Epigenetic Age Acceleration and Chronological Age: Associations With Cognitive Performance in Daily Life

DNA methylation-derived epigenetic clocks offer the opportunity to examine aspects of age acceleration (ie, the difference between an individual's biological age and chronological age), which vary among individuals and may better account for age-related changes in cognitive function than chronological age. Leveraging existing ambulatory cognitive assessments in daily life from a genetically diverse sample of 142 adults in midlife, we examined associations between 5 measures of epigenetic age acceleration and performance on tasks of processing speed and working memory. Covarying for chronological age, we used multilevel models to examine associations of epigenetic age acceleration (Horvath 1, Horvath 2, Hannum, PhenoAge, and GrimAge clocks) with both average level and variability of cognitive performance. Positive age acceleration (ie, epigenetic age greater than chronological age) was associated with poorer mean processing speed (Horvath 1 and 2) and working memory (GrimAge). Higher chronological age was also associated with poorer mean processing speed and working memory performance. Further, positive age acceleration was generally associated with greater intraindividual variability in working memory and processing speed tasks, whereas being chronologically older was associated with less intraindividual variability. Although further work is needed, our results indicate age acceleration effects have comparable or greater size as those for chronological age differences, suggesting that epigenetic age acceleration may account for additional risk and interindividual variation in cognitive performance above chronological age.

MEASURING PERSONALITY IN DAILY LIFE: EVIDENCE FROM AN AGE-HETEROGENEOUS ADULT SAMPLE

Research on personality has theorized that repeated short-term experiences can lead to changes in personality traits across years or decades. Whereas much research on these short-term experiences relevant to personality has been done in samples of college students, this study intended to measure personality-relevant short-term experiences among an age-heterogeneous sample of adults. As part the Effects of Stress on Cognitive Aging, Physiology, and Emotions study, 260 participants (Mage=46.49 years, range=25-65 years) completed a measure of Big Five personality traits before completing a 14-day ecological momentary assessment (EMA) period during which participants reported their momentary negative and positive thoughts, emotions, and social interactions up to six times per day on study-provided smartphones. We hypothesized that these EMA reports could be used as daily markers of trait extraversion and trait neuroticism such that these daily experiences could be interpreted as manifestations of personality traits in daily life. Results of parallel multilevel confirmatory factor analyses showed good model fit (extraversion: CFI=0.96; TLI=0.95; RMSEA=0.03; neuroticism: CFI=0.95; TLI=0.94; RMSEA=0.04). For both extraversion and neuroticism, the latent trait factor and the latent daily-marker factor were positively correlated (extraversion: r=0.36; SE=0.07; p<.001; neuroticism: r=0.45; SE=0.07; p<.001). Results suggest that among an age-heterogeneous adult sample, momentary thoughts, feelings, and behaviors across a two-week period represented expressions of extraversion and neuroticism in daily life. Measuring these short-term experiences is meaningful for understanding how personality changes across adulthood, and future work can use longitudinal data to test if daily markers of personality are sensitive to fluctuations and changes in personality.

Assessing Personality in Daily Life: Variability Between and Within Persons

Trait personality measures may not be able to detect subtle personality changes and fluctuations which may be indicative of cognitive impairment. Measuring personality in daily life may allow sufficient sensitivity to capture this within-person variability. Eighty-six older adults from the Einstein Aging Study completed items assessing daily extraversion and neuroticism for a median of 17 days. Using separate unconditional models, we calculated the proportions of variance in daily extraversion and neuroticism that were due to between-person and within-person variability. Variability in daily extraversion was relatively evenly related to between-person differences and within-person fluctuation (Intra-Class Correlation [ICC] = 0.576), but the majority of variability in daily neuroticism was at the between-person level (ICC = 0.730). Thus, although these daily assessments were sensitive enough to capture within-person variability in personality in daily life, different traits may exhibit more or less of this variability.

Can Ecological Momentary Assessments Be Used as Daily Markers of Personality Traits?

