Ageing as a risk factor for disease

Association between grip strength and cognitive function in older adults: results from a cross-sectional study and Mendelian randomization analyses

BACKGROUND

Impaired cognitive function is a known marker of human aging, and the causal relationship between grip strength, as a part of physical activity, and cognitive function is still unclear.

METHOD

Data on grip strength and cognitive function were collected in a cross-sectional study conducted in Guangxi Gongcheng 2018-2019. Generalized linear regression models were utilized to assess the relationship between grip strength and cognitive impairment. A two-way two-sample MR study was used to further determine the causal relationship, mainly using Inverse variance weighted (IVW), weighted median, and MR-Egger. Sensitivity analysis was also used to confirm the robustness of the results. Finally, MVMR analysed BMI and CRP as potential confounders.

RESULT

A total of 1723 participants were included in the cross-sectional study. Generalized linear regression models showed that low grip strength was a risk factor for cognitive impairment after adjusting for covariates such as age, gender, and ethnicity (OR: 0.965; 95 % CI: 0.947 to 0.984), and the onset of cognitive impairment led to reduced grip strength (OR: 0.251; 95 % CI: 0.113 to 0.559). The results of the two-way two-sample MR also supported the mutual causal relationship between low grip strength (OR = 0.93; 95 % Cl: 0.89-0.97) and cognitive impairment (OR = 0.878; 95 % Cl: 0.794-0.971). The results of the MVMR analysis also proved this relationship.

CONCLUSION

Low grip strength increases the risk of cognitive impairment, and conversely, cognitive impairment contributes to an increased risk of reduced grip strength.

Sex-specific decline in prefrontal cortex mitochondrial bioenergetics in aging baboons correlates with walking speed

Mitochondria play a crucial role in brain homeostasis and changes in mitochondrial bioenergetics are linked to age-related neurodegenerative diseases, including Alzheimer's disease and Parkinson's disease. We investigated changes in the activities of the electron transport chain (ETC) complexes in normally aging baboon brains and determined how these changes relate to donor sex, morning cortisol levels, and walking speed. We assessed mitochondrial bioenergetics from archived prefrontal cortex (PFC) tissues from a large cohort (60 individuals) of well-characterized aging baboons (6.6-22.8 years, approximately equivalent to 26.4-91.2 human years). Aging was associated with a decline in mitochondrial ETC complexes in the PFC, which was more pronounced when normalized for citrate synthase activity, suggesting that the decline is predominantly driven by changes in the specific activity of individual complexes rather than global changes in mitochondrial content. When donor sex was used as a covariate, we found that ETC activity was preserved with age in females and declined in males. Males had higher activities of each individual ETC complex and greater lactate dehydrogenase activity at a given age relative to females. Circulating cortisol negatively correlated with walking speed when male and female data were combined. We also observed a robust positive predictive relationship between walking speed and respiration linked to complexes I, III, and IV in males but not in females. This data reveals a link between frailty and PFC bioenergetic function and highlights a potential molecular mechanism for sexual dimorphism in brain resilience.

Recent and chronic ambient air pollution exposure in association with telomere length and mitochondrial DNA content in the general population

Telomere length (TL) and mitochondrial DNA content (mtDNAc) are biomarkers of biological ageing that respond to multiple stressors, including air pollution. Despite growing research interest, the association between recent and chronic air pollution and these biomarkers in the general population remains unclear. This study investigated the association between air pollution exposure and TL and mtDNAc using data from the 2018 Belgian Health Examination Survey. Multivariable adjusted generalised linear mixed models were applied to assess the exposure to nitrogen dioxide (NO2), fine particulate matter ≤2.5 μm (PM2.5), and black carbon (BC) over 1-week (recent) and 1-year (chronic) periods prior to participation, estimated with a high-resolution spatiotemporal model. Leucocyte TL and mtDNAc were measured using qPCR. A total of 756 participants (mean age 50.6 years, 49.9 % women) were included in the study. Recent exposure to PM2.5 was associated with a 2.40 % (95 % CI: 0.16, 4.69; p = 0.036) longer TL per IQR increment. Trends of lower mtDNAc were observed for chronic exposure to BC (-3.11, 95 % CI: -6.19, 0.07; p = 0.055) and NO2 (-4.02, 95 % CI: -8.22, 0.36; p = 0.072) per IQR increment. No significant associations were observed between chronic air pollution and TL or recent exposure and mtDNAc. These results suggest an inverse association between chronic air pollution and mtDNAc, and a positive association between recent exposure and TL, providing insight into the time-sensitive and air pollutant effects on ageing biomarkers.

Biomolecular conformational changes and transient druggable binding sites through full-length AMPK molecular dynamics simulations

AMPK (AMP-activated protein kinase) is a crucial signaling protein found in essentially all eukaryotic organisms and acts as an energy sensor. When activated by metabolic stress, AMPK phosphorylates a variety of molecular targets, altering enzyme activity and gene expression to regulate cellular responses. In general, in response to low intracellular ATP levels (high ADP:ATP ratio), AMPK triggers the activation of energy-producing pathways while simultaneously inhibiting energy-consuming processes. Recent studies have established a connection between molecular pathways involved in sensing energy and potential for extending longevity. AMPK indirect activator compounds have shown a potential strategy to obtain an anti-aging biological activity. This study explores the conformational changes and transient druggable binding pockets over the 1 μs trajectory of molecular dynamics simulations to comprehend the behavior of main domains and allosteric drug and metabolite (ADaM) site. The described conformations of the apo-ADaM site suggest an important influence of specific residues on the cavity volume variations. A clustering set of representative AMPK conformations allowed to identify the more favorable binding site volume and shape at the protein apo form, including the carbohydrate-binding module (CBM) region which exhibited a stable movement near the ADaM site of the alpha-subunit. The identification of gamma-subunit transient druggable binding pocket CBS3 during the microscale time trajectory simulations also offers valuable insights into structure-based AMP-mimetic drug design for AMPK activation.

Associations of Accelerated Biological Aging With Dementia and the Mediation Role of Brain Structure: Findings From a Longitudinal Study

BACKGROUND AND OBJECTIVES

The association between biological aging and dementia, as well as the underlying mechanism, remains limited. The aim of this study was to investigate the relationships of biological age (BA) with incident dementia and examine the underlying neurobiological mechanisms.

METHODS

This study used data from the UK Biobank, a prospective longitudinal study. We included participants free of diagnosed dementia at baseline. BA was evaluated from clinical traits using the Klemera-Doubal method biological age (KDM-BA) and PhenoAge algorithms. Genetic risk of dementia was assessed using the apolipoprotein E (APOE) ε4 genotype and polygenic risk scores (PRSs). Cox proportional hazard regression models were used to estimate the associations of BA and the combined effect of genetic risk and BA with dementia. In addition, the potential roles of brain structures (gray matter volume [GMV], cortical mean thickness, and cortical surface area) in the associations between BA and dementia were evaluated using mediation analysis.

RESULTS

A total of 280,918 participants (mean age 56.80 years, 54.59% female) were enrolled in this study. Over a median follow-up of 13.58 years, 4,770 cases of dementia were recorded. Every SD increase in KDM-BA accelerations and PhenoAge accelerations was associated with a 14% (hazard ratio [HR] = 1.14; 95% CI 1.10-1.18) and 15% (HR = 1.15; 95% CI 1.12-1.19) higher incidence of dementia, respectively. Individuals with APOE ε4 and highest PhenoAge accelerations had the highest risk of dementia (HR = 4.20, 95% CI 3.69-4.78) compared with those with non-APOE ε4 and lowest PhenoAge accelerations, with significant interaction effect (Pinteraction < 0.001). We did not find significant modification effects of PRS on the associations between BA accelerations and dementia (Pinteraction = 0.347 for KDM-BA acceleration, Pinteraction = 0.279 for PhenoAge acceleration), as well as APOE ε4 on the association between KDM-BA accelerations and dementia (Pinteraction = 0.212). Mediation analysis showed that the identified GMV, cortical mean thickness, and cortical surface area partly mediated the association between BA accelerations and incident dementia, with proportion-mediated percentage ranging from 6.64% to 17.98%.

DISCUSSION

Advanced BA may be a potential risk factor of incident dementia. The risk is possibly mediated through the widespread reduction of brain structures.

Aging at the Crossroads of Organ Interactions: Implications for the Heart

Aging processes underlie common chronic cardiometabolic diseases such as heart failure and diabetes. Cross-organ/tissue interactions can accelerate aging through cellular senescence, tissue wasting, accelerated atherosclerosis, increased vascular stiffness, and reduction in blood flow, leading to organ remodeling and premature failure. This interorgan/tissue crosstalk can accelerate aging-related dysfunction through inflammation, senescence-associated secretome, and metabolic and mitochondrial changes resulting in increased oxidative stress, microvascular dysfunction, cellular reprogramming, and tissue fibrosis. This may also underscore the rising incidence and co-occurrence of multiorgan dysfunction in cardiometabolic aging in the population. Examples include interactions between the heart and the lungs, kidneys, liver, muscles, and brain, among others. However, this phenomenon can also present new translational opportunities for identifying diagnostic biomarkers to define early risks of multiorgan dysfunction, gain mechanistic insights, and help to design precision-directed therapeutic interventions. Indeed, this opens new opportunities for therapeutic development in targeting multiple organs simultaneously to disrupt the crosstalk-driven process of mutual disease acceleration. New therapeutic targets could provide synergistic benefits across multiple organ systems in the same at-risk patient. Ultimately, these approaches may together slow the aging process itself throughout the body. In the future, with patient-centered multisystem coordinated approaches, we can initiate a new paradigm of multiorgan early risk prediction and tailored intervention. With emerging tools including artificial intelligence-assisted risk profiling and novel preventive strategies (eg, RNA-based therapeutics), we may be able to mitigate multiorgan cardiometabolic dysfunction much earlier and, perhaps, even slow the aging process itself.

