The aging population: demographics and the biology of aging

Development of a nomogram for overall survival prediction in primary upper lobe lung cancer patients: A SEER population-based analysis

BACKGROUND

The upper lobe is the most common site of primary lung cancer, however, very few reports focus on its prognosis. This study aims to identify prognostic factors of lung cancer in the upper lobe, as well as to establish an effective nomogram for individualized overall survival (OS) prediction.

METHODS

Patients diagnosed with lung cancer were collected from the Surveillance, Epidemiology, and End Results Program (SEER) database for the period of 2010-2017,as recorder in the 2021 SEER database release. The demographic characteristics and OS differed in the primary sites of the upper, middle and lower lobes were drawn. The primary upper lobe lung cancer patients were further stratified by the risk indicators including Mets at DX-bone, stage, histology, grade and sex; and their OS differences in stratification were compared by the Kaplan-Meier method and the Log-Rank test. The univariate and the multivariate Cox regression were employed to determine the independent prognostic factors for the primary upper lobe lung cancer and to build a nomogram model for its OS prediction.

RESULTS

Depending on the different primary sites of lung cancer occurrence, all the collected patients were divided into three groups of the upper lobe (30295 individuals), the middle lobe (2801 individuals) and the lower lobe (16757 individuals), where the upper lobe group gained our attention with the largest population and an overwhelmingly low OS compared to the middle lobe group (P <0.0001). With the results of the univariate and multivariate Cox regression model analyses, age, sex, grade, histology type, stage, regional lymph nodes removed, bone metastasis and liver metastasis were selected as the prognostic factors and a prediction nomogram model was built. The calibration curves showed no significant bias from the reference line and the concordance index between the survival nomogram prediction and the actual outcome for 2-year and 3-year OS was 0.761 (95% CI, 0.757-0.765). The time-dependent receiver operating characteristic curves showed that the areas under curve for 2-year and 3-year OS were 0.840 and 0.836, respectively.

CONCLUSION

A novel nomogram was established which achieved good performance in predicting the probability of OS in the primary upper lobe lung cancer, indicating its potential value in individualized prediction of the clinical outcome in these patients.

Wear investigation of implant-supported upper removable prothesis with electroplated gold or PEKK secondary crowns

OBJECTIVES

The aim of the present study was to investigate, whether polyetherketoneketone (PEKK) secondary crowns could be considered as alternative to gold standard in terms of their physical properties and manufacturing costs.

METHODS

An upper jaw model with six implants was used. Frameworks with either 6 PEKK- or 6 electroplated secondary crowns were cemented in a wear simulator. A total of 20 specimens (10 PEKK, 10 gold) run 10,000 cycles in the wear simulator with a lubricant. Additionally, 10,000 cycles in the thermocycling baths with 5 °C and 55 °C have gone through, before running extra 10,000 cycles in the wear simulator again. Finally, the abutments were analysed for signs of wear under the electron microscope.

RESULTS

The mean pulling out force value for PEKK was 21 N. For the electroplated gold secondary crowns an average of 19 N was measured. Multiple fluctuations were observed in the gold series of tests. After 20,000 cycles in the wear simulator and 10,000 cycles in the thermocycling machine, there were no major losses to be measured in terms of wear for both materials. In the microscopic analysis of the abutments, traces of wear could be seen in pull-out direction, mainly in the gold samples.

CONCLUSIONS

PEKK secondary crowns have lower costs, more stable retention force values and are easier to produce than the gold standard. On average, the pull-out force values were 11 N higher than recommended.

Suppression of NF-κB/NLRP3 by nanoligomer therapy mitigates ethanol and advanced age-related neuroinflammation

Binge alcohol use is increasing among aged adults (>65 yr). Alcohol-related toxicity in aged adults is associated with neurodegeneration; yet, the molecular underpinnings of this age-related sensitivity to alcohol are not well described. Studies utilizing rodent models of neurodegenerative disease reveal heightened activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and Nod-like receptor 3 (NLRP3) mediate microglia activation and associated neuronal injury. Our group, and others, have implicated hippocampal-resident microglia as key producers of inflammatory mediators; yet, the link between inflammation and neurodegeneration has not been established in models of binge ethanol exposure and advanced age. Here, we report binge ethanol increased the proportion of NLRP3+ microglia in the hippocampus of aged (18 to 20 mo) female C57BL/6N mice compared with young (3 to 4 mo). In primary microglia, ethanol-induced expression of reactivity markers and NLRP3 inflammasome activation were more pronounced in microglia from aged mice compared with young. Using a NLRP3-specific inhibitor (OLT1177) and a novel brain-penetrant Nanoligomer that inhibits NF-κB and NLRP3 translation (SB_NI_112), we find ethanol-induced microglial reactivity can be attenuated by OLT1177 and SB_NI_112 in microglia from aged mice. In a model of intermittent binge ethanol exposure, SB_NI_112 prevented ethanol-mediated microglia reactivity, IL-1β production, and tau hyperphosphorylation in the hippocampus of aged mice. These data suggest early indicators of neurodegeneration occurring with advanced age and binge ethanol exposure are driven by NF-κB and NLRP3. Further investigation is warranted to explore the use of targeted immunosuppression via Nanoligomers to attenuate neuroinflammation after alcohol consumption in the aging populations.

Microbial Production of Nicotinamide Mononucleotide: Key Enzymes Discovery, Host Cells Selection, and Pathways Design and Optimization

As an important bioactive substance in cells, nicotinamide mononucleotide (NMN) has been proven to play an important role in antiaging, treatment of neurodegenerative diseases, and cardioprotection. It presents a high potential for application in the research fields of functional foods, cosmetics, healthcare products, and active pharmaceuticals. With the increased demand, whether NMN can achieve large-scale industrial production has been a wide concern. The chemical synthesis method of NMN mainly faces the problems of separation, purification, and complex process control; in contrast, biosynthesis methods such as microbial fermentation and enzyme catalysis are considered to be the mainstream of the future industrial production of NMN due to the advantages of environmental friendliness, high efficiency, and simple separation. This review first describes the physiological functions of NMN and the related areas of its applications. Subsequently, it focuses on the research progress on different synthetic pathways of NMN in biosynthetic approaches, mining and modification of key enzymes, chassis cell design and optimization, and whole-cell catalysis. Meanwhile, the regulatory strategies, methods, and process control of the microbial synthesis of NMN are also elaborated, and the synthesis efficiencies of different chassis cells are systematically compared. Finally, this review summarizes the existing problems and challenges of microbial synthesis of NMN and proposes future strategies and directions to address these issues. This work provides technical references and a theoretical basis for researching efficient NMN microbial synthesis and application.

Association between methyl donor nutrients' dietary intake with phenotypic aging among US adults: a cross-sectional study from NHANES 2005-2018

This study investigates the association between dietary methyl donor nutrients intake and phenotypic aging. This cross-sectional study comprised 27,211 adult participants from the NHANES 2005-2018. The methyl-donor nutritional quality index (MNQI) was calculated by assessing the intake of the seven methyl donor nutrients: protein, folate, choline, riboflavin, vitamin B6, vitamin B12, and zinc. Phenotypic age acceleration (PhenoAge.Accel) was calculated using biochemical markers to assess biological aging. Weighted generalized linear regression models were utilized to assess the associations between MNQI and PhenoAge.Accel, and the impact of different demographic and health characteristics was evaluated through interaction effect tests. After adjusting for various potential confounding factors, a significant negative association was found between MNQI and PhenoAge.Accel (β = - 0.66; 95% CI - 0.91, - 0.40; P < 0.0001), indicating that an increase in MNQI is associated with a slowdown in PhenoAge.Accel. Furthermore, subgroup analysis indicated stronger negatively association between MNQI and PhenoAge.Accel in males (β = - 0.94; 95% CI - 1.36, - 0.52) with significant interactions (Pinteraction = 0.02). In adult populations, the dietary MNQI is negatively associated with PhenoAge Accel, suggesting that choosing high-quality methyl-donor foods can help develop effective nutritional strategies to enhance healthy longevity.

"Chew on This: Oral health is associated with cognitive function among Canadians enrolled in the Canadian Longitudinal Study on Aging"

OBJECTIVES

Life expectancy has increased globally, leading to a higher proportion of older adults, particularly in developed countries like Canada. This demographic shift strains healthcare systems and is associated with an increased risk of dementia, a condition characterised by cognitive decline. Oral health has emerged as a potential modifiable risk factor for dementia, yet the evidence remains conflicting. This study examines the association between oral health parameters and cognitive functioning in the Canadian population, utilizing data from the Canadian Longitudinal Study on Aging (CLSA).

METHODS

A cross-sectional analysis was conducted using baseline data from the comprehensive cohort of the CLSA, comprising 30,097 participants aged 45-85 years. Oral health was assessed via self-reported oral health (SROH) and masticatory ability (MA). Cognitive function was evaluated using a battery of neuropsychological tests, and a Cognitive Impairment Indicator (CII) was derived. Logistic regression models were employed to examine the association between oral health and cognitive impairment, adjusting for confounders.

RESULTS

We found that poor SROH was not significantly associated with cognitive impairment (OR = 1.19, 95 % CI = 0.63-2.09), while inadequate MA was significantly associated with higher odds of cognitive impairment (OR = 2.82, 95 % CI = 1.82-4.25).

