60 years of healthy aging: On definitions, biomarkers, scores and challenges

Conceptualisation and measurement of healthy ageing: Insights from a systematic literature review

This paper enhances the understanding and measurement of Healthy Ageing (HA) through a systematic review of its multidimensional operationalisation. Despite progress in HA research, no consensus exists on its constitutive elements, and current frameworks often do not capture its full complexity. Building on the World Health Organization (WHO) HA definition, we organise empirical evidence under three dimensions: intrinsic capacity (IC), functional ability (FA) and the environment (ENV). To identify conceptual, empirical and methodological gaps, we provide a structured synthesis of concepts, measures and instruments used in HA research, evaluating methodological advancement and standardisation in HA measurement. Following PRISMA guidelines, we extract data from 55 quantitative, qualitative and mixed-methods studies with a multidimensional HA focus. We arrange evidence into three primary domains (IC, FA and ENV; first order), 15 sub-domains (second order) and 84 themes (third order). We identify operational categories via thematic analysis and inductively determine the final categorisation, moving from third to first order based on conceptual and measurement considerations. Given the lack of systematic knowledge on ENV, we generate a more nuanced categorisation capturing different levels of analysis and contexts. We compute a mean usage ratio to assess differences in the application of validated tools across HA aspects. The review revealed substantial variability in HA conceptualisation and measurement. IC and FA are the most extensively studied domains, with well-established measurement approaches and widespread use. Common themes include locomotion, cognitive capacities and functional status. ENV remains significantly underexplored and lacks standardised measurement, as mainstream assessments still prioritise deficit-based approaches over enabling environments. This analysis calls for a standardised, multidimensional HA model integrating individual and contextual factors, recognising the role of structural environmental supports in shaping ageing trajectories. Future research should prioritise comprehensive HA measurement and pursue an interdisciplinary approach bridging conceptual and methodological gaps to inform HA policies effectively.

Risk factors for sarcopenia in community setting across the life course: A systematic review and a meta-analysis of longitudinal studies

BACKGROUND

Sarcopenia is generally an age-related condition in older people that impacts adverse health consequences in terms of quality of life, morbidity and mortality. With the increasing interest of clinical and research interest in sarcopenia internationally, the epidemiological evidence reveals sarcopenia risk begins in early adulthood, influenced by gene, lifestyle and a range of chronic conditions across life course.

OBJECTIVES

The purpose of this study was to systematically summarize the risk factors for sarcopenia across the life course, and to identity the high-risk population.

METHODS

Searches were performed in PubMed, Web of Science, Scopus, Embase, MEDLINE, and SPORTDiscus databases from inception to July 2024. Longitudinal studies assessing the risk factors for sarcopenia in community setting were included in the analysis. Fixed- and random-effect models were used to pool effect size. Based on the results of meta-analysis, we developed a risk predictive model for sarcopenia.

RESULTS

Fifty-three studies were included in our systematic review. Risk factors associating with sarcopenia were grouped into eight domains: sociodemographic, anthropometric, health behaviors, health condition, biomarkers, early life factors, psychosocial and living environment factors. Fifteen risk factors derived from the twenty-three included studies were eligible for meta-analysis, and ten variables were identified as statistically significant. A risk predictive model was developed for secondary sarcopenia in community setting.

CONCLUSIONS

This study provides a fully understanding of sarcopenia across the life-course. Our risk predictive model could facilitate the early identification and prevention of secondary sarcopenia in community setting.

REGISTRATION

The systematic review and meta-analysis have been registered in PROSPERO(CRD42024536346).

The mechanism underlying of Zuoguiyin on liver and kidney in D-gal-induced subacute aging female rats: A perspective on SIRT1-PPARγ pathway regulation of oxidative stress, inflammation and apoptosis

ETHNOPHARMACOLOGICAL RELEVANCE

Aging is a complex biological metabolic process. Traditional Chinese Medicine (TCM) theory posits that deficiencies in the liver and kidneys in women is closely associated with aging. Zuoguiyin (ZGY), originating from the Jing Yue Quan Shu (A.D. 1624), is renowned for its efficacy in nourishing Yin and tonifying the kidneys. Pharmacological studies have confirmed that ZGY could enhance liver and kidney functions in aging females, but its molecular mechanisms remain unclear.

AIM OF THE STUDY

This study aims to investigate the effects and potential mechanisms of ZGY on the liver and kidneys in female subacute aging model rats.

MATERIALS AND METHODS

A combination of network pharmacology and animal experiments was employed to identify the active components and potential targets of ZGY. A subacute aging model was established in female rats using D-galactose (D-gal) injection. After intervention with ZGY, its effects and mechanisms on the liver and kidney were evaluated using behavioral tests, ELISA, H&E staining, immunohistochemistry, Western blot analysis, and molecular docking.

RESULTS

Network pharmacology analysis indicated that the effects of ZGY on subacute aging female rats might be associated with the regulation of oxidative stress and inflammatory responses via the sirtuin 1 (SIRT1)- peroxisome proliferator-activated receptor gamma (PPARγ) pathway. Compared to female subacute aging model rats, ZGY significantly improved behaviors in model rats. It notably reduced levels of MDA, NF-κB, and IL-6 in serum, liver, and kidney tissues, while increasing the levels of SOD, CAT, and IL-10. Furthermore, ZGY enhanced liver and kidney functions, alleviated pathological damage to these organs, decreased BAX expression, increased Bcl-2 expression, and inhibited apoptosis in liver and kidney cells. Western blot analysis further validated that ZGY activates the expression of proteins in the SIRT1-PPARγ pathway. Molecular docking implicated that 65 enter blood components of ZGY might be the active components.

CONCLUSION

This study reveals that ZGY exerts positive effects on the liver and kidney in D-gal-induced subacute aging female rats. Its mechanisms are associated with the activation of the SIRT1-PPARγ pathway, which regulates oxidative stress, inflammation, and apoptotic pathways.

Age-related changes in myelin and myelin water quantified with short-TR adiabatic inversion-recovery (STAIR) sequences

Myelin proton density fraction (MPDF) and myelin water fraction (MWF) measured with short-TR adiabatic inversion-recovery (STAIR) sequences are potential biomarkers of aging and neurodegeneration, but the effects of aging on MPDF/MWF remain unknown. This study aims to assess relationships between age and MPDF/MWF using the 3D STAIR ultrashort echo time (STAIR-UTE) and STAIR short echo time (STAIR-STE) sequences, respectively. 42 volunteers (29 young (<55y), 13 old (>55y)), were recruited for MPDF and MWF mapping for white matter (WM) and gray matter (GM) on a 3 T scanner. Excellent inter-reader reliability was demonstrated for MPDF and MWF measurements with ICC values of 0.97 and 0.98, respectively, between two readers. In the young group, WM MPDF and MWF range from 8-13 % and 6-13 %, respectively, while GM MPDF and MWF range from 5-7 % and 3-5 %, respectively. In the old group, WM MPDF and MWF range from 6-12 % and 5-13 %, and GM MPDF and MWF range from 3-6 % and 2-5 %, respectively. The young group's MPDF/MWF values were significantly higher than those of the old group. Altogether, the 42 volunteers display linear and quadratic associations of MPDF/MWF with age. MPDF demonstrated significant correlations with MWF in the majority of brain regions. This study demonstrates the capability of two myelin imaging biomarkers, STAIR-UTE measured MPDF and STAIR-STE measured MWF to map brain myelin and MW. These biomarkers hold the potential to differentiate normal aging from neuroinflammatory/neurodegenerative diseases.

