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The number of older people is increasing globally, particularly in middle-income countries like Turkey. The psychometric properties of the Turkish version of the Willingness to Work with Elderly People Scale (WEPS-T) was evaluated in this study. A descriptive, methodological and cross-sectional design was used. The data were collected using a sociodemographic form and WEPS-T during April to June 2021. The language and content validity, explanatory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the validity of the scale. The scale's reliability was obtained using Cronbach's alpha coefficient, item-total correlations, and test-retest reliability. Content validity index of WEPS-T was excellent (CVI was 1.00). All the factor loadings were found to be > 0.30 in factors analysis. In CFA, it was inferred that the model had a good fit (x2/df = 5.344; GFI = 0.864; CFI = 0.868; RMSEA = 0.079; RMR <0.01). A Cronbach's alpha value was obtained 0.881 for the entire scale. The test-retest reliability scores of the first sub-dimension were r = 0.84 and p < 0.001, the second r = 0.97 and p < 0.001, the third r = 0.98 and p < 0.001, the fourth r. = 0.95 and p < 0.001 and the total score was r = 0.96 and p < 0.001. WEPS-T is a valid and reliable measurement tool that determines the willingness of Turkish nursing and medical students to work with the older people.

Introduction: This study aimed to investigate the association between handgrip strength and suicidal ideation in representative samples of adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross‐sectional, community‐based data from the World Health Organization's Study on Global Aging and Adult Health were analyzed. Handgrip strength quintiles by sex were created based on the average value of two handgrip measurements of the dominant hand. Self‐reported information on past 12‐month suicidal ideation was collected. Multivariable logistic regression analysis was conducted to assess associations. Results: Data on 34,129 individuals were analyzed [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.1% females]. After adjustment for potential confounders, in the overall sample, compared to the handgrip strength quintile with the highest values [Quintile 1 (Q1)], Q2, Q3, Q4, and Q5 were associated with significant 2.15 (95% CI = 1.05–4.39), 2.78 (95% CI = 1.06–7.32), 3.53 (95% CI = 1.68–7.42), and 6.79 (95% CI = 2.80–16.48) times higher odds for suicidal ideation. Conclusions: Lower handgrip strength was significantly and dose‐dependently associated with higher odds for suicidal ideation in adults aged ≥50 years from LMICs. Future longitudinal studies are needed to understand the underlying mechanisms, and whether increasing general muscular strength and physical function may lead to reduction in suicidal ideation. [ABSTRACT FROM AUTHOR]

The purpose of this study to determinate whether there is a relationship between the nutritional status and white matter integrity in older patients by using Diffusion Tensor Imaging (DTI). The patients were evaluated by Mini-Nutritional Assessment Scale. The patients are categorized in the groups of well-nourished, risk of malnutrition, or malnourished, depending on the overall score> 23.5, 17–23.5, or 17; respectively. All patients had brain MRI and DTI. The mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) values were calculated by ROI-based method in white matter tracts. Total of the 224 patients; 86 patients had normal nutrition status (group 1), 107 patients were diagnosed with malnutrition risk (group 2) and 31 patients were diagnosed with malnutrition (group 3). Significantly decreased FA values of genu of corpus callosum, forceps minor and significantly increased MD values of middle cerebellar peduncle, and superior frontooccipital fasciculus were detected in group 2 in comparison to group 1 (p < 0.05). After adjusting for the folate and age, MD and RD values of cingulum remained significantly higher and the AD values of superior cerebellar peduncle remained significantly lower in group 3 (p < 0.05). Malnutrition was associated with deteriorated DTI values, especially in cingulum and superior cerebellar peduncle. Assessing the nutritional status of older individuals is crucial to avoid its negative impact on brain. Early diagnosis of malnutrition-related impaired WM integrity is important for prevention and intervention, and DTI is a useful non-invasive technique to be used for this purpose. [ABSTRACT FROM AUTHOR]

