients derived from two large prospective observational AF registries, conducted in Europe and Asia. Multimorbidity and polypharmacy were defined according to the number of comorbidities and drugs at baseline. Frailty was defined according to a 40-items frailty index (FI). Prescription of OAC was assessed at baseline. The primary outcome was the composite of all-cause death and major adverse cardiovascular events. European patients had a higher burden of multimorbidity, frailty, and polypharmacy domains compared with Asians. Asian patients with these domains were less likely to be prescribed OAC than Europeans, especially those who were frail. After adjustments, being frail was associated with lower OAC prescription, with Asians less likely prescribed than Europeans (OR 0.34, 95% CI 0.25-0.45 vs. OR 0.47, 95% CI 0.40-0.55, p_int = 0.037). Adjusted Cox regression found that multimorbidity, frailty, and polypharmacy domains were associated with a higher risk of the composite outcome. On subgroup analysis, frail Asian patients had a higher risk of the composite outcome (p_int = 0.007) than Europeans. Multimorbidity, frailty and polypharmacy have different epidemiological characteristics amongst European and Asian AF patients. Being frail was associated with a higher likelihood of not being prescribed OAC, particularly in Asian patients. The adverse impact of 'clinically complex' patient phenotypes on risks of adverse outcomes was greater in Asian patients than in Europeans.

Resting-state functional connectivity (rsFC) is a highly dynamic process that varies across different times of the day within each individual. Although this variability was long considered to be noise, recent evidence suggests it may allow for an optimal adaptation to changes in the environment. However, the way rsFC is shaped on a circadian scale and its association with cognition are still unclear. We analyzed data from 90 late middle-aged participants from the Cognitive Fitness in Aging study (61 women; 50-69 years). Participants completed five electroencephalographic (EEG) recordings of spontaneous resting-state activity spread over 20 h of prolonged wakefulness. Using a temporal multilayer network approach, we characterized the diurnal variations of the dynamic recruitment and integration of resting-state brain networks. We focused on the theta and gamma frequency bands within the default mode network (DMN), central executive network (CEN), and salience network (SN). Additionally, we investigated the relationship between the recruitment and integration of these networks with baseline cognitive performance and at a 7-year longitudinal follow-up, as well as with positron emission tomography (PET) early neuropathological markers of Alzheimer's disease such as β-amyloid and tau/neuroinflammation. Diurnal changes in theta and gamma dynamics were associated with distinct cognitive aspects. Specifically, higher baseline memory performance was associated with higher theta dynamic integration of the SN and the CEN, as well as higher theta dynamic recruitment of the DMN. Moreover, lower longitudinal memory decline at 7 years was associated with higher theta dynamic integration of the SN, CEN, and DMN. In contrast, higher gamma diurnal dynamic integration of the SN and the CEN was associated with lower executive and attentional performance, as well as higher early β-amyloid accumulation, at baseline. These findings suggest that maintaining a balance between network flexibility and stability throughout the diurnal phase of the circadian cycle may play a crucial role in cognitive aging, with stable theta-band connectivity supporting memory, whereas excessive gamma-band stability in the SN and CEN may contribute to executive decline and early amyloid accumulation. These insights highlight the importance of considering time-of-day in brain rsFC studies, calling for a temporal multilayer approach to capture these dynamic patterns more effectively.