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Purpose: This study investigated the adequacy of improvements in locomotive syndrome (LS) and other clinical outcomes after total knee arthroplasty (TKA) for medial knee osteoarthritis. Methods: A total of 74 patients who underwent unilateral primary TKA were evaluated pre-operatively and 3, 6, and 12 months post-TKA using the 25-question Geriatric Locomotive Function Scale (GLFS-25) to evaluate the severity of LS, the Japanese Knee Osteoarthritis Measure (JKOM), the Knee Society Score (KSS), the timed up and go (TUG) test, and range of motion of the knee joint (ROM). The GLFS-25 score and the severity of LS were compared between these patients and independent ambulatory community dwellers (273 males and 477 females). Results: The GLFS-25, JKOM, KSS, TUG scores, and ROM significantly improved post-operatively. The pre-operative incidence of LS stage 3, indicating the worst locomotive function, decreased from 81.1% to 24.3% at the final follow-up. However, the median (interquartile range) GLFS-25 score of 13 (6–23) seemed much worse, and the incidence of LS stage 3 of 24.3% seemed much higher even 12 months post-TKA compared with independent ambulatory community dwellers. Conclusions: The GLFS-25 score and other clinical outcome scales significantly improved after TKA. However, improvements in locomotive functions were not adequate as approximately 25% of patients remained with LS stage 3. Besides ordinary rehabilitation programmes after TKA, some interventions, such as more rigorous muscle exercises, would be necessary to obtain greater improvements in LS.

Decelerating motor decline is important for promoting healthy aging in the elderly population. Acorus tatarinowii Schott is a traditional Chinese medicine that contains β-asarone as a pharmacologically active constituent. We found that β-asarone can decelerate motor decline in various age groups of Caenorhabditis elegans, while concurrently prolonging their lifespan and modulating synaptic transmission. To understand the mechanisms of its efficacy in motor improvement, we investigated and discovered that mitochondrial fragmentation, a marker for aging, is delayed after β-asarone treatment. Moreover, their efficacy is blocked by dysfunctional mitochondria. Corresponding to their role in regulating mitochondrial homeostasis, we found that SKN-1/Nrf2 and GST-4 are critical in the β-asarone treatment, and they appear to be activated via the insulin/IGF-1 signaling pathway. Well-developed intestinal microvilli are required for this process. Our study demonstrates the efficacy and mechanism of β-asarone treatment in age-related motor decline, contributing to the discovery of drugs for achieving healthy aging.

Objectives: Intrinsic capacity impairment results in poor outcomes among older adults. Here we tested handgrip strength as a screening tool for IC impairment in community-dwelling older adults in Xinjiang, China. We assessed the diagnostic accuracy and established optimal cut-off points for handgrip strength in the detection of intrinsic capacity impairment. Methods: In total, 1072 participants were included using a multilevel random sampling method. Intrinsic capacity was constructed according to the definition of the Integrated Care for Older People screening tool proposed by the WHO. Results: Altogether, 73.4 % (787/1072) participants had intrinsic capacity impairment. The prevalence of intrinsic capacity impairment for hearing, vision, mobility, cognition, psychological, and vitality domains was 8.6 %, 4.8 %, 39.6 %, 47.3 %, 12.0 %, and 18.8 %, respectively. The adjusted odds ratios [95 % confidence interval) for handgrip strength was 0.935 [0.914–0.956]. The area under the curve of the receiver operating characteristic curve for handgrip strength of older men, and handgrip strength of older women with intrinsic capacity impairment were 0.7278, and 0.7534, respectively. The handgrip strength cut-off points were 28.47 kg (60–69 years), 25.76 kg (70–79 years), and 24.45 kg (≥80 years) for men, and 20.75 kg (60–69 years), 19.90 kg (70–79 years), and 16.17 kg (≥80 years) for women. Conclusions: Handgrip strength can be used as a convenient tool for evaluating intrinsic capacity. Weak handgrip strength and low education level were associated with intrinsic capacity impairment in community-dwelling older adults in Xinjiang. Using the cut-off points of handgrip strength for different age groups and genders, older adults with impaired intrinsic capacity can be identified, which may reduce the occurrence of adverse outcomes.

Normal aging presents subtle cognitive changes that can be detected before meeting the criteria for Mild cognitive impairment (MCI). Older people with low cognitive reserve and who receive limited cognitive stimulation are at greater risk of deterioration. In this regard, cognitive stimulation (CS) has been identified as an intervention that reduces this risk, provided that its design takes into account the differences in the level of cognitive reserve (CR) acquired throughout life and the baseline level of cognitive functioning. The general objective of this study is to evaluate, through a randomized clinical trial, the effectiveness of a computerized cognitive stimulation program, designed and adapted from Occupational Therapy based on the level of cognitive reserve in older adults in Primary Care. 100 participants will be randomized in a stratified manner according to the level of cognitive reserve (low/moderate/high), assigning 50 participants to the control group and 50 participants to the intervention group. The intervention group will carry out a computerized cognitive stimulation intervention designed and adapted from occupational therapy according to the level of cognitive reserve, through the “stimulus” platform. The main result expected to be achieved is the improvement of higher brain functions. As secondary results, we expect that those cognitive aspects most vulnerable to aging will decrease more slowly (in areas such as memory, executive function, attention and processing speed), and that the cognitive reserve of the participants will increase, in addition to being able to balance gender differences in these aspects. We think that these results can have a positive impact on the creation of adapted, meaningful and stimulating CS programs in older adults to prevent MCI and experience healthier aging.

Background: Functional disability, defined as acquired difficulty in performing basic daily tasks or more complex tasks needed for independent living. Functional assessment among community dwelling elderly is critical due to the changes taking place during the normal aging process, acute illness, worsening chronic illness, and hospitalization which compromises their performances necessary to live independently. Measuring their functional ability can provide objective data to assist with targeting individualized care plan for older adults being the highest consumers of medications due to greater burden of medical conditions in addition to being vulnerable to the effects of medications. It is crucial for the pharmacists to be aware of the geriatric functional disability as pharmacies are often the first point-of-care this elderly group may encounter in community settings. Methods: This study was conducted to estimate the prevalence of functional disability and the common difficulties in the daily task performance among elderly from a state in the Northern region of Malaysia. Besides, the differences in terms of functional disability in both genders were also explored. Among a total of 266 elderly participants. Results: Around 42 % was estimated to face at least one difficulty with Activities of Daily Living while more than half, 57 %, had at least one difficulty with Instrumental Activities of Daily Living. The most common difficulties reported with Activities of Daily Living and Instrumental Activities of Daily Living were transferring (22 %) and transportation (33 %), respectively. Conclusion: In order to deliver effective pharmaceutical care plan emphatically, both senior-friendly pharmacy curricula and pharmacy settings are imperative to address the most common difficulties faced by this vulnerable group.

Aging populations face significant cognitive challenges, particularly in working memory (WM). Transcranial alternating current stimulation (tACS) offer promising avenues for cognitive enhancement, especially when inspired by brain physiology. This study (NCT04986787) explores the effect of multifocal tACS on WM performance in healthy older adults, focusing on fronto-parietal network modulation. Individualized physiology-inspired tACS applied to the fronto-parietal network was investigated in two blinded cross-over experiments. The first experiment involved monofocal/bifocal theta-tACS to the fronto-parietal network, while in the second experiment cross-frequency theta-gamma interactions between these regions were explored. Participants have done online WM tasks under the stimulation conditions. Network connectivity was assessed via rs-fMRI and multichannel electroencephalography. Prefrontal monofocal theta tACS modestly improved WM accuracy over sham (d = 0.30). Fronto-parietal stimulation enhanced WM task processing speed, with the strongest effects for bifocal in-phase theta tACS (d = 0.41). Cross-frequency stimulations modestly boosted processing speed with or without impairing task accuracy depending on the stimulation protocol. This research adds to the understanding of physiology-inspired brain stimulation for cognitive enhancement in older subjects.

