JAR life最新文献

Background: Dementia disproportionately affects Hispanic communities, which may be partially attributable to disparities in resources to address modifiable risk factors. Addressing risk factors at younger ages would likely confer greater benefit than at older ages. Interest among Hispanic and younger persons participating in a dementia prevention program is unknown.

Objectives: To understand knowledge of dementia risk factors and attitudes toward prevention program participation among Arizona residents.

Design: Cross-sectional study.

Setting: Online survey conducted of Arizona residents in either English or Spanish between July 13, 2021 and August 2, 2021.

Participants: 1,303 persons age 35 and older; 332 (25.5%) were Hispanic.

Measurements: Survey questions about knowledge of dementia risk factors and dementia prevention program interest. Comparisons between Hispanic and non-Hispanic White and younger and older respondents were made using chi-squared tests.

Results: Overall, 30.7% of respondents were aware of any risk factors that increased risk for dementia with no differences between Hispanic and non-Hispanic White respondents. 76.4% of all respondents were "very" or "somewhat" interested in a dementia prevention program, interest was significantly higher in Hispanic (83.0% vs 73.3% "very" or "somewhat interested," X2 (3, N=1226) = 14.8, p=0.002) and younger respondents (82.2% vs 72.1% "very" or "somewhat" interested X2 (1, N=1302) = 20.0, p<0.001).

Conclusion: General knowledge of risk factors for dementia is low, contrasting with high interest in a prevention program. Interest is higher in Hispanic and younger persons compared with older or non-Hispanic White persons. A dementia prevention program accessible to younger and Hispanic populations could help narrow dementia outcome disparities.

Diet is a key modifiable risk factor in many chronic diseases, including age-related diseases. The Mediterranean diet (MedDiet) is an extensively studied dietary pattern which has been proposed as a lifestyle intervention to promote healthy aging in the general population, due to its numerous health benefits. Randomized controlled trials (RCTs) have attempted to explore the mechanism(s) by which the MedDiet exerts its beneficial effects on aging. One proposed mechanism is that the MedDiet helps to slow down a process called 'inflamm-aging', a type of chronic, low-grade inflammation which contributes to aging. To explore the evidence supporting this hypothesized mechanism, we conducted a scoping review of existing RCTs which used a MedDiet intervention and assessed at least one molecular outcome of potential relevance to inflamm-aging. We identified 14 papers representing 12 unique RCTs. Based on our findings, we present 10 recommendations for the next clinical trial of the MedDiet in inflamm-aging.

Background: Early detection of cognitive decline, including mild cognitive impairment, is expected to provide a better prognosis. Several studies have suggested an association between periodontitis and mild cognitive impairment.

Objectives/design: To test the hypothesis that there is an association between severe periodontitis and mild cognitive impairment in community residents who participated in a dental health check-up program.

Participants/setting: Community residents who participated in our dental health checkup program were enrolled (age=67.5±9.9, 62.9% female).

Measurements: Mild cognitive impairment was tested using the MCI screening test. Periodontitis was diagnosed based on a widely used clinical periodontal parameter, the probing pocket depth. Statistical analysis was based on logistic regression models adjusted for potential confounders.

Results: Among 321 subjects, mild cognitive impairment was detected in 41. Severe periodontitis (probing pocket depth > 6mm) was detected in 123 cases, with a higher prevalence of mild cognitive impairment in the severe periodontitis group (65.9%) than in the unimpaired group (34.3%). The inclusion of four variables (age, education, functional teeth, and presence of severe periodontitis) in a multivariate logistic regression model revealed a statistically significant difference in the association between severe periodontitis and mild cognitive impairment (odds ratio = 4.024, p < 0.001).

Conclusions: A strong association was seen between severe periodontitis and mild cognitive impairment. Severe periodontitis appears to be a risk factor for mild cognitive impairment, and patients with severe periodontitis should be assessed for mild cognitive impairment.

Frailty is a clinical condition common among older persons with heart failure (HF) and has been associated with an increased risk of adverse outcomes such as falls, disability, long-term care, and death. Malnutrition in terms of weight loss and sarcopenia is closely related to frailty. This review summarises nutritional interventions to improve components of frailty in older persons with HF. The online databases of Medline, Embase, Web of Science and Cinahl were searched in 2022 to identify studies of nutritional interventions among older persons with HF with outcomes related to frailty (e.g., body composition or functional measures). The records were screened, and eligible articles identified. In addition, reference lists of eligible articles and of four previously published reviews regarding HF and nutrition were screened. Eight articles were included in the review, of which seven were controlled trials and one was a feasibility study. Nutritional interventions included: vitamin D supplementation (n =2), protein supplementation (n =3), enteral nutrition (EN) or oral nutritional supplements (ONS) (n =2), or a low carbohydrate diet (n =1). The studies using protein supplementation, ONS or EN reported improvements on functional measures or body composition. Furthermore, the results from this review add to the evidence of the importance of combining nutritional support with physical activity to improve muscle mass and functional outcomes among older persons with HF.

Background: Falls, and more specifically, fall-related injuries, are costly to the healthcare system and can harm one's autonomy.

Objectives: To study the impact of sedentary behaviour associated with fall-related injuries and how a change in sedentary behaviour may impact the risk of a fall-related injury.

Design: From baseline to the first follow-up, cross-sectional and longitudinal data analysis from the Canadian Longitudinal Study of Aging (CLSA) cohort.

Participants: CLSA data from 43,558 Canadians aged 45-85 were included in this study.

