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To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of social capital on health behaviors of middle-aged and older adults based on 2020 CHARLS data. Using binary logistic regression models, we discussed the association between social capital and five health behaviors. The results suggest that structural social capital significantly increases physical activity and physical examination behaviors among middle-aged and older adults but also decreases the probability of abstinence behaviors. Cognitive social capital increases the probability that middle-aged and older adults will have a reasonable amount of sleep and physical activity. However, it also decreases the probability that smoking cessation behaviors will occur. Further attention needs to be paid to the role of social capital, the creation of a harmonious social environment and the enhancement of social trust, the strengthening of communities and grass-roots social organizations, and the provision of more platforms for the participation of middle-aged and older adults in social activities, to improve the quality of the healthy lives of middle-aged and older adults and, in turn, to promote the establishment of healthy behaviors. [ABSTRACT FROM AUTHOR]

There is a global ageing of the world's population. Ageing is associated with multiple pathologies, reductions in physical activity, and losses in cognitive function. This study aimed to analyse the associations between the frequency of leisure-time physical activity (PAF) in middle-aged Spaniards and subjective cognitive limitations (SCLs): self-reported problems for remembering or concentrating (data extracted from the 2017 National Health Survey and the 2020 European Health Survey in Spain). Furthermore, the study aimed to evaluate risk factors that could be related to a higher probability of developing SCLs. This was a cross-sectional study with 15,866 middle-aged Spaniards. The associations between FAP and SCLs were analysed using chi-square. Also, the risk factors for SCLs were evaluated using binary multiple logistic regression. The median age of participants was 55 years, with 49% men and 51% women. Associations were found between PAF and SCLs (p < 0.001). The highest prevalence of SCLs was found in physically inactive people and the lowest in very active people (13.7% vs. 5.8%, p < 0.05), and people with SCLs had a higher prevalence of inactivity than those without SCLs (47.2% vs. 33.8%, p < 0.05). Physical inactivity, low educational level, low social class, and being female were the main risk factors for SCLs. Among the actions to prevent cognitive limitations, as well as interventions in people with cognitive limitations, it would be advisable to include physical activity programmes, both as a preventive measure to delay cognitive limitations and to reduce the risk of other pathologies in people who already have them. [ABSTRACT FROM AUTHOR]

BackgroundProsody voice measures, especially jitter and shimmer, have been associated with cognitive impairment and hold potential as early indicators of risk for cognitive decline. Prior research suggests that voice measures assessed concurrently with longitudinal cognitive outcomes are associated with 10-year cognitive declines in middle-age and older adults from Midlife in the U.S. (MIDUS) study.ResultsUsing a subsample from the same study, we expanded previous research to examine voice measures that were (1) collected 8 years before cognitive outcomes, (2) derived from narrative speech in logical memory tests instead of word list recall tests, and (3) independent of the cognitive outcomes. Multilevel analyses controlled for covariates of age, sex, education, neurological conditions, depressive symptoms, and chronic conditions. The results indicated that higher jitter and lower shimmer predicted greater 10-year declines in episodic memory and working memory.ConclusionThese findings extend previous research by highlighting prosody voice measures assessed 8 years earlier as predictors of subsequent cognitive declines over a decade.

AimWe aim to investigate the association between body roundness index (BRI) and abdominal aortic calcification (AAC) among middle aged and elderly US residents.MethodsThis cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2013–2014 cycle, including 3,079 middle-aged and elderly participants aged 40 and above. AAC scores for these participants were assessed using dual-energy x-ray absorptiometry (DXA). BRI was calculated from participants’ height and waist circumference, with all measurements conducted by trained surveyors using standardized methods. The relationship between BRI and AAC was analyzed using weighted multivariate logistic regression, adjusting for confounding variable. Additionally, restricted cubic splines (RCS) analysis was also employed.ResultsWe found that those with AAC were significantly older and had a higher prevalence of smoking and chronic kidney disease (CKD) prevalence compared to those without AAC. Using weighted multivariable logistic regression, we determined that an increase of one unit in BRI was associated with a 22% higher risk of AAC. Additionally, higher BRI quartiles (Q2, Q3, Q4) showed significantly increased risks of AAC compared to the lowest quartile. Visualization using RCS indicated a gradual increase in AAC risk with higher BRI, which plateaued beyond a BRI of 7.2. This relationship was significant across different age and gender group.ConclusionThere is a positive association between abdominal obesity (as measured by BRI) and AAC in the middle-aged and elderly population. This suggests the impact of abdominal obesity on vascular health and that this factor should be considered in public health strategies.

It is commonly believed that in the debate on the Immaculate Conception of the Blessed Virgin Mary, representatives of the Order of St. Francis were supporters of the Marian privilege, while the Dominicans were against it. The aim of this article is to verify this opinion by analyzing selected Dominican homilies from the 13th –15th centuries, seeking answers to the questions: has the maculist position expressed by preachers been maintained over the centuries? What caused Dominicans to remain unchanged in their views, despite the gradual spread of the opinion about the Immaculate Conception of Mary, which was finally officially accepted by the Church? What role did Saint’s opinion play? Thomas Aquinas to the position of later Dominicans? The results of the analysis of medieval Dominican sermons allow us to consider the opinion that has so far been widespread as one-sided and superficial. The Dominican position is much more complex.

The present study aimed to examine the impact of the level of physical activity on prefrontal cortex activation in older adults during single- and dual-task walking. Thirty physically inactive and 36 active older adults (60–85 years old) performed six 2-min tasks on a treadmill: two static cognitive tasks, two single-task walking tests, and two dual-task walking tests. Hemodynamics at the level of the prefrontal cortex were measured continuously using functional near-infrared spectroscopy to evaluate cortical activation. The perceived difficulty of the task, cognitive performance, and gait parameters were also measured. During the walking tasks, the level of prefrontal cortex activation, the perceived difficulty of the task, cognitive performance, and motor parameters were not significantly different between active and inactive older adults. This unchanged activation with physical activity was likely the consequence of a similar motor and cognitive load and cardiorespiratory fitness in both active and inactive older adults. [ABSTRACT FROM AUTHOR]

Decreased muscle quality (MQ) may explain functional capacity impairments during aging. Thus, it is essential to verify the interaction between MQ and functional capacity in older adults. We investigated the relationship between MQ and functional capacity in older adults (n = 34; 66.3 ± 4.6 year). MQ was estimated by maximum strength of knee extensors normalized to thigh muscle mass. Maximum strength was assessed on an isokinetic dynamometer (peak torque), while dual-energy X-ray absorptiometry (DXA), ultrasonography, and anthropometry were used to determine thigh muscle mass. Functional capacity was verified by 30-s sit to stand and timed up and go tests. Significant correlations were found between MQ assessed by DXA with 30-s sit to stand (r =.35; p <.05) and timed up and go (r = −.47; p <.05), and MQ assessed by anthropometry with timed up and go (r = −.41; p <.05), but not between MQ assessed by ultrasonography with functional capacity (p >.05). No significant relationship between muscle mass with functional capacity was observed. Thus, MQ assessed by DXA and MQ assessed by anthropometry may partially explain functional capacity in older adults. Interestingly, muscle mass alone did not explain performance in functional tests in this population. [ABSTRACT FROM AUTHOR]

