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Background: Processes leading to the clinical presentation of Alzheimer´s disease (AD) start to develop years or even decades beforehand. Chronic low‐grade inflammation is suggested to play a role in the pathogenesis of many aging‐related chronic illnesses, including AD. The aim of this study was to evaluate whether low‐grade inflammation, commonly associated with obesity and the metabolic syndrome, is associated in cognitive decline after 10 years. We hypothesized that low‐grade inflammation at midlife, estimated by tumor necrosis factor alpha (TNF‐α), Interleukin‐6 (IL‐6) and high‐sensitivity CRP (hs‐CRP), predicts cognitive decline. Method: 915 subjects aged 45 to 74 years (median age 54, 55% women) participated a Finnish nationwide, population‐based Health 2000 Examination Survey, its supplemental cardiovascular and metabolic examinations in 2000‐2001 and the follow‐up Health 2011 Survey. Associations between baseline low‐grade chronic inflammation and cognitive performance at follow‐up in 2011 and the change in cognition from baseline to follow‐up were evaluated. TNF‐α, IL‐6 and hs‐CRP were measured in 2001. Categorical verbal fluency (VF), word‐list learning (WLL) and word‐list delayed recall (WLDR) were used as measures of cognitive performance at baseline and at follow‐up. Statistical analyses were performed with multivariable linear models adjusted for age, sex, education, APOEε4 genotype, type 2 diabetes, hypertension, hypercholesterolemia, body mass index, depressive symptoms and smoking, and for the change in cognition also baseline cognition. Result: Higher TNF‐α and IL‐6 at baseline individually predicted poorer performance in all three cognitive tests at follow‐up (VF: TNF‐α slope:‐2.29, p=0.003, IL‐6 slope:‐1.71, p<0.0001; WLL: TNF‐α slope:‐1.02, p=0.02, IL‐6 slope:‐0.80, p=0.002; WLDR: IL‐6: slope:‐0.30, p=0.02). TNF‐α and IL‐6 predicted also a greater decline in VF (TNF‐α slope:‐1.69, p=0.009, IL‐6 slope:‐1.34, P=0.0009) from baseline to follow‐up. IL‐6, but not TNF‐α predicted greater decline in WLL (IL‐6 slope:‐0.71, p=0.02) and WLDR (IL‐6: slope:‐0.30, p=0.01). Baseline hs‐CRP was not associated with cognitive performance or decline after 10 years. Conclusion: In this middle‐aged population, low grade inflammation measured with TNF‐α and IL‐6 predicts worse cognitive performance and IL‐6 predicts greater decline in cognitive function over a 10‐year follow‐up. Potentially, developing interventions that target these inflammatory processes could help reduce cognitive decline in the future. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Type 2 diabetes is an independent risk factor for cognitive decline. Insulin resistance occurring during midlife may increase the risk of cognitive decline later in life. We hypothesised that insulin resistance is associated with poorer cognitive performance and that sex and APOE*E4 might modulate this association. Methods: The association of insulin resistance and APOE*E4 genotype on cognitive function was evaluated in a nationwide Finnish population-based study ( n = 5,935, mean age 52.5 years, range 30-97 years). HOMA-IR was used to measure insulin resistance. Cognitive function was tested by word-list learning, word-list delayed-recall, categorical verbal fluency and simple and visual-choice reaction-time tests. Linear regression analysis was used to determine the association between HOMA-IR and the results of the cognitive tests. Results: Higher HOMA-IR was associated with poorer verbal fluency in women ( p < 0.0001) but not in men ( p = 0.56). Higher HOMA-IR was also associated with poorer verbal fluency in APOE*E4 -negative individuals ( p = 0.0003), but not in APOE*E4 carriers ( p = 0.28). Furthermore, higher HOMA-IR was associated with a slower simple reaction time in the whole study group ( p = 0.02). Conclusions/interpretation: To our knowledge, this is the first comprehensive, population-based study, including both young and middle-aged adults, to report that female sex impacts the association of HOMA-IR with verbal fluency. Our study was cross-sectional, so causal effects of HOMA-IR on cognition could not be evaluated. However, our results suggest that HOMA-IR could be an early marker for an increased risk of cognitive decline in women. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aimed to explore nurses' knowledge of foot care and related factors in home care nursing. Background Nurses caring for older people are increasingly confronted with clients who have multiple foot problems and need support with their foot health. The role of nurses in promoting foot health, caring for existing foot problems and supporting older people in foot self-care is especially important in the home care context. However, this entails up-to-date foot care knowledge and practices. Design A cross-sectional correlational survey study design. Methods Nurses' knowledge of foot care was evaluated using the Nurses' Foot Care Knowledge Test developed for this study. The data were analysed with descriptive and inferential statistics. Results Nurses (registered nurses, public health nurses and licensed practical nurses) from public home care ( n = 322, response rate 50%) participated the study. Nurses' knowledge in foot care varied. The knowledge scores were highest for skin and nail care and lowest for the identification and care of foot structural deformities. Longer working experience in the current work place and participation in continuing education explained higher Nurses' Foot Care Knowledge Test scores. Conclusions Nurses need more knowledge, and hence continuing education, in the foot care of older people to effectively prevent, recognise and care for foot problems and promote independent living in the community. Relevance to clinical practice Nurses' have clinically relevant knowledge gaps. Therefore, foot care knowledge of nurses needs to be improved by continuing education in clinical settings. Adequate foot care knowledge among nurses is important to identify, prevent and care foot problems especially in older people. [ABSTRACT FROM AUTHOR]

Background A positive life orientation ( PLO) is important for staying healthy physically, mentally and functionally. However, little is known about the factors connected with PLO in home-dwelling older people, even though it is an important topic. Aim The aim of this study was to identify factors connected with positive life orientation among home-dwelling older people. Study design An explorative, population-based cross-sectional study of the age cohort of 70-year-olds living at home at the age of 70, 80, 85 and 90. Methods The data were collected in 1991 among all residents of Turku, Finland, born in 1920 (N = 1530). Follow-ups were conducted in 2001 (n = 656), 2006 (n = 304) and 2011 (n = 156). A multiple regression analysis was conducted to estimate a model of factors that connected with PLO. Results Several factors were significantly connected with PLO at ages 70, 80, 85 and 90. For example, if 70-year-old respondents perceived themselves as being in better health than others of the same age, it improved their PLO. We also observed that PLO was improved by good self-rated health during the past 12 months at 80, good self-rated health at 85 and good self-rated health compared to others of the same age at 90. The various explanatory models explained between 24 and 36% of the variance in outcomes. Conclusion Overall, our results showed that the respondents' own subjective views were significant independent factors of PLO in all four analyses (70, 80, 85 and 90 years). These subjective experiences remained significant even when objective indicators such as medication use, the presence of diseases and functional capacity were taken into account. [ABSTRACT FROM AUTHOR]

The aim of the current study was to characterize the anthocyanin content and composition of a purple potato landrace cultivar (Solanum tuberosum 'Synkeä Sakari') and to compare the postprandial effects of purple-fleshed potatoes, yellow-fleshed potatoes and bilberries in potato starch on postprandial glycemia and insulinemia in healthy males. The purple potato meal caused smaller insulinemia than the yellow potato meal (iAUC 120 min 1347 and 2226, respectively, p = 0.012 and iAUC 240 min 1448 and 2403, p = 0.007) or the bilberry meal (iAUC 120 min 1920, p = 0.027). The purple potato meal caused a smaller plasma glucose at 40 min postprandially compared with the yellow potato meal (p = 0.044). The results of this study suggest that anthocyanin-containing purple-fleshed potatoes influence the postprandial insulinemia positively. Since potatoes are the world's largest non-grain commodity, replacing yellow-fleshed potatoes with purple-fleshed potatoes as staple food could have large potential in maintaining public health. [ABSTRACT FROM AUTHOR]