Background: Conventional approaches to frailty assessment rely on in-person evaluation by health professionals in medical settings. The COVID-19 pandemic drastically limited access to both primary care and face-to-face appointments, highlighting a need for novel and forward-thinking frailty screening methods to bridge this gap. Community-based seniors-serving organizations are well-positioned to implement remote frailty assessment, given its potential to enhance virtual services and referrals. Methods: The Clinical Frailty Scale (CFS) was adapted and implemented as Virtual Frailty Screening (VFS), using the Plan-Do-Study-Act (PDSA) framework, in an inner-city organization for older adults. Participants participated in phone assessments by social workers (SWs); in-person visits included the CFS for comparative purposes. As a component of our larger quality improvement initiative, pilot data were analyzed descriptively alongside inferential methods consisting of Kendall's τb, Χ2-test of association, and Wilcoxon matched-pairs signed-rank test. Results: Over 101 older adults were screened, with 79.21 % being assigned as very mild to moderately frail. VFS usage enabled crucial referrals for 70 older adults to receive long-term frailty-specific support and services in the community. Analysis found that the VFS performed similarly to the CFS, established by high convergent validity and alignment between both scales. Conclusions: Findings support the implementation of remote frailty assessment by SWs in community-based seniors serving organizations. This integration bridges immediate service gaps, introducing a transformative approach to frailty assessment which has the potential for scalability. Success was attributed to a multidisciplinary approach with rapid PDSA changes in a nimble organization.

Background: Given the established association between sarcopenia and cognitive impairment was mainly in the older and oldest-old population or people with relatively limited education, this study extends the investigation to community-dwelling middle-to-old age adults in urban communities, emphasizing the need for preventive intervention for muscle health and healthy longevity. Methods: Data of 712 participants from the Gan-Dau Healthy Longevity Plan were retrieved for analysis, and all participants were stratified by age (50–64, 65–74 and 75+ years old). Possible sarcopenia was defined by 2019 consensus report of the Asian Working Group for Sarcopenia (AWGS). This study used four neuropsychological tests for analysis, i.e., Mini-Mental Status Examination (MMSE), California Verbal Learning Test II (CVLT-SF), Digital Symbol Substitution Test (DSST) and Verbal fluency (VF) for global and domain-specific cognitive function. Multivariate generalized linear models (GLMs) were employed to investigate the associations between possible sarcopenia and cognitive function in each age-specific groups. Results: The prevalence of possible sarcopenia increased with age, with 31.8 %, 37.7 %, and 55.6 % in participants aged 5064, 65–74 and, 75+ years, respectively. On the other hand, cognitive performance declined with age. In particular, among participants aged 75+ years with possible sarcopenia, their cognitive performance were poorer than robust counterparts, including MMSE (26.6 [3.4] vs. 27.4 [2.6]), CVTL-SF (total score: 21.5 [5.4] vs. 23.8 [5.5]; 30-second delayed recall: 6.0 [1.7] vs. 6.5 [1.6]), DSST (32.8 [14.3] vs. 41.3 [18.7]), and VF (12.8 [5.1] vs. 14.8 [4.9]). Multivariate generalized linear model indicated that possible sarcopenia was associated with lower MMSE (β: −0.70, p = 0.014) and lower DSST (β: −7.00, p = 0.010) in those aged 50–64 years. Moreover, possible sarcopenia was associated with lower CVLT-SF (total score β:-1.90, p = 0.028), lower DSST (β: −6.45, p

Objectives: Only a few studies have investigated dietary patterns and intrinsic capacity (IC). This study examined the prospective associations between dietary patterns, IC, and IC sub-domains over 6 years in community-dwelling Korean older adults. Design: A prospective cohort study. Setting and participants: Data were obtained from participants aged 70–84 years in the Korean Frailty and Aging Cohort Study (2016–2022). The study population included 665 enrollees at baseline who completed IC and dietary data. Methods: Dietary data were obtained from baseline surveys of the nutritional sub-cohort using two nonconsecutive 24‐hour dietary recalls, and dietary patterns were derived using cluster analysis. IC was constructed by measuring cognitive, locomotor, vitality, sensory, and psychological domains. A generalized estimating equation was used to analyze the longitudinal associations between dietary patterns, IC, and IC sub-domain scores. Results: In total, 665 enrollees were included in the analysis. After adjusting for confounders, in older men, the dietary pattern of cluster 1 (variety of healthy foods and alcohols) compared to that of cluster 2 (rice and kimchi) was positively associated with changes in the IC score (ß = 0.41, 95% confidence interval [CI] = 0.04−0.78). In older women, the dietary pattern of cluster 1 (variety of healthy foods) was positively associated with changes in the IC score (ß = 0.30, 95% CI = 0.02–0.58), IC score group (ß = 0.11, 95% CI = 0.02–0.20), and psychological domain (ß = 0.25, 95% CI = 0.11–0.38) compared to that of cluster 3 (rice, vegetables, and kimchi). Conclusions: Dietary patterns (variety of healthy foods) were positively associated with changes in IC scores and their sub-domains in older adults.

Background: Digital inclusion of older people is an important agenda for the future and well-being of the older population, as it represents a form of social inclusion with significant gains for healthy aging. The present study aimed to understand the experiences of Brazilian older adults who use smartphones and the implications in their daily lives. Method: A qualitative study was developed using a constructivist grounded approach. Older people (≥60 years) with prior access to a smartphone were invited to participate in the study. Participation took place through semi-structured, audio-recorded interviews. Data collection and analysis occurred simultaneously using a constant comparative approach. Data management and analysis used the Atlas.ti® software. Results: Overall, 37 older people participated, with an average age of 70.60 ± 6.95 years, predominantly female (n = 33), white (n = 25), married (n = 26) and retired (n = 27). The first sample group included 27 older people with family support and the second group included 10 older people without family support (who lived alone in their homes). A core category emerged from the data analysis—“Expanding the personal and social development of older adults through smartphone communication”—around which three main categories emerged: 1) The smartphone as “a window to the world”; 2) The problem of misinformation and fake news on virtual networks; 3) Technological paradoxes in the use of smartphones. Conclusions: The digital transition associated with smartphone use brings unimaginable benefits to older adults who adopt positive habits to improve their well-being and expand their social connections, following efforts proposed by the Decade of Healthy Aging. However, older adults still face disparities and experience a significant digital divide, which represents a major challenge. Barriers to access are further aggravated in developing countries. We hope this study contributes to public health policies on digital inclusion and healthy aging.

Background: Aging triggers intricate physiological changes, particularly in whole-body fat-free mass (FFM) and handgrip strength, affecting overall health and independence. Despite existing research, the broader significance of how muscle health is affected by the intricate interplay of lifestyle factors simultaneously during aging needs more exploration. This study aims to examine how nutrition, physical activity, and sleep impact on FFM and handgrip strength in middle-aged men and women, facilitating future personalized recommendations for preserving muscle health. Methods: The cross-sectional analysis of the UK Biobank involved 45,984 individuals (54 % women) aged 40–70 years with a complete dataset. Multiple linear regression explored determinants of FFM and handgrip strength, considering traditional, socio-demographics, medication use and smoking as covariates, with sex and age (younger and older than 55 years) stratifications. Results: In older men and women, higher physical activity beneficially affect both FFM (respectively Β = 3.36 × 10−3, p-value = 1.66 × 10−3; Β = 2.52 × 10−3, p-value = 3.57 × 10−4) and handgrip strength (Β = 6.05 × 10−3, p-value = 7.99 × 10−5, Β = 8.98 × 10−3, p-value = 2.95 × 10−15). Similar results were found in fiber intake for FFM in older men and women (respectively B = 3.00 × 10−2, p-value = 2.76 × 10−5; B = 2.68 × 10−2, p-value = 1.78 × 10−9) and handgrip strength (Β = 3.27 × 10−2, p-value = 1.40 × 10−3; Β = 3.12 × 10−2, p-value = 1.34 × 10−5). Other lifestyle factors influence FFM and handgrip strength differently. Key determinants influencing handgrip strength included higher protein intake, lower water intake, higher alcohol intake, and extended sleep duration whereas mainly higher water intake is associated with higher FFM. Conclusions: In both men and women, the main factors associated with FFM and handgrip strength are physical activity and fiber intake, which may underlie a connection between gut and muscle health. Given the observed complexity of muscle health in the age and sex strata, further longitudinal research is needed to provide personalized lifestyle recommendations.

