Aging Clinical and Experimental Research最新文献

Background

Handgrip strength (HGS) weakness and asymmetry are both abnormal conditions of upper-limb muscle strength. The association between HGS weakness and physical performance is controversial, and the link between HGS asymmetry and physical performance remains unclear.

Aims

This study aimed to investigate the associations of HGS weakness and asymmetry separately and concurrently with low physical performance among Chinese older people.

Methods

The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015. HGS weakness and asymmetry were defined according to the maximal HGS and the HGS ratio, respectively. Participants were classified into 4 groups according to HGS status: normal, asymmetry only, weakness only, and concurrent weakness and asymmetry. The logistic regression model was used to investigate the cross-sectional association between low physical performance and each of maximal HGS, HGS ratio, and HGS status, as well as the prospective association between baseline HGS status and new-onset physical performance decline after two years.

Results

Participants with HGS asymmetry only, weakness only, and two abnormalities showed a higher prevalence of low physical performance when asymmetry defined as an HGS ratio exceeding 1.20 and 1.30 (all, p < 0.001), with the greatest odds in those with two abnormalities (20% threshold: OR 3.83; 30% threshold: OR 5.41). The longitudinal analysis found that HGS weakness can predict the new-onset low physical performance over a two-year period, with concurrent HGS asymmetry further increased the future risk of physical performance decline.

Conclusions

Both HGS weakness and asymmetry were associated with a higher prevalence of low physical performance, in an additive way. This study will help screen older people with low physical performance more efficiently, and identify those at higher risk of developing new-onset physical performance decline within two years.

Background

Both long and short sleep durations may lead to cognitive decline in the elderly individuals, though the underlying mechanisms remain unclear.

Aims

To explore the mediating mechanism of activities of daily living and depression on different sleep durations and cognitive function in older Chinese older adults.

Methods

This retrospective study used data from 5,899 older adults who completed the 2018 China Health and Retirement Longitudinal Surveys. We used the PROCESS macro in SPSS to determine the chain mediating effect of ADL and depression on the relationship between different sleep durations and cognitive functions.

Results

(1) There were significant correlations among sleep duration, ability to perform ADL, depression, and cognitive function. (2) For sleep durations ≤ 7 h/night or > 7 h/night, ADL and depression play a chain mediating role in the relationship between sleep duration and cognitive function.

Conclusions

Shorter or longer sleep durations were associated with cognitive decline by weakening ADL and worsening depression, which suggests that medical personnel should take action to correct abnormal sleep duration in older adults. Timely treatment of ADL impairment and depression may help prevent cognitive decline.

Background

Sarcopenic obesity is a condition where loss of muscle mass occurs alongside fat gain, and it is considered a risk factor for mortality. However, the use of various definitions for this condition has led to conflicting results.

Aim

To investigate whether the coexistence of low muscle mass and abdominal obesity, defined using two simple measures employed in clinical practice, is a risk factor for mortality in individuals aged 50 or older.

Methods

A longitudinal study with a 14-year follow-up was conducted involving 5,440 participants of the English Longitudinal Study of Ageing. Abdominal obesity and low muscle mass were respectively defined based on high waist circumference and low skeletal muscle mass index (SMMI) determined by an equation. The sample was divided into four groups: non-low muscle mass/non-abdominal obesity (NLMM/NAO), non-low muscle mass/abdominal obesity (NLMM/AO), low muscle mass/non-abdominal obesity (LMM/NAO), and low muscle mass/abdominal obesity (LMM/AO). Cox regression models were used to estimate the mortality risk as a function of muscle mass and abdominal obesity status.

Results

LMM/AO increased the risk of death by 83% (HR:1.83; 95%CI: 1.35–2.66) compared to those in the NLMM/NAO group. AO alone was not associated with a greater risk of mortality (HR:1.09; 95%CI: 0.93–1.27), whereas LMM alone increased the risk by 40% (HR:1.40; 95%CI:1.18–1.66).

Conclusions

Identifying LMM/AO in individuals aged 50 or older can be crucial for predicting the risk of mortality. Simple and easily applicable measures can serve as a proxy for sarcopenic obesity and aid in implementing the necessary interventions.

