Cognitive function in community-dwelling elderly women. Attentional demands and capacity to direct attention

Sex Differences in Depressive Symptom Networks Among Community-Dwelling Older Adults

BACKGROUND

Compared to males, an increased prevalence of depression has been reported in older females consistently over time. Sex differences in depressive symptom networks may help explain the underlying causes of this increased vulnerability for females.

OBJECTIVE

This cross-sectional study investigated the sex differences in depressive symptom networks among community-dwelling older adults in South Korea.

METHODS

The analysis was based on the 2019 Korean Community Health Survey data targeting adults aged 65 years or older. Using network analysis, depressive symptom networks were constructed according to the items listed in the Patient Health Questionnaire-9 for propensity score-matched male and female groups. Strength centrality and network stability were tested. A network comparison test was performed to investigate the difference between the networks based on the invariance of global strength, network structure, edge strength, and specific centrality measures.

RESULTS

Symptoms central to the network were similar between sexes, which were suicidal ideation, hopelessness, and psychomotor retardation/agitation. However, the global structure and network structure differed between sexes. The female symptom network showed more strengthened edges. Notably, four edges-loss of interest-hopelessness, sleep disturbance-low energy/fatigue, loss of interest-concentration difficulty, and worthlessness-concentration difficulty-were more pronounced in the female network. Strength centrality did not differ between the two networks.

DISCUSSION

Our results may help guide future research and clinical interventions for female depression. In addition, educating health professionals on the differences in depressive symptom presentation will be crucial to ensuring that older female adults receive appropriate treatment.

Leucine Supplementation Increases Muscle Strength and Volume, Reduces Inflammation, and Affects Wellbeing in Adults and Adolescents with Cerebral Palsy

BACKGROUND

Spastic cerebral palsy (CP) is characterized by muscle weakness owing, in part, to a blunted muscle protein synthetic response. This might be normalized by long-term leucine supplementation.

OBJECTIVES

The study assessed the effects of 10 wk leucine supplementation in adolescents and adults with CP.

METHODS

The study was a single-center randomized controlled trial. Twenty-four participants were randomly assigned to a control group (n = 12) or a leucine group (n = 12). l-Leucine (192 mg/kg body mass) was dissolved in water and administered daily for 10 wk. The primary outcome measures of elbow flexor muscle strength and muscle volume (measured by 3D ultrasound technique) and inflammation [C-reactive protein (CRP) concentration] were assessed before and after the 10 wk, alongside the secondary outcomes of body composition (measured by CP-specific skinfold assessment), metabolic rate (measured by indirect calorimetry), and wellbeing (measured by a self-reported daily questionnaire). Data were compared via a series of 2-factor mixed ANOVAs.

RESULTS

Twenty-one participants completed the intervention (control group: n = 11, mean ± SD age: 18.3 ± 2.8 y, body mass: 48.8 ± 11.9 kg, 45% male; leucine group: n = 10, age: 18.6 ± 1.7 y, body mass: 58.3 ± 20.2 kg, 70% male). After 10 wk, there was a 25.4% increase in strength (P = 0.019) and a 3.6% increase in muscle volume (P = 0.001) in the leucine group, with no changes in the control group. This was accompanied by a 59.1% reduction in CRP (P = 0.045) and improved perceptions of wellbeing (P = 0.006) in the leucine group. No changes in metabolism or body composition were observed in either group (P > 0.05).

CONCLUSIONS

Improvements in muscle strength and volume with leucine supplementation might provide important functional changes for adults and adolescents with CP and could be partly explained by reduced inflammation. The improved wellbeing highlights its capacity to improve the quality of daily living. This trial was registered at clinicaltrials.gov as NCT03668548.

A Physical-Cognitive Intervention to Enhance Gait Speed in Older Mexican Adults

Purpose.

To test the effects of a physical-cognitive exercise intervention on gait parameters under dual-task conditions in community-dwelling older adults.

Design.

