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• This is the first study to assess brain rs-FC in older masters athletes (MA). • Higher rs-FC within cognitive regions in MA compared to controls. • Higher rs-FC within motor regions in MA compared to controls. • Less rs-FC between cognitive and motor regions in MA compared to controls. • Aging-related rs-FC segregation patterns are attenuated in top-ranked athletes. Aging is characterized by a decline in physical and cognitive functions, often resulting in decreased quality of life. Physical activity has been suggested to potentially slow down various aspects of the aging process, a theory that has been supported by studies of Masters Athletes (MA). For example, MA usually have better cognitive and physical functions than age-matched sedentary and healthy older adults (OA), making them a valuable model to gain insights into mechanisms that promote physical and cognitive function with aging. The purpose of this study was to identify differences in resting-state functional connectivity (rs-FC) of motor and cognitive regions between MA and OA and determine if these differences in the resting brain are associated with differences in cognitive and physical performance between groups. Fifteen MA (9 males) and 12 age-matched OA (six males) were included. rs-FC images were compared to identify significant between-groups differences in brain connectivity. There was higher connectivity between the cognitive and motor networks for the OA group, whereas the MA group had stronger connectivity between different regions within the same network, both for the cognitive and the motor networks. These results are in line with the literature suggesting that aging reduces the segregation between functional networks and causes regions within the same network to be less strongly connected. High-level physical activity practiced by the MA most likely contributes to attenuating aging-related changes in brain functional connectivity, preserving clearer boundaries between different functional networks, which may ultimately favor maintenance of efficient cognitive and sensorimotor processing. [ABSTRACT FROM AUTHOR]

Deficits in physical function that occur with aging contribute to declines in quality of life and increased mortality. There has been a growing interest in examining associations between physical function and neurobiology. Whereas high levels of white matter disease have been found in individuals with mobility impairments in structural brain studies, much less is known about the relationship between physical function and functional brain networks. Even less is known about the association between modifiable risk factors such as body mass index (BMI) and functional brain networks. The current study examined baseline functional brain networks in 192 individuals from the Brain Networks and mobility (B-NET) study, an ongoing longitudinal, observational study in community-dwelling adults aged 70 and older. Physical function and BMI were found to be associated with sensorimotor and dorsal attention network connectivity. There was a synergistic interaction such that high physical function and low BMI were associated with the highest network integrity. White matter disease did not modify these relationships. Future work is needed to understand the causal direction of these relationships. [ABSTRACT FROM AUTHOR]

Purpose: We examined the associations between pulmonary impairments and physical function and whether age, HIV serostatus, or smoking modified these relationships.Methods: Using Multicenter AIDS Cohort Study data, we examined associations between pulmonary function (diffusing capacity for carbon monoxide [DLCO], one-second forced expiratory volume [FEV1]) and subsequent physical outcomes (gait speed, grip strength, frailty [non-frail, pre-frail, frail]) using mixed models.Results: Of 1,048 men, 55% were living with HIV, median age was 57(IQR=48,64) and median cumulative pack-years was 1.2(IQR = 0,18.1); 33% and 13% had impaired DLCO and FEV1(<80% predicted), respectively. Participants with impaired DLCO had 3.5 kg (95%CI: -4.6, -2.4) weaker grip strength, 0.04 m/sec (95%CI: -0.06, -0.02) slower gait speed and 4.44-fold (95%CI: 1.81, 10.93) greater odds of frailty compared to participants with normal DLCO. Participants with impaired FEV1 had 3.1 kg (95%CI: -4.8, -1.4) weaker grip strength, similar gait speed (-0.001 m/sec [95%CI: -0.04, 0.03]) and 5.72-fold (95%CI: 1.90, 17.19) greater odds of frailty compared to participants with normal FEV1. Age, but not smoking or HIV, significantly modified the DLCO effect on gait speed and grip strength.Conclusions: Pulmonary impairment and decreased physical function were associated. Preserving pulmonary function may help preserve physical function in aging men with and without HIV. [ABSTRACT FROM AUTHOR]

The aging population prompts studying risk factors and markers to predict healthy aging. Telomere length is a promising candidate for assessing various age-related traits. To investigate the association between physical performance and telomere length. We enrolled 323 older Mexican adults from the "Cohort of Obesity, Sarcopenia, and Frailty of Older Mexican Adults" affiliated with the Instituto Mexicano del Seguro Social and assessed their physical performance using the Short Physical Performance Battery, dividing participants into low (≤7) and high (>7) groups. Absolute telomere length was determined by qPCR, and individuals were classified into short (≤4.22 kb) and long (>4.22 kb) groups. We calculated the mean and adjusted mean, considering sex and age, among others, with 95% CI. We estimated the effect size between physical performance and telomere length using Cohen's d for unequal group sizes and calculated the odds ratio for physical performance based on telomere length. Participants with low physical performance had significantly shorter telomeres (mean 4.1 4.4 4.7 kb, adjusted mean 3.5 4.0 4.5 kb, p <0.001), while those with high physical performance exhibited longer telomeres (mean 5.5 5.7 5.9 kb, adjusted mean 4.7 5.3 5.8 kb, p <0.001), with a medium-to-high telomere length effect size (d = 0.762). The odds of low physical activity increased 2.1 3.6 6.1 -fold per kb of telomere attrition (adjOR 1.7 3.3 6.3 , p <0.001). Decreased physical function is associated with shorter telomere length. Absolute telomere length presents a promising biomarker for distinguishing between healthy and unhealthy aging, warranting further investigation. [ABSTRACT FROM AUTHOR]