CONCLUSION

The findings suggest a significant association between perceived MA and cognitive impairment within this cohort.. These results suggest that perceived ability to chew could be a potentially modifiable risk factor for cognitive decline. Further research is warranted to explore the mechanisms underlying these associations and to develop targeted preventive strategies.

CLINICAL SIGNIFICANCE

This paper highlights that middle aged and elderly Canadians with inadequate MA have a 2.82 times higher odds of experiencing cognitive impairment. Addressing chewing difficulties may serve as a modifiable risk factor for early cognitive decline, offering a potential window of opportunity to slow down the process of cognitive decline among aging populations.

The Global Burden of Atopic Dermatitis in Elderly Populations: Trends, Disparities, and Future Projections

Background: Atopic dermatitis (AD) is a common chronic inflammatory skin disease often affecting infants. However, its significance in adult populations is increasingly recognized. Notably, its prevalence and impact among elderly individuals remain poorly understood, highlighting the need for a deeper understanding of its global burden. This study aims to evaluate the prevalence, incidence, and Disability-Adjusted Life Years (DALYs) of AD in individuals aged 60 and older from 1990 to 2021, with projections to 2045. Methods: Data from the Global Burden of Disease (GBD) Study were used to analyze trends in the global burden of AD by region and sex. Key metrics were calculated using annual average percentage changes (AAPC). Based on historical trends, projections for 2022-2045 were developed. Results: In 2021, the prevalence of AD in the elderly exhibited substantial regional variation, with the highest rates observed in Northern Europe and North America. Although global prevalence slightly declined from 1990 to 2021, females consistently demonstrated a higher burden than males. Projections indicate a substantial increase in AD cases by 2045, particularly among elderly females, with the 60-64 age group expected to exceed 4 million cases. The disease burden correlated with Universal Health Coverage (UHC) indices, suggesting healthcare access impacts disease reporting and management. Conclusions: The increasing burden of AD, especially in elderly females, highlights the urgent need for targeted healthcare strategies to manage AD in aging populations. Further research is required to address regional and gender disparities in AD care.

Ferroptosis in neurodegenerative diseases: mechanisms and therapeutic potential of stem cell derivatives

Ferroptosis, a non-apoptotic, iron-dependent form of regulated cell death, is closely related to the pathogenesis of neurodegenerative diseases. Stem cells and their derivatives exhibit remarkable potential in modulating ferroptosis, offering promising therapeutic intervention for neurodegenerative diseases. In this review, we systematically explore neurological aging and its association with cognitive impairment and neurodegenerative diseases, with focus on the molecular mechanisms of ferroptosis in neurodegenerative diseases and the potential therapeutic strategies of stem cell derivatives for neurological diseases.

Burden of disease and risk factors for primary liver cancer by etiology in the United States, 1990-2021: Results from the Global Burden of Disease study, 2021

INTRODUCTION AND OBJECTIVES

The distribution of major causes of liver cancer (LC) in the United States (US) has changed significantly over time. This study analyzes recent temporal trends in the causes of LC in the US from 1990 to 2021 and predicts future trends.

MATERIALS AND METHODS

We obtained detailed data on LC in the US from the Global Burden of Disease (GBD) 2021 study. Estimated annual percentage change (EAPC) values for LC in the US were then calculated using linear regression models. An exponential smoothing (ES) projection model and Bayesian Age-Period-Cohort (BAPC) projection model were then used to predict the future disease burden of LC. Risk factors for LC were also assessed.

RESULTS

In 2021, the disease burden of LC in the US was significantly higher than in 1990. Hepatitis C virus (HCV)-associated LC resulted in the greatest burden of disease. The fastest growing burden of disease was attributed to metabolic dysfunction-associated steatotic liver disease (MASLD)-associated LC. Higher burdens of disease were seen in older and male populations.

CONCLUSIONS

In the US, the disease burden of LC from different etiologies continues to rise. As such, targeted prevention and control strategies should be developed to address these unique disease characteristics.

Robot-assisted radical cystectomy with the clinical application of "Y-shaped" end-to-side ureteral anastomosis in elderly and obese patients

OBJECTIVE

To investigate the clinical effect and safety of "Y-shaped" end-to-side ureteral anastomosis with robotic endoscopic technique in radical cystectomy (RC) and urinary diversion (UD) in elderly and obese patients with bladder cancer.

MATERIALS AND METHODS

We retrospectively reviewed the records of 10 patients with bladder cancer who underwent robot-assisted laparoscopic radical cystectomy and "Y-shaped" end-to-side ureteral anastomosis under general anesthesia at Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China, 310014) from October 2018 to January 2021. Demographic and clinical data are summarized. The incidence of postoperative complications such as papillary retraction, ureteral stricture, anastomotic stenosis, anastomotic fistula and ureteral calculi were observed and analyzed.

RESULTS

A total of 10 elderly and obese patients successfully underwent RC with "Y-shaped" end-to-side ureteral anastomosis in this research. Median age was (80.6 ± 5.7) y and BMI was (25.12 ± 3.83) kg/m2. The operation time was (95 ± 26) min and the estimated intraoperative blood loss was (100.5 ± 35.6) ml, with no perioperative blood transfusion and no readmission 30 days after operation. No serious complications above Clavien-Dindo grade 4 occurred in the early (≤ 30 d) and late (> 30 d) after surgery. 1 patient developed fever three days after operation and was cured by strengthening anti-infection. 1 patient had a small amount of urine leakage at the anastomotic site after operation, and recovered after strengthening nutrition and maintaining the patency of abdominal drainage tube and single J tube. Postoperatively, the patients replaced the single J tube regularly and were followed up for 3-28 months (average 15 months) until April 10, 2021. In two cases, the ureterostomy nipple was slightly retracted and collapsed without special treatment. one case formed ureteral calculi and was treated conservatively. No ureteral stenosis, necrosis, anastomotic stenosis or severe anastomotic fistula, hernia around the stoma occurred. No visceral metastases or new lesions of urothelial carcinoma were observed. All patients were satisfied with the postoperative quality of life.

CONCLUSIONS

The robot-assisted "Y-shaped" end-to-side ureteral anastomosis technique performed intracorporeally seems to be a straightforward, secure, and viable approach. It is considered suitable for radical resection of bladder cancer and urinary diversion in elderly and obese patients.

Immunosenescence promotes cancer development: from mechanisms to treatment strategies

The body's innate immune system plays a pivotal role in identifying and eliminating cancer cells. However, as the immune system ages, its functionality can deteriorate, becoming dysfunctional, inefficient, or even inactive-a condition referred to as immunosenescence. This decline significantly increases the risk of malignancies. While the pro-cancer effects of T-cell aging have been widely explored, there remains a notable gap in the literature regarding the impact of aging on innate immune cells, such as macrophages and neutrophils. This review seeks to address this gap, with emphasis on these cell types. Furthermore, although certain cancer immunotherapies, including immune checkpoint inhibitors (ICIs), have demonstrated efficacy across a broad spectrum of cancers, elderly patients are less likely to derive clinical benefit from these treatments. In some cases, they may even experience immune-related adverse events (irAEs). While senolytic strategies have shown promise in exerting anti-cancer effects, their adverse reactions and potential off-target effects present significant challenges. This review aims to elucidate the pro-cancer effects of immunosenescence, its implications for the efficacy and safety of ICIs, and potential anti-aging treatment strategies. In addition, optimizing anti-aging therapies to minimize adverse reactions and enhance therapeutic outcomes remains a critical focus for future research endeavors.

Exploring the potential of mucoadhesive buccal films in geriatric medicine

As the global demographic shifts toward an aging society, the geriatric patient population is steadily increasing. These patients often suffer from comorbidities and require numerous oral medications, which can be especially challenging for dysphagic geriatric patients. Mucoadhesive buccal films (MBFs) seem promising and could reduce pill burden, simplify administration, and enable individualized drug therapy. This review aims to explore the age-related changes in the oral cavity and their impact on MBF delivery, including potential strategies to overcome these age-related barriers to drug delivery. It was observed that aging impacts the oral mucosa as well the properties of the saliva. There are several studies in the application of buccal films including the use of a wide range of permeation enhancers. The 3D printing of buccal films seems to introduce dosing flexibility to buccal film manufacturing.

Time trends in coronary heart disease mortality attributed to outdoor PM2.5 in China: an age-period-cohort analysis using the Global Burden of Disease Study 2019

Background

In China, coronary heart disease (CHD) is a significant public health issue affecting the population's health. Evidence suggests that outdoor PM2.5 is a crucial environmental risk factor for CHD mortality. This study aims to provide scientific evidence for the prevention and treatment of CHD by analyzing the trend of CHD mortality attributed to outdoor PM2.5 in China from 1994 to 2019.

Methods

Data were obtained from the Global Burden of Disease Study (GBD) 2019. CHD mortality attributed to outdoor PM2.5 in China from 1994 to 2019 was extracted from the GBD Data tool. We used an age-period-cohort (APC) model based on the intrinsic estimator (IE) algorithm to decompose the age, period, and cohort effects related to CHD mortality attributed to outdoor PM2.5.