The interest in the Mediterranean diet has grown considerably due to its potential health benefits on the prevention of diverse age-related chronic diseases and its association with longevity. This dietary pattern, considered among the healthiest in the world, is not simply a combination of healthy foods but goes further in its historical and cultural roots. Mediterranean diet is not intrinsically tied to any specific religion or spiritual system, but its cultural and geographical context has influenced the dietary practices of its inhabitants, encompassing the history of Western civilization and of the three Monotheistic religions Christianity, Judaism, and Islam. These religions may have some impact on dietary choices due to religious customs and practices. In 2010 the Mediterranean diet was inscribed on the UNESCO’s Representative List of Intangible Cultural Heritage of Humanity, highlighting it as a social and cultural expression of the different food cultures of the Mediterranean region and indicating that the importance of this dietary and lifestyle pattern lies not only in its specific foods and nutrients, but in the way in which its characteristic foods are produced, cooked, and eaten. In this narrative review we will discuss the possible connections between the main religions originated in the Mediterranean basin and their influence on the composition of the Mediterranean diet, and the links between spirituality/religion and this dietary pattern. This traditional model can represent a form of conscious healthy eating and lifestyle in contrast to the unhealthy Western lifestyle and ultra-processed food consumption widespread throughout the world.

Sexuality is a fundamental part of human existence and it encompasses thoughts, desires, behaviors, relationships, as well as neuropsychological and physiological components. However, sexuality in older adults is under-researched from the neuropsychological and psychophysiological perspectives and is often neglected by healthcare providers in the clinical practice. This article aims to explore the state of the art on the neuropsychology and psychophysiology of older adults’ sexuality, proposing future research directions and emphasizing its significance. By summarizing current knowledge on the sexuality of younger individuals, it was possible to lay the groundwork for formulating research questions about older adults’ sexuality. The implications proposed in this article will potentially impact both the scientific and also the clinical field. In fact, gaining insights on the neuropsychological and psychophysiological aspects of sexuality in healthy older adults can also shed light into those with neurocognitive disorders.

Purpose

The relationship between dysmagnesemia and all-cause mortality probability in individuals with acute kidney injury (AKI) have not been investigated. In this study, we evaluated the correlation of varying magnesium levels with mortality in older adults undergoing AKI.

Patients and methods

Older adults receiving treatment at the Chinese PLA General Hospital between 2007 and 2018 were retrospectively recruited. All-cause mortality was evaluated at four preset magnesium concentrations: <0.8, 0.8–0.9, 0.9–1.0, and ≥ 1.0 mmol/L. Using multivariable-adjusted Cox assessment, the all-cause mortality risk was approximated by setting the reference magnesium concentration at 0.8–0.9 mmol/L.

Results

Totally 744 participants were enrolled, whose median age was 88 years, with most of them being male (94.2%). Among them, 184 patients were assigned into the < 0.8 mmol/L group, 156 into the 0.8–0.9 mmol/L group, 206 into the 0.9–1.0 mmol/L group, and 198 into the ≥ 1.0 mmol/L group. After 28 days, the mortality rates in the four strata were 26.6, 17.9, 17.5, and 37.4%, respectively. The corresponding mortalities after 90 days were 42.4, 23.7, 26.7, and 45.5%, respectively. Compared with patients who had magnesium levels of 0.8–0.9 mmol/L, those with magnesium levels < 0.8 mmol/L (P = 0.048), and ≥ 1.0 mmol/L (P < 0.001) exhibited higher 28-day mortalities. Significant correlations also showed that patients with magnesium levels < 0.8 mmol/L (P = 0.017) and ≥ 1.0 mmol/L (P < 0.001) were significantly related to the increased 90-day mortality.

Conclusion

Magnesium levels outside the interval of 0.8–1.0 mmol/L were related to the higher risks of 28- and 90-day mortalities among older adults with AKI.

Aims

We examined whether admission risk increases at a certain threshold of number of systems medicated or whether any increase confers greater admission risk in either sex in a community-dwelling cohort of older persons in Hertfordshire. This study uses a longitudinal retrospective study design.

Methods

Data from 2997 men and women (aged 59–73 at baseline) were analyzed. Participants were followed up from baseline (1998–2004) until December 2018 using Hospital Episode Statistics and mortality data, reporting clinical outcomes using ICD-10 coding. Number of systems medicated in relation to mortality (all-cause, cancer-related, cardiovascular-related) and admission (any, neurological, cardiovascular, and respiratory) were examined using Cox regression.

Results

Apart from cancer-related mortality among women, more systems medicated predicted increased risk of all events among both sexes (p ≤ 0.001). For ‘any’, cardiovascular and respiratory admissions, there were increases in risk for each category of number of systems medicated. For example, compared to men with no systems medicated, those with 1, 2 and > 2 systems medicated had hazard ratios (95% CI) for cardiovascular admissions of 1.82 (1.57,2.12), 2.39 (2.00,2.84) and 3.45 (2.84,4.20) respectively; estimates among women were 1.74 (1.44,2.11), 2.35 (1.92,2.88) and 3.40 (2.79,4.13).