Background: Physical activity (PA) is essential following an acute cardiac event. Cardiac rehabilitation (CR) is commonly prescribed, and PA after CR is recommended. Because of age-related changes in functional ability and multi-comorbidity, many older cardiac patients struggle to continue performing PA at home after CR. Depressive symptoms and anxiety are prevalent in cardiac patients and associated with poor self-care, including lack of daily PA. Yoga has been demonstrated to improve psychological and physical health outcomes in cardiac patients, but it is unknown whether yoga, modified for older CR patients – Gentle Yoga – is beneficial in managing psychological distress and maintaining PA following phase II CR. Our specific aims are to:1) determine the feasibility and acceptability of a modified gentle yoga intervention delivered via video conferencing for older cardiac patients; 2) compare, at 3-month follow-up, the effects and determine effect sizes of a gentle yoga intervention versus control on psychological health and physical health. Methods: We are conducting a 2-group (intervention versus control) randomized controlled pilot study. The intervention is a 12-week gentle yoga program delivered via video conference. Short-term effects will be evaluated at 3-month. Conclusion: This study is designed to be suited for older cardiac patients who would not have access to supervised PA opportunities after facility-based CR to enhance PA. This study will provide data about the feasibility and acceptability of the protocol for older cardiac patients and will offer effect sizes to determine sample size for a fully powered randomized controlled trial.

Objectives: Innovative precision dietary procedures are required to promote healthy aging. This study aimed to evaluate the effects of a personalised strategy based on the inclusion of individualised foods and digital tools on overall health status and quality of life within a follow-up of 3 months in older adults with overweight or obesity. Methods: 127 men and women aged between 50 and 80 years with overweight/obesity participated in the study—between January 2020 and September 2020 at the Center for Nutrition Research-University of Navarra and IMDEA-ALIMENTACIÓN—and were randomly assigned to a usual-care group (standard recommendations) or precision group (precision nutrition strategy based on the inclusion of individualised foods and a mobile application). Anthropometry, body fat percentage, biochemical parameters, diet, and quality of life (SF-36 Health Survey) were assessed at baseline and after 3 months. Results: Both strategies were found to improve overall metabolic health; however, the precision approach demonstrated significantly better outcomes. The precision strategy reduced body weight at 3 months (−4.3 kg; p

Aging is a major risk factor for neurodegenerative diseases like dementia and Alzheimer's disease. Even in non-pathological aging, decline in cognitive functioning is observed in the majority of the elderly population, necessitating the importance of studying the processes involved in healthy aging in order to identify brain biomarkers that promote the conservation of functioning. The default mode network (DMN) has been of special interest to aging research due to its vulnerability to atrophy and functional decline over the course of aging. Prior work has focused almost exclusively on functional (i.e. undirected) connectivity, yet converging findings are scarce. Therefore, we set out to use spectral dynamic causal modeling to investigate changes in the effective (i.e. directed) connectivity within the DMN and to discover changes in information flow in a sample of cognitively normal adults spanning from 48 to 89 years (n = 63). Age was associated to reduced verbal memory performance. Modeling of effective connectivity revealed a pattern of age-related downregulation of posterior DMN regions driven by inhibitory connections from the hippocampus and middle temporal gyrus. Additionally, there was an observed decline in the hippocampus’ susceptibility to network inputs with age, effectively disconnecting itself from other regions. The estimated effective connectivity parameters were robust and able to predict the age in out of sample estimates in a leave-one-out cross-validation. Attained education moderated the effects of aging, largely reversing the observed pattern of inhibitory connectivity. Thus, medial prefrontal cortex, hippocampus and posterior DMN regions formed an excitatory cycle of extrinsic connections related to the interaction of age and education. This suggests a compensatory role of years of education in effective connectivity, stressing a possible target for interventions. Our findings suggest a connection to the concept of cognitive reserve, which attributes a protective effect of educational level on cognitive decline in aging (Stern, 2009).

Background: Personalized nutrition risk assessment is crucial in addressing the association between healthy dietary habits across the life course and the development of disease, functional capacity, and healthy aging, as specific dietary pattern recommendations may not be suitable for diverse food cultures. Objective: To develop a data-driven, personalized nutrition risk assessment algorithm linked to incident hypertension, diabetes, and all-cause mortality utilizing the food frequency questionnaire among middle-aged and older individuals. Methods: A retrospective, population-based cohort study conducted between 1999 and 2015 utilized the nationally representative Taiwan Longitudinal Study on Aging (TLSA) survey to examine personalized dietary risk clusters and their associations with health outcomes. Latent class analysis was performed to derive the dietary diversity clusters among community-dwelling middle-aged and older individuals. Outcomes were defined as new-onset hypertension, diabetes mellitus and all-cause mortality at 4-, 8-, 12- and 16-year follow-ups. Results: Data from 1,811 participants (58.14% males, 43.90% aged 50−64 years) showed that around one-third of participants reported being illiterate, 21.98% widowed, and 51.46% engaging in regular physical exercise. Four dietary diversity clusters were identified: “least diverse”, “fish and meat”, “dairy, fruit, and vegetable”, and “most diverse”. The “most diverse” cluster was characterized by a high consumption of protein-rich foods, while the “dairy, fruit, and vegetable” cluster had the highest consumption of dairy products and beans/legumes. The “least diverse” cluster had the lowest intake of protein-rich foods, and dark-colored vegetables and fruits. The “most diverse” cluster had a significantly lower risk of hypertension development at the 4-year (aOR 0.58; p < 0.02) and 8-year (aOR 0.57; p < 0.01) follow-up and diabetes at the 4-year (aOR 0.44; p < 0.03) follow-up. Participants in the “most diverse” clusters exhibited lower risks of 8-year, 12-year, and 16-year mortality than those in the “least diverse” cluster (aOR 0.67, p < 0.05; 0.67, p < 0.03; and 0.50, p < 0.01, respectively). Conclusion: The personalized nutrition risk assessment algorithm from the food frequency questionnaire can effectively stratify personal health risks among diverse middle-aged and older individuals, making it a valuable tool in lifestyle modification and intervention studies.

Aims: The present study sought to analyze the effects of 6-month multicomponent training (MCT) combined with a 4-month detraining on metabolic syndrome (MetS) profile among older adults with decreased functional capacity. Methods: This quasi-experimental study included a total of 104 older adults (80.5 ± 6.0 years) and the sample was divided into a training (TRAIN, n = 55) or control group (CON). Harmonized definition was used to diagnose the MetS. Functional capacity, blood biochemical parameters, blood pressure, body composition and anthropometric measurements were assessed 3 times. Analysis of variance for repeated measures and Wilcoxon signed-rank test were used to check the differences within groups. Results: TRAIN decreased diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDLC) and total fat mass during training period, whereas CON did not show any significant changes. During detraining, TRAIN increased HDLC, systolic blood pressure (SBP), waist circumference (WC) and total fat mass; and decreased glucose and fat free mass, whereas CON increased the concentration of glucose and HDLC. From baseline to post-detraining assessment, CON increased the concentration of triglycerides and the WC, while TRAIN only increased the WC (all p

We compared the effects of velocity-monitored resistance training with an intra-set velocity loss (i.e., the decrement in repetition velocity over the set) of 10 % vs. 20 % on strength-related outcomes in older adults. We randomly assigned eighteen older adults to a velocity loss group of 10 % (n = 10; 78 ± 12 years) or 20 % (n = 8; 73 ± 10 years) to perform a 10-week training program. The primary outcomes were the one-repetition maximum (1RM) and the average mean velocity against absolute loads associated with loads 0.05). Both groups improved the 1RM leg press from pre- to mid- and post-test and the MVlow and MVhigh from pre- to mid-test (p 0.05), but both increased the MVlow from pre- to mid-test (p

Background: Sex differences in health status and life expectancy are widely accepted to exist. The mechanisms underlying it are still poorly understood. In this study, we aimed to clarify the influences and contributions of sex on the gut microbiome in healthy centenarians and to explore the different roles played by the gut microbiome in healthy aging between the sexes. Results: Taking covariates of different dimensions into account (social demographics, anthropometry, the activities of daily living, dietary structure, mental state, blood tests, lifestyle and disease history), our data showed that sex was one of the most significant covariates affecting the gut microbiome of healthy centenarians at both the species and Kyoto Encyclopedia of Genes and Genomes Orthology (KO) levels. The beta diversity between the sexes were significantly different (Adonis test: p = 0.011, R2 = 0.031), and the male centenarians had a greater alpha diversity than the females (Simpson and Shannon test: P

Aging is a process of time-dependent degeneration of biological functions, becoming more susceptible to diseases and eventually leading to death. Along with medical advances to extend lifespan, many researchers have made efforts to understand the complexities of aging further. The nematode Caenorhabditis elegans has been a part of this journey due to its short lifespan, genetic tractability, and conservation of aging-associated genes, which significantly contribute to the progress of aging studies. Here, we summarized current knowledge on aging studies, major genes, and genetic pathways involved in the aging of C. elegans. Furthermore, the current research expands its focus from lifespan to healthspan, encompassing various nutrition and environmental factors. Despite the challenges in translating findings from C. elegans to humans, efforts continue to increase our understanding of healthy aging to improve not only lifespan but also quality of life.

