How to Measure Population Aging? The Answer Is Less than Obvious: A Review

Preparation, in vitro and in vivo evaluation of phloretin-loaded TPGS/Pluronic F68 modified mixed micelles with enhanced bioavailability and anti-aging activity

Phloretin exhibits strong antioxidant and anti-aging properties by inhibiting mitochondrial oxidation of glutamate, succinic acid, and ascorbic acid. However, its clinical application is limited by poor aqueous solubility and low oral bioavailability. To enhance its bioavailability and efficacy, we incorporated phloretin into nano-micelles (phloretin-MM) using the thin film dispersion method. Characterization revealed that the optimal formulation had TPGS and Pluronic F68 in a 4:1 ratio as the excipients, which resulted in spherical micelles with an average particle size of 33.28 nm and an encapsulation efficiency of 71.2 ± 0.48%. The in vitro release profile showed that the phloretin-MM showed significantly higher cumulative release rates than free phloretin across various pH conditions, while the pharmaceutical analysis in rats indicated that phloretin-MM significantly improved the oral bioavailability of phloretin (about 5 folds) in circulation. Additionally, through the analysis of the staining of zebrafish under light microscopy and the average gray value, it can be concluded that phloretin has anti-aging drug effect, and phloretin-MM is better than free phloretin. These findings suggest that TPGS/Pluronic F68-modified phloretin-MM could serve as an excellent nano-drug carrier system, potentially enhancing the solubility, bioavailability, and anti-aging effects of phloretin for broader clinical applications.

The ecology of ageing in wild societies: linking age structure and social behaviour

The age of individuals has consequences not only for their fitness and behaviour but also for the functioning of the groups they form. Because social behaviour often changes with age, population age structure is expected to shape the social organization, the social environments individuals experience and the operation of social processes within populations. Although research has explored changes in individual social behaviour with age, particularly in controlled settings, there is limited understanding of how age structure governs sociality in wild populations. Here, we synthesize previous research into age-related effects on social processes in natural populations, and discuss the links between age structure, sociality and ecology, specifically focusing on how population age structure might influence social structure and functioning. We highlight the potential for using empirical data from natural populations in combination with social network approaches to uncover pathways linking individual social ageing, population age structure and societal functioning. We discuss the broader implications of these insights for understanding the social impacts of anthropogenic effects on animal population demography and for building a deeper understanding of societal ageing in general.This article is part of the discussion meeting issue 'Understanding age and society using natural populations'.

Pace of Aging in older adults matters for healthspan and lifespan

As societies age, policy makers need tools to understand how demographic aging will affect population health and to develop programs to increase healthspan. The current metrics used for policy analysis do not distinguish differences caused by early-life factors, such as prenatal care and nutrition, from those caused by ongoing changes in people's bodies due to aging. Here we introduce an adapted Pace of Aging method designed to quantify differences between individuals and populations in the speed of aging-related health declines. The adapted Pace of Aging method, implemented in data from the US Health and Retirement Study and English Longitudinal Study of Aging (N=21,463), integrates longitudinal data on blood biomarkers, physical measurements, and functional tests. It reveals stark differences in rates of aging between population subgroups and demonstrates strong and consistent prospective associations with incident morbidity, disability, and mortality. Pace of Aging can advance the population science of healthy longevity.

Association between Biological Age and Contrast-Associated Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Cross-Sectional Study

Background: Biological age is a reliable indicator reflecting the real physiological state and aging status of individuals. This study was aimed at exploring the association between biological age and contrast-associated acute kidney injury (CA-AKI).

Methods: This retrospective study was conducted on 4078 patients with coronary artery disease (CAD) undergoing coronary angiography (CAG). Biological age was calculated according to chronological age and blood biomarkers, and the “age gap,” reflecting retardation or acceleration of biological aging, was further determined. Logistic regression analysis was used to examine the association of the biological age and age gap with CA-AKI. Receiver operating characteristic (ROC) analysis and subgroup analysis were also conducted.

Results: Among the 4078 patients (68.00 [61.00, 74.00] years, 2680 (65.7%) men), 725 CA-AKI cases were identified. Older biological age (≥79.3 vs. <79.3 years, OR [95% CI] = 3.319 [2.714 to 4.059]) and greater age gap (≥1.12 vs. <1.12, OR [95% CI] = 2.700 [2.240 to 3.256]) were independent risk factors for CA-AKI (both P <0.001). ROC analysis indicated that biological age (AUC = 0.672) and age gap (AUC = 0.672) had better predictive ability for CA-AKI than chronological age (AUC = 0.583). Subgroup analysis also indicated similar findings (all P <0.001).

Conclusion: Biological age was found to be an independent risk factor for CA-AKI after CAG, with better predictive value than chronological age.