Older adults with multiple sclerosis (MS) present with low physical activity participation, cognitive and ambulatory dysfunctions, and compromised quality of life (QOL). We propose a NIH Stage-I, randomized controlled trial (RCT) that examines the feasibility and efficacy of a 16-week theory-based, remotely-delivered, exercise training program for improving cognitive and physical functions in older adults with MS who have moderate mobility disability without severe cognitive impairment. This Stage-I study utilizes a parallel-group RCT design. Participants (N = 50; age ≥ 50 years) will be randomly assigned into exercise training (combined aerobic and resistance exercise) or active control (flexibility and stretching) conditions. The conditions will be undertaken within a participant's home/community over a 16-week period, and monitored remotely and supported by Zoom-based chats guided by social cognitive theory (SCT) via a behavioral coach. Participants will receive training manuals and equipment, one-on-one behavioral coaching, action-planning calendars, self-monitoring logs, and SCT-based newsletters. The primary outcomes include feasibility (e.g., recruitment and retention rates), exercise behavior and physical activity; other outcomes include physical function (lower-extremity function, mobility, walking), cognition (processing speed, learning and memory, executive function), MS symptoms, QOL, and vascular function. We will collect outcome data at baseline (Week 0), post-intervention (Week 16), and follow-up (Week-32). Data analysis will follow intent-to-treat principles using linear mixed-effects models. This Stage-I trial adopts an innovative approach for exercise training via telerehabilitation and is convenient and accessible for older adults with MS. If successful, the study will provide foundations for future research using remotely-delivered exercise intervention for managing the consequences of aging with MS. Trial Registration Number: NCT05930821 [ABSTRACT FROM AUTHOR]

The onset of sarcopenia is intimately linked with aging, posing significant implications not only for individual patient quality of life but also for the broader societal healthcare framework. Early and accurate identification of sarcopenia and a comprehensive understanding of its mechanistic underpinnings and therapeutic targets paramount to addressing this condition effectively. This review endeavors to present a cohesive overview of recent advancements in sarcopenia research and diagnosis. We initially delve into the contemporary diagnostic criteria, specifically referencing the European Working Group on Sarcopenia in Older People (EWGSOP) 2 and Asian Working Group on Sarcopenia (AWGS) 2019 benchmarks. Additionally, we elucidate comprehensive assessment techniques for muscle strength, quantity, and physical performance, highlighting tools such as grip strength, chair stand test, dual-energy X-ray Absorptiometry (DEXA), bioelectrical impedance analysis (BIA), gait speed, and short physical performance battery (SPPB), while also discussing their inherent advantages and limitations. Such diagnostic advancements pave the way for early identification and unequivocal diagnosis of sarcopenia. Proceeding further, we provide a deep-dive into sarcopenia's pathogenesis, offering a thorough examination of associated signaling pathways like the Myostatin, AMP-activated protein kinase (AMPK), insulin/IGF-1 Signaling (IIS), and the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways. Each pathway's role in sarcopenia mediation is detailed, underscoring potential therapeutic target avenues. From a mechanistic perspective, the review also underscores the pivotal role of mitochondrial dysfunction in sarcopenia, emphasizing elements such as mitochondrial oxidative overload, mitochondrial biogenesis, and mitophagy, and highlighting their therapeutic significance. At last, we capture recent strides made in sarcopenia treatment, ranging from nutritional and exercise interventions to potential pharmacological and supplementation strategies. In sum, this review meticulously synthesizes the latest scientific developments in sarcopenia, aiming to enhance diagnostic precision in clinical practice and provide comprehensive insights into refined mechanistic targets and innovative therapeutic interventions, ultimately contributing to optimized patient care and advancements in the field. [Display omitted] [ABSTRACT FROM AUTHOR]

• Distinct trajectories exist for physical activity and BMI from middle to older age. • Trajectories in physical activity included an emergent physical activity group. • Stable-high and emergent physical activity groups had better later-life function. • Benefits of physical activity on function existed across different BMI trajectories. We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931–1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0–5 scale) and Large Muscle Function (0–4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P = 0.577), Large Muscle Function (P = 0.511), ADLs (P = 0.600), and IADLs (P = 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age. [ABSTRACT FROM AUTHOR]