Background: According to the World Health Organization (WHO), healthy aging is the process of developing and maintaining the functional capacity for health in old age. A rapidly growing number of research studies on healthy aging have been conducted worldwide. The purpose of this research work is to explore global scientific landscape of healthy aging research over the last 22 years. Methods: Scientific publications on healthy aging from January 1, 2000 to October 11, 2022 were retrieved from the Web of Science Core Collection (WoSCC) on October 11, 2022. A total of 6420 publications were included in the scientometric analysis. VOSviewer (1.6.18) was used to conduct scientometric and visualized analysis. Results: The publication growth rate was 35.68 from 2000 to 2021. The United States of America (USA) led in both productivity and citations. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA was prominent in terms of both the highest citation count and the highest average citation count. The National Institute on Aging (NIA) and Evans, Michele K. were the most influential organization and author, respectively. Research hotspots in healthy aging were identified based on the co-occurrence analysis of keywords: (1) physical activity and mental health of older adults; (2) diseases impacting the health and lifespan of older adults; and (3) neuroscience. Our analysis indicates that gut microbiota, loneliness, frailty, mitochondria and resilience were the emerging themes in healthy aging research. Conclusions: The quantity of annual publications on healthy aging has rapidly increased over the past 22 years, especially during 2018–2021. This analysis identified the status, trends, hot topics, and frontiers of healthy aging research. These findings will help researchers quickly understand the global representation of healthy aging research, influence resource dissemination, promote international collaborations, guide policy formulation, and improve health services for older adults.

According to the maintenance hypothesis (Nyberg et al., 2012), structural integrity of the brain’s grey matter helps to preserve cognitive functioning into old age. A corollary of this hypothesis that can be tested in cross-sectional data is that grey-matter structural integrity and general cognitive ability are positively associated in old age. Building on Köhncke et al. (2021), who found that region-specific latent factors of grey-matter integrity are positively associated with episodic memory ability among older adults, we examine associations between general factors of grey-matter integrity and a general factor of cognitive ability in a cross-sectional sample of 1466 participants aged 60–88 years, 319 of whom contributed imaging data. Indicator variables based on T1-weighted images (voxel-based morphometry, VBM), magnetization-transfer imaging (MT), and diffusion tensor imaging-derived mean diffusivity (MD) had sufficient portions of variance in common to establish latent factors of grey-matter structure for a comprehensive set of regions of interest (ROI). Individual differences in grey-matter factors were positively correlated across neocortical and limbic areas, allowing for the definition of second-order, general factors for neocortical and limbic ROI, respectively. Both general grey-matter factors were positively correlated with general cognitive ability. For the basal ganglia, the three modality-specific indicators showed heterogenous loading patterns, and no reliable associations of the general grey-matter factor to general cognitive ability were found. To provide more direct tests of the maintenance hypothesis, we recommend applying the present structural modeling approach to longitudinal data, thereby enhancing the physiological validity of latent constructs of brain structure.

Introduction: The Medicare annual wellness visit was designed to address health risks and encourage evidence-based preventive care in aging. However, it can be challenging for providers to dedicate time for comprehensive attention to wellness during these visits. Our project implements a group setting for Medicare wellness visits (GMWV) as an efficient method for delivering high value preventive care. Methods: Three hundred patients from two primary care ambulatory clinics in Detroit, MI in need of their annual Medicare visit were invited to participate in the pilot GMWV. Fifty-eight patients agreed and completed their GMWV. The visit included collection of vitals, vision screening, and risk assessment during check-in, followed by educational wellness presentations led by an interdisciplinary team of six healthcare professionals. Patients completed a post visit-satisfaction survey and researchers calculated rates of completion of health maintenance gaps (HMG), i.e. immunizations and cancer screenings, among participants. Results: The average age of participants (N female = 48) was 74 years old. Thirty-four participants had more than one HMG at baseline. On average, 8 % of immunization gaps and 12 % of screening gaps were completed at or within one-year post GMWV. Participant feedback reported that 82 % of patients felt that they learned something new from the presentation and 81 % of patients felt satisfied with the amount of time they spent with their physician. Discussion: GMWV is a feasible approach to promoting wellness and healthy aging that patients find satisfying although, additional study is needed to compare the effectiveness of this model to standard care.

Objectives: Although there is an association between socioeconomic factors and cognition, there are shortcomings in terms of examining the age of onset of decline between people with varying social backgrounds. This study aims to present the disparities in cognitive performance among older adults by simultaneously integrating health status, social characteristics, and age into an understandable metric. Study design: This study is cross-sectional. Methods: A sample of 3422 adults aged at least 60 was utilised from the 2015 wave of the China Health and Nutrition Survey to analyse the trajectories of cognitive ageing through the Characteristics approach. This approach generates an age-differential schedule whereby, as a hypothetical example, the cognition level Z of an individual aged 60 who has not completed schooling is demonstrated at age 66 by someone who has completed secondary schooling. Results: There was an increasing advantage with cognitive performance as the level of education completed increased; men aged 61.9 with a primary level of schooling and those aged 67.8 with postsecondary qualifications exhibit the same cognition performance as those aged 60 with no completed schooling. The observation also suggested that cognition advantages diminish through age. In terms of income, the age-differential schedule follows a similar pattern. albeit lower outcomes, to that of education differentials. Conclusion: When comparing education and income levels and their respective impacts on cognitive functioning, the former has been noted to have a larger effect. Education's effect has continuity in that it can influence opportunities until later ages.

Adverse childhood experiences (ACEs) have life-course impact and may be associated with healthy aging. This study aimed to explore the association between ACEs and healthy aging trajectories among middle- and older-aged adults in China. The data were obtained from the China Health and Retirement Longitudinal Study from 2011 to 2018. A total of 8906 respondents were enrolled in the analysis. Through latent growth mixture model, five categories of healthy aging trajectories which defined as ‘stable type with high starting point’, ‘stable type at the middle level’, ‘stable type with low starting point’, ‘rapid descending type with high starting point’, and ‘stable descending type with medium starting point’ were identified. Based on multinomial logistic regression, ACEs were significantly associated with healthy aging trajectories (stable type at the middle level/stable type with high starting point: relative risk reduction [RRR] = 1.19; P

The cofactor nicotinamide adenine dinucleotide (NAD+) plays a key role in a wide range of physiological processes and maintaining or enhancing NAD+ levels is an established approach to enhancing healthy aging. Recently, several classes of nicotinamide phosphoribosyl transferase (NAMPT) activators have been shown to increase NAD+ levels in vitro and in vivo and to demonstrate beneficial effects in animal models. The best validated of these compounds are structurally related to known urea-type NAMPT inhibitors, however the basis for the switch from inhibitory activity to activation is not well understood. Here we report an evaluation of the structure activity relationships of NAMPT activators by designing, synthesising and testing compounds from other NAMPT ligand chemotypes and mimetics of putative phosphoribosylated adducts of known activators. The results of these studies led us to hypothesise that these activators act via a through-water interaction in the NAMPT active site, resulting in the design of the first known urea-class NAMPT activator that does not utilise a pyridine-like warhead, which shows similar or greater activity as a NAMPT activator in biochemical and cellular assays relative to known analogues.