Background There is a scarcity of studies examining the longitudinal relationship between dynapenic abdominal obesity (DAO; ie, impairment in muscle strength and high waist circumference) and future fall risk. Therefore, we aimed to investigate the prospective association between DAO at baseline and falls occurring during 2 years of follow-up in a nationally representative sample of middle-aged and older individuals from Ireland. Methods Data from 2 consecutive waves of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as a waist circumference of >88 cm for women and >102 cm for men. DAO was assessed at Wave 1 (2009–2011) and was defined as having both dynapenia and abdominal obesity. Falls occurring between Wave 1 and Wave 2 (2012–2013) were self-reported. Multivariable logistic regression analysis was conducted. Results Data on 5 275 individuals aged ≥50 years were analyzed (mean [standard deviation { SD }] age 63.2 [8.9] years; 48.8% males). After adjustment for potential confounders, compared to no dynapenia and no abdominal obesity at baseline, DAO was significantly associated with 1.47 (95% confidence interval [CI]: 1.14–1.89) times higher odds for falls at 2-year follow-up. Dynapenia alone (odds ratio [OR] = 1.08; 95% CI: 0.84–1.40) and abdominal obesity alone (OR = 1.09; 95% CI: 0.91–1.29) were not significantly associated with falls at follow-up. Conclusions DAO increased the risk for falls among middle-aged and older adults in Ireland. Interventions to prevent or reverse DAO may be beneficial for fall reduction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Fear of falling (FoF) is common in patients with cognitive impairment. However, the role of sarcopenia and malnutrition, which are two important factors that cause falls, on FoF is unknown. The aim of this study was to explore the association between FoF and malnutrition and sarcopenia in older patients with dementia. METHODS: Two hundred and sixty-six dementia patients underwent comprehensive geriatric assessment. The Falls Efficacy Scale-International (FES-I) was applied to assign and classify FoF. Scores for the FES-I scale were categorized as ≥28, 20-27, or 16-19, representing high concern, moderate, and no or low concern about FoF, respectively. Mini Nutritional Assessment (MNA) scores <17, 17-23.5, or >23.5 were categorized as malnutrition, malnutrition risk, and well-nourished, respectively. Sarcopenia was defined using the SARC-F tool. SARC-F score ≥4 was categorized as sarcopenia. Serum folate, Vitamin B12, and Vitamin D deficiencies were also evaluated. The relationship between FoF groups and nutritional status, presence of sarcopenia, and micronutrient status was evaluated. RESULTS: The mean age was 80.83±6.61 years. The prevalence of moderate and high FoF in dementia patients was 51%. There was a significant difference in terms of cerebrovascular events, the history of falling, instrumental and basic activities of daily living (IADL and BADL), MNA, and SARC-F scores between the FoF groups (p<0.05). The association between sarcopenia and FoF persisted in multivariable analysis adjusted for MNA scores, cerebrovascular events, falls history, BADL, and IADL (OR=2.67, 95% CI: 1.50-4.50), but there was no significant association between malnutrition/micronutrient deficiencies and FoF (p>0.05). CONCLUSION: Sarcopenia is associated with the severity of FoF, but malnutrition or micronutrient deficiencies are not associated with the severity of FoF in older patients with dementia. [ABSTRACT FROM AUTHOR]

Frailty is a geriatric syndrome that has physical, cognitive, psychological, social, and environmental components and is characterized by a decrease in physiological reserves. Frailty is associated with several adverse health outcomes such as an increase in rehospitalization rates, falls, delirium, incontinence, dependency on daily living activities, morbidity, and mortality. Older adults may become frailer with each hospitalization; thus, it is beneficial to develop and implement preventive strategies. The present review aims to highlight the epidemiological importance of frailty in rehospitalization and to compile predictive strategies and related interventions to prevent hospitalizations. Firstly, it is important to identify pre-frail and frail older adults using an instrument with high validity and reliability, which can be a practically applicable screening tool. Comprehensive geriatric assessment-based care is an important strategy known to reduce morbidity, mortality, and rehospitalization in older adults and aims to meet the needs of frail patients with a multidisciplinary approach and intervention that includes physiological, psychological, and social domains. Moreover, effective multimorbidity management, physical activity, nutritional support, preventing cognitive frailty, avoiding polypharmacy and anticholinergic drug burden, immunization, social support, and reducing the caregiver burden are other recommended predictive strategies to prevent post-discharge rehospitalization in frail older adults. [ABSTRACT FROM AUTHOR]

Background Unclean cooking fuels (ie, polluting fuels including kerosene/paraffin, and solid fuels) are a major contributor to diseases and mortality, specifically in low- and middle-income countries. Methods This review aimed to identify potential mechanisms, public health implications, and future directions of unclean cooking fuel use and health outcomes in older adults. Results There is an expanding body of literature to demonstrate associations between unclean cooking fuel use and multiple mental and physical health outcomes in older adults. Two key mechanisms likely driving such associations include inflammation and oxidative stress. Conclusions Considering that inflammation and oxidative stress have been implicated in multiple other health conditions (eg, arthritis and osteoporosis) in addition to those investigated to date on this topic it would be prudent to continue investigation of unclean cooking fuel use and with yet to be studied health outcomes. Moreover, future research is indeed now required to identify pathways to eliminating unclean cooking fuel globally to better the health of an aging global population and to support the implementation of Sustainable Development Goal 7. [ABSTRACT FROM AUTHOR]