This study hypothesized that select ecological momentary assessment (EMA) survey items are sensitive to day-to-day fluctuations in personality traits Extraversion (E) and Neuroticism (N). As part of the Einstein Aging Study, 312 older adults (Mage=76.96 years, SD=4.85 years, range=70-90 years) completed up to 5 EMA surveys per day for 16 days and a Big Five trait personality measure. Parallel two-factor multilevel confirmatory factor analyses were conducted for E (Daily-E; Trait-E) and N (Daily-N; Trait-N). The E model showed good fit (CFI=.95; TLI=.94; RMSEA=.02) and a significant correlation of .20 between Daily-E and Trait-E factors. The N model showed poor fit (CFI=.68; TLI=.61; RMSEA=.06). Results suggest EMA items can be used as daily markers of Extraversion, yet results are unclear for Neuroticism due to poor model fit. Daily markers of Extraversion can be used to detect fluctuations in personality traits across days that may predict long-term personality change.

The Effect of Early Neighborhood Contexts on Cognitive Function in Midlife

We evaluated associations between objective and subjective early-life neighborhood contexts and cognitive function at midlife. Study participants grew up in different addresses but resided in the same urban zip code at the time of data collection thus controlling for concurrent neighborhood contexts. Participants provided their home address when they were five-years-old and recalled their age-five neighborhood conditions (Mage= 40.59 (7.91); n = 130). Age-five addresses were geocoded and linked with harmonized longitudinal Census tract boundaries and variables. Predictive models with a self-reported neighborhood conditions score, an objective neighborhood deprivation indicator, and other sociodemographic covariates indicated that poorer age-five self-reported neighborhood conditions were significantly associated with lower baseline (Cohen’s d = -.24) and average daily (d = -.21) working memory performance. There were no associations with objective age-five neighborhoods. Results contribute to a growing literature on the role of psychosocial neighborhood contexts on cognition that may extend back to childhood neighborhoods.

Does Chronic Stress Moderate Age Differences in Emotional Well-Being? Testing Predictions of Strength and Vulnerability Integration

OBJECTIVES

The Strength and Vulnerability Integration (SAVI) theory posits boundary conditions, such as chronic stress, which place constraints on positive emotional aging. We examine SAVI's prediction that higher levels of chronic stress will attenuate favorable age gradients for multiple indices of well-being.

METHODS

We used cross-sectional data from a diverse systematic probability sample of adults (n = 260, ages 25-65). Multiple regression analysis was used to examine age gradients and test age × chronic stress interactions on 5 measures of well-being relevant for SAVI's prediction: positive and negative affect, life satisfaction, emotional distress, and rumination.

RESULTS

Age was unrelated to well-being unless individual differences in health limitations were statistically controlled, in which case older age was associated with more favorable levels of well-being. Chronic stress significantly interacted with age for negative affect, emotional distress, rumination, and life satisfaction; examination of the interactions indicated that age was no longer associated with more favorable levels of well-being at higher levels of chronic stress.

DISCUSSION

Our findings support a key prediction of SAVI by demonstrating that high levels of chronic stress present a boundary condition for favorable age gradients on well-being. We discuss the implications of these findings for understanding the "paradox" of well-being.

A Qualitative Analysis of the Relationship Between Older Adults’ Daily Lives and Life Outlook

Leading theories of adult development suggest age-related changes in one’s life perspective and changes in one’s priorities are reflected in daily behavior. The present study explored how older adults understand their current lives through a qualitative study of midwestern Americans. Twenty-four participants (Mage= 69.53 years; age range=63-78 years) from the Notre Dame Study of Health & Well-Being (Whitehead & Bergeman, 2014) completed semi-structured interviews in which they were asked about turning points across their lives. Inductive analysis using the constant comparative method (Maykut & Morehouse, 1994) resulted in 10 life-domains based on common descriptions across participants. These domains represented the ways in which participants understood their identities over the course of their lives, as well as their organization and use of time and space in daily life. Participants’ descriptions of both general life outlook and daily life informed one another, revealing the dialectical relationship between micro-level behaviors and macro-level attitudes.

