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Remembering our decisions is crucial – it allows us to learn from past mistakes and construct future behavior. However, it is unclear if age-related memory declines impact the memorability of older adults’ decisions. Here, we compared younger and older adults’ ability to remember their decisions. In Studies 1 and 2, participants made choices between two objects based on their star rating (shopping context) or circle count (neutral context) and later remembered what they chose. while Study 3 tested participants’ memory for active vs. passive decisions. Overall, we found no evidence for age differences in the ability to remember decisions. Furthermore, age did not interact with context – both similarly benefitted from making and remembering their decisions in a more shopping-like context. These results reveal an aspect of cognition that appears to be preserved in healthy aging. Highlighting such aspects can help improve older adults’ self-perceptions and reframe the narrative around aging. [ABSTRACT FROM AUTHOR]

Purpose: Successful sentence production requires lexical encoding and ordering them into a correct syntactic structure. It remains unclear how different processes involved in sentence production are affected by healthy aging. We investigated (a) if and how aging affects lexical encoding and syntactic formulation during sentence production, using auditory lexical priming and eye tracking-while-speaking paradigms and (b) if and how verbal working memory contributes to age-related changes in sentence production. Methods: Twenty older and 20 younger adults described transitive and dative action pictures following auditory lexical primes, by which the relative ease of encoding the agent or theme nouns (for transitive pictures) and the theme and goal nouns (for dative pictures) was manipulated. The effects of lexical priming on off-line syntactic production and real-time eye fixations to the primed character were measured. Results: In offline production, older adults showed comparable priming effects to younger adults, using the syntactic structure that allows earlier mention of the primed lexical item in both transitive and dative sentences. However, older adults showed longer lexical priming effects on eye fixations to the primed character during the early stages of sentence planning. Preliminary analysis indicated that reduced verbal working memory may in part account for longer lexical encoding, particularly for older adults. Conclusion: These findings indicate that syntactic flexibility for formulating different grammatical structures remains largely robust with aging. However, lexical encoding processes are more susceptible to age-related changes, possibly due to changes in verbal working memory. [ABSTRACT FROM AUTHOR]

Background: The Decade of Healthy Aging (2021–2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging. Methods: The system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information. Results: A total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators. Conclusions: SIESDE is an effective system for providing an overall view of health, aging, and functional dependence. [ABSTRACT FROM AUTHOR]

Aging is characterized by a progressive decline in physiological function and underlies several disabilities, including the increased sensitivity of cells and tissues to undergo pathological oxidative stress. In recent years, efforts have been made to better understand the relationship between age and oxidative stress and further develop therapeutic strategies to minimize the impact of both events on age‐related diseases. In this work, we review the impact of the oxidant and antioxidant systems during aging and disease development and discuss the crosstalk of oxidative stress and other aging processes, with a focus on studies conducted in elderly populations. [ABSTRACT FROM AUTHOR]

Objectives: Paternalistic care behavior in health contexts reduces involvement in the decision-making process and dissatisfaction in healthcare, which may negatively influence older adults' mental health. This study comprised two main objectives: (1) to explore older adults' experiences of paternalistic behavior in the context of health services and (2) analyze the influence of paternalistic behavior on older adults' mental health. Methods: The sample involved 416 participants aged 65 to 81 (M = 70.1 ± 5.73) with three different nationalities (English, Brazilian ad Portuguese). All interviews went through content analysis. Results: For the first objective, content analysis identified seven themes: (1) perceived inattention to the uniqueness of each person (81%); (2) feeling a duality of supporting and suppressing independence (79%); (3) selective disclosure of information to keep the person's spirit up (74%); (4) feeling neglected (66%); (5) feeling unable to make decisions (64%); (6) receiving opposition to the person's requests (60%); and (7) routine actions being considered as the best action (57%). For the second objective, three main themes emerged: (1) feeling anxious and stressed (88%); (2) feeling frustration and despair (87%); and (3) feeling injustice and anger (72%). Conclusions: Healthcare paternalism negatively affects older adults' mental health, emphasizing the need for their agency, involvement in decisions, and personalized care. These findings highlight the negative influence of paternalistic behavior on the mental health of older adults and may contribute to future targeted interventions and policy programs among the older population. [ABSTRACT FROM AUTHOR]

Tai Chi (TC) practice has been shown to improve both cognitive and physical function in older adults. However, the neural mechanisms underlying the benefits of TC remain unclear. Our primary aims are to explore whether distinct age-related and TC-practice-related relationships can be identified with respect to either temporal or spatial (within/between-network connectivity) differences. This cross-sectional study examined recurrent neural network dynamics, employing an adaptive, data-driven thresholding approach to source-localized resting-state EEG data in order to identify meaningful connections across time-varying graphs, using both temporal and spatial features derived from a hidden Markov model (HMM). Mann–Whitney U tests assessed between-group differences in temporal and spatial features by age and TC practice using either healthy younger adult controls (YACs, n = 15), healthy older adult controls (OACs, n = 15), or Tai Chi older adult practitioners (TCOAs, n = 15). Our results showed that aging is associated with decreased within-network and between-network functional connectivity (FC) across most brain networks. Conversely, TC practice appears to mitigate these age-related declines, showing increased FC within and between networks in older adults who practice TC compared to non-practicing older adults. These findings suggest that TC practice may abate age-related declines in neural network efficiency and stability, highlighting its potential as a non-pharmacological intervention for promoting healthy brain aging. This study furthers the triple-network model, showing that a balancing and reorientation of attention might be engaged not only through higher-order and top-down mechanisms (i.e., FPN/DAN) but also via the coupling of bottom-up, sensory–motor (i.e., SMN/VIN) networks. [ABSTRACT FROM AUTHOR]

Background and Objectives Existing literature highlights notable health and social inequalities for people aging with a lifelong disability and the need for research to better understand how we can support this group to age well. This scoping review mapped existing literature related to "aging well" in people with lifelong disabilities. Research Design and Methods Five scientific databases and gray literature sources were searched for studies related to "aging well" and "lifelong disability" (defined as a disability that a person had lived with since birth or early childhood). Results We identified 81 studies that discussed aging well with a lifelong disability, with most (70%) focusing on intellectual disabilities. Two themes captured existing research on aging well with a lifelong disability: (1) framing aging well with a lifelong disability, which included the ways that people with lifelong disability, their supporters, and existing research frame aging well for this group and (2) supporting people to age well with a lifelong disability, which involves the micro-, meso-, and macro-level factors where research suggests interventions to facilitate aging well could be situated. Discussion and Implications This synthesis highlights how aging well is currently framed in the literature and where interventions to improve aging well in this group could be situated. Literature highlights the importance of considering multilevel interventions to improve aging well. Evidence gaps include the lack of research conducted with groups other than those with intellectual disabilities and the need for more research examining aging well interventions. [ABSTRACT FROM AUTHOR]

