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Older adults have difficulty maintaining side-to-side balance while navigating daily environments. Losing balance in such circumstances can lead to falls. We need to better understand how older adults adapt lateral balance to navigate environment-imposed task constraints. How do older adults adjust mediolateral balance while walking along continually-narrowing paths, and what are the stability implications of these adjustments? Eighteen older (71.6±6.0 years) and twenty younger (21.7±2.6 years) healthy adults traversed 25 m-long paths that gradually narrowed from 45 cm to 5 cm. Participants switched onto an adjacent path when they chose. We quantified participants' lateral center-of-mass dynamics and lateral Margins of Stability (MoS L) as paths narrowed. We quantified lateral Probability of Instability (PoI L) as the probability that participants would take a laterally unstable (MoS L <0) step as they walked. We also extracted these outcomes where participants switched paths. As paths narrowed, all participants exhibited progressively smaller average MoS L and increasingly larger PoI L. However, their MoS L variability was largest at both the narrowest and widest path sections. Older adults exhibited consistently both larger average and more variable MoS L across path widths. Taken into account together, these resulted in either comparable or somewhat larger PoI L as paths narrowed. Older adults left the narrowing paths sooner, on average, than younger. As they did so, older adults exhibited significantly larger average and more variable MoS L , but somewhat smaller PoI L than younger. Our results directly challenge the predominant interpretation that larger average MoS L indicate "greater stability", which we argue is inconsistent with the principles underlying its derivation. In contrast, analyzing step-to-step gait dynamics, together with estimating PoI L allows one to properly quantify instability risk. Furthermore, the adaptive strategies uncovered using these methods suggest potential targets for future interventions to reduce falls in older adults. • Daily environments challenge older adults' ability to maintain lateral balance. • Healthy older and younger adults walked down continuously-narrowing paths. • Average lateral Margins-of-Stability (MoS L) yielded paradoxical results. • Larger average MoS L measures do not indicate "greater stability". • Probability-of-Instability (PoI L) properly captured peoples' instability risk. [ABSTRACT FROM AUTHOR]

The senescence-associated secretory phenotype (SASP) is a biomarker index based on the profile of 22 blood proteins associated with cellular senescence. The SASP index has not been assessed in older patients with bipolar disorder (BD). We hypothesized that older adults with BD will have elevated cellular senescence burden as measured by the SASP index. We measured the 22 SASP proteins to calculate the SASP index in 38 older patients with BD and 34 non-psychiatric comparison individuals (HC). The SASP index scores were significantly higher in BD than HC after controlling for age, sex, psychopathology, and physical health (F(1,8) = 5.37, p = 0.024, η2 = 0.08). SASP index scores were also associated with higher age, more severe depressive symptoms, and physical illness burden (p < 0.05) in the whole sample. Cross-sectional study and small sample size. This is the first report of increased SASP index scores in older adults with BD. Our results suggest that dysregulation of age-related biological processes may contribute to more severe depressive symptoms and worse physical health in older adults with BD. • Older adults with bipolar disorder (BD) have a greater risk of age-related adverse health outcomes. • The SASP index is a marker of cellular senescence burden and is significantly elevated in older adults with BD. • The elevated SASP index may be an indicator of accelerated biological aging in older adults with BD. [ABSTRACT FROM AUTHOR]

The prevalence of sleep-related issues among older adults is a significant concern, with half of the older population reporting these problems. Consequently, strategies to improve sleep are needed for this population. This study aims to assess the effects of a health educational program on sleep behaviour among pre-frail or frail older adults residing in the community and to explore possible associations with frailty. This randomised controlled trial (NCT05610605) included a total of 197 community-dwelling older adults with frailty/pre-frailty, divided into control (n = 88) and educational (n = 109) groups, were assessed at baseline, after the 6-month educational program (6 months), and 6 months after the intervention (12 months). The intervention comprised four group sessions and six follow-up phone calls, focusing on frailty, physical activity, dietary habits, and cognitive training. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and wrist-worn accelerometry. At 6 months, a significant time-by-group interaction was found for self-reported [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] and accelerometer-measured [β = 0.505, 95%CI (0.085, 0.926), p = 0.019] sleep efficiency, showing improved sleep efficiency in the intervention group vs. controls. A significant time-by-group interaction at 6 months was noted for sleep awakenings [β = −0.402, 95%CI (−0.825, −0.020), p = 0.047]. The educational program led to a significant decrease in awakenings, while the control group experienced an increase. The change in the number of awakenings (Rs = 0.183, p = 0.020) at 6 months was significantly associated with changes in frailty. Moreover, a significant time-by-group interaction was reported at the 12-month assessment [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] for self-reported sleep quality, indicating better results in the intervention group compared to controls. The educational program improved sleep quality and sleep efficiency while reducing the number of awakenings per night among community-dwelling frail older adults, offering a practical approach to addressing sleep-related challenges in this demographic. • A health educational program improved sleep quality among older adults with frailty. • Participants who adhered to their usual healthcare experienced a decrease in sleep quality. • Interventions for frailty, activity, diet, and cognition can boost sleep quality in frail adults. [ABSTRACT FROM AUTHOR]

The hypothalamus regulates homeostasis across the lifespan and is emerging as a regulator of aging. In murine models, aging-related changes in the hypothalamus, including microinflammation and gliosis, promote accelerated neurocognitive decline. We investigated relationships between hypothalamic microstructure and features of neurocognitive aging, including cortical thickness and cognition, in a cohort of community-dwelling older adults (age range 65–97 years, n=124). Hypothalamic microstructure was evaluated with two magnetic resonance imaging diffusion metrics: mean diffusivity (MD) and fractional anisotropy (FA), using a novel image processing pipeline. Hypothalamic MD was cross-sectionally positively associated with age and it was negatively associated with cortical thickness. Hypothalamic FA, independent of cortical thickness, was cross-sectionally positively associated with neurocognitive scores. An exploratory analysis of longitudinal neurocognitive performance suggested that lower hypothalamic FA may predict cognitive decline. No associations between hypothalamic MD, age, and cortical thickness were identified in a younger control cohort (age range 18–63 years, n=99). To our knowledge, this is the first study to demonstrate that hypothalamic microstructure is associated with features of neurocognitive aging in humans. • In animal models, aging-related changes in the hypothalamus drive brain aging. • The role of the hypothalamus in neurocognitive aging in humans is unknown. • We show that hypothalamic microstructure is altered with aging in older adults. • Hypothalamic microstructure is associated with cortical thickness and cognition. [ABSTRACT FROM AUTHOR]

Women have a higher incidence of Alzheimer's disease (AD), even after adjusting for increased longevity. Thus, there is an urgent need to identify genes that underpin sex-associated risk of AD. PIN1 is a key regulator of the tau phosphorylation signaling pathway; however, potential differences in PIN1 expression, in males and females, are still unknown. We analyzed brain transcriptomic datasets focusing on sex differences in PIN1 mRNA levels in an aging and AD cohort, which revealed reduced PIN1 levels primarily within females. We validated this observation in an independent dataset (ROS/MAP), which also revealed that PIN1 is negatively correlated with multiregional neurofibrillary tangle density and global cognitive function in females only. Additional analysis revealed a decrease in PIN1 in subjects with mild cognitive impairment (MCI) compared with aged individuals, again driven predominantly by female subjects. Histochemical analysis of PIN1 in AD and control male and female neocortex revealed an overall decrease in axonal PIN1 protein levels in females. These findings emphasize the importance of considering sex differences in AD research. • Reduced PIN1 levels are driven by females in aging and Alzheimer's disease. • PIN1 is negatively correlated with neurofibrillary tangle density in females. • PIN1 levels are negatively correlated with global cognitive function in females. • PIN1 levels are decreased in subjects with mild cognitive impairment. [ABSTRACT FROM AUTHOR]