In recent years the focus of healthcare and nutritional science in older adults has shifted from mortality towards physical performance and quality of life. The aim of this review was to summarize observational studies on physical performance in malnourished (MN) or at risk of malnutrition (RMN) older adults compared with well-nourished (WN) older adults. Eligible studies had to report on nutritional status and objectively measured physical performance in older adults (≥60 y). MN or RMN groups had to be compared with a WN group, measured with a validated nutrition screener. Ovid Medline and Web of Science were searched until 13 November, 2020. Study quality was scored using a modified Newcastle–Ottawa Scale (NOS). Results were analyzed by meta-analysis when possible, or narratively reviewed otherwise. Forty-five studies (16,911 participants in total) were included from studies in outpatient clinics (n = 6), nursing homes (n = 3), community-dwelling older adults (n = 20), hospitalized patients (n = 15), or a combination (n = 1). Studies used 11 different screeners of malnutrition, and 8 types of physical performance measures. Meta-analysis showed that compared with MN, WN groups had better hand grip strength (mean difference [MD] = 4.92 kg; 95% CI: 3.43, 6.41; P < 0.001; n = 23), faster gait speed (MD = 0.16 m/s; 95% CI: 0.05, 0.27; P = 0.0033; n = 7), performed faster on timed-up-and-go (MD = –5.94 s; 95% CI: –8.98, –2.89; P < 0.001; n = 8), and scored 1.2 more short physical performance battery points (95% CI: 1.32, 2.73; P < 0.001; n = 6). Results were less pronounced when compared with RMN. Narratively, all studies showed an association for knee extension strength, 6-min walking test, and multicomponent tests, except for the chair stand test. Study limitations include no studies scoring "good" on NOS, lack of confounder adjustment, and high heterogeneity. Overall, evidence from cross-sectional studies indicate an association between malnutrition and worse physical performance in older adults. This study is registered in PROSPERO as CRD42020192893. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined the associations between changes in depressive symptoms and handgrip strength in older people. This study aimed to examine the magnitude of the association between depressive symptoms over 2 years and weak handgrip strength on the 4 years of follow-up.Methods: We conducted a longitudinal study using data from the English Longitudinal Study of Aging, a nationally representative panel survey of older adults in England. Data were derived from waves 4 (2008-2009), 5 (2010-2011), and 6 (2012-2013). A total of 5,080 participants were included in the analysis. Depressive symptoms were dichotomized using the eight-item Center for Epidemiological Studies Depression Scale in waves 4 and 5 and were regarded as the exposure. Handgrip strength measurements objectively measured in wave 6 were dichotomized according to the 25th percentile of the British norm and used as the outcome. The targeted maximum likelihood estimation model was utilized to assess time-variant depressive symptoms on handgrip strength, adjusted for time-variant and time-invariant covariates.Results: The maintenance of non-depressive symptoms (relative risk [RR], 0.72; 95% confidence interval [CI], 0.59-0.87) or improvement of depressive symptoms (RR, 0.71; 95% CI, 0.55-0.91) had a protective effect on weak handgrip strength compared with the persistence of depressive symptoms.Limitation: This study is not a randomized control trial but a longitudinal observational study, indicating that our study finding may still have been affected by unknown confounders.Conclusion: Our findings suggest the importance of managing depressive symptoms to prevent poor physical function. [ABSTRACT FROM AUTHOR]

Physical Unclonable Functions (PUFs) have gained attention as a lightweight hardware security primitive. In particular, the SRAM-based PUF uses the unpredictable power-up value of the cells within an SRAM. Although these values should ideally be always the same within each SRAM to accomplish a correct PUF operation, this is often not the case, especially when factors like circuit aging are considered. While certain studies explore the effects of aging on SRAM PUFs, they often simplify the analysis. For instance, some studies assume that only Bias Temperature Instability (BTI) contributes to circuit degradation while others evaluate the overall degradation without accounting for the stochastic effects of aging on each individual cell. In this work, we first perform a detailed characterization of the nature of aging in SRAM PUFs, demonstrating that the impact of Non-Conductive Hot-Carrier Injection cannot be neglected. We also show that different cells degrade differently, highlighting the importance of accounting for the stochasticity of aging. After that, a method based on the Data Retention Voltage metric to select the cells with the most stable power-up response is introduced. Using these cells to generate the PUF identifier will result in a more stable response, and thus a better PUF performance. [ABSTRACT FROM AUTHOR]

Almost 75% of US adults are overweight or obese. Though intentional weight loss of as little as 3% improves physical functioning and reduces cardiometabolic risk, most adults are unsuccessful at long-term weight maintenance. Our hypothesis is that intermittent fasting (IF: short periods of intense energy restriction) will reduce weight regain. IF may combat obesity due to its effects on nutrient-sensing signaling pathways and circadian rhythm. The objective of this randomized clinical trial is to test the effectiveness of an intensive body weight management program with and without IF. In the Promotion of Successful Weight Management in Overweight and Obese Veterans (POWER-VET) trial (NCT04131647), 154 middle-aged and older adults (50–75 years) who are overweight and obese (BMI: 25–40 kg/m2) and seen at either a Baltimore, MD or San Antonio, TX Veterans Affairs Medical Center will be enrolled. Participants will undergo 12 weeks of weight loss (including a low-calorie heart healthy (HH) diet and exercise). Following weight loss, participants will be randomly assigned to one of two 24-week weight maintenance (WM) interventions: WM alone (continuation of HH diet and exercise) or WM + IF. The primary aim is to determine the effect of WM + IF compared to WM alone on body weight maintenance after intentional weight loss. Determining effective, translatable strategies that minimize weight regain following successful weight loss holds public health relevance. This POWER-VET trial introduces an innovative practice of IF to prevent weight regain after clinically significant weight reduction and could provide evidence-based recommendations to promote this type of intervention in middle aged and older adults. [ABSTRACT FROM AUTHOR]