A Binary siRNA-Loaded Tetrahedral DNA Nanobox for Synergetic Anti-Aging Therapy

Extensive accumulation of senescent cells contributes to organismal aging, and slowing down the process of cellular senescence may ameliorate age-related pathologies. Targeted inhibition of the mechanistic target of rapamycin complex 1 (mTORC1) is found to suppress the conversion of cells to senescence. The regulatory-associated protein of mTOR (Raptor), a key component of mTORC1, has been implicated as important in the aging process, and its druggability deserves to be investigated. Due to high efficiency and high convenience in drug construction, siRNA shows great potential in silencing Raptor expression via RNA interfering therapy. Here, we developed a functionalized anti-aging nanoplatform based on tetrahedral DNA nanostructures (TDNs) encapsulating siRNA targeting Raptor for synergistic anti-aging therapy, named siR-TDNbox. Anti-inflammatory and antioxidant properties of TDN beneficially attenuate age-associated inflammation while serving as siRNA nanocarrier, and thus play a binary role. The results suggest that the siR-TDNbox binary therapeutic nanoplatform has demonstrated an excellent ability to delay aging, inhibit mTORC1 signaling, and extend lifespan. This anti-aging nanoplatform may provide a medium for the combined application of traditional senotherapeutic drugs and promote the upgrading of nanomaterials with anti-aging effects.

Associations of diet patterns with successful aging, longevity, and extreme longevity: a prospective cohort study among Chinese adults 65 years or older

PURPOSE

The role of dietary patterns in overall health and longevity among the elderly has not been comprehensively evaluated. We investigated the associations between multiple dietary indices and successful aging, longevity, and extreme longevity among older individuals, aiming to explore appropriate dietary patterns for the older Chinese population.

METHODS

A food frequency questionnaire was used to construct seven dietary indices: plant-based dietary index (PDI), healthful plant-based dietary index (hPDI), unhealthful plant-based dietary index (uPDI), animal-based dietary index (ADI), dietary diversity index (DDI), protein-enriched dietary diversity index (PEDDI), and anti-inflammatory dietary diversity index (AIDDI). When analyzing the associations between dietary indices and successful aging, longevity, and extreme longevity, logistic regression models or Cox proportional hazards models were employed. Followed by restricted cubic splines to examine the non-linear associations.

RESULTS

Each SD increment in PEDDI was associated with a 20% higher probability of successful aging (OR = 1.20, 95% CI: 1.06-1.36). One SD increment in PEDDI was related to a 26% higher probability of longevity (HR = 1.26, 95% CI: 1.14-1.39). Individuals in the top tertile group of PEDDI had a higher probability of achieving extreme longevity compared to those in the bottom tertile group of PEDDI (OR = 1.83, 95% CI:1.01-3.30).

CONCLUSIONS

For older adults in China, greater attention should be given to dietary patterns rich in protein, as higher PEDDI scores were statistically associated with promoting successful aging, longevity, and extreme longevity.

An Expert Consensus Statement on Biomarkers of Aging for Use in Intervention Studies

Biomarkers of aging serve as important outcome measures in longevity-promoting interventions. However, there is limited consensus on which specific biomarkers are most appropriate for human intervention studies. This work aimed to address this need by establishing an expert consensus on biomarkers of aging for use in intervention studies via the Delphi method. A 3-round Delphi study was conducted using an online platform. In Round 1, expert panel members provided suggestions for candidate biomarkers of aging. In Rounds 2 and 3, they voted on 500 initial statements (yes/no) relating to 20 biomarkers of aging. Panel members could abstain from voting on biomarkers outside their expertise. Consensus was reached when there was ≥70% agreement on a statement/biomarker. Of the 460 international panel members invited to participate, 116 completed Round 1, 87 completed Round 2, and 60 completed Round 3. Across the 3 rounds, 14 biomarkers met consensus that spanned physiological (eg, insulin-like growth factor 1, growth-differentiating factor-15), inflammatory (eg, high sensitivity C-reactive protein, interleukin-6), functional (eg, muscle mass, muscle strength, hand grip strength, Timed-Up-and-Go, gait speed, standing balance test, frailty index, cognitive health, blood pressure), and epigenetic (eg, DNA methylation/epigenetic clocks) domains. Expert consensus identified 14 potential biomarkers of aging which may be used as outcome measures in intervention studies. Future aging research should identify which combination of these biomarkers has the greatest utility.

Methods for the assessment of biological age - A systematic review

Biological age has long been proposed to complement chronological age because it has the potential to provide a more accurate assessment of someone's ageing process and functional status. At present, there are several methods to determine an individual's biological age through the measurement of biomarkers of ageing. This review compares methods for assessing biological age in adults, analyses biomarkers of ageing, and determines the goals for which biological age can be calculated, in order to help determine a gold standard for measuring biological age. Articles were eligible if studies included a test battery and statistical method to calculate biological age. Literature research included the databases Medline, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov. In total, 56 studies were included and the risk of bias in each of them was assessed. The most commonly used methods to assess biological age are Klemera and Doubal's method, principal component analysis, multiple linear regression, PhenoAge and Hochschild's method. Klemera and Doubal's method has proved the most reliable. Apart from using different statistical methods, the difference between the biological ageing scores lies in the choice of biomarkers of ageing, especially the inclusion of chronological age as a biomarker of ageing. Most of the included studies aimed to establish a new biological ageing score or compare biological age to different measurements of functionality of the human body. In conclusion, there is still no consensus on a gold standard and more research on this topic is necessary. Study protocol PROSPERO ID: CRD42021287548.

Relationship Between Force Steadiness and Functionality in Older Adults: A Systematic Review With Meta-Analysis

The relevance of force steadiness (FS) in relation to task performance remains unclear. This systematic review with meta-analysis examines the strength of the relationship between FS and the physical task performance aspect of functionality in older adults, focusing on both upper and lower limbs. We conducted a comprehensive search across databases, including MEDLINE, Ovid, CINAHL, Scopus, and Web of Science, up to February 2024. We included correlations from observational or longitudinal studies that provided objective measures of task performance in both healthy and unhealthy older adults. A meta-analysis with robust variance estimation was performed to account for dependencies among effect sizes. Of 1293 studies screened, 21 met the inclusion criteria and 15 contributed data to the meta-analysis. Our findings revealed a moderate, statistically significant relationship between FS and task performance in the upper limbs (r = 0.58, 95% CI [0.49-0.65], p < 0.01) with negligible heterogeneity (I2 = 0%). For the lower limbs, the relationship was also moderate (r = 0.45, 95% CI [0.27-0.58], p < 0.01) but with moderate heterogeneity (I2 = 50.66%). These results highlight a notable association between FS and physical function in both upper and lower limbs. However, caution is warranted due to the moderate to high risk of bias in 13 studies and evidence of publication bias in studies focused on the upper limbs. Despite these limitations, our study emphasizes the importance of FS in clinical practice and underscores the need for improved methods in measuring FS and its link to physical function. PROSPERO Registration: CRD42021247720.

[The challenge of healthy aging: Gaps between the needs of older adults and implemented policies in Argentina]

BACKGROUND AND OBJECTIVES

While the concept of healthy aging tends to be homogenized, differential characteristics are observed among regions and even within the same country. There are policies aimed at promoting healthy aging; however, it is essential to understand the needs of the population so that these policies can be effective. The objective of this project was to identify gaps between the needs of individuals over 60 years old to achieve healthy aging and the policies implemented in Argentina to support this purpose.