The study of longevity and its determinants has been revitalized with the rise of microbiome scholarship. The gut microbiota have been established to play essential protective, metabolic, and physiological roles in human health and disease. The gut dysbiosis has been identified as an important factor contributing to the development of multiple diseases. Accordingly, it is reasonable to hypothesize that the gut microbiota of long-living individuals have healthy antiaging-associated gut microbes, which, by extension, might provide specific molecular targets for antiaging treatments and interventions. In the present study, we compared the gut microbiota of Chinese individuals in two different age groups, long-living adults (aged over 90 years) and elderly adults (aged 65–74 years) who were free of major diseases. We found significantly lower relative abundances of bacteria in the genera Sutterella and Megamonas in the long-living individuals. Furthermore, we established that while biological processes such as autophagy (GO:0006914) and telomere maintenance through semiconservative replication (GO:0032201) were enhanced in the long-living group, response to lipopolysaccharide (GO:0032496), nicotinamide adenine dinucleotide oxidation (GO:0006116), and S-adenosyl methionine metabolism (GO:0046500) were weakened. Moreover, the two groups were found to differ with respect to amino acid metabolism. We suggest that these compositional and functional differences in the gut microbiota may potentially be associated with mechanisms that contribute to determining longevity or aging. [ABSTRACT FROM AUTHOR]

Large Language Models (LLMs) stand on the brink of reshaping the field of aging and dementia care, challenging the one-size-fits-all paradigm with their capacity for precision medicine and individualized treatment strategies. The "Large Pre-Trained Models with a Focus on AD/ADRD and Healthy Aging" symposium, organized by the National Institute on Aging and the Johns Hopkins Artificial Intelligence & Technology Collaboratory for Aging Research, served as a platform for exploring this potential. The symposium brought together diverse experts to discuss the integration of LLMs in aging and dementia care. They highlighted the roles LLMs can play in clinical decision support and predictive analytics, while also addressing critical ethical concerns including bias, privacy, and the responsible use of artificial intelligence (AI). The discussions focused on the need to balance technological advancement with ethical considerations in AI deployment. In conclusion, the symposium projected a future where LLMs not only revolutionize healthcare practices but also pose significant challenges that require careful navigation. [ABSTRACT FROM AUTHOR]

Purpose: To examine associations between time perspective and health promotion behaviors of physical activity and weight management. Design: Quantitative cross-sectional. Setting: This study is part of the Betula project on aging, memory, and dementia in Northern Sweden. Subjects: 417 older adults aged between 55 and 85 years. Measures: Swedish-Zimbardo Time Perspective Inventory; Physical Activity in the past year, past week, and in comparison with others of similar age; Weight Management = Body Mass Index (BMI; kg/m2). Results: After controlling for age, sex, and years of education, hierarchical linear regression indicated a Balanced Time Perspective was significantly associated with more physical activity in the past year (P =.04), the past week (P <.001), and in comparison with others (P <.01). Past Negative time perspective was associated with less physical activity in the past year (P =.03), and in comparison with others (P =.03). Present Fatalistic was associated with less physical activity during the past week (P =.03), and in comparison with others (P =.01). Present Hedonistic was associated with more physical activity the past week (P =.03), and in comparison with others (P =.03). Past Negative was associated with higher BMI (P =.02), and Future Negative were associated with lower BMI (P =.01). Taken collectively, greater positivity and flexibility across time perspectives was associated with more physical activity, whereas negative oriented time perspectives related with less physical activity and poorer weight management. Conclusion: Time perspective can be associated with health behaviors in older adults and have implications for health across the lifespan. Health promotion interventions may target older adults' enjoyment of exercise and weight management in the present, rather than highlight potential negative health outcomes in the future. [ABSTRACT FROM AUTHOR]

• Spousal caregiving is associated with higher levels of frailty in older adults. • The rate of increase in frailty levels over time is faster among spousal caregivers. • Specific intervention policies should be developed to enhance their adaptability. Older spousal caregivers bear the dual burden of managing health changes and caring for their partners. This study aimed to investigate the association between spousal caregiving and frailty in older adults. A retrospective cohort study with a 4-year follow-up was conducted using seven waves of data from the Health and Retirement Study (2006-2018). The mean age of participants was 65.1 years. A significant correlation was found between spousal caregiving and frailty increase. Multilevel analysis demonstrated a significant difference in the changes in frailty index over 12 years between caregivers and non-caregivers. This study uncovered a significant association between spousal caregiving and frailty in older adults, suggesting that becoming a spousal caregiver is not only linked to higher levels of frailty but also accelerates its progression. Healthcare providers can tailor support services to assist caregivers in managing challenges and promoting healthy aging. [ABSTRACT FROM AUTHOR]

Background: The Health Promoting Universities (HPU) concept is undertheorized, with no African university belonging to the International Network of Health Promoting Universities (IHPU). Aim: The study aimed to investigate the status of the HPU concept globally to inform emerging HPUs, more specifically in Africa, regarding its implementation. Methods: An integrative literature review of studies conducted between 1 January 2013 and 5 November 2023 was conducted from online databases (PubMed, Scopus, Web of Science, Lilacs, CINAHL and Medline). A VOS bibliometric analysis viewer was used to extract and analyze further relevant information that could have been missed in the review. Results: From 1128 records, 22 (N = 22) articles including two reports met the inclusion criteria. The main findings were that: (1) the HPU network is growing as a global network though undertheorized and less reported on, (2) the implementation of the HPU depends on a plethora of underpinning philosophies such as salutogenic and whole systems approach, and diverse programs and initiatives, 3) the terms HPU and healthy universities are often used interchangeably but the whole systems approach appears to be consistent in many HPU interventions. However, five contextual challenges that emanated from this review were discussed, including the definition of the HPU concept, theories for the HPU concept, measurement of the HPU concept, coordination and methods for measuring the HPU concept status. These challenges present obstacles to measuring the status of the HPU concept beyond the number of affiliated universities and HPU initiatives. Conclusion: Despite the challenges, the HPU concept is gaining momentum globally, as evidenced by the growing list of universities (HPU network) involved and the proliferation of interventions/initiatives targeting university students. [ABSTRACT FROM AUTHOR]

Relaxation correction is an integral step in quantifying brain metabolite concentrations measured by in vivo magnetic resonance spectroscopy (MRS). While most quantification routines assume constant T1 relaxation across age, it is possible that aging alters T1 relaxation rates, as is seen for T2 relaxation. Here, we investigate the age dependence of metabolite T1 relaxation times at 3 T in both gray‐ and white‐matter‐rich voxels using publicly available metabolite and metabolite‐nulled (single inversion recovery TI = 600 ms) spectra acquired at 3 T using Point RESolved Spectroscopy (PRESS) localization. Data were acquired from voxels in the posterior cingulate cortex (PCC) and centrum semiovale (CSO) in 102 healthy volunteers across 5 decades of life (aged 20–69 years). All spectra were analyzed in Osprey v.2.4.0. To estimate T1 relaxation times for total N‐acetyl aspartate at 2.0 ppm (tNAA2.0) and total creatine at 3.0 ppm (tCr3.0), the ratio of modeled metabolite residual amplitudes in the metabolite‐nulled spectrum to the full metabolite signal was calculated using the single‐inversion‐recovery signal equation. Correlations between T1 and subject age were evaluated. Spearman correlations revealed that estimated T1 relaxation times of tNAA2.0 (rs = −0.27; p < 0.006) and tCr3.0 (rs = −0.40; p < 0.001) decreased significantly with age in white‐matter‐rich CSO, and less steeply for tNAA2.0 (rs = −0.228; p = 0.005) and (not significantly for) tCr3.0 (rs = −0.13; p = 0.196) in graymatter‐rich PCC. The analysis harnessed a large publicly available cross‐sectional dataset to test an important hypothesis, that metabolite T1 relaxation times change with age. This preliminary study stresses the importance of further work to measure age‐normed metabolite T1 relaxation times for accurate quantification of metabolite levels in studies of aging. [ABSTRACT FROM AUTHOR]