Background Outdoor air pollution has been reported to be associated with frailty (including slow gait speed) in older adults. However, to date, no literature exists on the association between indoor air pollution (eg, unclean cooking fuel use) and gait speed. Therefore, we aimed to examine the cross-sectional association between unclean cooking fuel use and gait speed in a sample of older adults from 6 low- and middle-income countries (China, Ghana, India, Mexico, Russia, and South Africa). Methods Cross-sectional, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Unclean cooking fuel use referred to the use of kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass based on self-report. Slow gait speed referred to the slowest quintile based on height, age, and sex-stratified values. Multivariable logistic regression and meta-analysis were done to assess associations. Results Data on 14 585 individuals aged ≥65 years were analyzed (mean [standard deviation] age 72.6 [11.4] years; 45.0% males). Unclean cooking fuel use (vs clean cooking fuel use) was significantly associated with higher odds for slow gait speed (odds ratio = 1.45; 95% confidence interval: 1.14–1.85) based on a meta-analysis using country-wise estimates. The level of between-country heterogeneity was very low (I 2 = 0%). Conclusions Unclean cooking fuel use was associated with slower gait speed among older adults. Future studies of longitudinal design are warranted to provide insight into the underlying mechanisms and possible causality. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to examine the relationship of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from six low‐ and middle‐income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross‐sectional, community‐based, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. Self‐reported information on past 12‐month suicidal ideation and suicide attempts among people with depressive symptoms was collected. Pain was assessed with the question "Overall in the last 30 days, how much of bodily aches or pain did you have?" With answer options: "none", "mild", "moderate", "severe/extreme". Multivariable logistic regression was done to assess associations. Results: Data on 34,129 adults aged ≥50 years (mean [SD] age 62.4 [16.0] years; males 47.9%) were analyzed. Compared to no pain, mild, moderate, and severe/extreme pain were associated with 2.83 (95% CI = 1.51–5.28), 4.01 (95% CI = 2.38–6.76), and 12.26 (95% CI = 6.44–23.36) times higher odds for suicidal ideation. For suicide attempt, only severe/extreme pain was associated with significantly increased odds (OR = 4.68; 95% CI = 1.67–13.08). Conclusions: In this large sample of older adults from multiple LMICs, pain was strongly associated with suicidal thoughts and suicide attempts with depressive symptoms. Future studies should assess whether addressing pain among older people in LMICs may lead to reduction in suicidal thoughts and behaviors. Key points: Thirty‐four thousand one hundred twenty‐nine adults aged ≥50 years (mean [SD] age 62.4 [16.0] years; males 47.9%).Pain was strongly associated with suicidal thoughts.Pain was strongly associated with suicide attempts.Future studies should assess whether addressing pain may reduce suicide. [ABSTRACT FROM AUTHOR]

Background Pain and sarcopenia are common in older people. Cross-sectional studies have reported a significant association between these two conditions, but cohort studies exploring pain as a potential risk factor for sarcopenia are scarce. Given this background, the aim of the present work was to investigate the association between pain (and its severity) at baseline, and the incidence of sarcopenia over 10 years of follow-up in a large representative sample of the English older adult population. Methods Pain was diagnosed using self-reported information and categorized as mild to severe pain at four sites (low back, hip, knee, and feet). Incident sarcopenia was defined as having low handgrip strength and low skeletal muscle mass during the follow-up period. The association between pain at baseline and incident sarcopenia was assessed using an adjusted logistic regression analysis, and reported as odds ratios (ORs) with their 95% confidence intervals (CIs). Results The 4 102 participants without sarcopenia at baseline had a mean ± standard deviation age of 69.7 ± 7.2 years, and they were mainly male (55.6%). Pain was present in 35.3% of the sample. Over 10 years of follow-up, 13.9% of the participants developed sarcopenia. After adjusting for 12 potential confounders, people with pain reported a significantly higher risk of sarcopenia (OR = 1.46: 95% CI: 1.18–1.82). However, only severe pain was significantly associated with incident sarcopenia, without significant differences across the four sites assessed. Conclusions The presence of pain, particularly severe pain, was associated with a significantly higher risk of incident sarcopenia. [ABSTRACT FROM AUTHOR]