MATERIALS AND METHODS

Descriptive study with a mixed qualitative-quantitative approach was employed in three stages: 1. Documentary review of current programs in Argentina. 2. Visualization of the needs of individuals over 60 years old. 3. Identification of gaps between the stated needs and the proposals of the programs.

RESULTS

Twenty-eight programs were identified with components such as entertainment, peer relationships, social inclusion, and health care and promotion. When evaluating needs for healthy aging, the most frequent responses were maintaining good physical health, keeping the mind active, and continuing to engage in activities. In the gap analysis, it was observed that needs such as continuing activities, family support, and positive attitudes were prioritized more by participants than by the surveyed programs.

CONCLUSIONS

There were gaps between the needs identified by adults aged 60 and over and the evaluated programs. This study represents an initial contribution to identify priorities and contribute to aligning government policies with the specific needs of this population group.

Proteo-metabolomic insights for early dual physical and cognitive impairments: A search for biomarkers of healthy aging based on muscle-brain crosstalk

We employed an untargeted proteo-metabolomic approach to profile circulating biomarkers in plasma samples from the I-Lan Longitudinal Aging Study, aiming to identify biomarkers and pathways associated with physio-cognitive decline syndrome (PCDS). In 115 propensity score-matched PCDS case-control pairs, pathway analyses implicated dysregulation of fatty acid metabolism and inflammation in PCDS pathogenesis. Sex-specific associations were observed, with disruptions in central carbon metabolism (elevated PKM, MDH1, and GAPDH; decreased MINPP1) and tyrosine metabolism (decreased MIF, DBH; increased thyroxine) characterizing in men. In contrast, perturbations in glutathione and phenylalanine metabolism, including increased ANPEP, GSTP1, and decreased pyroglutamic acid, were identified in women. Results suggest that dysregulated energy and redox homeostasis likely contribute to PCDS development. Notably, ANPEP, PKM, and MIF emerged as potential biomarkers, elucidating the muscle-brain crosstalk framework. Our findings provide insights into potential molecular mechanisms underlying PCDS and the muscle-brain crosstalk, marking progress toward elucidating biomarkers in the journey of healthy aging.

Comparison of characteristics of bimanual coordinated movements in older adults with frailty, pre-frailty, and robust health

Introduction

Despite the growing concern regarding a potential increase in the number of older adults with frailty owing to an aging global population, the characteristics of bimanual coordination in such older adults remain unclear. This study aimed to compare bimanual coordinated movements among community-dwelling older adults with frailty, pre-frailty, and robust health and identify the specific characteristics of these movements in older adults with frailty.

Methods

Participants were categorized into frail, pre-frail, and robust groups based on Kihon Checklist scores. They performed bimanual coordination tasks in-phase (tapping the thumb and index finger together as fast as possible) and anti-phase (alternating the movement between the left and right fingers), and the task parameters were compared among the groups.

Results

The total travel distance during the anti-phase task in the frail group was significantly shorter than that in the robust group. However, all three groups showed lower finger dexterity during the anti-phase task than in the in-phase task and the left hand than in the right hand.

Conclusion

Older adults with frailty exhibit less movement during bimanual coordination tasks than robust older adults, suggesting that such tasks may be useful tools for assessing frailty.

Masticatory function and cognition in older adults: A population-based study

STATEMENT OF PROBLEM

The relationship between masticatory function based on paired teeth-functional tooth units (FTUs) and cognition has yet to be evaluated and reported in a nationally representative sample.

PURPOSE

The purpose of this population-based study was to investigate the association between masticatory function measured by FTUs and cognition in individuals aged 60 and older using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014.

MATERIAL AND METHODS

Data from NHANES 2011-2014 were used. The number of FTUs was defined as pairs of opposing natural and artificial teeth in the posterior region. Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Weighted multivariable linear regression and subgroup analyses were conducted to assess the association between FTUs and cognitive performance. Sensitivity tests were conducted on functional dentition and the presence of FTUs.

RESULTS

The regression models revealed a significant positive association between FTUs and cognitive performance among AFT, DSST, and global cognition. Individuals with higher FTU scores demonstrated better performance in verbal fluency, processing speed, sustained attention, working memory, and global cognition.

CONCLUSIONS

A significant and independent association was demonstrated between masticatory function as measured by FTUs and cognitive function in adults aged 60 and older.

Translation, cross-cultural adaptation and validation of the composite physical function scale in Chinese community-dwelling older adults

PURPOSE

To translate, cross-culturally adapt and validate the Composite Physical Function (CPF) scale in Chinese community-dwelling older adults.

METHODS

The Chinese version of the CPF (C-CPF) was constructed by following Brislin's guidelines. A cross-sectional study was conducted to evaluate the measurement properties of the C-CPF in 477 eligible older adults. Factor analysis, hypotheses testing, internal consistency and test-retest were performed to evaluate the validity and reliability of the C-CPF.

RESULTS

The C-CPF was consistent with the original version, which consisted of a single dimension with 12 items. It had a Cronbach's alpha coefficient of 0.901, fold-half reliability of 0.831 and test-retest reliability of 0.994. Structural validity was determined through exploratory factor analysis for a single-factor structure explained 75.391% of the total variance. Confirmatory factor analysis for a modified model provided an average fit index (chi-square/free ratio = 3.596, root mean square error of approximation = 0.099, normal fit index = 0.908, incremental fit index = 0.931, comparative fit index = 0.931 and Tucker-Lewis index = 0.909). Construct validity analysis revealed a significant difference in C-CPF scores amongst older adults in groups of different ages, regular exercise and physical activity habits (P < 0.01). Criterion validity was tested for the correlation between the results of C-CPF and the Senior Fitness Test (r = 0.446, P < 0.01).

CONCLUSIONS

The C-CPF scale serves as a valid and practical tool for widespread health screening to measure the level of comprehensive physical function and its decline amongst Chinese older adults. Further research is needed to explore the eligibility of the application of the C-CPF in a broad range of populations.

Analysis of an intergenerational service-learning experience based on physical exercise in a community setting: a mixed-method study

Introduction

Physical activity offers numerous benefits that improve psychological well-being, reduce dependency, and foster intergenerational relationships. Universities play a key role in promoting the health of students by proposing actions that contribute to a sustainable future, fostering a mature society and reducing ageism. This service-learning project aimed to assess the impact of an intergenerational cane-walking program on older adults and physiotherapy students in a community setting. The project focused on promoting health and fostering intergenerational relationships.

Methods

A concurrent, nested mixed-methods design was used for the intervention, involving intergenerational group walks during the 2022-2023 academic year. The program was designed and supervised by faculty members and three fourth-year fellows. Data collection was based on adherence to the intervention, the Behavioral Regulation in Exercise Questionnaire (BREQ-3), interviews with older adults and feedback questionnaires completed by them and participating students.

Results

Satisfactory adherence was evidenced among older adults, with 65.79% of participants who completed the project and 72% who adhered to the intervention, although there were no statistically significant differences in terms of motivation to exercise taking that adherence into account. The project's ability to foster intergenerational relationships was rated by the seniors at 9.50 ± 0.6, and 100% answered affirmatively about its capacity of contribute to improving their health and well-being. Student feedback also reflected high scores for fostering intergenerational relationships, with scores of 10 (fellows), 8.7 ± 1.2 (third-year students), and 8.27 ± 1.2 (second-year students). The project's contribution to skills development was rated positively by 100% of the fellows, 88.6% of the second-year students, and 74.1% of the third-year students. In the nested study, three key themes related to exercise emerged by older adults: (1) perceptions of exercise, (2) barriers to exercise and (3) motivations for exercise. Regarding satisfaction with the program, three main themes emerged: (1) intergenerational relationships, (2) strengths of the program and (3) suggestions for improvement.