Associations between Differential Aging and Lifestyle, Environment, Current, and Future Health Conditions: Findings from Canadian Longitudinal Study on Aging

INTRODUCTION

An aging population will bring a pressing challenge for the healthcare system. Insights into promoting healthy longevity can be gained by quantifying the biological aging process and understanding the roles of modifiable lifestyle and environmental factors, and chronic disease conditions.

METHODS

We developed a biological age (BioAge) index by applying multiple state-of-art machine learning models based on easily accessible blood test data from the Canadian Longitudinal Study of Aging (CLSA). The BioAge gap, which is the difference between BioAge index and chronological age, was used to quantify the differential aging, i.e., the difference between biological and chronological age, of the CLSA participants. We further investigated the associations between the BioAge gap and lifestyle, environmental factors, and current and future health conditions.

RESULTS

BioAge gap had strong associations with existing adverse health conditions (e.g., cancers, cardiovascular diseases, diabetes, and kidney diseases) and future disease onset (e.g., Parkinson's disease, diabetes, and kidney diseases). We identified that frequent consumption of processed meat, pork, beef, and chicken, poor outcomes in nutritional risk screening, cigarette smoking, exposure to passive smoking are associated with positive BioAge gap ("older" BioAge than expected). We also identified several modifiable factors, including eating fruits, legumes, vegetables, related to negative BioAge gap ("younger" BioAge than expected).

CONCLUSIONS

Our study shows that a BioAge index based on easily accessible blood tests has the potential to quantify the differential biological aging process that can be associated with current and future adverse health events. The identified risk and protective factors for differential aging indicated by BioAge gap are informative for future research and guidelines to promote healthy longevity.

Global cardiovascular diseases burden attributable to high sodium intake from 1990 to 2019

Sodium intake shows a positive correlation with blood pressure, resulting in an increased risk for cardiovascular diseases (CVD). Salt reduction is a key step toward the WHO's goal of 25% reduction in mortality from non-communicable diseases (NCDs) by 2025. This study aims to assess the current condition and temporal changes of the global CVD burden due to high sodium intake (HSI). We extracted data from the Global Burden of Disease (GBD) study 2019. The numbers and age-standardized rates of mortality and disability-adjusted life-years (DALYs), stratified by location, sex, and socio-demographic Index (SDI), were used to assess the high sodium intake attributable CVD burden from 1990 to 2019. The relationship between the DALYs rates and related factors was evaluated by stepwise multiple linear regression analysis. Globally, in 2019, the deaths and DALYs of HSI-related CVD were 1.72 million and 40.54 million, respectively, increasing by 41.08% and 33.06% from 1990. Meanwhile, the corresponding mortality and DALYs rates dropped by 35.1% and 35.2%, respectively. The high-middle and middle SDI quintiles bore almost two-thirds of CVD burden caused by HSI. And the leading cause of HSI attributable CVD burden was ischemic heart disease. Universal health coverage (UHC) was associated with the DALYs rates after adjustment. From 1990 to 2019, the global CVD burden attributable to HSI has declined with spatiotemporal and sexual heterogeneity. However, it remains a major public health challenge because of the increasing absolute numbers. Improving UHC serves as an effective strategy to reduce the HSI-related CVD burden.

Digital village construction, human capital and the development of the rural older adult care service industry

Background

The advancement of digital villages in China is shaped by the degree of human capital within the rural labor force, which not only restricts the potential of digital village but also influences the impact of digital empowerment on the progression of the rural older adult care service industry.

Materials and methods

Using panel data from 30 Chinese provinces between 2011 and 2020, we created benchmark and threshold regression models to investigate the influence of digital village construction on the development of the rural older adult care service industry and to delineate the threshold effects of human capital on it. We further scrutinized the correlation between the two systems, along with the factors that affect it, through a coupling coordination model.

Results

Preliminary, the baseline regression outcomes show that the digital village construction is conducive to the progression of the rural older adult care service industry (p < 0.05). Moreover, we identified a significant nonlinear threshold relationship between the digital village, human capital, and the advancement of the rural older adult care service industry (HUM1ST, p < 0.05; HUM2DT, p < 0.01; HUM3DT, p < 0.01). These results indicate that the digital technology's effect on the development of the rural older adult care service industry is limited by the rural human capital level. Lastly, we found that higher levels of human capital enhance the coupling of the digital village with the rural older adult care service industry (p < 0.01), with the influence of per capita education level being the most pronounced (CoefHUM1 > CoefHUM2 > CoefHUM3).

Conclusion

The digital village substantially empowers the rural older adult care service industry, with human capital exhibiting a significant threshold effect on this empowerment. Furthermore, variances in the level of human capital have a considerable impact on the integration of the digital village and the rural older adult care service industry.

