Sunan Gao, Xinkai Zhou, Lily Koffman, Amal A Wanigatunga, Jennifer A Schrack, Ciprian M Crainiceanu, John Muschelli
Background Step counting from wrist accelerometry data is widely used in physical activity research and practice. While several open-source algorithms can estimate steps from high-resolution accelerometry data, there is a critical need to compare these algorithms and provide practical recommendations for their use in older adults. Methods 1,282 Atherosclerosis Risk in Communities (ARIC) study participants (mean age 83.4, 60% female) wore ActiGraph GT9X wrist devices for 7 days, collecting 80Hz tri-axial accelerometry data. Five open-source step-counting algorithms (ADEPT, Oak, SDT, Verisense, and Stepcount) were applied to this data. Step count distributions and their cross-sectional associations with health outcomes were compared. Results The estimated mean daily step counts varied widely across algorithms, ranging from 988 for ADEPT to 23,607 for SDT. Pearson correlations across methods ranged from moderate (r=0.52) to very strong (r=0.96). All step counts were highly associated with age, with an estimated decline of 119.0 to 142.8 steps/year (all p<0.001) with comparable trends observed across demographic subgroups. After z-score standardization (subtracting the population mean and dividing by the population standard deviation), the estimated steps from each algorithm exhibited similar directionality and magnitude of association with various metabolic, cardiovascular, physical performance, and cognitive outcomes (all p<0.001). Conclusion The estimated step counts algorithms are highly correlated, and, after z-scoring, have similar and highly significant associations with health outcomes. Because the total number of steps varies widely across algorithms, interpretation and translation of results for health monitoring and clinical use in older adults depends on the choice of step counting algorithm.
{"title":"Comparing step counting algorithms for high-resolution wrist accelerometry data in older adults in the ARIC study","authors":"Sunan Gao, Xinkai Zhou, Lily Koffman, Amal A Wanigatunga, Jennifer A Schrack, Ciprian M Crainiceanu, John Muschelli","doi":"10.1093/gerona/glaf034","DOIUrl":"https://doi.org/10.1093/gerona/glaf034","url":null,"abstract":"Background Step counting from wrist accelerometry data is widely used in physical activity research and practice. While several open-source algorithms can estimate steps from high-resolution accelerometry data, there is a critical need to compare these algorithms and provide practical recommendations for their use in older adults. Methods 1,282 Atherosclerosis Risk in Communities (ARIC) study participants (mean age 83.4, 60% female) wore ActiGraph GT9X wrist devices for 7 days, collecting 80Hz tri-axial accelerometry data. Five open-source step-counting algorithms (ADEPT, Oak, SDT, Verisense, and Stepcount) were applied to this data. Step count distributions and their cross-sectional associations with health outcomes were compared. Results The estimated mean daily step counts varied widely across algorithms, ranging from 988 for ADEPT to 23,607 for SDT. Pearson correlations across methods ranged from moderate (r=0.52) to very strong (r=0.96). All step counts were highly associated with age, with an estimated decline of 119.0 to 142.8 steps/year (all p&lt;0.001) with comparable trends observed across demographic subgroups. After z-score standardization (subtracting the population mean and dividing by the population standard deviation), the estimated steps from each algorithm exhibited similar directionality and magnitude of association with various metabolic, cardiovascular, physical performance, and cognitive outcomes (all p&lt;0.001). Conclusion The estimated step counts algorithms are highly correlated, and, after z-scoring, have similar and highly significant associations with health outcomes. Because the total number of steps varies widely across algorithms, interpretation and translation of results for health monitoring and clinical use in older adults depends on the choice of step counting algorithm.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143435085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qian-Li Xue, Thomas Laskow, Mallak K Alzahrani, Ravi Varadhan, Jeremy D Walston, Jennifer A Schrack, Anne B Newman, Frederick Sieber, Karen Bandeen-Roche
Background As individuals age, their ability to cope with and recovering from health challenges becomes vital for maintaining independence and quality of life. This study aims to develop a multivariate phenotype of physical resilience based on individual recovery dynamics before and after a physical stressor. Methods This prospective observational study included 104 individuals aged ≥ 60 who underwent elective total knee replacement (TKR) for degenerative joint disease between December 2, 2019, and January 4, 2023. A multivariate resilience phenotype was derived from physical function assessments over 12 months after TKR using the Short Physical Performance Battery, the Pittsburgh Fatigability Scale Physical Subscale, the Knee Injury and Osteoarthritis Outcome Quality of Life Score, and the 36-Item Short Form Health Survey Physical Component Score. Validation was performed using markers (i.e., frailty and self-reported health) and determinants (e.g., the Charlson Comorbidity Index (CCI)) of recovery potential. Results Distinct resilience profiles were identified across the four measures, showing varied baseline levels and/or change rates over 12 months. By combining and analyzing resilience profiles across measures, two distinct groups emerged: 33.7% were classified as non-resilient and 66.4% as resilient. The non-resilient group had a higher prevalence of frailty (37.1% vs. 10.1%, p<0.01), poor or fair self-reported health (48.6% vs. 5.8%, p<0.01), and moderate or severe comorbidity burden (CCI >2; 28.6% vs. 10.1%, p=0.03). Conclusions Recovery trajectories after TKR revealed varying resilience levels that could not be fully explained by baseline health status. Understanding individual resilience can enhance patient care by promoting recovery and overall well-being.