Background Pain may increase the risk for sarcopenia, but existing literature is only from high-income countries, while the mediators of this association are largely unknown. Thus, we aimed to investigate the association between pain and sarcopenia using nationally representative samples of older adults from 6 low- and middle-income countries (LMICs), and to identify potential mediators. Methods Cross-sectional data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Sarcopenia was defined as having low skeletal muscle mass and weak handgrip strength, while the presence and severity of pain in the last 30 days were self-reported. Multivariable logistic regression and mediation analyses were performed. The control variables included age, sex, education, wealth, and chronic conditions, while affect, sleep/energy, disability, social participation, sedentary behavior, and mobility were considered potential mediators. Results Data on 14,585 adults aged ≥65 years were analyzed (mean [ SD ] age 72.6 [11.5] years; 55.0% females). Compared to no pain, mild, moderate, severe, and extreme pain were associated with 1.42 (95% confidence interval [CI] = 1.05–1.94), 1.43 (95%CI = 1.02–2.00), 1.92 (95%CI = 1.09–3.37), and 2.88 (95%CI = 1.10–7.54) times higher odds for sarcopenia, respectively. Disability (mediated percentage 18.0%), sedentary behavior (12.9%), and low mobility (56.1%) were significant mediators in the association between increasing levels of pain and sarcopenia. Conclusions Higher levels of pain were associated with higher odds for sarcopenia among adults aged ≥65 years in 6 LMICs. Disability, sedentary behavior, and mobility problems were identified as potential mediators. Targeting these factors in people with pain may decrease the future risk of sarcopenia onset, pending future longitudinal research. [ABSTRACT FROM AUTHOR]

Introduction: Physical multimorbidity is plausibly linked to sarcopenia. However, to date, only a few studies exist on this topic, and none have examined this association in low- and middle-income countries (LMICs). Thus, we aimed to investigate the association between multimorbidity and sarcopenia in a sample of older adults from six LMICs (China, Ghana, India, Mexico, Russia, South Africa). Methods: Cross-sectional, community-based data from the WHO Study on Global Ageing and Adult Health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. A total of 11 physical chronic conditions were assessed and multimorbidity referred to ≥2 chronic conditions. Multivariable logistic regression analysis was conducted. Results: Data on 14,585 adults aged ≥65 years were analysed (mean age 72.6 years, SD 11.5 years; 53.7% females). Adjusted estimates showed that compared to no chronic physical conditions, ≥2 conditions are significantly associated with 1.49 (95% CI = 1.02–2.19) and 2.52 (95% CI = 1.53–4.15) times higher odds for sarcopenia and severe sarcopenia, respectively. Conclusions: In this large sample of older adults from LMICs, physical multimorbidity was significantly associated with sarcopenia and severe sarcopenia. Our study results tentatively suggest that targeting those with multimorbidity may aid in the prevention of sarcopenia, pending future longitudinal research. [ABSTRACT FROM AUTHOR]

Background: There is a scarcity of literature on the association between physical multimorbidity (i.e., ≥2 chronic physical conditions) and depression among older adults, especially from low‐ and middle‐income countries (LMICs). In addition, the mediators in this association are largely unknown. Therefore, we aimed to examine this association among adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa), and to identify potential mediators. Methods: Cross‐sectional, nationally representative data from the Study on Global Ageing and Adult Health were analyzed. Depression was defined as past‐12 months DSM‐IV depression or receiving depression treatment in the last 12 months. Information on 11 chronic physical conditions were obtained. Multivariable logistic regression and mediation analyses were conducted. Results: Data on 34,129 individuals aged ≥50 years were analyzed [mean (SD) age 62.4 (16.0) years; maximum 114 years; 52.1% females]. Compared to no chronic conditions, 2, 3, 4, and ≥5 chronic conditions were associated with 2.55 (95% CI = 1.90–3.42), 3.12 (95% CI = 2.25–4.34), 5.68 (95% CI = 4.02–8.03), and 8.39 (95% CI = 5.87–12.00) times higher odds for depression. Pain/discomfort (% mediated 39.0%), sleep/energy (33.2%), mobility (27.5%), cognition (13.8%), perceived stress (7.3%), disability (6.7%), loneliness (5.5%), and food insecurity (1.5%) were found to be significant mediators in the association between physical multimorbidity and depression. Conclusions: Older adults with physical multimorbidity are at increased odds of depression in LMICs. Future studies should assess whether addressing the identified potential mediators in people with physical multimorbidity can lead to reduction in depression in this population. [ABSTRACT FROM AUTHOR]

Aim: The association between visual impairment and mild cognitive impairment (MCI) has not been investigated to date. Thus, we assessed this association among older adults from six low- and middle-income countries (LMICs) (China, India, Ghana, Mexico, Russia, and South Africa) using nationally representative datasets. Methods: Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment (at distance and near) was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better-seeing eye. The definition of MCI was based on the National Institute on Aging-Alzheimer's Association criteria. Multivariable logistic regression was conducted. Results: Data on 32,715 individuals aged ≥ 50 years [mean (SD) age 62.1 (15.6) years; 51.2% females] were analyzed. Compared to those without far or near vision impairment, those with near vision impairment but not far vision impairment (OR = 1.33; 95% CI = 1.16–1.52), and those with both far and near vision impairment (OR = 1.70; 95% CI = 1.27–2.29) had significantly higher odds for MCI. Only having far vision impairment was not significantly associated with MCI. Conclusions: Visual impairment is associated with increased odds for MCI among older adults in LMICs with the exception of far vision impairment only. Future longitudinal and intervention studies should examine causality and whether improvements in visual acuity, or early intervention, can reduce risk for MCI and ultimately, dementia. [ABSTRACT FROM AUTHOR]