• Dance combines aerobic, coordination and cognitive exercise. • Dance is a leisure activity that motivates people and elicits emotions. • Dance improves brain structure and function of older adults. • Dance training has a protective effect on cognition in older adults. Dance is a multidomain activity that combines aerobic, coordination and cognitive exercise. This music-associated physical and cognitive exercise is a leisure activity that motivates people, elicits emotions, and avoids boredom, promoting adherence to practice. Continuing physical activity is of paramount importance, since cognitive benefits tend to disappear or even reverse when training ceases. The question we addressed in this systematic review is what influence dance has on the brain and cognition of healthy middle-aged and older adults. We systematically reviewed the effects of dance on brain and cognition in older adults using MEDLINE, Psyc-Info, PubMed and Scopus databases. After screening 1051 studies, thirty-five met the eligibility inclusion criteria. These studies showed that dance improves brain structure and function as well as physical and cognitive functions. The protective effect of dance training on cognition in older adults, together with the possibility of adapting intensity and style to suit possible physical limitations makes this activity very suitable for older adults. [ABSTRACT FROM AUTHOR]

• This paper proposes a methodology for design and performance prediction strategy to target oscillation frequency (F OSC) of N-stage ring oscillators (RO). Then it is extended to mitigate the impact of aging on the reliability of RO-PUF without having any SPICE/aging simulation overhead. • A Python tool is developed to use our in-house developed CMOS inverter timing models (CITMs) to predict device-level variability (including aging) impact on F OSC of N-stage RO. • To maintain the reliability of an RO-PUF, effective W P / W N ratio for CMOS inverters in ROs in the pre-layout stage is evaluated to prevent bit flipping from occurring due to aging in RO-PUF without subjecting it to real-world operating stress conditions. This task is achieved by extending our developed CITMs to evaluate the impact of aging on the CMOS inverter's g. • With a one-time SPICE/aging simulation, the proposed methodology eliminates SPICE/aging simulation overhead for the prediction of variability impact on F osc of N -stage RO. • This approach mitigates the aging impact on the reliability of RO-PUF and provides a method for variability (including aging) aware design in the pre-layout stage. We propose a methodology to predict device-level variability (including aging) impact on the oscillation frequency (F o s c) of an N -stage ring oscillator (RO). This task is accomplished by creating a tool in a Python environment that uses our own developed variability-aware timing models of the CMOS inverter. Moreover, we use the model to foretell the impact of aging on the logical effort (g) of a CMOS inverter. Using the modified g , we resize ROs in an RO-based physical unclonable function (PUF) in the pre-layout stage to mitigate the impact of aging on the reliability of RO-PUF. The simulation is performed in the Cadence AMS environment using STMicroelectronics (STM) 28 nm CMOS process technology. With a one-time SPICE/aging simulation, the proposed methodology eliminates SPICE/aging simulation overhead for the prediction of variability impact on F osc of a given N -stage RO. This approach mitigates the impact of aging on the reliability of RO-PUF and provides a method for variability (including aging) aware design in the pre-layout stage. [ABSTRACT FROM AUTHOR]

Sarcopenia, defined as the loss of muscle mass and function, is a widely prevalent and severe condition in older adults. Since 2016, it is recognized as a disease. Strength exercise training and nutritional support are the frontline treatment of sarcopenia, with no drug currently approved for this indication. However, new therapeutic options are emerging. In this review, we evidenced that only very few trials have focused on sarcopenia/sarcopenic patients. Most drug trials were performed in different clinical older populations (e.g., men with hypogonadism, post-menopausal women at risk for osteoporosis), and their efficacy were tested separately on the components of sarcopenia (muscle mass, muscle strength and physical performances). Results from trials testing the effects of Testosterone, Selective Androgen Receptor Modulators (SARMs), Estrogen, Dehydroepiandrosterone (DHEA), Insulin-like Growth Factor-1 (IGF-1), Growth Hormone (GH), GH Secretagogue (GHS), drug targeting Myostatin and Activin receptor pathway, Vitamin D, Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), or β-blockers, were compiled. Although some drugs have been effective in improving muscle mass and/or strength, this was not translated into clinically relevant improvements on physical performance. Finally, some promising molecules investigated in on-going clinical trials and in pre-clinical phase were summarized, including apelin and irisin. [Display omitted] [ABSTRACT FROM AUTHOR]