Results

From 1994 to 2019, the crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs) of CHD attributed to outdoor PM2.5 in China showed an overall upward trend. The APC model analysis showed that the relative risk of CHD mortality attributed to outdoor PM2.5 increased exponentially with age, reaching 89.284 (95% CI: 48.669, 163.793) in the 90-95 age group. The period effect increased monotonically, with a relative risk of 3.699 (95% CI: 3.639, 3.760) in 2019. The cohort effect decreased monotonically, with the lowest relative risk of CHD mortality attributed to outdoor PM2.5 in residents born between 1990 and 1994, at 0.135 (95% CI: 0.031, 0.588).

Conclusion

The older adult, a high-risk population, should receive more attention. In the future, continuous efforts should be made to strengthen environmental air pollution control and implement targeted health interventions to reduce the impact of outdoor PM2.5 on CHD mortality.

Elevated Serum Copper, Zinc, Selenium, and Lowered α-Klotho Associations: Findings from NHANES 2011-2016 Dataset

The α-Klotho is crucial for human health and longevity. However, the relationship between trace elements and α-Klotho levels needs further investigation. We aimed to explore the relationship between serum levels of selenium (Se), copper (Cu), and zinc (Zn), and serum α-Klotho levels. We analyzed 2138 samples from the 2011-2016 National Health and Nutrition Examination Survey, and the weighted linear regression, WQS, and qgcomp models were utilized to evaluate the effects of these elements on serum α-Klotho levels, individually and combined. A negative correlation was observed between serum Cu concentration and serum α-Klotho levels (β =  - 0.128, 95% CI - 0.196, - 0.059), with each increase in Cu concentration grade showing a gradual decrease in serum α-Klotho levels (Ptrend = 0.002). The WQS model exhibited a negative correlation between the combined effect of Se, Cu, and Zn and serum α-Klotho levels (β =  - 0.035, 95%CI - 0.060, - 0.010), consistently in males (β =  - 0.038 (- 0.059, - 0.017)) and in the 40-49 age group (β =  - 0.059, 95% CI - 0.119, - 0.012). The qgcomp model mirrored these findings, showing a negative correlation in the combined effect index of Se, Cu, and Zn with serum α-Klotho levels (β =  - 0.027, 95% CI - 0.047, - 0.006), consistent in females (β =  - 0.032, 95% CI - 0.061, - 0.004) and in individuals with BMI ≥ 25 (β =  - 0.030, 95% CI - 0.054, - 0.006), and in the 40-49 age group (β =  - 0.047, 95% CI - 0.088, - 0.006). Elevated serum Cu levels may be associated with lower serum α-Klotho levels. The combined effect of serum Se, Cu, and Zn shows a negative correlation with serum α-Klotho levels, with Cu contributing the most. Our findings provide significant insights into assessing the role of trace nutrients in maintaining human health.

Association between air pollution and osteoporosis: A Mendelian randomization study

Osteoporosis (OP) is a significant disease in the aging society, which poses a threat to the physical well-being of older adults. Some studies suggest that air pollution may contribute to an increased incidence of OP; however, this causal relationship has not been firmly established. To address this gap, we conducted Mendelian randomization (MR) analysis to assess the potential causal association between air pollution (including nitrogen dioxide [N = 456,380], nitrogen oxides [N = 456,380], particulate matter [PM]2.5 [N = 423,796], and PM10 [N = 455,314]) and total-body bone mineral density (BMD) (N = 56,284). We utilized summary data from IEU Open GWAS on the database of genome-wide association studies (GWAS) and employed inverse variance weighting (IVW) as our primary analytical approach. The findings from our MR study in the European population using the IVW method indicated a potential causal link between nitrogen oxides: β = -0.59, confidence interval (CI) = (-1.03 to -0.16), P = 0.008; PM2.5: β = -0.60, CI = (-1.12 to -0.08), P = .025. These results suggest that there might be a causative relationship between nitrogen oxides, PM2.5, and BMD with regards to OP development among individuals exposed to air pollution. Importantly, the observed associations passed all statistical tests without any evidence of heterogeneity or pleiotropy. Furthermore, the presence of air pollution was found to be associated with an elevated risk of developing OP. This study provides compelling evidence for a causal connection between nitrogen oxides, PM2.5, and OP, suggesting that reducing air pollution could play a crucial role in preventing OP development.

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.

Investigation and analysis of sleep and mental health status among MEFCs

Objective

To investigate the sleep status and mental health of migrants elderly who followed their children (MEFC) and analyze the influencing factors.

Methods

A total of 583 MEFCs were surveyed using a general demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) scale, and the Symptom Checklist 90 (SCL90) scale.

Results

The mean PSQI score for MEFCs was 6.98 ± 0.17, and the average SCL90 score was 64.06 ± 2.03. Multiple linear regression analysis indicated that health status and adaptation to the migration destination were associated with PSQI scores (P < 0.05). Health status, adaptation to the migration destination, and family harmony were associated with SCL90 scores (P < 0.05). The association coefficient between the total PSQI and SCL90 scores was r=0.462 (P < 0.05).

Conclusion

The sleep and mental health of MEFCs were at a normal level. Health status and adaptation influenced sleep status, while health status, adaptation, and family harmony impacted mental health. However, the association between mental health and sleep status was weak.

Dietary carotenoid intakes and biological aging among US adults, NHANES 1999-2018

BACKGROUND

Carotenoids have been shown to have multiple health benefits, including antioxidant and anti-inflammatory. The data for the effect of dietary specific carotenoids on biological aging is limited. Our study aims to examine the association between dietary carotenoid intake levels and biological aging.

METHODS

This cross-sectional study was performed among 27,338 adults from NHANES 1999-2018. Dietary intake was assessed through two 24-hour dietary recall interviews. Biological aging indices included allostatic load (AL), homeostatic dysregulation (HD), Klemera-Doubal method (KDM), and phenoAge (PA). Multiple linear regression, weighted quantile sum (WQS) regression and quantile g-computation (QG-comp) were used to explore the associations of single carotenoid and mixed carotenoids with biological aging.

RESULTS

Associations between dietary carotenoid intake levels and biological aging indices were significant among adults across the United States. Multiple linear regression showed that most carotenoids were significantly negatively correlated with AL (β = -0.017 - -0.011), HD (β = -0.045 - -0.032), KDM (β = -0.984 - -0.471), and PA (β = -0.975 - -0.539). Subgroup analysis indicated that male, older individuals, smokers, alcohol drinkers, and less physically active individuals are particularly sensitive populations. Meanwhile, WQS regression and QG-comp analyses consistently indicated a negative association between mixed carotenoids exposure and four biological aging indices, highlighting that lutein/zeaxanthin and β-carotene were responsible for the outcomes.

CONCLUSIONS

Increased dietary intakes of various carotenoids were associated with lower biological aging indices, which was possibly and mainly driven by lutein/zeaxanthin and β-carotene.

DNA methylation of transposons pattern aging differences across a diverse cohort of dogs from the Dog Aging Project

Within a species, larger individuals often have shorter lives and higher rates of age-related disease. Despite this well-known link, we still know little about underlying age-related epigenetic differences, which could help us better understand inter-individual variation in aging and the etiology, onset, and progression of age-associated disease. Dogs exhibit this negative correlation between size, health, and longevity and thus represent an excellent system in which to test the underlying mechanisms. Here, we quantified genome-wide DNA methylation in a cohort of 864 dogs in the Dog Aging Project. Age strongly patterned the dog epigenome, with the majority (66% of age-associated loci) of regions associating age-related loss of methylation. These age effects were non-randomly distributed in the genome and differed depending on genomic context. We found the LINE1 (long interspersed elements) class of TEs (transposable elements) were the most frequently hypomethylated with age (FDR < 0.05, 40% of all LINE1 regions). This LINE1 pattern differed in magnitude across breeds of different sizes- the largest dogs lost 0.26% more LINE1 methylation per year than the smallest dogs. This suggests that epigenetic regulation of TEs, particularly LINE1s, may contribute to accelerated age and disease phenotypes within a species. Since our study focused on the methylome of immune cells, we looked at LINE1 methylation changes in golden retrievers, a breed highly susceptible to hematopoietic cancers, and found they have accelerated age-related LINE1 hypomethylation compared to other breeds. We also found many of the LINE1s hypomethylated with age are located on the X chromosome and are, when considering X chromosome inactivation, counter-intuitively more methylated in males. These results have revealed the demethylation of LINE1 transposons as a potential driver of intra-species, demographic-dependent aging variation.

Phage therapy as an alternative strategy for oral bacterial infections: a systematic review

BACKGROUND

Oral infectious diseases, such as dental caries, periodontitis and periapical periodontitis, are often complicated by causative bacterial biofilm formation and significantly impact human oral health and quality of life. Bacteriophage (phage) therapy has emerged as a potential alternative with successful applications in antimicrobial trials. While therapeutic use of phages has been considered as effective treatment of some infectious diseases, related research focusing on oral infectious diseases is few and lacks attention. Therefore, a systematic review was conducted to comprehensively evaluate the overall efficacy of phages in reducing bacterial infections associated with various oral diseases.

METHODS

A systematic search of PubMed, MEDLINE and Web of Science for literature published up to May 2024 was conducted according to inclusion criteria to identify studies assessing bacteriophages as potential therapy for oral infectious diseases. A total of four authors assessed study eligibility and performed data extraction.

