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Background: Many physical functions decline with aging, but it is not known whether oral functions vary according to sex or decline with aging, as it occurs with physical functions. The present study aimed to examine the association of sex, age, and elapsed years with occlusal force and tongue pressure using a generalized linear mixed‐effect model (GLMM) over a 3‐year period among old‐old Japanese adults. Methods: Participants were community‐dwelling older adults who participated in a survey (June 2014–March 2017) and a follow‐up survey (July 2017–December 2019) after 3 years (n = 951: 70‐year group, n = 466; 80‐year group, n = 391; 90‐year group, n = 94). Dental examinations including the number of teeth, occlusal force, and tongue pressure were conducted, and a GLMM was used to estimate the association of sex, age, and elapsed years with occlusal force and tongue pressure, adjusting for the number of teeth. Results: The GLMM showed that occlusal force was significantly associated with sex (reference; male, non‐standardized coefficient: B = −66.9 [female], p < 0.001), age (reference; 70‐year group, B = −81.7 [80‐year group], p < 0.001, B = −87.2 [90‐year group], p < 0.001), and the number of teeth (B = 13.8, p < 0.001), but did not significantly decrease with elapsed years. Tongue pressure was significantly associated with sex (reference; male, B = −0.94 [female], p = 0.034) and age (reference; 70‐year group, B = −1.78 [80‐year group], p < 0.001, B = −5.47 [90‐year group], p < 0.001). Tongue pressure decreased significantly with elapsed years (B = −0.82, p < 0.001). Conclusions: These findings suggest that tongue pressure significantly decreased over time, but occlusal force did not. Tongue‐related muscles may be more susceptible to aging than masticatory muscles. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVES: Exposure to air pollution may contribute to both increasing depressive symptoms and decreasing episodic memory in older adulthood, but few studies have examined this hypothesis in a longitudinal context. Accordingly, we examined the association between air pollution and changes in depressive symptoms (DS) and episodic memory (EM) and their interrelationship in oldest‐old (aged 80 and older) women. DESIGN: Prospective cohort data from the Women's Health Initiative Memory Study‐Epidemiology of Cognitive Health Outcomes. SETTING: Geographically diverse community‐dwelling population. PARTICIPANTS: A total of 1,583 dementia‐free women aged 80 and older. MEASUREMENTS: Women completed up to six annual memory assessments (latent composite of East Boston Memory Test and Telephone Interview for Cognitive Status) and the 15‐item Geriatric Depression Scale (GDS‐15). We estimated 3‐year average exposures to regional particulate matter with aerodynamic diameter below 2.5 μm (PM2.5) (interquartile range [IQR] = 3.35 μg/m3) and gaseous nitrogen dioxide (NO2) (IQR = 9.55 ppb) at baseline and during a remote period 10 years earlier, using regionalized national universal kriging. RESULTS: Latent change structural equation models examined whether residing in areas with higher pollutant levels was associated with annual changes in standardized EM and DS while adjusting for potential confounders. Remote NO2 (β =.287 per IQR; P =.002) and PM2.5 (β =.170 per IQR; P =.019) exposure was significantly associated with larger increases in standardized DS, although the magnitude of the difference, less than 1 point on the GDS‐15, is of questionable clinical significance. Higher DS were associated with accelerated EM declines (β = −.372; P =.001), with a significant indirect effect of remote NO2 and PM2.5 exposure on EM declines mediated by DS. There were no other significant indirect exposure effects. CONCLUSION: These findings in oldest‐old women point to potential adverse effects of late‐life exposure to air pollution on subsequent interplay between DS and EM, highlighting air pollution as an environmental health risk factor for older women. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether protein intake is associated with better disability trajectories in the oldest adults (≥85) and whether muscle mass and muscle strength would partially mediate this. Design Prospective cohort study. Setting: Newcastle‐upon‐Tyne and North Tyneside, United Kingdom. Participants: Community‐dwelling older adults aged 85 at baseline (N=722). Methods: Protein intake was estimated using two 24‐hour multiple‐pass recalls at baseline. Disability was measured as difficulty performing 17 activities of daily living at baseline and 18, 36, and 60 months. Trajectories were derived using mortality‐adjusted group‐based trajectory modelling. The effect of protein intake (g/kg of adjusted body weight (aBW)/d) on disability trajectories was examined using multinomial logistic regression. Results: Participants had 4 distinct disability trajectories (between the ages of 85 and 90: constant very low (AT1), mild (AT2), moderate (AT3), and severe (AT4). Each unit increase in protein (g) per kg of aBW/d was associated with greater odds of AT1 (odds ratio (OR=7.97, 95% confidence interval (CI)=1.96–32.43, p =.004) and AT2 (OR=3.28, 95% CI=1.09–9.87, p =.03) than of AT4 over 5 years in models adjusted for selected covariates. Participants with protein intake of 1.0 g/kg aBW/d or more were more likely to belong to AT1 (OR=3.65, 95% CI=1.59–8.38, p =.009) and AT2 (OR=2.12, 95% CI=1.16–3.90, p =.01) than to AT4. Conclusion: Higher protein intake, especially 1.0 g/kg aBW/d or more, was associated with better disability trajectories in the oldest adults. These findings will inform new dietary strategies to support active, healthy ageing. J Am Geriatr Soc 67:50–56, 2019. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the epidemiology of insomnia, including demographic and clinical correlates, in older adults. Design: Cross‐sectional. Setting: Community. Participants: Yale Precipitating Events Project participants (N=379; mean age 84.3; 67.8% female; 11.9% African American). Measurements: Insomnia Severity Index (ISI), with scores of 8 and higher indicating insomnia, which was further stratified according to ISI score as mild (8–14), moderate (15–21), or severe (22–28). Baseline characteristics included age, sex, race, education, smoking, obesity, medical conditions, depressive symptoms (Center for Epidemiologic Studies Depression score ≥16), cognitive impairment (Mini‐Mental State Examination score <24), restless legs syndrome (RLS), self‐reported sleep‐disordered breathing (SDB), medications, and daytime sleepiness (Epworth Sleepiness Scale (ESS), range 0–24). Results: Insomnia was established in 163 (43.0%) participants (average ISI score 12.3 (mild)). For the entire sample, average baseline characteristics were as follows: 30.1% did not complete high school, 5% were current smokers, 19.2% were obese, 28.2% had cardiovascular disease, 19.3% had chronic lung disease, 27.2% had depressive symptoms, 16.1% had cognitive impairment, 36.8% had RLS, and 3.4% had self‐reported SDB; mean number of medications was 9.2, and mean ESS was 6.4. In multivariable regression models, only depressive symptoms (adjusted odds ratio (aOR)=8.34, 95% confidence interval (CI)=4.49, 15.47) and RLS (aOR=2.49, 95% CI=1.48, 4.21) were significantly associated with insomnia. Conclusion: In a sample of older adults with high medical burden and polypharmacy, insomnia was highly prevalent but unexpectedly mild and associated only with depressive symptoms and RLS. The discordance of high prevalence but mild severity of insomnia in the oldest adults highlights the need for diagnostic confirmation with objective measures of sleep disturbances, whereas the strong associations with depressive symptoms and RLS inform priorities in managing insomnia. [ABSTRACT FROM AUTHOR]

Objectives To determine reference values for laboratory tests in individuals aged 85 and older. Design Cross-sectional cohort study. Setting International. Participants Long Life Family Study (LLFS) participants (N~5,000, age: range 25-110, median 67, 45% male). Measurements Serum biomarkers were selected based on association with aging-related diseases and included complete blood count, lipids (triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol), 25-hydroxyvitamin D2 and D3, vitamin D epi-isomer, diabetes mellitus-related biomarkers (adiponectin, insulin, insulin-like growth factor 1, glucose, glycosylated hemoglobin, soluble receptor for advanced glycation endproduct), kidney disease-related biomarkers (albumin, creatinine, cystatin), endocrine biomarkers (dehydroepiandrosterone, sex-hormone binding globulin, testosterone), markers of inflammation (interleukin 6, high-sensitivity C-reactive protein, N-terminal pro b-type natriuretic peptide), ferritin, and transferrin. Results Of 38 measured biomarkers, 34 were significantly correlated with age. Summary statistics were generated for all biomarkers according to sex and 5-year age increments from 50 and up after excluding participants with diseases and treatments that were associated with biomarkers. A biomarker data set was also generated that will be useful for other investigators seeking to compare biomarker levels between studies. Conclusion Levels of several biomarkers change with older age in healthy individuals. The descriptive statistics identified herein will be useful in future studies and, if replicated in additional studies, might also become useful in clinical practice. The availability of the reference data set will facilitate appropriate calibration of biomarkers measured in different laboratories. [ABSTRACT FROM AUTHOR]