The age of Canada's population is increasing, necessitating innovative methods and tools for assessing the needs of older adults and identifying effective health and social prescriptions. In Alberta, a community-based, senior-serving organization undertook the development and piloting of the Healthy Aging Asset Index, an assessment tool and social prescribing guide for use by a variety of professionals within the community. Tool development was rooted in medical complexity assessment and social work practice, and adhered to the determinants of healthy aging established by Alberta's Healthy Aging Framework, which is based on the determinants of healthy aging published by the World Health Organization. Results from the pilot showed improvement in the functionality of older adults within the determinants over time, as they were supported in addressing areas of personal vulnerability. Adopting tools such as the Healthy Aging Asset Index can bring cohesiveness to the support that older adults receive across the care continuum and has the potential to shift the balance of care away from the health system and towards the community, thus improving the capacity of health systems and government to meet the needs of Canada's older adults. [ABSTRACT FROM AUTHOR]

Introduction: Older adults with higher needs are ideal candidates for social prescribing interventions, given the complex and intersectoral nature of their needs. This article describes findings from a developmental evaluation of 19 social prescribing programs for older adults at risk of frailty. Methods: An evaluation of the programs was conducted from 2020 to 2023. We used data from three components of the evaluation: (1) initial evaluation data collected in 2020 and 2021; (2) program profiles developed in 2022; and (3) co-creation sessions conducted in 2023. Results: From startup until March 2023, the programs served a total of 2544 older adults. The community connectors identified factors at the individual, interpersonal, institutional, community and policy levels that contributed to the successful implementation and delivery of their programs (e.g. physician champions, communities of practice, strong pre-existing relationships with the health care system), as well as challenges (e.g. limited capacity of family physicians, lack of community resources). There was strong agreement among community connectors that successful social prescribing programs should include the following core elements: (1) making connections to needed community resources; (2) co-creation of a wellness plan with long-term clients or clients who require intensive supports; (3) ongoing follow-up and check-ins for clients with wellness plans; and (4) an assessment and triaging process for the prioritization of clients. Conclusion: To leverage the full potential of social prescribing interventions, it is essential that programs engage with a range of health and social care providers, that community connectors are skilled and well supported, and that adequate investments are made in the nonprofit and voluntary sector. [ABSTRACT FROM AUTHOR]

Despite beneficial cardiovascular effects, substantial long-term modulation of food pattern could only be achieved in a limited number of participants. The impact of attitude towards healthy nutrition (ATHN) on successful modulation of dietary behavior is unclear, especially in the elderly. We aimed to analyze whether the personal ATHN influences 12-month adherence to two different dietary intervention regimes within a 36-month randomized controlled trial. Methods: 502 subjects were randomized to an intervention group (IG; dietary pattern focused on high intake of unsaturated fatty acids (UFA), plant protein and fiber) or control group (CG; dietary recommendation in accordance with the German Society of Nutrition) within a 36-month dietary intervention trial. Sum scores for effectiveness, appreciation and practice of healthy nutrition were assessed using ATHN questionnaire during the trial (n = 344). Linear regression models were used to investigate associations between ATHN and dietary patterns at baseline and at month 12. Results: Retirement, higher education level, age and lower body mass index (BMI) were associated with higher ATHN sum scores. ATHN was similar in CG and IG. Higher baseline intake of polyunsaturated fatty acids (PUFA) and fiber as well as lower intake in saturated fatty acids (SFA) were associated with higher scores in practice in both groups. The intervention resulted in a stronger increase of UFA, protein and fiber in the IG after 12 months, while intake of SFA declined (p < 0.01). Higher scores in appreciation were significantly associated with higher intake of fiber and lower intake of SFA in the CG at month 12, whereas no associations between ATHN and macronutrient intake were observed in the IG after 12 months. Conclusions: While ATHN appeared to play a role in general dietary behavior, ATHN did not affect the success of the specific dietary intervention in the IG at month 12. Thus, the dietary intervention achieved a substantial modification of dietary pattern in the IG and was effective to override the impact of the individual ATHN on dietary behavior. [ABSTRACT FROM AUTHOR]

As the population ages, promoting healthy aging through targeted interventions becomes increasingly crucial. Growing evidence suggests that dietary interventions can significantly impact this process by modulating fundamental molecular pathways. This review focuses on the potential of targeted dietary strategies in promoting healthy aging and the mechanisms by which specific nutrients and dietary patterns influence key pathways involved in cellular repair, inflammation, and metabolic regulation. Caloric restriction, intermittent fasting, the Mediterranean diet, as well as the ketogenic diet showed promising effects on promoting healthy aging, possibly by modulating mTORC1 AMPK, an insulin signaling pathway. By understanding the intricate interplay between diet and molecular pathways, we can develop personalized dietary strategies that not only prevent age-related diseases, but also promote overall health and well-being throughout the aging process. [ABSTRACT FROM AUTHOR]

Background While the benefits of exercise on cognitive functions have already been reviewed, little is known about the impact of exercise on language performance. This scoping review was conducted to identify existing evidence on exercise-induced changes in language performance in healthy aging individuals and adults with stroke or neurodegenerative conditions. Methods & Results Using the Arksey and O'Malley framework, 29 studies were included. Eleven studies in healthy aging indicated enhanced language performance, with 72.72% having significant improvement in semantic/phonological Verbal Fluency (VF) following exercise. Among 18 studies on older adults with stroke or neurodegenerative conditions, 11 reported better language performance, with 44.44% having significant improvement in picture naming/description and semantic/ phonological VF by exercise. The seven remaining studies reported no significant change in language performance in persons with stroke or neurodegenerative conditions. Conclusion Overall, exercise interventions showed improvement in language performance in healthy aging, while selective enhancement was shown for language performance in persons with either stroke or neurodegenerative conditions. [ABSTRACT FROM AUTHOR]

Restorative environments have a positive impact on improving the physical and mental health of the elderly. In China, the proportion of elderly residents in aging urban communities is significantly higher than in newly constructed ones, making it essential to understand the restorative potential of public open spaces (POSs) in these settings to promote the development of aging-in-place models. To investigate this issue, we employed the Fuzzy Delphi Method (FDM) and the Analytic Hierarchy Process (AHP) to construct an evaluation system for the restorative potential of public open spaces. Subsequently, we assessed the restorative effects of POSs in the Dabeizhuang community using 320 residents' questionnaires and the fuzzy comprehension evaluation method. The results indicate that the dimension of safety is the most critical factor in creating restorative environments. In contrast, the dimension of comfort is the primary reason affecting the current evaluation of the community's restorative environment. By establishing a restorative environment evaluation system, this research will facilitate the creation of more restorative environments in urban areas, thereby promoting active and healthy aging among elderly residents. [ABSTRACT FROM AUTHOR]

