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Guided by current frameworks, including Feminist Disability Theory (FDT; Heller et al., 2019), we examine two contextual contributors to functional ability among women over the age 80 years. With data from the 2020 Behavioral Risk Factor Surveillance System from the Centers for Disease Control and Prevention (CDC), we probe the ways in which rurality and race influence functional ability. Data from 18,560 US women over age 80 years were included in a regression in which the effects of rurality (18% rural) on functional ability were moderated by race (89% White), F (3, 18058) = 32.72, p <.001). Rural women reported lower functional ability, especially when they identified as racially or ethnically diverse. Despite the small significant effects, these older women reported high levels of functioning in their daily lives. Informed by Haywood (1977) who articulated the problems of over-extending important research findings, our discussion advocates using caution when discussing small, but significant results. [ABSTRACT FROM AUTHOR]

This study analyzed data from the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) (2004~2021) and found that for the young-old with disabilities, the location of injury was roads and main roads, the activity at the time of injury was daily life, the mechanism of injury was falling and the type of transportation accident was collision with passenger cars. In the old-old, the characteristics by type of injury were fractures, the intentionality of the injury was unintentional, the place of injury was residence, the activity at the time of injury was daily life, the mechanism of injury was falling and the type of transportation accident was pedestrian. In conclusion, the old-old were more likely to suffer injuries at home and in daily life than the young-old with disabilities, and old-old injured patients were more active than the old-old, resulting in higher falls and transportation accidents and older seniors were more likely to have pedestrian accidents. Based on the information collected from the young-old and old-old, it is believed that efforts to prevent damage that consider the characteristics of the elderly are necessary.

Abstract Background Recurrent falls are a concerning problem in the elderly. Elderly people aged > 65 years who are prone to fall often require medical treatment for severe fall-related injuries, which is associated with a substantial financial burden. Therefore, this study aimed to identify factors related to recurrent falls in the community-dwelling young-old (65–74 years old) and old-old (≥ 75 years) in South Korea. Methods This study used a cross-sectional, correlation design. Data from the 2017 National Survey of Older Koreans were used, and 5,838 young-old and 4,205 old-old elderly people were included in the analysis. The questionnaire included general characteristics, fall experience, physical status, mental status, and presence of chronic diseases. The data were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis. Results In the young-old elderly people, limitations in activities of daily living (p

Purpose: To determine the safety and efficacy of transurethral resection of the prostate (TUR-P) in patients 85 years or older. Methods: In this retrospective, multicentre study, patients equal or older than 85 years at the time of surgery (2015–2020) were included. Several pre-, peri- and postoperative parameters were collected. The main outcome criterion was spontaneous voiding with a post-void residual (PVR) volume < 100 ml at dismission and at 12 months after surgery. Results: One hundred sixty-eight patients (median age: 87 years, interquartile range [IQR]: 86–89) were recruited. The patients took on average 5.2 permanent medications (3–8), 107 (64%) were anticoagulated preoperatively and neurological co-morbidities were present in 29 (17%). The indication for surgery was recurrent urinary retention in 66.3% (n = 110) with a mean retention volume of 849 ml. The mean PVR volume of the remaining 35% was 146 ml. Surgery was successfully completed in all patients. A perioperative surgical revision had to be performed in 3% and 13 patients (7.7%) required blood transfusion. After catheter removal, 85% of patients were able to void spontaneously with a PVR < 100 ml, and 14.3% were dismissed with a catheter. Twelve months data were available for 93 patients (55%). Of this cohort, 78 (83.9%) were able to void spontaneously with a PVR < 100 ml, 12 (12.9%) were on permanent catheterization. One patient (0.6%) died perioperatively. The only significant factor associated with an unsuccessful outcome was the number of permanent medications (6.8 vs. 5.0, p = 0.005). Conclusion: This retrospective multicentre study documents the safety and efficacy of TURP (monopolar and bipolar) in the old-old cohort. [ABSTRACT FROM AUTHOR]