This systematic review with meta-analyses investigates the impact of resistance training (RT), using meta-regressions, on functional performance in frail and pre-frail adults aged ≥ 65 years to determine the key variables of RT. Ten randomized controlled trials involving 1303 participants were analyzed. Five studies assessed habitual walking speed (HWS), three studies evaluated performance in the timed-up-and-go test (TUG), three studies evaluated performance in the Short Physical Performance Battery (SPPB), and three studies assessed performance in the sit-to-stand test (STS). RT alone improved STS time and SPPB scores in frail and pre-frail older adults. RT improved STS performance (Effect Size (ES):− 0.536; 95% CI − 0.874 to − 0.199; p =.002) and led to a 2.261-point increase in SPPB performance (ES:1.682; 95% CI 0.579–2.786; p =.003). At least two weekly training sessions are required to increase SPPB scores, and three sessions seem to optimize the improvements. Higher training volume per exercise and volume per session reduce the gains in SPPB performance. We did not observe any association between different doses of RT and STS time improvements. RT alone positively influenced TUG performance only in community-dwelling older frail and pre-frail adults but not in institutionalized older individuals. RT alone did not improve the HWS compared to the non-active control group. • Progressive resistance training alone can improve sit-to-stand time and SPPB. • At least two weekly training sessions of RT are needed to increase SPPB scores • The effect of different doses of RT to promote STS improvements is still unclear. • High RT volume per session and per exercise may not be ideal for SPPB changes. • Resistance training alone did not promote differences in walking speed. [ABSTRACT FROM AUTHOR]

• Commercial OTFTs have been characterized to evaluate their variability and reliability and their implementation as PUFs. • The large TZV of OTFTs can be exploited to implement binarized I D -based PUFs that exhibit good Uniformity and Uniqueness. • The reliability of the PUFs has been preliminary evaluated, considering device aging during an HCI-like stress. • Although the shift of the device current during its operation could be a drawback. It decreases with the stress time. • The application of a stress previously to the PUF operation may be beneficial to its reliability. Commercial Organic Thin Film Transistors (OTFT) have been characterized to evaluate their variability and reliability. The feasibility of implementing Physical Unclonable Functions (PUFs) based on these devices has been evaluated, taking advantage of the high variation in the electrical characteristics among different OTFTs. The eventual impact of device aging on PUFs reliability has been preliminary explored. [ABSTRACT FROM AUTHOR]

• Pressure ulcer prevalence remains high in nursing home residents with diabetes. • One third of residents with a pressure ulcer had an ulcer of stage 2 or greater. • The strongest risk factors included physical dependance, urinary incontinence, and bowel incontinence. Introduction: Nearly a third of US nursing home residents have diabetes mellitus. These residents have an increased risk of pressure ulcer (PU) development and progression; however, little is known about the characteristics of their PUs or the role of other risk factors. This study estimates the prevalence of PUs, describes characteristics of PUs, and quantifies associations between risk factors and PUs in nursing home residents with diabetes. Methods: We conducted a cross-sectional study of nursing home residents aged ≥50 years with diabetes mellitus using national 2016 Minimum Data Set 3.0 data. Pressure ulcers were defined as the presence of any stage PU and by subgroups of stage and tissue type. Prevalence estimates of PUs were calculated overall and by covariate subgroups. Unadjusted and adjusted odds ratios were calculated using logistic regression. Results: The prevalence of any unhealed PU was 8.1%. Of those with a PU, 19.4% had at least two ulcers and the most common subtypes were identified as unstageable and stage 2 ulcers. These were most often treated by pressure reducing devices. In our fully adjusted model, risk factors that were strongly associated with PUs were related to mobility, nutrition, incontinence, and infections. Conclusion: We observed that the prevalence of PUs remains high in nursing home residents with diabetes and that higher stage ulcers were common in this population. Our adjusted model highlights the importance of suspected risk factors in the development of PUs. Further research is needed to understand the unique needs of nursing home residents with diabetes. [ABSTRACT FROM AUTHOR]

• Elevated Allostatic Load Index determines worse physical performance states in older adults. • Distributions of Allostatic Load Averages do not differ significantly among the cities evaluated. • Total and Indirect Mediation Effects between Allostatic Load and the variables of age, socioeconomic and chronic conditions on physical performance scores were evidenced. This study aimed to evaluate the association between Allostatic Load (AL) and physical performance scores in older adults from four cities in North and South America. In this cross-sectional study, data from 1101 volunteers from three countries (Canada, Brazil, and Colombia) from the International Mobility in Aging Study (IMIAS) were used to evaluate the association between AL index and Short Physical Performance Battery (SPPB) scores. Three multiple linear regression models adjusted by age, Socioeconomic Status (SES), chronic conditions, depression symptoms, and Leganés Cognitive Test (LCT) were developed to estimate the independent association between SPPB and AL. Mediation analysis with 2012 LA data and covariates was performed to access the total, direct, and indirect effects of mediation on SPPB scores from 2016. AL and SPPB were inversely associated, with older adults with high allostatic load scoring lower on SPPB (β: -0.234, Std: 0.033, p-value: <0.001). Indirect effects were evidenced between age, SES and chronic conditions with AL and SPPB scores. Chronic conditions also had a total effect on SPPB scores and were also mediated by AL. However, indirect effects of depressive symptoms and LCT on SPPB scores mediated by AL were not observed. Findings from this study support that increased AL index determines worse physical performance states after full adjustments. AL has a mediator role between the number of chronic diseases, depressive symptoms, cognitive status and physical performance. Socioeconomic status also influenced physical scores mediated by the AL index. [ABSTRACT FROM AUTHOR]