Measurements: At baseline and follow-up, sedentary behaviour time was categorized as low (<1,080 minutes/week), moderate (1,080-1,440), or high (>1,440). Sedentary behaviour was estimated via the Physical Activity Scale for the Elderly (PASE). At follow-up, participants were dichotomized as either increased or decreased/no change in sedentary behaviour according to their categorical change between time points.

Results: Sedentary behaviour was associated with fall-related injuries independently of age, sex, number of chronic conditions, and total physical activity levels OR (95%CI) 1.10 (1.05-1.15). In contrast, a change in sedentary behaviour was not associated with the risk of fall-related injury 1.00 (0.92-1.01).

Conclusion: A higher level of sedentary behaviour is associated with injurious falls for people between 40 and 80 years old. However, a short-term change in sedentary behaviour does not influence the risk of injury-related falls. Despite the results, a more precise measure of sedentary behaviour is needed for epidemiology studies to capture changes over time better.

Biological age is a concept that uses bio-physiological parameters to account for individual heterogeneity in the biological processes driving aging and aims to enhance the prediction of age-related clinical conditions compared to chronological age. Although engaging in healthy lifestyle behaviors has been linked to a lower mortality risk and a reduced incidence of chronic diseases, it remains unclear to what extent these health benefits result from slowing the pace of the biological aging process. This short review summarized how modifiable lifestyle factors - including diet, physical activity, smoking, alcohol consumption, and the aggregate of multiple healthy behaviors - were associated with established estimates of biological age based on clinical or cellular/molecular markers, including Klemera-Doubal Method biological age, homeostatic dysregulation, phenotypic age, DNA methylation age, and telomere length. In brief, the available studies tend to show a consistent association of lifestyle factors with physiological measures of biological age, while findings regarding molecular-based metrics vary. The limited evidence highlights the need for further research in this field, particularly with a life-course approach.

Background: Metabolic Syndrome is a set of disorders that characterized by the association of three or more risk factors, like the obesity central, dyslipidemia, borderline blood pressure, hyperglycemia, and the increase of triglycerides. However, these factors also can be associated with pathophysiology of frailty.

Objectives: verifying whether the metabolic syndrome is associated to the positive frailty screening in the older people.

Design: Cross-sectional study. Participants: 443 older people living in Rio Branco, Brazil.

Setting: Data collection was carried out in two stages: a personal interview and blood collection.

Measurements: The diagnosis of metabolic syndrome was based on the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. The frailty screening was performed using subjective questions validated in a previous study. Descriptive statistics and multinomial logistic regression were used for data analyses.

Results: There was a predominance of female older people (69.07%), aged between 60 and 79 years (87.13%), with an income greater than or equal to one minimum wage (72.09%), no cognitive decline (75.94%) and depressive symptoms (63.31%), independent for BADL (86.46%) and dependent for IADL (51.69%). From the total sample, 56.88% of the older people were identified as frail, 34.09% pre-frail and 9.03% non frail. The prevalence of metabolic syndrome was 51.69%. After adjusting by the independent variables, an association between metabolic syndrome and pre-frailty was observed, and older people with metabolic syndrome were more likely to be prefrail (RRR=2.36; 95%CI=1.08-5.18).

Conclusion: The metabolic syndrome was associated to the increase chance of screening for prefrailty in the older people evaluated, which reinforces the needy to establish preventive measures in relation to the metabolic syndrome to avoid frailty in the older people.

Because nutrition is one of the main factors related to Alzheimer's disease (AD), questions arise about how taking nutrients as supplements can affect its pathophysiological process. In the present study, an overview of the potential effects of nutritional supplementation on the main biomarkers related to the AD pathophysiology (i.e., amyloid-β and tau) is explored. Trials testing the supplementation of single or combined nutrients versus placebo identified effects on some AD biomarkers, but changes were not always accompanied by positive effects on cognitive function. Differences in characteristics of studied populations (cognitive status, age, educational level), choice of nutrient combinations and doses, duration of intervention, and adjustments for potential confounders are some factors that may explain discrepancies in findings.

Physical exercise is well known for its benefits on brain health. However, the mechanisms through which these benefits occur remain discussed, especially in the context of cognitive conditions such as Alzheimer's disease. The present short review summarizes the findings of interventional studies that examined the effects of exercise training on the specific and non-specific biomarkers of Alzheimer's disease. Controlled exercise intervention studies published in the English language were selected if they assessed the effects of a physical exercise intervention of at least 2 weeks in middle-aged or older adults on one of the following biomarkers measured either in the brain, the cerebrospinal fluid or the blood: beta-amyloid, tau, neurofilament light chain, and glial fibrillary acidic protein. Overall, there was no strong evidence of significant effects of exercise interventions on any of the selected biomarkers. However, in specific populations, such as women with obesity, pre-diabetes, or depression, favorable changes in blood beta-amyloid concentrations were reported. Further benefits on cerebrospinal fluid beta-amyloid were also demonstrated in APOE-ε4 allele carriers with Alzheimer's disease. In conclusion, the current evidence suggests that physical exercise does not modulate the pathophysiology of Alzheimer's disease in the overall population of middle-aged and older adults. Nonetheless, some specific populations, such as women with metabolic disorders and Alzheimer's disease patients with APOE-ε4 genotype, seem to be favorably affected. Further studies, including long follow-ups, large sample sizes, and concomitantly assessing the effects of other factors such as sedentary behavior and diet, are required to bring further evidence to the field.