Background and Objectives The growing population of adults surviving past age 85 in the United States and Mexico raises questions about the living arrangements of the oldest old and those living with dementia. This study compares Mexican and Mexican American individuals aged 85 and older to identify associations with cognitive status and living arrangements in Mexico and the United States. Research Design and Methods This study includes 419 Mexican Americans in 5 southwestern states (Hispanic Established Population for the Epidemiologic Studies of the Elderly) and 687 Mexicans from a nationally representative sample (Mexican Health and Aging Study). It examines characteristics associated with living alone using logistic regression and describes the living arrangements of older adults with probable dementia in each country. Results Older adults with dementia were significantly less likely to live alone than with others in the United States while there were no relationships between dementia and living arrangements in Mexico. However, a substantial proportion of older adults with dementia lived alone in both nations: 22% in the United States and 21% in Mexico. Among Mexican Americans with dementia, those living alone were more likely to be women, childless, reside in assisted living facilities, and less likely to own their homes. Similarly, Mexican individuals with dementia who lived alone were also less likely to be homeowners than those living with others. Discussion and Implications Contextual differences in living arrangements and housing between the United States and Mexico pose different challenges for aging populations with a high prevalence of dementia. [ABSTRACT FROM AUTHOR]

Research on multitasking driving has suggested age-related deterioration in driving performance. It has been shown that physical and cognitive functioning, which are related to driving performance and decline with aging, are positively associated with physical activity behavior. This study aimed to explore whether driving performance decline becomes severe with advancing age and whether physical activity behavior modifies age-related deterioration in driving performance. A total of one hundred forty-one healthy adults were categorized into three groups based on their age; old-old (74.21 ± 2.33 years), young-old (66.53 ± 1.50 years), and young adults (23.25 ± 2.82 years). Participants completed a realistic multitasking driving task. Physical activity and cardiorespiratory fitness levels were evaluated. Older groups drove more slowly and laterally than young adults, and old-old adults drove slower than young-old ones across the whole driving course. Physical activity level did not interact with the aging effect on driving performance, whereas cardiovascular fitness interacted. Higher-fitness young-old and young adults drove faster than higher-fitness old-old adults. Higher-fitness old adults drove more laterally than higher-fitness young adults. The present study demonstrated a gradual decline in driving performance in old adults, and cardiorespiratory fitness interacted with the aging effect on driving performance. Future research on the interaction of aging and physical activity behavior on driving performance in different age groups is of great value and may help deepen our knowledge. [ABSTRACT FROM AUTHOR]

Background: Many physical functions decline with aging, but it is not known whether oral functions vary according to sex or decline with aging, as it occurs with physical functions. The present study aimed to examine the association of sex, age, and elapsed years with occlusal force and tongue pressure using a generalized linear mixed‐effect model (GLMM) over a 3‐year period among old‐old Japanese adults. Methods: Participants were community‐dwelling older adults who participated in a survey (June 2014–March 2017) and a follow‐up survey (July 2017–December 2019) after 3 years (n = 951: 70‐year group, n = 466; 80‐year group, n = 391; 90‐year group, n = 94). Dental examinations including the number of teeth, occlusal force, and tongue pressure were conducted, and a GLMM was used to estimate the association of sex, age, and elapsed years with occlusal force and tongue pressure, adjusting for the number of teeth. Results: The GLMM showed that occlusal force was significantly associated with sex (reference; male, non‐standardized coefficient: B = −66.9 [female], p < 0.001), age (reference; 70‐year group, B = −81.7 [80‐year group], p < 0.001, B = −87.2 [90‐year group], p < 0.001), and the number of teeth (B = 13.8, p < 0.001), but did not significantly decrease with elapsed years. Tongue pressure was significantly associated with sex (reference; male, B = −0.94 [female], p = 0.034) and age (reference; 70‐year group, B = −1.78 [80‐year group], p < 0.001, B = −5.47 [90‐year group], p < 0.001). Tongue pressure decreased significantly with elapsed years (B = −0.82, p < 0.001). Conclusions: These findings suggest that tongue pressure significantly decreased over time, but occlusal force did not. Tongue‐related muscles may be more susceptible to aging than masticatory muscles. [ABSTRACT FROM AUTHOR]