The relationship between inflammatory markers and bone turnover in adults is well known, and a negative association between cardiorespiratory fitness (CRF) and inflammatory markers has also been described. Hence, we tested whether the association between CRF and bone turnover markers is mediated by inflammatory markers in adults with metabolic syndrome. A total of 81 adults (58.5 ± 5.0 years, 62.7% women) were included in the analysis. CRF was measured by the 6-min walking test. Serum interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha, high-sensitivity c-reactive protein (hsCRP) and vascular endothelial growth factor, collagen type I cross-linked C-telopeptide, procollagen type I N-terminal propeptide (P1NP), and total osteocalcin were assessed using a sensitive ELISA kit. Body composition was assessed by dual-energy X-ray absorptiometry. Partial correlation was used to test the relationship between CRF, inflammatory markers, and bone turnover markers, controlling for sex, lean mass, and fat mass. Boot-strapped mediation procedures were performed, and indirect effects with confidence intervals not including zero were interpreted as statistically significant. CRF was positively correlated with P1NP levels (r =.228, p =.044) and osteocalcin levels (r =.296, p =.009). Furthermore, CRF was positively correlated with IL-1β levels (r =.340, p =.002) and negatively correlated with hsCRP levels (r = −.335, p =.003), whereas IL-1β levels were positively correlated with P1NP levels (r =.245, p =.030), and hsCRP levels were negatively correlated with P1NP levels (r = −.319, p =.004). Finally, the association between CRF and P1NP levels was totally mediated by hsCRP (percentage of mediation = 39.9). Therefore, CRF benefits on bone formation could be dependent on hsCRP concentrations in this population. [ABSTRACT FROM AUTHOR]

The aim of this study was to translate and culturally adapt the Fear of Falling Avoidance Behavior Questionnaire (FFABQ) into Brazilian–Portuguese (FFABQ-B), and to examine its reliability and validity in Brazilian older adults. The FFABQ-B was translated and tested in 10 Brazilian older adults. We assessed 52 community-dwellers, 68.7 (±6.2) years, using the FFABQ-B, BERG Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, 6-Minute Walk Test, Timed Up and Go test, and activity monitor. Internal consistency, test–retest reliability, construct validity, and floor and ceiling effects were analyzed. The FFABQ-B had adequate internal consistency (Cronbach's α =.90) and test–retest reliability (intraclass correlation coefficient =.81; 95% confidence interval [.68,.90]). The FFABQ-B was associated with 6-Minute Walk Test, Timed Up and Go, BERG Balance Scale, physical activity time (p <.05), Activities-specific Balance Confidence scale, and Falls Efficacy Scale (p <.001). The FFABQ-B is both reliable and valid to assess avoidance behavior in activities and participation due to fear of falling in Brazilian community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Background: Sleep is one of the most important psychological and physiological processes for brain function and mental health that control human health. Sleep quality is essential in middle-aged society, and sleep problems in this society are recognized as a main risk factor for mental and physical health problems. So far, the effectiveness of various treatments have been performed to improve sleep quality in middle-aged people, but no study has compared cognitive behavioral therapy and acceptance and commitment therapy. Aims: The present study was conducted with the aim of comparing the effectiveness of cognitive behavioral therapy and acceptance and commitment-based therapy on improving insomnia in middle-aged people. Methods: The research method was experimental with a pre-test and post-test design with a control group and a three-month follow-up. The statistical population of this research included all middle-aged men and women suffering from insomnia who referred to health centers in Hamedan city in 2022. 60 people were selected as available sampling and randomly divided into 3 groups of 20 people (two experimental groups and one control group), cognitive behavioral therapy, commitment and acceptance therapy and control group. The measurement tool in this research was the insomnia disorder questionnaire of Homai Maaz et al. (2023). The experimental groups were subjected to cognitive behavioral therapy based on acceptance and commitment for 9 sessions of 75 minutes respectively, and the control group received the usual treatment. Results: The findings showed that after the intervention, both treatment methods improved the insomnia disorder compared to the control group, and the treatment results were maintained in the follow-up period (p

Abstract Light and moderate alcohol use has been reported to be associated with both impaired and enhanced cognition. The purpose of this study was to explore whether there was a linear relationship between visual memory and alcohol consumption in males and females in a large middle-aged birth cohort population in cross-sectional and longitudinal settings. Data were collected from 5585 participants completing 31-year (1997–1998) and 46-year (2012–2014) follow-ups including Paired Associate Learning (PAL) test at 46-years follow-up. The participants were originally from 12,231 study population of the Northern Finland Birth Cohort 1966 (NFBC1966). The PAL test was conducted to assess visual memory. Reported alcohol use was measured as total daily use of alcohol, beer, wine, and spirits converted into grams and as frequency and amount of use of beer, wine, and spirits. The total daily alcohol use was not associated with reduced visual memory. The frequency of use of beer and wine in males was associated with better visual memory in cross-sectional and longitudinal settings. Using six or more servings of spirits was associated with worse visual memory in males in cross-sectional and longitudinal settings. The study suggested a lack of a linear association between drinking and visual memory in the middle-aged population.

This study explored how personality and serious leisure activities, such as playing pickleball, contribute to eudaimonic well-being in middle-aged and older adults. Data were collected at pickleball events at the 2017 Huntsman World Senior Games from a convenience sample of 250 players aged between 50 and 91 years (M = 65.11, SD = 7.49). Of the five personality dispositions examined, conscientiousness (β = 0.32, p <.001), neuroticism (β = −0.22, p <.01), and openness to experience (β = 0.18, p <.01) were discovered to be significant predictors of eudaimonic well-being. Serious leisure also contributed to eudaimonic well-being (β = 0.28, p <.01). The findings of this study enhance the understanding of the behaviors exhibited by older adults and elucidate the positive impact exerted on eudaimonic well-being by personality and serious leisure. [ABSTRACT FROM AUTHOR]

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate–vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p =.007). There were no statistical differences between frequent exercise status for other health care expenditure types (p >.05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not. [ABSTRACT FROM AUTHOR]

Background: Propofol is effective and used as a kind of routine anesthetics in procedure sedative anesthesia (PSA) for ureteroscopy. However, respiratory depression and unconscious physical activity always occur during propofol-based PSA, especially in elderly patients. Esketamine has sedative and analgesic effects but without risk of cardiorespiratory depression. The purpose of this study is to investigate whether esketamine can reduce the propofol median effective dose (ED50) for successful ureteroscope insertion in elderly male patients. Materials and methods: 49 elderly male patients undergoing elective rigid ureteroscopy were randomly divided into two groups: SK Group (0.25 mg/kg esketamine+propofol) and SF Group (0.1 µg/kg sufentanil+propofol). Patients in both two groups received propofol with initial bolus dose of 1.5 mg/kg after sufentanil or esketamine was administered intravenously. The effective dose of propofol was assessed by a modified Dixon's up-and-down method and then was adjusted with 0.1 mg/kg according to the previous patient response. Patients' response to ureteroscope insertion was classified as "movement" or "no movement". The primary outcome was the ED50 of propofol for successful ureteroscope insertion with esketamine or sufentanil. The secondary outcomes were the induction time, adverse events such as hemodynamic changes, hypoxemia and body movement were also measured. Result: 49 patients were enrolled and completed this study. The ED50 of propofol for successful ureteroscope insertion in SK Group was 1.356 ± 0.11 mg/kg, which was decreased compared with that in SF Group, 1.442 ± 0.08 mg/kg (P = 0.003). The induction time in SK Group was significantly shorter than in SF Group (P = 0.001). In SK Group, more stable hemodynamic variables were observed than in SF Group. The incidence of AEs between the two groups was not significantly different. Conclusion: The ED50 of propofol with esketamine administration for ureteroscope insertion in elderly male patients is 1.356 ± 0.11 mg/kg, significantly decreased in comparsion with sufentanil. Trial registration: Chinese Clinical Trial Registry, No: ChiCTR2300077170. Registered on 1 November 2023. Prospective registration. http://www.chictr.org.cn. [ABSTRACT FROM AUTHOR]