Background: Games are a promising strategy for rehabilitating older adults. The effect of games on promoting healthy lifestyles and preventing frailty remains uncertain. This article aims to describe the process of development and validation of the game "Bem-me-quer para a saúde"® to promote the acquisition of healthy lifestyles and prevent frailty in over 65-year-olds. Methods: This study comprised three distinct phases, spanning from December 2023 to June 2024. The first phase comprised a thorough review of the scientific literature on the frailty and lifestyles of older adults, a second phase of game design, and a third phase of content and semantic validation conducted by specialized nurses and older adults. Results: After revising literature, this study utilized an e-Delphi with a panel of 14 specialist nurses who underwent two rounds of evaluation. The "Bem-me-quer para a saúde"® game includes a puzzle board with 54 pieces and 30 educational cards. In the final phase, we evaluated the game on a cohort of 50 older adults, highlighting its reflective, interactive, and educational aspects. Conclusions: The game presented sufficient evidence of content validity and relevance to clinical practice. We should conduct additional research to evaluate its impact on lifestyle modification and frailty prevention. [ABSTRACT FROM AUTHOR]

Abstract Mild and persisting gastrointestinal symptoms (MPGS) as bloating, constipation or diarrhea are widespread in older adults and often accompanied by gut microbiota dysbiosis. Nutritional interventions help to regulate and restore microbiota and gut function. In this non-randomized continuous prospective cohort study, we evaluated the effects of a 21-day intervention using a dietary dairy-based supplement (AGIJOY™) on self-reported gastrointestinal (GI) symptoms, fecal microbiota composition and short chain fatty acids (SCFA) levels in a cohort of Chinese adults (N = 46, age 27–73) suffering from MPGS. Questionnaire data and fecal samples were collected at baseline (D0), on day 7 and 21 of intervention (D7 and D21). The results showed significant improvement in the self-reported GI symptoms on D21 and a gradual shift in the fecal microbiota composition. In the first week of intervention, the relative abundance (RA) of fecal bifidobacteria significantly increased and the RA of Bacteroides and Helicobacter decreased (p

Abstract Functional capacity is an important objective health metric, and relies on the maintenance of physiological homeostasis. Autonomic nervous system is known to coordinates the maintenance of multi-organ homeostasis. The objective of this study was to examine the association of autonomic nervous system function with functional capacity in adults aged 55 years and older. A cohort of 542 adults (mean age of 70.1 years) received repeated measurements of heart rate variability, an autonomic nervous system function marker, and chair rise time, a functional capacity measure. Linear mixed models analysis showed that 1 SD lower powers in low-frequency range at baseline was associated with a 0.11 (95% CI 0.01–0.21) s/year faster increase in chair rise time during the follow-up, whereas 1 SD increase in powers in high-frequency range and 1 SD decrease in the ratio of powers in low-frequency range to powers in high-frequency range during the follow-up were associated with a 0.22 (95% CI 0.06–0.39) s and 0.17 (95% CI 0.01–0.33) s increase in chair rise time. In conclusion, autonomic nervous system function and its changes were longitudinally associated with changes in functional capacity in older adults.

Abstract Background Preventing metabolic syndrome (MetS) and frailty in older adults is crucial for healthy aging. The association between MetS and physical frailty is well-documented, with low-grade inflammation as potential explanation. However, the association between MetS and frailty as a multidimensional concept, and the association of low-grade inflammation with presence of MetS and frailty, is yet unclear. Therefore, we examined these associations low-grade inflammation in a large cohort of community-dwelling older adults. Methods This cross-sectional study was performed among adults aged ≥ 65 years enrolled in the Dutch Lifelines population cohort. MetS was defined according to the Joint Interim Statement of 2009. Frailty was measured by the Groningen Frailty Indicator (GFI), which consists of 15 self-reported items on both physical and psychosocial functioning, with a score ≥ 4 indicating presence of frailty. The association between MetS and its five components and frailty was assessed using logistic regression models. Low-grade inflammation was represented by high-sensitivity C-reactive protein (hsCRP) level. The association of hsCRP level with presence of MetS and frailty was assessed using multinomial logistic regression in a sub-cohort with available hsCRP measurements. Results Of 11,552 adults (52.1% women) included, the prevalences of MetS and frailty were 28% and 15%, respectively. MetS was positively associated with frailty after adjusting for relevant covariates (OR: 1.37; 95% CI: 1.22–1.53). MetS components elevated blood pressure was most strongly associated with frailty. In the sub-cohort of 3896 participants, high hsCRP was associated with presence of MetS and frailty (OR: 1.31; 95% CI: 1.15–1.51), and MetS alone (OR: 1.44; 95% CI: 1.33–1.56), but not to frailty alone. A higher hsCRP level was associated with a higher score on the physical domain of frailty (b: 0.06; 95% CI: 0.03–0.08). Conclusions Presence of MetS is associated with presence of frailty indicated by a multidimensional index in a large group of Dutch older adults. Low-grade inflammation, indicated by plasma hsCRP level, was found to be associated with both presence of MetS and frailty and presence of MetS alone. Increased hsCRP levels were associated with the physical component of frailty, but not with frailty as a multidimensional concept.

Abstract Background The latest evidence on health literacy in China revealed that only 8% of individuals aged 65–69 years, a segment of the geriatric population, possess adequate health literacy levels, indicating a low level in China. Studies have demonstrated that improving the organizational health literacy of healthcare institutions is a crucial approach to addressing low health literacy among older patients. Objective To explore the obstacles hindering the advancement of organizational health literacy in healthcare institutions in meeting the needs of older patients. Design A mixed-methods approach was employed to investigate both the status and barriers to the establishment of organizational health literacy within two healthcare institutions. Participants Participants included older individuals aged over 60, clinical staff, and managerial personnel from these two health institutions. Methods This research utilized the social-ecological model as its theoretical foundation and utilized a mixed-methods approach to examine the current status and challenges in developing organizational health literacy within healthcare institutions. Initially, a survey using a questionnaire (n = 178) was conducted among older patients to evaluate the establishment of organizational health literacy from their perspective. Following this, interviews (n = 22) were carried out with administrators, clinical personnel, and elderly patients to identify the barriers hindering the development of organizational health literacy within healthcare institutions. Results Quantitative research indicates that health institutions have been less accommodating to the requirements of older patients, with health information dissemination and communication emerging as the weakest areas. Qualitative investigations revealed three key influencing factors: patient-related factors, including physiological and cognitive decline, as well as low educational attainment among older patients; organizational factors, including inadequate clinical staff numbers, deficient long-term systematic training, and a digital divide resulting from health institutions’ digital advancements; and policy-related factors indicating a lack of regulations governing the establishment of organizational health literacy within healthcare institutions. Conclusion The two most vulnerable aspects of OHL in medical institutions regarding the needs of older patients are health information and communication. The factors influencing the construction of OHL in medical institutions are multifaceted, encompassing micro, meso, and macro levels. At the macro level, it is essential for medical institutions to enhance leadership awareness of OHL and to incorporate its development into institutional strategic plans. At the meso-level, medical institutions should be made to optimize the medical environment for elderly patients and to prioritize health literacy training for medical staff. At the micro level, attention must be given to the characteristics and needs of elderly patients. Ultimately, by implementing a comprehensive construction of intervention strategies, the response ability of medical institutions to the needs of elderly patients can be enhanced.

Abstract Background Cannabis use has been increasing among older adults in Canada, particularly during the COVID-19 pandemic. This study aims to examine the association between loneliness and cannabis use among older Canadians during the pandemic. Methods Quantitative data analyses were performed based on 2,020 participants aged 55 years and older from the Canadian Perspectives Survey Series 6, 2021: Substance Use and Stigma During the Pandemic. Results This study found that participants who used cannabis in the 30 days before the survey reported significantly higher loneliness scores than those who never used cannabis after adjusting social-demographic, social interaction, and pandemic-related factors. Participants who kept using cannabis during the pandemic also reported significantly higher loneliness scores than those who never used cannabis. Conclusion The findings about the correlation between cannabis use and greater loneliness contribute to the discourse on potential health and wellbeing harms of cannabis use among older adults.