Effect of hypoxia conditioning on physical fitness in middle-aged and older adults-a systematic review and meta-analysis

Background

Hypoxic conditioning has emerged as a promising intervention for enhancing physiological adaptations. This systematic review and meta-analysis of randomized controlled trials aims to investigate the efficacy of hypoxic conditioning on physical fitness measures in aging populations.

Methods

The Embase, PubMed, Cochrane Library, and Web of Science were searched from inception to November 2024 (Prospero registration: CRD42023474570). The Cochrane Evaluation Tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework were used for risk of bias assessment and evidence certainty evaluation. Mean differences (MD) and standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using the Review Manager software. Subgroup analysis was performed to explore possible associations between the study characteristics and the effectiveness of the intervention.

Results

A total of 13 randomized controlled trials (RCTs) with 368 subjects were included in the meta-analysis. High certainty evidence found hypoxic conditioning (HC) significantly improved peak oxygen uptake (VO2peak) (SMD = 0.31, 95% CI [0.01-0.61]; P < 0.05), while very low to moderate certainty evidence shown that hypoxic conditioning (HC) have not induced greater changes on functional outcomes (SMD = -0.21, 95% CI [-0.66-0.24]; P > 0.05), muscle strength (SMD = -0.19, 95% CI [-0.63-0.26]; P > 0.05), maximal power output (SMD = 0.29, 95% CI [-0.17-0.76]; P > 0.05), VO2max (SMD = -0.39, 95% CI [-1.12-1.90]; P > 0.05), and exercise workload (MD = -10.07, 95% CI [-34.95-14.80]; P > 0.05).

Conclusion

This study suggests that hypoxia conditioning has a greater effect on enhancing VO2peak compared to equivalent normoxic training in the middle-aged and older population. More high-quality RCTs are needed in the future to explore the optimal oxygen concentration and exercise intensity during hypoxia conditioning.

Exploring geriatricians' perspectives on aging biomarkers: A reflexive thematic analysis

OBJECTIVES

Aging biomarkers have been developed to identify people at higher risk of age-related decline. The objective of this study is to understand geriatricians' perspectives on aging biomarkers in order to facilitate their integration into geriatric medicine.

STUDY DESIGN

Using reflexive thematic analysis, this qualitative study explores the views of geriatricians on the potential role of aging biomarkers in clinical practice based on thirteen semi-structured interviews.

MAIN OUTCOME MEASURES

Geriatricians' views on the role, utility, and challenges of the use of aging biomarkers in geriatric medicine.

RESULTS

Two main themes were developed: the complexity of geriatric medicine and the importance of trust in biomarkers. Clinicians highlighted the heterogeneity of the older patient population, noting that current assessments, such as the Comprehensive Geriatric Assessment (CGA), rely on the geriatricians' clinical judgment. While most participants saw potential for aging biomarkers to supplement the CGA in assessment of patients' resilience in recovery from invasive treatment, they emphasized the need to prove value beyond current treatment decisions. Furthermore, participants stressed the need for actionable, reliable, and context-specific tools. Concerns included the risk of oversimplifying the assessment of resilience, lack of applicability to the frail clinical population, and the ethical implications for both health care and society more broadly in the implementation of aging biomarkers.

CONCLUSIONS

This study emphasizes the importance of aligning biomarker development with the reality of geriatric medicine and clinicians' needs. Efforts from geriatricians, aging biomarker researchers, ethicists, and primary treating physicians are needed to successfully adopt aging biomarkers into geriatric medicine.

[Self-perceived risk of cancer in Spain: a cross-sectional study]

OBJECTIVE

To identify the variables that influence the most the self-perceived risk of developing cancer and to explore the main reasons associated with the degree of self-perceived risk.

METHOD

A cross-sectional study was carried out using a questionnaire designed ad hoc, between February and September 2020. A total of 4769 responses were collected by telephone from men and women over 18 years of age residing in Spain, with a response rate of 29.6%. A descriptive analysis and a binary logistic regression model were performed using the self-perceived risk of developing cancer as the dependent variable.

RESULTS

More than 60% of the participating population believe they have a very high or high risk of being diagnosed at some point in their lives. Having experienced cancer either firsthand or through close family members substantially increased the probability of having a very high or high risk of developing the disease (aOR: 3.243, 95% CI: 2.284-4.605, and aOR: 3.950, 95%CI: 3.316-4.706, respectively). In addition, other sociodemographic and attitudinal variables have been shown to influence the self-perceived risk of developing cancer.

CONCLUSIONS

Close experiences with cancer, either one's own or someone else's, have a significant impact on the higher perception of risk of suffering from the disease. Other variables related to lifestyle or sociodemographic profile that increase the probability that this perception is higher. Therefore, these findings highlight the importance of reinforcing public policies in the field of primary and secondary prevention in order to improve the perception of cancer risk in less aware people.

Discovery of Non-antibacterial Enrofloxacin Derivatives with Emerging Antiaging Effects through Drug Repurposing and Secondary Development

Aging induces dysfunction and increases the risk of chronic diseases in the elderly, positioning the development of antiaging drugs to the forefront of research. Drug repurposing offers an efficient strategy for identifying antiaging lead compounds. In this study, we employed phenotypic screening and discovered that enrofloxacin could extend the lifespan in Caenorhabditis elegans. Based on these findings, we conducted rational drug design to eliminate its antibacterial activity while maintaining the lifespan-extending effect, with the goal of developing safe and novel antiaging compounds. Consequently, JX10 exhibited minimal antibacterial activity and competent antiaging effects in C. elegans, senescent cells, and aged mice. In terms of its mechanism, JX10 acted as a senomorphic agent by suppressing the expression of p38 MAPK and NF-κB. Furthermore, JX10 demonstrated favorable safety and pharmacokinetic properties, supporting the feasibility of JX10 as a promising candidate with the potential for therapeutic interventions in aging and aging-related diseases.

Life-threatening bleeding caused by artery pseudoaneurysm after endoscopic procedure successfully treated by artery embolization

The Kakinuma et al's case report shows that non-pregnancy-related arterial pseudoaneurysm is a relatively rare, little known by some gynecologists, endoscopists, surgeons or radiologists, which can cause massive bleeding. Arterial pseudoaneurysm is a condition in which the wall of a blood vessel collapses due to some invasive event, and the resulting leaked blood is engulfed by soft tissues, forming a cavity that is in communication with the vessel. It is a potentially life-threatening complication that could occurs after some deliveries and some gynecological invasive procedures. Remarkably, an undetermined percentage of pseudoaneurysms are asymptomatic, and in an asymptomatic patient it is difficult to predict the risk of haemorrhage and the attitude to follow, which depends on several factors, such as, the size and location of the vessel involved, changes in the size of the pseudoaneurysm, or the available therapeutic resources to be offered to patients, among others circumstances. The management of abdominal arterial pseudoaneurysm does not have consistent scientific evidence, but it seems that, regardless of the associated circumstances, the pseudoaneurysm could be treated at least initially, and mainly, through endovascular procedures, as done by Kakinuma et al.

Health and well-being of older adults in rural and urban Rwanda: epidemiological findings from a population based cross-sectional study

Background

Ageing often leads to multimorbidity, frailty, and disability; these interconnected conditions significantly impact quality of life (QoL) and strain healthcare systems through increased dependency and care needs. Despite their importance for health system planning, they remain understudied in Rwanda's older population. Here we describe the epidemiology of these outcomes in Rwanda's ageing population.

Methods

We conducted a cross-sectional, population-based study among Rwandan adults aged ≥40 years across urban and rural districts, whereby we used validated tools to assess multimorbidity (≥2 chronic conditions), frailty (Fried Frailty Score), disability (World Health Organization Disability Assessment Schedule (WHODAS) 2.0), and QoL (European Health Interview Survey - World Health Organization Quality of Life (EUROHIS-QoL)). We used multivariable analyses to examine associations between the outcomes and demographic and socioeconomic factors.

Results

Among 4369 adults, multimorbidity prevalence was 55.2% (95% confidence interval (CI) = 53.7, 56.6), with frailty affecting 14.5% (95% CI = 13.5, 15.6) of this population. Disability prevalence was relatively low, with a median score of 10.4% (interquartile range = 2.1-25.0), while the mean QoL score was 48.2% (standard deviation = 15.6). We observed impairment in activities of daily living (ADL) in 16.0% (95% CI = 14.9, 17.1) of the sample. Health outcomes worsened with age, particularly among those aged ≥70 years, and among females compared to males. Multivariable analyses showed that higher socioeconomic status and urban residence were significantly associated with lower frailty, disability, and ADL impairment, though urban residents had higher multimorbidity rates and poorer QoL. Higher educational status was associated with reduced disability and improved QoL.