To examine nativity differences of co-occurring liver disease (LD) and heart failure (HF) on 13-year mortality among Mexican American older adults. Prospective cohort study of 1601 Mexican Americans aged ≥ 75 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/05–2016). Participants were grouped into four groups: no LD and no HF (n = 1138), LD only (n = 53), HF only (n = 382), and both LD and HF (n = 28). We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of death over time. The HR of death, as a function of HF only, was 1.32 (95% CI=1.07–1.62) among US-born and 1.36 (95% CI=1.04–1.78) among foreign-born participants, vs. those with no LD and no HF. Among foreign-born participants, the HR of death as a function of LD and HF was 3.39 (95% CI=1.65–6.93) vs. those without either. LD alone was not associated with mortality in either group. Among US-born, co-occurring LD and HF was not associated with mortality. Foreign-born participants with both LD and HF were at higher risk of mortality over 13 years of follow up. [ABSTRACT FROM AUTHOR]

Growing evidence suggests that aging is associated with impaired endogenous pain modulation, and that this likely underlies the increased transition from acute to chronic pain in older individuals. Resting-state functional connectivity (rsFC) offers a valuable tool to examine the neural mechanisms behind these age-related changes in pain modulation. RsFC studies generally observe decreased within-network connectivity due to aging, but its relevance for pain modulation remains unknown. We compared rsFC within a set of brain regions involved in pain modulation between young and older adults and explored the relationship with the efficacy of distraction from pain. This revealed several age-related increases and decreases in connectivity strength. Importantly, we found a significant association between lower pain relief and decreased strength of three connections in older adults, namely between the periaqueductal gray and right insula, between the anterior cingulate cortex (ACC) and right insula, and between the ACC and left amygdala. These findings suggest that the functional integrity of the pain control system is critical for effective pain modulation, and that its function is compromised by aging. • Older adults showed decreased rsFC within the descending pain control system. • This decrease was associated with lower distraction-related pain relief. • rsFC markers for pain modulation efficacy in aging have clear clinical benefits. [ABSTRACT FROM AUTHOR]

The aging population suffers from memory impairments. Slow-wave activity (SWA) is composed of slow (0.5–1 Hz) and delta (1–4 Hz) oscillations, which play important roles in long-term memory and working memory function respectively. SWA disruptions might lead to memory disturbances often experienced by older adults. We conducted behavioral tests in young and older C57BL/6 J mice. SWA was monitored using wide-field imaging with voltage sensors. Cell-specific calcium imaging was used to monitor the activity of excitatory and inhibitory neurons in these mice. Older mice exhibited impairments in working memory but not memory consolidation. Voltage-sensor imaging revealed aberrant synchronization of neuronal activity in older mice. Notably, we found older mice exhibited no significant alterations in slow oscillations, whereas there was a significant increase in delta power compared to young mice. Calcium imaging revealed hypoactivity in inhibitory neurons of older mice. Combined, these results suggest that neural activity disruptions might correlate with aberrant memory performance in older mice. • Slow wave activity disruptions lead to memory disturbances in older adults. • Older mice show impairments in working memory, but not memory consolidation. • Older mice showed abnormal synchronization of neuronal activity across the cortex. • Older mice exhibited aberrant activity of inhibitory neurons within the circuit. • The neural activity disruptions may be related to memory impairments in Older mice. [ABSTRACT FROM AUTHOR]

Sequence memory is subject to age-related decline, but the underlying processes are not yet fully understood. We analyzed electroencephalography (EEG) in 21 healthy older (60–80 years) and 26 young participants (20–30 years) and compared time-frequency spectra and theta-gamma phase-amplitude-coupling (PAC) during encoding of the order of visually presented items. In older adults, desynchronization in theta (4–8 Hz) and synchronization in gamma (30–45 Hz) power did not distinguish between subsequently correctly and incorrectly remembered trials, while there was a subsequent memory effect for young adults. Theta-gamma PAC was modulated by item position within a sequence for older but not young adults. Specifically, position within a sequence was coded by higher gamma amplitude for successive theta phases for later correctly remembered trials. Thus, deficient differentiation in theta desynchronization and gamma oscillations during sequence encoding in older adults may reflect neurophysiological correlates of age-related memory decline. Furthermore, our results indicate that sequences are coded by theta-gamma PAC in older adults, but that this mechanism might lose precision in aging. • Sequence memory, an important aspect of episodic memory, declines in healthy aging. • Lower theta and higher gamma activity in encoding of correct trials in young adults. • No subsequent memory effect in oscillatory brain activity in healthy older adults. • Theta phase modulates gamma amplitude to code for item position in older adults. [ABSTRACT FROM AUTHOR]

The association between obesity and depressive symptoms remains controversial. The Weight-adjusted waist index (WWI) shows advantages in assessing central obesity. This study aimed to investigate the longitudinal relationship between WWI and depressive symptoms. This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011–2020. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depressive Symptoms Scale (CESD-10) scores. Linear mixed models were used to examine longitudinal associations. A total of 6835 participants over the age of 45 were included. WWI was positively associated with CESD-10 scores (β per 1 SD increase = 0.052SD; 95%CI: 0.021 to 0.083SD) and was linked to a faster increase in CESD-10 scores over time (β = 0.095SD/year; 95%CI: 0.090 to 0.100 SD/year). Conversely, BMI was negatively associated with CESD-10 scores (β per 1 SD increase = −0.067SD; 95%CI: −0.097 to −0.038SD). However, the negative association between BMI and CESD-10 scores weakened over time (β per 1 SD increase = 0.008SD/y; 95%CI: 0.003 to 0.013 SD/y). Nonlinear associations were detected between both WWI and BMI with CESD-10 scores. Self-reported depressive symptoms assessments may have introduced information bias. The observational design limits ruling out unobserved confounding factors. Our findings highlight the association between WWI and the long-term progression of depressive symptoms in middle-aged and older adults. WWI may enhance our understanding of the link between obesity and depressive symptoms and could be superior to BMI in predicting depressive symptom progression. • The association between obesity and depression remains controversial. • Weight-adjusted Waist Index has advantages in reflecting abnormal body composition. • Heterogeneity in depression trajectories was detected among older adults. • Weight-adjusted Waist Index may accelerate the progression of depression. [ABSTRACT FROM AUTHOR]

The effect of lifestyle factors on cognitive function related to four major noncommunicable diseases (NCDs) including diabetes, cardiovascular disease, cancer, and chronic respiratory diseases, and the relationship between these NCDs and cognitive function have not been fully studied. We aimed to investigate the longitudinal associations between these NCDs and cognitive function in middle-aged and older people, and the combined effects of lifestyle factors. By employing the data from three large-scale cohort studies from the U.S. Health and Retirement Study (2010–2019), English Longitudinal Study of Aging (2014–2019), and China Health and Retirement Longitudinal Study (2011–2019), this study carried out a multi-cohort analysis to 77, 210 participants. Fixed-effects regression models were used to examine associations between NCD status and cognitive function. Margin plots were used to illustrate the effect of lifestyle factors. Our findings revealed the dose-dependent association between mounting these NCDs and declining cognitive performance, ranging from one NCD (β = −0.05, 95 % CI: −0.08 to −0.02) to four NCDs (β = −0.51, 95 % CI: −0.75 to −0.28). Decline in cognitive function associated with NCDs was exacerbated with physical inactivity, current smoking status, and an increase in unhealthy lifestyle behaviors. The observational study design precludes causal interrogation of lifestyles and four NCDs on cognitive function. An increasing number of these NCDs were dose-dependently associated with the decline in cognitive function score. Unhealthy lifestyle factors expedite decline in cognitive function linked to these NCDs. • Rise in 4 major NCDs and decline in cognitive function alarms health. • More NCDs dose-dependently associated with lower cognitive function scores. • Unhealthy lifestyle factors expedite decline in NCD-linked cognitive function. [ABSTRACT FROM AUTHOR]