Background: To examine the association between self-reported food insecurity and depression in 34,129 individuals aged ≥50 years from six low- and middle-income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa).Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Self-reported past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Multivariable logistic regression analysis and meta-analysis were conducted to assess associations.Results: In total, 34,129 individuals aged ≥50 years [mean (SD) age, 62.4 (16.0) years; 52.1% females] were included in the analysis. Overall, the prevalence of moderate and severe food insecurity was 6.7% and 5.1%, respectively, while the prevalence of depression was 6.0%. Meta-analyses based on countrywise estimates showed that overall, moderate food insecurity (vs. no food insecurity) is associated with a nonsignificant 1.69 (95% confidence interval [CI] = 0.82-3.48) times higher odds for depression, while severe food insecurity is significantly associated with 2.43 (95% CI = 1.65-3.57) times higher odds for depression.Conclusions: In this large representative sample of older adults from six LMICs, those with severe food insecurity were over two times more likely to suffer from depression (compared with no food insecurity). Utilizing lay health counselors and psychological interventions may be effective mechanisms to reduce depression among food-insecure populations. Interventions to address food insecurity (e.g., supplemental nutrition programs) may reduce depression at the population level but future longitudinal studies are warranted. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency is a public health problem. The resulting data showed that vitamin D is associated not only with calcium homeostasis, skeletal muscle health, but also with some chronic diseases. The aim of the study was to investigate long-term effects of vitamin D deficiency on gait-balance parameters in older adults. 370 patients who applied to the geriatric outpatient clinic three times at six-months intervals and underwent comprehensive geriatric assessment (CGA), were retrospectively screened. Patients, whose sociodemographic characteristics, systemic diseases and laboratory findings were reviewed, were divided into 3 groups according to basal serum 25-hydroxy D vitamin [25(OH)D] level: Group 1 (<10 ng/mL), Group 2 (10–20 ng/mL), Group 3 (≥20 ng/mL). The balance-gait performance of patients, the 25(OH)D level of whom reached to the sufficient level at the end of 12th month, was compared to other patients by the Performance Oriented Mobility Assessment (POMA) scale. Demographic characteristics and systemic diseases were similar in the groups except for education (p > 0.05). At baseline, Group 1 had lower Basic and Instrumental Activities of Daily Living (ADL), POMA balance and total score (p < 0.05). At the end of 12th month, POMA balance and total scores improved in the Group 1 patients who reached a sufficient 25(OH)D level, however these scores failed to catch Group 3 (p < 0.05). The basal, 6th and 12th month evaluations of three groups showed that mean POMA balance, gait and total scores were better in patients whose 25(OH)D level was ≥20 ng/mL. Vitamin D replacement, especially to severe deficient patients, may improve balance and gait functions in older adults. Therefore, vitamin D deficiency should be screened routinely and treated effectively. [ABSTRACT FROM AUTHOR]

We investigated the association between sedentary behavior (SB) and wish to die (WTD; i.e., feeling that one would be better off dead or wishing for one's own death), and the extent to which this can be explained by sleep problems, depression, anxiety, loneliness, perceived stress, and social network in a nationally representative sample of adults aged ≥50 years from Ireland. Cross-sectional data from Wave 1 of the Irish Longitudinal Study on Ageing 2009–2011 were analyzed. WTD was defined as answering affirmatively to the question "In the last month, have you felt that you would rather be dead?" SB was used as a continuous variable (hours/day), and also as a categorical (< or ≥8 h/day) variable. Multivariable logistic regression and mediation analyses were conducted. Data on 8163 adults aged ≥50 years were analyzed [mean (SD) age 63.6 (9.1) years; 48.0% males]. Overall, ≥8 (vs. <8) hours/day of SB was associated with a significant 2.04 (95%CI = 1.50–2.76) times higher odds for WTD, while a 1-h increase in SB per day was associated with 1.11 (95%CI = 1.06–1.16) times higher odds for WTD. Mediation analysis showed that sleep problems, depression, loneliness, perceived stress, and social network explained a modest proportion of the association between SB and WTD (mediated percentage 9.3%–14.8%). The present cross-sectional study found that increasing or higher levels of SB is positively associated with WTD. Addressing the identified potential mediators may reduce WTD among people who are sedentary. However, future longitudinal and intervention studies are needed to make concrete recommendations. [ABSTRACT FROM AUTHOR]