Background: Triglyceride and glucose (TyG) index, a surrogate marker of insulin resistance, has been validated as a predictor of cardiovascular disease. However, effects of TyG-related indices combined with obesity markers on cardiovascular diseases remained unknown. We aimed to investigate the associations between TyG index and modified TyG indices with new-onset cardiovascular disease and the time-dependent predictive capacity using a national representative cohort. Methods: This study is a retrospective observational cohort study using data from China Health and Retirement Longitudinal Study (CHARLS) of 7 115 participants. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The modified TyG indices were developed combining TyG with body mass index (BMI), waist circumference (WC) and waist-to‐height ratio (WHtR). We used adjusted Cox proportional hazards regression to analyze the association and predictive capacity based on hazard ratio (HR) and Harrell's C‐index. Results: Over a 7-year follow‐up period, 2136 participants developed cardiovascular disease, including 1633 cases of coronary heart disease and 719 cases of stroke. Compared with the lowest tertile group, the adjusted HR (95% CI) for new-onset cardiovascular disease in the highest tertile for TyG, TyG-BMI, TyG-WC, and TyG-WHtR were 1.215 (1.088–1.356), 1.073 (0.967–1.191), 1.078 (0.970–1.198), and 1.112 (1.002–1.235), respectively. The C‐indices of TyG index for cardiovascular disease onset were higher than other modified TyG indices. Similar results were observed for coronary heart disease and stroke. Conclusion: TyG and TyG-WhtR were significantly associated with new-onset cardiovascular diseases, and TyG outperformed the modified TyG indices to identify individuals at risk of incident cardiovascular event. [ABSTRACT FROM AUTHOR]

Background: The prevalence of diabetes has increased rapidly, and comorbid chronic conditions are common among diabetes patients. However, little is known about the pattern of multimorbidity in diabetes patients and the effect on physical and cognitive function. This study aimed to assess the disease clusters and patterns of multimorbidity in diabetes patients using a novel latent class analysis (LCA) approach in middle-aged and older adults and explore the association between different clusters of multimorbidity in diabetes and the effect on physical and cognitive function. Methods: This national observational study included 1,985 diabetes patients from the four waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2011 to 2018. Thirteen chronic diseases were used in latent class analysis to identify the patterns of multimorbidity in diabetes, which span the cardiovascular, physical, psychological, and metabolic systems. Cognitive function is assessed via a structured questionnaire in three domains: memory, executive function, and orientation. We combined activities of daily living (ADL) with instrumental activities of daily living (IADL) to measure physical function. Linear mixed models and negative binomial regression models were used to analyze the association between patterns of multimorbidity in diabetes and the effect on cognitive function and disability, respectively. Results: A sample of 1,985 diabetic patients was identified, of which 1,889 (95.2%) had multimorbidity; their average age was 60.6 years (standard deviation (SD) = 9.5), and 53.1% were women. Three clusters were identified: "cardiometabolic" (n = 972, 51.5%), "mental-dyslipidemia-arthritis" (n = 584, 30.9%), and "multisystem morbidity" (n = 333, 17.6%). Compared with diabetes alone, the "multisystem morbidity" class had an increased association with global cognitive decline. All patterns of multimorbidity were associated with an increased risk of memory decline and disability; however, the "multisystem morbidity" group also had the strongest association and presented a higher ADL-IADL disability (ratio = 4.22, 95% CI = 2.52, 7.08) and decline in memory Z scores (β = 0.322, 95% CI = 0.550, 0.095, p = 0.0058). Conclusion: Significant longitudinal associations between different patterns of multimorbidity in diabetes patients and memory decline and disability were observed in this study. Future studies are needed to understand the underlying mechanisms and common risk factors for multimorbidity in diabetes patients and to propose treatments that are more effective. [ABSTRACT FROM AUTHOR]

This study evaluated the feasibility and safety of a telehealth delivered exercise plus plant-based protein diet in adults with non-alcoholic fatty liver disease (NAFLD). This was a 12-week, randomised controlled feasibility trial including twenty-eight adults aged > 45 years with NAFLD randomised to a home muscle strengthening program (3 d/week) with increased protein intake (target ∼1·2–1·5 g/kg/d) from predominately plant-based sources and behavioural change support (3–4 text messages/week) (Pro-Ex n 14) or usual care (UC, n 14). Feasibility was assessed via retention (≤ 10 % attrition), adherence (exercise ≥ 66 %; recommended daily protein serves ≥ 80 %) and safety (adverse events). Secondary outcomes included macronutrient intake (3 × 24-h records), weight, moderate-to-vigorous physical activity (MVPA) and 30 s sit-to-stand (STS) performance. Study retention was 89 %. Mean exercise adherence (Pro-Ex) was 52 % with one adverse event from 241 sessions. In Pro-Ex, mean daily plant protein serves increased (0·9 to 1·4/d) and animal protein decreased (1·5 to 1·2/d) after 12-weeks, but overall adherence (serves/day) was 32[RD1] % (plant) and 42 % (animal). Relative to UC, Pro-Ex experienced a mean 2·7 (95 % CI: 0·9, 4·4) increase in 30 s STS number, 46-minute (95 % CI: −153, 245) increase in MVPA, 1·7 kg (95 % CI: −3·5, 0·2) decrease in weight, 35·2 g (95 % CI: 11·0, 59·3) increase in protein. In adults with NAFLD a telehealth home exercise and dietary intervention was safe and improved habitual plant and animal protein intake, but overall adherence was modest suggesting more intensive healthcare support may be required. [ABSTRACT FROM AUTHOR]