RESULTS

A total of 487 articles published between 1975 and 2024 were retrieved. Among the 10 eligible reports, preliminary studies have been conducted on seven types of phages and reported their antibacterial effect. To be more specific, 3 contained data on dental caries (n = 32), 5 focused on periodontitis (n = 105) and 2 examined periapical diseases (n = 7). The majority of publications (9 out of 10) discussed the impact of phages on biofilm formation. Only one report (1 out of 10) mentioned the safety concern in phage application.

CONCLUSIONS

This review strongly suggests that phages isolated from oral cavity with certain characteristics can be highly effective and are considered suitable candidates for phage therapy in treating oral/odontogenic infections caused by bacteria.

Distal Access Catheter Improves Balloon Guide and Stent Retriever Thrombectomy Outcomes in Nonagenarians

BACKGROUND AND PURPOSE

The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR).

METHODS

We analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group). Demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale score at 24 h [24h-NIHSS] and modified Rankin Scale score at 3 months) were compared. Predictors of the first-pass effect (FPE), defining Modified Treatment In Cerebral Ischemia 2c-3 (mTICI 2c-3) after one pass, were explored.

RESULTS

Of the 4111 patients from the ROSSETTI registry, 243 nonagenarians (68.7% female) were included in the analysis. The distribution of endovascular techniques was 101-group (61.4%), 111-group (15.6%), and 011-group (23%). The 101-group and 111-group had significantly shorter procedural times than the 011-group. The 111-group had a higher FPE rate, a lower number of passes, and a higher rate of final mTICI ≥2c than the other groups. The 24h-NIHSS score was significantly lower in the 111-group. In multivariate analysis, the only independent predictor for FPE was the BGC+DAC+SR endovascular technique (odds ratio 2.74 [confidence interval 1.16-6.47]; p = 0.021).

CONCLUSIONS

The addition of a DAC to a BGC increases the likelihood of FPE in nonagenarians with anterior circulation LVO SR-based thrombectomy for acute stroke.

Prevalence and influencing factors of skin tears in older adults: A systematic review and meta-analysis

OBJECTIVE

To systematically evaluate the prevalence and influencing factors of skin tears in older adults.

METHODS

The Cochrane Library, Web of Science, Embase, PubMed, CNKI, VIP, WanFang Data, and CBM databases were searched to collect studies related to the prevalence and influencing factors of skin tears in older adults, and the search period was from inception to October 29, 2024. The examined literature was independently screened, data extracted, and evaluated for risk of bias, and the meta-analysis was performed using Stata17.0.

RESULTS

A total of 23 studies with a sample size of 59,489 older adults were included. Meta-analysis showed that the prevalence of skin tears in older adults was 6.5 % (95 % CI: 4.7 %-8.4 %, P < 0.01). A history of skin tears (OR = 9.30, 95 % CI: 1.66-52.25, P = 0.012), purpura (OR = 3.26, 95 % CI: 2.14-4.98, P < 0.01), and a risk of having a pressure injury (OR = 2.60, 95 % CI: 1.10-6.13, P = 0.029) were associated with skin tears in older adults.

CONCLUSIONS

Current evidence suggests that older adults have a high prevalence of skin tears. Skin tears in older adults are influenced by a history of skin tears, purpura, and a risk of having a pressure injury. Early screening should be conducted on the influencing factors of skin tears, and targeted intervention measures should be developed to reduce the impact of adverse outcomes on older adults and optimize the management of skin tears.

Ultrasonographic characteristics of the shoulder in patients with shoulder pain: A retrospective study comparing younger and older age groups

BACKGROUND

Shoulder pain can be caused by structures within the shoulder joint or external structure to shoulder and the prevalence of shoulder pain is high.

OBJECTIVE

The purpose was to investigate the ultrasonographic characteristics of patients with shoulder pain and to study the association between age groups (less than 60 years vs. 60 years and above) and commonly found abnormal ultrasonographic findings.

METHODS

A retrospective study was conducted on 253 patients experiencing shoulder pain over a month. Data included gender, age, side of pain, pain duration, painful area, previous treatments, clinical assessment of shoulder pain. The abnormal findings in shoulder ultrasound images were reported, and the association between age group with common ultrasound abnormalities were analyzed using the chi-square test.

RESULTS

Common abnormal ultrasound findings included subdeltoid bursitis (82.7%), biceps tendon effusion (48.7%), and supraspinatus tendinosis (44.2%). Moreover, patients aged 60 years and above had a significantly higher prevalence of biceps tendon effusion (53.6% vs 36.0%), supraspinatus tendon tear (19.3% vs 8.6%) and subscapularis tendon tear (6.1% vs 1.4%) compared to those aged less than 60 years.

CONCLUSION

The common abnormal ultrasound findings in patients with shoulder pain were subdeltoid bursitis, biceps tendon effusion and supraspinatus tendinosis. Patients aged 60 years and above had a significantly higher prevalence of biceps tendon effusion and tears in the supraspinatus and subscapularis tendons.

Causality of genetically determined glucosamine supplementation on cognition and sarcopenia: a Mendelian randomization study

BACKGROUND

Evidence indicates a negative link between glucosamine and age-related cognitive decline and sarcopenia. However, the causal relationship remains uncertain. This study aims to verify whether glucosamine is causally associated with cognitive function and sarcopenia.

METHOD

Forty-eight genetic variants linked to glucosamine use were extracted from the MRC-IEU consortium. Besides, we gathered cognition proxy indicators [cognitive performance and fluid intelligence score (FIS)], and sarcopenia-related indicators, namely, appendicular lean mass (ALM), whole body fat-free mass (WBFM), low hand grip strength, facial aging (FA), moderate to vigorous physical activity levels, usual walking pace and DNA methylation GrimAge acceleration from the large publicly available genome-wide association studies. Initially, Mendelian randomization (MR) analyses were conducted to ascertain the causal impact of glucosamine on cognition and sarcopenia-related traits. Subsequently, the two-step MR and multivariable MR (MVMR) were employed to examine whether any mediators causally mediated the observed associations.

RESULT

MR analysis indicated that glucosamine was associated with increased cognitive performance (p = 8.46E-04), FIS (p = 7.50E-04), ALM (p = 6.45E-08), WBFM (p = 1.97E-03), usual walking pace (p = 2.55E-07), and moderate to vigorous physical activity levels (p = 3.29E-03), but associated with decreased FA risk (p = 3.77E-05) and DNA methylation GrimAge acceleration (p = 0.001). However, there were no significant causal associations between glucosamine and low hand grip strength. Multivariable MR showed that glucosamine continued to have a significant effect on cognitive performance, FIS, ALM, WBFM, usual walking pace, and moderate to vigorous physical activity levels after controlling for osteoarthritis (OA) and body mass index (BMI) (p < 0.05). We further found that C-reactive protein levels (CRP) may mediate the association of glucosamine and ALM, WBFM, usual walking pace, and physical activity (p < 0.05), and basal metabolic rate (BMR) may mediate the association of glucosamine and cognitive performance, FIS, ALM, WBFM, and usual walking pace (p < 0.05).

CONCLUSION

Regular glucosamine use enhances cognitive function and postpones sarcopenia for preserving the functional capacities necessary, and the impact of glucosamine on cognition and sarcopenia could be partially attributed to the mediation of BMR and CRP.

Investigating cognitive impairments and hippocampal proteome alterations in aged male rats with TAA-Induced minimal hepatic encephalopathy

The aging population faces a gradual decline in physical and mental capacities, with an increased risk of liver cirrhosis and chronic liver diseases leading to hepatic encephalopathy (HE). The intertwining of physiological manifestations of aging with the pathophysiology of HE significantly impairs cognitive ability, reduces quality of life, and increases mortality. Hence, effective therapeutic intervention is imperative. The present study investigated the impact of minimal HE (MHE) on cognitive impairment in an aged rat population by analyzing hippocampal proteome dynamics. For this purpose, an old MHE rat model was induced via thioacetamide. The label-free LC‒MS/MS method was employed to explore hippocampal proteomic changes and associated dysregulated biological pathways. A total of 1533 proteins were identified, and among these, 30 proteins were significantly differentially expressed (18 upregulated, and 12 downregulated). Three upregulated proteins, namely, fetuin-A, p23, and intersectin-1 were selected and validated for their increased expression via western blotting and immunofluorescence analysis, which confirmed the mass spectrometry results. These proteins have not been reported previously in MHE cases. We also identified the possible dysregulated biological pathways associated with the differentially expressed proteins via Metascape, a network analysis tool. We found that the differentially expressed proteins may be involved in the generation of precursor metabolites and energy, the neurotransmitter release cycle, positive regulation of dendritic spine development, chaperone-mediated protein folding and protein stabilization. This study highlights the potential mechanisms underlying neurological dysfunction in the aged population with MHE and identifies novel therapeutic targets for improved disease management.

Trend, disparities, and projection analysis of public data on shoulder fractures in Sweden: a retrospective analysis of two hundred and sixty two thousand, four hundred and forty four fractures

PURPOSE

We aimed to identify temporal trends, seasonal changes and regional differences in shoulder fractures in Sweden during 2008-2022.