Conclusions

Our findings show a substantial burden of multimorbidity and frailty among older adults in Rwanda, with significant gender, socioeconomic, and urban-rural disparities. Integrated care models that address both the physical and social determinants of health, with a focus on reducing gender, socioeconomic, and geographical disparities, are needed to improve the well-being of older adults in Rwanda.

Upregulation of COX-2 and NADPH Oxidase and Reduced eNOS in Perivascular Adipose Tissue Are Associated With Resistance Artery Dysfunction and Hypertension in Naturally Aged Mice

Aging is a major risk factor for cardiovascular disease, with hypertension being the most common outcome. Hypertension often stems from resistance arteries endothelial dysfunction. Recent research highlights the pivotal role of perivascular adipose tissue (PVAT) in regulating endothelial function. We hypothesized that PVAT senescence contributes to vascular dysfunction and hypertension during aging. We showed that naturally aged mice developed hypertension and elevated pro-inflammatory cytokines levels. Moreover, resistance mesenteric arteries showed impaired vascular relaxation that was normalized by apocynin, an antioxidant. The vascular dysfunction was endothelium- and PVAT-dependent, and marked by: decreased nitric oxide- and cyclooxygenase-dependent vascular relaxation, decreased expression of endothelial nitric oxide synthase, and increased cyclooxygenase 2 and NADPH oxidase subunits p22phox and gp91phox expressions in the endothelium and PVAT. Additionally, we observed that PVAT shows greater signs of senescence, particularly with higher p16 expression, indicating that PVAT is more prone to age-related cellular aging. Our findings suggest that in resistance mesenteric arteries PVAT-derived factors are crucial for triggering and amplifying vascular dysfunction in aging, leading to hypertension. The underlying mechanisms involve downregulation of endothelial nitric oxide synthase-derived nitric oxide, NADPH oxidase-dependent oxidative stress, and cyclooxygenase 2-derived vascular contractile factors. This research improves our understanding of the mechanisms behind age-related vascular dysfunction and associated hypertension and opens perspectives for targeted therapeutic strategies.

Mitochondrial transplantation combined with coenzyme Q10 induces cardioprotection and mitochondrial improvement in aged male rats with reperfusion injury

Ischaemic heart diseases (IHD) are among the major causes of mortality in the elderly population. Although timely reperfusion is a common treatment for IHD, it causes additional damage to the ischaemic myocardium known as ischaemia-reperfusion (IR) injury. Considering the importance of preventing reperfusion injuries, we aimed to examine the combination effect of mitochondrial transplantation (MT) and coenzyme Q10 (CoQ10) in myocardial IR injury of aged male rats. Seventy-two aged male Wistar rats were randomly divided into six groups: Sham, IR, CoQ10, MT, combination therapy (MT + CoQ10) and vehicle. Myocardial IR injury was established by occlusion of the left anterior descending coronary artery followed by reopening. Young male Wistar rats were used as mitochondria donors. Isolated mitochondria were injected intraventricularly (500 µL of a respiration buffer containing 6 × 106 ± 5 × 105 mitochondria/mL) in MT-receiving groups at the onset of reperfusion. CoQ10 (10 mg/kg/day) was injected intraperitoneally for 2 weeks before IR induction. Twenty-four hours after reperfusion, haemodynamic parameters, myocardial infarct size (IS), lactate dehydrogenase (LDH) release and cardiac mitochondrial function (mitochondrial reactive oxygen species (ROS) generation and membrane potential) were measured. The combination of MT and CoQ10 improved haemodynamic index changes and reduced IS and LDH release (P < 0.05). It also decreased mitochondrial ROS generation and increased membrane potential (P < 0.05). CoQ10 also showed a significant cardioprotective effect. Combination therapy displayed greater cardioprotective effects than single treatments. This study revealed that MT and CoQ10 combination treatment can be considered as a promising cardioprotective strategy to reduce myocardial IR injury in ageing, in part by restoring mitochondrial function.

Novel effects of reverse transcriptase inhibitor supplementation in skeletal muscle of old mice

Aging is the primary risk factor for the development of many chronic diseases, including dementias, cardiovascular disease, and diabetes. There is significant interest in identifying novel "geroprotective" agents, including by repurposing existing drugs, but such treatments may affect organ systems differently. One current example is the nucleoside reverse transcriptase inhibitor 3TC, which has been increasingly studied as a potential gerotherapeutic. Recent data suggest that 3TC may reduce inflammation and improve cognitive function in older mice; however, the effects of 3TC on other tissues in aged animals are less well characterized. Here, we use transcriptomics (RNA-seq) and targeted metabolomics to investigate the influence of 3TC supplementation on skeletal muscle in older mice. We show that 3TC 1) does not overtly affect muscle mass or functional/health markers, 2) largely reverses age-related changes in gene expression and metabolite signatures, and 3) is potentially beneficial for mitochondrial function in old animals via increases in antioxidant enzymes and decreases in mitochondrial reactive oxygen species. Collectively, our results suggest that, in addition to its protective effects in other tissues, 3TC supplementation does not have adverse effects in aged muscle and may even protect muscle/mitochondrial health in this context.NEW & NOTEWORTHY Recent studies suggest that the nucleoside reverse transcriptase inhibitor 3TC may improve brain health and cognitive function in old mice, but its effects on other aging tissues have not been comprehensively studied. This is the first study to use a multiomics approach to investigate the effects of 3TC treatment on skeletal muscle of old mice. The results suggest that 3TC reverses age-related transcriptomic and metabolite signatures and is potentially beneficial for mitochondrial function in aged muscle.

Differential Organ Ageing Is Associated With Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a progressive disorder and the leading cause of central vision loss. Age is the most important risk factor, followed by genetics and smoking. However, ageing is a complex process, and biological age can deviate from chronological age between individuals and within different organ systems. Initially, we used machine learning to predict the biological age of the immune, cardiovascular, pulmonary, renal, musculoskeletal, metabolic and hepatic systems by analysing various physiological and physical markers in the UK Biobank cohort. Then, we investigated the association of each organ's biological age with incident AMD derived from electronic health record data as well as with different AMD genetic risk scores. We observed that most organ systems in participants who developed AMD after recruitment showed accelerated ageing compared with controls, with the immune system being the most affected, especially in younger males. Surprisingly, we found that AMD patients showed slower ageing of their hepatic system compared to controls, particularly in female patients. The overall AMD genetic risk score was associated with faster organ ageing across all tissues except cardiovascular and pulmonary, while genetic risk scores stratified by pathways differently influenced each organ system. In conclusion, we found differential organ ageing associated with AMD. Significantly, genetic risk variants of AMD are associated with differential ageing of various organ systems.

Age-related p53 SUMOylation accelerates senescence and tau pathology in Alzheimer's disease

Aging is a major risk factor for Alzheimer's disease (AD). With the prevalence of AD increased, a mechanistic linkage between aging and the pathogenesis of AD needs to be further addressed. Here, we report that a small ubiquitin-related modifier (SUMO) modification of p53 is implicated in the process which remarkably increased in AD patient's brain. Mechanistically, SUMOylation of p53 at K386 residue causes the dissociation of SET/p53 complex, thus releasing SET into the cytoplasm, SET further interacts with cytoplasmic PP2A and inhibits its activity, resulting in tau hyperphosphorylation in neurons. In addition, SUMOylation of p53 promotes the p53 Ser15 phosphorylation that mediates neuronal senescence. Notably, p53 SUMOylation contributes to synaptic damage and cognitive defects in AD model mice. We also demonstrate that the SUMOylation inhibiter, Ginkgolic acid, recovering several senescent phenotypes drove by p53 SUMOylation in primary neurons. These findings suggest a previously undiscovered etiopathogenic relationship between aging and AD that is linked to p53 SUMOylation and the potential of SUMOylated p53-based therapeutics for neurodegeneration such as Alzheimer's disease.

Genetic determinants of proteomic aging

Changes in the proteome and its dysregulation have long been known to be a hallmark of aging. We derived a proteomic aging trait using data on 1459 plasma proteins from 44,435 UK Biobank individuals measured using an antibody-based assay. This metric is strongly associated with four age-related disease outcomes, even after adjusting for chronological age. Survival analysis showed that one-year older proteomic age, relative to chronological age, increases all-cause mortality hazard by 13 percent. We performed a genome-wide association analysis of proteomic age acceleration (proteomic aging trait minus chronological age) to identify its biological determinants. Proteomic age acceleration showed modest genetic correlations with four epigenetic clocks (Rg = 0.17 to 0.19) and telomere length (Rg = -0.2). Once we removed associations that were explained by a single pQTL, we were left with three signals mapping to BRCA1, POLR2A and TET2 with apparent widespread effects on plasma proteomic aging. Genetic variation at these three loci has been shown to affect other omics-related aging measures. Mendelian randomisation analyses showed causal effects of higher BMI and type 2 diabetes on faster proteomic age acceleration. This supports the idea that obesity and other features of metabolic syndrome have an adverse effect on the processes of human aging.