Objectives To determine whether simple functional indicators are predictors of survival prognosis in very old adults. Design In-person survey conducted over a 3-month period in 1998; assessment of survival over a 15-year follow-up period. Setting Denmark. Participants All 3,600 Danes born in 1905 and living in Denmark in 1998, were invited to participate regardless of residence and health; 2,262 (63%) participated in the survey: 1,814 (80.2%) in person and 448 (19.8%) through a proxy. Measurements Socioeconomic factors, medications and diseases, activities of daily living, physical performance, cognition, depression symptomatology, self-rated health, and all-cause mortality, evaluated as average remaining lifespan and chance of surviving to 100 years. Results Men aged 92 to 93 had an overall 6.0% chance of surviving to 100 years, whereas the chance for women was 11.4%. Being able to rise without use of hands increased the chance for men to 11.2% (95% confidence interval (CI) = 7.7-14.7) and for women to 22.0% (95% CI = 18.9-25.1). When combining this with a Mini-Mental State Examination (MMSE) scores from 28 to 30, the chances were 21.7% (95% CI = 11.5-31.9) for men and 34.2% (95% CI = 24.8-43.5) for women. Conclusion Chair stand score combined with MMSE score is a quick and easy way to estimate overall chance of survival in very old adults, which is particularly relevant when treatment with potential side effects for nonacute diseases is considered. [ABSTRACT FROM AUTHOR]

Objectives To determine whether symptoms and clinical signs of swallowing dysfunction could be easily identified in community-dwelling elderly adults and to examine the association between self-report and direct observation of symptoms and signs of swallowing dysfunction. Design Physiological substudy conducted as a home visit within an observational cohort study. Setting Baltimore City and County, Maryland. Participants Community-dwelling elderly women without history of dysphagia or neurological disease aged 85 to 94 enrolled in the Women's Health and Aging Study II (N = 47). Measurements Three trials of the 3-ounce water swallowing test, swallowing function questionnaire, and frailty status. Results Thirty-four (72%) subjects demonstrated swallowing dysfunction in at least one swallowing trial and 16 (34%) in all three trials. The most common signs of dysfunction were throat clear and wet voice. Conversely, participants reported few symptoms of dysphagia on a swallowing function questionnaire. The most common symptom, reported by approximately 15% of participants, was the sensation of the food going 'down the wrong way,' 8.5% or fewer participants reported other symptoms. Conclusion Signs of swallowing dysfunction were present in a large majority of community-dwelling old-old women, but they were largely unrecognized and reported. Formal evaluation of swallowing function in community-dwelling elderly adults is necessary to determine the clinical consequences of these findings. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine whether well-known predictors of mortality change their predictive power over time, being reduced or even reversed in the old-old. DESIGN: A multidimensional survey of the Cross-Sectional and Longitudinal Aging Study conducted from 1989 to 1992 with follow-up of mortality after 6, 8, 10, and 12 years since 1989. SETTING: Israel. PARTICIPANTS: Participants (N=1,369) were drawn from a national sample of the Jewish Israeli population aged 75 to 94. MEASUREMENTS: Data included sociodemographic factors and measures of health, physical condition, cognitive performance, and depression. RESULTS: The results showed that age, sex, disability, self-rated health, and marital status predicted mortality and that their predictive power changed over 9 years. CONCLUSION: In the old-old, predictors of mortality changed over time, and their predictive effect eventually diminished. The predictors found to be most significant (age, sex, disability, and self-rated health) support the common cause theory. [ABSTRACT FROM AUTHOR]

Evaluates the personal care assistance for the elderly patients in Israel. Assessment on the assistance of disabled older people; Factors affecting the assistance with activities of daily living (ADL) of older people; Comparison between the levels of ADL disability and caretaking arrangements for the disabled older people.