METHODS

Data from the Swedish National Board of Health and Welfare were used to assess incidence rates per 100,000 people, categorized by sex, age, and month.

RESULTS

Results showed an average of 17,496 fractures annually, with a decline in 2020 followed by a resurgence in 2021-2022. Elderly women, especially those over 65, had higher rates. Winter months exhibited increased incidence.

CONCLUSIONS

Projection analysis indicated a gradual decrease in fractures over the next 15 years. Understanding these patterns can inform preventive strategies and resource allocation for shoulder fractures in Sweden.

A competing-risk nomogram for predicting gastric cancer-specific survival in patients over 70 years: A SEER-based study

BACKGROUND

Cancer-specific survival in older patients with gastric cancer is competitively affected by death from other causes. This study aimed to investigate cancer-specific survival and associated risk factors by competing-risk analysis in older patients with gastric cancer.

METHODS

The data of this study are from the SEER database, using univariable and multivariable analysis of competitive risk model to weaken the impact of competitive events, explore the risk factors of cancer-specific survival, and developed a nomogram model. Then, the performance of the model is verified by C-index, ROC curve, calibration curve and DCA, and the new model is compared with the traditional TNM stage by NRI and IDI.

RESULTS

Our study encompassed a total of 8183 patients, with 5731 in the training cohort and 2452 in the validation cohort. Univariable and multivariable analysis showed that age, years of diagnosis, race, site, SEER stage, TNM stage, surgery, radiation or chemotherapy, LNE, tumor grade and size are independent risk factors for cancer-specific survival in older patients with gastric cancer. Based on the risk factors, we developed a diagram model to predict cancer-specific survival. C-index, ROC curve, calibration curve and DCA also show good results. We compared the new model with the traditional TNM stage model, and the NRI and IDI showed the new model has been significantly improved.

CONCLUSION

This study developed a nomogram to predict the cancer-specific survival of older patients with gastric cancer, which can accurately predict the prognosis and contribute to clinical treatment decision-making.

Associations between ethylene oxide exposure and biological age acceleration: evidence from NHANES 2013-2016

Introduction

Population aging is a global concern, with the World Health Organization predicting that by 2030, one in six individuals worldwide will be 60 years or older. Ethylene oxide (EO) is a widely used industrial chemical with potential health risks, including associations with age-related diseases. This study investigates the relationship between EO exposure and biological age acceleration.

Method

Data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 were analyzed, including 3,155 participants after exclusions. Blood EO levels were measured using hemoglobin adducts (HbEO). Biological age acceleration was assessed using two methods: Phenotypic Age Acceleration (PhenoAgeAccel) and Klemera-Doubal Method Age Acceleration (KDM-AA). Linear and logistic regression models were applied, adjusting for various covariates, and restricted cubic spline (RCS) regression was used to explore non-linear associations.

Results

Higher EO exposure was significantly associated with increased PhenoAgeAccel and KDM-AA across all models. In the continuous model, substantial positive associations were observed (PhenoAgeAccel: β = 0.73, p < 0.001; KDM-AA: β = 0.66, p < 0.001) in Model 3. Quintile analysis indicated a trend of increasing biological age acceleration with higher EO exposure. RCS regression demonstrated a significant linear relationship between EO exposure and PhenoAgeAccel (p for non-linearity = 0.067), as well as with KDM-AA (p for non-linearity = 0.083). Subgroup and interaction analyses revealed significant modifying effects by factors such as body mass index, gender, diabetes status, and physical activity level.

Conclusion

Our study demonstrates a significant association between EO exposure and accelerated biological aging. These findings highlight the need for further prospective and mechanistic studies to validate and explore this phenomenon.

Knowledge and Experiences of Oral Health Care and Periodontitis of Caregivers of Older Adults With Cognitive Impairment

BACKGROUND AND OBJECTIVES

There is limited evidence on knowledge of related health among healthcare personnel who care for older adults. The objective of this study was to investigate the knowledge and experience of oral health care among family members and medical staff responsible for older adults with varying degrees of cognitive impairment and Alzheimer's disease.

MATERIALS AND METHODS

This qualitative study explored the experiences and knowledge of 30 family members and medical staff through in-depth, semi-structured interviews. The interviews were recorded using both audio and video formats: digital platforms were used for immediate family members, while formal caregivers were interviewed in person. Researchers transcribed and analysed the recordings, categorising the answers to identify emerging topics until reaching saturation.

RESULTS

The core emerging themes among the direct family members were: (1) Lack of knowledge about oral health; (2) Oral hygiene role for the patients; (3) Consequences of a poor oral care; and (4) Recommendations for a better oral health care. For the formal caregivers the emerging themes were: (1) Lack of knowledge and experiences about oral health; (2) Deficient oral hygiene of residents; (3) Impact on quality of life; and (4) Suggestions for improving oral health.

CONCLUSION

Despite recognising the significance of oral health, direct family members and formal caregivers of older adults with cognitive impairment or dementia still need additional tools to effectively carry out necessary hygiene techniques and care.

β-Hydroxybutyrate alleviates brain aging through the MTA1 pathway in D-galactose injured mice

Aging is an inevitable law of the process of life during which many physiological functions change. Brain aging is an important mechanism in the occurrence and development of degenerative diseases of the central nervous system. β-Hydroxybutyrate (BHBA) is a water-soluble, endogenous small-molecule ketone that can cross the blood-brain barrier and induce neuroprotective effects. This study aimed to investigate the effects of BHBA on D-galactose (D-gal) induced aging in mice and its underlying mechanisms using in vitro and in vivo experiments. These results indicated that D-gal-induced senescence, oxidative stress, and inflammatory responses were inhibited by BHBA, and autophagy was promoted by BHBA. Mechanistically, we explored the role of metastasis-associated antigen-1 (MTA1) in D-gal-induced damaged in HT22 cells using small interfering RNA (siRNA). The results demonstrated that the expression of MTA1 was significantly increased by BHBA, which attenuated D-gal-induced aging, oxidative stress, and inflammatory responses, and promoted autophagy through the upregulation of MTA1. In conclusion, MTA1 may be a novel target for treating aging caused by neurological damage. BHBA improves brain aging by activating the MTA1 pathway.

Long-term trends in the burden of breast cancer in China over three decades: a joinpoint regression and age-period-cohort analysis based on Global Burden of Disease 2021

We analyzed the trends in breast cancer (BC) morbidity, prevalence, and mortality among Chinese residents from 1990 to 2021. We then used joinpoint regression to further assess BC morbidity and mortality. We screened the morbidity, mortality, and prevalence of BC in Chinese residents (1990-2021) from the Global Burden of Disease. We used age-period-cohort (APC) modeling to assess the effects of age, period, and cohort on BC morbidity and mortality separately. We also used the joinpoint model to characterize trends in BC morbidity and mortality in China. From 1990 to 2021, age-standardized rates of morbidity have risen significantly, whereas mortality has declined. We discovered that the risk of morbidity and death rose with age by using the APC model. We also found that mortality and morbidity roughly continued to increase over time, and finally, we found that the later the birth cohort, the lower the mortality and the higher the morbidity. From 1990 to 2021, the burden of BC disease in China will continue to rise, and the situation of BC prevention and control will remain severe. Therefore, regular imaging and palpation examinations should be performed in the regular population over 40 years of age. When treating patients with BC, healthcare workers should develop individualized treatment plans to further reduce mortality.

Comparison of the Cost-Effectiveness and Safety between Staged Bilateral Total Knee Arthroplasty and Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Cohort Study between 2001 and 2022

A substantial proportion of Hong Kong's aging population suffers from osteoarthritis in both knees. Bilateral total knee arthroplasty (BTKA) is a surgical option for addressing this condition and can be performed via two approaches: simultaneous BTKA (SimBTKA) and staged BTKA (StaBTKA). We compared the cost-effectiveness and safety of these two methods in our institution. We retrospectively reviewed 2,372 patients (SimBTKA, 772; StaBTKA, 1,600; females, 1,780; males, 592; mean age at SimBTKA, 70.4 ± 7.99 years; mean age at StaBTKA, 66.4 ± 7.50 years; p < 0.001) who underwent BTKA in our institution from 2001 to 2022. Patients were categorized according to the surgical approach. Patients undergoing BTKA in our institution were included. Particularly for SimBTKA, patients were assessed by anesthetists to be medically fit before undergoing the procedure according to their age, American Society of Anesthesiologists status, and osteoarthritis severity. The primary outcome was the length of stay (LOS) after surgery. The secondary outcomes were the 30-day unintended readmission, intensive care unit (ICU) admission, and death. SimBTKA had a shorter mean total LOS (acute hospital + rehabilitation center; SimBTKA, 13.09 days; StaBTKA, 18.12 days; p < 0.001) and mean LOS in acute hospital (SimBTKA, 7.70 days; StaBTKA, 10.42 days; p < 0.001). However, no significant difference was found in the mean LOS in rehabilitation centers (SimBTKA, 5.47 days; StaBTKA, 6.32 days; p > 0.05) between the two approaches. The 30-day unintended readmission rate was lower in SimBTKA (SimBTKA, 2.07%; StaBTKA, 3.30%; odds ratio [OR] = 1.60; p > 0.05) but statistically insignificant. SimBTKA was less costly than StaBTKA by US$ 8,422.22 per patient. No significant differences in ICU admission and death rates were found (p > 0.05) between the two groups. SimBTKA had a shorter LOS and lower cost than StaBTKA and comparable complication rates. Therefore, SimBTKA should be indicated in medically stable patients.