Conclusion

The program appears to improve the well-being of older adults and provide valuable experiential learning for students. Thus, service-learning projects could effectively promote sustainable health practices, highlighting the important role of universities in community health initiatives.

Proposal for a revised Barthel index classification based on mortality risk assessment in functional dependence for basic activities of daily living

Introduction

Functional dependence on the performance of basic activities of daily living (ADLs) is associated with increased mortality. In this study, the Barthel index and its activities discriminate long-term mortality risk, and whether changes in this index are necessary to adapt it to detect mortality risk is examined.

Methods

Longitudinal study, carried out at the Orcasitas Health Center, Madrid (Spain), on the functional dependent population (Barthel ≤ 60). It included 127 people, with a mean age of 86 years (78.7% women and 21.3% men). Functional capacity was assessed using the Barthel index, and this index and each item it contains were analyzed as a test in relation to survival at three years, using tools that evaluate precision, discrimination, and calibration. The date of death was obtained from the health system.

Results

Greater dependency to perform chair-to-bed transfers was associated with an increased mortality risk (HR 2.957; CI 1.678-5.211). Also, individuals with severe (HR 0.492; CI 0.290-0.865) and moderate (HR 0.574; CI 0.355-0.927) ADL dependence had a reduced mortality risk when more independent in chair-to-bed transfers. Among people with moderate ADL dependence, this percentage was 48%. Using dependence-independence for chair-to-bed transfer as a screening test for mortality, the test showed high sensitivity (0.91) and specificity (0.83), a positive likelihood ratio of 5.45, and a negative likelihood ratio of 0.11. The area under the ROC curve was 0.814 (CI 0.658-0.970; p = 0.001), with a χ 2 = 0.235; p = 0.889, according to the Hosmer-Lemeshow test. The concordance C index was 0.814. According to Nagelkerke's R2, the model explained 53.1% of the variance in survival. As a screening test, "chair-to-bed transfer" was superior to the Barthel index.

Conclusion

ADL dependence for chair-to-bed transfers is an independent risk factor for mortality for any level of dependency. Therefore, a new classification of the Barthel index is proposed, in which "being dependent or requiring great assistance to perform chair-to-bed transfers" is considered severe dependence, even when the total score obtained via the Barthel Index is ≥40. We propose its use as a screening test in parallel to the Barthel index. The study suggests that the Barthel Index may have limitations in adequately discriminating mortality risk.

Evaluation and analysis of respiratory infectious disease prevention behaviors in older adults

Background

Respiratory infectious diseases (RIDs) are a global public health problem, characterized by strong infectivity, high transmissibility, and a high incidence in the population. This study aimed to explore RID prevention behaviors among older adults and analyze their influencing factors.

Methods

A cross-sectional study was conducted to examine RID prevention behaviors among 2219 Chinese older adults. Analysis of variance and the Kruskal-Wallis test were used to compare behaviors among subjects with different characteristics. Pearson's correlation analysis was used to assess the relationships between knowledge, skills, and behavior, and a generalized linear model was used for multi-factor analysis.

Results

The participants in this questionnaire survey were predominantly older adults individuals aged 65-70 years (45.65%), with no more than a primary school educational level (86.70%). Univariate analysis revealed statistically significant associations between age, education, place of residence, living condition, marital status, annual income in the past year, type of medical insurance, health status, smoking status, drinking status, weekly exercise durations, and sleep status in older adults and their RID prevention behavior. Pearson's correlation analysis indicated a moderate correlation between knowledge, skills, and behavioral scores. Multivariate analysis identified place of residence, annual income, smoking habits, alcohol consumption, exercise frequency, knowledge level, and skill level as influential factors for behaviors related to the prevention and control of RID in older adults.

Conclusion

Our results confirm the importance of a healthy lifestyle in RID prevention among older adults, especially in terms of smoking, alcohol consumption, and regular exercise, and provide empirical evidence for the development of health promotion programs for older adults people, particularly in rural areas.

Intergenerational support, activities of daily living, and the interaction on psychological distress in older adults

Objectives

The purpose of this study is to examine the effects of intergenerational support and activities of daily living (ADL) on psychological distress in older adults, and to analyse the effects of the interaction between ADL and intergenerational support on psychological distress in older adults.

Methods

A probability sample of 1,065 older adults aged 60 and above was conducted in Xuzhou, China, from 18 June to 26 August 2023. ADL was assessed using the ADL scale combined with the Barthel Index; Intergenerational support was measured using the Intergenerational Support Scale; and psychological distress was measured using the Kessler 10 scale. An ordered multichotomous logistic regression model was constructed to analyse the factors influencing psychological distress in the elderly. The interaction model was constructed by one-way analysis of variance to further analyse the effect of the interaction between financial support, instrumental support and emotional support and ADL on psychological distress in the elderly.

Results

Elderly living in rural areas, with an annual household income of less than 30,000 yuan, who engaged in manual labor before retirement, who did not receive financial support and who received instrumental support were more likely to experience psychological distress, and the higher the degree of restriction in ADL, the higher the risk of psychological distress. A significant interaction was observed between ADL and financial support (F = 221.570, p < 0.05), as well as between ADL and emotional support (F = 399.805, p < 0.01). Additionally, a significant interaction was found among ADL, financial support, and instrumental support (F = 227.187, p < 0.05).

Conclusion

(1) A significant association between place of residence, annual household income, occupation, financial support, instrumental support, ADL, and psychological distress in older adults; (2) When the level of ADL was moderate, the risk of psychological distress in older adults who received emotional support was significantly lower than that of older people who did not receive emotional intergenerational support; When the level of ADL was completely independent, financial support was beneficial in reducing psychological distress in the elderly; (3) the risk of psychological distress in the elderly who received instrumental support increased with the severity of ADL limitations, regardless of whether they received additional financial support.

Study on the age-period-cohort effects of cognitive abilities among older Chinese adults based on the cognitive reserve hypothesis

BACKGROUND

Cognitive abilities serves as a critical indicator of healthy aging. As China progresses into a stage of advanced population aging, there has been a significant increase in the number of elderly individuals experiencing age-related cognitive decline. Despite this demographic shift, there is a paucity of longitudinal research examining cognitive abilities among older Chinese adults over extended time periods. This study aims to investigate changes in cognitive abilities and explore group differences among older Chinese adults aged 65 to 110 years, employing a multidimensional temporal approach that encompasses age, period, and birth cohort effects.

METHODS

This study utilizes data from eight waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), spanning from 1998 to 2018. The dataset comprises 94,116 observations from 36,157 unique participants. Cognitive abilities are assessed using Mini-Mental State Examination (MMSE) scores as a proxy measure. To address the issue of perfect collinearity in the temporal dimension, the study employs the Hierarchical Age-Period-Cohort Cross-Classified Random Effects Model (HAPC-CCREM). This model allows for the examination of age effects, period effects, and cohort effects on cognitive abilities among older Chinese adults. In the model specification, age is treated as a fixed effect, while period and birth cohort are incorporated as random effects. Drawing upon the cognitive reserve hypothesis, the study investigates significant factors influencing cognitive abilities in this population.

RESULTS

At the fixed-effect level, demographic factors, health behaviors, self-rated health, subjective well-being, and childhood adversity significantly influence cognitive abilities among older Chinese adults. The age effects are significant, with cognitive abilities exhibiting an inverted U-shaped curve across the lifespan. At the random-effect level, period effects are significant, revealing a gradual annual increase in overall cognitive levels among older Chinese adults since 2008. Cohort effects are also significant, demonstrating an increasing trend in overall cognitive levels for the earlier-born cohorts in the first six groups. Conversely, later-born cohorts in the latter five groups show a declining trend in overall cognitive levels. Notably, period effects significantly enhance cohort effects.