Abstract Filtering efficiency (FE) has been suggested as a task-related process of working memory (WM) in older adults, but the interaction of distractors with WM when implemented as a training to improve WM capacity is unclear. To investigate the effect of manipulations of WM and/or FE load in a multicomponent model-based WM training in improving WM capacity. 205 healthy older adults (129 women; aged 64.0 ± 8.3 years) were randomised into three WM training groups with manipulations of WM and FE load (high WM; low FE load, high WM; high FE load and low WM; high FE load). All groups underwent three online cognitive testing sessions and twelve 40-min training sessions over three weeks using the SmartBrain smartphone application. WM capacity was measured with complex span tasks and FE using the Change Detection Task. Linear mixed-effect models adjusted for age, sex, education and pre-baseline performance showed increased WM capacity post-training, but no difference between groups. While both distractors and WM are needed to improve WM in the absence of distraction, manipulations of the FE and WM load do not influence improvements following training.

Abstract A clinically useful characterization of the cognitive aging process requires the development of valid and robust behavioral tests, with an emphasis on explaining and understanding typical inter-individual variability in cognition. Here, using a dataset that includes behavioral scores collected with the National Institute of Health Toolbox Cognition Battery (NIHTB-CB) and other auxiliary tests, we examined (1) the differences between young and old adults across different cognitive domains, (2) the strength of across-subject correlations in behavioral test scores, (3) the consistency of low-dimensional behavioral representations across age using factor analysis, and (4) the accuracy of behavioral scores in predicting participants’ age. Our results revealed that (1) elderly females had better verbal episodic memory scores than elderly males, (2) across-subject correlations between behavioral tests varied with age group, (3) although a three-factor model explained the behavioral data in both age groups, some tasks loaded to different factors between the two groups, and (4) age-performance relationship (i.e. a regression model linking age to cognitive scores) in one group cannot be extrapolated to predict age in the other group, indicating an inconsistency in age-performance relationships across groups. These findings suggest that executive function tests might tap into different cognitive processes in different age groups, which might ultimately suggest that a statistically significant between-group difference in test performance might not always reflect differences in the same underlying cognitive processes. Overall, this study calls for more caution when interpreting age-related differences and similarities between age groups with different cognitive abilities even when the same tests are used.

Abstract Background Physical activity (PA) plays a vital role in maintaining the functional ability that enables well-being in older age (healthy aging), potentially also saving costs for the healthcare system and society. The aim of this study was to examine the association between PA and healthcare and societal costs in a sample of very mild to moderately frail older adults. Methods This cross-sectional study is a secondary analysis using baseline data from the PromeTheus randomized-controlled trial, which included 385 very mild to moderately frail community-dwelling older adults (70 + years) from Germany. Participants self-reported their health-related resource use in the previous 6 months (FIMA questionnaire), which was monetarily valued using standardized unit costs. PA was also self-reported using the German Physical Activity Questionnaire for middle-aged and older adults (German-PAQ-50+) and categorized as ‘insufficient’/’sufficient’ or ‘insufficient’/‘moderate’/‘high’ in accordance with the World Health Organization guidelines for PA. Mean and median healthcare costs (including outpatient, inpatient, rehabilitation, formal care, and medication costs) and societal costs (healthcare costs plus informal care costs) for different PA groups were estimated using generalized linear models and quantile regression, with sociodemographic variables and physical capacity (Short Physical Performance Battery) as covariates. Results Of the sample, 24% were classified as insufficiently, 23% as moderately, and 54% as highly active. Sufficient PA, especially high PA, was associated with lower costs in the 6 months prior to data collection compared to insufficient PA (-€6,237, 95% CI [-10,656; -1,817] and -€8,333, 95% CI [-12,183; -4,483], respectively). The cost difference between PA intensity groups was largely driven by differences in informal care costs and decreased substantially when physical capacity was accounted for in the analyses; e.g., the mean difference in societal costs between sufficient and insufficient PA decreased from -€7,615 (95% CI [-11,404; -3,825]) to -€4,532 (95% CI [-7,930; -1,133]). Conclusion Promoting PA throughout the lifespan as a means of promoting healthy aging and reducing dependency in old age could potentially provide economic benefits and help to mitigate the economic consequences of an aging population with increasing health and long-term care needs. Future longitudinal studies should attempt to disentangle the mediating and confounding role of physical capacity and health status in the association between PA and costs.

Abstract Background The worldwide number of adults aged 60 years and older is expected to double from 1 billion in 2019 to 2.1 billion by 2050. As the population lives longer, the rising incidence of chronic diseases, cognitive disorders, and behavioral health issues threaten older adults’ health span. Exercising, getting sufficient sleep, and staying mentally and socially active can improve quality of life, increase independence, and potentially lower the risk for Alzheimer’s disease or other dementias. Nonpharmacological approaches might help promote such behaviors. Indoor lighting may impact sleep quality, physical activity, and cognitive function. Dynamically changing indoor lighting brightness and color throughout the day has positive effects on sleep, cognitive function, and physical activity of its occupants. The aim of this study is to investigate how different indoor lighting conditions affect such health measures to promote healthier aging. Methods This protocol is a randomized, cross-over, single-site trial followed by an exploratory third intervention. Up to 70 older adults in independent living residences at a senior living facility will be recruited. During this 16-week study, participants will experience three lighting conditions. Two cohorts will first experience a static and a dynamic lighting condition in a cluster-randomized cross-over design. The static condition lighting will have fixed brightness and color to match lighting typically provided in the facility. For the dynamic condition, brightness and color will change throughout the day with increased brightness in the morning. After the cross-over, both cohorts will experience another dynamic lighting condition with increased morning brightness to determine if there is a saturation effect between light exposure and health-related measures. Light intake, sleep quality, and physical activity will be measured using wearable devices. Sleep, cognitive function, mood, and social engagement will be assessed using surveys and cognitive assessments. Discussion We hypothesize participants will have better sleep quality and greater physical activity during the dynamic lighting compared to the static lighting condition. Additionally, we hypothesize there is a maximal threshold at which health-outcomes improve based on light exposure. Study findings may identify optimal indoor lighting solutions to promote healthy aging for older adults. Trial registration ClinicalTrials.gov Identifier: NCT05978934.