Moderate BMI accumulation modified associations between blood benzene, toluene, ethylbenzene and xylene (BTEX) and phenotypic aging: mediating roles of inflammation and oxidative stress

The associations between blood benzene, toluene, ethylbenzene, and xylenes (BTEX) and biological aging among general adults remain elusive. The present study comprised 5780 participants from the National Health and Nutrition Examination Survey 1999-2010. A novel measure of biological aging, phenotypic age acceleration (PhenoAge.Accel), derived from biochemical markers was calculated. Weighted generalized linear regression and weighted quantile sum regression (WQS) were utilized to assess the associations between BTEX components and mixed exposure, and PhenoAge.Accel. The mediating roles of systemic immune-inflammation index (SII) and oxidative stress indicators (serum bilirubin and gamma-glutamyl transferase), along with the modifying effects of body mass index (BMI) were also examined. In the single-exposure model, the highest quantile of blood benzene (b = 0.89, 95%CI: 0.58 to 1.20), toluene (b = 0.87, 95%CI: 0.52 to 1.20), and ethylbenzene (b = 0.80, 95%CI: 0.46 to 1.10) was positively associated with PhenoAge.Accel compared to quantile 1. Mixed-exposure analyses revealed a consistent positive association between BTEX mixed exposure and PhenoAge.Accel (b = 0.88, 95%CI: 0.56 to 1.20), primarily driven by benzene (92.78%). The association between BTEX and PhenoAge.Accel was found to be partially mediated by inflammation and oxidative stress indicators (ranging from 3.2% to 13.7%). Additionally, BMI negatively modified the association between BTEX mixed exposure and PhenoAge.Accel, with a threshold identified at 36.2 kg/m^2. Furthermore, BMI negatively moderated the direct effect of BTEX mixed exposure on PhenoAge.Accel in moderated mediation models, while positively modified the link between SII and PhenoAge.Accel in the indirect path (binteraction = 0.04, 95%CI: 0.01 to 0.06). Overall, BTEX mixed exposure was associated with PhenoAge.Accel among US adults, with benzene may have reported most contribution, and inflammation and oxidative damage processes may partially explain this underlying mechanism. The study also highlighted the potential benefits of appropriate BMI increased. Additional large-scale cohort studies and experiments were necessary to substantiate these findings.

Association between masticatory function and depression in older adults: Results from NHANES 2009 to 2018

AIM

Depression is prevalent among older adults. Although the number of missing teeth is considered to be associated with depression, the relationship between masticatory function, which is usually indicated by functional tooth units (FTUs), and depression in older adults remains unclear.

MATERIALS AND METHODS

This study used data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. The number of FTUs was defined as pairs of opposing natural and artificial teeth. Depression was accessed using the Patient Health Questionnaire (PHQ-9), and participants who scored ≥10 on PHQ-9 were diagnosed with depression. Logistic regression analyses, propensity score matching (PSM) analyses and subgroup analyses were conducted to assess the association between FTU and depression.

RESULTS

The analysis included 5764 individuals over 60 years. An association between FTU and the risk of depression among older adults was detected (odds ratio [OR] = 0.951, 95% confidence interval [CI] 0.915-0.989), suggesting protective roles of more FTUs. Significant increase in the risk of depression in 0 ≤ FTUs ≤ 3 was observed compared with 10 ≤ FTUs ≤ 12 (OR = 1.819, 95% CI 1.157-2.858). However, no significant increase in the risk of depression in 4 ≤ FTUs ≤ 9 was found. After PSM, significant increase in the risk of depression in 0 ≤ FTUs ≤ 3 was still detected compared with 4 ≤ FTUs ≤ 12 (OR = 1.484, 95% CI 1.030-2.136). Subgroup analyses demonstrated consistent results in all subgroups, except for individuals aged 76-80 and drinking regularly.

CONCLUSIONS

The findings suggested the association between impaired masticatory function and the risk of depression among older adults. Longitudinal studies are needed to elucidate the role of masticatory function impairment in the development of depression further.

Burdens and trends of blindness and vision loss among those aged 55 years and older: A systematic analysis for the Global Burden of Disease Study 2019

PURPOSE

To systematically analysis the burden and trends of blindness and vision loss for those aged ≥55 years from 1990 to 2019 and to predict trends over the next few years.

METHODS

The data were extracted from the Global Burden of Disease Study (GBD) 2019. Trends from 1990 to 2019 were calculated using average annual percentage change (AAPC) by joinpoint regression analysis. Bayesian age-period-cohort (BAPC) models were used to predict future trends.

RESULTS

In 2019, the global prevalence of blindness and vision loss was 471.1 million with 15.9 million disability-adjusted life-years (DALYs) for those aged ≥55 years. These numbers will reach 640.3 million cases and 18.9 million DALYs in 2030. The prevalence rate (per 100,000 population) increased from 32,137.8 (95% uncertainty interval [UI], 26,307.9-39,246.3) in 1990 to 33,509 (95% UI, 27,435.5-40,996.2) in 2019, with an AAPC of 0.143 (95% confidence interval [CI], 0.125-0.161; P < 0.001). The DALY rate (per 100,000 population) decreased from 632.9 (95% UI, 447.7-870.9) in 1990 to 579.3 (95% UI, 405.2-803.4) in 2019, with an AAPC of -0.293 (95% CI, -0.323-[-]0.263). Although the prevalence rates of cataracts, age-related macular degeneration, glaucoma, and near vision loss showed increasing trends from 1990 to 2019, the DALY rates indicated a downward trend for all blindness-causing diseases. The burden is heavier for women and in low Socio-demographic Index (SDI) regions.

CONCLUSIONS

Despite a decline from 2001 to 2019, the burden of blindness and vision loss, measured by prevalence and DALYs, continues to rise after adjusting for population growth and aging. Blindness and vision loss are significant public health burdens, especially for women and in low-SDI regions.

Ten years' evaluation of periodontal status and its changes among Japanese older adults

AIMS

This study aims to evaluate the periodontal status and its changes among Japanese older adults over a 10-year period.

METHODS AND RESULTS

A total of 206 dentate older adults aged 70 years who completely participated in 10 years of oral examination were included. The community periodontal index (CPI) was used to assess the gingival and periodontal pocket status, while the loss of attachment (LA) scoring system was used to report the extensive LA. A higher score in CPI (Code 3 and Code 4) and more extensive attachment loss were found in a majority of participants. During follow-up evaluation, mean number of sextants with CPI code 4 remained stable, while CPI code 3 significantly decreased particularly in male participants. Whereas, sextants without attachment loss significantly decreased on average. The mean number of missing sextants significantly increased from 1.1 to 1.9, and 5.8% of subjects had all sextants excluded in the follow-up.

CONCLUSION

This study indicated that majority of the older people experienced severe periodontal disease and this condition remained stable during 10-year period. Additionally, the incidence of tooth loss increased as individuals aged. Regular oral care and maintenance are highly recommended for older population.

Oral health, treatment burden and demographics of elders with care-resistant behavior: A cross-sectional study

AIMS

To assess oral health, treatment burden, mortality risk, and demographics in elders with care-resistant behaviors (CRB) in nursing homes (NH) and compare them with those without CRB.

METHODS AND RESULTS

503 participants from eight NH who received dental treatment through a mobile dental clinic were included. Their medical and dental records were screened regarding oral/dental health, treatment history, general health, demographics, and CRB. Statistical analysis was performed to show correlations between CRB and the measured parameters. Data were verified for normal distribution; a point-biserial correlation model was used (95% CI: α = 0.05). No correlation was found between CRB and Decayed Missing Filled Teeth (DMF-T) (rpb = -0.061, p = .177), as well as periodontal status (rpb = 0.004, p = .946). A negative correlation was observed between CRB and the required number of treatment procedures (rpb = -0.181, p < .0001), time (rpb = -0.118, p = .010), and costs (rpb = -0.100, p = .028). Sex predilection for men regarding CRB was evident (rpb = -0.155, p = .01). No correlation appeared between CRB and vital status (rpb = -0.41, p = .355).

CONCLUSION

Oral health seems to be similar in institutionalized elders with or without CRB. Treatment burden was not elevated, but even reduced in elders with CRB, evincing that few/no treatment procedures were performed in those elders. CRB demonstrated a sex predilection for men. An association between CRB and increased mortality was not evident.