Background: Low handgrip strength has been shown to be associated with higher levels of depressive symptoms. One area of mental health that is understudied in relation to grip strength is chronic stress, which can exist independently to depression, or as a comorbidity or precursor to this condition. The present study examined cross‐sectional associations between grip strength, an established marker of physical function, and (a) depressive symptoms and (b) chronic stress utilizing hair cortisol concentrations, while accounting for multiple pertinent confounding variables. Method: Data were used from wave 6 (2012/13) of the English Longitudinal Study of Aging, a panel study of older (≥50 years) community‐dwelling men and women. Grip strength was measured in kg using a hand‐held dynamometer. Depressive symptoms were assessed using the 8‐item Center for Epidemiologic Studies Depression scale. Hair cortisol concentrations (pg/mg) were determined from samples of scalp hair and log‐transformed for analysis to correct skewness. Associations of grip strength with depressive symptoms and hair cortisol concentration were tested using linear regression models adjusted for age, sex, ethnicity, wealth, smoking status, physical activity, body mass index, limiting long‐standing illness, arthritis, diabetes, and hair treatment. Results: The sample comprised of 3741 participants (mean age 68.4 years, 66.4% female). After adjustment for age and sex, grip strength was significantly and negatively associated with both depressive symptoms (B = −0.038, SE = 0.004, P < 0.001) and hair cortisol (B = −0.003, SE = 0.001, P = 0.029). However, in the fully‐adjusted models, both associations were attenuated and only the association with depressive symptoms remained statistically significant (B = −0.015, SE = 0.004, P < 0.001; hair cortisol B = −0.002, SE = 0.001, P = 0.088). Conclusion: In a large sample of older adults in England, grip strength was negatively associated with depressive symptoms. Results were inconclusive regarding the association between grip strength and chronic stress. Further research examining the longitudinal relationships between muscular strength and specific aspects of mental health, while also exploring the neurobiological mechanisms underlying these associations, is warranted before recommendations for policy and practice can be made. [ABSTRACT FROM AUTHOR]

Aim: The Kihon Checklist (KCL) was developed to identify vulnerable older adults residing in Japan who are at a high risk of becoming dependent. The present study aimed to determine the validity of the KCL for detecting frailty in Turkish older adults. Methods: A total of 300 outpatients were enrolled in the study. All patients underwent comprehensive geriatric assessment and completed a Turkish translation of the KCL. Frailty status was defined by five dimensions, including weight loss, exhaustion, low levels of activity, weakness and slowness: 0 for robust, 1–2 for prefrail and 3–5 for frail. Results: The mean age of the patients was 73.85 ± 7.12 years. According to Fried definitions, 25.7% were considered frail, 48.0% prefrail and 26.3% robust. There was a significant difference between the groups in terms of age, sex, education, Charlson's Comorbidity Index, the number of medications used, sarcopenia, dynapenia and all the comprehensive geriatric assessment parameters (P < 0.05). Cronbach's α value of the KCL was 0.876. The area under the receiver operating characteristics curve was 0.855 for frail, and 0.697 for prefrail. We found that the KCL can show frail and prefrail older adults when the cut‐off values are ≥9 and ≥ 4, respectively, with a sensitivity of 80.52% and 65.28%, and specificity of 81.17% and 56.96%. Conclusions: The KCL can be used as a quick, simple and sensitive screening method for detecting frailty among Turkish older adults. We recommend its use by healthcare professionals in Turkey in order to identify frail older adults and direct them to relevant support. Geriatr Gerontol Int 2019; 19: 616–621. [ABSTRACT FROM AUTHOR]

Background: Comprehensive neurocognitive assessment may not be performed in clinical practice, as it takes too much time and requires special training. Development of easily applicable, time-saving, and cost effective screening methods has allowed identifying the individuals that require further evaluation. The aim of present study was to assess the diagnostic value of the Attended With (AW) and Head-Turning Sign (HTS) for screening cognitive impairment (CI).Methods: Comprehensive geriatric assessment was performed in 529 elderly outpatients, and the presence or absence of AW and HTS was investigated in them all.Results: Of the 529 patients, of whom the mean age was 75.67 ± 8.29 years, 126 patients were considered as CI (102 dementia, 24 mild CI). The patients with positive AW had significantly lower scores on Mini-Mental State Examination, Cognitive State Test, and Montreal Cognitive Assessment, and activities of daily living compared to AW (-) patients (p < 0.001). Similar significant findings were obtained in the patients with positive and negative HTS (p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of AW in detecting CI were 92%, 37%, 31.4%, and 93.7%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of HTS were 80%, 64%, 41.8%, and 91.5%, respectively. The area under the receiver-operating characteristics curve was 0.90 for AW and 0.82 for HTS.Conclusion: AW and HTS are fast, simple, effective, and sensitive methods for detecting CI. Therefore, they can be used for older adults attending the primary care settings with memory loss. Those with positive AW or HTS can be referred to the relevant centers for detailed cognitive assessment. [ABSTRACT FROM AUTHOR]