Introduction. Recommendations for the use of the Mediterranean diet apply to many nosologies, which made it expedient to consider the principles of such nutrition and adherence to it for patients with high cardiovascular risk. Objectives. In order to evaluate the nature of the diet of patients with high cardiovascular risk and their adherence to the Mediterranean diet, the principles of the diet were described according to the data from the Pubmed database. Adherence to and compliance with the principles of Mediterranean diet in patients with high cardiovascular risk were determined according to the Food Questionnaire in 29 outpatients with stable chronic forms of coronary heart disease and arterial hypertension: 18 men, 11 women aged 55.72±2.59 years with excessive body weight; the results were processed by the methods of variational statistics. Results. The Mediterranean diet is recommended for patients with high cardiovascular risk, excess body weight, steatotic liver disease, inflammatory bowel diseases, autoimmune changes in the thyroid gland, dementia, chronic obstructive pulmonary diseases, and oncological processes. It is based on grains, cereals, vegetables and fruits, beans, nuts, and seeds; a small amount of meat, eggs, fish, and poultry; olive oil and moderate daily consumption of cheeses and yogurts. According to the Food Questionnaire, patients with a high cardiovascular risk are not sufficiently aware of the principles of this diet, do not fully follow the recommendations for replacing fats with extra virgin olive oil, do not consume enough fish, vegetables, fruits, nuts, whole grain pasta and hard cereals. In addition, they tend to consume meat, soft cereals, ordinary types of bread and pasta, sweets, carbonated beverages, beer, and spirits in excessive amounts or too often. Conclusions. Insufficient awareness and non-adherence to the Mediterranean diet require the activation of educational work to deepen knowledge about its principles and details.

Background: Games are a promising strategy for rehabilitating older adults. The effect of games on promoting healthy lifestyles and preventing frailty remains uncertain. This article aims to describe the process of development and validation of the game “Bem-me-quer para a saúde”® to promote the acquisition of healthy lifestyles and prevent frailty in over 65-year-olds. Methods: This study comprised three distinct phases, spanning from December 2023 to June 2024. The first phase comprised a thorough review of the scientific literature on the frailty and lifestyles of older adults, a second phase of game design, and a third phase of content and semantic validation conducted by specialized nurses and older adults. Results: After revising literature, this study utilized an e-Delphi with a panel of 14 specialist nurses who underwent two rounds of evaluation. The “Bem-me-quer para a saúde”® game includes a puzzle board with 54 pieces and 30 educational cards. In the final phase, we evaluated the game on a cohort of 50 older adults, highlighting its reflective, interactive, and educational aspects. Conclusions: The game presented sufficient evidence of content validity and relevance to clinical practice. We should conduct additional research to evaluate its impact on lifestyle modification and frailty prevention.

Abstract Background The benefits of comprehensive geriatric assessment (CGA) are well established for hospital care but less so for primary care. Our primary objective was to assess the effect of two multifaceted interventions based on a CGA adapted for primary care on a composite criterion combining all-cause mortality, emergency department visits, unplanned hospital admissions, and institutionalisation. Methods This open-label, pragmatic, three-arm, cluster-randomised controlled trial involved 39 general practices in France. It included 634 patients aged 70 years or over with chronic health conditions and/or an unplanned hospital admission in the past 3 months, between 05/2016 and 08/2018. Interventions were in arm 1: a systematic nurse-led CGA; arm 2: a GP-led CGA, at the GP’s discretion; arm 3: standard care. The primary composite endpoint was assessed at 12 months. The secondary endpoints included: components of the composite endpoint, health-related quality of life (Duke Health Profile), functional status (Katz Activities of Daily Living Index) and medications (number) at 12 months. Pairwise comparisons between the experimental groups and the control were tested. The main analysis was performed on the intention-to-treat (ITT) population, after imputing missing information and adjusting for baseline imbalances by mixed effects regressions. Results For the primary composite outcome, no statistically significant difference was found between arm 1 and the control (adjusted odds ratio [aOR] = 0.81 [95%CI 0.54–1.21], P = 0.31), whereas arm 2 and the control differed significantly (aOR = 0.60 [0.39–0.93], P = 0.022). A statistically lower risk of unplanned hospital admission in arm 2 vs control (aOR = 0.57 [0.36–0.92], P = 0.020)) was observed, while no statistically significant differences were found for the other components and between arm 1 and the control. None of the other secondary endpoints differed between arms. Conclusions Our study led in community-dwelling older patients with chronic conditions found no significant effect of a CGA adapted for primary care on mortality, functional independence and quality of life, but suggests that a GP-led CGA may reduce the risk of unplanned hospital admission. Our study demonstrates the feasibility of incorporating CGA into clinical practice and highlights its potential benefits when applied on a case-by-case basis, guided by the GPs who develop the resulting PCP. Trial registration NCT02664454.

Abstract Background Falls are the leading cause of injury related morbidity and mortality in older adults. Primary and secondary prevention strategies that address modifiable risk factors are critically important to reduce the number of falls and fall related injuries. A number of evidence-based fall prevention programs are available, but few offer potential for broad dissemination and public health impact due to implementation barriers, such as a need for trained program leaders and clinicians. Methods The study will use a randomized controlled trial design to evaluate incorporating physical therapy exercises (primary prevention strategy) within an existing intervention called Walk with Ease. While Walk with Ease has an established evidence-base related to the management of arthritis pain and symptoms, the present study will determine the potential to also reduce falls and fall risk in community-dwelling older adults. The integrated process and outcome evaluation will determine the relative effectiveness of individually-prescribed exercises (compared to standardized exercises) as well as the potential of ‘habit training’ resources (relative to generic behavior prompts) to improve compliance with exercises in this population. Discussion The study, conducted through a local clinical-community partnership will advance both the science and practice of community-based fall prevention programming, while also informing implementation strategies needed to promote broader dissemination. Trial registration ClinicalTrials.gov, NCT05693025, Registered January 20, 2023, Updated March 1, 2023.

This scoping review investigates peer-led programs as a strategy to promote physical activity (PA) among older adults, addressing a gap in the literature concerning in-depth assessment of the characteristics, components, and effectiveness of such programs. Seven databases were searched for articles published in English, Portuguese, or Spanish on peer-led initiatives aimed at encouraging PA in older adults. A total of 53 studies were included, with a notable increase in publications since 2018, primarily focusing on randomized clinical trials involving participants of both sexes. The findings highlight that peer leaders typically have an average age of 65.2 years, with a minority having prior training in PA, although over half received specific training for leading PA programs. These programs, which predominantly span 1 to 4 months, often involve resistance exercises, walking, and flexibility/stretching/mobility activities, conducted in homes and community spaces. Despite the substantial number of studies utilizing peer-led approaches, a consistent lack of detailed reporting on the specific characteristics of peer leaders was observed, underscoringa need for more comprehensive documentation to enhance the understanding and implementation of these programs for older adults.

Abstract Background The Decade of Healthy Aging (2021–2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging. Methods The system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information. Results A total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators. Conclusions SIESDE is an effective system for providing an overall view of health, aging, and functional dependence.