Some research has shown that older adults benefit more from multisensory information than do young adults. However, more recent evidence has shown that the multisensory age benefit varies considerably across tasks. In the current study, older (65 – 80) and young (18 – 30) adults (N = 191) completed a speeded perceptual discrimination task either online or face-to-face to assess task response speed. We examined whether presenting stimuli in multiple sensory modalities (audio-visual) instead of one (audio-only or visual-only) benefits older adults more than young adults. Across all three experiments, a consistent speeding of response was found in the multisensory condition compared to the unisensory conditions for both young and older adults. Furthermore, race model analysis showed a significant multisensory benefit across a broad temporal interval. Critically, there were no significant differences between young and older adults. Taken together, these findings provide strong evidence in favour of a multisensory benefit that does not differ across age groups, contrasting with prior research. • Multisensory information is responded to faster than unisensory information. • Both young and older adults benefit similarly from multisensory information. • An age-specific multisensory benefit was not replicated from prior research. [ABSTRACT FROM AUTHOR]

Prior studies have reported inconsistent results regarding the relationships between the integrity of the fornix and parahippocampal cingulum and both memory performance and longitudinal change in performance. In the present study, we examined associations in a sample of cognitively healthy older adults between free water-corrected fractional anisotropy (FA) metrics derived from the fornix and cingulum, baseline memory performance, and 3-year memory change. Neither fornix nor cingulum FA correlated with memory performance at baseline. By contrast, FA of each tract was predictive of memory change, such that greater FA was associated with less longitudinal decline. These associations remained significant after controlling for FA of other white matter tracts and for performance in other cognitive domains. Furthermore, fornix and cingulum FA explained unique variance in memory change. These results suggest that free water-corrected measures of fornix and parahippocampal cingulum integrity are reliable predictors of future memory change in cognitively healthy older adults. The findings for the fornix in particular highlight the utility of correcting for free water when estimating diffusion tensor imaging metrics of white matter integrity. • Free water-corrected fornix and cingulum FA were unrelated to memory performance. • FA of both fornix and cingulum demonstrated a specific association with memory change. • Fornix and cingulum FA explained unique variance in memory change. [ABSTRACT FROM AUTHOR]

• The proposed AMS framework in LTCF should focus on five domains: strategic vision, team, interventions, patient-centred care and awareness. • Internists can partner with geriatrists, pharmacists and infectious disease specialists to address barriers and to improve patient care. • AMS interventions are associated with reduced side effects, lower mortality, shorter hospital stays, and reduced costs. Older adults hospitalized in internal medicine wards or long-term care facilities (LTCF) are progressively increasing. Older adults with multimorbidity are more susceptible to infections, as well as to more vulnerable to adverse effects (and interactions) of antibiotics, resulting in a need for effective and safer strategies for antimicrobial stewardship (ASM), both in hospitalization wards and long-term care facilities. Studies on antimicrobial stewardship in older patients are scarce and guidelines are required. Given the peculiarities of the optimization of antimicrobial prescription in individual older adults for common infections, tactics to overcome barriers need an update. The use of rapid diagnosis tests, biomarkers, de-escalation and switching from intravenous to oral/subcutaneous therapy strategies are examples of successful AMS interventions. AMS interventions are associated with reduced side effects, lower mortality, shorter hospital stays, and reduced costs. The proposed AMS framework in LTCF should focus on five domains: strategic vision, team, interventions, patient-centred care and awareness. Internists can partner with geriatrists, pharmacists and infectious disease specialists to address barriers and to improve patient care. [ABSTRACT FROM AUTHOR]

Exercise training is among the main strategies that have been proposed to promote cognitive and brain health outcomes in older individuals with and without cognitive impairment. The effects of exercise on cognition are mediated, in part, by structural and functional adaptations in the brain, including changes in gray matter volumes and white matter microstructural integrity. Muscular contractions during exercise produce a category of cytokines referred to as myokines, which represent a potential molecular pathway mediating neuroplastic adaptations and associated cognitive improvements in response to exercise. Understanding the ideal combination of exercise training parameters across populations and life stages could lead to interventions that promote greater effects on cognitive and brain health outcomes. Exercise training is an important strategy to counteract cognitive and brain health decline during aging. Evidence from systematic reviews and meta-analyses supports the notion of beneficial effects of exercise in cognitively unimpaired and impaired older individuals. However, the effects are often modest, and likely influenced by moderators such as exercise training parameters, sample characteristics, outcome assessments, and control conditions. Here, we discuss evidence on the impact of exercise on cognitive and brain health outcomes in healthy aging and in individuals with or at risk for cognitive impairment and neurodegeneration. We also review neuroplastic adaptations in response to exercise and their potential neurobiological mechanisms. We conclude by highlighting goals for future studies, including addressing unexplored neurobiological mechanisms and the inclusion of under-represented populations. [ABSTRACT FROM AUTHOR]

Aging affects the scalp-to-cortex distance (SCD) and the comprising tissues. This is crucial for noninvasive neuroimaging and brain stimulation modalities as they rely on traversing from the scalp to the cortex or vice versa. The specific relationship between aging and these tissues has not been comprehensively investigated. We conducted a study on 250 younger and older adults to examine age-related differences in SCD and its constituent tissues. We identified region-specific differences in tissue thicknesses related to age and sex. Older adults exhibit larger SCD in the frontocentral regions compared to younger adults. Men exhibit greater SCD in the inferior scalp regions, while women show similar-to-greater SCD values in regions closer to the vertex compared to men. Younger adults and men have thicker soft tissue layers, whereas women and older adults exhibit thicker compact bone layers. CSF is considerably thicker in older adults, particularly in men. These findings emphasize the need to consider age, sex, and regional differences when interpreting SCD and its implications for noninvasive neuroimaging and brain stimulation. [Display omitted] • Scalp-to-cortex distance (SCD) and the comprising tissues are different across age groups. • Across 19 regions, we examined age and sex effects on the SCD tissues in 250 adults. • Older adults have larger SCD values in frontal and central regions than younger adults. • The comprising tissues show unique age and sex differences, depending on the region. • Considering tissue changes is key for scalp-based neuroimaging and brain stimulation. [ABSTRACT FROM AUTHOR]

• 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]

• In a population of non-institutionalized 75 years-old subjects, lncRNA H19 predicts all-cause mortality over a follow-up of 14 years. • lncRNA H19 is differentially expressed in males and females, and it is a possible feature of sex differences in lifespan. • low-levels of lncRNA NKILA are associated with an increased risk of lacunar stroke, detected by magnetic resonance, over a follow-up of 7.5 years. Differential expression of long non-coding RNAs (lncRNAs) is a hallmark of cardiovascular aging, cerebrovascular diseases, and neurodegenerative disorders. This research article investigates the association between a panel of lncRNAs and the risk of death and ischemic stroke in a cohort of non-institutionalized elderly subjects. A total of 361 healthy individuals aged 75 years old, prospectively recruited in the Vienna Transdanube Aging (VITA) cohort, were included. Expression of lncRNAs at baseline was assessed using quantitative polymerase chain reaction PCR with pre-amplification reaction, using 18S for normalization. The primary endpoint was all-cause mortality; the secondary endpoint was the incidence of new ischemic brain lesions. Death was assessed over a 14-year follow-up, and ischemic brain lesions were evaluated by magnetic resonance imaging (MRI) over a 90-month follow-up. Ischemic brain lesions were divided into large brain infarcts (Ø ≥ 1.5 cm) or lacunes (Ø < 1.5 cm) The primary endpoint occurred in 53.5 % of the study population. The incidence of the secondary endpoint was 16 %, with a 3.3 % being large brain infarcts, and a 12.7 % lacunes. After adjustment for potential confounders, the lncRNA H19 predicted the incidence of the primary endpoint (HR 1.194, 95 % C.I. 1.012–1.409, p = 0.036), whereas the lncRNA NKILA was associated with lacunar stroke (HR 0.571, 95 % C.I. 0.375–0.868, p = 0.006). In a prospective cohort of non-institutionalized elderly subjects, high levels of lncRNA H19 are associated with a higher risk of death, while low levels of lncRNA NKILA predict an increased risk of lacunar stroke. [Display omitted] [ABSTRACT FROM AUTHOR]