Aim Depression and frailty are prevalent and burdensome in older age. However, the relationships between these entities are unclear and no quantitative meta- analysis exists. We conducted a systematic review and meta-analysis to investigate the associations between depression and frailty. Methods Two authors searched major electronic databases from inception until November-2016 for cross-sectional/longitudinal studies investigating depression and frailty. The strength of the reciprocal associations between frailty and depression was assessed through odds ratios (ORs) adjusted for potential confounders. Results From 2306 non duplicated hits, 24 studies were included. The overall prevalence of depression in 8023 people with frailty was 38.60% (95% CI 30.07–47.10, I 2 = 94%). Those with frailty were at increased odds of having depression (OR adjusted for publication bias 4.42, 95%CI 2.66–7.35, k = 11), also after adjusting for potential confounders (OR = 2.64; 95%CI: 1.59–4.37, I 2 = 55%, k = 4). The prevalence of frailty in 2167 people with depression was 40.40% (95%CI 27.00–55.30, I 2 = 97%). People with depression were at increased odds of having frailty (OR = 4.07, 95%CI 1.93–8.55, k = 8). The pooled OR for incident frailty, adjusted for a median of 7 confounders, was 3.72 (95%CI 1.95–7.08, I 2 = 98%, k = 4), whilst in two studies frailty increased the risk of incident depression with an OR = 1.90 (95%CI 1.55–2.32, I 2 = 0%). Conclusion This meta-analysis points to a reciprocal interaction between depression and frailty in older adults. Specifically, each condition is associated with an increased prevalence and incidence of the other, and may be a risk factor for the development of the other. However, further prospective investigations are warranted. [ABSTRACT FROM AUTHOR]

Magnesium plays a crucial role in hundreds of bodily processes relevant to aging, but consumption of dietary magnesium intake has been shown to be inadequate in a large proportion of older adults. Identifying groups at risk of low magnesium intake is important for informing targeted advice. Using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2016, we examined the association between ethnicity (Caucasian/African American/Hispanic/other) and magnesium intake in a large representative sample of U.S. older adults (≥65 y, n = 5682, mean (SD) 72.9 (0.10) y). Analyses adjusted for total energy intake and a range of relevant covariates. Overall, 83.3% of participants were not meeting the recommended level of dietary magnesium intake, ranging from 78.1% of other ethnic groups to 90.6% of African Americans. In the fully adjusted model, magnesium intake was lower among African American older adults (−13.0 mg/d, 95% CI: −18.8 to −7.2), and higher among Hispanics (14.0 mg/d, 95% CI: 7.5 to 20.5) and those from other ethnic groups (17.2, 95% CI: 3.8 to 30.5) compared with Caucasian older adults. These results highlight the need for targeted interventions to increase magnesium intake in U.S. older adults, with a focus on African Americans, in order to reduce the burden of morbidity and ethnic inequalities in health in later life. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate associations of unclean cooking fuels with depression and anxiety symptoms in a large sample of adults aged ≥65 years from six low- and middle-income countries (LMICs).Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Depression referred to DSM-IV depression based on past 12-month symptoms or receiving depression treatment in the last 12 months. Anxiety symptoms referred to severe/extreme problems with worry or anxiety in the past 30 days. Multivariable logistic regression analysis and meta-analysis were conducted.Results: Data on 14,585 people aged ≥65 years were analyzed [mean (SD) age 72.6 (11.5) years; maximum age 114 years; 55.0% females]. After adjustment for potential confounders, unclean cooking fuel was associated with a significant 2.52 (95%CI = 1.66-3.82) times higher odds for depression with a low level of between-country heterogeneity (I2 = 0.0%). For anxiety symptoms, unclean fuel use was not significantly associated with anxiety symptoms (OR = 1.13; 95%CI = 0.77-1.68; I2 = 0.0%).Limitations: 1. Cross-sectional design. 2. Self-reported measures. 3. No information about outdoor pollution exposure, personal exposure, and smoke composition of different cooking fuels.Conclusions: Unclean cooking fuel was significantly associated with higher odds for depression, but not anxiety, with little observed variability between settings. Findings from the present study provide further support and call for action in appropriate implementation of the United Nations Sustainable Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to investigate associations between food insecurity with suicidal ideation and suicide attempts in adults aged ≥50 years from six low- and middle-income countries (LMICs).Methods: Cross-sectional, community-based data from the World Health Organisation's Study on Global Aging and Adult Health were analyzed. Self-reported information on past 12-month suicidal ideation and suicide attempts was collected. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the association between food insecurity and suicidal ideation or suicide attempts.Results: The final analytical sample included 34,129 individuals aged ≥50 years [mean (SD) age 62.4 (16.0) years; 52.1% females]. Compared to no food insecurity, severe food insecurity was associated with a significant 2.78 (95%CI = 1.73-4.45) times higher odds for suicidal ideation, while moderate and severe food insecurity were associated with 2.59 (95%CI = 1.35-4.97) and 5.15 (95%CI = 2.52-10.53) times higher odds for suicide attempts, respectively.Limitations: The cross-sectional design, the use of self-reported wish to die as a measure of suicide ideation, and that suicidal ideation and suicide attempts were only assessed among those who had depressive symptoms, could be considered limitations of our study.Conclusions: Food insecurity was positively associated with suicidal ideation and suicide attempts. Targeting food insecurity among older adults in LMICs may lead to reduction in suicidal ideation and suicide attempts, although future longitudinal studies are warranted to confirm this. [ABSTRACT FROM AUTHOR]