• Higher levels of personal mastery can protect older adults from mobility disability. • Sense of personal control promotes positive physiological functioning and health behaviors. • This knowledge contributes to better inform physicians practice, encouraging them to improve self-mastery among older adults. Personal mastery is a psychological resource recognized as a domain of quality of life that helps individuals cope with life strains. Despite its relevance, there is a lack surrounding the relationship between mobility disability and personal mastery. This study aimed to investigate the influence of personal mastery on mobility disability among older adults and identify the mechanisms that underlie this influence. A systematic review was conducted by searching four databases (i.e., PubMed, Scopus, ScienceDirect, and the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information) using combinations of the following words: mastery, personal mastery, self-control, mobility, disability, older adults, older people, and aging. We summarized and analyzed the findings of cross-sectional and longitudinal/prospective studies. Twenty-one studies were included. There was high heterogeneity in how the studies had assessed mobility disability. Although a majority of the studies had used the Pearlin's Self-Mastery Scale (PSMS) to assess personal mastery, there were variations in the number of response anchors and scoring strategies that were used. Nevertheless, findings revealed that personal mastery influences mobility disability by acting as a protective resource against adverse outcomes among older adults. The authors of the reviewed articles had provided physiological and behavioral explanations for their findings. Higher level of personal mastery can protect older adults from mobility disability, because it confers a sense of personal control, which in turn promotes positive physiological functioning and health behaviors. This knowledge contributes to the maintenance of physical functioning in old age. [ABSTRACT FROM AUTHOR]

This systematic review with meta-analysis aimed to compare the changes caused by exercise intervention with those provoked by usual care on physical function biomarkers in older adults immediately after hospital discharge. Two independent authors performed a systematic search (PubMed, Scopus, Web of Science, and SciELO) of studies published from database inception until August 2021. Randomized clinical trials investigating the effects of an exercise intervention compared to usual care were included. The Cochrane Collaboration assessment tool was used to analyze the risk of bias. The comparisons included handgrip strength, the short physical performance battery scale, six-minute walking test, and 10-m gait speed. Overall, the exercise intervention led to significantly greater changes compared to usual care in physical function biomarkers [standard mean difference = 0.89, 95% CI = 0.39, 1.42; P = 0.001]. However, considering the very few studies investigating each variable separately, our sub-analysis did not reveal a significant effect of the exercise intervention on handgrip strength, the short physical performance battery, six minutes walking test, and 10-m gait speed. This systematic review with meta-analysis of randomized clinical trials suggests that exercise intervention induce greater physical function biomarker alterations in older adults after hospitalization than usual care including physical activity guidance. Future trials comparing the effects of these intervention groups on physical function biomarkers in this population are needed to confirm our results. Potential mechanism involved in mitigating impairments in physiological resilience and declines in physical function biomarkers induced by exercise interventions in older adults after hospital discharge. [Display omitted] • Acute hospitalization causes an impact dramatic and permanent on physical function biomarkers during hospital-based care. • Vulnerability conferred by hospitalization in older adults leads to impairment in these biomarkers also after discharge. • Exercise intervention is better than usual care to improve physical function biomarkers in older adults after discharge. • Exercise intervention might help older adults recover from adverse effects caused by hospitalization also after discharge. [ABSTRACT FROM AUTHOR]

• Individuals' active aging refers to an overall active approach to life. • Active aging covers one's will, ability, opportunity and extent of doing activities. • Individuals with limited neighborhood mobility obtain lower active aging scores. • Active aging scores declined similarly regardless of baseline neighborhood mobility. • Engagement in several activities is possible despite limited neighborhood mobility. Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we studied active aging scores two years prior to and amid COVID-19, when governments restricted mobility of residents to slow the COVID-19 outbreak. AGNES cohort data were collected in 2017–2018 and spring 2020. Individuals were queried about their will, ability, and opportunity, and extent of doing 17 activities, and subsequently, item, composite and sub-scores of active aging were computed. Neighborhood mobility was assessed as frequency of moving in or beyond own neighborhood (limited, regular, daily=reference). Associations were studied using Generalized Linear Models (cross-sectionally, n = 1007) and General Estimating Equations (prospectively, n = 774). Participants with limited baseline neighborhood mobility had lower active aging scores than those with daily mobility, but the decline over time was similar. Some item scores on opportunity to act and extent of doing, e.g. for making one's day more interesting and advancing matters of faith or worldview, were better retained amid COVID-19 by those with limited mobility, attenuating group differences. Active aging scores were somewhat compromised in individuals with limited neighborhood mobility, but opportunities for and engagement in several activities seemed to be better retained amid COVID-19 than for those with daily mobility. Thus, active aging may be possible despite mobility restriction. [ABSTRACT FROM AUTHOR]