The Impact of Perceived Neighborhoods in Childhood and Adulthood on Daily Cognitive Function

Neighborhood experiences may have a cumulative effect on cognitive health outcomes across the lifespan. We investigated independent and combined associations between current and retrospective childhood neighborhoods and daily cognitive function in 209 adults (Mage=47.07; range: 25-65) who participated in a 14-day ecological momentary assessment study. Participants reported perceptions of their current neighborhood and the neighborhood they lived in at age 5; including neighborhood cohesion, safety, violence, and physical conditions. Greater current neighborhood violence was independently associated with poorer spatial working memory. Childhood neighborhood violence was not significantly associated with performance. The interaction between current and childhood neighborhood ratings was significant: individuals who reported greater childhood neighborhood violence, but lower current violence had better performance than those who experienced consistently high or low neighborhood violence. Effects for other neighborhood domains were not significant. Results indicate that neighborhood influences on cognition in adulthood may be moderated by childhood neighborhood experiences.

COGNITIVE FUNCTIONING AMONG BREAST CANCER SURVIVORS AND NON-CANCER PARTICIPANTS: EVIDENCE FOR SIMILARITIES

Breast cancer survivors may experience accelerated decline in cognitive functioning compared to same-aged peers with no cancer history (Small et al., 2015). Survivors may show important differences in mean-level performance or variability in cognitive functioning compared to those without a history of cancer (Yao et al., 2016). This study compared ambulatory cognitive functioning in a sample of breast cancer survivors and an age-matched community sample without a history of cancer (n_cancer=47, n_non-cancer=105, age range: 40-64 years, M=52.13 years). Participants completed three cognitive tasks measuring working memory, executive functioning, and processing speed up to five times per day for 14 days. Results indicated no mean-level differences in cognitive performance on the three tasks between cancer survivors and those without cancer history (p’s>.05). Unexpectedly, women without cancer history showed more variability than survivors on working memory but not on the other two tasks. Across both groups, those without a college education performed worse on executive functioning (B=-0.05, SE=0.03, p<.05) and working memory (B=0.94, SE=0.36, p<.05) compared to those that completed college. Additionally, older age was associated with slower processing speed (B=31.67, SE=7.44, p<.001). In sum, this study did not find mean-level group differences in cognitive functioning between cancer survivors and age-matched women without a history of cancer. Contrary to hypotheses, those without a history of cancer were more variable on working memory. Results suggested similarities in cognitive functioning in the two samples and that education and age are important predictors of cognitive functioning independent of cancer history.

Aging process, adherence to Mediterranean diet and nutritional status in a large cohort of nonagenarians: Effects on endothelial progenitor cells

BACKGROUND AND AIM

Adherence to the Mediterranean Diet (MD) has been associated with a longer and better life. The aim of this study was to examine the effects of adherence to the MD, and of nutritional habits on endothelial progenitor (EPCs) and circulating progenitor (CPCs) cells in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status.

METHODS AND RESULTS

Four hundred twenty-one nonagenarians (306 F, 115 M, mean age: 93.1 ± 3.2 years) were evaluated. Adherence to MD was assessed through the Mediterranean Diet Score. Elderly subjects who were in the fourth quartile of the Mediterranean diet score showed significantly higher EPCs than subjects grouped into the other three quartiles. After adjustment for confounders, elderly subjects who were in the highest quartile of adherence to the MD score reported to have EPCs' levels significantly higher than those who reported lower values of adherence to the MD. Furthermore, by analyzing different food categories, it was reported that daily consumption of olive oil and a higher consumption of fruit and vegetables showed higher CPCs CD34⁺ and EPCs CD34⁺/KDR⁺ than subjects with not daily or lower consumption.

CONCLUSION

Our results support the hypothesis that the adherence to MD, as well as a daily consumption of olive oil and fruit and vegetables, characteristics of MD, may protect against the development of endothelial dysfunction through increasing EPCs and CPCs in older age.

Mediterranean Diet, Food Consumption and Risk of Late-Life Depression: The Mugello Study

OBJECTIVES

To investigate eating habits and adherence to Mediterranean Diet (MD) in relation to the risk of depression in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status.

DESIGN

Cross-sectional study.

SETTING

Homes and nursing homes in the Mugello area, Florence, Italy.