Older people with rheumatic diseases tend to have a greater number of associated comorbidities, which will require the use of more drugs, increasing the risk of hospitalizations, complications, and drug interactions. In Mexico, there has been an estimated prevalence of polypharmacy of up to 55%, however there are scarce reports on the topic in our elderly population with rheumatic diseases. We aimed to determine the prevalence of polypharmacy and the association of drug interactions in patients treated for rheumatic disease. A retrospective observational study was conducted on patients undergoing treatment for rheumatic diseases who were treated in geriatrics and rheumatology clinics from January to December 2021. The presence of polypharmacy and drug interactions was evaluated using the BOT Plus Pharmacological Surveillance System. The prevalence of polypharmacy and the association of drug interactions were estimated. We evaluated 320 patients, with a mean age of 67.05 ± 5.8 years, predominantly female (85%). The prevalence of polypharmacy was 68.1% (n = 218), of which 214 (98.1%) patients had related drug interactions; 27.1% were severe and 53.2% as moderate interactions. Factors related with increased risk of drug interactions were being exposed to hypertension increased the risk of drug interactions (POR 1.75, 95% CI 1.44–2.14; P < 0.001), having osteoarthritis (POR 1.21, 95% CI 1.04–1.42; P = 0.032) and thyroid disease (POR 1.45, 95% CI 1.28–1.65; P = 0.001). The most prevalent serious interactions were leflunomide–methotrexate in 27 (46.5%) patients and buprenorphine–tramadol in 8 (13.7%). A high prevalence of polypharmacy and drug interactions was observed in elderly patients with rheumatic diseases. The main associated factors were comorbidities, particularly high blood pressure, osteoarthritis and thyroid diseases. [ABSTRACT FROM AUTHOR]

• Readiness for change in mobility may be an important element in promoting smooth transitions to non-driving for older people. • Participants who reported positive attitudes towards driving relative to themselves and others were less ready for mobility transition. • Participants who reported lower agreeableness were less ready for mobility transition. For many older adults, driving is an important means of community mobility. With changes in health, aging increases the likelihood of ceasing to drive. Driving cessation is associated with a host of negative physical and mental health outcomes. Increased readiness to transition to non-driving status may mitigate some of the adverse consequences of driving cessation, making the transition to non-driving a pivotal period for intervention. We examined the relationship between attitudes towards driving (positive and negative) and readiness for mobility transition. Participants (n = 253, mean age = 79.13) completed measures of health, cognition, personality, attitudes towards driving, and readiness for mobility change. The results from the multiple hierarchical regression analysis showed that individuals who reported more positive attitudes towards driving relative to themselves (i.e., pro-self scale) and others (i.e., pro-other scale), as well as scored lower on the personality trait agreeableness, were less ready for mobility transition. The results emphasize the importance of taking into account driver attitudes, in addition to health considerations, when supporting the transition to non-driving. [ABSTRACT FROM AUTHOR]

We explored neural processing differences associated with aging across four cognitive functions. In addition to ERP analysis, we included task-related microstate analyses, which identified stable states of neural activity across the scalp over time, to explore whole-head neural activation differences. Younger and older adults (YA, OA) completed face perception (N170), word-pair judgment (N400), visual oddball (P3), and flanker (ERN) tasks. Age-related effects differed across tasks. Despite age-related delayed latencies, N170 ERP and microstate analyses indicated no age-related differences in amplitudes or microstates. However, age-related condition differences were found for P3 and N00 amplitudes and scalp topographies: smaller condition differences were found for in OAs as well as broader centroparietal scalp distributions. Age group comparisons for the ERN revealed similar focal frontocentral activation loci, but differential activation patterns. Our findings of differential age effects across tasks are most consistent with the STAC-r framework which proposes that age-related effects differ depending on the resources available and the kinds of processing and cognitive load required of various tasks. • ERP and microstate analyses showed that age effects differed across four tasks. • Microstates with ERPs help distinguish among current theories of neural aging. • Spatial distributions of neural processing phases differ by age across time and task. • Different age-related effects across tasks were most consistent with STAC-r. [ABSTRACT FROM AUTHOR]

Enlarged perivascular spaces (ePVS) may adversely affect cognition. Little is known about how basal ganglia ePVS interact with apolipoprotein (APOE)-ε4 status. Vanderbilt Memory and Aging Project participants (n = 326, 73 ± 7, 59% male) underwent 3 T brain MRI at baseline to assess ePVS and longitudinal neuropsychological assessments. The interaction between ePVS volume and APOE -ε4 carrier status was related to baseline outcomes using ordinary least squares regressions and longitudinal cognition using linear mixed-effects regressions. ePVS volume interacted with APOE -ε4 status on cross-sectional naming performance (β = −0.002, p = 0.002), and executive function excluding outliers (β = 0.001, p = 0.009). There were no significant longitudinal interactions (p-values>0.10) except for Coding excluding outliers (β = 0.002, p = 0.05). While cross-sectional models stratified by APOE -ε4 status indicated greater ePVS related to worse cognition mostly in APOE -ε4 carriers, longitudinal models stratified by APOE -ε4 status showed greater ePVS volume related to worse cognition among APOE -ε4 non-carriers only. Results indicated that greater ePVS volume interacts with APOE- ε4 status on cognition cross-sectionally. Longitudinally, the association of greater ePVS volume and worse cognition appears stronger in APOE -ε4 non-carriers, possibly due to the deleterious effects of APOE -ε4 on cognition across the lifespan. • ePVS volume interacts with APOE- ε4 status on cognition cross-sectionally. • Greater ePVS relates to worse cognition in APOE -ε4 carriers cross-sectionally. • No interaction between ePVS volume and APOE- ε4 status on cognition longitudinally. [ABSTRACT FROM AUTHOR]

Life expectancy of patients with congenital heart disease (CHD) has increased rapidly, resulting in a growing and aging population. Recent studies have shown that older people with CHD have higher morbidity, health care use, and mortality. To maintain longevity and quality of life, understanding their evolving medical and psychosocial challenges is essential. The authors describe the frailty and cognitive profile of middle-aged and older adults with CHD to identify predictor variables and to explore the relationship with hospital admissions and outpatient visits. Using a cross-sectional, multicentric design, we included 814 patients aged ≥40 years from 11 countries. Frailty phenotype was determined using the Fried method. Cognitive function was assessed by the Montreal Cognitive Assessment. In this sample, 52.3% of patients were assessed as robust, 41.9% as prefrail, and 5.8% as frail; 38.8% had cognitive dysfunction. Multinomial regression showed that frailty was associated with older age, female sex, higher physiologic class, and comorbidities. Counterintuitively, patients with mild heart defects were more likely than those with complex lesions to be prefrail. Patients from middle-income countries displayed more prefrailty than those from higher-income countries. Logistic regression demonstrated that cognitive dysfunction was related to older age, comorbidities, and lower country-level income. Approximately one-half of included patients were (pre-)frail, and more than one-third experienced cognitive impairment. Frailty and cognitive dysfunction were identified in patients with mild CHD, indicating that these concerns extend beyond severe CHD. Assessing frailty and cognition routinely could offer valuable insights into this aging population. [Display omitted] [ABSTRACT FROM AUTHOR]

Walking requires frequent maneuvers to navigate changing environments with shifting goals. Humans accomplish maneuvers and simultaneously maintain balance primarily by modulating their foot placement, but a direct trade-off between these two objectives has been proposed. As older adults may rely more on foot placement to maintain lateral balance, they may be less able to adequately adapt stepping to perform lateral maneuvers. How do older adults adapt stepping to enact lateral lane-change maneuvers, and how do physical and perceived ability influence their task performance? Twenty young (21.7 ± 2.6 yrs) and 18 older (71.6 ± 6.0 yrs) adults walked on a motorized treadmill in a virtual environment. Following an audible and visual cue, participants switched between two parallel paths, centered 0.6 m apart, to continue walking on their new path. We quantified when participants initiated the maneuver following the cue, as well as their step width, lateral position, and stepping variability ellipses at each maneuver step. Young and older adults did not differ in when they initiated the maneuver, but participants with lower perceived ability took longer to do so. Young and older adults also did not exhibit differences in step width or lateral positions at any maneuver step, but participants with greater physical ability reached their new path faster. While only older adults exhibited stepping adaptations prior to initiating the maneuver, both groups traded off stability for maneuverability to enact the lateral maneuver. Physical and perceived balance ability, rather than age per se, differentially influenced maneuver task performance. Humans must make decisions related to the task of walking itself and do so based on both physical and perceived factors. Understanding and targeting these interactions may help improve walking performance among older adults. ● Walking requires frequent maneuvers to navigate changing environments. ● Healthy younger and older participants made repeated lateral lane-change maneuvers. ● Participants with lower perceived ability took longer to initiate these maneuvers. ● Older adults traded-off stability for maneuverability sooner to enact the lateral maneuvers. [ABSTRACT FROM AUTHOR]