Application of Artificial Intelligence in Geriatric Care: Bibliometric Analysis

BACKGROUND

Artificial intelligence (AI) can improve the health and well-being of older adults and has the potential to assist and improve nursing care. In recent years, research in this area has been increasing. Therefore, it is necessary to understand the status of development and main research hotspots and identify the main contributors and their relationships in the application of AI in geriatric care via bibliometric analysis.

OBJECTIVE

Using bibliometric analysis, this study aims to examine the current research hotspots and collaborative networks in the application of AI in geriatric care over the past 23 years.

METHODS

The Web of Science Core Collection database was used as a source. All publications from inception to August 2022 were downloaded. The external characteristics of the publications were summarized through HistCite and the Web of Science. Keywords and collaborative networks were analyzed using VOSviewers and Citespace.

RESULTS

We obtained a total of 230 publications. The works originated in 499 institutions in 39 countries, were published in 124 journals, and were written by 1216 authors. Publications increased sharply from 2014 to 2022, accounting for 90.87% (209/230) of all publications. The United States and the International Journal of Social Robotics had the highest number of publications on this topic. The 1216 authors were divided into 5 main clusters. Among the 230 publications, 4 clusters were modeled, including Alzheimer disease, aged care, acceptance, and the surveillance and treatment of diseases. Machine learning, deep learning, and rehabilitation had also become recent research hotspots.

CONCLUSIONS

Research on the application of AI in geriatric care has developed rapidly. The development of research and cooperation among countries/regions and institutions are limited. In the future, strengthening the cooperation and communication between different countries/regions and institutions may further drive this field's development. This study provides researchers with the information necessary to understand the current state, collaborative networks, and main research hotspots of the field. In addition, our results suggest a series of recommendations for future research.

The measurement of structural ageing – an axiomatic approach

The structural ageing of the population is one of the key global trends of the 21st Century. In this paper, we outline four axioms that, along with easy interpretability, we believe should underpin a theoretically valid measure of structural ageing: (1) population size invariance; (2) strong dominance; (3) weak dominance; and (4) age sensitivity. We then present a class of structural ageing indices that satisfy the axioms and are easily interpretable, with root-mean-squared-age (RMSA) as our preferred measure within the class. Using historical and cross-national data from the World Population Prospects, state-level data from the US Census Bureau, and local-authority-level data from New Zealand, we demonstrate that our preferred measure is correlated with conventional measures of structural ageing. Nevertheless, in each case there are large disparities in ranking for some countries, states, or local authorities between the different measures. These ranking disparities could be highly consequential for the allocation of resources, particularly between states or local areas within countries. Our proposed class of measures may help to avoid these disparities due to their axiomatically-consistent nature. Finally, we present considerations for future extensions of this important work, including the development of equivalent measures based on prospective age.

Subjective age and the association with intrinsic capacity, functional ability, and health among older adults in Norway

This study investigates the relationships between subjective age, intrinsic capacity, functional ability and health among Norwegians aged 60 years and older. The Norwegian Survey of Health and Ageing (NORSE) is a population-based, cross-sectional study of home-dwelling individuals aged 60-96 years in the former county of Oppland. Age- and sex-adjusted regression models were used to investigate the gap between subjective and chronological age and this gap's association with self-reported and objectively measured intrinsic capacity (covering all six sub domains defined by WHO), health, and functional ability among 817 NORSE participants. The results show most participants felt younger than their chronological age (86.5%), while relatively few felt the same as their chronological age (8.3%) or older (5.2%). The mean subjective age was 13.8 years lower than mean chronological age. Participants with urinal incontinence, poor vision, or poor hearing felt 3.1 [95% confidence interval (CI) (0.6, 5.5)], 2.9 [95% CI (0.2, 5.6)], and 2.9 [95% CI (0.3, 5.5)] years older, respectively, than participants without those conditions, whereas none of the following factors-anxiety, depression, chronic disease, Short Physical Performance Battery score, grip strength, cognition, or frailty-significantly had an impact on the gap. In line with prior research, this study finds that feeling considerably younger than one's chronological age is common at older ages. However, those with poor hearing, poor vision, and urinal incontinence felt less young compared to those not having these conditions. These relationships may exert undesirable effects on vitality and autonomy, which are considered key factors of intrinsic capacity and healthy ageing.

Evaluating the association between anthropometric parameters and successful aging in older adults

This study aimed to determine the relationship between successful aging (SA) and anthropometric parameters in older adults. We used body mass index (BMI), waist circumference, hip circumference, and calf circumference to reflect anthropometric parameters. SA was assessed by the following five aspects: self-rated health, self-rated psychological status or mood, cognitive function, activities of daily life, and physical activity. Logistic regression analyses were employed to examine the relationship between anthropometric parameters and SA. Results showed that larger BMI, waist circumference, and calf circumference are related to a higher prevalence of SA in older women; greater waist circumference and calf circumference are associated with a higher rate of SA in old-old adults. These findings suggest that the greater BMI, waist circumference, hip circumference, and calf circumference are associated with a higher rate of SA in older adults, and the associations are influenced to some extent by the sex and age.