{"title":"Multivariate Profiling of Physical Resilience in Older Adults After Total Knee Replacement Surgery: Results from a Prospective Observational Study","authors":"Qian-Li Xue, Thomas Laskow, Mallak K Alzahrani, Ravi Varadhan, Jeremy D Walston, Jennifer A Schrack, Anne B Newman, Frederick Sieber, Karen Bandeen-Roche","doi":"10.1093/gerona/glaf032","DOIUrl":"https://doi.org/10.1093/gerona/glaf032","url":null,"abstract":"Background As individuals age, their ability to cope with and recovering from health challenges becomes vital for maintaining independence and quality of life. This study aims to develop a multivariate phenotype of physical resilience based on individual recovery dynamics before and after a physical stressor. Methods This prospective observational study included 104 individuals aged ≥ 60 who underwent elective total knee replacement (TKR) for degenerative joint disease between December 2, 2019, and January 4, 2023. A multivariate resilience phenotype was derived from physical function assessments over 12 months after TKR using the Short Physical Performance Battery, the Pittsburgh Fatigability Scale Physical Subscale, the Knee Injury and Osteoarthritis Outcome Quality of Life Score, and the 36-Item Short Form Health Survey Physical Component Score. Validation was performed using markers (i.e., frailty and self-reported health) and determinants (e.g., the Charlson Comorbidity Index (CCI)) of recovery potential. Results Distinct resilience profiles were identified across the four measures, showing varied baseline levels and/or change rates over 12 months. By combining and analyzing resilience profiles across measures, two distinct groups emerged: 33.7% were classified as non-resilient and 66.4% as resilient. The non-resilient group had a higher prevalence of frailty (37.1% vs. 10.1%, p&lt;0.01), poor or fair self-reported health (48.6% vs. 5.8%, p&lt;0.01), and moderate or severe comorbidity burden (CCI &gt;2; 28.6% vs. 10.1%, p=0.03). Conclusions Recovery trajectories after TKR revealed varying resilience levels that could not be fully explained by baseline health status. Understanding individual resilience can enhance patient care by promoting recovery and overall well-being.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kerry M Sheets, Howard A Fink, Lisa Langsetmo, Allyson M Kats, John T Schousboe, Kristine Yaffe, Kristine E Ensrud
Background Cognitive impairment and dementia are associated with higher healthcare costs; whether these increased costs are attributable to greater comorbidity burden is unknown. We sought to determine associations of cognitive impairment and dementia with subsequent total and sector-specific healthcare costs after accounting for comorbidities and to compare costs by method of case ascertainment. Methods Index examinations (2002-2011) of four prospective cohort studies linked with Medicare claims. 8,165 community-dwelling Medicare fee-for-service beneficiaries (4,318 women; 3,847 men). Cognitive impairment identified by self-or-proxy report of dementia and/or abnormal cognitive testing. Claims-based dementia and comorbidities derived from claims using Chronic Condition Warehouse algorithms. Annualized healthcare costs (2023 dollars) ascertained for 36 months following index examinations. Results 521 women (12.1%) and 418 men (10.9%) met criteria for cognitive impairment; 388 women (9%) and 234 men (6.1%) met criteria for claims-based dementia. After accounting for age, race, geographic region, and comorbidities, mean incremental costs of cognitive impairment versus no cognitive impairment in women (men) were $6,883 ($7,276) for total healthcare costs, $4,160 ($4,047) for inpatient costs, $1,206 ($1,587) for SNF costs, and $689 ($668) for HHC costs. Mean adjusted incremental total and inpatient costs associated with claims-based dementia were smaller in magnitude and not statistically significant. Mean adjusted incremental costs of claims-based dementia versus no claims-based dementia in women (men) were $759 ($1,251) for SNF costs and $582 ($535) for HHC costs. Conclusions Cognitive impairment is independently associated with substantial incremental total and sector-specific healthcare expenditures not fully captured by claims-based dementia or comorbidity burden.