The efficacy of training to improve road safety in elderly pedestrians: A systematic review

Elderly pedestrians are involved in disproportionately more vehicle-pedestrian crashes than younger age groups. Training programs have been found to be effective in training children in pedestrian behaviours that improve their safety, however there is no consensus on whether older adults benefit from training. This systematic review aimed to identify whether training is effective for older adult pedestrians through analysis of training type, modalities, and the lasting effects of training. A systematic search of Medline, PsycINFO, and Scopus was conducted in March 2022 and updated in September 2023. Eight studies met the criteria all of which were high quality. Four distinct training types were found: physical (e.g., training physical strength or balance), behavioural (e.g., training specific pedestrian safety behaviours), cognitive (e.g., training reaction time and executive functioning), and educational (training knowledge about pedestrian safety behaviours). Physical training types were found to be most effective, followed by behavioural, cognitive, and educational respectively. Twelve pedestrian behaviours were measured across the eight studies. Reaction time was the most effectively trained outcome, followed by missed crossing opportunities. Errors of stimuli, median accepted time gap, initiation time and crossing were not effectively trained. The effects of training were maintained at follow-up for missed crossing opportunities only. There was preliminary evidence of potential efficacy of training for specific pedestrian safety behaviours, however, the long-term efficacy of training was not promising. Theory-driven research is needed to better understand why some behaviours are more trainable than others. More research is also needed to determine the real-world generalisability if training is to be recommended for older adult pedestrians.

Beta-to-Theta Entropy Ratio of EEG in Aging, Frontotemporal Dementia, and Alzheimer's Dementia

BACKGROUND

Aging, frontotemporal dementia (FTD), and Alzheimer's dementia (AD) manifest electroencephalography (EEG) alterations, particularly in the beta-to-theta power ratio derived from linear power spectral density (PSD). Given the brain's nonlinear nature, the EEG nonlinear features could provide valuable physiological indicators of aging and cognitive impairment. Multiscale dispersion entropy (MDE) serves as a sensitive nonlinear metric for assessing the information content in EEGs across biologically relevant time scales.

OBJECTIVE

To compare the MDE-derived beta-to-theta entropy ratio with its PSD-based counterpart to detect differences between healthy young and elderly individuals and between different dementia subtypes.

METHODS

Scalp EEG recordings were obtained from two datasets: 1) Aging dataset: 133 healthy young and 65 healthy older adult individuals; and 2) Dementia dataset: 29 age-matched healthy controls (HC), 23 FTD, and 36 AD participants. The beta-to-theta ratios based on MDE vs. PSD were analyzed for both datasets. Finally, the relationships between cognitive performance and the beta-to-theta ratios were explored in HC, FTD, and AD.

RESULTS

In the Aging dataset, older adults had significantly higher beta-to-theta entropy ratios than young individuals. In the Dementia dataset, this ratio outperformed the beta-to-theta PSD approach in distinguishing between HC, FTD, and AD. The AD participants had a significantly lower beta-to-theta entropy ratio than FTD, especially in the temporal region, unlike its corresponding PSD-based ratio. The beta-to-theta entropy ratio correlated significantly with cognitive performance.

CONCLUSION

Our study introduces the beta-to-theta entropy ratio using nonlinear MDE for EEG analysis, highlighting its potential as a sensitive biomarker for aging and cognitive impairment.

Is 90 the new 80? Temporal trends in nonagenarians undergoing percutaneous coronary interventions

BACKGROUND

Coronary artery disease (CAD) is a leading cause of death in the elderly population. Data regarding percutaneous coronary interventions (PCIs) in nonagenarians are scarce, and differences in long term outcomes between generations remain unclear. We aimed to study the pattern and temporal trends of nonagenarians treated with PCI.

MATERIALS AND METHODS

A total of 14,695 patients underwent PCI between 2009-2020. We identified 2,034 (13.8%) octogenarians (age 80-89), and 222 (1.5%) nonagenarians (age 90-99). Endpoints included mortality and major adverse cardiac events (MACE) at 1 year.

MATERIALS AND METHODS

A total of 14,695 patients underwent PCI between 2009-2020. We identified 2,034 (13.8%) octogenarians (age 80-89), and 222 (1.5%) nonagenarians (age 90-99). Endpoints included mortality and major adverse cardiac events (MACE) at 1 year.

RESULTS

The number of nonagenarians undergoing PCI has increased substantially during the study time period, from 89 patients in the earlier time period (2009-2014) to 133 patients in the later time period (2015-2020). At 1-year, nonagenarians had significantly higher rates of both death (24.3% vs. 14.9%, p<0.01), and MACE (30.6% vs. 22.0%, p<0.01), as compared to octogenarians. The cumulative survival rate was higher among octogenarians both in the early and late time period (p<0.01 and p=0.039, respectively). A significant reduction in nonagenarian MACE rates were observed during the study time period, resulting in a non-significant difference in MACE rates in the later time period between both groups.

CONCLUSION

The number of nonagenarians who undergo PCI is on the rise. While their clinical outcomes are inferior as compared to younger age groups, improvement was noted in the late time period.

Brief report: Aging adult utilization of an mHealth intervention for problem drinking

Alcohol consumption among aging adults is a growing concern due to its potential to exacerbate age-related health conditions. Developing accessible interventions for this demographic is imperative. Mobile health (mHealth) interventions offer a promising avenue, but their effectiveness and engagement among aging adults remain uncertain. This study is a secondary analysis that aimed to compare the utilization and outcomes of an mHealth intervention between aging (50+) and younger adults in a clinical trial of an mHealth intervention (Step Away) for reduced drinking. At the three-month follow-up, both age groups exhibited significant reductions in alcohol consumption and increased readiness for change. Furthermore, aging adults utilized the mHealth intervention significantly more, expressed a higher likelihood of continued use, and rated the intervention higher on the System Usability Scale (SUS). These findings suggest that mHealth interventions for alcohol-related issues can be equally effective for aging adults and that they readily engage with such tools and find them acceptable. This study underscores the potential of mHealth interventions as a viable solution for addressing alcohol-related concerns among aging adults. Further research targeting mHealth interventions tailored specifically to this demographic is warranted. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04447794, Identifier [NCT04447794].

Relationship between physical activities and mental health in older people: a bibliometric analysis

Objective

To summarize the general situation and focal points of research on the physical activity and mental health of older people over the past 15 years and provide references for future research.

Methods

Literature published between January 1, 2009, and December 31, 2023, was retrieved from the Web of Science core database. A bibliometric visualization analysis of countries/regions, institutions, authors, keywords, and references was conducted using CiteSpace6.1.R6.

Results

A total of 4,329 articles were included, and the annual number of articles published over the past 15 years showed an upward trend. The articles were primarily from 65 countries/regions and 626 institutions. The most represented country and institution were the USA and the University of Pittsburgh, respectively. Among the authors identified, Schuch and Callow were the most influential. The research focuses on four areas: the psychological effects of physical activity in older people; physical activity intervention approaches to the mental health of older people; physical activity and mental health assessment questionnaires; and the impact of physical activity on multidimensional aging. Research frontiers involve emerging topics such as the assessment and intervention of mental health in older people and the relationship between their physical activity and cognitive function.

Conclusion

This study conducted a comprehensive, objective, and visual analysis of publications and revealed the status of relevant studies, trending topics, and trends concerning the physical activity and mental health of older people from 2009 to 2023. We hope that this work will help researchers identify new perspectives on potential collaborators, important topics, and research frontiers.

Estimates of multidimensional poverty and its determinants among older people in rural China: evidence from a multicenter cross-sectional survey

BACKGROUND

In 2020, China declared that the absolute poverty in the country had been eradicated, but older people in rural areas are deprived in multiple domains. Poverty is multidimensional and involves deprivations in health, social welfare, living standards, and income. This study focused on assessing the poverty status of rural older persons and providing a basis for decision-making at all levels of government in China.

METHODS

A multicenter cross-sectional survey was conducted in four rural areas of China. Individuals aged 60 years and older were selected through stratified sampling. People with aphasia and severe cognitive impairment were excluded. An electronic questionnaire was used to collect older people's information, including basic demographics, major illnesses, disabilities, chronic diseases, functional disorders, and ability to perform activities of daily living. It also asked about the medical, financial, and social security assistance that respondents received, food and clothing standards, safe housing, clean energy, safe drinking water, and reliable electricity. Specific questions were asked regarding income sufficiency, financial support from children, and pension income. Multidimensional poverty measurements were used to compare regional disparities and indicators differences. Logistic regression was used to identify the risk factors influencing poverty.

RESULTS

A total of 1272 older people were analyzed. Of them, 704 (55.35%) were women and 652 (51.26%) were aged between 60 and 69 years. The most frequently mentioned causes of poverty were illness, a lack of employment, inadequate technology, and poor transportation. We found that as multidimensional poverty indicators increased (from 6 to 10), the number of poor older people decreased (from 1218 to 437), as did the poverty incidence (from 95.75 to 34.36%) and multifaceted poverty index (from 53.41 to 25.06%). Xuanwei had the highest incidence of poverty (66.61%) and multidimensional poverty index (0.66) among the four provinces studied. Regarding the contribution of indicators, financial alleviation made the greatest contribution to multidimensional poverty among rural older adults (up to 70.51%). Age, marital status, education level, awareness of poverty alleviation policies, and region were significant predictors of multidimensional poverty among older rural residents(P < 0.05).

CONCLUSIONS

China's subsidy system and financial support must be enhanced. Particular attention should be given to the re-education of rural older individuals, basic vocational education should be strengthened in rural areas, and social participation should be encouraged.