Background: Malnutrition (excess or defect) and sedentariness act as an accelerator in the older people frailty process. A systemic solution has been developed to engage older people in a healthier lifestyle using serious games and food monitoring. The study aimed to evaluate protocol influence on variables related to unhealthy behaviors improving dietary habits through a remote nutritional coaching approach and stimulating the population to increase physical activity through Exergames. Methods: Thirty-two subjects (25 Treatments and 7 Controls, aging 65–80 years), of which 15 (11 Treatments and 4 Controls) living in the UK (ACCORD and ExtraCare Villages placed in Shenley Wood (Milton Keynes), St. Crispin (Northampton), and Showell Court (Wolverhampton)) and 17 (14 Treatments and 3 Controls) in Italy (Genoa, Liguria), were recruited and characterized in terms of nutritional status, physical, somatometric, hemodynamic and biochemical measurements, and body composition. Participants were stimulated to adopt the Mediterranean dietary pattern, by a food diary diet-app, and perform regular physical activity, by the Exergame app, for three months. At the end of the trial, users underwent the same test battery. Data were tested for normality of distribution by the Shapiro-Wilk test. Comparisons between groups were performed at baseline by unpaired Student's t-test for continuous variables, chi-square test, or Fisher's exact test for categorical variables. Analysis of Variance (ANOVA) for repeated measures was used to analyze the significance of changes over time between groups. Results: At the end of the trial, significant reductions of systolic (15 mmHg, P = 0.001), diastolic (5 mmHg, P = 0.025), mean (10 mmHg, P = 0.001) blood pressure, and rate-pressure product (RPP) (1,105 mmHg*bpm, P = 0.017) values were observed in DOREMI users. A trend of improvement of physical performance by the short physical performance battery (SPPB) was observed for balance and walk subtests. A significant decrease (0.91 kg, P = 0.043) in Body Mass Index (BMI) was observed in overweight subjects (BMI >25 kg/m2) after DOREMI intervention in the entire population. The Mini Nutritional Assessment (MNA) score (1, P = 0.004) significantly increased after intervention, while waist measure (3 cm, P

Health benefits of physical activity (PA) are well known; however, specific PA patterns that relate most strongly to cognitive aging outcomes are poorly understood. We characterized latent profiles of PA among older adults and examined associations with cognition and vascular burden. 124 functionally normal older adults wore a Fitbit™ for 30 days. Daily average step count, sedentary time (0 steps/min), and high-intensity time (≥120 steps/min) were calculated. Participants completed neurocognitive testing assessing cognitive domains of executive functioning and memory; medical history, from which vascular burden (i.e., a count of cardiovascular conditions) was calculated; and brain MRI (n = 44). Subgroups with similar PA patterns were identified via latent profile analysis. Three latent PA classes emerged: Class 1Low PA (n = 49), Class 2Average PA (n = 59), and Class 3High-intensity PA (n = 16). PA class related to executive functioning and vascular burden, driven by better outcomes in Class 3 than Class 1. Sex-stratified analyses revealed these associations were strongest in males. Post hoc analyses showed a positive association between high-intensity PA and white matter integrity among males. High-intensity PA related to better cognitive and vascular health, particularly among males. Findings inform physical activity-specific and person-specific recommendations for optimal cognitive aging.

Healthy neurocognitive aging has been associated with the microstructural degradation of white matter pathways that connect distributed gray matter regions, assessed by diffusion-weighted imaging (DWI). However, the relatively low spatial resolution of standard DWI has limited the examination of age-related differences in the properties of smaller, tightly curved white matter fibers, as well as the relatively more complex microstructure of gray matter. Here, we capitalize on high-resolution multi-shot DWI, which allows spatial resolutions < 1 mm3 to be achieved on clinical 3T MRI scanners. We assessed whether traditional diffusion tensor-based measures of gray matter microstructure and graph theoretical measures of white matter structural connectivity assessed by standard (1.5 mm3 voxels, 3.375 μl volume) and high-resolution (1 mm3 voxels, 1μl volume) DWI were differentially related to age and cognitive performance in 61 healthy adults 18–78 years of age. Cognitive performance was assessed using an extensive battery comprising 12 separate tests of fluid (speed-dependent) cognition. Results indicated that the high-resolution data had larger correlations between age and gray matter mean diffusivity, but smaller correlations between age and structural connectivity. Moreover, parallel mediation models including both standard and high-resolution measures revealed that only the high-resolution measures mediated age-related differences in fluid cognition. These results lay the groundwork for future studies planning to apply high-resolution DWI methodology to further assess the mechanisms of both healthy aging and cognitive impairment.

Altered blood flow in the human brain is characteristic of typical aging. However, numerous factors contribute to inter-individual variation in patterns of blood flow throughout the lifespan. To better understand the mechanisms behind such variation, we studied how sex and APOE genotype, a primary genetic risk factor for Alzheimer's disease (AD), influence associations between age and brain perfusion measures. We conducted a cross-sectional study of 562 participants from the Human Connectome Project - Aging (36 to >90 years of age). We found widespread associations between age and vascular parameters, where increasing age was associated with regional decreases in cerebral blood flow (CBF) and increases in arterial transit time (ATT). When grouped by sex and APOE genotype, interactions between group and age demonstrated that females had relatively greater CBF and lower ATT compared to males. Females carrying the APOE ε4 allele showed the strongest association between CBF decline and ATT incline with age. This demonstrates that sex and genetic risk for AD modulate age-associated patterns of cerebral perfusion measures.

Objective: This study aimed to revise the Constitution in Chinese Medicine Questionnaire (Elderly Edition) (CCMQ-EE), as well as evaluate its reliability and validity. The objective was to provide a more accurate Chinese medicine constitution identification tool for geriatric health management and help further research on the relationship between geriatric diseases and constitution type, etc. Methods: The Delphi method and a cross-sectional survey of the elderly population were used. From April to October 2021, experts in different fields were invited to participate in the questionnaire, and items were revised through the experts’ ratings and feedback. From December 2021 to February 2022, the revised CCMQ-EE was validated in the elderly population. Results: The coefficients of variation of rationality and importance scores decreased to less than 0.25 in the third round of Delphi. The Kendall coordination coefficients of rationality and importance in the third round were 0.15 and 0.17 (P = .031 and P = .007, respectively). The revised CCMQ-EE was established with 34 items. The factor loadings of subscales were between 0.39 and 0.92, and the fitting effects of other subscales were acceptable, except for the inherited special constitution. The Cronbach alpha and test–retest reliability coefficients of each subscale ranged from 0.65 to 0.83, and 0.66 to 0.96, respectively. The composite reliability and average variance extraction were between 0.66 and 0.84, and between 0.32 and 0.57, respectively. The reliability and validity of the revised CCMQ-EE were acceptable or satisfactory. Conclusion: The revised CCMQ-EE was developed through a three-round Delphi process and internal team discussion. After the verification in the elderly in Beijing area, its measurement performance was good. The updated questionnaire can probably replace the initial version to better promote health management and help healthy aging by identifying the constitution type of the elderly.

Background: Healthy older adults show a decrease in motor performance and motor learning capacity as well as in working memory (WM) performance. WM has been suggested to be involved in motor learning processes, such as sequence learning. Correlational evidence has shown the involvement of the frontoparietal network (FPN), a network underlying WM processes, in motor sequence learning. However, causal evidence is currently lacking. Non-invasive brain stimulation (NIBS) studies have focused so far predominantly on motor-related areas to enhance motor sequence learning while areas associated with more cognitive aspects of motor learning have not yet been addressed. Hypothesis: In this study, we aim to provide causal evidence for the involvement of WM processes and the underlying FPN in the successful performance of a motor sequence learning task by using theta transcranial alternating current stimulation (tACS) targeting the FPN during a motor sequence learning task. Methods: In a cohort of 20 healthy older adults, we applied bifocal tACS in the theta range to the FPN during a sequence learning task. With the use of a double-blind, cross-over design, we tested the efficacy of active compared to sham stimulation. Two versions of the motor task were used: one with high and one with low WM load, to explore the efficacy of stimulation on tasks differing in WM demand. Additionally, the effects of stimulation on WM performance were addressed using an N-back task. The tACS frequency was personalized by means of EEG measuring the individual theta peak frequency during the N-back task. Results: The application of personalized theta tACS to the FPN improved performance during the motor sequence learning task with high WM load (p