{"title":"Incremental Healthcare Costs of Dementia and Cognitive Impairment in Community-Dwelling Older Adults: A Prospective Cohort Study","authors":"Kerry M Sheets, Howard A Fink, Lisa Langsetmo, Allyson M Kats, John T Schousboe, Kristine Yaffe, Kristine E Ensrud","doi":"10.1093/gerona/glaf030","DOIUrl":"https://doi.org/10.1093/gerona/glaf030","url":null,"abstract":"Background Cognitive impairment and dementia are associated with higher healthcare costs; whether these increased costs are attributable to greater comorbidity burden is unknown. We sought to determine associations of cognitive impairment and dementia with subsequent total and sector-specific healthcare costs after accounting for comorbidities and to compare costs by method of case ascertainment. Methods Index examinations (2002-2011) of four prospective cohort studies linked with Medicare claims. 8,165 community-dwelling Medicare fee-for-service beneficiaries (4,318 women; 3,847 men). Cognitive impairment identified by self-or-proxy report of dementia and/or abnormal cognitive testing. Claims-based dementia and comorbidities derived from claims using Chronic Condition Warehouse algorithms. Annualized healthcare costs (2023 dollars) ascertained for 36 months following index examinations. Results 521 women (12.1%) and 418 men (10.9%) met criteria for cognitive impairment; 388 women (9%) and 234 men (6.1%) met criteria for claims-based dementia. After accounting for age, race, geographic region, and comorbidities, mean incremental costs of cognitive impairment versus no cognitive impairment in women (men) were $6,883 ($7,276) for total healthcare costs, $4,160 ($4,047) for inpatient costs, $1,206 ($1,587) for SNF costs, and $689 ($668) for HHC costs. Mean adjusted incremental total and inpatient costs associated with claims-based dementia were smaller in magnitude and not statistically significant. Mean adjusted incremental costs of claims-based dementia versus no claims-based dementia in women (men) were $759 ($1,251) for SNF costs and $582 ($535) for HHC costs. Conclusions Cognitive impairment is independently associated with substantial incremental total and sector-specific healthcare expenditures not fully captured by claims-based dementia or comorbidity burden.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yang Li, Jiao Wang, Yuyang Miao, Michelle M Dunk, Silvia Maioli, Zhongze Fang, Qiang Zhang, Weili Xu
Background Plasma fatty acids have been linked to various chronic diseases and mortality, but the extent to which fatty acids are associated with the trajectory of multimorbidity remains unclear. We investigated the association of fatty acid profile with multimorbidity trajectories and event-free survival. Methods Within the UK Biobank, 138,685 chronic disease-free participants were followed for up to 16 years. 17 plasma fatty acids were measured by nuclear magnetic resonance. A comprehensive healthy fatty acid score (HFAS) was constructed using LASSO regression. Incidence of chronic diseases and death were ascertained through linkages to medical and death records. Event-free survival was defined as survival without chronic diseases or death. Data were analyzed using a linear mixed-effects model, Cox regression, and Laplace regression. Results High HFAS was associated with lower risk of chronic diseases/death (hazard ratio [HR]: 0.907, 95% confidence interval [CI]: 0.888-0.925) and prolonged event-free survival time by 0.636 (95% CI: 0.500-0.774) years compared to low HFAS. High HFAS was also associated with a slower accumulation trajectory of multimorbidity (β: -0.042, 95% CI: -0.045 to -0.038). There was a significant multiplicative interaction between moderate-to-high HFAS and healthy lifestyle on chronic disease/death (P for interaction = 0.002) and multimorbidity accumulation trajectories (P for interaction<0.001). Conclusions A healthier plasma fatty acid metabolic profile is associated with a slower accumulation of multimorbidity and prolonged event-free survival time. A healthy lifestyle may strengthen the protective association of HFAS with the risk of chronic diseases/death and the accumulation trajectory of multimorbidity.