BackgroundThe aim of this research was to compare associations of self-perceived successful aging (SPSA) among Young-Old (Y-O; age 50-74 years) versus Old-Old (O-O; 75-99 years) community-dwelling adults. To our knowledge, this is the first study to compare respondents' self-perceptions of successful aging among O-O relative to Y-O adults.MethodsParticipants included 365 Y-O and 641 O-O adults. The two age groups were compared in terms of the association of SPSA with other preselected measures including sociodemographic information, physical and mental functioning, objective and subjective cognitive functioning, emotional health, and positive psychological constructs.ResultsThe O-O group reported higher levels of SPSA than the Y-O group. In multiple regression modeling examining predictors of SPSA in each group, there was a tendency toward lower associations in the O-O group overall. Most notably, the associations between physical and mental functioning with SPSA were significantly lower in the O-O versus Y-O group. There were no associations with SPSA that were significantly higher in the O-O versus Y-O group.ConclusionThe lower predictive power of physical and mental functioning on SPSA among O-O relative to Y-O adults is particularly noteworthy. It is apparent that SPSA is a multidimensional construct that cannot be defined by physical functioning alone. Continuing to clarify the underlying factors impacting SPSA between groups may inform tailored interventions to promote successful aging in Y-O and O-O adults.

Abstract Background Research on the effects of sedentary behavior on the health-related quality of life (HRQoL) of the elderly is limited. The present study aimed to determine the association between sedentary behavior and the HRQoL of the young-old (aged 65–74 years) people and old-old (aged ≥75 years) people. Methods This study used the raw data of the 7th Korea National Health and Nutrition Examination Survey for 2016. The study subjects were 1,415 people aged over 65 years. The association between HRQoL and average daily sitting time was analyzed using the point biserial correlation coefficient. The effect of sedentary behavior on HRQoL was analyzed by logistic regression analysis. Results Overall, elderly people aged ≥65 years spent 7.9 h in sedentary pursuits: the young-old spent 7.7 h and the old-old spent 9.0 h. Longer sitting time was found to be associated with lower HROoL while shorter sitting time was associated with higher HROoL, with the relationship stronger among the old-old than among the young-old. This means that the effects of either having longer time sitting per day and low quality of life or shorter time sitting per day and high quality of life are more pronounced in the old-old in comparison to the young-old. Conclusions Sedentary behavior is significantly associated with people’s HRQoL. Interventions towards improving the HRQoL by reducing sedentary behavior based on the respective characteristics of young-old and old-old people are needed.

BACKGROUND/OBJECTIVES: Exposure to air pollution may contribute to both increasing depressive symptoms and decreasing episodic memory in older adulthood, but few studies have examined this hypothesis in a longitudinal context. Accordingly, we examined the association between air pollution and changes in depressive symptoms (DS) and episodic memory (EM) and their interrelationship in oldest‐old (aged 80 and older) women. DESIGN: Prospective cohort data from the Women's Health Initiative Memory Study‐Epidemiology of Cognitive Health Outcomes. SETTING: Geographically diverse community‐dwelling population. PARTICIPANTS: A total of 1,583 dementia‐free women aged 80 and older. MEASUREMENTS: Women completed up to six annual memory assessments (latent composite of East Boston Memory Test and Telephone Interview for Cognitive Status) and the 15‐item Geriatric Depression Scale (GDS‐15). We estimated 3‐year average exposures to regional particulate matter with aerodynamic diameter below 2.5 μm (PM2.5) (interquartile range [IQR] = 3.35 μg/m3) and gaseous nitrogen dioxide (NO2) (IQR = 9.55 ppb) at baseline and during a remote period 10 years earlier, using regionalized national universal kriging. RESULTS: Latent change structural equation models examined whether residing in areas with higher pollutant levels was associated with annual changes in standardized EM and DS while adjusting for potential confounders. Remote NO2 (β =.287 per IQR; P =.002) and PM2.5 (β =.170 per IQR; P =.019) exposure was significantly associated with larger increases in standardized DS, although the magnitude of the difference, less than 1 point on the GDS‐15, is of questionable clinical significance. Higher DS were associated with accelerated EM declines (β = −.372; P =.001), with a significant indirect effect of remote NO2 and PM2.5 exposure on EM declines mediated by DS. There were no other significant indirect exposure effects. CONCLUSION: These findings in oldest‐old women point to potential adverse effects of late‐life exposure to air pollution on subsequent interplay between DS and EM, highlighting air pollution as an environmental health risk factor for older women. [ABSTRACT FROM AUTHOR]