Background: The aims of the present study were to examine prospective associations of multimorbidity (i.e., ≥2 chronic conditions) at baseline with incident and persistent anxiety over a two-year follow-up period among Irish older adults, and to quantify the extent to which sleep, pain, and disability mediate the multimorbidity-anxiety relationship.Methods: Data from The Irish Longitudinal Study on Aging (TILDA) conducted between 2009 and 2011 with a follow-up after two years were analyzed. Anxiety referred to score ≥ 8 on the anxiety section of the Hospital Anxiety and Depression Scale. Lifetime diagnosis of 14 chronic conditions was obtained. Outcomes were incident and persistent anxiety at two-year follow-up.Results: Data on 5871 adults aged ≥50 years at baseline were analyzed [Mean (SD) age 63.3 (9.0) years; 51.2% women]. After adjustment for potential confounders, compared to no chronic physical conditions at baseline, ≥3 chronic conditions were associated with a significant 1.89 (95% CI = 1.16-3.08) times higher risk for new onset anxiety at follow-up. Furthermore, having 1, 2, and ≥3 conditions at baseline were associated with significant 1.48 (95% CI 1.02, 2.14), 1.74 (95% CI 1.19, 2.53), and 1.84 (95% CI 1.27, 2.68) times higher risk for persistent anxiety at follow-up. Sleep problems, pain, and disability were identified as significant mediators, explaining 22.9%-37.8% of the associations.Conclusion: Multimorbidity was associated with both new onset and persistent anxiety among Irish older adults. Future interventional studies should examine whether addressing the identified mediators may lead to lower risk for incident or persistent anxiety among those with physical multimorbidity. [ABSTRACT FROM AUTHOR]

Background: This paper aims to examine associations between pet ownership and symptoms of depression in a large, population-based sample of older adults. Specifically, we tested whether: (i) people who report more depressive symptoms are more likely to own a pet; (ii) pet ownership protects against an increase in depressive symptoms over time; (iii) associations differ by symptom type.Methods: Data were drawn from the English Longitudinal Study of Ageing, a longitudinal panel study of men and women aged 50 and older (n = 7,617, 52.5% female). Pet ownership (dog/cat/other/none) was self-reported in 2010/11. Depressive symptoms were assessed in 2010/11 and 2016/17 using the 8-item centre for Epidemiologic Studies Depression (CES-D) scale. We analysed total CES-D score and derived symptom subscales (depressed mood, anhedonia, somatic symptoms) in relation to pet ownership, adjusting for sociodemographic and health-related covariates.Results: A one-symptom increase in total CES-D score was associated with 7% increased odds of dog ownership (OR=1.07, 95% CI 1.03-1.11). Significant associations were observed between each subset of depressive symptoms and dog ownership, with models run on z-scores showing a slightly stronger association for symptoms of depressed mood (OR=1.13, 95% CI 1.06-1.21) compared with anhedonia (OR=1.10, 95% CI 1.04-1.17) or somatic symptoms (OR=1.10, 95% CI 1.03-1.18). Prospectively, no significant associations were found.Limitations: Self-reported data; small sample size for some pet categories.Conclusion: Amongst older adults in England, those with more depressive symptoms are more likely to own a dog, but pet ownership is not significantly associated with change in depressive symptoms over time. [ABSTRACT FROM AUTHOR]