PARTICIPANTS

Subjects aged 90-99 years [N=388 (271F; 117M) mean age: 92.7±3.1].

MEASUREMENTS

All subjects were evaluated through questionnaires and instrumental examinations. Adherence to MD was assessed through the Mediterranean Diet Score. A shorter version of the Geriatric Depression Scale (GDS) was used to detect the possible presence of depressive symptoms. In addition, cognitive and functional status was assessed using the Mini-Mental State Examination, the Clock Drawing Test, as well as the Basic and Instrumental Activities of Daily Living test.

RESULTS

Depressed subjects (DS) (GDS score≥5, 43.8%) were older, females and widows, than non-depressed subjects (NDS). DS reported a slightly but not statistically significant lower MD score than NDS (33.9±3.9 vs. 34.6±3.3, p=0.149). Subjects who reported to consume a greater amount of olive oil and fruit were associated with a lower risk of depression (OR=0.35, 95%CI=0.20-0.59, p<0.001 and OR=0.46, 95%CI=0.26-0.84, p=0.011, respectively) after adjustment for many possible confounders. Similar results were obtained for women, while no statistically significant differences emerged for men.

CONCLUSION

Our results support the hypothesis that a diet rich in olive oil and fruit, characteristics of MD, may protect against the development of depressive symptoms in older age.

Higher uric acid serum levels are associated with better muscle function in the oldest old: Results from the Mugello Study

BACKGROUND

Sarcopenia is the progressive loss of muscle mass and strength that occurs with advancing age and plays a pivotal role in the causal pathway leading to frailty, disability and, eventually, to death among older persons. As oxidative damage of muscle proteins has been shown to be a relevant contributory factor, in this study we hypothesized that uric acid (UA), a powerful endogenous antioxidant, might exert a protective effect on muscle function in the oldest old and we tested our hypothesis in a group of nonagenarians who participated in the Mugello Study.

METHODS

239 subjects, 73 men and 166 women, mean age 92.8years±SD 3.1, underwent the assessment of UA serum level and isometric handgrip strength, a widely used clinical measure of sarcopenia.

RESULTS

Mean UA serum level was 5.69mg/dL±SD 1.70 and mean handgrip strength was 15.0kg±SD 6.9. After adjusting for relevant confounders, higher UA serum levels remained independent positive predictors of isometric handgrip strength (β 1.24±SE(β) 0.43, p=0.005).

CONCLUSION

Our results show that higher UA serum levels are associated with better muscle function in the oldest old and, accordingly, might slow down the progression of sarcopenia.

Dynamic Reorganization of Vortex Matter into Partially Disordered Lattices

We report structural evidence of dynamic reorganization in vortex matter in clean NbSe(2) by joint small-angle neutron scattering and ac susceptibility measurements. The application of oscillatory forces in a transitional region near the order-disorder transition results in robust bulk vortex lattice configurations with an intermediate degree of disorder. These dynamically originated configurations correlate with intermediate pinning responses previously observed, resolving a long-standing debate regarding the origin of such responses.