While physical activity ensures healthy aging, rural community-dwelling older women tend to be more physically inactive compared with their counterparts in Malaysia. As social support is one of the key determinants of physical activity, this retrospective, cross-sectional study investigated the prevalence of physical activity and its association with social support among 1,221 rural community-dwelling older women in Kuala Pilah, Negeri Sembilan, Malaysia. The prevalence of physical activity among older women was 45.1% with the highest prevalence reported for housework domain (52.3%). The total mean Duke Social Support index score was 27.24 ± 3.40. Multivariate analysis reported age, employment status, and income level to demonstrate significant association with the physical activity after adjusting for confounders. Older women with an increase in social interaction score were more likely (odds ratio = 1.22; 95% confidence interval [1.10, 1.34]; p <.001) to have high physical activity when adjusted for sociodemographic, health, mental health, and physical disability. Contrarily, older women with an increase in one subjective social support score were less likely (odds ratio = 0.91; 95% confidence interval [0.87, 0.96]; p <.001) to have high physical activity when adjusted for confounders. The findings were insightful to tailor interventions on promoting social support for physical activity enhancement among older women. [ABSTRACT FROM AUTHOR]

Background: Most reviews investigating physical activity interventions for older people consider evidence primarily from high-income countries. This review examined physical activity interventions for older people from low- and middle-income countries. Methods: We searched 9 electronic databases to identify randomized controlled trials or quasi-randomized trials studies investigating physical activity interventions for people aged 60+ in low- and middle-income countries. Following study selection, one reviewer extracted relevant data. A second reviewer double-checked the data extraction of a randomly selected sample of interventions (20%). Data were summarized using descriptive statistics. Results: We included 234 studies from 19 countries, investigating 259 distinct physical activity interventions. Studies were mostly conducted in upper middle-income countries (89%), often assessing physical activity interventions through randomized controlled trials (82%). Most studies investigated a mixed population in terms of sex (68%), with a mean age between 65 and 70 years (36%), not selected on the basis of having a specific health condition (55%). The intervention most commonly investigated was structured exercise (63%) and "no intervention" was the most frequent comparator (47%). The outcomes measured more often were intrinsic capacity (59%) and functional ability (51%), whereas physical activity, falls, and social outcomes were rare. Only 2 studies targeted underserved populations. Conclusion: Although we identified a substantial number of randomized controlled trials, most evidence for physical activity interventions for older people in low- and middle-income countries is limited to upper middle-income countries. Gaps identified included interventions targeting populations with underserved backgrounds, using sport as an intervention, and assessing the impact of physical activity interventions on physical activity, falls, and social outcomes. [ABSTRACT FROM AUTHOR]

This study was to identify factors at the intrapersonal, interpersonal, and community levels that relate to physical leisure participation in Taiwanese community-dwelling older adults and to examine their relative importance. We used a cross-sectional study with purposive sampling (N = 160). Physical leisure participation was quantified as the variety, frequency, and duration of participation. Data were analyzed using a series of hierarchical multiple linear regressions. The results showed that higher variety, frequency, or duration of physical leisure participation was associated with older males and with those who reported having better health, fewer depressive symptoms, and greater social support. Intrapersonal- and interpersonal-level factors play a relatively more important role in predicting physical leisure participation than factors at the community level. Understanding factors that relate to these three levels of participation has the potential to inform interventions that are tailored to individual profiles. [ABSTRACT FROM AUTHOR]

Physical activity (PA) is linked to better cognitive and brain health, though its mechanisms are unknown. While brain iron is essential for normal function, levels increase with age and, when excessive, can cause detrimental neural effects. We examined how objectively measured PA relates to cerebral iron deposition and memory functioning in normal older adults. Sixty-eight cognitively unimpaired older adults from the UCSF Memory and Aging Center completed neuropsychological testing and brain magnetic resonance imaging, followed by 30-day Fitbit monitoring. Magnetic resonance imaging quantitative susceptibility mapping (QSM) quantified iron deposition. PA was operationalized as average daily steps. Linear regression models examined memory as a function of hippocampal QSM, PA, and their interaction. Higher bilateral hippocampal iron deposition correlated with worse memory but was not strongly related to PA. Covarying for demographics, PA moderated the relationship between bilateral hippocampal iron deposition and memory such that the negative effect of hippocampal QSM on memory performances was no longer significant above 9120 daily steps. PA may mitigate adverse iron-related pathways for memory health.

ObjectivesAdverse childhood experiences (ACEs) are associated with higher risk of chronic disease, but little is known about the association with late life cognitive decline. We examined the longitudinal association between ACEs and late-life cognitive decline in the Study of Healthy Aging in African Americans (STAR).DesignLinear mixed models with random intercepts and slope examined the association of individual and composite ACEs with cognitive change adjusting for years from baseline (timescale), baseline age, sex, parental education, childhood socioeconomic status and childhood social support. Participants reported whether they had experienced nine types of ACEs. Executive function and verbal episodic memory were measured up to three times over a 3-year period using the Spanish and English Neuropsychological Assessment Scales.SettingsKaiser Permanente Northern California members living in the Bay Area.ParticipantsSTAR is a cohort study of cognitive ageing launched in 2018 that has enrolled 764 black Americans ages ≥50 years (mean age=67.5; SD=8.5).ResultsTwenty-one per cent of participants reported no ACEs, 24% one ACE, 20% two ACEs, 17% three ACEs and 17% four or more ACEs. Compared with no ACEs, two ACEs (β=0.117; 95% CI 0.052 to 0.182), three ACEs (β=0.075; 95% CI 0.007 to 0.143) and four or more ACEs (β=0.089; 95% CI 0.002 to 0.158) were associated with less decline in executive function. There were no significant associations between number of ACEs and baseline or longitudinal verbal episodic memory or between individual ACEs and executive function or verbal episodic memory.ConclusionIn this cohort of older black Americans, there was no association between ACEs and baseline cognition or cognitive change in verbal episodic memory; however, experiencing ≥ 2 ACEs was associated with less decline in executive function. These results may indicate that participants who survived to age 50+ and experienced ACEs may have cognitive resilience that warrants further investigation.

Increasing evidence suggests that intact social bonds are protective against age-related morbidity, while bond disruption and social isolation increase the risk for multiple age-related diseases. Social attachments, the enduring, selective bonds formed between individuals, are thus essential to human health. Socially monogamous species like the prairie vole (M. ochrogaster) form long-term pair bonds, allowing us to investigate the mechanisms underlying attachment and the poorly understood connection between social bonds and health. In this review, we explore several potential areas of focus emerging from data in humans and other species associating attachment and healthy aging, and evidence from prairie voles that may clarify this link. We examine gaps in our understanding of social cognition and pair bond behavior. Finally, we discuss physiologic pathways related to pair bonding that promote resilience to the processes of aging and age-related disease. Advances in the development of molecular genetic tools in monogamous species will allow us to bridge the mechanistic gaps presented and identify conserved research and therapeutic targets relevant to human health and aging.

Nepal’s national geriatric health strategy 2021–2030 focuses on enhancing the health and well-being of senior citizens by providing comprehensive health services and promoting healthy aging. The strategy addresses the increasing prevalence of chronic conditions and multimorbidities among the older people, emphasizing the need for tailored health-care services. Key priorities include improving access to quality health services, promoting social health insurance, and strengthening family and community support systems. The strategy also aims to integrate geriatric health issues into the national health system, enhance the capacity of health facilities, and ensure gender-equitable and inclusive services. By fostering multisectoral coordination and collaboration, the strategy supports Nepal’s pursuit of universal health coverage and aims to build state capacity to support healthy aging, ensuring that senior citizens can lead active and quality lives.

