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Background: Cognitive frailty (CF) is a major precursor to dementia, and multidomain interventions have the potential to delay, prevent or reverse its early onset. However, the successful translation and sustainability of such interventions in real-life settings remain uncertain. In this study, we aimed to explore the insights of older adults with CF and their caregivers regarding the impact and participation in the AGELESS multidomain intervention. Methods: This qualitative study was conducted following the completion of AGELESS multidomain intervention. Semi-structured interviews covering domains such as perceptions, benefits, barriers, facilitators, and program preferences were conducted among 17 older adults with CF and 10 caregivers following the completion of the intervention. The data obtained were transcribed verbatim and analyzed using thematic analysis. Each transcript was reviewed and coded to identify prevailing themes derived from the interview data. Results: The analysis revealed five distinct themes: (1) impact of the program, (2) facilitators enhancing participation, (3) barriers hindering participation, (4) suggestions for improving participation and (5) challenges to adopt digital platforms. Based on the findings, the AGELESS multidomain intervention had a positive impact on the participants and their caregivers. It was noted that they showed preference for in-person sessions over virtual ones. The study highlighted key factors critical for successful participation, including diversity and inclusivity. It emphasized incorporating a multi-component, group-based approach with social aspects. The intervention should be people-centered, dignified, affordable, and customized to meet the unique needs of each participant. Conclusions: The AGELESS multidomain intervention was well received by older adults with CF and their caregivers who participated in this study. Moving forward, it is recommended that future initiatives focus on identifying opportunities to implement existing evidence-based programs on a larger scale for the prevention of dementia in older adults. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is the most common type of dementia that affects the elderly population. Lately, blood-based proteomics have been intensively sought in the discovery of AD biomarkers studies due to the capability to link external environmental factors with the development of AD. Demographic differences have been shown to affect the expression of the proteins in different populations which play a vital role in the degeneration of cognitive function. Method: In this study, a proteomic study focused on Malaysian Chinese and Malay prospects was conducted. Differentially expressed proteins (DEPs) in AD patients and normal controls for Chinese and Malays were identified. Functional enrichment analysis was conducted to further interpret the biological functions and pathways of the DEPs. In addition, a survey investigating behavioural practices among Chinese and Malay participants was conducted to support the results from the proteomic analysis. Result: The variation of dysregulated proteins identified in Chinese and Malay samples suggested the disparities of pathways involved in this pathological condition for each respective ethnicity. Functional enrichment analysis supported this assumption in understanding the protein-protein interactions of the identified protein signatures and indicate that differentially expressed proteins identified from the Chinese group were significantly enriched with the functional terms related to Aβ/tau protein-related processes, oxidative stress and inflammation whereas neuroinflammation was associated with the Malay group. Besides that, a significant difference in sweet drinks/food intake habits between these two groups implies a relationship between sugar levels and the dysregulation of protein APOA4 in the Malay group. Additional meta-analysis further supported the dysregulation of proteins TF, AHSG, A1BG, APOA4 and C4A among AD groups. Conclusion: These findings serve as a preliminary understanding in the molecular and demographic studies of AD in a multi-ethnic population. [ABSTRACT FROM AUTHOR]

Introduction: The common assumption that urinary incontinence occurs in osteoarthritis (OA) due to poor mobility is supported by limited evidence. The influence of gender in such associations is also yet to be elucidated. Objective: This study, therefore, identified any potential associations between knee OA symptoms and urinary incontinence and further explore sex differences in the associations. Design: Cross‐sectional study. Setting: University Hospital. Participants: This was a cross‐sectional study from a longitudinal research study comprising 1221 community‐dwelling older persons (57% women), mean age (SD) 68.95 (7.49) years. Main Outcome Measure(s): Presence of urinary incontinence: mixed, stress and urge symptoms. Physical performance and C‐reactive protein levels were also assessed. Results: Two hundred and seventy‐seven (22.83%) individuals reported the presence of urinary incontinence: mixed (41.5%), stress (30%), and urge (28.5%) symptoms. In an unadjusted analysis, stratified by gender, the association between knee pain and urinary incontinence was only present in women with mixed symptoms. After further adjustment of demographics differences and body mass index, the association between knee pain with any urinary incontinence and mixed symptoms remained significant with the odds ratios (95% confidence interval): 1.48 (1.02–2.15) and 1.73 (1.06–2.83), respectively. This relationship was attenuated after further adjustment for waist circumference and impaired lower limb mobility. Conclusion: Our study refutes previous assumptions that urinary incontinence in individuals with OA is attributed to impaired mobility alone, but introduces the role of abdominal obesity in this relationship, particularly in women. Future studies should assess the temporal relationship between body fat distribution and OA with urinary incontinence. [ABSTRACT FROM AUTHOR]