Elderly people's preferences for healthcare facilities in Shanghai: gender features and influencing factor analysis

BACKGROUND

China has one of the fastest paces of the growing aging population, High-level policymakers have recently recognized the aging population presents significant challenges to the Chinese healthcare system. In this context, the healthcare-seeking behaviors of the elderly population have become an essential field of study. It is necessary to understand their access to health services and to improve their quality of life, as well as to help policymakers to formulate healthcare policy. The study empirically investigates the factors influencing the elderly population's healthcare-seeking behaviors in Shanghai, China, especially in choosing the quality of healthcare facilities to visit.

METHODS

We designed a cross-sectional study. The data of this study were derived from the "Shanghai elderly medical demand characteristics questionnaire" in the middle of November to early December 2017. A total of 625 individuals were included in the final sample. Logistic regression was adopted to investigate the differences in healthcare-seeking behaviors between elderly people when suffer from mild illness, severe illness and follow-up treatment. Next, the differences in gender were also discussed.

RESULTS

Factors affecting the healthcare-seeking behaviors of the elderly differ in mild illness and severe illness situations. For mild illness, demographic factors (gender and age) and socioeconomic factors (income and employment) play an important role in elderly healthcare choices. Female and older elderlies are more likely to choose local, lower-quality facilities, whereas those with high income and private employment are more likely to choose higher-quality facilities. For severe illness, socioeconomic factors (income and employment) are important. Furthermore, individuals with basic medical insurance are more likely to choose lower-quality facilities.

CONCLUSION

This study has shown that the affordability of public health services should be addressed. Medical policy support may be an important way to reduce the gap in access to medical services. We should pay attention to the gender differences in the elderly's choice of medical treatment behavior, consider the differences in the needs of male and female elderly. our findings are only for elderly Chinese participants in the greater Shanghai area.

Oxidation, Glycation, and Carbamylation of Salivary Biomolecules in Healthy Children, Adults, and the Elderly: Can Saliva Be Used in the Assessment of Aging?

Background

Aging is inextricably linked to oxidative stress, inflammation, and posttranslational protein modifications. However, no studies evaluate oxidation, glycation, and carbamylation of salivary biomolecules as biomarkers of aging. Saliva collection is non-invasive, painless, and inexpensive, which are advantages over other biofluids.

Methods

The study enrolled 180 healthy subjects divided into six groups according to age: 6–13, 14–19, 20–39, 40–59, 60–79, and 80–100 years. The number of individuals was determined a priori based on our previous experiment (power of the test = 0.8; α = 0.05). Non-stimulated saliva and plasma were collected from participants, in which biomarkers of aging were determined by colorimetric, fluorometric, and ELISA methods.

Results

The study have demonstrated that modifications of salivary proteins increase with age, as manifested by decreased total thiol levels and increased carbonyl groups, glycation (Nε-(carboxymethyl) lysine, advanced glycation end products (AGE)) and carbamylation (carbamyl-lysine) protein products in the saliva of old individuals. Oxidative modifications of lipids (4-hydroxynonenal) and nucleic acids (8-hydroxy-2’-deoxyguanosine (8-OHdG)) also increase with age. Salivary redox biomarkers correlate poorly with their plasma levels; however, salivary AGE and 8-OHdG generally reflect their blood concentrations. In the multivariate regression model, they are a predictor of aging and, in the receiver operating characteristic (ROC) analysis, significantly differentiate children and adolescents (under 15 years old) from the working-age population (15–64 years) and the older people (65 years and older).

Conclusion

Salivary AGE and 8-OHdG have the most excellent diagnostic utility in assessing the aging process. Saliva can be used to evaluate the aging of the body.