{"title":"Association of plasma fatty acid profile with trajectory of multimorbidity and mortality: A community-based longitudinal study","authors":"Yang Li, Jiao Wang, Yuyang Miao, Michelle M Dunk, Silvia Maioli, Zhongze Fang, Qiang Zhang, Weili Xu","doi":"10.1093/gerona/glaf031","DOIUrl":"https://doi.org/10.1093/gerona/glaf031","url":null,"abstract":"Background Plasma fatty acids have been linked to various chronic diseases and mortality, but the extent to which fatty acids are associated with the trajectory of multimorbidity remains unclear. We investigated the association of fatty acid profile with multimorbidity trajectories and event-free survival. Methods Within the UK Biobank, 138,685 chronic disease-free participants were followed for up to 16 years. 17 plasma fatty acids were measured by nuclear magnetic resonance. A comprehensive healthy fatty acid score (HFAS) was constructed using LASSO regression. Incidence of chronic diseases and death were ascertained through linkages to medical and death records. Event-free survival was defined as survival without chronic diseases or death. Data were analyzed using a linear mixed-effects model, Cox regression, and Laplace regression. Results High HFAS was associated with lower risk of chronic diseases/death (hazard ratio [HR]: 0.907, 95% confidence interval [CI]: 0.888-0.925) and prolonged event-free survival time by 0.636 (95% CI: 0.500-0.774) years compared to low HFAS. High HFAS was also associated with a slower accumulation trajectory of multimorbidity (β: -0.042, 95% CI: -0.045 to -0.038). There was a significant multiplicative interaction between moderate-to-high HFAS and healthy lifestyle on chronic disease/death (P for interaction = 0.002) and multimorbidity accumulation trajectories (P for interaction&lt;0.001). Conclusions A healthier plasma fatty acid metabolic profile is associated with a slower accumulation of multimorbidity and prolonged event-free survival time. A healthy lifestyle may strengthen the protective association of HFAS with the risk of chronic diseases/death and the accumulation trajectory of multimorbidity.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faerie Mattins, Shriya Nagrath, Yijie Fan, Tomás Kevin Delgado Manea, Shoham Das, Aditi Shankar, John Tower
Falls are a significant cause of human disability and death. Risk factors include normal aging, neurodegenerative disease, and sarcopenia. Drosophila melanogaster is a powerful model for study of normal aging and for modeling human neurodegenerative disease. Aging-associated defects in Drosophila climbing ability have been observed to be associated with falls, and immobility due to a fall is implicated as one cause of death in old flies. An automated method for quantifying Drosophila falls might facilitate the study of causative factors and possible interventions. Here, machine learning methods were developed to identify Drosophila falls in video recordings of 2D movement trajectories. The study employed existing video of aged flies as they approached death, and young flies subjected to lethal dehydration/starvation stress. Approximately 9,000 frames of video were manually annotated using open-source tools and used as the training set for You Only Look Once (YOLOv4) software. The software was tested on specific hours within a 22 hour video that was originally manually-annotated for number of falls per hour and corresponding timestamps. The model predictions were evaluated against the manually-annotated ground truth, revealing a strong correlation between the predicted and actual falls. The frequency of falls per hour increased dramatically 2-4 hours prior to death caused by dehydration/starvation stress, whereas extended periods of increased falls were observed in aged flies prior to death. This automated method effectively quantifies falls in video data without observer bias, providing a robust tool for future studies aimed at understanding causative factors and testing potential interventions.