CONCLUSIONS

The cognitive reserve hypothesis supports the significance of the majority of identified influencing factors. Cognitive abilities demonstrate an accelerating decline with increasing age, following an evolutionary trajectory consistent with physiological principles among older Chinese adults. Since 2008, cognitive abilities have shown a monotonic increasing trend annually, further validating the Flynn effect in this population. The cognitive abilities of the six earlier-born cohorts exhibit an increasing trend, supporting the compression of morbidity hypothesis. Conversely, the cognitive abilities of the five later-born cohorts show a declining trend, supporting the expansion of morbidity hypothesis. These findings collectively contribute to our understanding of cognitive aging patterns and their underlying mechanisms among older Chinese adults.

The Impact of SGLT1 Inhibition on Frailty and Sarcopenia: A Mediation Mendelian Randomization Study

BACKGROUND

Although pharmacological effects of SGLT2 inhibitors on the development of frailty and sarcopenia were known, the role of SGLT1 remained less clear. The present study investigated the possible effect of SGLT1 inhibition on these conditions and explored potential mediators.

METHODS

A two-sample Mendelian randomization (MR) analysis was performed to assess the effect of SGLT1 inhibition on frailty index (FI) and low grip strength in individuals aged 60 years and older using both the FNIH and EWGSOP criteria. Subsequently, a two-step MR analysis was conducted to investigate the mediating role of insulin resistance phenotype and identify potential mediators of the effect of SGLT1 inhibition on the FI and low grip strength from 1558 plasma proteins and 1352 metabolites.

RESULTS

Genetically predicted SGLT1 inhibition was associated with decreased FI (β: -0.290 [95% CI: -0.399, -0.181]) and reduced risk of low grip strength in individuals aged 60 years and older under both FNIH (β: -0.796 [95% CI: -1.216, -0.376]) and EWGSOP criteria (β: -0.287 [95% CI: -0.532, -0.041]). The two-step MR analysis demonstrated the role of insulin resistance phenotype in mediating SGTL1 inhibition on alleviating frailty (mediation proportion = 19.56% [95% CI: 8.42%, 30.70%]). After screening, 24 proteins and 16 metabolites were identified as mediators of the impact of SGLT1 inhibition on FI. Additionally, 13 proteins and 16 metabolites were found to mediate the effect of SGLT1 inhibition on low grip strength according to FNIH criteria while 22 proteins and 6 metabolites were shown to mediate the impact of SGLT1 inhibition on low grip strength under EWGSOP criteria.

CONCLUSIONS

SGLT1 inhibition potentially mitigated frailty and sarcopenia through several biological mediators, shedding new light for therapeutic intervention.

Causal associations and shared genetic etiology of neurodegenerative diseases with epigenetic aging and human longevity

The causative mechanisms underlying the genetic relationships of neurodegenerative diseases with epigenetic aging and human longevity remain obscure. We aimed to detect causal associations and shared genetic etiology of neurodegenerative diseases with epigenetic aging and human longevity. We obtained large-scale genome-wide association study summary statistics data for four measures of epigenetic age (GrimAge, PhenoAge, IEAA, and HannumAge) (N = 34,710), multivariate longevity (healthspan, lifespan, and exceptional longevity) (N = 1,349,462), and for multiple neurodegenerative diseases (N = 6618-482,730), including Lewy body dementia, Alzheimer's disease (AD), Parkinson's disease, amyotrophic lateral sclerosis, and multiple sclerosis. Main analyses were conducted using multiplicative random effects inverse-variance weighted Mendelian randomization (MR), and conditional/conjunctional false discovery rate (cond/conjFDR) approach. Shared genomic loci were functionally characterized to gain biological understanding. Evidence showed that AD patients had 0.309 year less in exceptional longevity (IVW beta = -0.309, 95% CI: -0.38 to -0.24, p = 1.51E-19). We also observed suggestively significant causal evidence between AD and GrimAge age acceleration (IVW beta = -0.10, 95% CI: -0.188 to -0.013, p = 0.02). Following the discovery of polygenic overlap, we identified rs78143120 as shared genomic locus between AD and GrimAge age acceleration, and rs12691088 between AD and exceptional longevity. Among these loci, rs78143120 was novel for AD. In conclusion, we observed that only AD had causal effects on epigenetic aging and human longevity, while other neurodegenerative diseases did not. The genetic overlap between them, with mixed effect directions, suggested complex shared genetic etiology and molecular mechanisms.

Sex differences in the association between social frailty and diet quality among older adults in Spain

OBJECTIVE

The aim was to examine the association between social frailty and diet quality in adults over 65 years of age, and whether results differed by sex.

DESIGN

Population-based cross-sectional study using data from the Spanish National Health Survey.

PARTICIPANTS

5,071 community-dwelling people ≥65 years from Spain.

MEASUREMENTS

Social frailty was deemed to exist when the person both lived alone and had low social support, measured with the Duke-UNC scale. Diet was assessed with the Spanish Healthy Eating Index (S-HEI), ranging from 0 to 100 points (highest diet quality). Means and 95% confidence intervals of the S-HEI score for each social frailty group were calculated using linear regressions, with socially robust people as reference. Analyses were adjusted for main confounders, including sociodemographic, lifestyle and morbidity variables.

RESULTS

There were no differences in the S-HEI adjusted mean of socially frail (74.3 points, 95%CI: 73.4-75.2) compared to socially robust older adults (75.4 points; 95%CI: 75.1-75.7). In sex-stratified analyses, the S-HEI adjusted mean of socially frail men (71.9 points; 95%CI: 70.6-73.2) was lower than robust men (74.8 points; 95%CI: 74.4-75.3). Specifically, social frailty was associated with lower consumption of vegetables, fruits, dairy and lower diet variety in men. Differences were not observed according to social frailty among older women.

CONCLUSIONS

Social frailty was associated with poor diet quality in community-dwelling older men, but not in women in Spain. Gender differences in self-care could partly explain this association. Sex-specific interventions are required to minimize the impact of social frailty on diet quality.

Assessing food digestion in the elderly using in vitro gastrointestinal models

With the global population of individuals aged 65 and older projected to exceed 1.5 billion by 2050, understanding the impact of aging on digestion and nutrient absorption is essential for addressing the nutritional needs of the elderly. This review explores the limitations of traditional in vivo studies and underscores the growing importance of in vitro gastrointestinal models as an ethical and cost-effective alternative for investigating digestion in the elderly. The review provides a comprehensive analysis of age-related physiological changes in the gastrointestinal tract (GIT), and critically evaluates how static and dynamic in vitro models have been adapted to simulate these changes. We also discuss the significant challenges these models face in accurately replicating the complexities of elderly digestion, particularly in mimicking the interactions between digestive processes and the gut microbiome. By addressing these challenges, particularly through the development of more physiologically relevant and personalized in vitro models, this review highlights the potential to enhance our understanding of elderly digestion and improve nutritional strategies, ultimately contributing to better health outcomes for the aging population.