In this paper, we evaluate a pre-pandemic multi-dimensional healthy aging program promoted by an Italian private Foundation to provide new insights on interventions that address both health and social needs within an age-friendly community framework. Using propensity score matching and linear regression models, with specific controls for individuals' self-selection into the program, we compare lifestyles, physical health, mental conditions, and healthy life expectancy of subjects enrolled into the program with those of similar, but non-enrolled, subjects. Our main finding is that, to be more effective, healthy aging interventions should target the key dimensions of aging - physical, mental, and social - in a holistic approach. Indeed, we show that the multi-dimensionality of the healthy aging intervention under study - the contemporaneous target of older adults' physical, mental, and social health - is crucial in improving both quantity and quality of life. [ABSTRACT FROM AUTHOR]

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Southeast Asia Region is expected to experience a significant increase in its ageing population, with the proportion of people age ≥ 65 years projected to reach 13.7% by 2030 and 20.3% by 2050. In Bhutan, which has a population of 681,720, the proportion of adults aged > 60 years has increased from 7.0% in 2005 to 8.8% in 2017 and is projected to increase to 19.7% in 2047. Bhutan has always prioritized the well-being of all its citizens through the principles of Gross National Happiness, however older adults increasingly face challenges such as poorer health, higher poverty rates, and limited social security. This demographic shift, combined with an increasing old age dependence ratio and emigration of young adults abroad underscores the urgent need to reorient strategic socio-economic and health policies. To promote healthy ageing and create enabling conditions for the pursuit of happiness, we recommend the development and implementation of a comprehensive strategic plan for the care of older adults. The healthcare system should put in place relevant infrastructure and human resources to address the physical and emotional needs, while religious organizations may be actively engaged in providing spiritual needs to the older adults. In this article, we summarize key population parameters on the nature of demographic shift and healthcare policies relating to the care of older adults in Bhutan. [ABSTRACT FROM AUTHOR]

Shift work disrupts natural circadian rhythms, sleep-wake cycles, negatively impacting workers' psychosomatic health and overall quality of life. Even in peaceful conditions, the nature of military service significantly differs from the daily routines and work activities of civilian population with a number of notable and significant features. Military service is always performed under stressful conditions, characterized by frequent deviations from standard work schedules, workloads and disruptions to normal daily rhythms, especially due to shift work. These stress factors have a negative effect on the working ability and health of servicemen. Moreover, this impact increases as the duration of military service extends. This situation is exacerbated among servicemen on combat duty due to constant stress and psychological strain. Shift work is associated with sleep disturbances, depressive mood and anxiety, cognitive impairment, low quality of life and even suicidal thoughts, leading to increased safety risks. Shift work, sleep deprivation, and related fatigue endanger personal safety, task performance, and national security as well. Shift work, sleep deprivation and daily rhythm disruptions lead to metabolic, cardiovascular, musculoskeletal system, mental, physical and functional cognitive disorders. Its impact on family and social life can result in psychological stress and psychosomatic disorders. Furthermore, it can negatively affect marital relations, fulfillment of parental responsibilities, and children's education. Published articles provide considerably more data on the impacts of shift work on civilian workers than it does on servicemen. Present study was conducted to demonstrate the detrimental effects of shift work on the psychosomatic health and life quality of workers with various professions, including military personnel. Various methods have been suggested to evaluate servicemen's suitability for work, to reduce professional errors, to ensure service safety and to mitigate the negative impact of shift work. [ABSTRACT FROM AUTHOR]

Yoga-based clinical research has shown considerable promise in varied ageing-related health outcomes in older adults. However, robust frameworks have yet to be used in intervention research to endorse yoga as a healthy ageing intervention to test the multidimensional construct of healthy ageing. This was an assessor-masked, randomized controlled trial conducted among 258 sedentary, community-dwelling older adults aged 60–80 years, randomly allocated to 26-week yoga-based intervention (YBI) (n = 132) or waitlist control (WLC) (n = 126). The effectiveness of YBI was assessed through two separate global statistical tests, generalized estimating equations and rank sum-based test, against a comprehensive healthy aging panel comprised of ten markers representing the domains of physiological and metabolic, cognitive, physical capability, psychological, and social well-being. The secondary outcomes were individual primary marker scores, Klotho, inflammatory markers, and auxiliary blood markers. We could establish the healthy aging effect of the 26-week YBI over WLC using two models of global statistical test (GEE, β = 0.29; 95% CI = 0.20 to 0.38, p < 0.001), and rank sum-based test (β = 0.28, 95% CI = 0.19 to 0.36, p < 0.001). There were also significant improvements in direction of benefit at individual levels of all the aging markers. Exploratory evaluation with adopted indices from contemporary clinical trials also validated the potential of YBI for healthy aging; HATICE adapted composite score (mean difference = − 0.18; 95% CI = − 0.26 to − 0.09, p < 0.001) and healthy ageing index (mean difference = − 0.33; 95% CI = − 0.63 to − 0.02, p = 0.03). The global effect of YBI across multiple ageing-related outcomes provides a proof of concept for further large-scale validation. The findings hold a great translational value given the accelerated pace of population aging across the globe. Trial registration: CTRI/2021/02/031373. [ABSTRACT FROM AUTHOR]

Reduced insulin/IGF-1 signalling (rIIS) improves survival across diverse taxa and there is a growing interest in its role in regulating immune function. Whilst rIIS can improve anti-bacterial resistance, the consequences for anti-viral immunity are yet to be systematically examined. Here, we show that rIIS in adult Caenorhabditis elegans increases the expression of key genes in two different anti-viral immunity pathways, whilst reducing viral load in old age, increasing survival and reducing rate-of-senescence under infection by naturally occurring positive-sense single-stranded RNA Orsay virus. We found that both drh-1 in the anti-viral RNA interference (RNAi) pathway and cde-1 in the terminal uridylation-based degradation of viral RNA pathway were upregulated in early adulthood under rIIS and increased anti-viral resistance was not associated with reproductive costs. Remarkably, rIIS increased anti-viral gene expression only in infected worms, potentially to curb the costs of constitutively upregulated immunity. RNA viruses are found across taxa from plants to mammals and we demonstrate a novel role for rIIS in regulating resistance to viral infection. We therefore highlight this evolutionarily conserved signalling pathway as a promising therapeutic target to improve anti-viral immunity. [ABSTRACT FROM AUTHOR]

The goal of this study was to examine associations between accelerometer-measured physical activity (PA) and sedentary time (ST) with mortality by a genetic risk score (GRS) for longevity. Among 5,446 women, (mean [SD]: age, 78.2 [6.6] years), 1,022 deaths were observed during 33,350 person-years of follow-up. Using multivariable Cox proportional hazards models, higher light PA and moderate to vigorous PA were associated with lower mortality across all GRS for longevity categories (low/medium/high; all ptrend <.001). Higher ST was associated with higher mortality (ptrend across all GRS categories <.001). Interaction tests for PA and ST with the GRS were not statistically significant. Findings support the importance of higher PA and lower ST for reducing mortality risk in older women, regardless of genetic predisposition for longevity. [ABSTRACT FROM AUTHOR]

Age-related changes affect the ratio between two steroid hormones of the hypothalamic-pituitary-adrenal axis, cortisol and dehydroepiandrosterone (sulfate) (DHEA[S]). Physical activity (PA) may buffer the effects of chronic stress and counteract the aging decline of DHEA(S). Therefore, a systematic review was conducted to understand how PA influences physiological markers of cortisol and/or DHEA(S) and whether there is a difference in observational associations or experimental effects in older adults aged 65 years and older. A narrative synthesis was performed on nine observational studies, and meta-analyses were performed on 22 randomized controlled trials. There was low- to moderate-quality evidence that regular PA beneficially reduces cortisol and increases DHEA(S) levels. Subgroup analyses showed no clinically important differences between men and women, different exercise modalities, or health states. The findings cautiously suggest that regular PA of older adults' own choice that they find enjoyable could be recommended to improve cortisol and/or DHEA(S) levels. [ABSTRACT FROM AUTHOR]