{"title":"Machine learning scoring reveals increased frequency of falls proximal to death in Drosophila melanogaster","authors":"Faerie Mattins, Shriya Nagrath, Yijie Fan, Tomás Kevin Delgado Manea, Shoham Das, Aditi Shankar, John Tower","doi":"10.1093/gerona/glaf029","DOIUrl":"https://doi.org/10.1093/gerona/glaf029","url":null,"abstract":"Falls are a significant cause of human disability and death. Risk factors include normal aging, neurodegenerative disease, and sarcopenia. Drosophila melanogaster is a powerful model for study of normal aging and for modeling human neurodegenerative disease. Aging-associated defects in Drosophila climbing ability have been observed to be associated with falls, and immobility due to a fall is implicated as one cause of death in old flies. An automated method for quantifying Drosophila falls might facilitate the study of causative factors and possible interventions. Here, machine learning methods were developed to identify Drosophila falls in video recordings of 2D movement trajectories. The study employed existing video of aged flies as they approached death, and young flies subjected to lethal dehydration/starvation stress. Approximately 9,000 frames of video were manually annotated using open-source tools and used as the training set for You Only Look Once (YOLOv4) software. The software was tested on specific hours within a 22 hour video that was originally manually-annotated for number of falls per hour and corresponding timestamps. The model predictions were evaluated against the manually-annotated ground truth, revealing a strong correlation between the predicted and actual falls. The frequency of falls per hour increased dramatically 2-4 hours prior to death caused by dehydration/starvation stress, whereas extended periods of increased falls were observed in aged flies prior to death. This automated method effectively quantifies falls in video data without observer bias, providing a robust tool for future studies aimed at understanding causative factors and testing potential interventions.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"180 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The impact of mid-late-life exercise on the aging heart remains unclear, particularly the effects of high-intensity interval training (HIIT) and continuous moderate-intensity training (CMIT). This study was the first to examine cardiac function, tissue characteristics, electrical remodeling, mitochondrial morphology and homeostasis in old mice subjected to CMIT or HIIT, compared to untrained controls. Our results showed that 8-week HIIT significantly improved the survival rate of old mice. HIIT presented advantages on cardiac function, deposition of collagen fibers, neovascularization, aging biomarkers and mitochondrial homeostasis. Only CMIT alleviated age-related cardiac hypertrophy. However, CMIT potentially exacerbated adverse cardiac electrical remodeling. Those findings suggested HIIT as a particularly appealing option for clinical application for aging populations.
{"title":"Comparison between the effect of mid-late-life high-intensity interval training and continuous moderate-intensity training in old mouse hearts","authors":"Qiaowei Li, Qin Liu, Zhong Lin, Wenwen Lin, Zhonghua Lin, Feng Huang, Pengli Zhu","doi":"10.1093/gerona/glaf025","DOIUrl":"https://doi.org/10.1093/gerona/glaf025","url":null,"abstract":"The impact of mid-late-life exercise on the aging heart remains unclear, particularly the effects of high-intensity interval training (HIIT) and continuous moderate-intensity training (CMIT). This study was the first to examine cardiac function, tissue characteristics, electrical remodeling, mitochondrial morphology and homeostasis in old mice subjected to CMIT or HIIT, compared to untrained controls. Our results showed that 8-week HIIT significantly improved the survival rate of old mice. HIIT presented advantages on cardiac function, deposition of collagen fibers, neovascularization, aging biomarkers and mitochondrial homeostasis. Only CMIT alleviated age-related cardiac hypertrophy. However, CMIT potentially exacerbated adverse cardiac electrical remodeling. Those findings suggested HIIT as a particularly appealing option for clinical application for aging populations.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background This study aimed to assess the association between obesity, sarcopenia, and sarcopenic obesity with hypertension and to explore the potential mediation of inflammation indicators and insulin resistance. Methods Data from the UK Biobank, a large-scale prospective cohort, were utilized. Obesity was defined using percentage of fat mass, while sarcopenia was defined as low muscle mass and low muscle strength. The primary outcome assessed was new-onset hypertension within a 5-year follow-up period. The association analysis was examined using a Cox regression model. Results A total of 183,091 participants were enrolled in this study. During 5 years of follow-up, 3812 (2.08%) developed hypertension. In the fully adjusted model, compared to men without these conditions, those with obesity, sarcopenia, and sarcopenic obesity had 2.32 times (95% CI, 2.12-2.55), 3.10 times (95% CI, 2.35-4.08), and 3.66 times (95% CI, 2.98-4.50) higher risks of developing hypertension, respectively. Women with obesity, sarcopenia, and sarcopenic obesity had 2.27 times (95% CI, 2.03-2.54), 2.93 times (95% CI, 1.95-4.39), and 4.04 times (95% CI, 3.32-4.91) higher risks of hypertension, respectively. Significant mediating effects of C-reactive protein, neutrophils, white blood cells, triglyceride-glucose index, and triglyceride to high-density lipoprotein cholesterol ratio were found, with mediations ranging from 6% to 13% for men and 2% to 21% for women in the association between sarcopenic obesity and hypertension. Conclusions Obesity, sarcopenia, and sarcopenic obesity significantly increased the risk of hypertension. Inflammation and insulin resistance appeared to mediate the association between sarcopenic obesity and hypertension.