Although several studies have demonstrated the associations between lifetime cumulative adversity and late-life physical health, many of them were conducted at a single time point and examined events that occurred in childhood only. Less is known about the effect of lifelong adversity on the aging process over time. This study aimed to investigate the impact of cumulative adversity on the accelerated deterioration in health over time - mobility limitation and self-rated state of health in old age. This study provides a 14-year, 6-time-point follow-up on a representative sample of Europeans using the SHARE Project - longitudinal survey panel. The sample included a total of 7195 respondents aged 65 and older from nine countries in Europe. The outcome measurements were the number of mobility limitations and self-rated health – trajectories along 6 measurements. The independent variable was Lifetime Cumulative Adversity, and the analyses included also control variables – age, gender, socioeconomic status, depression, and country. Time-based Latent Growth Curve Modeling has demonstrated that the effects of Lifetime Cumulative Adversity were significant on both health measures, by means of the intercepts and the slopes: Greater experience of adversities correlated with a higher physical health impairment at baseline and a higher decline along time. The effects of self-rated health were weaker than the effects of mobility limitations. Given that the populations of numerous countries are rapidly aging, understanding the risk factors associated with health deterioration is important, especially for policymakers and medical health care experts, to raise awareness of the relationship between lifelong adversity and health decline and to build preventive interventions to deal with these consequences. • Evaluated a 14-year growth model of cumulative adversity and late-life physical health. • Used Survey of Health, Ageing and Retirement in Europe as database. • Higher cumulative adversity was related to an accelerated decline in health. • The effects on mobility limitation were stronger than self-rated health. [ABSTRACT FROM AUTHOR]

Despite policy commitments to support ageing in place, we know very little about the everyday realities and experiences of older people living in different environmental circumstances, with varying personal capabilities. This paper: 1) examines the valued place-based functionings of older people through the use of geo-spatial and in-situ methods, where functionings are defined as states of being and doing, and place-based functionings are defined as places, activities, interactions, routes, and routines that support these beings and doings; and 2) demonstrates the utility of a capability approach by amalgamating the interconnected concepts 'ageing in place' and 'ageing well'. Three in-depth individual experiences of ageing at home in a Dublin (Ireland) suburb show how differing health and mobility challenges are managed, and illustrate how conceptions of ageing well in place can be identified from geographically-grounded lifeworlds. Participants' place-based functionings are identified by combining qualitative and geo-spatial approaches through the use of annotated maps, using data obtained from traditional interviews, go-along interviews, and mapping exercises. Results demonstrate the diversity of place-based functionings valued by each individual, and how functionings are negotiated depending on different needs, wishes, and health or mobility challenges. Results also highlight the importance of supportive environments and social supports in enabling older people to realise their most valued functionings over time, which include being able to get out and about, engage and connect with others, carry out daily tasks and errands confidently, and remain independent. By paying attention to subjectively valued place-based functionings, as well as the specific supports required to sustain them, we can facilitate older people to not just age in place, or age well, but to age - as well as they can - in place. • This article considers ageing well in place through a Capability Approach lens. • Geo-spatial and qualitative methods can illustrate place-based functionings. • Older people should be supported to age – as well as they can – in place. [ABSTRACT FROM AUTHOR]

Abstract: The theory of allostatic load [McEwen, B.S., Stellar, E., 1993. Stress and the individual: mechanisms leading to disease. Arch. Intern. Med. 153, 2093–2101] describes how the cumulative experience of emotional challenges and stressful events over the life course may take a significant physiological toll on multiple interrelated systems of the body. Various summary measures of these effects have been proposed in the literature, but few studies focus on systematically evaluating them. We use data from a population-based sample of older Taiwanese to compare the explanatory power and cross-sectional predictive performance of several measures of allostatic load for diverse health outcomes. We find that choices regarding which biomarkers to include in a summary measure and how the measure is formed have modest effects across the basic prediction models we evaluate. Our findings suggest that count-based summary measures incorporating risk at both high and low tails and measures that preserve the continuous properties of the biological variables are strategies that may yield stronger predictions of a wider array of health outcomes than other measures. These fundamental insights are useful for researchers in search of empirical formulations of allostatic load and for those who are focused on the development of improved measurement strategies. [Copyright &y& Elsevier]

While low-income midlife and older adults are disproportionately affected by non-communicable diseases that can be alleviated by regular physical activity, few physical activity programs have been developed specifically with their needs in mind. Those programs that are available typically do not address the recognized local environmental factors that can impact physical activity. The specific aim of the Steps for Change cluster-randomized controlled trial is to compare systematically the initial (one-year) and sustained (two-year) multi-level impacts of an evidence-based person-level physical activity intervention (Active Living Every Day [ALED] and age-relevant health education information), versus the ALED program in combination with a novel neighborhood-level citizen science intervention called Our Voice. The study sample (N = 300) consists of insufficiently active adults ages 40 years and over living in or around affordable senior public housing settings. Major study assessments occur at baseline, 12, and 24 months. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of physical activity, assessed via validated self-report measures supported by accelerometry, and physical function and well-being variables. Additional intervention impacts are assessed at 24 months. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. clinicaltrial.gov Identifier = NCT03041415 [ABSTRACT FROM AUTHOR]