Frailty, a condition that many people share nowadays, is connected to both the modern way of life and also age, physical and mental condition of a person. Sometimes, it is characterized by rapid weight alterations, slow walking speed and extreme tiredness, symptoms which vary according to the patient. It is a condition that can be altered or in other cases treated and thus it is can be a challenge for both the doctor and patient. Osteoporosis in such patients can be a riddle - sometimes it is not discovered or it is not treated properly leading to more problems. Sarcopenic patients, namely those with severe anorexic disorders, people with transplants and malignant tumors can be harmed even more because their conditions allow osteoporosis not only to grow but also become harder to be traced by the doctors. Bone loss appreciation is an urgent process because it can prove to be supportive to the patients and doctors and by all means improves the problems that may occur to people suffering from frailty. [ABSTRACT FROM AUTHOR]

The Chinese old-old (80+) population has steadily increased in recent years; however, limited studies have examined how this group ages. The purpose of this study is to explore how the old-old in urban China define successful aging. Guided by grounded theory, we conducted semi-structured, in-depth interviews with community-dwelling old-old participants (N = 97). Participants identified self-reliance as the goal of successful aging, which was supported by four proactive behaviors: physical activity, financial security, community connectedness, and willing acceptance of reality. In our model, we conceptualized these four proactive behaviors to constitute the ribs of an umbrella, supporting a canopy to protect the pole of self-reliant successful aging. This study offers new understanding of the dynamic and nuanced ways that the old-old in urban China age successfully and of their valiant efforts to maintain self-reliance. [ABSTRACT FROM AUTHOR]

The study aimed to investigate factors influencing older adults' physical activity engagement over time. The authors analyzed 3 waves of data from a sample of Israelis age 75-94 (Wave 1 n = 1,369, Wave 2 n = 687, Wave 3 n = 154). Findings indicated that physical activity engagement declined longitudinally. Logistic regressions showed that female gender, older age, and taking more medications were significant risk factors for stopping exercise at Wave 2 in those physically active at Wave 1. In addition, higher functional and cognitive status predicted initiating exercise at Wave 2 in those who did not exercise at Wave 1. By clarifying the influence of personal characteristics on physical activity engagement in the Israeli old-old, this study sets the stage for future investigation and intervention, stressing the importance of targeting at-risk populations, accommodating risk factors, and addressing both the initiation and the maintenance of exercise in the face of barriers. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the factors associated with oral frailty among community-dwelling older adults. In particular, we compared the factors between individuals in the young-old and old-old groups and clarified the differences between the two groups., Methods: We measured the basic attributes, body composition, grip strength, gait function, oral function, cognitive function, and daily living function using the Kihon checklist in older people living independently in T City, Aichi Prefecture. The risk of oral frailty was assessed using the Oral Frailty Screening and Evaluation Form (OFI-8), and the measurement results were compared between two groups: those with and those without risk. To identify the factors associated with oral frailty, we performed a multivariate analysis with the risk of oral frailty as the dependent variable and a univariate analysis separately for the young-old and old-old groups., Results: The mean age of the 100 subjects was 76.6±4.6 years old. Forty-four subjects were at risk of oral frailty, and 55 subjects were not at risk. The high-risk group had significantly higher rates of polypharmacy, depression, and a slow walking speed than the no-risk group. The risk factors associated with oral frailty were living alone, polypharmacy, and depression. The risk factors for oral frailty were a poor ambulatory function in the young-old and a poor ambulatory function, decline in the cognitive function, and depression in the old-old., Conclusions: The results of this study suggest that the risk factors for oral frailty differ between older individuals in the young-old and old-old groups and that age-appropriate support is necessary to prevent oral frailty in older people.