{"title":"Obesity, sarcopenia, sarcopenic obesity and hypertension: mediating role of inflammation and insulin resistance","authors":"Yuanlin Zou, Hua Ye, Ziqing Xu, Qian Yang, Jicun Zhu, Tiandong Li, Yifan Cheng, Yongjian Zhu, Junxi Zhang, Yacong Bo, Peng Wang","doi":"10.1093/gerona/glae284","DOIUrl":"https://doi.org/10.1093/gerona/glae284","url":null,"abstract":"Background This study aimed to assess the association between obesity, sarcopenia, and sarcopenic obesity with hypertension and to explore the potential mediation of inflammation indicators and insulin resistance. Methods Data from the UK Biobank, a large-scale prospective cohort, were utilized. Obesity was defined using percentage of fat mass, while sarcopenia was defined as low muscle mass and low muscle strength. The primary outcome assessed was new-onset hypertension within a 5-year follow-up period. The association analysis was examined using a Cox regression model. Results A total of 183,091 participants were enrolled in this study. During 5 years of follow-up, 3812 (2.08%) developed hypertension. In the fully adjusted model, compared to men without these conditions, those with obesity, sarcopenia, and sarcopenic obesity had 2.32 times (95% CI, 2.12-2.55), 3.10 times (95% CI, 2.35-4.08), and 3.66 times (95% CI, 2.98-4.50) higher risks of developing hypertension, respectively. Women with obesity, sarcopenia, and sarcopenic obesity had 2.27 times (95% CI, 2.03-2.54), 2.93 times (95% CI, 1.95-4.39), and 4.04 times (95% CI, 3.32-4.91) higher risks of hypertension, respectively. Significant mediating effects of C-reactive protein, neutrophils, white blood cells, triglyceride-glucose index, and triglyceride to high-density lipoprotein cholesterol ratio were found, with mediations ranging from 6% to 13% for men and 2% to 21% for women in the association between sarcopenic obesity and hypertension. Conclusions Obesity, sarcopenia, and sarcopenic obesity significantly increased the risk of hypertension. Inflammation and insulin resistance appeared to mediate the association between sarcopenic obesity and hypertension.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olivier Beauchet, Kevin Galéry, Pierrette Gaudreau, Gilles Allali
Both motoric cognitive risk syndrome (MCR) and C-reactive protein (CRP) serum levels have been separately associated with increased risk of incident major neurocognitive disorder. The study aims to compare the CRP serum levels of older adults with and without MCR, and to examine the associations of MCR, CRP serum levels and their combination with incident major neurocognitive disorder. 915 individuals participating in an older adults population-based observational cohort study with a 3-year follow-up design, were selected. MCR and CRP serum levels were collected at baseline. Incident major neurocognitive disorder was measured at annual follow-up visits using the modified mini-mental state (≤79/100) and simplified instrumental activity daily living scale (<4/4) score values. The prevalence of MCR at baseline assessment was 3.7%. The overall incidence of major neurocognitive disorder was 3.0%. MCR alone (Hazard Ratio (HR)=28.09 with 95% Confidence Interval (CI=[7.00;112.72] and P≤0.001) and MCR with a high CRP serum level (HR=6.33, with 95% CI[1.45;27.62] and P=0.014) were significantly associated with incident major neurocognitive disorder. MCR is a significant risk factor for predicting major neurocognitive disorder in older adults, while serum CRP levels are not. In addition, serum CRP levels reduce the predictive strength of MCR for major neurocognitive disorder.