Detailing the biomedical aspects of geroscience by molecular data and large-scale "deep" bioinformatics analyses

As scientists investigated the molecular mechanisms of the biology of aging, they discovered that these are malleable and can enhance healthy longevity by intervening in the drivers of aging, which are leading to disease, dysfunction and death. These exciting observations gave birth to the field of geroscience. As the mechanisms of aging affect almost all mechanisms of life, detailed molecular mechanistic knowledge must be gained or expanded by considering and integrating as many types of data as possible, from genes and transcripts to socioenvironmental factors. Such a large-scale integration of large amounts of data will in turn profit from "deep" bioinformatics analyses that provide insights beyond contextualizing and interpreting the data in the light of knowledge from databases such as the Gene Ontology. The authors suggest that "deep" bioinformatics, employing methods based on artificial intelligence, will be a key ingredient of future analyses.

Small effects of olfactory identification and discrimination on global cognitive and executive performance over 1 year in aging people without a history of age-related cognitive impairment

Olfactory and cognitive performance share neural correlates profoundly affected by physiological aging. However, whether odor identification and discrimination scores predict global cognitive status and executive function in healthy older people with intact cognition is unclear. Therefore, in the present study, we set out to elucidate these links in a convenience sample of 204 independently living, cognitively intact healthy Czech adults aged 77.4 ± 8.7 (61-97 years) over two waves of data collection (one-year interval). We used the Czech versions of the Montreal Cognitive Assessment (MoCA) to evaluate global cognition, and the Prague Stroop Test (PST), Trail Making Test (TMT), and several verbal fluency (VF) tests to assess executive function. As a subsidiary aim, we aimed to examine the contribution of olfactory performance towards achieving a MoCA score above vs. below the published cut-off value. We found that the MoCA scores exhibited moderate associations with both odor identification and discrimination. Furthermore, odor identification significantly predicted PST C and C/D scores. Odor discrimination significantly predicted PST C/D, TMT B/A, and standardized composite VF scores. Our findings demonstrate that olfaction, on the one hand, and global cognition and executive function, on the other, are related even in healthy older people.

Enhancing active aging through IRAGE: Mitigating social isolation with intergenerational gaming

This paper presents the outcomes of a pioneering study that explores the potential of remote intergenerational communication to combat social isolation among children and older adults, especially under constraints posed by pandemics such as COVID-19. Acknowledging the limited mobility of many older adults, this research aims to provide insights into how digital platforms can facilitate meaningful exchanges between generations. Utilizing a mixed methodology approach, the study first conducted a user interaction analysis to outline guidelines for participant engagement with the Information and Communication Technology (ICT)-based tool called IRAGE (Intergenerational Remote Access to Gaming Experiences) designed specifically for this purpose. Following the development of the ICT tool, three sessions of the remote intergenerational experience were held, during which participants' interactions were recorded and subsequently analyzed quantitatively and qualitatively. Key findings from the study reveal that remote intergenerational communication can significantly mitigate feelings of isolation among older adults, contributing to their mental health and emotional well-being. Moreover, the study highlights the effectiveness of the web-based platform in facilitating these interactions, with older adults and children finding the user interface intuitive and the overall experience engaging. These outcomes underscore the importance of leveraging technology to maintain social connections during challenging times and offer valuable guidelines for developing ICT tools that cater to the needs of diverse user groups. By demonstrating the feasibility and benefits of remote intergenerational communication, this research contributes to the broader discourse on active aging and the role of digital technologies in promoting social inclusion and emotional health.

Polygonati Rhizoma: A review on the extraction, purification, structural characterization, biosynthesis of the main secondary metabolites and anti-aging effects

ETHNOPHARMACOLOGICAL RELEVANCE

Polygonati Rhizome (PR) is a plant that is extensively widespread in the temperate zones of the Northern Hemisphere. It is a member of the Polygonatum family of Asparagaceae. PR exhibits diverse pharmacological effects and finds applications in ethnopharmacology, serving as a potent tonic for more than two millennia. PR's compounds endow it with various pharmacological properties, including anti-aging, antioxidant, anti-fatigue, anti-inflammatory, and sleep-enhancing effects, as well as therapeutic potential for osteoporosis and age-related diseases.

AIM OF THE STUDY

This review seeks to offer a thorough overview of the processing, purification, extraction, structural characterization, and biosynthesis pathways of PR. Furthermore, it delves into the anti-aging mechanism of PR, using organ protection as an entry point.

MATERIALS AND METHODS

Information on PR was obtained from scientific databases (Google Scholar, Web of Science, ScienceDirect, SciFinder, PubMed, CNKI) and books, doctoral theses, and master's dissertations.

RESULTS

In this investigation, 49 polysaccharides were extracted from PR, and the impact of various processing, extraction, and purification techniques on the structure and activity of these polysaccharides was evaluated. Additionally, 163 saponins and 46 flavonoids were identified, and three key biosynthesis pathways of secondary metabolites were outlined. Notably, PR and Polygonat Rhizomai polysaccharides (PRP) exhibit remarkable protective effects against age-induced injuries to the brain, liver, kidney, intestine, heart, and vessels, thereby promoting longevity and ameliorating the aging process.

CONCLUSIONS

PR, a culinary and therapeutic herb, is rich in active components and pharmacological activities. Based on this review, PR plays a meaningful role in lifespan extension and anti-aging, which can be attributed to PRP. Future research should delve deeper into the structural aspects of PRP that underlie its anti-aging effects and explore potential synergistic interactions with other compounds. Moreover, exploring the potential applications of PR in functional foods and pharmaceutical formulations is recommended to advance the development of industries and resources focused on healthy aging.

Focus on senescence: Clinical significance and practical applications

The older population is increasing worldwide, and life expectancy is continuously rising, predominantly thanks to medical and technological progress. Healthspan refers to the number of years an individual can live in good health. From a gerontological viewpoint, the mission is to extend the life spent in good health, promoting well-being and minimizing the impact of aging-related diseases to slow the aging process. Biologically, aging is a malleable process characterized by an intra- and inter-individual heterogeneous and dynamic balance between accumulating damage and repair mechanisms. Cellular senescence is a key component of this process, with senescent cells accumulating in different tissues and organs, leading to aging and age-related disease susceptibility over time. Removing senescent cells from the body or slowing down the burden rate has been proposed as an efficient way to reduce age-dependent deterioration. In animal models, senotherapeutic molecules can extend life expectancy and lifespan by either senolytic or senomorphic activity. Much research shows that dietary and physical activity-driven lifestyle interventions protect against senescence. This narrative review aims to summarize the current knowledge on targeting senescent cells to reduce the risk of age-related disease in animal models and their translational potential for humans. We focused on studies that have examined the potential role of senotherapeutics in slowing the aging process and modifying age-related disease burdens. The review concludes with a general discussion of the mechanisms underlying this unique trajectory and its implications for future research.

Joint trajectories of loneliness, social isolation and sarcopenia and associations with adverse outcomes: A prospective cohort study

This study aimed to examine joint trajectories of loneliness, social isolation and sarcopenia and their associations with adverse outcomes. A total of 4701 participants aged ≥60 years who had a baseline and at least one follow-up assessment of loneliness, social isolation and sarcopenia across 2011, 2013 and 2015 waves in China Health and Retirement Longitudinal Study. Adverse outcomes were obtained in 2018 wave. Joint trajectories were fit using the parallel process latent class growth analysis, and their associations with adverse outcomes were evaluated using modified Poisson regression. Joint trajectory patterns for social relationship and sarcopenia did not vary by the assessment for sarcopenia, but did vary by the assessment for social relationship. Older adults exhibit distinct joint trajectories and those with persistent combination of loneliness or social isolation and sarcopenia experience greatest risk of adverse outcomes. These findings implicate integration of health care and social care for community-dwelling older adults.

Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition

This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.