The Role of Oxidative Stress in the Aging Heart

Medical advances and the availability of diagnostic tools have considerably increased life expectancy and, consequently, the elderly segment of the world population. As age is a major risk factor in cardiovascular disease (CVD), it is critical to understand the changes in cardiac structure and function during the aging process. The phenotypes and molecular mechanisms of cardiac aging include several factors. An increase in oxidative stress is a major player in cardiac aging. Reactive oxygen species (ROS) production is an important mechanism for maintaining physiological processes; its generation is regulated by a system of antioxidant enzymes. Oxidative stress occurs from an imbalance between ROS production and antioxidant defenses resulting in the accumulation of free radicals. In the heart, ROS activate signaling pathways involved in myocyte hypertrophy, interstitial fibrosis, contractile dysfunction, and inflammation thereby affecting cell structure and function, and contributing to cardiac damage and remodeling. In this manuscript, we review recent published research on cardiac aging. We summarize the aging heart biology, highlighting key molecular pathways and cellular processes that underlie the redox signaling changes during aging. Main ROS sources, antioxidant defenses, and the role of dysfunctional mitochondria in the aging heart are addressed. As metabolism changes contribute to cardiac aging, we also comment on the most prevalent metabolic alterations. This review will help us to understand the mechanisms involved in the heart aging process and will provide a background for attractive molecular targets to prevent age-driven pathology of the heart. A greater understanding of the processes involved in cardiac aging may facilitate our ability to mitigate the escalating burden of CVD in older individuals and promote healthy cardiac aging.

Factors related to depression in older adults during the COVID-19 pandemic in two coastal regions of Peru: An analytical cross-sectional study

Background: Mental health problems such as anxiety, depression and their aggravation have been studied extensively in the general population. However, there are few studies on depression in older adults and the few existing results may be contradictory, especially in the context of the COVID-19 pandemic. The aim of this study is to determine the factors associated with depression in older adults in two coastal regions of Peru during the COVID-19 pandemic. Methods: This study uses an analytical cross-sectional design in a population of older adults, who participated in a non-governmental ambulatory social support program in Callao and Ica, two coastal regions of Peru. We administered an on-site structured questionnaire to record sociodemographic data, the Geriatric Depression Scale by Yesavage to measure depression, and the Barthel Index to assess physical function. In order to determine cognitive impairment as an exclusion criterion, the MEC-30 was used. The association between variables was assessed through contingency tables, using the odds ratio (OR) with its corresponding confidence interval (95% CI) and the X2 test. Finally, a binary logistic regression analysis was performed. Results: Out of the 244 older adults surveyed, 39% had depressive symptoms, of which 28.3% (n=69) and 10.7% (n=26) were moderately and severely depressive, respectively. The findings significantly associated with the presence of depressive symptoms were being 76 years old or older [p=0.005, OR: 2.33, 95% CI: 1.29-4.20], not participating in weekly recreational activities [p=0.004, OR: 2.28, 95% CI: 1.31-3.99] and the presence of comorbidities [p=0.026, OR: 1.88, 95% CI: 1.07-3.29]. Conclusion: There are few studies exploring depression in older adults during the COVID-19 pandemic; this research shows the importance of mental health care in this population and, particularly, of those who are 76 or older because they suffer from comorbid conditions and have interrupted recreational activities.

Factors related to depression in older adults during the COVID-19 pandemic in two coastal regions of Peru: An analytical cross-sectional study

Background: Mental health problems such as anxiety, depression and their aggravation have been studied extensively in the general population. However, there are few studies on depression in older adults and the few existing results may be contradictory, especially in the context of the COVID-19 pandemic. The aim of this study is to determine the factors associated with depression in older adults in two coastal regions of Peru during the COVID-19 pandemic. Methods: This study uses an analytical cross-sectional design in a population of older adults, who participated in a non-governmental ambulatory social support program in Callao and Ica, two coastal regions of Peru. We administered an on-site structured questionnaire to record sociodemographic data, the Geriatric Depression Scale by Yesavage to measure depression, and the Barthel Index to assess physical function. In order to determine cognitive impairment as an exclusion criterion, the MEC-30 was used. The association between variables was assessed through contingency tables, using the odds ratio (OR) with its corresponding confidence interval (95% CI) and the X2 test. Finally, a binary logistic regression analysis was performed. Results: Out of the 244 older adults surveyed, 39% had depressive symptoms, of which 28.3% (n=69) and 10.7% (n=26) were moderately and severely depressive, respectively. The findings significantly associated with the presence of depressive symptoms were being 76 years old or older [p=0.005, OR: 2.33, 95% CI: 1.29-4.20], not participating in weekly recreational activities [p=0.004, OR: 2.28, 95% CI: 1.31-3.99] and the presence of comorbidities [p=0.026, OR: 1.88, 95% CI: 1.07-3.29]. Conclusion: There are few studies exploring depression in older adults during the COVID-19 pandemic; this research shows the importance of mental health care in this population and, particularly, of those who are 76 or older because they suffer from comorbid conditions and have interrupted recreational activities.