First Report of Plum pox virus Strain M Isolates in Apricot in Sicily, Italy

Sharka or plum pox disease is one of the most economically important virus diseases of stone fruits. Plum pox virus (PPV), the causal agent, is a member of the genus Potyvirus of the family Potyviridae transmitted by aphids in a non-persistent manner and by grafting. To date, nine PPV strains have been described on the basis of their biological, serological, and molecular properties: M and D are the most widespread and economically important strains, PPV-Rec and PPV-C have been reported mainly in Europe, PPV-EA confined to Egypt, PPV-T to Turkey, PPV-W from Canada, Ukraine, Latvia, and Russia, PPV-CR detected in Russia, and finally a putative PPV strain infecting plum in Albania described as the ancestor of the M. PPV-M is responsible for major epidemics in many Italian regions and despite phytosanitary measures, the infection rate increases each year. The D and Rec isolates are sporadically reported while PPV-C, once signaled in Apulia, has been successfully eradicated. Except for a report from the 1980s, which is no longer traceable, Sicily was considered free from the virus (2). In 2012, two new foci of sharka in a coastal area of Catania in Sicily were first reported by the national plant protection service to the European Commission (DG-SANCO). In spring 2013, plants of different varieties of apricot (Prunus armeniaca) and peach (P. persica) showing typical symptoms of flower color break, yellowing and leaf deformation, chlorotic spots or rings, and malformation on fruits were tested positive to PPV by DAS-ELISA using polyclonal antibodies. In order to characterize two isolates from apricot varieties (Carmen Top and Ninfa), total RNAs, extracted using the RNeasy Plant Mini Kit (Qiagen) from ELISA-positive samples, were analyzed by RT-PCR with primers P1/P2, targeting the 3'-terminal region of the coat protein (CP) gene (5) followed by RFLP analysis after digestion with Rsa1. Subsequently total RNAs were analyzed with the type-specific primers P1/PM and P1/PD (3), P3M/P4b and P3D/P4b amplifying the N-terminal region of the CP gene (1) and, finally, with primers mD5/mD3, mM5/mM3, and mD5/mM3, amplifying the region 3'NIb-5'CP, including the recombination site of Rec isolates (4). Only primer pairs P1/P2, P1/PM, P3M/P4b, and mM5/mM3 produced amplicons of the expected size (243, 198, 466, and 459 bp, respectively). The RFLP assay confirmed both isolates belonging to the M strain. Moreover, no reaction was obtained with primer pair mD5/mM3, excluding isolates belonging to Rec-type. Isolate characterization was completed by direct sequencing in both directions of the of P1/P2 and P3M/P4b amplicons obtained from apricot samples L9-1 (Carmen Top isolate) and 9-335 (Ninfa isolate). The P1/P2 sequences (KJ994235, KJ994237) showed 98% similarity with PPV-M or PPV-Rec isolates. The P3M/P4b sequences (KJ994236, KJ994238) confirmed that Sicilian isolates belong to the PPV-M strain showing 99% similarity with those already present in GenBank, thus ruling out the possibility of an infection with a PPV-Rec isolate. This outbreak of the Marcus strain of PPV in Sicily represents a high risk for the expanding production of stone fruit in southern Italy. An eradication plan was quickly activated by the regional phytosanitary service. References: (1) T. Candresse et al. Phytopathology 101:611, 2011. (2) EPPO. PQR-EPPO database on quarantine pests (available online). http://www.eppo.int , 2014. (3) A. Olmos et al. J. Virol. Methods 68:127, 1997. (4) Z. Subr et al. Acta Virol. 48:173, 2004. (5) T. Wetzel et al. J. Virol. Methods 33:355, 1991.

Predictors of response to exercise therapy for chronic low back pain: result of a prospective study with one year follow-up

BACKGROUND

Low back pain (LBP) management is a critical public health issue in all developed countries. Most approaches show evidence of effects only in the short term.

AIM

To identify predictors of functional outcome on discharge and at 1 year.

DESIGN

Prospective cohort study.

SETTING

Outpatient rehabilitation department.

POPULATION

Patients aged >18 addressed to exercise therapy for persisting LBP.

METHODS

The individually designed physiotherapy program provided 7 sessions (45'); patients were given advice to stay active and continue exercise program on discharge. Baseline (T0) assessment included: age, sex, time since onset, pain-related drug use, previous treatments, job, physical activity, pain (NRS) and Mental Health (SF36 sub-score); at follow-up (T2), we also enquired to on adherence to exercise prescription, physical activity, drugs. The primary outcome measure was the Roland and Morris Disability Questionnaire (RMDQ) patients scoring improvement >30% (minimal clinical important difference) were classified as respondent.

RESULTS

211 completed follow-up (70% women; age 70.4±11.9). Average RMDQ score was reduced by 35% at T1 and by 31% at T2; NRS by 28% (T1) and 24% (T2); 125 patients (59%) were responders on discharge; 106 (50%) at follow-up. Only higher baseline NRS predicted poor response to treatment at T1 (OR=0.83, 95% CI: 0.71-0.95, P=0.012)). At T2, older age (OR=0.94, 95% CI: 0.91-0.98, P=0.003), drug use (OR=0.18, 95% CI: 0.08-4,69, P<0.001) and previous treatments (OR 0.33, 95% CI: 0.15 to 0.71, P=0.004) were significantly associated with poor response, while, baseline mental health (OR=1.1, 95% CI: 1.01-1.24, P=0.02) and adherence to exercises for LBP (OR=2.10, 95% CI: 1.03-4.42, P=0.04) predicted improved outcome.