Background: Afforestation of non-forestland is a new measure by the European Union to enhance climate mitigation and biodiversity. Hybrid aspen (Populus tremula L. × P. tremuloides Michx.) is among the suitable tree species for afforestation to produce woody biomass. However, the best performing genotypic material for intensive biomass production and its physiological adaptation capacity is still unclear. We compared 22 hybrid aspen genotypes growth and leaf physiological characteristics (stomatal conductance, net photosynthesis, intrinsic water-use efficiency) according to their geographical north- or southward transfer (European P. tremula parent from 51° to 60° N and North American P. tremuloides parent from 45° to 54° N) to hemiboreal Estonia (58° N) in a completely randomized design progeny trial. We tested whether the growth ranking of genotypes of different geographical origin has changed from young (3-year-old) to mid-rotation age (13-year-old). The gas exchange parameters were measured in excised shoots in 2021 summer, which was characterised with warmer (+ 4 °C) and drier (17% precipitation from normal) June and July than the long-term average. Results: We found that the northward transfer of hybrid aspen genotypes resulted in a significant gain in growth (two-fold greater diameter at breast height) in comparison with the southward transfer. The early selection of genotypes was generally in good accordance with the middle-aged genotype ranking, while some of the northward transferred genotypes showed improved growth at the middle-age period in comparison with their ranking during the early phase. The genotypes of southward transfer demonstrated higher stomatal conductance, which resulted in higher net photosynthesis, and lower intrinsic water-use efficiency (iWUE) compared with northward transfer genotypes. However, higher photosynthesis did not translate into higher growth rate. The higher physiological activity of southern transferred genotypes was likely related to a better water supply of smaller and consequently more shaded trees under drought. Leaf nitrogen concentration did not have any significant relation with tree growth. Conclusions: We conclude that the final selection of hybrid aspen genotypes for commercial use should be done in 10–15 years after planting. Physiological traits acquired during periods of droughty conditions may not fully capture the growth potential. Nonetheless, we advocate for a broader integration of physiological measurements alongside traditional traits (such as height and diameter) in genotype field testing to facilitate the selection of climate-adapted planting material for resilient forests. [ABSTRACT FROM AUTHOR]

Presbycusis is one of the most prevalent disabilities in aged populations of industrialized countries. As we age less excitation reaches the central auditory system from the periphery. To compensate, the central auditory system [e.g., the inferior colliculus (IC)], downregulates GABAergic inhibition to maintain homeostatic balance. However, the continued downregulation of GABA in the IC causes a disruption in temporal precision related to presbycusis. Many studies of age-related changes to neurotransmission in the IC have therefore focused on GABAergic systems. However, we have discovered that dense core vesicles (DCVs) are significantly upregulated with age in the IC. DCVs can carry neuropeptides, co-transmitters, neurotrophic factors, and proteins destined for the presynaptic zone to participate in synaptogenesis. We used immuno transmission electron microscopy across four age groups (3-month; 19-month; 24-month; and 28-month) of Fisher Brown Norway rats to examine the ultrastructure of DCVs in the IC. Tissue was stained post-embedding for GABA immunoreactivity. DCVs were characterized by diameter and by the neurochemical profile (GABAergic/non-GABAergic) of their location (bouton, axon, soma, and dendrite). Our data was collected across the dorsolateral to ventromedial axis of the central IC. After quantification, we had three primary findings. First, the age-related increase of DCVs occurred most robustly in non-GABAergic dendrites in the middle and low frequency regions of the central IC during middle age. Second, the likelihood of a bouton having more than one DCV increased with age. Lastly, although there was an agerelated loss of terminals throughout the IC, the proportion of terminals that contained at least one DCV did not decline. We interpret this finding to mean that terminals carrying proteins packaged in DCVs are spared with age. Several recent studies have demonstrated a role for neuropeptides in the IC in defining cell types and regulating inhibitory and excitatory neurotransmission. Given the age-related increase of DCVs in the IC, it will be critical that future studies determine whether (1) specific neuropeptides are altered with age in the IC and (2) if these neuropeptides contribute to the loss of inhibition and/or increase of excitability that occurs during presbycusis and tinnitus. [ABSTRACT FROM AUTHOR]

Background: Low social participation is a potentially modifiable risk factor for cognitive deterioration in the general population and related to lower quality of life (QoL). We aimed to find out whether social participation is linked to cognitive deterioration and QoL for people with borderline intellectual functioning and mild intellectual disability. Method: We used data from the National Child Development Study, consisting of people born during one week in 1958, to compare midlife social participation in people with mild intellectual disability, borderline intellectual functioning, and without intellectual impairment. We defined social participation as 1. confiding/emotional support from the closest person and social network contact frequency at age 44, and 2. confiding relationships with anyone at age 50. We then assessed the extent to which social participation mediated the association between childhood intellectual functioning and cognition and QoL at age 50. Results: 14,094 participants completed cognitive tests at age 11. People with borderline intellectual functioning and mild intellectual disability had more social contact with relatives and confiding/emotional support from their closest person, but fewer social contacts with friends and confiding relationships with anyone than those without intellectual disability. Having a confiding relationship partially mediated the association at age 50 between IQ and cognition (6.4%) and QoL (27.4%) for people with borderline intellectual functioning. Conclusion: We found adults with intellectual disability have positive family relationships but fewer other relationships. Even at the age of 50, confiding relationships may protect cognition for people with borderline intellectual functioning and are important for QoL. [ABSTRACT FROM AUTHOR]

Sensory processing sensitivity (SPS), linked with a penchant for the arts and creativity, exerts its bivalent influences, contingent on context, on individuals' health-related outcomes. But little is known about how it interacts with creative self-concept (CSC). Focusing on the role of SPS, this study identified risk and protective factors of resilience among artistically inclined individuals from middle to later life during the coronavirus 2019 (COVID-19) restriction period and examined the interaction effect between SPS and CSC on depression. Two stages of analyses were pursued. Stage 1 identified factors associated with resilience by using regression and profile analyses on data from 224 anonymized respondents from middle to third age (Mage = 54.08, SD = 10.08, range = 40–84) with diverse disciplinary backgrounds in visual arts. Stage 2 examined the influence of SPS on the relationship between CSC and depression. SPS, lack of peer support of shared interests in the arts, and depression emerged as risk factors associated with lower levels of resilience. The profiles of SPS components among the relatively high and low resilience groups were found to be divergent. The effects of CSC on depression were contingent upon SPS, controlling for neuroticism. The findings call for future research to examine the differential correlational patterns among the SPS components and neuroticism across different populations. The risk/protective factors and patterns found in this study provide directions for research in SPS and applied work to support artistically inclined individuals from middle to later life. [ABSTRACT FROM AUTHOR]