Network pharmacology approach to unravel the neuroprotective potential of natural products: a narrative review

Aging is a slow and irreversible biological process leading to decreased cell and tissue functions with higher risks of multiple age-related diseases, including neurodegenerative diseases. It is widely accepted that aging represents the leading risk factor for neurodegeneration. The pathogenesis of these diseases involves complex interactions of genetic mutations, environmental factors, oxidative stress, neuroinflammation, and mitochondrial dysfunction, which complicate treatment with traditional mono-targeted therapies. Network pharmacology can help identify potential gene or protein targets related to neurodegenerative diseases. Integrating advanced molecular profiling technologies and computer-aided drug design further enhances the potential of network pharmacology, enabling the identification of biomarkers and therapeutic targets, thus paving the way for precision medicine in neurodegenerative diseases. This review article delves into the application of network pharmacology in understanding and treating neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease, and spinal muscular atrophy. Overall, this article emphasizes the importance of addressing aging as a central factor in developing effective disease-modifying therapies, highlighting how network pharmacology can unravel the complex biological networks associated with aging and pave the way for personalized medical strategies.

Lived Experiences of Medically Admitted Tuberculosis Patients in a Public Hospital and Its Implications for TB Treatment Management and Care: A Narrative Analysis Around the First-Hand Experience in a Tuberculosis Ward

INTRODUCTION

Along with bodily suffering, tuberculosis causes various socio-economic problems, including major crises on the personal end. For medically admitted chronic TB patients, a hospital is a place of more than only treatment that over time becomes a living place. The present study explored the individual patients' perspectives on TB treatment.

METHODS

The present ethnographic study was undertaken among the admitted tuberculosis patients of both sexes in the 18-70 age group in a referral government TB hospital in Odisha. Thirty selected in-depth interviews and case studies were taken to collect the data.

RESULTS

TB challenges and in several contexts shatters the socio-economic conditions of such patients bringing several crises at the individual and interpersonal levels. The findings of the study suggest that social marginalization, poor socio-economic conditions, loss of livelihood, desertion, and abandonment of women and elderly, gender disparity while seeking health and treatment, gender-based family negligence, stigma, superstitious beliefs, and traditional medicinal practices had heavy bearings in tuberculosis patients' lives.

CONCLUSION

The present hospital ethnography on TB patients indicates that emphasizing patients' perspectives, provision of socio-psychological support at community and institutional levels in the hospital ward, and addressing tuberculosis-associated concerns have important positive outcomes in patients' lives; it will also have major support in treatment adherence and early recovery by ensuring successful TB management and elimination.

The role of Ergothioneine in cognition and age-related neurodegenerative disease: a systematic review

Ergothioneine (ET) is an under recognised diet-derived compound which has the potential to be a "longevity vitamin". It was found to be beneficial for cognitive function and age-related neurodegenerative disorder (ARND). Thus, this study was conducted to synthesise the existing evidence of ET's effects on cognition and ARND, emphasizing its potential as a micronutrient for healthy aging. This study also highlights the future prospects of the research regarding ET's effects on cognition and ARND that are suggested in existing literature. Three databases (Pubmed, Scopus, and Web of Science) were used to search for the studies that meet the inclusion and exclusion criteria. A total of 19 studies were included after screening in this review. The risk of bias of each study was assessed using the Office of Health Assessment and Translation (OHAT) risk of bias rating tool. All studies' characteristics and main findings were tabulated according to their type of study. Mechanisms of ET in improving cognitive function and preventing ARND were found to be through its antioxidative, anti-inflammatory and antisenescence properties. Its role in neurotransmission and neuroprotection also contributed to improving cognition and preventing ARND. In conclusion, ET is a potential compound to be explored as its role in cognition and ARND have been discovered through several studies.

Human umbilical cord mesenchymal stem cell-derived exosome ameliorate doxorubicin-induced senescence

BACKGROUND

Cellular senescence refers to a condition where cells permanently cease division while maintaining metabolic activity. Doxorubicin (Dox) is known as an agent of induction of cellular senescence. This study aimed to explore the potential role of human umbilical cord mesenchymal stem cell-derived exosomes (hucMSC-Exo) in mitigating Dox induced senescent.

METHOD

NIH3T3 cells were treated by various concentrations of Dox with or without hucMSC-Exo, cell morphology, viability, migration, senescence-associated SA-β-Gal staining were monitored. Cellular senescence was induced in C57BL/6J mice via administration of 5 mg/kg Doxorubicin, followed by treatment with hucMSC-Exo or metformin. Assessments included body weight, liver and kidney weight, colon length, SA-β-Gal staining of kidney and skin, molecular biomarkers of aging such as p16INK4A, p53, and p21Waf1/Clip1 to evaluate senescence status.

RESULT

We found that after the treatment of exosomes or metformin improved several aging-related phenotypes in both mouse and cellular models, including increases in body weight, liver and kidney weights, and the reduction of SA-β-Gal positive cells in kidney and skin tissues as well as cell models. At the molecular level, hucMSC-Exo resulted in the downregulation of inflammatory factors and senescence markers in liver and kidney tissues as well as cell models.

CONCLUSION

Our study demonstrates hucMSC-Exo may ameliorate Dox induced senescence either in NIH3T3 cells or in mice.

Proteomic Profiling of Age-Related Proteins Following Extracorporeal Apheresis

Lipoprotein apheresis (LA) is often the last option to adequately reduce lipoproteins in patients with familial hypercholesterolemia and lipoprotein (a) hyperlipidemia. Characterized by mild side effects, it is now the most effective method of preventing major cardiovascular events (CVEs). This benefit is due not only to the lowering of lipoprotein levels, but probably also to many other pleiotropic effects that have been extensively described in the literature. These include the reduction of inflammatory signaling substances, fibrinogen, plasminogen or components of the oxidative stress response. Here, we performed a proteomic analysis of 12 patients treated with therapeutic apheresis using two different pore size filters to quantify the effect on age-related plasma proteins. This study showed that important proteins such as α-2-macroglobulin, apolipoprotein C-III, complement C1s subcomponent, C4b-binding protein alpha chain, CD5 antigen-like and pregnancy zone protein, whose role in numerous aging processes has been well described, were significantly reduced by apheresis treatment. We conclude that therapeutic apheresis may be a promising approach to reduce these age-related proteins and that these treatments may become an essential part of managing cardiovascular risk in an aging population.

Red Ginseng Aqueous Extract Superior to White Ginseng Exhibited Anti-Aging Property Through IIS Signaling Pathway in Caenorhabditis elegans

The traditional Chinese herbal medicine Panax ginseng can optimize physical health and is anticipated to be a valuable resource for investigating anti-aging therapies. This study investigated the anti-aging effects of red ginseng aqueous extract (RG) and white ginseng aqueous extract (WG). Network pharmacology forecasted that the key mechanisms of anti-aging in white and red ginsengs were the PI3K-Akt and IIS signaling pathways. Experiments conducted on Caenorhabditis elegans (C. elegans) showed that 5 mg/mL WG and RG notably prolonged lifespan and improved stress resistance. The qPCR analysis revealed that changes in upstream genes activated downstream genes in the IIS pathway. Furthermore, forward and reverse validation indicated that WG and RG acted through the IIS pathway in promoting longevity. RG exhibited superior anti-aging effects compared to WG at the same concentration. This might be attributed to the fact that RG contained more reducing sugars, polyphenols, melanoidins, total saponin content, and especially the conversion of ginsenosides. Molecular docking showed that ginsenosides interacted with the key protein DAF-2, with ginsenosides Rg3, Rg5, Rh4, Rf, and Rc binding more strongly than ginsenosides Rb1, Rb2, and Rd. Overall, RG possessed different active ingredients compared to WG and showed superior results in improving aging in C. elegans.

The L-shaped link between total antioxidant capacity and phenotypic age acceleration: evidence from NHANES 2003-2010

This study aimed to investigate the relationship between total antioxidant capacity (TAC) and phenotypic age acceleration (PhenoAgeAccel), a measure of accelerated biological aging, using data from the National Health and Nutrition Examination Survey (NHANES). Data from the 2003-2010 NHANES surveys, encompassing 16,395 participants, were analyzed. Principal component analysis (PCA) was used to reduce data dimensionality. Multivariate logistic regression models were employed to evaluate the association between TAC and antioxidant vitamins (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein-zeaxanthin, vitamin A, vitamin C, vitamin E) with PhenoAgeAccel, adjusting for demographic, lifestyle, and clinical factors. Smoothed curve fitting and threshold effects analysis were conducted to explore the nonlinear relationship between log-transformed TAC and PhenoAgeAccel. Subgroup analyses were performed to assess potential effect modifiers based on age, gender, race, education, smoking, alcohol use, diabetes, hypertension, and hyperlipidemia. The weak correlations between the original variables prevent PCA from effectively capturing the primary variability within the data. Higher TAC was significantly inversely associated with PhenoAgeAccel in both unadjusted and adjusted models. Participants in the second tertile (T2) of TAC exhibited 11% lower odds of PhenoAgeAccel compared to those in the first tertile (T1) (OR = 0.89, 95% CI: 0.81-0.98, P = 0.0176). Intake of several antioxidant vitamins, including α-carotene, β-carotene, lutein-zeaxanthin, vitamin A, vitamin C, and vitamin E, was also inversely associated with the odds of PhenoAgeAccel. A nonlinear relationship between log-transformed TAC and PhenoAgeAccel was observed, with a significant protective effect within a specific range of TAC. Subgroup analyses revealed no significant effect modification by most factors, except for gender, smoking, and alcohol consumption. TAC is closely associated with PhenoAgeAccel. A nonlinear relationship was observed, with higher TAC exhibiting significant protective effects within a specific range, particularly among males, smokers, and alcohol consumer. These findings underscore the potential value of TAC in mitigating the aging process.