CONCLUSIONS

The individually designed exercise therapy program for chronic LBP was associated to clinically significant functional improvement both on discharge and at 1 year. Only severe pain intensity predicted poor treatment response on discharge. At one year, younger age and better mental health predicted improved outcome, while use of drugs and previous LBP treatments were associated with worse response. Adherence to the exercise program almost doubled the probability of a favorable outcome.

CLINICAL REHABILITATION IMPACT

Adherence to an extensive individually designed exercise therapy program improves long term functional outcome of chronic low back pain.

Higher uric acid levels are associated with better functional recovery in elderly patients receiving cardiac rehabilitation

BACKGROUND AND AIMS

Whether uric acid (UA) serves as risk factor for cardiovascular diseases or as antioxidant defense has not yet been completely clarified. In this study we investigated the effects of UA on functional recovery in patients receiving cardiac rehabilitation.

METHODS AND RESULTS

306 patients, 209 men and 97 women, age range 25-87 years (mean 68 ± 11), performed the 6-min walk test (6mWT) before and after the rehabilitation, and the increase in walking distance was considered as the outcome measure of the study. Baseline UA serum levels ranged from 1.0 to 10.9 mg/dL (mean 5.2 ± 1.7). As there was a significant (p = 0.005) age*UA levels interaction, patients were divided into two subgroups, less then 65 years (n. 103, 68 men and 35 women, mean age 56 ± 9) and 65 years or more (n. 203, 141 men and 62 women, mean age 74 ± 5). After adjusting for relevant confounders, higher UA levels remained independent positive predictors of the increase in walking distance in older (p < 0.001) but not in younger patients (p = 0.807).

CONCLUSIONS

Our findings show an independent association of higher UA levels with better functional recovery after cardiac rehabilitation selectively in elderly patients, suggesting that higher UA levels might reflect the decline in antioxidant defenses that occurs with advancing age. Future studies aimed at understanding the several contradictions concerning UA should, probably, address the issue within this perspective.

Predictors of functional outcome in patients with chronic low back pain undergoing back school, individual physiotherapy or spinal manipulation

BACKGROUND

Recent studies on chronic low back pain (cLBP) rehabilitation suggest that predictors of treatment outcome may be differ according to the considered conservative treatment.

AIM

To identify predictors of response to back school (BS), individual physiotherapy (IP) or spinal manipulation (SM) for cLBP.

POPULATION

outpatients with cLBP.

SETTING

Outpatient rehabilitation department.

DESIGN

Retrospective analysis from a randomized trial.

METHODS

Two hundred and ten patients with cLBP were randomly assigned to either BS, IP or SM; the Roland Morris Disability Questionnaire (RM) was assessed before and after treatment: those who decreased their RM score <2.5 were considered non-responders. Baseline potential predictors of outcome included demographics, general and cLBP history, life satisfaction.

RESULTS

Of the 205 patients who completed treatment (140/205 women, age 58+14 years), non-responders were 72 (34.2%). SM showed the highest functional improvement and the lowest non-response rate. In a multivariable logistic regression, lower baseline RM score (OR 0.82, 95% CI 0.76-0.89, P<0.001) and received treatment (OR 0.32, 95% CI 0.21-0.50, P<0.001) were independent predictors of non-response. Being in the lowest tertile of baseline RM score (<6) predicted non response to treatment for BS and IP, but not for SM (same risk for all tertiles).

CONCLUSIONS

In our patients with cLBP lower baseline pain-related disability predicted non-response to physiotherapy, but not to spinal manipulation.

CLINICAL REHABILITATION IMPACT

Our results suggest that, independent form other characteristics, patients with cLBP and low pain-related disability should first consider spinal manipulation as a conservative treatment.