Neural tracking of spoken speech is considered a potential clinical biomarker for speech-processing difficulties, but the reliability of neural speech tracking is unclear. Here, younger and older adults listened to stories in two sessions while electroencephalography was recorded to investigate the reliability and generalizability of neural speech tracking. Speech tracking amplitude was larger for older than younger adults, consistent with an age-related loss of inhibition. The reliability of neural speech tracking was moderate (ICC ∼0.5–0.75) and tended to be higher for older adults. However, reliability was lower for speech tracking than for neural responses to noise bursts (ICC >0.8), which we used as a benchmark for maximum reliability. Neural speech tracking generalized moderately across different stories (ICC ∼0.5–0.6), which appeared greatest for audiobook-like stories spoken by the same person. Hence, a variety of stories could possibly be used for clinical assessments. Overall, the current data are important for developing a biomarker of speech processing but suggest that further work is needed to increase the reliability to meet clinical standards. • Neural speech tracking is a potential EEG biomarker for impaired speech processing. • However, reliability and generalizability of neural speech tracking are unclear. • Younger and older adults show moderate reliability of neural speech tracking. • Neural tracking also moderately generalized across speech materials. • Current results are critical for the development of a biomarker of speech processing. [ABSTRACT FROM AUTHOR]

Episodic memory performance declines with increasing age, and older adults typically show reduced activation of inferior temporo-parietal cortices in functional magnetic resonance imaging (fMRI) studies of episodic memory formation. Given the age-related cortical volume loss, it is conceivable that age-related reduction of memory-related fMRI activity may be partially attributable to reduced grey matter volume (GMV). We performed a voxel-wise multimodal neuroimaging analysis of fMRI correlates of successful memory encoding, using regional GMV as covariate. In a large cohort of healthy adults (106 young, 111 older), older adults showed reduced GMV across the entire neocortex and reduced encoding-related activation of inferior temporal and parieto-occipital cortices compared to young adults. Importantly, these reduced fMRI activations during successful encoding could in part be attributed to lower regional GMV. Our results highlight the importance of controlling for structural MRI differences in fMRI studies in older adults but also demonstrate that age-related differences in memory-related fMRI activity cannot be attributed to structural variability alone. [Display omitted] • Structural differences in distinct age groups may in part explain fMRI differences. • We included voxel-wise GMV into models of the fMRI subsequent memory effect. • Reduced encoding-related activations could in part be attributed to lower local GMV. • Care is advised when modelling fMRI effects for groups with structural differences. • Structural modalities may in part explain alleged differences in function. [ABSTRACT FROM AUTHOR]

Healthy aging is typically accompanied by cognitive decline. Previous work has shown that engaging in multiple, non-work activities during midlife can have a protective effect on cognition several decades later, rendering it less dependent on brain structural health; the definition of "cognitive reserve". Other work has shown that increasing age is associated with reduced segregation of large-scale brain functional networks. Here we tested the hypothesis that functional segregation (SyS) mediates this effect of middle-aged lifestyle on late-life cognition. We used fMRI data from three tasks in the CamCAN dataset, together with cognitive data on fluid intelligence, episodic memory, and retrospective lifestyle data from the Lifetime of Experiences Questionnaire (LEQ). In all three tasks, we showed that SyS related to fluid intelligence even after adjusting for the (nonlinear) age effects. However, we found no evidence that SyS in late-life mediated the relationship between non-specific (non-occupation) midlife activities and either measure of cognition in late-life. Thus, the brain correlates of cognitive reserve arising from mid-life activities remain to be discovered. • System segregation (SyS) is stable across different brain states. • SyS is negatively associated with age. • Fluid intelligence, but not episodic memory, was robustly predicted by SyS. • Late life SyS was not associated with midlife outside of work activities. [ABSTRACT FROM AUTHOR]

While capacity for motor skill acquisition changes with healthy aging, there has been little consideration of how age-related changes in brain function or baseline brain structure support motor skill acquisition. We examined: (1) age-dependent changes in functional reorganization related to frontoparietal regions during motor skill acquisition, and (2) whether capacity for motor skill acquisition relates to baseline white matter microstructure in frontoparietal tracts. Healthy older and younger adults engaged in 4 weeks of skilled motor practice. Resting-state functional connectivity (rsFC) assessed functional reorganization before and after practice. Diffusion tensor imaging indexed microstructure of a frontoparietal tract at baseline, generated by rsFC seeds. Motor skill acquisition was associated with decreases in rsFC in healthy older adults and increases in rsFC in healthy younger adults. Frontoparietal tract microstructure was lower in healthy older versus younger adults, yet it was negatively associated with rate of skill acquisition regardless of group. Findings indicate that age-dependent alterations in frontoparietal function and baseline structure of a frontoparietal tract reflect capacity for motor skill acquisition. [ABSTRACT FROM AUTHOR]

The relationship between tau deposition and cognitive decline in cognitively healthy older adults is still unclear. The tau PET tracer 18F-MK-6240 has shown favorable imaging characteristics to identify early tau deposition in aging. We evaluated the relationship between in vivo tau levels (18F-MK-6240) and retrospective cognitive change over 5 years in episodic memory, processing speed, and reasoning. For tau quantification, a set of regions of interest (ROIs) was selected a priori based on previous literature: (1) total-ROI comprising selected areas, (2) medial temporal lobe-ROI, and (3) lateral temporal lobe-ROI and cingulate/parietal lobe-ROI. Higher tau burden in most ROIs was associated with a steeper decline in memory and speed. There were no associations between tau and reasoning change. The novelty of this finding is that tau burden may affect not only episodic memory, a well-established finding but also processing speed. Our finding reinforces the notion that early tau deposition in areas related to Alzheimer's disease is associated with cognitive decline in cognitively unimpaired individuals, even in a sample with low amyloid-β pathology. [ABSTRACT FROM AUTHOR]

The objective of this article is to discuss the importance of oral health in achieving healthy ageing and the role of all stakeholders in improving oral health for older adults. The World Health Organization defined healthy ageing as the process of developing and maintaining the functional ability that enables well-being in older age. It recognized healthy ageing as an important goal and the key to turn population ageing from a challenge to an opportunity. Healthy ageing has positive impacts on individual older adults, their families and societies. It enhances quality of life of older adults, strengthen family bonding of families and reduce resource demand of the societies. Maintaining oral health and function is essential in healthy ageing. Oral health affects systemic health, cognitive health and psychological health. Oral functions such as eating ensure nutritional health in older adults. Most oral diseases are preventable and oral function decline can be recovered by intervention. Unfortunately, oral diseases remain prevalent and oral function decline is being neglected in older adults. Policy makers, national dental associations, academics and healthcare professionals should collaborate to provide a patient-centred, comprehensive and integrated care to older adults. Health policy reforms are needed to reduce the global oral health inequalities in older adults. Population-wide prevention should be accessible, affordable and available to older adults. Universal oral health coverage is crucial for integration of oral health into general health care. [ABSTRACT FROM AUTHOR]

[Display omitted] [ABSTRACT FROM AUTHOR]