Causal association between dietary factors and telomere length revealed by mendelian randomization

Observational studies have reported associations between dietary factors and telomere length. However, the inherent limitations of observational study designs render them susceptible to confounding and reverse causation biases. Therefore, this study aims to explore the association between dietary factors and telomere length using Mendelian Randomization (MR) to minimize the influence of confounding factors and reverse causality. The IEU Open GWAS project was the source of exposure and outcome datasets. The exposure datasets included 20 dietary factors. We conducted MR analyses to explore the relationship between dietary factors and telomere length. We used MRPRESSO and Radial-MR test to identify any level of multi-effect outliers. Heterogeneity and pleiotropic analysis were performed to ensure the accuracy of the results. The stability of the effect of significant results is assessed using multivariable Mendelian randomization (MVMR) and MR-lap. Two-sample MR analysis revealed a statistically significant association between dried fruit intake and telomere length (β = 0.223, 95% CI 0.091 to 0.356, PIVW=9.089 × 10^-4). After removing outliers and reanalyzing the data, the association remained significant (β = 0.163, 95% CI: 0.163 0.090 to 0.235, PIVW-FE=7.323 × 10^-5), with no significant pleiotropy detected in sensitivity analyses. Following adjustment for confounders, the MVMR results and MR-lap results continued to support a causal relationship between dried fruit intake and telomere length. Other dietary factors' effects on telomere length still need further confirmation. Our findings suggest a potential causal relationship between dried fruit intake and longer telomere length. This finding highlights potential dietary strategies for exploring the beneficial effects of dried fruit intake on preventing diseases and extending lifespan.

Evaluating the reproducibility of a deep learning algorithm for the prediction of retinal age

Recently, a deep learning algorithm (DLA) has been developed to predict the chronological age from retinal images. The Retinal Age Gap (RAG), a deviation between predicted age from retinal images (Retinal Age, RA) and chronological age, correlates with mortality and age-related diseases. This study evaluated the reliability and accuracy of RA predictions and analyzed various factors that may influence them. We analyzed two groups of participants: Intravisit and Intervisit, both imaged by color fundus photography. RA was predicted using an established algorithm. The Intervisit group comprised 26 subjects, imaged in two sessions. The Intravisit group had 41 subjects, of whom each eye was photographed twice in one session. The mean absolute test-retest difference in predicted RA was 2.39 years for Intervisit and 2.13 years for Intravisit, with the latter showing higher prediction variability. The chronological age was predicted accurately from fundus photographs. Subsetting image pairs based on differential image quality reduced test-retest discrepancies by up to 50%, but mean image quality was not correlated with retest outcomes. Marked diurnal oscillations in RA predictions were observed, with a significant overestimation in the afternoon compared to the morning in the Intravisit cohort. The order of image acquisition across imaging sessions did not influence RA prediction and subjective age perception did not predict RAG. Inter-eye consistency exceeded 3 years. Our study is the first to explore the reliability of RA predictions. Consistent image quality enhances retest outcomes. The observed diurnal variations in RA predictions highlight the need for standardized imaging protocols, but RAG could soon be a reliable metric in clinical investigations.

Establishing minimal clinically important differences and cut-off values for the lower limb motricity index and trunk control test in older patients with acute stroke: a prospective cohort study

OBJECTIVE

To establish the Minimal Clinically Important Differences (MCIDs) for lower limb strength measured by the Motricity Index (LLMI) and trunk function assessed by the Trunk Control Test (TCT) in the acute phase of stroke in older patients. Further, the study sought to determine the cutoff values predicting functional prognosis at discharge for both the LLMI and TCT.

METHODS

This prospective cohort study was conducted for older patients (≥65 years) admitted for acute stroke, receiving guideline-based stroke care that includes early rehabilitation. The LLMI and TCT were measured within 7 days of admission and at discharge. The MCID was derived from receiving operating characteristic curves, based on a ≥ 1 point shift in the modified Rankin Scale (mRS) from admission to discharge. A good functional prognosis at discharge was defined as an mRS score of ≤ 3.

RESULTS

A total of 201 older patients with acute stroke were included. The TCT achieved an MCID of 13 (area under the curve [AUC] = 0.704, 95% confidence interval [CI]: 0.633-0.775), whereas the LLMI lacked the precision to produce a significant MCID. The optimal cutoff points for predicting a good outcome were found to be an LLMI score of 65 (AUC = 0.770, 95% CI: 0.705-0.835) and a TCT score of 25 (AUC = 0.827, 95% CI: 0.768-0.887) upon admission.

CONCLUSIONS

This study identified a valid MCID for the TCT, failed to do so for the LLMI, and established cutoff values for both the LLMI and TCT that can predict good outcomes in older patients with acute stroke.

A computational framework for detecting inter-tissue gene-expression coordination changes with aging

Aging is a complex and systematic biological process that involves multiple genes and biological pathways across different tissues. While existing studies focus on tissue-specific aging factors, the inter-tissue interplay between molecular pathways during aging remains insufficiently explored. To bridge this gap, we propose a novel computational framework to identify the effect of aging on the coordinated patterns of gene-expression across multiple tissues. Our framework includes (1) an adjusted multi-tissue weighted gene co-expression network analysis, (2) differential network connectivity analysis between age groups and (3) machine learning models, XGBoost and Random Forest (RF) fed by gene expression levels and lower-dimensional pathway score space, to identify unique key inter-tissue genes and biological pathways for classifying aging. We applied our approach to three representative tissues: Adipose-Subcutaneous, Muscle-Skeletal and Brain-Cortex. The RF model demonstrated the best performance in predicting age group (AUC < 88%) highlighting key genes involved in inter-tissue coordination processes in aging. We also identified the inter-tissue involvement of lipid metabolism, immune system, and cell communication pathways during aging and detected distinct aging pathways manifested between tissues. The proposed framework highlights the importance of inter-tissue coordination processes underlying aging and provides valuable insights into aging mechanisms which can further assist in the development of therapeutic strategies promoting healthy aging.

Age-dependent cytokine surge in blood precedes cancer diagnosis

Aging is associated with increased variability and dysregulation of the immune system. We performed a system-level analysis of serum cytokines in a longitudinal cohort of 133 healthy individuals over 9 y. We found that cancer incidence is a major contributor to increased cytokine abundance variability. Circulating cytokines increase up to 4 y before a cancer diagnosis in subjects with age over 80 y. We also analyzed cytokine expression in 10 types of early-stage cancers from The Cancer Genome Atlas. We found that a similar set of cytokines is upregulated in tumor tissues, specifically after the age of 80 y. Similarly, cellular senescence activity and CDKN1A/p21 expression increase with age in cancer tissues. Finally, we demonstrated that the cytokine levels in serum can be used to predict cancers among subjects age at 80+ y. Our results suggest that latent senescent cancers contribute to age-related chronic inflammation.

The association between anti-inflammatory therapies and renal outcomes in patients with established cardiovascular disease or high cardiovascular risks: a meta-analysis of randomised controlled trials

BACKGROUND

To assess the relationship between anti-inflammatory therapy and renal events risk in participants with cardiovascular risks or diagnosed cardiovascular disease (CVD).

METHODS

Literature searches were carried out in PubMed, Embase, clinicaltrial.gov and the Cochrane Central Register of Controlled Trials. Randomised controlled trials that were published from January 1995 to July 2024, compared anti-inflammatory therapy and placebo in participants at cardiovascular risks or with diagnosed CVD and with reports of renal outcomes were included. The results were shown as risk ratio (RR) and 95% confidence interval (CI).

RESULTS

In comparison to placebo, therapies targeting inflammation did not exhibit a significant association with the risk of composite renal outcomes (worsening of renal function, death due to kidney disease and end-stage renal disease) (RR = 0.89, 95% CI 0.40 to 1.99, I2 = 0%). The risk of worsening of renal function (RR = 0.81, 95% CI 0.21 to 3.07, I2 = NA), end-stage renal disease (RR = 0.94, 95% CI 0.31 to 2.85, I2 = 0%), death due to kidney disease (RR = 3.00, 95% CI 0.12 to 73.56, I2 = NA), chronic kidney disease (RR = 1.77, 95% CI 0.74 to 4.23, I2 = 0%), chronic renal failure (RR = 1.70, 95% CI 0.56 to 5.15, I2 = 61%) and acute kidney injury (RR = 1.16, 95% CI 0.95 to 1.42, I2 = 0%) showed no significant difference between patients receiving anti-inflammatory therapy and placebo.