Prior studies of perceived stress and mortality have yielded mixed results, but most are based on one-time measurements of perceived stress. We use daily diary data from the Midlife in the United States study to measure exposure to stressors and perceived severity of stress and investigate their associations with mortality. We also explore whether the associations vary by age and assess whether the associations are stronger for extrinsic than intrinsic mortality, which is more likely to be aging-related. The analysis included 4,756 observations for 2,915 respondents aged 21–95 who participated in at least one of three waves (1996–97, 2004–09, 2017–19) of the National Study of Daily Experiences. Participants reported daily stressors and perceived severity on 8 consecutive evenings at each wave. Mortality was followed through December 31, 2021. In fully-adjusted models, daily exposure to stressors was associated with mortality, but only at younger ages (HR = 1.20 per SD at age 50, 95% CI: 1.01‒1.42). The association was slightly stronger for extrinsic (HR = 1.31 per SD at age 50, 95% CI: 1.01‒1.69) than for intrinsic mortality, which was not significant (HR = 1.24 per SD at age 50, 95% CI: 0.98‒1.56). When we used an alternative measure of daily perceived severity of stress, the demographic-adjusted association appeared to be similar in magnitude, but after careful adjustment for potential confounding with health status, the association weakened and was no longer statistically significant (HR = 1.17 per SD at age 50, 95% CI: 0.99–1.37). Perceived severity was not significantly associated with either extrinsic or intrinsic mortality even at age 50. Most Americans die at older ages, where stress exposure does not appear to be significantly associated with mortality. Nonetheless, our results suggest that stress exposure is more strongly associated with midlife mortality, which has an undue influence on overall life expectancy. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Introduction: Wrist-worn activity monitors have seen widespread adoption in recent times, particularly in young and sport-oriented cohorts, while their usage among older adults has remained relatively low. The main limitations are in regards to the lack of medical insights that current mainstream activity trackers can provide to older subjects. One of the most important research areas under investigation currently is the possibility of extrapolating clinical information from these wearable devices. Methods: The research question of this study is understanding whether accelerometry data collected for 7-days in free-living environments using a consumer-based wristband device, in conjunction with data-driven machine learning algorithms, is able to predict hand grip strength and possible conditions categorized by hand grip strength in a general population consisting of middle-aged and older adults. Results: The results of the regression analysis reveal that the performance of the developed models is notably superior to a simple mean-predicting dummy regressor. While the improvement in absolute terms may appear modest, the mean absolute error (6.32 kg for males and 4.53 kg for females) falls within the range considered sufficiently accurate for grip strength estimation. The classification models, instead, excel in categorizing individuals as frail/pre-frail, or healthy, depending on the T-score levels applied for frailty/pre-frailty definition. While cut-off values for frailty vary, the results suggest that the models can moderately detect characteristics associated with frailty (AUC-ROC: 0.70 for males, and 0.76 for females) and viably detect characteristics associated with frailty/pre-frailty (AUC-ROC: 0.86 for males, and 0.87 for females). Conclusions: The results of this study can enable the adoption of wearable devices as an efficient tool for clinical assessment in older adults with multimorbidities, improving and advancing integrated care, diagnosis and early screening of a number of widespread diseases. [ABSTRACT FROM AUTHOR]

Background: Elevated FSH often occurs in women of advanced maternal age (AMA, age ≥ 35) and in infertility patients undergoing controlled ovarian stimulation (COS). There is controversy on whether high endogenous FSH contributes to infertility and whether high exogenous FSH adversely impacts patient pregnancy rates. Methods: The senescence-accelerated mouse-prone-8 (SAMP8) model of female reproductive aging was employed to assess the separate impacts of age and high FSH activity on the percentages (%) of viable and mature ovulated oocytes recovered after gonadotropin treatment. Young and midlife mice were treated with the FSH analog equine chorionic gonadotropin (eCG) to model both endogenous FSH elevation and exogenous FSH elevation. Previously we showed the activin inhibitor ActRIIB:Fc increases oocyte quality by preventing chromosome and spindle misalignments. Therefore, ActRIIB:Fc treatment was performed in an effort to increase % oocyte viability and % oocyte maturation. Results: The high FSH activity of eCG is ootoxic to ovulatory oocytes, with greater decreases in % viable oocytes in midlife than young mice. High FSH activity of eCG potently inhibits oocyte maturation, decreasing the % of mature oocytes to similar degrees in young and midlife mice. ActRIIB:Fc treatment does not prevent eCG ootoxicity, but it restores most oocyte maturation impeded by eCG. Conclusions: FSH ootoxicity to ovulatory oocytes and FSH maturation inhibition pose a paradox given the well-known pro-growth and pro-maturation activities of FSH in the earlier stages of oocyte growth. We propose the FOOT Hypothesis ("FSH OoToxicity Hypothesis), that FSH ootoxicity to ovulatory oocytes comprises a new driver of infertility and low pregnancy success rates in DOR women attempting spontaneous pregnancy and in COS/IUI patients, especially AMA women. We speculate that endogenous FSH elevation also contributes to reduced fecundity in these DOR and COS/IUI patients. Restoration of oocyte maturation by ActRIB:Fc suggests that activin suppresses oocyte maturation in vivo. This contrasts with prior studies showing activin A promotes oocyte maturation in vitro. Improved oocyte maturation with agents that decrease endogenous activin activity with high specificity may have therapeutic benefit for COS/IVF patients, COS/IUI patients, and DOR patients attempting spontaneous pregnancies. [ABSTRACT FROM AUTHOR]

SCANDINAVIAN ARTEFACTS FROM THE VIKING AGE ONWARDS are found in Slavic areas, suggesting interactions between Slavs and Scandinavians. In this paper, whetstones from present-day Norway are regarded as a proxy for this contact, and three different locations within the Oder estuary district in present-day north-western Poland are investigated, the Viking-Age town of Wolin, Szczecin Castle Hill and Lubin Stronghold. Geological characterisation and analysis of whetstones indicate that from the 9th/10th to the 13th centuries, whetstones at these sites were largely imported from quarries in present-day Norway, from Mostadmarka in Trøndelag and Eidsborg in Telemark. A reliance on distantly sourced products among Slavic people is demonstrated, and despite cultural and linguistic differences there seem to have been long-lasting networks between Norse and Slavic areas through the centuries. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the impact of pension on depressive symptoms among Chinese older adults. Additional effort is made to test the mediating effect of multidimensional downward intergenerational support and the moderating effect of age on this relationship. Methods: A total of 1828 Chinese older community‐dwellers who met our inclusion criteria are drawn from the 2018 China Health and Retirement Longitudinal Study. Multivariate regression modeling is applied to analyze the effect of pensions on depressive symptoms of older adults. Additionally, bootstrap method with resampling strategies is used to estimate the mediating effect of three dimensions of downward intergenerational support (instrumental, emotional, and financial support). Further, Johnson‐Neyman technique is employed to analysis and visualize the moderating effect of age. Results: The findings reveal a significant inverse relationship between pension levels and depressive symptoms (B = −6.664, SE = 2.826, p < 0.05). The analysis shows that downward intergenerational emotional support (B = −0.195, Boot SE = 0.103, 95% Boot CI [−0.404, −0.003]) serves as a partial mediator in this relationship. Furthermore, the results highlight the moderating role of age in the linkage between pension and depressive symptoms (B = 0.065, SE = 0.039, p < 0.1). Discussion: This investigation is pioneering in simultaneously assessing the mediating role of multidimensional downward intergenerational support and the moderating effect of age in the context of pension and depressive symptoms. The study underscores the necessity of an interdisciplinary approach in devising comprehensive intervention strategies. These should encompass pension policy consultation, respite services, and other crucial elements aimed at mitigating the severity or reducing the risk of depressive symptoms among the older adults. Key points: We discovered a moderating effect of age on the relationship between pension benefits and depressive symptoms in older adults, and further elucidated this effect using the Johnson‐Neyman method.Concurrently, we employed bootstrapping methods to validate the mediating effect of downward intergenerational support between pension benefits and depressive symptoms in older adults. [ABSTRACT FROM AUTHOR]