Kyphoplasty is associated with reduced mortality risk for osteoporotic vertebral compression fractures: a systematic review and meta-analysis

BACKGROUND

Vertebral augmentation, such as vertebroplasty (VP) or kyphoplasty (KP), has been utilized for decades to treat OVCFs; however, the precise impact of this procedure on reducing mortality risk remains a topic of controversy. This study aimed to explore the potential protective effects of vertebral augmentation on mortality in patients with osteoporotic vertebral compression fractures (OVCFs) using a large-scale meta-analysis.

MATERIALS AND METHODS

Cochrane Library, Embase, MEDLINE, PubMed and Web of Science databases were employed for literature exploration until May 2023. The hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized as a summary statistic via random-effect models. Statistical analysis was executed using Review Manager 5.3 software.

RESULTS

After rigorous screening, a total of five studies with substantial sample sizes were included in the quantitative meta-analysis. The total number of participants included in the study was an 2,421,178, comprising of 42,934 cases of vertebral augmentation and 1,991,244 instances of non-operative management. The surgical intervention was found to be significantly associated with an 18% reduction in the risk of mortality (HR 0.82; 95% CI 0.78, 0.85). Subgroup analysis revealed a remarkable 71% reduction in mortality risk following surgical intervention during short-term follow-up (HR 0.29; 95% CI 0.26, 0.32). Furthermore, KP exhibited a superior and more credible decrease in the risk of mortality when compared to VP treatment.

CONCLUSIONS

Based on a comprehensive analysis of large samples, vertebral augmentation has been shown to significantly reduce the mortality risk associated with OVCFs, particularly in the early stages following fractures. Furthermore, it has been demonstrated that KP is more reliable and effective than VP in terms of mitigating mortality risk.

The Haemato-Oncology Frailty (HOF) score to assess frailty in lymphoma

Morbidity and mortality during chemotherapy in older adults with haematological malignancy can be unpredictable. The Haemato-Oncology Frailty (HOF) score was previously found to predict outcomes in a cohort of patients with plasma cell myeloma. In this study, we assess its utility in assessing frailty in patients with lymphoma, and compare its performance to that of two other frailty scores. The HOF score was able to predict progression-free survival in this population, and was also shown to have potential in assessing the dynamism of frailty during chemotherapy. It performed well when compared to the Charlson Comorbidity Index (CCI) score and the Haematopoietic Cell Transplantation-Specific Comorbidity Index (HCTCI), although the study was not powered to assess for non-inferiority. The HOF score is a new score with the potential for application in different haematological malignancies.

Insights into targeting cellular senescence with senolytic therapy: The journey from preclinical trials to clinical practice

Interconnected, fundamental aging processes are central to many illnesses and diseases. Cellular senescence is a mechanism that halts the cell cycle in response to harmful stimuli. Senescent cells (SnCs) can emerge at any point in life, and their persistence, along with the numerous proteins they secrete, can negatively affect tissue function. Interventions aimed at combating persistent SnCs, which can destroy tissues, have been used in preclinical models to delay, halt, or even reverse various diseases. Consequently, the development of small-molecule senolytic medicines designed to specifically eliminate SnCs has opened potential avenues for the prevention or treatment of multiple diseases and age-related issues in humans. In this review, we explore the most promising approaches for translating small-molecule senolytics and other interventions targeting senescence in clinical practice. This discussion highlights the rationale for considering SnCs as therapeutic targets for diseases affecting individuals of all ages.

Relationship Between eHealth Literacy and Healthy Aging in Older Chinese People: The Mediating Effect of Health Behaviors

OBJECTIVES

Healthy aging is an important means of promoting the well-being of older individuals. However, no studies have examined the relationship between eHealth literacy and healthy aging or its mechanism. Therefore, this study aimed to examine the relationship between eHealth literacy and healthy aging and the mediating effect of health behaviors in older Chinese individuals.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

We recruited 2144 older individuals from Jinan, Shandong Province, China.

METHODS

We used the eHealth Literacy Scale to assess eHealth literacy. Healthy aging was evaluated based on multimorbidity, functional limitations, mild cognitive impairment, depressive symptoms, and social isolation. Moreover, health behaviors were assessed using the Health-Promoting Lifestyle Profile. Logistic and linear regression models were used to analyze the relationships between eHealth literacy, healthy aging, and its components. Finally, a structural equation model was used to analyze the mediation.

RESULTS

High eHealth literacy was associated with all healthy aging components (P < .05), including the absence of multimorbidity [odds ratio (OR), 1.014; 95% CI, 1.002-1.025], no functional limitation (OR, 1.035; 95% CI, 1.022-1.047), no mild cognitive impairment (OR, 1.042; 95% CI, 1.024-1.061), no depressive symptoms (OR, 1.049; 95% CI, 1.027-1.072), and no social isolation (OR, 1.033; 95% CI, 1.018-1.048). In the adjusted model, eHealth literacy (β = 0.174; 95% CI, 0.132-0.217) was positively correlated with healthy aging. Health behaviors had a partial mediating effect on the relationship between eHealth literacy and healthy aging.

CONCLUSIONS AND IMPLICATIONS

Higher eHealth literacy was associated with better healthy aging in older Chinese individuals, and health behaviors mediated this relationship. Improving eHealth literacy may be an effective intervention for achieving healthy aging.

Living Longer or Better-Patient's Choice in Cardiac Surgery Is Gender-Dependent-A Multicenter Study

In view of the increasing age of cardiac surgery patients, questions arise about the expected postoperative quality of life and the hoped-for prolonged life expectancy. Little is known so far about how these, respectively, are weighted by the patients concerned. This study aims to obtain information on the patients' preferences. Between 2015 and 2017, data were analyzed from 1349 consecutive patients undergoing cardiac surgery at seven heart centers in Germany. Baseline data regarding the patient's situation as well as a questionnaire regarding quality of life versus lifespan were taken preoperatively. Patients were divided by age into four groups: below 60, 60-70, 70-80, and above 80 years. As a result, when asked to decide between quality of life and length of life, about 60% of the male patients opted for quality of life, independent of their age. On the other hand, female patients' preference for quality of life increased significantly with age, from 51% in the group below sixty to 76% in the group above eighty years. This finding suggests that female patients adapt their preferences with age, whereas male patients do not. This should impact further the treatment decisions of elderly patients in cardiac surgery within a shared decision-making process.

"Think positive and don't die alone" - Foreign-born, South Asian older adults' perceptions on healthy aging

South Asians are the largest and fastest-growing racialized group in Canada, yet there are limited data on various aspects of health and well-being within this population. This includes the South Asian older adults' ethnoculturally informed perceptions of ageing. The study aimed to understand how social and cultural forces impact the meaning assigned to healthy ageing amongst older South Asians in Canada. We recruited with purposeful and snowball sampling strategies in Southern Ontario. We conducted in-depth focus group and individual interviews (n = 19) in five South Asian languages, employing a multilingual and cross-cultural qualitative approach. In our analysis, we identified three central themes: (a) taking care of body (b) taking care of mind and heart and (c) healthy ageing through the integration of mind and body. Our study demonstrates that older immigrants are a diverse and heterogeneous population and that their conception of healthy ageing is strongly influenced by their country of origin. This study also demonstrates how racialized foreign-born older adults might provide distinctive perspectives on the ageing process and on social theories of ageing due to their simultaneous immersion in and belonging to global majority and global minority cultures. This research also adds to the limited body of literature on the theories of ageing, despite migration trends, still has a white-centric lens.