A repeated-measures quasi-experimental design, with control and exercise groups, was used.

Setting.

Study participants consist of a convenience sample recruited from senior citizens' centers in Monterrey, Mexico.

Subjects.

A total of 143 sedentary participants ages 65 to 92 years per group participated.

Intervention.

A combined 45- to 60-minute program of physical and cognitive exercises was conducted in three weekly sessions during 12 weeks for the exercise group.

Measures.

The spatial gait parameters of speed (cm/s), step width, and stride length (cm); and the temporal parameters of single and double support time, cadence (steps per minute), and swing time(s) were measured using the GaitRite. Counting backwards or naming animals represented cognitive performance.

Analysis.

Two (groups: exercise group vs. control group) by three (time: baseline, week 6, and week 12) repeated-measures multivariate analysis of variance (MANOVA) was applied.

Results.

Repeated-measures multivariate analysis of variance revealed a significant group effect (Wilks lambda F4,279 = 6.78, p < .001); univariate analysis showed significant differences for gait speed (m/s), stride length, cadence, step width, and double support time. Time-by-group interaction showed significance in gait speed and stride length.

Conclusion.

The exercise group participants showed increased gait speed, cadence, and stride length, and reduced their step width and time spent with both feet on the ground. Walking while simultaneously performing a cognitive task might prepare older adults for competing/interfering demands from their environments. The protective health benefits of this intervention remain to be investigated.

Cochlear implant rehabilitation in older adults: literature review and proposal of a conceptual framework

OBJECTIVES

To review studies investigating cochlear implant (CI) outcomes in older adults, and to develop a conceptual framework demonstrating important interactions between characteristics of hearing disability, aging, and the CI intervention.

DESIGN

Review of English literature with titles containing the words "cochlear implant" and generic term referring to older adults or numerical value for age greater than 65.

RESULTS

Hearing loss is a prevalent consequence of aging and poses special challenges for older adults. Particularly when superimposed on other age-related conditions, presbycusis (age-related hearing loss) places older adults at risk for social isolation and associated psychological and general health sequelae. The increasing cognitive demand of verbal communication and the diminished sense of social and physical connectedness can contribute to a feeling of vulnerability and poor health that worsens with advancing presbycusis. This cascade of downstream effects of hearing loss has implications for the self-assessment of health-related quality of life (HRQoL) and resulting estimates of associated costs. There is accumulating evidence of a potential role for CI in older adults with poor word understanding despite conventional hearing aid use. This review of the literature provides strong evidence of the benefits of restoring communication capacity in the deaf and hard-of-hearing geriatric population. There is, however, a lack of attention to communication performance in the real world and HRQoL outcomes, and significant gaps in knowledge regarding how CI rehabilitation interacts with changing psychosocial and functional status with aging.

CONCLUSION

A broader conceptual framework than is currently available for the role of CI rehabilitation in the management of severe-to-profound hearing loss in older adults is proposed. It is posited that the use of such a model in future investigations is needed to guide multidisciplinary investigations into the unique challenges of hearing loss in older adults and may open new opportunities for innovation.

Attentional Demands and Daily Functioning Among Community-Dwelling Elders

Everyday life is full of numerous demands for attention that can affect the ability to function. For elders, examples of these attentional demands include negotiating public transportation and driving, sensory losses, and physical discomforts and worries that make it harder to concentrate and complete tasks. The purpose of this study was to examine the relation between attentional demands and the ability to manage daily activities requiring concentration for 54 community-dwelling elders (34 women, 20 men). As theorized, attentional demands correlated (r = -.58) significantly with daily functioning: Elders with more attentional demands perceived themselves as having greater difficulty managing tasks requiring concentration. Attentional demands accounted for a significant proportion of variance in functioning (12%), even after partialling out the effects of depressive symptoms and health. Findings support the theorized relation between attentional demands and daily functioning, as well as nursing interventions aimed at decreasing attentional demands to promote effective functioning for elders.