CONCLUSION

Current evidence did not indicate associations between anti-inflammatory therapies and adverse renal events risks in patients with cardiovascular risks or established CVD. Future researches are needed to explore the renal effects of anti-inflammatory therapy.

The Effect of SGLT2 Inhibition on Brain-related Phenotypes and Aging: A Drug Target Mendelian Randomization Study

INTRODUCTION

An observational study suggested sodium-glucose cotransporter 2 (SGLT2) inhibitors might promote healthy aging. However, whether brain-related phenotypes mediate this association is still a question. We applied Mendelian randomization (MR) to investigate the effect of SGLT2 inhibition on chronological age, biological age, and cognition and explore the mediation effects of brain imaging-derived phenotypes (IDPs).

METHODS

We selected genetic variants associated with both expression levels of SLC5A2 (Genotype-Tissue Expression and eQTLGen data; n = 129 to 31 684) and hemoglobin A1c (HbA1c) levels (UK Biobank; n = 344 182) and used them to proxy the effect of SGLT2 inhibition. Aging-related outcomes, including parental longevity (n = 389 166) and epigenetic clocks (n = 34 710), and cognitive phenotypes, including cognitive function (n = 300 486) and intelligence (n = 269 867) were derived from genome-wide association studies. Two-step MR was conducted to explore the associations between SGLT2 inhibition, IDPs, and aging outcomes and cognition.

RESULTS

SGLT2 inhibition was associated with longer father's attained age [years of life increase per SD (6.75 mmol/mol) reduction in HbA1c levels = 6.21, 95% confidence interval (CI) 1.27-11.15], better cognitive function (beta = .17, 95% CI 0.03-0.31), and higher intelligence (beta = .47, 95% CI 0.19-0.75). Two-step MR identified 2 IDPs as mediators linking SGLT2 inhibition with chronological age (total proportion of mediation = 22.6%), where 4 and 5 IDPs were mediators for SGLT2 inhibition on cognitive function and intelligence, respectively (total proportion of mediation = 61.6% and 68.6%, respectively).

CONCLUSION

Our study supported that SGLT2 inhibition increases father's attained age, cognitive function, and intelligence, which was mediated through brain images of different brain regions. Future studies are needed to investigate whether a similar effect could be observed for users of SGLT2 inhibitors.

Multiplatform Lipid Analysis of the Brain of Aging Mice by Mass Spectrometry

Lipids are critical to brain structure and function, accounting for approximately 50% of its dry weight. However, the impact of aging on brain lipids remains poorly characterized. To address this, here we applied three complementary mass spectrometry techniques: multiple reaction monitoring (MRM) profiling, untargeted liquid chromatography tandem mass spectrometry (LC-MS/MS), and desorption electrospray ionization-MS imaging (DESI-MSI). We used brains from mice of three age groups: adult (3-4 months), middle-aged (10 months), and old (19-21 months). Phospholipids such as phosphatidylcholine, phosphatidylethanolamine, and phosphatidylglycerol were more abundant, while phosphatidylinositol and phosphatidylserine were reduced in old mice compared to adults or middle-aged mice. Key lipids such as polyunsaturated fatty acids, including DHA, AA, HexCer, SHexCer, and SM, were among the most abundant lipids in aged brains. DESI-MSI revealed spatial lipid distribution patterns consistent with findings from MRM profiling and LC-MS/MS. Integration of lipidomic data with the recently published proteomics data from the same tissues highlighted changes in proteins and phosphorylation levels of several proteins associated with Cer, HexCer, FA, PI, SM, and SHexCer metabolism, aligning with the multiplatform lipid surveillance. These findings shed insight into age-dependent brain lipid changes and their potential contribution to age-related cognitive decline.

Polysaccharides with Arabinose: Key Players in Reducing Chronic Inflammation and Enhancing Immune Health in Aging

Aging is associated with a decline in physiological performance leading to increased inflammation and impaired immune function. Polysaccharides (PLs) found in plants, fruits, and fungi are emerging as potential targets for therapeutic intervention, but little is known about their effects on chronic inflammation and aging. This review aims to highlight the current advances related to the use of PLs, with the presence of arabinose, to attenuate oxidative stress and chronic and acute inflammation, and their immunomodulatory effects associated with antioxidant status in monocytes, macrophages, and neutrophil infiltration, and leukocyte rolling adhesion in neutrophils. In addition, recent studies have shown the importance of investigating the 'major' monosaccharide, such as arabinose, present in several of these polysaccharides, and with described effects on gut microbiome, glucose, inflammation, allergy, cancer cell proliferation, neuromodulation, and metabolic stress. Perspectives and opportunities for further investigation are provided. By promoting a balanced immune response and reducing inflammation, PLs with arabinose or even arabinose per se may alleviate the immune dysregulation and inflammation seen in the elderly, therefore providing a promising strategy to mitigate a variety of diseases.

Glymphatic dysfunction and neurodegeneration in ALS: Longitudinal insights from rNLS8 TDP-43 mice

Dysfunctional Tar DNA binding protein-43 (TDP-43) is found in approximately 95 % of all people with amyotrophic lateral sclerosis (ALS). Recent evidence suggests that the glymphatic system, which clears the brain of waste proteins, is impaired in ALS and may contribute to the accumulation of TDP-43. This study extends this work to investigate how glymphatic function changes over time in the rNLS8 doxycycline (Dox)-dependent TDP-43 mouse model of ALS. Motor function, advanced MRI biomarkers of neurodegeneration, and cortical glymphatic pathway gene expression were assessed together with dynamic contrast-enhanced MRI (DCE-MRI) assessment of glymphatic function at 0-, 3-, 7-, and 21-days after removing mice from Dox feed to initiate cytoplasmic human TDP-43 expression. A trend toward increased glymphatic influx was observed at 3-days post-Dox, together with MRI evidence of brain changes that occurred in the absence of hind-limb clasping and motor impairment. Glymphatic flow is facilitated by aquaporin-4 (AQP4) water channels polarized to astrocytic end feet. We found that while glymphatic function normalized to control levels at 7-days post-Dox, AQP4 expression in the cortex was significantly decreased. After 3-weeks of human TDP-43 expression, glymphatic dysfunction, weight loss, neurodegeneration, motor impairments and astrogliosis were observed. Our findings highlight early glymphatic dysfunction in ALS, suggesting its potential as a therapeutic target.

Unveiling the cell-type-specific landscape of cellular senescence through single-cell transcriptomics using SenePy

Senescent cells accumulate in most tissues with organismal aging, exposure to stressors, or disease progression. It is challenging to identify senescent cells because cellular senescence signatures and phenotypes vary widely across distinct cell types and tissues. Here we developed an analytical algorithm that defines cell-type-specific and universal signatures of cellular senescence across a wide range of cell types and tissues. We utilize 72 mouse and 64 human weighted single-cell transcriptomic signatures of cellular senescence to create the SenePy scoring platform. SenePy signatures better recapitulate in vivo cellular senescence than signatures derived from in vitro senescence studies. We use SenePy to map the kinetics of senescent cell accumulation in healthy aging as well as multiple disease contexts, including tumorigenesis, inflammation, and myocardial infarction. SenePy characterizes cell-type-specific in vivo cellular senescence and could lead to the identification of genes that serve as mediators of cellular senescence and disease progression.

The Role of Hypoxia in Longevity

Aging is marked by a progressive decrease in physiological function and reserve capacity, which results in increased susceptibility to diseases. Understanding the mechanisms of driving aging is crucial for extending health span and promoting human longevity. Hypoxia, marked by reduced oxygen availability, has emerged as a promising area of study within aging research. This review explores recent findings on the potential of oxygen restriction to promote healthy aging and extend lifespan. While the role of hypoxia-inducible factor 1 (HIF-1) in cellular responses to hypoxia is well-established, its impact on lifespan remains complex and context-dependent. Investigations in invertebrate models suggest a role for HIF-1 in longevity, while evidence in mammalian models is limited. Hypoxia extends the lifespan independent of dietary restriction (DR), a known intervention underlying longevity. However, both hypoxia and DR converge on common downstream effectors, such as forkhead box O (FOXO) and flavin-containing monooxygenase (FMOs) to modulate the lifespan. Further work is required to elucidate the molecular mechanisms underlying hypoxia-induced longevity and optimize clinical applications. Understanding the crosstalk between HIF-1 and other longevity-associated pathways is crucial for developing interventions to enhance lifespan and healthspan. Future studies may uncover novel therapeutic strategies to promote healthy aging and longevity in human populations.

