Advances in Gerontology最新文献

Autophagy is a dynamic process of delivery of non-functional cytoplasmic components into lysosomes for subsequent degradation, serving to renew cellular contents and utilize protein aggregates and organelles. This process is necessary to maintain cell metabolism under conditions of energy and nutrient deficiency. The pathogenesis of aging-associated diseases is associated with disturbances in the autophagy process. In the liver of senescent-accelerated OXYS rats and Wistar rats (control) at the age of 4 and 16 months, the transcriptional activity of key genes of the autophagy process was studied during its induction by fasting (12, 24 and 48 h) and inhibition by chloroquine. At the age of 4 months, modulation of autophagy in the liver of rats revealed changes in the mRNA level of the Atg7, Gabarapl1, Nbr1 and p62/Sqstm1 genes. At the age of 16 months, in response to food deprivation, the mRNA level of the Atg7, Map1lc3b, Gabarapl1 and Nbr1 genes increased, and the dynamics of changes in their expression depended on the genotype of the animals. Interstrain differences were revealed in the mRNA levels of Atg7 at 4 months and Gabarapl1 at 16 months during administration of chloroquine, which neutralized the effects of fasting. Our study is the first to demonstrate the effect of chloroquine on the transcriptional activity of autophagy-associated genes in rat liver. The effects of chloroquine (a late-stage autophagy blocker) on autophagy-related gene expression were age- and genotype-dependent, providing direct evidence of altered autophagic flux in the liver with aging. The observed strain-specific differences in autophagy-related gene expression in response to modulation suggest variations in the baseline state and reactivity of hepatic autophagy between OXYS and Wistar rats. These differences may contribute to the accelerated aging phenotype in OXYS rats. Given the established connection between metabolic homeostasis and aging pathologies, we hypothesize that targeting autophagic flux could represent a strategy for regulating hepatic metabolism in age-related decline.

Various views on the “correct” definition of aging are analyzed. It is emphasized that a huge number of such definitions have emerged in recent decades, and several million scientific publications devoted to this topic can be found online. At the same time, most gerontologists based their definitions on the premise that aging (with various modifications) is a set of age-related changes in the body that lead to an increased probability of death. However, as numerous new data emerged in gerontological research, many specialists began to question the suitability of this “classical” definition. This was due, among other things, to the identified impact of long-term chronic diseases such as HIV or COVID-19 on age-related mortality dynamics, to the dramatic changes in recent decades in the understanding of cellular aging and the relationship between aging and various age-related diseases, as well as to the correct methodology for determining biological age. The apparent lack of progress in fundamental gerontology to date and the emergence of a large number of studies in which the presence/absence of aging in the studied organisms was in no way linked to the obtaining survival curves also played a significant role. The evolution of approaches to defining aging is discussed, as well as potential future modifications to this definition.

Older adults are disproportionately vulnerable to physical, mental, and social health challenges, particularly during times of crisis. Understanding the factors that enhance their resilience is essential for developing supportive interventions. This study aimed to explore perceived contributors to resilience among Iranian older adults during the COVID-19 pandemic, using qualitative methods to capture the depth of lived experience. Data were collected through in-depth, semi-structured interviews with 37 older adults. A purposive sampling strategy with maximum variation was employed to ensure a diverse range of participants, followed by theoretical sampling to achieve conceptual saturation. Thematic analysis was used to code and interpret the data. The findings revealed that access to various forms of capital—economic, cultural, spiritual, and familial (filial support)—plays a pivotal role in strengthening resilience among older adults. These multidimensional resources go beyond material wealth, highlighting the significance of intangible assets such as cultural heritage, spiritual beliefs, and intergenerational support. Additionally, formal social support systems were identified as critical contributors to resilience. The presence or absence of these resources significantly shaped individuals’ capacity to cope with crises. Participants described access to economic, cultural, familial and spiritual resources, and formal social support, as contributors to their capacity to cope. These findings describe associations and lived experience; they are hypothesis-generating and do not establish causal relationships. Future quantitative or longitudinal research is required to test causal mechanisms.