Factors related to depression in older adults during the COVID-19 pandemic in two coastal regions of Peru: An analytical cross-sectional study

Background: Mental health problems such as anxiety, depression and their aggravation have been studied extensively in the general population. However, there are few studies on depression in older adults and the few existing results may be contradictory, especially in the context of the COVID-19 pandemic. The aim of this study is to determine the factors associated with depression in older adults in two coastal regions of Peru during the COVID-19 pandemic. Methods: This study uses an analytical cross-sectional design in a population of older adults, who participated in a non-governmental ambulatory social support program in Callao and Ica, two coastal regions of Peru. We administered an on-site structured questionnaire to record sociodemographic data, the Geriatric Depression Scale by Yesavage to measure depression, and the Barthel Index to assess physical function. In order to determine cognitive impairment as an exclusion criterion, the MEC-30 was used. The association between variables was assessed through contingency tables, using the odds ratio (OR) with its corresponding confidence interval (95% CI) and the X2 test. Finally, a binary logistic regression analysis was performed. Results: Out of the 244 older adults surveyed, 39% had depressive symptoms, of which 28.3% (n=69) and 10.7% (n=26) were moderately and severely depressive, respectively. The findings significantly associated with the presence of depressive symptoms were being 76 years old or older [p=0.005, OR: 2.33, 95% CI: 1.29-4.20], not participating in weekly recreational activities [p=0.004, OR: 2.28, 95% CI: 1.31-3.99] and the presence of comorbidities [p=0.026, OR: 1.88, 95% CI: 1.07-3.29]. Conclusion: There are few studies exploring depression in older adults during the COVID-19 pandemic; this research shows the importance of mental health care in this population and, particularly, of those who are 76 or older because they suffer from comorbid conditions and have interrupted recreational activities.

Older adults in virtual communities: understanding the antecedents of knowledge contribution and knowledge seeking through the lens of socioemotional selectivity and social cognitive theories

Purpose

As older adults are increasingly active in virtual communities (VCs), these platforms for knowledge exchange present opportunities for companies to use elder human capital. The purpose of this study is to understand the antecedent factors that motivate older adults’ knowledge contribution and knowledge seeking (KS) behaviors in VCs.

Design/methodology/approach

Rooted in socio-emotional selectivity and social cognitive theories, this study included five key variables and developed models for older adults’ knowledge contributing (KC)/KS behaviors. This paper tested the hypotheses using data from a sample of 204 older adults in 3 VCs in China.

Findings

The results provide support for most of the hypotheses and show that while other members’ participation (MP) acts as a substitute for meaning in life and attitude toward aging, it acts as a complement for outcome expectations (OE) focused on others and OE focused on oneself in their impacts on KC/KS activities.

Practical implications

The study provides practical insights for developing elder human resources via VCs to avoid knowledge loss.

Originality/value

This study described older adults’ unique characteristics when modeling their information and communication technologies-related behaviors and built two models to explain their KC/KS behaviors. It confirmed that the same factor has different levels of impact on older adults’ KC/KS behaviors in VCs. In addition, it confirmed and reinforced the complementary and substitutive effects of other MP as an environmental factor on these behaviors.

Dyadic Interviews versus In-Depth Individual Interviews in Exploring Food Choices of Norwegian Older Adults: A Comparison of Two Qualitative Methods

The term “dyadic interview” refers to interviewing two participants together. Although there has been an increase in the use of dyadic interviews as a data collection method in qualitative studies, the literature on the use of this method with older adults is limited. This study was designed to explore the suitability of dyadic interviews as a method of data collection among older adults living at home. The study involved a direct comparison of the data obtained from dyadic interviews and in-depth individual interviews concerning older adults’ food choices. The study sample consisted of eight dyads for the dyadic interviews and six participants for the in-depth individual interviews. The dyads were composed of pairs who share a pre-existing relationship as well as pairs of strangers. We also discussed the role of participant selection and pairing in dyadic interviewing and how the interactions between the dyads may affect the result. Our results indicated that dyadic interviews can be used as an important data collection tool for home-living older adults, particularly when exploring a topic that often involves a dyadic decision. Our findings can be useful for researchers to make a more informed choice when choosing qualitative data collection methods, particularly when interviewing older people.

Relationship between Depression and Cognitive Impairment among Elderly: A Cross-sectional Study

Introduction: Depression and cognitive impairment are common mental health problems among elderly, although few studies have examined their co-occurrence in aging population. So the aim of this study was to determine the relationship between depression and cognitive impairment in older adults.

Methods: This cross-sectional population-based study was conducted on 506 older adults were presented to the health centers of the municipality of Tehran, Iran. Data were collected using the sociodemographic questionnaire, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS). Data were analyzed by using SPSS-17 with correlation analysis and logistic regression.

Results: The mean age of the participants was 65.71 years. Older people (>75 years) had more twice risk (95% CI: 1.01-4.90) for cognitive dysfunction. There was a significant correlation between MMSE and GDS. Elderly with collegiate education had 85% (95% CI: 0.1-0.5) and employed elderly had 56% (95% CI: 0.04-0.74) lower risk for cognitive dysfunction. Elderly with severe depression had twice risk (95% CI: 1.41-4.8) for cognitive dysfunction.