{"title":"Association of motoric cognitive risk syndrome and high C-reactive protein serum levels with incident major neurocognitive disorder: Results from the Quebec NuAge cohort","authors":"Olivier Beauchet, Kevin Galéry, Pierrette Gaudreau, Gilles Allali","doi":"10.1093/gerona/glae260","DOIUrl":"https://doi.org/10.1093/gerona/glae260","url":null,"abstract":"Both motoric cognitive risk syndrome (MCR) and C-reactive protein (CRP) serum levels have been separately associated with increased risk of incident major neurocognitive disorder. The study aims to compare the CRP serum levels of older adults with and without MCR, and to examine the associations of MCR, CRP serum levels and their combination with incident major neurocognitive disorder. 915 individuals participating in an older adults population-based observational cohort study with a 3-year follow-up design, were selected. MCR and CRP serum levels were collected at baseline. Incident major neurocognitive disorder was measured at annual follow-up visits using the modified mini-mental state (≤79/100) and simplified instrumental activity daily living scale (&lt;4/4) score values. The prevalence of MCR at baseline assessment was 3.7%. The overall incidence of major neurocognitive disorder was 3.0%. MCR alone (Hazard Ratio (HR)=28.09 with 95% Confidence Interval (CI=[7.00;112.72] and P≤0.001) and MCR with a high CRP serum level (HR=6.33, with 95% CI[1.45;27.62] and P=0.014) were significantly associated with incident major neurocognitive disorder. MCR is a significant risk factor for predicting major neurocognitive disorder in older adults, while serum CRP levels are not. In addition, serum CRP levels reduce the predictive strength of MCR for major neurocognitive disorder.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Cho, Oonjee Oh, Nancy Greene, Larissa Gordon, Sherry Morgan, Lisa Walke, George Demiris
Integration of artificial intelligence (AI) in health and healthcare, especially for older adults, has significantly advanced healthcare delivery. AI technologies, with capabilities such as self-learning and pattern recognition, are employed to address social isolation and monitor older adults' daily activities. However, rapid AI development often fails to consider the heterogeneous needs of older populations, which could exacerbate an existing digital divide and inequality. This scoping review examines older adults’ involvement in AI system design, implementation, and evaluation of AI systems in health and healthcare literature, emphasizing the necessity of their input for beneficial AI systems. We conducted a scoping review according to PRISMA-SCR. We reviewed 17 studies, finding that half of these studies (n = 8) engaged older adults during the design phase, a small number (n = 3) during the evaluation stage, and even fewer (n = 2) involved older adults in the implementation stage. Despite AI’s growing role, design processes often overlook older adults’ needs. Our findings emphasize the need for inclusive, participatory design approaches to address ethical and equity challenges, enhancing user engagement and relevance. We also highlight how these approaches address the needs of older adults and improve outcomes. Specifically, we integrated evidence showing the practical benefits of these approaches for better accessibility, usability, and engagement among older adults. While AI has potential to improve healthcare delivery, these approaches must be part of broader efforts to ensure ethical, inclusive, and equitable AI practices, especially in gerontology.
{"title":"Engagement of Older Adults in the Design, Implementation and Evaluation of Artificial Intelligence Systems for Aging: A Scoping Review","authors":"Hannah Cho, Oonjee Oh, Nancy Greene, Larissa Gordon, Sherry Morgan, Lisa Walke, George Demiris","doi":"10.1093/gerona/glaf024","DOIUrl":"https://doi.org/10.1093/gerona/glaf024","url":null,"abstract":"Integration of artificial intelligence (AI) in health and healthcare, especially for older adults, has significantly advanced healthcare delivery. AI technologies, with capabilities such as self-learning and pattern recognition, are employed to address social isolation and monitor older adults' daily activities. However, rapid AI development often fails to consider the heterogeneous needs of older populations, which could exacerbate an existing digital divide and inequality. This scoping review examines older adults’ involvement in AI system design, implementation, and evaluation of AI systems in health and healthcare literature, emphasizing the necessity of their input for beneficial AI systems. We conducted a scoping review according to PRISMA-SCR. We reviewed 17 studies, finding that half of these studies (n = 8) engaged older adults during the design phase, a small number (n = 3) during the evaluation stage, and even fewer (n = 2) involved older adults in the implementation stage. Despite AI’s growing role, design processes often overlook older adults’ needs. Our findings emphasize the need for inclusive, participatory design approaches to address ethical and equity challenges, enhancing user engagement and relevance. We also highlight how these approaches address the needs of older adults and improve outcomes. Specifically, we integrated evidence showing the practical benefits of these approaches for better accessibility, usability, and engagement among older adults. While AI has potential to improve healthcare delivery, these approaches must be part of broader efforts to ensure ethical, inclusive, and equitable AI practices, especially in gerontology.