Aging and health research最新文献

Background

This study examined hippocampal subfields volumes in patients with mild cognitive impairment (MCI) as potential non-invasive predictive neuroimaging markers of cognitive decline.

Methods

T1-weighted images and Addenbrooke's cognitive examination III (ACE-III) data were obtained from 36 healthy controls and 27 MCI patients. The hippocampal subfields volumes were extracted using Freesurfer software, and group differences and correlation were assessed using general linear model (GLM) with age, sex, and total intracranial volume (TIV) as covariates.

Results

MCI participants exhibited significant decrease in memory scores and notable volumetric changes in hippocampal subfields, including the bilateral hippocampal tail, subiculum, CA1, CA3, molecular layer, as well as the left presubiculum, parasubiculum, CA4, GC-ML-DG, and HATA. Moreover, the left presubiculum, left parasubiculum, and left GC-ML-DG showed significant positive correlations with ACE memory scores in MCI patients.

Conclusions

The alterations in hippocampal subfields in MCI patients may indicate underlying neurodegenerative processes associated with Alzheimer's disease (AD) pathology.

Background

The success of falls prevention exercise intervention is dependent on adherence. This study investigated the trajectories of adherence to an instructor-led, face-to-face, community group-based falls-prevention exercise intervention, baseline factors associated with these trajectories, and the impact of these adherence trajectories on post-intervention physical functioning. Qualitative interviews were also examined to gather insights into participants’ profiles.

Methods

Attendance data from 144 older adults who participated in a 12-week falls prevention exercise intervention were used to assess adherence. Physical functioning was assessed at baseline and post-intervention using Short Physical Performance Battery. We used Latent Class Growth Modelling to identify the types of adherence trajectories. Multinomial logistic regression and multivariate linear regression were used to examine antecedents and consequences associated with the adherence trajectories. Content and cross-tabulation analysis were conducted on 30 semi-structured qualitative interviews.

Results

We identified four types of adherence trajectories: high adherence, moderate adherence, low adherence, and non-adherence. Non-adherent participants were younger than those with a high adherence trajectory. Those with low adherence trajectory were younger, more likely to be an ethnic minority, and had lower exercise self-efficacy. Older adults with low or non-adherence trajectories had lower post-intervention physical functioning than those with high adherence trajectory. Qualitative analysis indicated that participants with low adherence trajectory had prioritized exercise lower than other life commitments and had frequent hospitalizations and multiple medical appointments.

Conclusion

Non and low adherence trajectories attenuate the impact of falls prevention exercise intervention. Findings from this study can be used to develop strategies to improve adherence.

Background

Evidence on health and social care resource utilisation and associated costs, and how this varies across people with Alzheimer's disease (AD) dementia is limited.

Methods

Retrospective cohort, using the Discover dataset, which includes linked health and social care records for approximately 2.5 million people in North-West London. Individuals were followed up from the latter of 2010 or from diagnosis of AD dementia (index) up to 2019. Outcomes were overall survival, care home admission, health and social care utilisation and associated costs, and cardiovascular outcomes. Variation was explored in subpopulations and by stratifying by cost quintile. Generalised linear modelling was used to estimate the association between clinical and demographic characteristics and healthcare costs.

Results

The cohort included 18,116 people diagnosed with AD dementia whose mean age at index was 81 years, 62 % were female and 65 % were of white ethnicity. Median survival from index was 4.9 years (95 %CI: 4.8–5.0). Mean healthcare costs were £4,548(£4,491–£4,604) per person year(ppy). Healthcare costs for the 48 % who used social care were £5,433ppy(£5,353–£5,514) and social care costs were £24,374ppy(£24,372–£24,376). In the overall cohort costs in the highest cost quintile were £13,665ppy(£13,420–£13,911), of which 70 % was from inpatient hospitalisation. Subpopulations admitted to care home (£7,535 £7,362–£7,709), with cardiovascular disease (£6,106;£5,990–£6,222) and with type 2 diabetes (£6,049;£5,901–£6,198) accrued the highest healthcare costs. Factors most strongly associated with cost were dying during follow up (+£2,224;£2,010–£2,493), being frail (+£1,246;£1,051–£1,440) and prior stroke (+£1,207;£908–£1,507).

Conclusion

Characteristics of individuals with high healthcare costs include requirement for social care and cardiometabolic comorbidities. Identifying individuals early in their disease course may improve health outcomes and reduce the cost of AD dementia in later life.

Ageing is not formally in the core pillars of Smart City framework under the Sustainable Development Goals of United Nations. Its undermined significance is usually detected under some of these pillars connected with each other. Somehow not many measurements on ageing to positively or negatively influence smart city development are well-defined or in some sense provide solid insights to policy makers. This article tries to guide readers where ageing considerations should be recommended on any stages of smart city development and how research studies should look for or measure these performances and interconnections with no overlooking on ageing aspects.

Background

Older adults have faced not only health threats but grave mental health challenges since the emergence of the Coronavirus disease 2019 (COVID-19) pandemic. Using factor analysis, this study is the first to identify the underlying dimensions of COVID-19-related stressors, then examine the relationship between these factors and mental health and alcohol use/misuse longitudinally in a middle aged to older adult sample in the United States.

Methods

As part of a long-term follow-up study, 921 survey participants completed measures of COVID-related stressors, psychological distress, and alcohol use/misuse in a 2020 survey. An exploratory factor analysis was conducted to examine the dimensionality of COVID-related stress. Regression models were utilized to examine relationships between the extracted factors and depression, anxiety, and alcohol-related outcomes measured approximately one year later, in 2021.