Purpose: Visual impairment, hearing impairment, and masticatory discomfort each influence quality of life (QoL). However, little is known regarding the impact of their coexistence on QoL. Therefore, we aimed to investigate the influence of the coexistence of visual impairment, hearing impairment, and masticatory discomfort on QoL among middle-aged adults aged 40-64. Methods: This study involved a secondary data analysis utilizing the data from years 1 and 2 of the eighth Korea National Health and Nutrition Examination Survey. To evaluate the influence of the coexistence of visual impairment, hearing impairment, and masticatory discomfort on QoL, we conducted a complex sample hierarchical multiple regression analysis. Results: When visual impairment, hearing impairment, and masticatory discomfort coexisted, the QoL was significantly lower than in individuals without any of these conditions. Conclusion: The coexistence of visual impairment, hearing impairment, and masticatory discomfort was negatively correlated with QoL. Therefore, it is important to prepare for old age through appropriate health management during middle age. [ABSTRACT FROM AUTHOR]

Crime is often considered a behavior of teenagers and young adults, peaking in adolescence, and declining with age. A growing body of research, however, has demonstrated that the age–crime relationship is neither universal, as the contours of the age–crime distribution vary across countries, nor uniform, as it varies over time. We argue that the dynamics of the age–crime relationship can best be understood through a lens situating birth cohorts within the broader sociohistorical contexts in which they enter their formative years. We apply this framework to the Republic of Korea, a country that has experienced rapid demographic transitions accompanied by decades of economic development and social upheaval after the Korean War. Our findings suggest that the age–crime distribution in Korea has shifted substantially since the mid‐1970s, moving from the quintessential age–crime curve characteristic of Western countries to one in which the modal age at arrest is now concentrated in middle age. We find that much of this change can be attributed to the aging of a specific birth cohort—the 86 generation—whose members were dually disadvantaged by being born during a fertility boom and entering young adulthood during the pro‐democracy student movements in the 1980s. [ABSTRACT FROM AUTHOR]

This study examined the moderating role of perceived community belonging in the relationship between childhood abuse and health and well-being outcomes among Canadian individuals aged 55 and older. Using data from the 2014 Canadian General Social Survey (n = 14,416), multiple linear regression models revealed that women who experienced either childhood physical or sexual abuse reported poorer self-rated general and mental health, as well as lower life satisfaction, compared to those without such histories. The most pronounced effects were observed among women who experienced both types of abuse. For men, a similar pattern was evident only for those who experienced childhood physical abuse. Notably, among women, a strong sense of community belonging lessened the negative effects of both types of childhood abuse on all examined outcomes. These findings underscore the protective role of perceived community belonging against the consequences of childhood abuse for older women. They illuminate the crucial role of gerontological social workers and scholars in promoting community integration and support. Focusing on these areas, especially for those with traumatic histories, can potentially improve their overall health and well-being. [ABSTRACT FROM AUTHOR]

Middle-aged adults typically play multiple roles with centralized responsibility for younger and older persons. Midlife health and well-being impact the state of aging in later years. Limited studies have investigated midlife experiences from the perspective of the middle-aged group themselves. This paper presents a systematic review of middle-aged women's perceptions and experiences of midlife through a qualitative synthesis. Systematic databases searches resulted in 938 articles. Six selected articles were analyzed and three core themes were identified using thematic analysis: heightened awareness of lifespan, expectation of establishment and freedom from expectations, clarity of values, and self-acceptance. The findings showed the interconnected and progressive nature of midlife experiences toward a hoped for sense of congruence, revealing its connectivity to subsequent life stages and importance for healthy development. Credible and relevant information need to be provided as resources for the middle-aged women themselves and pertinent healthcare professionals. Proper information is also needed to address stereotypes, educate the public and equip relevant educators with evidence-based knowledge. Further research on midlife experiences in general from the perspective of middle-aged males, and in diverse settings is recommended. [ABSTRACT FROM AUTHOR]

The relationship between exercise‐induced troponin elevation and non‐obstructive coronary artery disease (CAD) is unclear. This observational study assessed non‐obstructive CAD's impact on exercise‐induced cardiac Troponin I (cTnI) elevation in middle‐aged recreational athletes. cTnI levels of 40 well‐trained recreational athletes (73% males, 50 ± 9 years old) were assessed by a high‐sensitive cTnI assay 24 h before, and at 3 and 24 h following two high‐intensity exercises of different durations; a cardiopulmonary exercise test (CPET), and a 91‐km mountain bike race. Workload was measured with power meters. Coronary computed tomography angiography was used to determine the presence or absence of non‐obstructive (<50% obstruction) CAD. A total of 15 individuals had non‐obstructive CAD (Atherosclerotic group), whereas 25 had no atherosclerosis (normal). There were higher post‐exercise cTnI levels following the race compared with CPET, both at 3 h (77.0 (35.3–112.4) ng/L vs. 11.6 (6.4–22.5) ng/L, p < 0.001) and at 24 h (14.7 (6.7–16.3) vs. 5.0 (2.6–8.9) ng/L, p < 0.001). Absolute cTnI values did not differ among groups. Still, the association of cTnI response to power output was significantly stronger in the CAD versus Normal group both at 3 h post‐exercise (Rho = 0.80, p < 0.001 vs. Rho = −0.20, p = 0.33) and 24‐h post‐exercise (Rho = 0.87, p < 0.001 vs. Rho = −0.13, p = 0.55). Exercise‐induced cTnI elevation was strongly correlated with exercise workload in middle‐aged athletes with non‐obstructive CAD but not in individuals without CAD. This finding suggests that CAD influences the relationship between exercise workload and the cTnI response even without coronary artery obstruction. [ABSTRACT FROM AUTHOR]

Introduction: Age‐related decline in physical functioning has significant implications for health in later life but declines begin earlier in midlife. Physical activity (PA) volume is associated with physical function, but the importance of the pattern in which PA is accumulated is unclear. This study investigates associations between patterns of PA accumulation, including the composition, variation, and temporal distribution of upright and stepping events, with physical function in midlife. Methods: Participants (n = 4378) from the 1970 British Cohort Study wore an activPAL3 accelerometer on the thigh for 7 consecutive days. Exposure measures included a suite of metrics describing the frequency, duration, and composition of upright events, as well as the duration and volume (total steps) of stepping events. In addition, patterns of accumulation of upright and sedentary events were examined including how fragmented/transient they were (upright‐to‐sedentary transition probability [USTP]) and their burstiness (the tendency for events to be clustered together followed by longer interevent times). Physical function outcomes included grip strength (GS), balance, and SF‐36 physical functioning subscale (SF‐36pf). Cross‐sectional analyses included multivariable linear regression models to assess associations, adjusting for covariates including overall PA volume (mean daily step count). Results: Higher upright event burstiness was associated with higher GS, and higher USTP was associated with lower GS. Duration and step volume of stepping events were positively associated with SF‐36pf in females. Step‐weighted cadence was positively associated with SF‐36pf and balance. Contradictory findings were also present (e.g., more transient stepping events were associated with better GS) particularly for GS in males. Inconsistencies between sexes were observed across some associations. Conclusion: Our study reveals that diverse patterns of PA accumulation exhibit distinct associations with various measures of physical function in midlife, irrespective of the overall volume. Contradictory findings and inconsistency between sexes warrant further investigation. Patterns of PA accumulation, in addition to volume, should be considered in future PA research. Longitudinal studies are required to determine whether a given volume of activity accumulated in different patterns, impacts associations between PA and health outcomes. [ABSTRACT FROM AUTHOR]