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143192040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jianhua Tay, Weilan Wang, Lihuan Guan, Rajkumar Dorajoo, Lei Feng, Brian K Kennedy, Yap Seng Chong, Tze Pin Ng, Woon-Puay Koh, Andrea B Maier
Deoxyribonucleic acid (DNA) methylation (DNAm) clocks estimate biological age according to DNA methylation. This study investigated the associations between measures of physical function and physical performance and ten DNAm clocks in the oldest-old in Singapore. The SG90 cohort included a subset of community-dwelling oldest-old from the Singapore Chinese Health Study (SCHS) and Singapore Longitudinal Ageing Study (SLAS). Physical function and performance were assessed using Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living (IADL), World Health Organization Disability Assessment Schedule (WHODAS), Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), handgrip strength, normal gait speed, SPPB fast gait speed (FGS), and. DNAm age from peripheral blood mononuclear cells (PBMC) was measured using 18 DNAm clocks, including first generation clocks (PCHorvath1, PCHorvath2, PCHannum, AltumAge, ENCen100+, ENCEN40+, IntrinClock, RetroAgev1 and RetroAgev2) second and third generation clocks (PCPhenoAge, PCGrimAge, GrimAge2, ZhangMRscore, DNAmFitAge and DunedinPACE) and causality-enriched clocks (YingCausAge, YingAdaptAge, YingDamAge). Linear regression was used to analyse associations. The 433 oldest-old individuals had a median age of 88.6 years [87.5; 90.4] and were predominantly Chinese (95.6%) and female (60.3%). Better performance in IADL, WHODAS, SPPB, SPPB FGS and balance were associated with lower GrimAge2 after adjustment for age, sex, and smoking status (pAdj<0.05). GrimAge2 outperformed other DNAm clocks after adjustment for DNAm smoking-pack-years and DNAm-based cell compositions. Better physical function and physical performance were associated with lower DNAm age deviation and pace of ageing. Longitudinal and intervention studies are needed to explore biological mechanisms underlying these observed associations.
{"title":"The association of physical function and physical performance with DNA methylation clocks in oldest-old living in Singapore - the SG90 cohort","authors":"Jianhua Tay, Weilan Wang, Lihuan Guan, Rajkumar Dorajoo, Lei Feng, Brian K Kennedy, Yap Seng Chong, Tze Pin Ng, Woon-Puay Koh, Andrea B Maier","doi":"10.1093/gerona/glaf022","DOIUrl":"https://doi.org/10.1093/gerona/glaf022","url":null,"abstract":"Deoxyribonucleic acid (DNA) methylation (DNAm) clocks estimate biological age according to DNA methylation. This study investigated the associations between measures of physical function and physical performance and ten DNAm clocks in the oldest-old in Singapore. The SG90 cohort included a subset of community-dwelling oldest-old from the Singapore Chinese Health Study (SCHS) and Singapore Longitudinal Ageing Study (SLAS). Physical function and performance were assessed using Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living (IADL), World Health Organization Disability Assessment Schedule (WHODAS), Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), handgrip strength, normal gait speed, SPPB fast gait speed (FGS), and. DNAm age from peripheral blood mononuclear cells (PBMC) was measured using 18 DNAm clocks, including first generation clocks (PCHorvath1, PCHorvath2, PCHannum, AltumAge, ENCen100+, ENCEN40+, IntrinClock, RetroAgev1 and RetroAgev2) second and third generation clocks (PCPhenoAge, PCGrimAge, GrimAge2, ZhangMRscore, DNAmFitAge and DunedinPACE) and causality-enriched clocks (YingCausAge, YingAdaptAge, YingDamAge). Linear regression was used to analyse associations. The 433 oldest-old individuals had a median age of 88.6 years [87.5; 90.4] and were predominantly Chinese (95.6%) and female (60.3%). Better performance in IADL, WHODAS, SPPB, SPPB FGS and balance were associated with lower GrimAge2 after adjustment for age, sex, and smoking status (pAdj&lt;0.05). GrimAge2 outperformed other DNAm clocks after adjustment for DNAm smoking-pack-years and DNAm-based cell compositions. Better physical function and physical performance were associated with lower DNAm age deviation and pace of ageing. Longitudinal and intervention studies are needed to explore biological mechanisms underlying these observed associations.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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