The difference between age predicted using anatomical brain scans and chronological age, i.e., the brain-age delta, provides a proxy for atypical aging. Various data representations and machine learning (ML) algorithms have been used for brain-age estimation. However, how these choices compare on performance criteria important for real-world applications, such as; (1) within-dataset accuracy, (2) cross-dataset generalization, (3) test-retest reliability, and (4) longitudinal consistency, remains uncharacterized. We evaluated 128 workflows consisting of 16 feature representations derived from gray matter (GM) images and eight ML algorithms with diverse inductive biases. Using four large neuroimaging databases covering the adult lifespan (total N = 2953, 18–88 years), we followed a systematic model selection procedure by sequentially applying stringent criteria. The 128 workflows showed a within-dataset mean absolute error (MAE) between 4.73–8.38 years, from which 32 broadly sampled workflows showed a cross-dataset MAE between 5.23–8.98 years. The test-retest reliability and longitudinal consistency of the top 10 workflows were comparable. The choice of feature representation and the ML algorithm both affected the performance. Specifically, voxel-wise feature spaces (smoothed and resampled), with and without principal components analysis, with non-linear and kernel-based ML algorithms performed well. Strikingly, the correlation of brain-age delta with behavioral measures disagreed between within-dataset and cross-dataset predictions. Application of the best-performing workflow on the ADNI sample showed a significantly higher brain-age delta in Alzheimer's and mild cognitive impairment patients compared to healthy controls. However, in the presence of age bias, the delta estimates in the patients varied depending on the sample used for bias correction. Taken together, brain-age shows promise, but further evaluation and improvements are needed for its real-world application.

Aging is characterized by a gradual decline of the body’s biological functions, which can lead to increased production of reactive oxygen species (ROS). Antioxidants neutralize ROS and maintain balance between oxidation and reduction. If ROS production exceeds the ability of antioxidant systems to neutralize, a damaging state of oxidative stress (OS) may exist. The reduced form of glutathione (GSH) is the most abundant antioxidant, and decline of GSH is considered a marker of OS. Our review summarizes the literature on GSH variations with age in healthy adults in brain (in vivo, ex vivo) and blood (plasma, serum), and reliability of in vivo magnetic resonance spectroscopy (MRS) measurement of GSH. A systematic PubMed search identified 35 studies. All in vivo MRS studies (N = 13) reported good to excellent reproducibility of GSH measures. In brain, 3 out of 4 MRS studies reported decreased GSH with age, measured in precuneus, cingulate, and occipital regions, while 1 study reported increased GSH with age in frontal and sensorimotor regions. In post-mortem brain, out of 3 studies, 2 reported decreased GSH with age in hippocampal and frontal regions, while 1 study reported increased GSH with age in a frontal region. Oxidized glutathione disulfide (GSSG) was reported to be increased in caudate with age in 1 study, suggesting OS. Although findings in the brain lacked a clear consensus, the majority of studies suggested a decline of GSH with age. The low number of studies (particularly ex vivo) and potential regional differences may have contributed to variability in the findings in brain. In blood, in contrast, GSH levels predominately were reported to decrease with advancing age (except in the oldest-old, who may represent a select group of particularly successful agers), while GSSG findings lacked consensus. The larger number of studies assessing age-specific GSH level changes in blood (N = 16) allowed for more robust consensus across studies than in brain. Overall, the literature suggests that aging is associated with increased OS in brain and body, but the timing and regional distribution of changes in the brain require further study. The contribution of brain OS to brain aging, and the effect of interventions to raise brain GSH levels on decline of brain function, remain understudied. Given that reliable tools to measure brain GSH exist, we hope this paper will serve as a catalyst to stimulate more work in this field.

Purpose: The neurometabolic timecourse of healthy aging is not well-established, in part due to diversity of quantification methodology. In this study, a large structured cross-sectional cohort of male and female subjects throughout adulthood was recruited to investigate neurometabolic changes as a function of age, using consensus-recommended magnetic resonance spectroscopy quantification methods. Methods: 102 healthy volunteers, with approximately equal numbers of male and female participants in each decade of age from the 20s, 30s, 40s, 50s, and 60s, were recruited with IRB approval. MR spectroscopic data were acquired on a 3T MRI scanner. Metabolite spectra were acquired using PRESS localization (TE=30 ms; 96 transients) in the centrum semiovale (CSO) and posterior cingulate cortex (PCC). Water-suppressed spectra were modeled using the Osprey algorithm, employing a basis set of 18 simulated metabolite basis functions and a cohort-mean measured macromolecular spectrum. Pearson correlations were conducted to assess relationships between metabolite concentrations and age for each voxel; Spearman correlations were conducted where metabolite distributions were non-normal. Paired t-tests were run to determine whether metabolite concentrations differed between the PCC and CSO. Finally, robust linear regressions were conducted to assess both age and sex as predictors of metabolite concentrations in the PCC and CSO and separately, to assess age, signal-noise ratio, and full width half maximum (FWHM) linewidth as predictors of metabolite concentrations. Results: Data from four voxels were excluded (2 ethanol; 2 unacceptably large lipid signal). Statistically-significant age*metabolite Pearson correlations were observed for tCho (r(98)=0.33, p0.20). Age associations for tCho, tCr, mI and sI in the CSO and for NAAG, tCho, and tCr in the PCC remained when controlling for sex in robust regressions. CSO NAAG and Asp, as well as PCC tNAA, sI, and Lac were higher in women; PCC Gln was higher in men. When including an age*sex interaction term in robust regression models, a significant age*sex interaction was seen for tCho (F(1,96)=11.53, p=0.001) and GSH (F(1,96)=7.15, p=0.009) in the CSO and tCho (F(1,96)=9.17, p=0.003), tCr (F(1,96)=9.59, p=0.003), mI (F(1,96)=6.48, p=0.012), and Lac (F(1,78)=6.50, p=0.016) in the PCC. In all significant interactions, metabolite levels increased with age in females, but not males. There was a significant positive correlation between linewidth and age. Age relationships with tCho, tCr, and mI in the CSO and tCho, tCr, mI, and sI in the PCC were significant after controlling for linewidth and FWHM in robust regressions. Conclusion: The primary (correlation) results indicated age relationships for tCho, tCr, mI, and sI in the CSO and for NAAG, tCho, tCr, and Gln in the PCC, while no age correlations were found for tNAA, NAA, Glx, Glu, GSH, PE, Lac, or Asp in either region. Our results provide a normative foundation for future work investigating the neurometabolic time course of healthy aging using MRS.

Microbiome epidemiology is an emerging field for the discovery of novel disease biomarkers or intervention targets in human epidemiological studies. The determinants and consequences of human microbiome variations, especially for the gut microbiome, are both important and unsolved research questions, while the majority of findings of prior research are based on small-scale human studies with limited statistical power and a lack of replication/generalizability across different populations. Here, we initiated the Westlake Gut (WeGut) project, a consortium of gut microbiome-based human cohort studies in China. The WeGut project aims to provide a platform for the integration of gut microbiome data across different cohort studies, including two major components: 1) cohorts for healthy ageing and 2) cohorts for healthy pregnancy. The WeGut consortium includes seven core/foundation cohorts involving over 32,000 participants with gut microbiome and rich phenotype data across 17 provinces/megacities in China. Within the WeGut framework, we hope to disentangle the interplay among diet, lifestyle factors, host genetics and the gut microbiome in human health and explore the role of the gut microbiome for the precision prevention of chronic diseases in Chinese populations.

Background: Normal aging is known to include declines in several cognitive domains, with parallel grey matter atrophy. However, there are inconsistencies in the largely cross-sectional literature as to which regions of grey matter show change over time, with some investigations reporting whole brain and others reporting more focal regions of atrophy. More longitudinal analyses are needed to better understand the neurostructural and functional changes that occur gradually in older adulthood. Objective: The aim of the current study was to investigate changes in cognitive performance and grey matter atrophy in a sample of healthy older adults over four years. Methods: MRI and cognitive data were retrieved from the Alzheimer's Disease Neuroimaging Initiative database for 35 participants in the cognitively normal cohort at two time points separated by four years (mean age at baseline = 75.02, SD = 6.51, 54% female). Grey matter structure was assessed via voxel-based morphometry and cognition was measured across four domains (memory, executive function, language and visuospatial skills). Results: Results indicated widespread grey matter atrophy, including frontal, temporal, and subcortical regions. Cognitive performance was largely stable, with the exception of executive function, which showed significant decline over time. Conclusion: Findings indicate that cognitive abilities are largely preserved over a four year period, even when grey matter atrophy is present in the aging brain.