A decline in oral function, including tongue pressure, decreases physical function and increases the risk of physical frailty and hospitalization as well as mortality. Although no underlying mechanism has been determined for the relationship between decreased tongue pressure and muscle strength, their association is clear. Herein, we aimed to determine whether upper- or lower-body muscle strength is more strongly associated with tongue pressure in older adults. This cross-sectional study included community residents aged ≥65 years. Tongue pressure and grip strength were measured as upper limb muscle strength; knee extension muscle strength was measured as lower limb muscle strength. In addition, muscle mass in the limbs and trunk was evaluated, and demographic data were collected. Bayesian statistics were used for analysis using a linear regression model. Data were analyzed for 51 men (mean age [standard deviation], 77.94 [5.40] years) and 117 women (mean age [standard deviation], 77.28 [5.44] years). Tongue pressure in community-dwelling older adults with good physical function was strongly related to upper-body muscle strength in men (expected a posteriori = 0.51; 95% Bayesian credible interval: 0.19–0.84) and with lower-body muscle strength in women (expected a posteriori = 0.33; 95% Bayesian credible interval: 0.10–0.56). In summary, tongue pressure in community-dwelling older adults was strongly related to upper-body muscle strength in men and lower-body muscle strength in women. These associations should be investigated longitudinally to develop strategies to prevent tongue-pressure reduction in community-dwelling older adults.

Guidelines promote high-quality care for older adults. Exercise training recommendations have not been fully characterized. Objective: To propose a training protocol for functional muscle strength and postural balance in older adults, based on main literature findings. Methods: A systematic review, including studies for individuals aged 65 years or older, providing recommendations for strength and balance training between 2017 and March 2025. Results: A total of 1979 articles were initially identified. After removing duplicates and applying filters, 1880 articles were screened, and 11 studies met the inclusion criteria. These studies assessed multicomponent, concurrent, and strength training, and their effects on muscle strength, physical performance, balance, quality of life, and fall-related outcomes. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Significant improvements were observed in muscle strength, physical performance, and balance in the intervention groups. Training protocols typically included exercises targeting both upper and lower limbs, with variations in intensity, frequency, and progression. Recommendations from the American College of Sports Medicine emphasized gradual progression and balance across muscle groups. The findings highlight studies that recommend exercise training for diverse older adult populations and various health outcomes, establishing exercise as a recognized component of care. These findings contrast with clinical reports indicating low implementation rates of exercise training, suggesting guideline recommendations may often be overlooked. Conclusions: Improving adherence to guideline-concordant exercise training could enhance function and quality of life in older adults. The presence of qualified fitness professionals during training sessions is essential to ensure safety and efficacy.

Background: The aging phenomenon is occurring at a faster rate in the developing countries compared to the developed countries. The most important issue in aging is promoting health, maintaining the independence of the elderly, and continuing to live an active life. Since reference values for hand grip strength vary across different populations and geographic regions, this study aimed to determine the reference values for hand grip strength and its influencing factors in the elderly of Amirkola. Methods: This cross-sectional study was a part of the second phase of the Amirkola Elderly Cohort and was conducted on 1375 elderly individuals aged 60 years and above willing to participate in the study. Muscle strength was measured using a dynamometer (Digital Hand Grip Dynamometer) in kilograms (kg). Other variables examined included demographic and anthropometric information, which were extracted using appropriate questionnaires and tools. Results: Based on the data, the median hand grip strength for women was 18 kg (range 11–26 kg), and for men was 32 kg (range 18–44 kg). Age and sex had the greatest impact on hand grip strength. A significant relationship was also observed between chronic disease, physical activity, bone mineral density, and fat-free mass with hand grip strength (P = 0.0001). Body Mass Index (BMI) and fat mass had a positive and significant effect in men. Educational level and marital status had a significant effect in both groups. Conclusion: The main factors affecting hand grip strength were age and sex. Other influential factors included chronic disease, physical activity, bone mineral density, and fat-free mass.

Falls among older adults represent a significant public health concern. This study, using a two-group posttest-only randomized experimental design aimed to investigate whether an 8-week combined exercise program reduces fall risk by improving vibration sense, proprioception, muscle strength, static balance, reaction time, and postural stability in women aged 65 years and older, compared to their matched sedentary counterparts. A total of 42 individuals who performed regular exercise (study group) and 42 age-matched participants with a sedentary lifestyle (control group) were included. Participants in the exercise group engaged in a combined exercise program under the supervision of a physiotherapist, 2–3 days per week for 8 weeks. Physical activity levels were assessed using the International Physical Activity Questionnaire (IPAQ)-Short Form. The variables evaluated included vibration and proprioception senses, isometric ankle muscle strength, static balance, postural stability, and reaction time. The Morse Fall Scale (MFS) was used to assess fall risk for each participant. The study group showed statistically significant improvements in ankle proprioception, isometric plantar and dorsiflexor muscle strength, static balance, ankle reaction time, postural stability, and fall risk outcomes compared to the control group (p < 0.050). In contrast, vibration sense and isometric invertor and evertor muscle strength did not differ significantly between the two groups (p > 0.050). Regular participation in an 8-week combined exercise program significantly enhances sensory-motor functions, reduces fall risk, and improves overall postural stability in older females aged 65 and above. These findings highlight the critical role of structured exercise in fall prevention strategies for this population.