Exploring the link between fat-soluble vitamins and aging-associated immune system status: a literature review

The importance of vitamin D for a well-functioning immune system is becoming increasingly evident. Nevertheless, the other fat-soluble vitamins A, E and K also seem to play a central role regarding the adequate function of immune cells and to counteract excessive immune reactions and inflammatory processes. However, recognizing hidden hunger, particularly micronutrient deficiencies in vulnerable groups like the elderly, is crucial because older adults often lack sufficient micronutrients for various reasons. This review summarizes the latest findings on the immune modulating functions of fat-soluble vitamins in a physiological and pathophysiological context, provides a graphical comparison of the Recommended Daily Allowances between Deutschland, Austria, Confoederatio Helvetica (D-A-CH; eng. GSA, Germany, Switzerland, Austria), Deutsche Gesellschaft für Ernährung (DGE; eng. German Nutrition Society) and National Institutes of Health (NIH) across all age groups and, in particular, addresses the question regarding the benefits of supplementation of the respective micronutrients for the aging population of industrialized nations to strengthen the immune system. The following review highlights the importance of fat-soluble vitamins A, D, E and K which play critical roles in maintaining immune system function and, in some cases, in preventing excessive immune activation. Therefore, a better understanding of the relevance of adequate blood levels and consequently potential supplementation strategies may contribute to the prevention and management of infectious diseases as well as better overall health of the elderly.

Sheer drop ahead: reviewing sarcopenia outcomes in elderly patients undergoing bariatric surgery

The global prevalence of obesity among elderly patients continues to rise. Despite the availability of new antiobesity medications, bariatric surgery remains an effective treatment option for carefully selected candidates. However, it is not risk-free, especially in a vulnerable population, predisposing to falls, fractures and sarcopenia. Following bariatric surgery, there is rapid loss of muscle mass, particularly within the first 3 months. Muscle quality, on the other hand, characterized by functionality and indirectly assessed through strength tests, appears to be preserved. This is attributed to reductions in ectopic intramuscular fat deposits. Strategies to mitigate muscle loss and functional impairment include combined exercises (resistive and aerobic training), adequate protein and vitamin D intake, beta-hydroxy-beta-methylbutyrate (HMB) supplementation, and testosterone replacement therapy for men with confirmed hypogonadism. It is important to emphasize that, to date, no specific trial has evaluated the current sarcopenia criteria in elderly patients undergoing bariatric surgery. Therefore, future studies are needed to assess this particularly vulnerable population, not only to monitor changes in muscular health, but also to develop strategies for preventing therapeutic inertia.

Integrating electrocardiogram and fundus images for early detection of cardiovascular diseases

Cardiovascular diseases (CVD) are a predominant health concern globally, emphasizing the need for advanced diagnostic techniques. In our research, we present an avant-garde methodology that synergistically integrates ECG readings and retinal fundus images to facilitate the early disease tagging as well as triaging of the CVDs in the order of disease priority. Recognizing the intricate vascular network of the retina as a reflection of the cardiovascular system, alongwith the dynamic cardiac insights from ECG, we sought to provide a holistic diagnostic perspective. Initially, a Fast Fourier Transform (FFT) was applied to both the ECG and fundus images, transforming the data into the frequency domain. Subsequently, the Earth Mover's Distance (EMD) was computed for the frequency-domain features of both modalities. These EMD values were then concatenated, forming a comprehensive feature set that was fed into a Neural Network classifier. This approach, leveraging the FFT's spectral insights and EMD's capability to capture nuanced data differences, offers a robust representation for CVD classification. Preliminary tests yielded a commendable accuracy of 84%, underscoring the potential of this combined diagnostic strategy. As we continue our research, we anticipate refining and validating the model further to enhance its clinical applicability in resource limited healthcare ecosystems prevalent across the Indian sub-continent and also the world at large.

A biological age based on common clinical markers predicts health trajectory and mortality risk in dogs

Predicting aging trajectories through biomarkers of biological aging can guide interventions that optimize healthy lifespan in humans and companion animals. Differences in physiology, genetics, nutrition, and lifestyle limit the generalization of such biomarkers and may therefore require species-specific algorithms. Here, we compared correlations of standard clinical blood parameters with survival probability in humans with those of the two most common mammalian companion animals, cats and dogs, and highlighted universal and species-specific relationships. Based on this comparative analysis, we generated and validated an algorithm that predicts biological age in canines using a longitudinal dataset with health records, blood count, and clinical chemistry from 829 dogs spanning over 12 years. Positive deviations of biological from chronological age (AgeDev) measured by this composite score significantly correlated with a decreased survival probability (hazard ratio = 1.75 per 1 year of AgeDev, p = 3.7e - 06). Importantly, in nearly half of the dogs whose biological age was accelerated by more than 1 year, none or only a single individual marker scored outside its respective reference range, suggesting practical applications for the detection of unfavorable health trajectories. Analyzing samples from a unique 14-year life-long diet restriction study, we show that restricted caloric intake lowers biological age, an effect that can be quantified at midlife years before a difference in survival is observed. Thus, a biological age clock based on clinical blood tests predicts the health trajectories of dogs for use in research and veterinary practice.

Effective engagement in computerized cognitive training for older adults

Computerized cognitive training (CCT) is a frontline therapy to prevent or slow age-related cognitive decline. A prerequisite for CCT research to provide clinically relevant improvements in cognition is to understand effective engagement, i.e., the pattern of energy investment that ensures CCT effectiveness. Even though previous studies have assessed whether particular variables (e.g., gamification) predict engagement and/or CCT effectiveness, the field lacks a systematic approach to understanding effective engagement. Here, by comprehensively reviewing and evaluating engagement and adjacent literature, we propose a standardized measurement and operational framework to promote effective engagement with CCT targeting cognitive decline in older adults. We suggest that promoting effective engagement with CCT has two key steps: 1) comprehensively measuring engagement with CCT and 2) identifying which aspects of engagement are essential to achieve the pre-specified outcome of clinically relevant improvements in cognition. The proposed measurement and operational framework of effective engagement will allow future research to maximize older adults' engagement with CCT to slow/prevent age-related cognitive decline.

Stay social, stay young: a bioanthropological outlook on the processes linking sociality and ageing

In modern human societies, social interactions and pro-social behaviours are associated with better individual and collective health, reduced mortality, and increased longevity. Conversely, social isolation is a predictor of shorter lifespan. The biological processes through which sociality affects the ageing process, as well as healthspan and lifespan, are still poorly understood. Unveiling the physiological, neurological, genomic, epigenomic, and evolutionary mechanisms underlying the association between sociality and longevity may open new perspectives to understand how lifespan is determined in a broader socio/evolutionary outlook. Here we summarize evidence showing how social dynamics can shape the evolution of life history traits through physiological and genetic processes directly or indirectly related to ageing and lifespan. We start by reviewing theories of ageing that incorporate social interactions into their model. Then, we address the link between sociality and lifespan from two separate points of view: (i) considering evidences from comparative evolutionary biology and bioanthropology that demonstrates how sociality contributes to natural variation in lifespan over the course of human evolution and among different human groups in both pre-industrial and post-industrial society, and (ii) discussing the main physiological, neurological, genetic, and epigenetic molecular processes at the interface between sociality and ageing. We highlight that the exposure to chronic social stressors deregulates neurophysiological and immunological pathways and promotes accelerated ageing and thereby reducing lifespan. In conclusion, we describe how sociality and social dynamics are intimately embedded in human biology, influencing healthy ageing and lifespan, and we highlight the need to foster interdisciplinary approaches including social sciences, biological anthropology, human ecology, physiology, and genetics.

Circulating lipocalin-2 across the adult lifespan

Lipocalin-2 (LCN2), a hormone produced by adipocytes, osteoblasts, and renal tubular cells, is implicated in age-related diseases, including cardio-metabolic disease. To understand the role LCN2 may play in pathological states, we first need to elucidate the relationship between circulating LCN2 with indices of cardio-metabolic health during "normal" aging. This study examined the relationship between serum levels of LCN2, age, and cardio-metabolic measures across the adult lifespan in males and females. We conducted a pooled cohort analysis including 124 community-dwelling males (n = 52) and females (n = 72) (age 20-87 yr, median BMI 25.92 [23.04, 29.81] kg/m2). Serum LCN2 was analyzed using a two-step chemiluminescent microparticle monoclonal immunoassay. The relationship between LCN2 and age was evaluated by linear regression and cubic spline. Simple linear regressions were performed to investigate the relationship between LCN2 and the following variables: BMI, VO2peak, serum glucose, and body composition (DXA). For every 1 yr increase in age, LCN2 levels were 0.26 mg/L higher (P = .007, 95% CI [0.07, 0.45]). Each 1 unit increase in BMI (kg/m2) was associated with 0.88 mg/L higher LCN2 levels (P = .027, [0.10, 1.66]) and each 1 unit increase in VO2peak (mL/kg/min) was associated with 0.38 mg/L lower LCN2 (p = .003, [-0.63, -0.13]).There was no significant relationship between LCN2 and sex, glucose levels or body composition (all p > .05). LCN2 increased linearly across the adult lifespan while it decreased as fitness level increased. Future research should build on these findings to determine whether LCN2 can be used as a biomarker for chronic disease and if exercise can mitigate age-related disease associated with LCN2 changes.