Decelerating motor decline is important for promoting healthy aging in the elderly population. Acorus tatarinowii Schott is a traditional Chinese medicine that contains β-asarone as a pharmacologically active constituent. We found that β-asarone can decelerate motor decline in various age groups of Caenorhabditis elegans, while concurrently prolonging their lifespan and modulating synaptic transmission. To understand the mechanisms of its efficacy in motor improvement, we investigated and discovered that mitochondrial fragmentation, a marker for aging, is delayed after β-asarone treatment. Moreover, their efficacy is blocked by dysfunctional mitochondria. Corresponding to their role in regulating mitochondrial homeostasis, we found that SKN-1/Nrf2 and GST-4 are critical in the β-asarone treatment, and they appear to be activated via the insulin/IGF-1 signaling pathway. Well-developed intestinal microvilli are required for this process. Our study demonstrates the efficacy and mechanism of β-asarone treatment in age-related motor decline, contributing to the discovery of drugs for achieving healthy aging., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Subjective cognitive concerns (SCC) are common even in cognitively normal older adults who lack objectively-detectable deficits on standard neuropsychological evaluation. The clinical relevance of these concerns, particularly considering the nature of concerns (e.g., memory versus non-memory), remains unclear. Thus, we examined whether baseline memory and non-memory SCC relate to longitudinal change in brain volume and neuropsychological test performance in 476 functionally-intact, objectively unimpaired older adults (M age = 72y, 56 % female, follow-up time = 1 - 9 years). Mixed-effects models revealed that both higher baseline memory and non-memory SCC predicted greater atrophy in total gray matter and dorsolateral prefrontal cortex atrophy over time, while only memory SCC predicted steeper medial temporal lobe atrophy. Regarding neuropsychological performance, higher non-memory SCC predicted decline in processing speed performance, while memory SCC did not predict neuropsychological trajectories. SCC are a risk factor for more adverse brain and cognitive aging trajectories, even in functionally-intact, seemingly cognitively normal older adults., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Cognitive and physical performance is impaired by aging and fatigue. Cognitive and exercise training may mitigate such impairments. Accordingly, we investigated the effect of Brain Endurance Training (BET) - combined cognitive and exercise training - on cognitive and physical performance when fresh and fatigued in older adults., Design: Twenty-four healthy sedentary women (65-78 years) were randomly allocated to one of three training groups: BET, exercise training, and control (no training). The BET and exercise training groups completed the same physical training protocol comprising three 45-min exercise sessions (20-min resistance exercise plus 25-min endurance exercise) per week for eight weeks. The BET group completed a 20-min cognitive task prior to exercise tasks. Cognitive (tasks: psychomotor vigilance, Stroop) and physical (tests: walk, chair-stand, arm curl) performance was tested when fresh and fatigued (before and after a 30-min cognitive task) at weeks 0 (pre-test), 4 (mid-test), 8 (post-test), and 12 (follow-up test)., Results: Cognitive and physical and performance was generally superior when fresh and fatigued at mid-test and post-test for both BET and exercise training groups compared to the control group. The BET group outperformed the exercise group when fatigued at mid-test and post-test both cognitively (always) and physically (sometimes). The pre-to-post changes in cognitive performance when fresh and fatigued averaged 3.7 % and 7.8 % for BET, 3.6 % and 4.5 % for exercise, and -0.4 % and 0.3 % for control groups. The corresponding changes in physical performance averaged 16.5 % and 29.9 % for BET, 13.8 % and 22.4 % for exercise, and 10.8 % and 7.1 % for control groups., Conclusion: These findings show that BET can improve cognitive and physical performance in older adults., Competing Interests: Declaration of competing interest We have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: The rapidly ageing world has placed considerable demands on health and social care. To address this, the World Health Organization (WHO) and United Nations (UN) have declared action for this decade (2021-2030) to promote healthy ageing. Operationalisation of successful ageing in the oral health context in terms of its dimensions and their interconnectedness was determined., Methods: A citation analysis was conducted following a scoping review to determine oral health's relationship with 5 key dimensions of successful ageing. This included examining the occurrence and co-occurrence amongst dimensions and over time. Specific consideration of citations by country, journal type, and authors through overlay visualisation was performed to map their interconnectedness., Results: The scoping review identified 263 publications covering 1730 specific terms. There was a growing interest in successful ageing in the oral health context, mostly in the past decade (2010 onwards; 65.8%, 173 publications). The dimension of key consideration was "health and ADLs" (activities of daily living); this dimension appeared in 97.3% of publications (n = 256) and was found earliest to emerge, with the greatest link strengths compared to other dimensions. Country-level variations in citation data were observed, and there was good citation interconnectedness between them. Key oracles for dissemination have been medical rather than dental-specific journals. Amongst authors, there was considerable interconnectedness in the field., Conclusions: Findings highlight how successful ageing in the oral health context has been studied, with implications for addressing the significance of oral health to older peoples' lives in line with the WHO and UN's agenda. Citation analyses identified the "known unknowns" area for further consideration, and these findings have the potential to inform how dental research may best move forward with the successful ageing agenda to bring about translational impact., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024. Published by Elsevier Inc.)

Background: Costa Rica is experiencing a fast demographic aging. Healthy diets may help to ameliorate the burden of aging-related conditions., Objective: This study aimed to investigate the association of a traditional dietary pattern and 2 of its major components (beans and rice) with all-cause mortality among elderly Costa Ricans., Methods: The Costa Rican Longevity and Healthy Aging Study (CRELES), a prospective cohort study of 2827 elderly Costa Ricans (60+ y at baseline), started in 2004. We used a food frequency questionnaire (FFQ) to assess usual diet. We calculated dietary patterns using principal component analysis. Multivariate energy-adjusted proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs)., Results: Over a 15-y follow-up, encompassing 24,304 person-years, 1667 deaths occurred. The traditional Costa Rican dietary pattern was more frequent in rural parts of the country, and it was inversely associated with all-cause mortality. Subjects in the fifth quintile of intake had 18% lower all-cause mortality than those in the first quintile (HR: 0.82; 95% CI: 0.69, 0.98; P-trend = 0.01), particularly among males (HR: 0.73; 95% CI: 0.56, 0.95). Bean intake was associated with lower all-cause mortality among all subjects (HR: 0.79; 95% CI: 0.68, 0.91, highest compared with lowest tertile) and in sex-stratified analysis. Rice consumption was inversely associated with all-cause mortality solely among males (HR: 0.75; 95% CI: 0.60, 0.94, highest compared with lowest tertile)., Conclusions: Our results suggest that a traditional Costa Rican rural dietary pattern is associated with lower all-cause mortality in elderly Costa Ricans. Beans, a major component of this traditional dietary pattern, was also associated with lower all-cause mortality. These findings could have important implications for public health, given the nutritional transition and the reduction of intake of traditional diets in Latin American countries., Competing Interests: Conflict of interest The authors report no conflict of interest., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Objective: Midlife dyslipidemia is associated with higher risk of dementia in late-life dementia, but the impact of late-life dyslipidemia on dementia risk is uncertain. This may be due to the large heterogeneity in cholesterol measures and study designs employed. We used detailed data from a large prospective cohort of older persons to comprehensively assess the relation between a broad range of cholesterol measures and incident dementia, addressing potential biases, confounders, and modifiers., Design: Post hoc observational analysis based on data from a dementia prevention trial (PreDIVA)., Setting and Participants: 3392 community-dwelling individuals, without dementia, aged 70-78 years at baseline (recruited between June 2006 and March 2009)., Methods: Total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and apolipoprotein A1 and B were assessed. Over a median of 6.7 years' follow-up, dementia was established by clinical diagnosis confirmed by independent outcome adjudication. Hazard ratios (HRs) for dementia and mortality were calculated using Cox regression., Results: Dementia occurred in 231 (7%) participants. One-SD increase in LDL/HDL conveyed a 19% (P = .01) lower dementia risk and a 10% (P = .02) lower risk of dementia/mortality combined. This was independent of age, cardiovascular risk factors, cognitive function, apolipoprotein E genotype, and cholesterol-lowering drugs (CLD). This association was not influenced by the competing risk of mortality. Consistent and significant interactions suggested these associations were predominant in individuals with low body mass index (BMI) and higher education., Conclusions and Implications: Dyslipidemia in older individuals was associated with a lower risk of dementia. Low BMI and higher education level mitigate poor outcomes associated with dyslipidemia. These findings suggest that a different approach may be appropriate for interpreting lipid profiles that are conventionally considered adverse in older adults. Such an approach may aid predicting dementia risk and designing intervention studies aimed at reducing dementia risk in older populations., Competing Interests: Disclosures The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: To describe the characteristics and relationships of social isolation and health promoting behaviors of Chinese older adults with different health statuses. Methods: Totally 485 older adults were recruited. They were divided into three groups based on their health status: healthy group (n = 72), group with one disease (n = 183) and group with multimorbidity (n = 230). Lubben Social Network Scale-6 and Health-Promoting Lifestyle Profile II were used to measure their social isolation and health-promoting behaviors, respectively. Results: Among the aged with one disease or multimorbidity, 30.6% (56/183) and 31.7% (73/230) were socially isolated, respectively, based on the score of the Lubben Social Network Scale-6. The three groups differed significantly in health-promoting behaviors and scores on several subscales. The group with multimorbidity exhibited more social isolation and fewer health-promoting behaviors than other groups. Social isolation was among the factors adversely affecting health-promoting behaviors in older adults. Conclusions: Health care providers should help older adults with multimorbidity preserve the remaining abilities to improve health-promoting behaviors. Meanwhile, it is important to support healthy older adults to increase self-responsibility to achieve healthy aging.