Whether obstructive sleep apnea (OSA) increases the risk of cognitive decline and how sex and age influence this association is not clear. Here, we characterized the sex- and age-specific associations between OSA risk and 3-year cognitive change in middle-aged and older adults. We included 24,819 participants aged 45–85 (52% women) from the Canadian Longitudinal Study on Aging. OSA risk was measured at baseline using the STOP combined to body mass index (STOP-B). Neuropsychological tests assessed memory, executive functioning, and psychomotor speed at baseline and at 3-year follow-up. We conducted age- and sex-specific linear mixed models to estimate the predictive role of baseline STOP-B score on 3-year cognitive change. Men at high-risk for OSA aged 45–59 years showed a steeper decline in psychomotor speed (+13.2 [95% CI: −1.6, 27.9]) compared to men at low-risk. Men at high-risk for OSA aged 60–69 showed a steeper decline in mental flexibility (−1.2 [−1.9, −0.5]) and processing speed (+0.6 [0.3, 0.9]) than those at low-risk. Women at high-risk for OSA aged 45–59 showed a steeper decline in processing speed (+0.1 [−0.2, 0.4]) than women at low-risk, while women at high-risk ≥70 years had a steeper decline in memory (−0.2 [−0.6, 0.1]) and processing speed (+1.0 [0.4, 1.5]). Associations between OSA risk and cognitive decline over 3 years depend on age and sex. Being at high-risk for OSA is associated with a generalized cognitive decline in attention and processing speed, while a memory decline is specific to older women (≥70 years). • Obstructive sleep apnea is linked to a decline in attention and processing speed. • Obstructive sleep apnea is linked to greater memory decline in older women. • Obstructive sleep apnea is not associated with cognitive decline in older men. [ABSTRACT FROM AUTHOR]

Dysfunction of the cholinergic basal forebrain (BF) system and amyloid-β (Aβ) deposition are early pathological features in Alzheimer's disease (AD). However, their association in early AD is not well-established. This study investigated the nature and magnitude of volume loss in the BF, over an extended period, in 516 older adults who completed Aβ-PET and serial magnetic resonance imaging scans. Individuals were grouped at baseline according to the presence of cognitive impairment (CU, CI) and Aβ status (Aβ−, Aβ+). Longitudinal volumetric changes in the BF and hippocampus were assessed across groups. The results indicated that high Aβ levels correlated with faster volume loss in the BF and hippocampus, and the effect of Aβ varied within BF subregions. Compared to CU Aβ+ individuals, Aβ-related loss among CI Aβ+ adults was much greater in the predominantly cholinergic subregion of Ch4p, whereas no difference was observed for the Ch1/Ch2 region. The findings support early and substantial vulnerability of the BF and further reveal distinctive degeneration of BF subregions during early AD. [ABSTRACT FROM AUTHOR]

Aging is associated with decreased cognitive function. One theory posits that this decline is in part due to multiple neural systems becoming dedifferentiated in older adults. Exercise is known to improve cognition in older adults, even after only a single session. We hypothesized that one mechanism of improvement is a redifferentiation of neural systems. We used a within-participant, cross-over design involving 2 sessions: either 30 minutes of aerobic exercise or 30 minutes of seated rest (n = 32; ages 55–81 years). Both functional Magnetic Resonance Imaging (fMRI) and Stroop performance were acquired soon after exercise and rest. We quantified neural differentiation via general heterogeneity regression. There were 3 prominent findings following the exercise. First, participants were better at reducing Stroop interference. Second, while there was greater neural differentiation within the hippocampal formation and cerebellum, there was lower neural differentiation within frontal cortices. Third, this greater neural differentiation in the cerebellum and temporal lobe was more pronounced in the older ages. These data suggest that exercise can induce greater neural differentiation in healthy aging. [ABSTRACT FROM AUTHOR]

Using data from a clinical trial, we tested the hypothesis that daily sessions modulating heart rate oscillations affect older adults' volume of a region-of-interest (ROI) comprised of adjacent hippocampal subregions with relatively strong locus coeruleus (LC) noradrenergic input. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5 weeks: (1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); (2) engage in self-selected strategies to decrease heart rate oscillations (Osc-). The interventions did not significantly affect younger adults' hippocampal volume. Among older adults, the two conditions affected volume in the LC-targeted hippocampal ROI differentially as reflected in a significant condition × time-point interaction on ROI volume. These condition differences were driven by opposing changes in the two conditions (increased volume in Osc+ and decreased volume in Osc-) and were mediated by the degree of heart rate oscillation during training sessions. [ABSTRACT FROM AUTHOR]

The blood–brain barrier (BBB) impairment plays a crucial role in the pathological processes of aging-accompanied neurological diseases (AAND). Meanwhile, circadian rhythms disruption and gut microbiota dysbiosis are associated with increased morbidity of neurological diseases in the accelerated aging population. Importantly, circadian rhythms disruption and gut microbiota dysbiosis are also known to induce the generation of toxic metabolites and pro-inflammatory cytokines, resulting in disruption of BBB integrity. Collectively, this provides a new perspective for exploring the relationship among circadian rhythms, gut microbes, and the BBB in aging-accompanied neurological diseases. In this review, we focus on recent advances in the interplay between circadian rhythm disturbances and gut microbiota dysbiosis, and their potential roles in the BBB disruption that occurs in AAND. Based on existing literature, we discuss and propose potential mechanisms underlying BBB damage induced by dysregulated circadian rhythms and gut microbiota, which would serve as the basis for developing potential interventions to protect the BBB in the aging population through targeting the BBB by exploiting its links with gut microbiota and circadian rhythms for treating AAND. This review focuses on the recent advances in the interplay between circadian rhythm disturbances and gut microbiota dysbiosis, and their potential roles in the BBB disruption that occurs in aging-accompanied neurological diseases. [Display omitted] [ABSTRACT FROM AUTHOR]

Facilitating communication between generations has become increasingly important. However, individuals often demonstrate a preference for their own age group, which can impact social interactions, and such bias in young adults even extends to inhibitory control. To assess whether older adults also experience this phenomenon, a group of younger and older adults completed a Go/NoGo task incorporating young and old faces, while undergoing functional magnetic resonance imaging. Within the networks subserving successful and unsuccessful response inhibition, patterns of activity demonstrated distinct neural age bias effects in each age group. During successful inhibition, the older adult group demonstrated significantly increased activity to other-age faces, whereas unsuccessful inhibition in the younger group produced significantly enhanced activity to other-age faces. Consequently, the findings of the study confirm that neural responses to successful and unsuccessful inhibition can be contingent on the stimulus-specific attribute of age in both younger and older adults. These findings have important implications in regard to minimizing the emergence of negative consequences, such as ageism, as a result of related implicit biases. [ABSTRACT FROM AUTHOR]

Early identification of the middle-aged and elderly people with high risk of developing depression disorder in the future and the full characterization of the associated risk factors are crucial for early interventions to prevent depression among the aging population. Canadian Longitudinal Study on Aging (CLSA) has collected comprehensive information, including psychological scales and other non-psychological measures, i.e., socioeconomic, environmental, health, lifestyle, cognitive function, personality, about its participants (30,097 subjects aged from 45 to 85) at baseline phase in 2012–2015. We applied machine learning models for the prediction of these participants' risk of depression onset approximately three years later using information collected at baseline phase. Individual-level risk for future depression onset among CLSA participants can be accurately predicted, with an area under receiver operating characteristic curve (AUC) 0.791 ± 0.016, using all baseline information. We also found the 10-item Center for Epidemiological Studies Depression Scale coupled with age and sex information could achieve similar performance (AUC 0.764 ± 0.016). Furthermore, we identified existing subthreshold depression symptoms, emotional instability, low levels of life satisfaction, perceived health, and social support, and nutrition risk as the most important predictors for depression onset independent from psychological scales. Depression was based on self-reported doctor diagnosis and depression screening tool. The identified risk factors will further improve our understanding of the depression onset among middle-aged and elderly population and the early identification of high-risk subjects is the first step for successful early interventions. • Survey data accurately predicts future depression onset of a large aging cohort. • Two psychological scales with 20 items accurately predict future depression onset. • Subthreshold symptoms, personality, objective feeling, nutrition risk could be potential predictors of depression onset independent from psychological scales. [ABSTRACT FROM AUTHOR]