Emergency Detection in Smart Homes Using Inactivity Score for Handling Uncertain Sensor Data

In an aging society, the need for efficient emergency detection systems in smart homes is becoming increasingly important. For elderly people living alone, technical solutions for detecting emergencies are essential to receiving help quickly when needed. Numerous solutions already exist based on wearable or ambient sensors. However, existing methods for emergency detection typically assume that sensor data are error-free and contain no false positives, which cannot always be guaranteed in practice. Therefore, we present a novel method for detecting emergencies in private households that detects unusually long inactivity periods and can process erroneous or uncertain activity information. We introduce the Inactivity Score, which provides a probabilistic weighting of inactivity periods based on the reliability of sensor measurements. By analyzing historical Inactivity Scores, anomalies that potentially represent an emergency can be identified. The proposed method is compared with four related approaches on seven different datasets. Our method surpasses existing approaches when considering the number of false positives and the mean time to detect emergencies. It achieves an average detection time of approximately 05:23:28 h with only 0.09 false alarms per day under noise-free conditions. Moreover, unlike related approaches, the proposed method remains effective with noisy data.

Effect of Blood Flow Restriction on Gait and Mobility in Older Adults: A Systematic Review and Meta-Analysis

Older adults demonstrate gait impairments that increase their risk for falls. These age-related mobility impairments are in part due to declines in muscle mass and strength. High-intensity exercise can improve muscle strength and mobility but may not be tolerable for older adults due to musculoskeletal injury and pain. Blood flow restriction (BFR) with lower-intensity exercise offers a strategy that may be more tolerable for older adults, but whether BFR improves gait and mobility in older adults is unclear. The purpose of this systematic review and meta-analysis was to determine the effect of BFR on gait and mobility in healthy older adults. PubMed, Embase, Cochrane Library, and CINAHL were systematically searched for articles utilizing BFR in older adults. Articles were included if adults were over 60 years, did not have chronic health conditions, had undergone randomized controlled trials, and presented objectively measured gait outcomes. The search identified 1501 studies, of which 9 were included in the systematic review and 8 studies in the meta-analysis. Outcome measures included the Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), 400 m walk test, Short Physical Performance Battery (SPPB), and 10 m walk test. Meta-analyses found improvements in the TUG (mean difference (MD) = -0.71; 95% CI = -1.05, -0.37; p < 0.001) and SPPB (MD = -0.94; 95% CI = -1.48, -0.39; p < 0.001) in BFR compared to no BFR. There were no differences in gait speed (MD = 0.59; 95% CI = -0.22, 1.41; p = 0.16). BFR may be effective for gait and mobility tasks over shorter distances. Clinicians may consider incorporating BFR to improve mobility and gait function in older adults.

Trend of gastrointestinal and liver diseases in China: Results of the Global Burden of Disease Study, 2019

BACKGROUND

China is one of the countries with the largest burden of gastrointestinal and liver diseases (GILD) in the world. The GILD constitutes various causes of mortality and disability. The study aimed to investigate the trend of GILD in China using the Global Burden of Diseases Study 2019 (GBD 2019) data resources from 1990 to 2019.

METHODS

The data on the age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for GILD in China from 1990 to 2019 were collected from the GBD 2019 data resources. Furthermore, the ranking of the main causes of deaths and DALYs, as well as the trends of ASMR, DALYs, years of life lost (YLLs), and years of life lost due to disability (YLDs) per 1,000,000 in GILD were reported.

RESULTS

The ASMR and DALYs for stomach cancer, liver cancer, and esophageal cancer, which ranked top three among the GILDs from 1990 to 2019, were gradually decreasing. Significant decreases in the ASMR and DALYs were found in diarrheal diseases and acute hepatitis (A, E, and C). However, noteworthy increases were found in those of colon and rectum cancer (CRC) and pancreatic cancer. Trend of DALYs, mortality, and YLLs rates for most of GILD were decreasing from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trend. The DALYs, mortality and YLLs of most GILD diseases showed decreasing trends from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trends.

CONCLUSIONS

The result of the GBD 2019 showed that the rates of most GILDs decreased in China; however, gastrointestinal and liver cancer, such as stomach cancer still held the top ranking. Furthermore, the shift from infectious diseases to non-communicable causes among GILD burden is occurring.

Tooth loss from the perspective of studies employing a life course approach: a systematic review

The life course approach scrutinizes factors that shape the development of diseases over time. Tooth loss, which is influenced by social, behavioral and biological factors, can occur at various stages of life and tends to become more prevalent in later years. This systematic review examined the influence of socioeconomic, psychosocial, biological and behavioral adversities in life on the likelihood of tooth loss. Searches were conducted in the Embase, PubMed, Web of Science, Ovid, PsycINFO, Scopus and LILACS databases. Reference management was performed using EndNote online. The risk of bias was appraised using the Newcastle-Ottawa Scale (NOS). The electronic searches yielded 1366 records, 17 of which (13 cohort and four cross-sectional studies) met the inclusion criteria. According to the NOS, all studies had a low risk of bias. Two studies found a link between a lower education and higher incidence of tooth loss and socioeconomic status exerted a significant influence in 47% of the studies. Disadvantaged socioeconomic trajectories and health-related factors, such as smoking, general health perception and oral health behaviors, increased the likelihood of tooth loss. Factors such as dental visits, a history of toothache and exposure to fluoridated water influenced the likelihood of tooth loss. Individuals who experienced adversities in socioeconomic, behavioral and biological aspects throughout their life course were more prone to tooth loss.

APE1: A critical focus in neurodegenerative conditions

The global growth of the aging population has resulted in an increased prevalence of neurodegenerative diseases, characterized by the progressive loss of central nervous system (CNS) structure and function. Given the high incidence and debilitating nature of neurodegenerative diseases, there is an urgent need to identify potential biomarkers and novel therapeutic targets thereof. Apurinic/apyrimidinic endonuclease 1 (APE1), has been implicated in several neurodegenerative diseases, as having a significant role. Abnormal APE1 expression has been observed in conditions including Alzheimer's disease, stroke, amyotrophic lateral sclerosis, Parkinson's disease, Huntington's disease, and epilepsy. However, whether this dysregulation is protective or harmful remains unclear. This review aims to comprehensively review the current understanding of the involvement of APE1 in neurodegenerative diseases.

Targeting PYK2, entrectinib allays anterior subcapsular cataracts in mice by regulating TGFβ2 signaling pathway

BACKGROUND

Fibrosis cataract occurs in patients receiving cataract extraction. Still, no medication that can cure the disease exists in clinical. This study aims to investigate the effects and mechanisms of Entrectinib on fibrotic cataract in vitro and in vivo.

METHODS

The human lens cells line SRA 01/04 and C57BL/6J mice were applied in the study. Entrectinib was used in animals and cells. Cataract severity was assessed by slit lamp and Hematoxylin and Eosin staining. Expression of alpha-smooth muscle actin, fibronectin, and collagen I were examined by real-time quantitative PCR, western blotting, and immunofluorescence. Cell proliferation was evaluated by Cell Counting Kit-8. Cell migration was measured by wound healing and transwell assays. Molecular docking, Drug Affinity Responsive Target Stability, and Cellular Thermal Shift Assay were applied to seek and certify the target of Entrectinib treating fibrosis cataract.

RESULTS

Entrectinib can ameliorate fibrotic cataract in vitro and in vivo. At the RNA and the protein levels, the expression of alpha-smooth muscle actin, collagen I, and fibronectin can be downgraded by Entrectinib, while E-cadherin can be upregulated. The migration and proliferation of cells were inhibited by Entrectinib. Mechanistically, Entrectinib obstructs TGFβ2/Smad and TGFβ2/non-Smad signaling pathways to hinder the fibrosis cataract by targeting PYK2 protein.

CONCLUSIONS

Targeting with PYK2, Entrectinib can block TGF-β2/Smad and TGF-β2/non-Smad signaling pathways, lessen the activation of EMT, and alleviate fibrosis cataract. Entrectinib may be a potential treatment for fibrosis cataract in clinic.

Global, regional, and national burdens of Alzheimer's disease and other forms of dementia in the elderly population from 1999 to 2019: A trend analysis based on the Global Burden of Disease Study 2019

Dementia represents a significant health issue, afflicting both patients and their families. To assess the global trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of Alzheimer's disease (AD) and other dementias in the elderly population, the Global Burden of Disease Study (1999-2019) was used. The average annual percentage change (AAPC) was estimated using linear regression. Stratified analysis of the global trends by age, sex, region, national level, and social development index (SDI) were also performed. The global incidence of AD and other dementias increased from 507.96 per 100,000 in 1990 to 569.39 per 100,000 in 2019, showing a significant increase in this period. In males, the incidence increased from 387.56 per 100,000 population in 1990 to 462.40 per 100,000 in 2019 (AAPC = 0.61), whereas females experienced a slower rise (AAPC = 0.31) and had a higher incidence in 2019 (662.93 per 100,000 population). The most significant increase was observed in individuals aged 60-64 and those in the middle-SDI quintile. Regionally, the high-income Asia Pacific had the highest incidence (890.01 per 100,000 population) and DALYs (3043.86 per 100,000) in AD and other dementias in 2019. As for national trends, Japan had the most pronounced increase in the incidence and DALYs of AD and other dementias during the 1990-2019 period. These findings highlight the growing burden of dementias on life expectancy at a population level, which is significant for healthcare professionals and decision-makers to conduct the ongoing debate on the policy of AD and other dementias.