Non-fungible tokens in healthcare: a scoping review

Introduction

Non-Fungible Tokens (NFTs) are digital assets that are verified using blockchain technology to ensure authenticity and ownership. NFTs have the potential to revolutionize healthcare by addressing various issues in the industry.

Method

The goal of this study was to identify the applications of NFTs in healthcare. Our scoping review was conducted in 2023. We searched the Scopus, IEEE, PubMed, Web of Science, Science Direct, and Cochrane scientific databases using related keywords. The article selection process was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results

After applying inclusion and exclusion criteria, a total of 13 articles were chosen. Then extracted data was summarized and reported. The most common application of NFTs in healthcare was found to be in health data management with 46% frequency, followed by supply chain management with 31% frequency. Furthermore, Ethereum is the main blockchain platform that is applied in NFTs in healthcare with 70%.

Discussion

The findings from this review indicate that the NFTs that are currently used in healthcare could transform it. Also, it appears that researchers have not yet investigated the numerous potentials uses of NFTs in the healthcare field, which could be utilized in the future.

Geriatric anesthesia: Demographics, epidemiology, state of the art at international level, educational needs, and future perspectives

Population aging has induced in the last year a corresponding aging inside the surgical population, currently accounting for 45%.50% of the total surgical population in the majority of the advanced countries. This has induced a number of new challenges in the daily anesthesia practice, ranging from the need of implementing specific education in the field of geriatric medicine, organizational adjustments aimed to adapt our preoperative evaluation methodology to the needs older patients present, and a careful redesign of the whole perioperative course for these patients. Today's anesthesiologists are called to became familiar with the aging processes and their impact on the patho.physiological perioperative course, with the concept of functional impairment and frailty and with the dimensions of polypathology, polymedication, and reduced functional reserves. The introduction of new trends such as the team-based approach and interdisciplinary culture are essential to overcome these emerging criticalities.

Construction of healthy aging index from two different datasets

Introduction

The aging population presents both unique challenges and opportunities for societies around the world. To develop an effective healthy aging strategy, a tool for assessing aging process is needed. Numerous attempts to quantify the aging process have been made. However, there is still a challenge in developing and choosing a good enough score that is easy to apply, has a construct of variables that are available in most nationwide surveys for comparable results, and at the same time reflects the aging process of older individuals. The purpose of this study is to present our approach to construct a comparable Healthy Aging Index (HAI).

Materials and methods

In Latvia, data from Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE), involving 420 respondents, were used. For comparative analysis, data from a HL20 study on the health and wellbeing of the older adults in Iceland, which included 1,033 respondents, were used.

Results

For Latvia, 13 items were selected, and for Iceland, nine items were selected. We constructed the HAI with four similar subscales for both countries-"Autonomy," "Health," "Wellbeing," and "Activities," and an additional subscale "Cognitive" for Latvia. We found matching items in all four subscales. For the Autonomy subscale, they were related to difficulties with everyday and daily tasks. In the Health subscale, the only matching item was self-rated physical health. One item related to loneliness was found for the Wellbeing subscale and one item related to social participation for the Activities subscale.

Discussion

In our study, we found evidence for the successful construction of a HAI in two different datasets. The strength of our construct lies in the use of data from one of the largest social science panel studies in Europe (SHARE). As we were able to apply the construct to the Icelandic study, we believe that items presented in our approach are available in other population-based studies as well, and, therefore, can be easily replicated by others. By examining the existing SHARE data, HAI could be used to analyze long-term changes and could provide a foundation for comparing and monitoring the evolution of aging over time as well as comparing the aging process across societies. This is required for the authorities to conduct further analyses, proposals, and action plans in support of healthy aging.

The role of arts engagement in reducing cognitive decline and improving quality of life in healthy older people: a systematic review

In recent years, arts engagement has been proposed as a non-pharmacological approach to reduce cognitive decline and increase well-being and quality of life in specific populations such as the elderly or patients with severe disease. The aim of this systematic review was to assess the effects of receptive or active arts engagement on reducing cognitive decline and improving quality of life and well-being in healthy populations, with a particular focus on the role of arts engagement in the long term. A comprehensive search strategy was conducted across four databases from February to March 2023. Ten studies with a total of 7,874 participants were incorporated in accordance with the PRISMA guidelines. Active and receptive arts engagement was found to be an effective approach to reduce cognitive decline and improve well-being and quality of life in healthy populations. The role of the positive effects of arts engagement could be determined by the combination of several factors such as exposure to cultural activities and the group effect. There is limited evidence of the protective effects of active arts engagement over a long period of time. Given the increasing demand for preventive programmes to reduce the negative effects of population ageing, more research on arts engagement should be conducted to identify its mechanisms and long-term effects.

Effectiveness of Theory-Based Physical Activity and Nutrition Interventions in Aging Latino Adults: A Scoping Review

In the United States (US), Latino individuals older than 50 years face health disparities compared to their White counterparts. Considering the rising life expectancy and the projected increase of older Latino adults in the US, this scoping review aimed to determine the effectiveness of theory-based and culturally relevant strategies that promote healthy aging in Latinos. Web of Science and PubMed databases were searched between December 2022 and February 2023 for peer-reviewed articles assessing healthy aging interventions tailored to community-dwelling aging Latino adults. We included nine studies describing the effects of seven interventions on physical activity- or nutrition-related outcomes. Although not always statistically significant, interventions had a beneficial impact on well-being indicators. The most commonly used behavioral theories were Social Cognitive Theory and Attribution Theory. Latino cultural elements in these studies included partnering with community organizations that serve Latinos (such as Catholic churches), delivery of in-person bilingual group sessions by trusted community members (such as promotoras or Latino dance instructors), and incorporating values such as family and religion into the health curriculum, among others. Future strategies that promote healthy aging in Latino adults should proactively culturally adapt the theoretical foundations and the design, recruitment, and implementation processes to ensure their relevance and effectiveness.

Relationship between Social Support, Sarcopenia, and Cognitive Impairment in Chinese Community-Dwelling Older Adults

BACKGROUND

Cognitive impairment and sarcopenia have become important challenges for the growing aging population. Social support has been shown to protect against cognitive impairment, but its impact on sarcopenia remains unknown. The purpose of this study was to explore the correlation between social support, sarcopenia, and cognitive impairment in Chinese older adults.

METHOD

A multi-stage whole group sampling method was used to conduct a cross-sectional survey of 720 community-dwelling older people in Shanghai. The definition of sarcopenia was in accordance with the criteria of the Asian Working Group for Sarcopenia (AWGS) 2019. Cognitive impairment was evaluated using a computerized neuropsychological assessment device that had been previously validated. Social support was assessed using the Social Support Rate Scale. Logistic regression analyses were conducted to explore the relationship between social support cognitive impairment and sarcopenia, fully adjusting for all potential confounding factors.

RESULTS

Our study found that 230 (31.94%) of the participants had cognitive impairment and 97 (13.47%) of the participants had sarcopenia. The mean social support score was 35.10 ± 7.54. Besides, the results showed that cognitive impairment was associated with sarcopenia (OR:1.650, 95% CI: 1.048, 2.596, P=0.030) after adjusting for confounding factors. Older adults with high level social support had the lowest risk of cognitive impairment (OR: 0.297, 95% CI: 0.115, 0.680, P=0.021) and sarcopenia (OR: 0.113, 95% CI: 0.031, 0.407, P=0.001), respectively.

CONCLUSION

Our analysis revealed that high level social support was negatively associated with sarcopenia and cognitive impairment. These findings provide strong support for the health promotion effect of social networks against sarcopenia and cognitive impairment in Chinese community-dwelling older adults, with important implications for healthcare policy makers.