Aging is associated with a wide range of physiological and behavioral changes in many species. Zebrafish, like humans, rodents, and birds, exhibits gradual senescence, and thus may be a useful model organism for identifying evolutionarily conserved mechanisms related to aging. Here, we compared behavior in the novel tank test of young (6-month-old) and middle aged (12-month-old) zebrafish from two strains (TL and TU) and both sexes. We find that this modest age difference results in a reduction in locomotor activity in male fish. We also found that background strain modulated the effects of age on predator avoidance behaviors related to anxiety: older female TL fish increased bottom dwelling whereas older male TU fish decreased thigmotaxis. Although there were no consistent effects of age on either short-term (within session) or long-term (next day) habituation to the novel tank, strain affected the habituation response. TL fish tended to increase their distance from the bottom of the tank whereas TU fish had no changes in bottom distance but instead tended to increase thigmotaxis. Our findings support the use of zebrafish for the study of how age affects locomotion and how genetics interacts with age and sex to alter exploratory and emotional behaviors in response to novelty. [ABSTRACT FROM AUTHOR]

In our series of studies, the changes in the skin characteristics of mice caused by aging were investigated in correlation with the stem cells for keratinocytes and melanocytes in the natural hair cycle until middle age. The aim of the present review was to investigate these characteristics of hair follicles (HFs) at older age and complete the analysis of these changes as a study throughout the mouse lifetime. In addition, stem cells for keratinocytes and melanocytes were evaluated for changes in skin characteristics caused by aging. Postnatal day 200 (P200) appears to be the age of complete maturation of skin and the onset of aging with regard to HFs. Keratin 15-positive keratinocyte stem cells complete their localization as a quantitatively sufficient amount of progenitor in the hair bulge region and orchestrate the regeneration of hairs in every anagen phase thereafter. Although their frequency is low, an unusual structure of HFs, curved HFs, appear for the first time at P200. Thereafter, abnormal hair curvature continues to increase throughout life. In contrast, HF characteristics derived from melanocytes begin to show a high frequency of hypopigmented hair bulbs at P200 and appear to lead to a significant increase in the number of white hairs. Curved HFs and white hairs were considered biomarkers of aging in mice. The number of tyrosinase-related protein 2-positive melanocyte stem cells in the hair bulge is extremely low and may be one cause underlying not only the induction of melanocyte-derived characteristics by aging but possibly also that of keratinocyte-derived characteristics. These results provide insight into the mechanisms of the actions of stem cells on hair regeneration through the aging process. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD)-related mortality has declined substantially in the United Kingdom (UK) in recent decades, but the continued relevance of conventional risk factors for prediction of CVD mortality throughout the life-course is uncertain. We compared the 10-year risks and lifetime risks of CVD mortality associated with conventional risk factors recorded in middle and old age. The Whitehall study was a prospective study of 19,019 male London civil servants (mean age 52 years) when enrolled in 1967–1970 and followed-up for 50 years for cause-specific mortality. In 1997, 7044 (83%) survivors (mean age 77 years) were re-surveyed. The 10-year and lifetime risks of CVD mortality were estimated by levels of CVD risk factors recorded in middle-age and old-age, respectively. By July 2020, 97% had died (22%, 51% and 80% before age 70, 80 and 90 years, respectively) and 7944 of 17,673 deaths (45%) were from CVD. The 10-year and lifetime risks of CVD death increased linearly with higher levels of CVD risk factors recorded in middle-age and in old-age. Individuals in the top versus bottom 5% of CVD risk scores in middle age had a 10.3% (95% CI:7.2–13.4) vs 0.6% (0.1–1.2) 10-year risk of CVD mortality, a 61.4% (59.4–65.3) vs 31.3% (24.1–34.5) lifetime risk of CVD mortality and a 12-year difference in life expectancy from age 50 years. The corresponding differences using a CVD risk score in old-age were 11.0% (4.4–17.5) vs 0.8% (0.0–2.2) for 10-year risk and 42.1% (28.2–50.0) vs 30.3% (6.0–38.0) for lifetime risk of CVD mortality and a 6-year difference in life expectancy from age 70 years. Conventional risk factors remained highly predictive of CVD mortality and life expectancy through the life-course. The findings highlight the relevance of estimation of both lifetime risks of CVD and 10-year risks of CVD for primary prevention of CVD. [ABSTRACT FROM AUTHOR]

Cerebrovascular reactivity (CVR) decreases with advancing age, contributing to increased risk of cognitive impairment; however, the mechanisms underlying the age-related decrease in CVR are incompletely understood. Age-related changes to T cells, such as impaired mitochondrial respiration, increased inflammation, likely contribute to peripheral and cerebrovascular dysfunction in animals. However, whether T-cell mitochondrial respiration is related to cerebrovascular function in humans is not known. Therefore, we hypothesized that peripheral T-cell mitochondrial respiration would be positively associated with CVR and that T-cell glycolytic metabolism would be negatively associated with CVR. Twenty middle-aged adults (58 ± 5 yr) were recruited for this study. T cells were separated from peripheral blood mononuclear cells. Cellular oxygen consumption rate (OCR) and extracellular acidification rate (ECAR, a marker of glycolytic activity) were measured using extracellular flux analysis. CVR was quantified using the breath-hold index (BHI), which reflects the change in blood velocity in the middle-cerebral artery (MCAv) during a 30-s breath-hold. In contrast to our hypothesis, we found that basal OCR in CD8+ T cells (β = −0.59, R² = 0.27, P = 0.019) was negatively associated with BHI. However, in accordance with our hypothesis, we found that basal ECAR (β = −2.20, R² = 0.29, P = 0.015) and maximum ECAR (β = −50, R² = 0.24, P = 0.029) were negatively associated with BHI in CD8+ T cells. There were no associations observed in CD4+ T cells. These associations appeared to be primarily mediated by an association with the pressor response to the breath-hold test. Overall, our findings suggest that CD8+ T-cell respiration and glycolytic activity may influence CVR in humans. NEW & NOTEWORTHY Peripheral T-cell metabolism is related to in vivo cerebrovascular reactivity in humans. Higher glycolytic metabolism in CD8+ T cells was associated with lower cerebrovascular reactivity to a breath-hold in middle-aged adults, which is possibly reflective of a more proinflammatory state in midlife. [ABSTRACT FROM AUTHOR]

Objectives: The immediate living environment might, like other lifestyle factors, be significantly related to mental well‐being. The current study addresses the question whether five relevant subjective home environment variables (i.e., protection from disturbing nightlight, daylight entering the home, safety at home, quality of window views, and noise disturbance) are associated with levels of self‐reported depression over and above well‐known sociodemographic and common lifestyle variables. Methods: Data from the Hamburg City Health Study (HCHS) were analyzed. In N = 8757 with available PHQ‐9 depression data, multiple linear regression models were computed, with demographic data, lifestyle variables, and variables describing the subjective evaluation of the home environment. Results: The model explained 15% of variance in depression levels, with ratings for the subjective evaluation of home environment accounting for 6%. Better protection from disturbing light at night, more daylight entering the home, feeling safer, and perceived quality of the window views, were all significantly associated with lower, while more annoyance by noise was associated with higher levels of self‐reported depression. Results did not differ if examining a sample of the youngest (middle‐aged participants: 46−50 years) versus oldest (70−78 years) participants within HCHS. Conclusion: Beyond studying the role of lifestyle factors related to self‐reported depression, people's homes may be important for subclinical levels of depression in middle and older age, albeit the direction of effects or causality cannot be inferred from the present study. The development of a consensus and tools for a standardized home environment assessment is needed. [ABSTRACT FROM AUTHOR]