Several cardiometabolic factors such as diabetes, hypertension and dyslipidemia which are prevalent in older adults with increased body mass index (BMI) may play an important role in sarcopenia development.[[2], [7]] Excess fat mass interrupts the blood glucose pathway and triggers insulin resistance which may then further enhance the development of sarcopenia. Hospitalization rates over 5 years among individuals with BMI >= 30 kg/m SP 2 sp compared to those with normal BMI following adjustments in Model 2 and remained significant with slight attenuation after differences in diabetes status were accounted for [RR (95%CI): 1.90 (1.11-3.28), Model 3]. The direct effect of BMI categories on the risk of all outcomes (Y1, Y2, Y3) was significant for BMI >= 30 kg/m SP 2 sp but not BMI < 18.5 or BMI: 25-29.9 kg/m SP 2 sp compared to those the BMI: 18.5-25 kg/m SP 2 sp group, suggesting the potential mediating role of FBG (Figure 2A-C). [Extracted from the article]

Objective: Alzheimer's disease (AD), the commonest form of dementia which is characterized by progressive decline in cognitive function, can only be definitively diagnosed after death. Although biomarkers may aid diagnosis, currently available AD biomarkers, which are predominantly based on cerebrospinal fluid and neuroimaging facilities, are either invasive or costly. Blood-based biomarkers for AD diagnosis are highly sought after due to its practicality at the clinic. This study was undertaken to determine the differential protein expression in plasma amongst Malaysian AD, mild cognitive impairment (MCI) and non-AD individuals. Methods: A proteomic approach which utilized two-dimensional differential in gel electrophoresis (2 D DIGE) was performed for blood samples from 15 AD, 14 MCI and 15 non-AD individuals. Results: Mass spectrometry (MS)-based protein identification via MALDI ToF/ToF showed that fibrinogen-β-chain (spot 64) and fibrinogen-γ-chain (spot 91) with differential expression ratio >1.5 were significantly upregulated (p < 0.05) in AD patients when compared to non-AD individuals. Further data analysis using Pearson correlation found that the upregulated fibrinogen-γ-chain was weakly but significantly (p < 0.05) and inversely correlated with cognitive decline. Conclusion: Fibrinogen isoforms may play important roles in the vascular pathology of AD as well as neuroinflammation. As such, fibrinogen appears to be a promising blood-based biomarker for AD. Further validation of the present findings in larger population is now warranted. [ABSTRACT FROM AUTHOR]

Purpose: Consensus definitions currently define initial orthostatic hypotension (IOH) as ≥ 40 mmHg systolic (SBP) or ≥ 20 mmHg in diastolic blood pressure (DBP) reductions within 15 s of standing, while classical orthostatic hypotension (COH) is defined as a sustained reduction ≥ 20 mmHg SBP or ≥ 10 mmHg SBP within 3 min of standing. The clinical relevance of the aforementioned criteria remains unclear. The present study aimed to determine factors influencing postural blood pressure changes and their relationship with physical, functional and cognitive performance in older adults. Methods: Individuals aged ≥ 55 years were recruited through the Malaysian Elders Longitudinal Research (MELoR) study and continuous non-invasive BP was monitored over 5 min of supine rest and 3 min of standing. Physical performance was measured using the timed-up-and-go test, functional reach, handgrip and Lawton's functional ability scale. Cognition was measured with the Montreal Cognitive Assessment. Participants were categorized according to BP responses into four categories according to changes in SBP/DBP reductions from supine to standing: < 20/10 mmHg within 3 min (no OH), ≥ 20/10 mmHg from 15 s to 3 min (COH), ≥ 40/20 mmHg within 15 s and ≥ 20/10 mmHg from 15 s to 3 min (COH + IOH) and ≥ 40/20 mmHg within 15 s and < 20/10 mmHg within 3 min (IOH). Results: A total of 1245 participants were recruited, COH + IOH 623 (50%), IOH 165 (13%) and COH 145 (12%). Differences between groups existed in age, gender, hypertension, diabetes, use of alpha-blocker and/or beta-blocker, ACE-inhibitors, diuretics, biguanides, and baseline systolic BP. In univariate analyses, differences between groups were present in physical performance and cognition. Multivariate comparisons revealed better physical performance in IOH compared to no OH, better physical and cognitive performance in COH + IOH compared to no OH, and cognition in COH than no OH. Conclusion: Our findings suggest that older adults who fulfil current consensus definitions for IOH had better physical performance and cognitive scores. This indicates that an initial postural BP drop in people aged ≥ 55 years may not necessarily be associated with increased frailty, as suggested by previously published literature. [ABSTRACT FROM AUTHOR]