• Drivers with preclinical Alzheimer disease drive more slowly compared to drivers without. • Road diets decrease speed variance between older drivers. • Attentional control partially mediates observed differences in driving speed. The driving populace of the United States is aging. The prevalence of Alzheimer disease (AD) will increase in the coming decades. Road diets (that is, the reallocation of one or more lanes of car traffic to other uses) have been proposed as a modification to increase pedestrian safety, particularly for older adults. In contrast, we considered the impacts of road diets on aging drivers, and on those with early pathological accumulation of AD. We observed naturalistic driving data for 60 cognitively normal older drivers (Age Range = 62–87 years, Median = 75 years) driving across three road segments located in the St. Louis metropolitan area, Missouri, United States. We used neuroimaging and lumbar puncture derived biomarker data to determine which of the drivers had preclinical AD. Since previous AD studies identified a variety of changes in driving behavior among older drivers with preclinical AD, we examined driving speed before and after lane repurposing. We found that drivers with preclinical AD drove at lower speeds compared to those without preclinical AD prior to road diet implementation. After lanes were repurposed, there was no statistical difference in the speed between older drivers with and without preclinical AD. We evaluated cognitive performance and found that attentional control had a mediating effect on driver speed, suggesting that an individual's ability to focus on a specific task and filter out distractions was associated with faster driving. Driving speed after lane repurposing is not mediated by attentional control, suggesting that road diets are impervious to individual driver capacity. We conclude that lane repurposing has potential as an important mobility infrastructure solution that could enhance older driver safety and facilitate aging in place. [ABSTRACT FROM AUTHOR]

The characteristics and clinical consequences of bacteremia in older people, who are highly susceptible to infections, need to be clarified. This study aimed to determine the epidemiological characteristics, prognosis, and predictors of 7-day mortality in patients with community-acquired (CA), healthcare-associated (HCA), and hospital-onset (HO) bacteremia in older adults aged ≥65 years. Patients aged ≥65 years with positive blood cultures between April 1, 2015, and March 31, 2018, were divided into three groups: pre-old (65–74 years), old (75–89 years), and super-old (≥90 years). Characteristics based on medical exposure, including CA, HCA, and HO, were also compared and factors related to mortality were identified. Overall, 1716 episodes of bacteremia were identified in 1415 patients. Of the 1211 episodes without contamination, 32.8%, 54.3%, and 12.9% occurred in pre-old, old, and super-old patients. Central line-associated bloodstream infections were more common in pre-old patients and urinary tract infections in the old and super-old. The 7-day mortality rates in the pre-old, old, and super-old groups were 7.4%, 5.8%, and 14.2% (P = 0.002), respectively. Multivariable logistic regression showed that super-old age (adjusted odds ratio, aOR: 2.09 [1.13–3.88], P = 0.019) and HO bacteremia (aOR: 1.97 [1.18–3.28], P = 0.010) were independent risk factors for 7-day mortality. Infectious disease consultation had a protective effect on 7-day mortality (aOR: 0.59 [0.35–0.99], P = 0.047). The epidemiology of bacteremia differs among older people; thus, they should not be treated as a single entity. A careful approach is needed for the optimal management of bacteremia in these vulnerable patients. [ABSTRACT FROM AUTHOR]

We investigated how resting electroencephalography (EEG) measures are associated with risk factors for late-life cognitive impairment and dementia, including age, apolipoprotein E ɛ4 (APOE-ɛ4) carriage, and cardiometabolic burden. Resting EEG was recorded from 86 adults (50–80 years of age). Participants additionally completed the Addenbrooke's Cognitive Examination (ACE) III and had blood drawn to assess APOE-ɛ4 carriage status and cardiometabolic burden. EEG power spectra were decomposed into sources of periodic and aperiodic activity to derive measures of aperiodic component slope and alpha (7–14 Hz) and beta (15–30 Hz) peak power and peak frequency. Alpha and beta peak power measures were corrected for aperiodic activity. The aperiodic component slope was correlated with ACE-III scores but not age. Alpha peak frequency decreased with age. Individuals with higher cardiometabolic burden had lower alpha peak frequencies and lower beta peak power. APOE-ɛ4 carriers had lower beta peak frequencies. Our findings suggest that the slope of the aperiodic component of resting EEG power spectra is more closely associated with measures of cognitive performance rather than chronological age in older adults. [ABSTRACT FROM AUTHOR]

Global aging is leading to an increased incidence of geriatric diseases, namely degenerative scoliosis. Vesicular trafficking of proangiogenic factors drives the progression of intervertebral disc degeneration. Neovascularization promotes the infiltration of inflammatory cells in the nucleus pulposus. Matrix metalloproteinases contribute to the asymmetric remodeling of the extracellular matrix in the intervertebral disc. Osteoporosis and sarcopenia increase the risk of spine deformity, which predisposes patients to adult degenerative scoliosis. The global aging population has led to an increase in geriatric diseases, including adult degenerative scoliosis (ADS). ADS is a spinal deformity affecting adults, particularly females. It is characterized by asymmetric intervertebral disc and facet joint degeneration, leading to spinal imbalance that can result in severe pain and neurological deficits, thus significantly reducing the quality of life. Despite improved management, molecular mechanisms driving ADS remain unclear. Current literature primarily comprises epidemiological and clinical studies. Here, we investigate the molecular mechanisms underlying ADS, with a focus on angiogenesis, inflammation, extracellular matrix remodeling, osteoporosis, sarcopenia, and biomechanical stress. We discuss current limitations and challenges in the field and highlight potential translational applications that may arise with a better understanding of these mechanisms. [ABSTRACT FROM AUTHOR]

This study assessed trends in depression symptoms, executive function, and their association across age among older adults. Subgroup comparisons were made between older adults meeting and not meeting physical activity guidelines on variables and associations of interest. Participants (n = 2473) were older adults ages 60 to 79 from the 2011–2014 National Health and Nutrition Examination Survey. Depression symptoms, executive function, and physical activity were assessed, and weighted time-varying effect modeling was used for analyses. Depression symptoms were most severe at age 62 followed by a modest decline before a second peak around age 67. Executive function was highest at age 60 and declined steadily through age 77. Depression symptoms and executive function were negatively associated, but the strength and significance of this association varied with age. Older adults meeting physical activity guidelines had increased executive function and less severe depression symptoms, and meeting physical activity guidelines buffered the association between depression symptoms and executive function at key ages during older adulthood. Differences by age should be considered when designing and implementing health programs and treatments focusing on mental health and cognition in older adulthood. Encouraging moderate-intensity physical activity may help protect older adults from depression-related cognitive decline. [ABSTRACT FROM AUTHOR]

The current evidence of a relationship between periodic leg movements during sleep (PLMS) and cognitive functioning is limited and inconsistent. This cross-sectional study assessed associations between PLMS and cognitive functioning among community-dwelling older adults. We included community-dwelling older adults who underwent a polysomnography and a cognitive assessment. The PLMS index (PLMI) and PLMS arousal index (PLMAI) were categorized into tertiles: PLMI <5/h (reference), 5–29.9/h, ≥30/h; and PLMAI <1/h (reference), 1–4.9/h, ≥5/h. The cognitive assessment consisted of ten scores covering the main cognitive domains: global cognition, processing speed, executive function, language, episodic verbal memory, and visuospatial function. Associations between PLMI, PLMAI, and cognitive scores were assessed using regression unadjusted and adjusted models. A total of 579 individuals without dementia were included (mean age: 71.5 ± 4.4 years; men 45.4%). The number of participants in the high-PLMI categories, 5–29.9/h and ≥30/h, was 185 (32.0%) and 171 (29.5%), respectively. Participants in the high-PLMI categories showed no significant difference compared to the reference group regarding their cognitive performance according to the unadjusted and adjusted models. Similarly, we found no association between PLMAI severity and cognitive functioning. This study shows no cross-sectional association between PLMS severity and cognitive functioning among community-dwelling older adults. However, given the paucity of data in this field, further studies are needed to clarify the relationship between PLMS and cognitive functioning. • Little is known about the link between PLMS and cognition. • We tested associations between PLMS and cognition in community-dwelling older adults. • In this cross-sectional study, PLMS were not associated with cognitive functioning. • Further studies are needed to clarify the potential link between PLMS and cognition. [ABSTRACT FROM AUTHOR]