Microvascular endothelial cells display organ-specific responses to extracellular matrix stiffness

The extracellular matrix was originally thought of as simply a cellular scaffold but is now considered a key regulator of cell function and phenotype from which cells can derive biochemical and mechanical stimuli. Age-associated changes in matrix composition drive increases in matrix stiffness. Enhanced matrix stiffness promotes the progression of numerous diseases including cardiovascular disease, musculoskeletal disease, fibrosis, and cancer. Macrovascular endothelial cells undergo endothelial dysfunction in response to enhanced matrix stiffness. However, endothelial cells are highly heterogeneous, adopting structural and gene expression profiles specific to their organ of origin. Endothelial cells isolated from different vessels (i.e. arteries, veins or capillaries) respond differently to changes in substrate stiffness. It is unknown whether microvascular endothelial cells isolated from different organs also display organ-specific responses to substrate stiffness. In this study, we compare the response of microvascular endothelial cells isolated from both the mouse lung and mammary gland to a range of physiologically relevant substrate stiffnesses. We find that endothelial origin influences microvascular endothelial cell response to substrate stiffness in terms of both proliferation and migration speed. In lung-derived endothelial cells, proliferation is bimodal, where both physiologically soft and stiff substrates drive enhanced proliferation. Conversely, in mammary gland-derived endothelial cells, proliferation increases as substrate stiffness increases. Substrate stiffness also promotes enhanced endothelial migration. Enhanced stiffness drove greater increases in migration speed in mammary gland-derived than lung-derived endothelial cells. However, stiffness-induced changes in microvascular endothelial cell morphology were consistent between both cell lines, with substrate stiffness driving an increase in endothelial volume. Our research demonstrates the importance of considering endothelial origin in experimental design, especially when investigating how age-associated changes in matrix stiffness drive endothelial dysfunction and disease progression.

Validation of a Smartphone Application for Monitoring Circadian Appetite: A Randomized Crossover Trial in Free-Living and Controlled Settings

BACKGROUND/OBJECTIVES

Appetite is affected by the circadian clock and exhibits diurnal variations. Nevertheless, accurately measuring subjective appetite throughout the day in a free-living setting poses a challenge. This study presents the validation of a novel smartphone application designed to capture, process and analyze circadian appetite fluctuations in a free-living setting.

METHODS

Twenty-four healthy participants (ages 38.34 ± 3.2 years) completed this randomized crossover study. Participants completed subjective appetite questionnaires every 30 min in a free-living environment, starting from waking hours until bedtime, using visual analog scale (VAS) via the pen and paper (PP) method and the new smartphone application (App). In addition, on two experimental days, separated by a week of washout, participants were provided either a high-energy breakfast (850 kcal) or a low-energy breakfast (250 kcal). Participants completed the appetite questionnaires using both methods every 30 min for 4 h, followed by an ad libitum lunch.

RESULTS

The high-energy breakfast led to significantly increased fullness sensation and decreased hunger, desire to eat, prospective consumption, and appetite score compared with the low-energy breakfast. There was no significant difference between the methods (PP and App) in all measured parameters under both the free-living environment and the controlled environment. Additionally, Bland-Altman analysis revealed a high degree of agreement between the PP and App methods. Moreover, most participants rated the App as the preferred method regardless of age.

CONCLUSIONS

Our findings show that the new smartphone application is a valid, reliable tool for measuring subjective appetite, suitable for use in chrononutritional studies conducted in a free-living environment and controlled settings.

The beneficial effects of curcumin on aging and age-related diseases: from oxidative stress to antioxidant mechanisms, brain health and apoptosis

Aging and age-related disease are among the most common and challenging issues worldwide. During the aging process, the accumulation of oxidative stress, DNA damage, telomere dysfunction, and other related changes lead to cellular dysfunction and the development of diseases such as neurodegenerative and cardiovascular conditions. Curcumin is a widely-used dietary supplement against various diseases such as cancer, diabetes, cardiovascular diseases and aging. This agent mediates its effects through several mechanisms, including the reduction of reactive oxygen species (ROS) and oxidative stress-induced damage, as well as the modulation of subcellular signaling pathways such as AMPK, AKT/mTOR, and NF-κB. These pathways are involved in cellular senescence and inflammation, and their modulation can improve cell function and help prevent disease. In cancer, Curcumin can induce apoptosis in a variety of different tumor cell lines. Curcumin also activates redox reactions within cells inducing ROS production that leads to the upregulation of apoptosis receptors on the tumor cell membrane. Curcumin can also upregulate the expression and activity of p53 that inhibits tumor cell proliferation and increases apoptosis. Furthermore, curcumin has a potent inhibitory effect on the activity of nuclear factor kappa B (NF-κB) and cyclooxygenase-2 (COX-2), which are involved in the overexpression of antiapoptosis genes such as Bcl-2. It can also attenuate the regulation of antiapoptosis phosphoinositide 3-kinases (PI3K) signaling and increase the expression of mitogen-activated protein kinases (MAPKs) to induce endogenous production of ROS. Therefore, herein, we aim to summarize how curcumin affect different epigenetic processes (such as apoptosis and oxidative stress) in order to change aging-related mechanisms. Furthermore, we discuss its roles in age-related diseases, such as Alzheimer, Parkinson, osteoporosis, and cardiovascular diseases.

Ageing, clinical complexity, and exercise therapy: a multidimensional approach

Ageing is a multidimensional concept related to the progressive decline in physiological functions. The decrease of physical autonomy due to the ageing process leads to frailty, which in turn is associated with disability and comorbidity. Ageing represents the primary risk factor for chronic degenerative diseases, especially involving cardiovascular, metabolic, respiratory, and osteoarticular systems, determining the decrease in activities and quality of daily life. Regular physical activity can significantly reduce the risk of chronic degenerative diseases, moderate or severe functional limitations, and premature death in older adults. In light of the relationship between ageing, sedentary lifestyle, disability, comorbidity, and physical activity, a clear need emerges within the health system. Better control on the territory of pathologies related to ageing with the management of clinical and care complexity, multidimensional and multi-professional evaluation of the elderly complex and fragile patient, also through the definition of specific outpatient packages for pathology that allow the simplification of the evaluation process. There is a need for integration between local services, hospitals, and social assistance services. Aim of this review is to highlight the importance of the multidimensional approach is essential to be able to classify the complex elderly patient according to a multi-professional vision aimed at evaluating comorbidities and frailties, including sarcopenia, nutritional deficits, functional capacity, and planning a personalized and monitored motor training program, to improve motor, metabolic, cardiovascular and respiratory functions. In addition, developing an integrated hospital-community-care services management program to follow up with patients post-care is crucial.

Public Interest in Research on Aging: Analysis of Altmetric Attention Scores Over 5 Years

This study pinpoints the areas in gerontological research that have commanded the most public attention as scored by Altmetric. We collected 12,740 outputs published in gerontological journals over 5 years from 2017 to 2022. Next, we identified the top 5% of outputs with the highest Altmetric Attention Scores. After removing duplicate publications and those without an abstract, 588 outputs remained. Our content analysis of the abstracts was conducted deductively and inductively. Theme 1 (50%; N = 293) revolved around "Health and Well-Being" (Theme 1). Theme 2 (28%; N = 164) was about "Health Services, Interventions and Innovations." Theme 3 was about "Informal and Long-Term Care" (13%; N = 80). Theme 4 focused on "Structural Inequalities" affecting older adults (9%; N = 51). Gerontologists should strengthen collaboration with other stakeholders to better engage the public across different age-related issues. These partnerships will enable the creation of initiatives that better serve the needs of aging populations.

Impact of insurance payer type (medicare vs. private) on the patient reported outcomes after shoulder arthroplasty

Background

This study's purpose is to determine if there is a difference in patient-reported outcome measures (PROMs) following shoulder arthroplasty (SA) based upon payer insurance type, with a secondary outcome of determining if any appreciable difference surpasses the minimal clinically important difference (MCID).

Methods

Subjects undergoing anatomic and reverse total shoulder arthroplasty were prospectively enrolled between March 2019 and March 2021. Subjects completed patient reported outcomes measurement information system upper extremity (P-UE), the American Shoulder and Elbow Surgeons score (ASES), and the simple shoulder test (SST) preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months, postoperatively. Descriptive statistics of baseline patient characteristics and preoperative PROMs (ASES, SST, and P-UE) were compared between insurance types.

Results

143 patients were identified who met the inclusion criteria for this study. There were 98 patients within the Medicare cohort and 45 patients with private insurance. Patients in the Medicare cohort were older (mean age 70.5 vs. 61.3 years), with high proportion of smokers, diabetics, and reverse total shoulder arthroplasty compared to the private payor cohort. There were no significant differences between the two cohorts with respect to outcomes scores except for significantly better SST in the private insurance cohort (69.3 vs. 79.4, P = .02). No significant differences were noted for the achievement of MCID between cohorts [P-UE (P = 1.0), ASES (P = .25), and SST (0.52)] and pre-to-postoperative improvements for P-UE (P = .62), ASES (P = .4), or SST (0.66).

Conclusion

Our study demonstrates that, at a tertiary-level academic institution in a metropolitan city, payor type does not have significant impact on achieving MCID or pre-to-postoperative improvements in PROMs after SA.