Sensory impairments and cognitive decline in older adults: A review from a population-based perspective

The relationship between physical activity and appetite among older adults - A scoping review

BACKGROUND

Appetite loss among older adults is common and may lead to malnutrition, reduced function and frailty. Regular physical activity may help regulate appetite and enhance overall wellbeing. However, evidence concerning the relationship between physical activity and appetite in older adults remains scarce.

OBJECTIVES

This study aims to examine the existing literature for the relationship between appetite and physical activity among older adults, contributing to the identification of existing research gaps.

METHOD

A scoping review was conducted using a block search strategy with keywords including physical activity, exercise, appetite, and older adults. Searches were performed in Web of Science, PubMed, and CINAHL on November 23, 2023. The inclusion criteria were: English language, human studies, population aged 55+ without severe disease, addressing both appetite and physical activity, original articles, and not qualitative studies.

RESULTS

Of 1190 articles identified, 25 were included. Females comprised 52% of the participants and most studies focused on community-dwelling older adults, primarily in the US and northern Europe. Research design and methodologies varied widely. Of the 25 studies, 14 were cross-sectional studies, seven randomized controlled trials, three non-randomized controlled trials, and one longitudinal observational study. Associations between physical activity and appetite were found in a longitudinal observational study including 186 participants, two randomized trials involving higher-intensity exercise, all non-randomized studies, and 10 cross-sectional studies.

CONCLUSION

Although an association between appetite and physical activity among older adults has been observed, the lack of randomized controlled trials limits conclusions regarding whether exercise can effectively regulate appetite in older adults.

Predictors of Quality of Life Among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health

OBJECTIVES

The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas.

METHODS

A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations.

RESULTS

Multiple linear regression analysis indicated that cardiovascular endurance was the strongest significant factor associated with QoL in rural areas (B=0.027, standard error [SE]=0.013, p=0.050). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.447, SE=2.360, p<0.001), followed by hemoglobin level (B=-1.842, SE=0.744, p=0.015), age (B=-0.822, SE=0.217, p<0.001), and cognitive function (B=0.396, SE=0.162, p=0.016).

CONCLUSIONS

Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.

Dual sensory loss and cognitive impairment: A study in elderly users of gerontological centers in a Galician urban area

SIGNIFICANCE

Several studies indicate that dual sensory loss (DSL) is related to cognitive impairment. However, there are still no conclusive data on the role of each individual deficit on cognitive performance when both co-occur in the same person.

PURPOSE

This study aimed to analyze the possible association between sensory deficit and cognitive impairment in a sample of older adults and whether this association differs in subjects with DSL compared with those with single or no sensory impairment.

METHODS

Participants of this study were older adult users of gerontological centers in an urban area of Galicia (Spain). All subjects underwent visual and auditory screening tests to detect the presence of DSL. The Spanish version of the Mini-Mental State Examination test was used to identify cognitive impairment. Hearing loss was defined according to Ventry and Weinstein's criteria. Visual impairment was defined as a binocular presenting visual acuity <0.5 (20/40). The presence of DSL was established on the basis of the definitions of the single deficits.

RESULTS

A total of 534 subjects were examined. Older adults with DSL had the worst results in the Mini-Mental test, and those without sensory impairment had the best. The likelihood of cognitive impairment was greater in older adults with DSL than in those without sensory impairment (odds ratio, 6.06 [3.14 to 11.65]). When only visual impairment was present, the likelihood of cognitive impairment was 3.73 times higher (0.95 to 3.09) than that of subjects with no sensory impairment. Hearing loss alone seems not to be significantly associated with a higher risk of cognitive impairment.

CONCLUSIONS

The results of this study highlight the importance of continuing research in DSL for the prevention of cognitive impairment, the design of intervention plans, and the optimization of health resources.

Self-reported sensory impairment and social participation among Korean older adults: mediating roles of cognitive function and digital technology use

OBJECTIVES

This study investigates the correlation between self-reported sensory impairment, cognitive function, digital technology use, and social participation among older adults in South Korea.

METHOD

Data from the 2020 National Survey of Older Koreans, comprising a nationally representative sample of 7849 individuals aged 65 years or older, were analyzed. A serial mediation analysis (Model = 6) was conducted using the PROCESS macro for SPSS.

RESULTS

Following adjustment for covariates, cognitive function and digital technology use serially mediated the relationship between self-reported sensory impairment and social participation among older adults (B = -0.0020, SE = 0.0005, 95% confidence interval [CI] = [-0.0030, -0.0010]). Specifically, self-reported sensory impairment exhibited a negative correlation with cognitive function (B = -0.3277, SE = 0.0753, p < .001), which was positively associated with digital technology use (B = 0.0763, SE = 0.0056, p < .001), subsequently linking to enhanced social participation (B = 0.0784, SE = 0.0037, p < .001).

CONCLUSION

Through cross-sectional analysis, this study confirms that self-reported sensory impairment in older adults may precede cognitive decline, hindering digital technology use and reducing social participation. Early diagnosis and treatment are crucial in preventing cognitive decline, while age-friendly digital devices may alleviate cognitive burden and promote social engagement.

The relationship between self-reported sensory decline and cognitive frailty in older persons

This study aimed to explore the relationship between self-reported sensory decline, including poor hearing and vision, and cognitive frailty in older persons. This cross-sectional study analyzed data from the 2020 National Survey of Living Conditions and Welfare Needs of Older Koreans. Binomial logistic regression analysis was performed to analyze the relationship between self-reported sensory decline and cognitive frailty. Of 9,692 participants, 39.8 % experienced sensory decline. The prevalence of cognitive frailty was 15.7 % among participants with poor hearing, 6.9 % among those with poor vision, and 17.9 % among those with combined poor hearing and vision. In our model, adjusted for sociodemographic and health-related variables, the cognitive frailty was significantly associated with poor hearing alone and combined poor hearing and vision. The findings suggest that healthcare professionals should prioritize their attention to the risk of cognitive frailty in older adults experiencing poor hearing alone and combined with poor vision.

Defining and assessing intrinsic capacity in older people: A systematic review and a proposed scoring system

INTRODUCTION

The World Health Organization has introduced the term 'intrinsic capacity' (IC) as a marker of healthy ageing. However, controversy exists on the definition and assessment of IC. We aimed to review the definitions and methods used for the assessment of IC in older adults. In addition, we proposed a new IC scoring method.

METHODS

A systematic search was performed in PubMed, Web of Science, Cochrane Library, Scopus and SPORTDiscus (up to February 10th, 2022) for studies assesing IC in older adults (>60 years).

RESULTS

Thirty-three studies were included. There is overall consensus on the definition of IC as well as on its different dimensions, that is: locomotion, vitality, sensory, cognition and psychological. However, the methods for assessing each of these five dimensions differ substantially across studies and there is no consensus on the best method to compute an eventual global compound score to evaluate IC taking into account all its different dimensions.

CONCLUSIONS

The IC represents a highly relevant clinical concept that has been unfortunately underutilized. We propose a standardization for the assessment of each dimension of IC, with a global 0 (worst) to 10 (highest) score.