Socioeconomic status (SES) is associated with white matter hyperintensities (WMHs) and contributes to racial and ethnic health disparities. However, traditional measures of SES may not accurately represent individual financial circumstances among non-Latinx Black and Latinx older adults due to longstanding structural inequities. This study examined associations between multiple SES indicators (education, income, subjective financial worry) and WMHs across non-Latinx Black, Latinx, and non-Latinx White older adults in the Washington Heights-Inwood Columbia Aging Project (N = 662). Latinx participants reported the lowest SES and greatest financial worry, while Black participants evidenced the most WMHs. Greater financial worry was associated with higher WMHs volume above and beyond education and income, which were not associated with WMHs. However, this association was only evident among Latinx older adults. These results provide evidence for the minority poverty hypothesis and highlight the need for systemic socioeconomic interventions to alleviate brain health disparities in older adulthood. [ABSTRACT FROM AUTHOR]

Brain-derived estrogen is an endogenous neuroprotective agent, whether and how might this protective function with aging, especially postmenopausal drops in circulating estrogen, remain unclear. We herein subjected 6, 14, and 18 Mon female rats to mimic natural aging, and found that estrogen synthesis is more active in the healthy aged brain, as evidenced by the highest levels of mRNA and protein expression of aromatase, the key enzyme of E2 biosynthesis, among the three groups. Aromatase knockout in forebrain neurons (FBN-Aro-/-) impaired hippocampal and cortical neurons, and cognitive function in 18 Mon rats, compared to wild-type controls. Furthermore, estrogen nuclear receptors (ERα/β) displayed opposite changes, with a significant ERα decrease and ERβ increase, while membrane receptor GPR30 expressed stably in hippocampus during aging. Intriguingly, GPR30, but not ERα and ERβ, was decreased by FBN-Aro-/-. The results indicate that GPR30 is more sensitive to brain local E2 synthesis. Our findings provide evidence of a critical role for brain-derived estrogen in maintaining healthy brain function in older individuals, possibly involving GPR30. [ABSTRACT FROM AUTHOR]

The mismatch negativity (MMN) and P300 event-related potentials (ERPs) have been studied in relation to phoneme discrimination and categorization, respectively. Although the effects of aging and sex on pure-tone perception have been widely investigated using these ERPs, evidence relating to phoneme perception is scarce. The current study aimed to provide insight into the effects of aging and sex on phoneme discrimination and categorization, as measured through the MMN and P300. An inattentive and attentive oddball paradigm containing a phonemic articulation place contrast were administered during EEG registration in sixty healthy individuals (thirty males and females), of which an equal number of young (20–39 years), middle-aged (40–59 years) and elderly (60+ years) subjects were included. The amplitude, onset latency and topographical distribution of the MMN and P300 effect, as well as the amplitude of the P1-N1-P2 complex, were analyzed for age group and sex differences. With respect to aging, elderly subjects demonstrated a reduced MMN and P300 amplitude compared to the young group, whereas the scalp distribution of both components was unaffected. No aging effects on the P1-N1-P2 complex were found. In elderly individuals, the P300 was found to be delayed compared to the young group, while no such effect on MMN latency could be observed. No differences in MMN and P300 measures could be identified between males and females. Differential effects of aging were found on the MMN and P300, specifically in terms of latency, in relation to phoneme perception. In contrast, sex was found to scarcely affect both processes. • Phoneme discrimination and categorization can be measured by the MMN and P300 ERP. • MMN and P300 amplitude are reduced in elderly, but scalp topography is unaltered. • Aging affects efficiency of phoneme discrimination and categorization differently. • No sex effect on amplitude, onset latency or scalp distribution of the MMN and P300 [ABSTRACT FROM AUTHOR]

Topographic maps form a critical feature of cortical organization, yet are poorly described with respect to their microstructure in the living aging brain. We acquired quantitative structural and functional 7T-MRI data from younger and older adults to characterize layer-wise topographic maps of the primary motor cortex (M1). Using parcellation-inspired techniques, we show that quantitative T1 and Quantitative Susceptibility Maps values of the hand, face, and foot areas differ significantly, revealing microstructurally distinct cortical fields in M1. We show that these fields are distinct in older adults and that myelin borders between them do not degenerate. We further show that the output layer 5 of M1 shows a particular vulnerability to age-related increased iron, while layer 5 and the superficial layer show increased diamagnetic substance, likely reflecting calcifications. Taken together, we provide a novel 3D model of M1 microstructure, where body parts form distinct structural units, but layers show specific vulnerability toward increased iron and calcium in older adults. Our findings have implications for understanding sensorimotor organization and aging, in addition to topographic disease spread. [ABSTRACT FROM AUTHOR]

The study aimed to assess the association between depressive symptoms and social support measures among non-institutionalized Brazilian older adults. A cross-sectional study was carried out with data from the last National Health Survey, conducted in 2019. A descriptive analysis of the study variables was performed, followed by a multiple regression analysis to teste the association between the dependent variable (depressive symptoms, assessed by the Patient Health Questionnaire (PHQ-9) and independent variables (household arrangement, marital relationship, leisure activities, voluntary activity, religious activity, activities in associations/leaderships, work and receiving social support (friends and family). The sample comprised 22,723 older adults and 13.1 % had depressive symptoms. There was a positive relationship between the number of people in the household and the prevalence of depressive symptoms. Individuals with support from family members only (PR 0.69; 95 % CI 0.51; 0.92) and those with support from family and friends (PR 0.53 95 % CI 0.40; 0.70) had a lower prevalence of depressive symptoms than those without support. Participation in leisure and religious activities was inversely associated with depressive symptoms. A negative association was found between work and the presence of depressive symptoms (PR 0.83; 95 % CI 0.70; 0.99). The cross-sectional design limits causal inferences and the survey did not include institutionalized individuals. The lower prevalence of the outcome among older adults with social support highlights the importance of evaluating these measures and practicing activities that allow personal and social interactions among this age group. • About 13 % of Brazilian older adults have depressive symptoms. • Depressive symptoms are associated with different types of social support measures. • There is a negative association between receiving social support from family and friends and depression. [ABSTRACT FROM AUTHOR]

Muscle strength gradually decreases with advancing age. This study aimed to explore the relationship between handgrip strength and successful aging and its specific dimensions in older adults using a nationally representative sample. A total of 5269 adults aged 60 and older were included in this study. Handgrip strength was measured using a dynamometer and was organized into quartiles by sex. Successful aging was defined by Rowe and Kahn's conceptual model including the following five dimensions: (a) no major diseases; (b) freedom from disability; (c) high cognitive function; (d) good psychological status; and (e) active social engagement in life. Logistic regression models were used to examine the association between handgrip strength and successful aging and its specific dimensions. The prevalence of successful aging was found to be 35.1 % in Chinese older adults. Compared to older adults with handgrip strength in the first quartile, those with handgrip strength in the second quartile, third quartile, and fourth quartile had a higher probability of successful aging (adjusted odds ratio (OR): 1.40 (95 % CI: 1.16, 1.69) to 2.06 (95 % CI: 1.70, 2.50)). We further found that the association between handgrip strength and successful aging was related to different ages. This study suggested that there is a close association between handgrip strength and successful aging. Older adults who have greater handgrip strength can successfully deal with the challenges of aging. For older people, keeping a high level of muscle strength in late life may be helpful to the constant successful aging. • The prevalence of successful aging was 35.1 % in Chinese older adults aged 60 and older. • There was a close association between handgrip strength and successful aging. • Older adults who had older ages and lower handgrip strength had an additive effect on successful aging. • Keeping a high level of muscle strength in late life may be helpful to the constant successful aging. [ABSTRACT FROM AUTHOR]