Conclusion: Findings suggest there is a relationship between depression and cognitive impairment among the elderly. These findings emphasis on assessing cognitive impairment and depression in geriatric assessment in elderly.

Health profiles and socioeconomic characteristics of nonagenarians residing in Mugello, a rural area in Tuscany (Italy)

Background

Health, as defined by the WHO, is a multidimensional concept that includes different aspects. Interest in the health conditions of the oldest-old has increased as a consequence of the phenomenon of population aging. This study investigates whether (1) it is possible to identify health profiles among the oldest-old, taking into account physical, emotional and psychological information about health, and (2) there are demographic and socioeconomic differences among the health profiles.

Methods

Latent Class Analysis with covariates was applied to the Mugello Study data to identify health profiles among the 504 nonagenarians residing in the Mugello district (Tuscany, Italy) and to evaluate the association between socioeconomic characteristics and the health profiles resulting from the analysis.

Results

This study highlights four groups labeled according to the posterior probability of determining a certain health characteristic: “healthy”, “physically healthy with cognitive impairment”, “unhealthy”, and “severely unhealthy”. Some demographic and socioeconomic characteristics were found to be associated with the final groups: older nonagenarians are more likely to be in worse health conditions; men are in general healthier than women; more educated individuals are less likely to be in extremely poor health conditions, while the lowest-educated are more likely to be cognitively impaired; and office or intellectual workers are less likely to be in poor health conditions than are farmers.

Conclusions

Considering multiple dimensions of health to determine health profiles among the oldest-old could help to better evaluate their care needs according to their health status.

Using grip strength to compute physical health-adjusted old age dependency ratios

The standard approach for comparing the potential challenges of population aging across countries based on conventional old-age dependency ratios (OADR) does not account for cross-population differences in health, functional capacity or disability, despite their importance for labor force participation and dependency more broadly. We investigate how OADRs observed across selected low-, middle-, and high-income countries change if population differences in physical health measured by hand-grip strength are accounted for. Specifically, we propose and calculate an adjusted measure of the OADR based on hand-grip strength, which serves as an objective indicator of muscle function and has been shown to predict future morbidity, disability and mortality. We show that adjusting the OADR for differences in hand-grip strength results in substantial changes in country rankings by OADR compared to a ranking based on the conventional OADR definition. Accounting for cross-population differences in hand-grip strength, the estimated OADRs for low- and middle-income countries tend to increase compared to the conventional OADR approach based on age only, whereas the estimated OADRs in high-income countries decline substantially relative to the standard approach. Since hand-grip strength is an important prerequisite for maintaining functional capacity and productivity and preventing disability -especially in economies in low-income settings- our grip-strength-adjusted OADRs clearly show that population aging is not just a challenge in high-income countries but also an important concern for economies in the developing world.

Activities of daily living, life orientation, and health-related quality of life among older people in nursing homes: a national cross-sectional study in China

PURPOSE

This study aimed to explore the current status of activities of daily living (ADLs), life orientation, and health-related quality of life (HRQoL) among older people in nursing homes and to further examine the mediating role of life orientation in the impact of ADLs on HRQoL.

METHODS

A national cross-sectional study was conducted among older people aged 60 and above in nursing homes by the randomly stratified cluster sampling method. The status of ADLs, life orientation and HRQoL were measured using an ADL scale, a life orientation scale and the SF-12v2 scale, respectively. Multiple linear regression models were used to identify explanatory factors associated with ADLs, life orientation, and HRQoL. The potential mediating role of life orientation in the relationship between ADL and HRQoL was explored by mediation analysis.

RESULTS

The overall prevalence of ADL disability was 52.67%, and 84.37% of older people in nursing homes had a negative life orientation. The mean scores of physical health and mental health among older people in nursing homes were 45.44 ± 6.46 and 42.67 ± 8.48, respectively. Some sociodemographic characteristics were associated with poor physical health and mental health. After adjustments were made for covariates, the life orientation score mediated 13.81% of the total effect of the ADL score on physical component score of HRQoL and mediated 45.33% of the mental component score of HRQoL.

CONCLUSION

A sizeable proportion of older people had ADL disability and negative life orientation, and HRQoL was poor among older Chinese people in nursing homes. Life orientation partially mediates the relationship between ADLs and HRQoL.