Conclusions

Increases in numbers of systems medicated conferred greater risk of admission in both sexes. Interventions aimed at reducing the burden of chronic disease in mid-late adulthood are required.

Background

Physical inactivity is an ongoing problem throughout the lifespan. For older people, inactivity has a negative impact on wellbeing, which worsened during the COVID-19 pandemic. Digital technologies can be employed to encourage uptake of social and physical activity through remotely delivered interventions to improve wellbeing, however, we need to understand older people’s perceptions and experiences of using digital technologies before implementing these interventions.

Aims

To explore the perceptions and experiences of older people on the use of digital technologies during the COVID-19 pandemic.

Methods

Qualitative semi-structured interviews were conducted with 16 community dwelling older people from Hertfordshire, United Kingdom who were all programme participants in a remotely delivered mind-body physical activity programme called Positive Movement. Interviews were conducted before programme participation. The audio recorded interviews were transcribed and analysed using thematic analysis.

Results

Four themes emerged from the data. The perceived impact of COVID-19 on social contact, perceived impact of COVID-19 on mental wellbeing, using digital platforms for health or exercise and using digital platforms for social contact.

Discussion

Participants reported reduced social contact due to COVID-19. Most participants reported using digital technologies for social inclusion rather than health reasons, and there were mixed views on the willingness to use digital technologies for physical activity.

Conclusion

Digital technologies offered a lifeline during COVID-19 to maintain social contact and their use was found acceptable by older people. Digital platforms such as Zoom can be further employed to conduct remotely delivered interventions with the aim to increase uptake of social and physical activity interventions within this population.

Recent methodological developments have contributed to a significant advance in computerised neuropsychological instruments and procedures, including those accessible from remote. In this paper we present Auto-GEMS, a newly developed, web-based, self-administered screening test allowing to quickly estimate an individual’s cognitive state also considering their cognitive reserve. Auto-GEMS measures cognitive functioning on eleven items similarly to the in-person paper-and-pencil version (GEMS) and to the remote (phone or video call) version (Tele-GEMS) of the same screening. We collected normative data on a sample of 1308 Italian-speaking participants (age range 18–93) to verify its psychometric properties and computed regression models on demographic variables to establish clinical cut-offs. The psychometric properties of Auto-GEMS have shown good internal consistency, test-retest reliability and convergent validity. This short and user-friendly tool has a number of potential applications. For instance, it can be useful in clinical practice to monitor the cognitive profile of patients or vulnerable individuals, or even administered in a face-to-face, standard clinical setting. It can also be used in research studies to screen participants. The testing materials and the collected data are freely available in a digital archive along with a web App to visualise the test outcome with reference to its normative data.

Background

The German version of the SarQoL^®, a sarcopenia-specific quality of life (QoL) questionnaire, has not been validated hindering its widespread use. This study aimed to evaluate the psychometric properties of the German SarQoL^®.

Methods

Via a cross-sectional study participants were recruited in two geriatric outpatient facilities and one acute geriatric ward in Munich (Germany). Sarcopenia and probable sarcopenia were diagnosed with the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm. From 185 participants (age 79.8 ± 6.1), 77 had probable sarcopenia, and 51 had sarcopenia. Participants completed the SarQoL^® and the European Quality-of-Life 5-Dimension (EQ-5D) questionnaires. The validation included examination of the discriminative power, construct validity, internal consistency, test-retest reliability, and floor/ceiling effects.

Results

Lower SarQoL^®scores for sarcopenic (p = 0.002) and probable sarcopenic subjects (p < 0.001) compared to controls indicated good discriminative power. Consistent construct validity was found for sarcopenic subjects: moderate to high correlations with domains capturing similar constructs of the EQ-5D: ‘Activities of daily living’ (r = -0.58, p < 0.001), ‘Mobility’ (r = -0.72, p < 0.001) and low correlations with domains related to different constructs like ‘Pain’ (r = -0.32, p < 0.022). Similar correlations were found for probable sarcopenic subjects. The Cronbach’s alpha was 0.8. Test-retest reliability was excellent (intraclass coefficient correlation of = 0.96; 95% CI = 0.91–0.99), and no floor/ceiling effects were observed.

Conclusion

QoL was similarly reduced in both patient cohorts compared to controls. The German SarQoL^® is a valid and reliable instrument for measuring QoL in patients > 65 years of age with sarcopenia and probable sarcopenia and can now be used in epidemiological studies and clinical trials in a German-speaking population.

Trial registration

German Clinical Trials Register (DRKS)-ID: DRKS00020504 (March 12th, 2021) .