Results

Four dimensions of COVID-19 stressors were extracted, including 1) jobs, finances and loss of routine; 2) practical difficulties; 3) social worries and challenges; and 4) supply shortages. Practical difficulties were associated with higher depression at follow-up, while jobs, finances and loss of routine were associated with past 12 month frequency of intoxication at follow-up. Conclusions: Challenges from the pandemic may have longer-term implications for mental health in older adults past the acute phase of the pandemic. It is important to allocate sufficient attention and resources to the prevention of late life depression and mental health as policymakers and health professionals continue to deal with the pandemic and future variants of the virus.

With the current global population expansion and increasing life expectancy, more people are living in their later years, when neurological issues are most common. Both environmental and geographical factors contribute to the incidence of various neurological diseases (NDs) in India. These diseases involve the gradual or complete loss of structure and function of neurons, including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), epilepsy, stroke, and amyotrophic lateral sclerosis (ALS). The exact cause of these illnesses is still unknown in medicine. Still, it may be linked to protein deterioration, oxidative stress, inflammation, environmental factors, mitochondrial deficiencies, familial history, and abnormal protein build-up. In this review, we have discussed briefly the pathophysiology of various neurological diseases from Indian studies as well as possible diagnostic markers, drugs used, traditional Indian medicinal plants, and alternative therapeutic approaches for detecting and treating these NDs.

Background

Despite risks of vaccine-preventable infectious diseases, many older adults are under vaccinated. The present study investigates possible barriers to acceptance of vaccines recommended for older adults and considers demographic variation and links to acceptance for distinct vaccines.

Methods

A mailed survey was conducted with 901 older adults (aged 65+) across the state of North Dakota, oversampling for rural regions. The survey addressed demographic characteristics, barriers to vaccination (including needle phobia, cost, lacking doctor recommendation, transportation, and scheduling uncertainty), and vaccine acceptance (including provider guidance acceptance and uptake for influenza, shingles, pneumococcal, and COVID-19 vaccines).

Results

Cost (27.2 %) and needle phobia (24.1 %) were the most prevalent barriers. Rural, lower educated, non-white, and living alone older adults experienced increased risks of barriers such as cost, lacking a doctor recommendation, transportation, and uncertainty how to schedule. Cost was associated with shingles vaccine uptake, whereas lacking doctor recommendation was associated with uptake for all vaccines except shingles. Needle phobia was associated with uptake of all vaccines except COVID-19. Transportation barrier was only associated with pneumococcal vaccine uptake.

Conclusions

These findings highlight relatively low prevalence of barriers, yet variability by older adults’ demographic characteristics. Further, the influence of barriers on acceptance varied by vaccine type. By better understanding the nuanced role of barriers to older adults’ vaccination, strategies to increase vaccination rates can be developed.

A prominent gap exists in understanding stigma among racialized persons living with dementia, care partners, and community. A scoping review was conducted to explore stigmatizing perceptions of dementia among racialized groups living in Anglosphere countries. Eligible studies focused on dementia and stigma, and reported data on racialized groups (i.e., Black, Hispanic, South Asian, East Asian, Middle Eastern) living in Anglosphere countries (i.e., Canada, United States, United Kingdom, Ireland, Australia, New Zealand). All publication dates were included. Eligible studies were published in English. Scopus, CINAHL, PubMed, PsycINFO, Medline(Ovid), EMBASE databases were searched in November 2022. Data extraction and thematic analysis was performed on eligible studies using Corrigan's Model of Stigma. Themes were categorized into stereotypes, prejudices, and discrimination. Thirty-six studies were included. Themes aligning with stereotypes included derogatory and unpredictable labels, religious beliefs and mysticism toward dementia, and associating dementia with other diseases. Themes aligning with prejudices included shame or embarrassment of dementia. Themes aligning with discrimination included discouragement in help-seeking and isolation, and lack of social acceptance. Stigmatizing perceptions of dementia among racialized communities may delay diagnosis, treatment, and participation in support programs. Future studies must aim to educate and promote dementia awareness among racialized groups.

Alzheimer's disease (AD) is a neurodegenerative disease with reduced cognitive function due to mitochondrial dysfunction and oxidative stress. Recent studies show that the pathophysiology of AD may be influenced by mitochondrial dysfunctionality, Ca²⁺ imbalance, apoptosis, decreased energy, and alteration in its metabolism. Study indicates that damaged mitochondria play critical roles in the pathogenesis of AD, even if the precise mechanism behind AD pathogenesis remains unknown. It is thought that a healthy pool of mitochondria protects neurons by reducing oxidative damage caused by mitochondria and also promotes neuronal activity by giving neurons enough energy and other associated mitochondrial functions. In this sense, investigation of the mitochondrial mechanisms that altered the pathogenesis of AD constitutes novel, promising therapeutic targets for the disease. Mitochondria enhances energy generation, antioxidants to scavenge reactive oxygen species and reduce oxidative damage substrate supply, glucose metabolism, and potential drug candidates that target apoptotic and mitophagy pathways to remove damaged mitochondria. Although mitochondrial therapy approaches have shown promise in preclinical studies, there hasn't been much advancement in clinical trials thus far. Therefore, we try to find out the role of mitochondria in AD and highlight the development of compounds that target mitochondria as potential therapeutic targets for AD.