This study employed novel GPS methods to assess the effect of a multilevel physical activity (PA) intervention on device-measured walking locations in 305 community dwelling older adults, ages 65+ (mean age = 83, 73% women). Retirement communities were randomized to a 1-year PA intervention that encouraged neighborhood walking, or to a healthy aging control condition. Total time and time spent walking in four life-space domains were assessed using GPS and accelerometer devices. The intervention increased the time spent walking as a proportion of total time spent in the Campus, Neighborhood and Beyond Neighborhood domains. Intervention effects on walking location were observed in both genders and across physical and cognitive functioning groups. Results demonstrate that an intervention providing individual, social and environmental support for walking can increase PA in larger life-space domains for a broad spectrum of older adults. [ABSTRACT FROM AUTHOR]

• The COVID-19 pandemic may have changed the movement behavior of older adults • Housing type was associated with changes in movement behavior during the pandemic • Residing in apartment and row house was associated with unhealthy movement behavior • Changes in movement behavior were less evident in those residing in detached house To investigate the association between housing characteristics with objectively measured changes in physical activity (PA) and sedentary behavior (SB) during the COVID-19 pandemic in older adults with hypertension. Thirty-five older adults with hypertension were included in this exploratory study. Accelerometer-based PA and SB measures were assessed before and during a period of social distancing policy imposed due to the COVID-19 pandemic. Housing type, housing surface area and household size were tested as predictors of changes in PA and SB. A generalized linear mixed model was used for the analysis. Housing type was associated with changes in PA and SB. Individuals residing in an apartment showed a greater decrease in light PA on weekdays (β= –65 min/day, p=0.035) and a trend for an increase in SB (β= 55 min/day, p=0.056) compared to those residing in a detached house. Individuals residing in a row house showed a greater decrease in moderate-vigorous PA (β= –10 min/day, p=0.037) and steps/day (β= –2064, p=0.010) compared to those residing in a detached house. Individuals residing in an apartment showed a greater decrease in light PA on the weekends (β= –83 min/day, p=0.015) and an increase in SB (β= 72 min/day, p=0.036) compared to those residing in a detached house. No association was found for housing surface area and household size. Older adults with hypertension residing in an apartment or row house have greater unhealthy changes in movement behavior during the COVID-19 pandemic. Further studies are needed to confirm our preliminary findings. [ABSTRACT FROM AUTHOR]

DO-HEALTH is a multi-center clinical trial among 2157 community-dwelling European men and women age 70 and older. The 2x2x2 randomized-control factorial design trial tested the individual and additive benefit, as well as the cost-effectiveness, of 3 interventions: vitamin D 2000 IU/day, omega-3 fatty acids 1000 mg/day (EPA + DHA, ratio 1:2), and a 30-minute 3 times/week home exercise (strength versus flexibility). Each treatment tested has shown considerable prior promise from mechanistic studies, small clinical trials, or large cohort studies, in the prevention of common age-related chronic diseases, but definitive data are missing. DO-HEALTH will test these interventions in relation to 6 primary endpoints (systolic and diastolic blood pressure, non-vertebral fractures, Short Physical Performance Battery score, the Montreal Cognitive Assessment, and risk of infections), plus several secondary endpoints explored in ancillary studies (i.e. rate of any falls and injurious falls, joint pain, oral health, quality of life, and incident frailty). As the 3 interventions have distinct mechanisms of action for each of the 6 primary endpoints, a maximum benefit is expected for their additive benefit as a "multi-modal" intervention. The trial duration is 3 years with in-person contacts with all participants at 4 clinical visits and by quarterly phone calls. Baseline and follow-up blood samples were collected in all participants to measure changes in 25-hydroxyvitamin D and poly-unsaturated fatty acid concentrations. Our objective was to test interventions that are expected to promote healthy aging and longer life expectancy and that can be easily and safely implemented by older community-dwelling adults. [ABSTRACT FROM AUTHOR]

• Wisdom, a personality trait with affective (compassionate), cognitive, and reflective dimensions, has been associated with greater well-being and health in the general population, but its role in the health of people with HIV (PWH) has not been examined. • Total wisdom score, as well as affective (compassionate) and reflective wisdom dimensions, were positively related to physical and mental well-being both in PWH and HIV- subjects. • Our findings point to a possibility that enhancing these dimensions of wisdom might improve health outcomes in PWH. Wisdom is a unique human personality trait with cognitive, affective or compassionate, and reflective dimensions. We evaluated relationships of three specific dimensions of wisdom with cognitive function and physical and mental well-being in people with HIV (PWH) and HIV-negative (HIV-) participants. Subjects included 138 adults (61 PWH, 77 HIV-) from the San Diego community. Validated measures were used to assess wisdom and well-being. Cognitive function was assessed via the Montreal Cognitive Assessment. We conducted multivariate linear regressions to evaluate the associations of wisdom dimensions with cognitive function and physical and mental well-being. Compared to the HIV- group, PWH had lower mean scores on cognitive function, and physical and mental well-being, and cognitive and reflective dimensions of wisdom, but similar scores on affective or compassionate wisdom. Among PWH, higher total wisdom scores were associated with older age, lower likelihood of substance dependence, greater mental well-being, better cognitive function, higher resilience, social support, and optimism scores, as well as lower levels of perceived stress and nadir CD4 count. Our findings of an association of different dimensions of wisdom with physical and/or mental well-being in PWH would point to a possibility that enhancing these dimensions of wisdom might improve health outcomes in PWH. [ABSTRACT FROM AUTHOR]