Summary: Background: While efforts have been made to validate intrinsic capacity (IC) as a multidimensional indicator of healthy aging in high-income countries, we still need evidence from lower-income countries. We examined associations of IC with wide ranges of activities of daily living in a nationally representative sample of Brazilians aged≥50 years. Methods: This cross-sectional analysis included 7175 participants from the Brazilian Longitudinal Study of Aging. IC domains (cognitive, psychological, sensory, locomotor, and vitality) were determined using self-reported and physical performance measures. IC was operationalized through factorial analysis. We investigated associations of IC and its domains with functional ability in basic, instrumental, and advanced activities of daily living (ADL, IADL, and AADL) using logistic regressions adjusted for sociodemographic, clinical, and modifiable risk factors. Findings: The IC bi-factorial model revealed satisfactory goodness-of-fit. Preserved ability in ADL and IADL, respectively, ranged from 69% and 29% to 89% and 74% across IC quartiles. In adjusted analyses, every standard deviation increment in IC composite score was associated with almost twice the odds of preserved ADL (OR=1·72; 95%CI=1·54-1·93), preserved IADL (OR=1·95; 95%CI=1·77-2·16), and high performance in AADL (OR=1·79; 95%CI=1·59-2·00). Similar results were reported using the IC domains as predictors. Although age, race/ethnicity, and education did not modify associations of IC with functional ability, we found sex differences with stronger relationships of IC with preserved ADL or IADL in females. Interpretation: Our results support IC validity and reliability to measure healthy aging in diverse socioeconomic and cultural settings. Incorporating IC in routine practices can promote holistic and person-centered care approaches in aging societies. Funding: The Brazilian Ministry of Health and Ministry of Science, Technology, Innovation, and Communication.

Objective: The decade 2021–2030 has been declared the Decade of Healthy Aging by the United Nations General Assembly, underlining that health is central to the experience of older age and the opportunities that aging brings. Self-rated health (SRH) appears consistent with the state of objective health, and therefore can serve as a simple core indicator of healthy aging. SRH can be affected by psychological and lifestyle factors, and by the developmental and sociodemographic context, which can directly and indirectly influence subjective health status. The aim of the present study was to establish the structure of the relationships between SRH, health-related behavior, subjective wellbeing, developmental tasks attainment and sociodemographic factors in the late-life period. Methods: The study group consisted of 340 Polish retired seniors, aged 61 to 94 (M = 70.75, SD = 6.48): 88 men (25.9 %) and 252 women (74.1 %). The respondents completed the following measures: 10-point numerical scale for SRH, Health-Related Questionnaire for Seniors, Satisfaction with Life Scale, Developmental Tasks Questionnaire for Seniors and a sociodemographic survey. Results: The group demonstrated a medium level of SRH and other variables. SHR was positively correlated with health-related behavior, wellbeing, developmental tasks attainment and perceived economic status, and negatively with age. Structural equation model revealed that health-related behavior, wellbeing, age and economic status have a direct influence on SRH. Developmental tasks attainment was found to predict health behavior, although no direct relationship with SRH was found. Conclusions: A broader understanding of healthy aging is achieved by considering the context of its factors. Psychological interventions should promote a healthy lifestyle and adapt it to the late life period to promote health among seniors.

Resumen: Introducción: En 2011 se impulsó desde la Subdirección de Salud Pública de Gipuzkoa la iniciativa Ttipi-Ttapa para la promoción comunitaria del ejercicio físico en personas mayores mediante rutas saludables en colaboración con ayuntamientos, asociaciones ciudadanas y atención primaria. Objetivo: Evaluar desde la perspectiva de los participantes la experiencia Ttipi-Ttapa en el periodo 2012-2017 para identificar los principales aciertos y carencias y compartir propuestas de continuidad y mejora. Método: Diseño mixto con investigación cualitativa central y encuesta suplementaria a todos los caminantes en salidas en 13 localidades. Test de ji al cuadrado para comparación de porcentajes. En el estudio cualitativo, muestreo intencional con diferentes perfiles de participantes mediante nueve grupos focales y 10 entrevistas individuales. Grabación en audio previo consentimiento. Análisis temático con ayuda de mapas conceptuales y el programa MAXQDA. Triangulación entre investigadores en un contexto de investigación-aprendizaje. Resultados: Se analizaron 464 cuestionarios; 64% mujeres y 36% hombres. Edad media 69,8 años y 75% mayores de 65 años. Satisfacción general de 9,05/10, con diferencias significativas a favor de las mujeres, los grupos de mayor edad y las personas viudas. En el estudio cualitativo participaron 43 mujeres y 37 hombres. Se identifican tres áreas temáticas principales a partir de las categorías codificadas y sus solapamientos: a) no solo es caminar; b) organización, valores y personas; y c) claves colaborativas y retos de futuro. Conclusiones: Los beneficios percibidos en salud desbordan el ejercicio físico con implicaciones importantes en la interacción y la cohesión social. La complejidad de los procesos evaluados conlleva exigencias metodológicas, organizativas y colaborativas. Abstract: Introduction: In 2011 the Tipi-Tapa initiative was endorsed by the Public Health Department of Gipuzkoa to promote physical exercise through healthy walks in community-dwelling older adults, in collaboration with municipalities, citizens associations and primary care. Objective: To evaluate, from the participants’ perspective, the Tipi-Tapa experience during 2012-2017 to identify the main successes and failures and share proposals of continuity and improvement. Method: Mixed methods design with a qualitative core component and a supplementary questionnaire to all participants from 13 municipalities. The Chi-squared test was used to compare percentages. In the qualitative study, a purposive sampling was applied considering participants’ profiles through nine focus groups and 10 individual interviews. The interviews were audio recorded with previous consent. A thematic analysis was performed using conceptual maps and the MAXQDA software. Triangulation among researchers was done in a research-learning context. Results: We analysed 464 questionnaires; 64% from women and 36% from men. The participants’ mean age was 69.8 years; 75% were older than 65 years. The general satisfaction was 9.05/10 with significant differences in favour of women, older age groups and widows. In the qualitative study, 43 women and 37 men participated. Three main thematic areas were identified based on category coding and overlap: a) it is not just walking; b) organization, values and persons; and c) collaborative keystones and future challenges. Conclusions: The health benefits perceived by participants go beyond physical exercise, with important implications for social interaction and cohesion. The complexity of the processes assessed entails methodological, organizational and collaborative requirements.