When effective treatments against neurodegenerative diseases become a reality, it will be important to know the age these pathologies begin to develop. We investigated alpha‐synuclein pathology in brain tissue of the Tampere Sudden Death Study—unselected forensic autopsies on individuals living outside hospital institutions in Finland. Of 562 (16–95 years) participants, 42 were positive for Lewy‐related pathology (LRP). The youngest LRP case was aged 54 years, and the frequency of LRP in individuals aged ≥50 years was 9%. This forensic autopsy study indicates LRP starts already in middle age and is more common than expected in the ≥50 years‐of‐age non‐hospitalized population. ANN NEUROL 2024;95:843–848 [ABSTRACT FROM AUTHOR]

Background: The incidence of postoperative cognitive dysfunction (POCD) is notably high after cardiac surgery, ranging from 25% to 30%, and is associated with a lower quality of life, increased patient dependency, and heightened mortality. Anaesthesia during cardiothoracic surgery significantly contributes to the risk of POCD in older adults by adversely affecting the brain, including reductions in blood flow and oxygen levels. Aim: This review aimed to evaluate factors associated with anaesthesia‐related postoperative cognitive dysfunction (POCD) among adults younger than 65 years who underwent cardiothoracic surgeries. Study Design: A systematic keyword search, following the scoping review framework, was performed in the PubMed and CINAHL databases. Original English‐language studies that included adults younger than 65 years and addressed cognitive function after surgery along with anaesthesia management were included. Retrospective studies, animal research and in vitro and in vivo studies were excluded. Results: Twenty‐three articles were included (65.2% interventional studies). All studies lacked theoretical or conceptual frameworks. Ketamine's neuroprotective potential is questionable, and intravenous lidocaine may be considered a possible early agent for preventing POCD, but long‐term effectiveness is uncertain. Compared to inhalational anaesthesia, total intravenous anaesthesia (TIVA) may be related to a decreased incidence of POCD. Variation in POCD assessment impacted the lack of homogeneity in obtained data. Moreover, the shorter‐term timing of POCD evaluation such as in early days after surgery could be greatly influenced by medication and delirium. Conclusion: Although strategies such as TIVA, the use of neuroprotective anaesthetics and comprehensive preoperative assessments are suggested to prevent POCD, this multifactorial phenomenon cannot be explicitly attributed solely to anaesthetics or anaesthesia‐related techniques. Use of standardized, reliable and valid tools for POCD assessment is encouraged for cross‐study comparison. Relevance to Clinical Practice: Nurses and certified nurse anaesthetists must be aware of risk factors for postoperative delirium and POCD so they can assess patients before and after surgery. Patients and caregivers need to be educated about cognitive changes after surgery and advised to report them to their health care provider if they occur. [ABSTRACT FROM AUTHOR]

Purpose: Due to e-commerce growth, technological advancements and environmental concerns, developing a more nuanced service portfolio has become a critical issue for last-mile logistics service providers. Concurrently, consumers are adopting new modes of consumption. This paper aims to investigate the potential for last-mile logistics service providers to act as intermediaries in access-based consumption and to revitalise their service offerings through product-service systems – a pioneering strategy not executed in the market yet. Design/methodology/approach: This strategic customer foresight study uses a quantitative survey of 1,000 respondents and an online focus group comprising 10 early adopter consumers to investigate emerging last-mile service models. Potential service concepts were identified through the survey, and two distinct concepts were subsequently selected for evaluation and co-development within the focus group. The research was conducted in partnership with an SME logistics company in Finland. Findings: The consumers expressed selective interest in access-based consumption related to the proposed offering of essential household goods. Young adults and consumers in early middle age living in the city centre emerged as the most potential user groups. Economic reasons and short-term needs were the primary motivations for adopting access-based consumption. Practical implications: The study showed that engaging consumers in a customer foresight process is viable for SMEs innovating their offerings and demonstrates how the process works in practice. Originality/value: Documented cases of customer integration into foresight processes are rare in earlier research, and this paper extends the knowledge base through a multidisciplinary examination of future consumer behaviour in the last-mile logistics domain. The paper also expands the limited literature on the role of logistics in access-based consumption. [ABSTRACT FROM AUTHOR]

Introduction: The relationship between cognitive function and subsequent sarcopenia remains unclear. Therefore, this study aimed to examine the associations of performance on multiple cognitive domains with sarcopenia in the middle-aged and older adults. Methods: This longitudinal analysis (wave 2011–2013) included 2,934 participants from the CHARLS study. Sarcopenia was defined by the Asian Sarcopenia Working Group 2019 criteria. Cognitive function was measured by the Chinese version of the Mini-Mental State Examination (MMSE). Three interpretable techniques, namely SHapley Additive exPlanations (SHAP) and two built-in methods (coefficients of logistic regression and Gini importance of random forest), were used to assess the relationship between MMSE, its components (orientation, attention, episodic memory, and visuospatial ability) and sarcopenia. In addition, the association of MMSE score and its components with sarcopenia was further validated using stepwise regression. Results: All interpretable methods showed that MMSE score was important predictors of sarcopenia, especially the SHAP (MMSE score ranked top one). For its components, episodic memory, visuospatial ability, and attention showed high predictive value compared with orientation. Stepwise regression analyses showed that MMSE score and its components of episodic memory and visuospatial ability were correlated with sarcopenia, with their odds ratios of 0.93 (95% CI: 0.91–0.96, p < 0.001), 0.87 (95% CI: 0.82–0.93, p < 0.001), and 1.32 (95% CI: 1.05–1.65, p = 0.016), respectively. Conclusions: Better cognitive function especially episodic memory and visuospatial ability was negatively associated with incident sarcopenia among community middle-aged and older adults. Plain Language Summary: • Interpretable machine learning is helpful for understanding the association between cognitive function and sarcopenia. • Better cognitive function is negatively associated with incident sarcopenia. • Better episodic memory and visuospatial ability are negatively associated with incident sarcopenia. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate factors related to recurrent falls among older adults attending primary health care, considering the biopsychosocial perspective. A representative sample of 201 older adults were interviewed in three Primary Health Care units randomly selected in a city in southeastern Brazil. Outcome included self-report of two or more falls in the past 12 months. Exposures included personal and environmental aspects, according to domains of International Classification of Functioning of the World Health Organization (ICF-WHO). Recurrent falls were reported by 24.4% of the participants. Associations with depressive symptoms (p =.003), having osteoporosis (p =.031), chronic musculoskeletal pain (p =.020), frailty (p =.013), sleep satisfaction (p <.001), and functional status (p <.001) were found. In logistic regression models, cognitive status, musculoskeletal pain, and functional status were predictors of recurrent falls; however, only sleep satisfaction remained significant in the final model. Strategies aimed at preventing recurrent falls in primary health care should consider assessments and interventions targeting sleep aspects among older adults. [ABSTRACT FROM AUTHOR]