Two-photon imaging of oxidative stress in living erythrocytes as a measure for human aging

According to the "oxidative stress theory" of aging, this process is accompanied by a progressive and irreversible accumulation of oxidative damage caused by reactive oxygen species (ROS). This, in turn, has a deleterious impact on molecular mechanisms in aging thereby altering the physiological function of the organism, increasing the risk of different aging-related diseases, as well as impacting the life span. The aim of the current study was to investigate oxidative stress in living red blood cells (RBCs) in human aging as an oxidative stress-related pathological condition. Two-photon laser scanning and light microscopy techniques were applied to analyze the oxidative stress in RBCs and the cell viability. Spectrophotometric analyzes were performed to determine the percentage of RBC hemolysis, activities of superoxide dismutase and catalase in RBCs, as well as the ferroxidase activities of ceruloplasmin in blood plasma samples. The studies included three human aging groups, young, middle-aged, and elderly. According to the results, the two-photon fluorescence of carboxy-DCFDA, indicating the intensity of oxidative stress, significantly increase in RBCs by the increase of age (P < 0.05), and these intensities are in statistically significant positive correlation with age (P < 0.001) and a strong negative correlation (P < 0.05) with the activity of catalase in RBCs and ferroxidase activity of ceruloplasmin in plasma. In conclusion, two-photon fluorescent imaging of oxidative stress in human living RBCs is a valuable and accurate method for the determination of aging processes in humans and can be suggested as a novel indicator for human aging processes in individual aging.

Live-interactive teledermatology program in Taiwan: One-year experience serving a district hospital in rural Taitung County

BACKGROUND/PURPOSE

Population aging and unequal accessibility of health care are increasingly important in developed countries. One strategy to overcome these issues is utilizing telemedicine, which is recently made possible technologically by the advancement of internet speed, high speed zooming cameras, and the information storages. In Taiwan, the telemedicine is granted legally by the amendment for Taiwan's Physician Act in 2018.

METHODS

Kaohsiung Chang Gung Memorial Hospital (Kaohsiung CGMH) is the first hospital in Taiwan to provide the telemedicine service connecting to Cheng Kung Branch of Taitung Hospital since Nov 2018. Consultation services from Dermatology, ENT, and Ophthalmology have been delivered in the live-interactive and face to face module every week.

RESULTS

Dermatology consultation comprises the majorities. In the first year, there were totally 426 dermatology consultation services. Eczema, fungal infections, and scabies infestation were the three most common diseases in the beginning. The disease diagnosis became more diverse after several months, including some ready-to-treat diseases pending correct diagnosis, such as pediculosis, psoriasis, and urticaria. Coupled with dermoscopic images, diseases such as hair loss, pediculosis capitis, skin tumor, and scabies, were diagnosed promptly. The subjective patient improvement rate was more than 75% year-round and the case closure rate was more than 85% year-round.

CONCLUSION

Teledermatology is a promising approach to serve the remote medical-underprivileged regions. The teledermatology is anticipated to help underserved regions, nursing homes, prisons, and in situations with severe pandemic infections, such as COVID-19.

Anti-ageing gene therapy: Not so far away?

Improving healthspan is the main objective of anti-ageing research. Currently, innovative gene therapy-based approaches seem to be among the most promising for preventing and treating chronic polygenic pathologies, including age-related ones. The gene-based therapy allows to modulate the genome architecture using both direct (e.g., by gene editing) and indirect (e.g., by viral or non-viral vectors) approaches. Nevertheless, considering the extraordinary complexity of processes involved in ageing and ageing-related diseases, the effectiveness of these therapeutic options is often unsatisfactory and limited by their side-effects. Thus, clinical implementation of such applications is certainly a long-time process that will require many translation phases for addressing challenges. However, after overcoming these issues, their implementation in clinical practice may obviously provide new possibilities in anti-ageing medicine. Here, we review and discuss recent advances in this rapidly developing research field.

Construction of a comprehensive observer-based scale assessing aging-related health and functioning in captive rhesus macaques

Aging-related health and functioning are difficult to quantify in humans and nonhuman primates. We constructed an observer-based scale for daily application in assessing the aging-related health and functioning of rhesus macaques. Ten items referring to an aging appearance, musculoskeletal aging and aging-related eating behavior were selected through a panel consensus. The Aging-related Health and Functioning Scale (AHFS) was constructed based on these scored items form 57 healthy rhesus macaques. High reliability of the AHFS was shown based on Cronbach’s alpha coefficient (0.877). The structure of the AHFS was validated by three exploratory factors. The largest factor, whose four components were dietary uptake, iliac muscle mass, hair condition and fragility, and sex, explained 50.5% of the variation in aging-related health and functioning scores. The second factor, involving age, tooth loss and tooth wear, explained 15.5% of the variation. The lowest-ranking factor comprised only facial redness and accounted for 10% of the variation. A hierarchical cluster analysis validated the good applicability of the scale in distinct samples. From these scale-scored results, complicated aging phenomena observed in humans, including the sex-survival paradox and the calorie-related health-survival paradox, were both demonstrated in rhesus macaques. Therefore, the AHFS provides a valuable approach for aging-related research.