This study investigates rural-urban disparities in digital healthcare utilisation among elderly populations in Assam, with a focus on the mediating role of digital literacy. Primary survey data from 400 respondents aged 60 and above were used to construct a Digital Literacy Index (DLI) and a Digital Healthcare Utilisation Index (DHUI) via Principal Component Analysis. Multiple regression analysis identified age, education, income, living arrangements, and digital literacy as significant determinants, with rural residence linked to lower utilisation odds. The Oaxaca-Blinder decomposition revealed a DHUI gap of 2.946 units, of which 73% was explained by differences in characteristics, primarily digital literacy, education, and income. Digital literacy alone accounted for over one-third of the explained gap, while the unexplained component pointed to infrastructural, contextual, and socio-cultural barriers. Findings show that low education, economic constraints, and limited digital skills disproportionately hinder rural elderly from accessing e-health services despite greater healthcare needs. The study indicates digital literacy as the most actionable factor, advocating tailored, age-sensitive training, simplified interfaces, and social support mechanisms. Addressing these disparities is essential to prevent digital health initiatives from exacerbating inequalities and to ensure equitable inclusion of elderly populations in India’s evolving digital health ecosystem.

Background and Objectives: Loneliness and depression are major public health issues among the elderly. Self-management and self-care interventions can enhance resilience and promote well-being. The World Health Organization’s (WHO) mobile-Ageing (mAgeing) program, which delivers daily health messages to older adults, aims to promote healthy aging and strengthen intrinsic capacity and functional ability. This study evaluated the effects of the WHO mAgeing smartphone-based program on loneliness, depression, and resilience among retired education professionals. Methods: This one-group pretest–posttest quasi-experimental study included 210 older adults aged over 60, recruited through convenience sampling. Participants received daily mAgeing messages and activity instructions via WhatsApp for eight weeks. Loneliness, depressive symptoms, and resilience were measured at baseline, week 8, and week 12 using the UCLA Loneliness Scale, Geriatric Depression Scale-5 (GDS-5), and the Connor-Davidson Resilience Scale (CD-RISC) questionnaires. Results: Among participants, 109 (54.8%) were women and 90 (45.2%) were men, with a mean age of 64.68 ± 3.23 years. After the intervention, the mean loneliness score decreased from 46.21 to 41.56, and the mean depression score declined from 1.25 to 0.89. The mean resilience score increased from 43.83 to 47.84. Statistical analyses showed significant reductions in depression and loneliness (p < 0.001) and a significant improvement in resilience and its five components (p < 0.001). Older age, male gender, being widowed or divorced, and a history of illness were negative demographic predictors of loneliness. Older age and male gender also predicted higher depression and lower resilience, whereas higher educational level and time progression positively predicted all three outcomes. Conclusion: The mAgeing program is feasible for use among older adults and can effectively reduce loneliness and depressive symptoms while improving resilience after an eight-week intervention. We emphasize that, given the single-group design, results indicate associations rather than causal effects.

The number of different medications per day has been linked to reduced physical function in older adults. The aim of the present study was to investigate the associations between medication count and physical function in older adults with particular consideration of the potentially mediating effects of physical activity, skeletal muscle mass, cognitive function and the body’s fluid balance. This was a cross-sectional study conducted in 2022 including 69 community dwelling participants (age = 82.5 ± 6.5 years) who were service users provided by a nursing home in Reykjavik, Iceland. Each participant attended one session of ~60 min with the study staff for doing physical tests (anthropometrics, muscle strength, physical function) and answering questionnaires on lifestyle and health. Among the 46 women and 23 men, the prevalence of sarcopenia was 60.3%, and 52.2% of participants reported using ≥5 medications/day. When adjusted for sex and age, medication count was significantly associated with lower grip strength (B = –0.46 kg, P = 0.039), lower chair-rise test score (B = –0.15, P = 0.004) and lower short-physical-performance-battery score (B = –0.23, P = 0.040). Further adjustment for skeletal muscle mass and cognitive function only slightly attenuated the associations. However, adjusting for physical activity and extracellular/total body water ratio reduced the effect sizes by approximately 35–65%, and most associations were no longer statistically significant. In this specific, highly frail group of older adults there was a high prevalence of sarcopenia, low muscular strength and low physical function. The number of medications per day was found to be significantly associated with low muscle strength and poor physical function. Our study further indicates that the associations between the number of different medications per day and strength and physical function are partly mediated by low physical activity and high extracellular/total body water ratio in participants with higher daily medication use.