The oldest old (aged ≥80 years) are often the population subgroup at high nutritional risk due to age-related metabolic changes. We performed a validation analysis of a dietary screening tool (DST) which was developed for older adults among the oldest old. We examined dietary intakes using three 24-hour dietary recalls and the DST among 122 participants (aged 82–97) of the Geisinger Rural Aging Study. DST scores were compared with the Health Eating Index (HEI)-2015 scores, which were calculated based on three-day dietary recalls. Pearson correlations were used to characterize concurrent validity and Bland-Altman plots were used to identify potential bias. DST scores were significantly correlated with HEI scores (adjusted r = 0.68; p < 0.001) in an age- and sex-adjusted model. Those within the not-at-risk DST group had significantly higher HEI scores (adjusted means = 79.6 ± 3.68) compared with those who were in the at-risk (adjusted means = 51.2 ± 1.56) and the possibly-at-risk (adjusted means = 66.3 ± 1.79) groups (p-trend < 0.001). The DST appears to be a valid measure of diet quality in the oldest old when compared with the HEI and may be a potential tool to assess overall diet quality in this population. [ABSTRACT FROM AUTHOR]

The article discusses various aspects of living, aging, and dying in healthy and just societies in relation to the author's father's experiences as a man who died at the age of 102. Palliative care and quality of life improvements for patients are examined, along with the need for love and compassion throughout the palliative care process. Nursing home care is assessed, along with inequalities in access to pain relief and end-of-life care. Opioid addiction is examined.

Objectives: To determine whether protein intake is associated with better disability trajectories in the oldest adults (≥85) and whether muscle mass and muscle strength would partially mediate this. Design Prospective cohort study. Setting: Newcastle‐upon‐Tyne and North Tyneside, United Kingdom. Participants: Community‐dwelling older adults aged 85 at baseline (N=722). Methods: Protein intake was estimated using two 24‐hour multiple‐pass recalls at baseline. Disability was measured as difficulty performing 17 activities of daily living at baseline and 18, 36, and 60 months. Trajectories were derived using mortality‐adjusted group‐based trajectory modelling. The effect of protein intake (g/kg of adjusted body weight (aBW)/d) on disability trajectories was examined using multinomial logistic regression. Results: Participants had 4 distinct disability trajectories (between the ages of 85 and 90: constant very low (AT1), mild (AT2), moderate (AT3), and severe (AT4). Each unit increase in protein (g) per kg of aBW/d was associated with greater odds of AT1 (odds ratio (OR=7.97, 95% confidence interval (CI)=1.96–32.43, p =.004) and AT2 (OR=3.28, 95% CI=1.09–9.87, p =.03) than of AT4 over 5 years in models adjusted for selected covariates. Participants with protein intake of 1.0 g/kg aBW/d or more were more likely to belong to AT1 (OR=3.65, 95% CI=1.59–8.38, p =.009) and AT2 (OR=2.12, 95% CI=1.16–3.90, p =.01) than to AT4. Conclusion: Higher protein intake, especially 1.0 g/kg aBW/d or more, was associated with better disability trajectories in the oldest adults. These findings will inform new dietary strategies to support active, healthy ageing. J Am Geriatr Soc 67:50–56, 2019. [ABSTRACT FROM AUTHOR]

Conceptual and empirical work has long suggested that personality and health are closely intertwined later in life. Little is known, however, about the nature and direction of time-ordered associations between the 2 domains within-persons. We applied continuous time auto- and cross-effects models to up to 6 waves of 13-year longitudinal data from the Berlin Aging Study (N = 516, M = 84.92, SD = 8.66, age range 70 to 103) and examined time-ordered relations between personality traits (i.e., extraversion and neuroticism) and performance-based indicators of functional health (i.e., physical and sensory functioning) in late life. Consistent with proposals to distinguish the young-old (age 70 to 84) from the oldest-old (aged 85+) in later life, results suggest that predictive effects of neuroticism on functional health are stronger in younger as compared with older individuals. In contrast, health decrements precede and predict change in neuroticism in the oldest-old more strongly as compared with the young-old. In addition, we found that decreases in extraversion predict subsequent decreases in functional health and vice versa, with effects being equally pronounced among younger and older participants. Furthermore, by employing continuous time models we could demonstrate that the magnitude of these effects varies depending upon the time interval under consideration. These findings suggest that personality and functional health are closely intertwined in old and very old age, and that the nature of time-ordered associations differs between traits and age period. We discuss conceptual and practical implications. [ABSTRACT FROM AUTHOR]

The prevalence of very elderly patients (aged 85 years and older) with visually significant cataracts continues to rise in the United States. We conducted a focused review of literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to investigate the impact of very old age on cataract surgery outcomes. The studies suggest that very elderly patients, relative to their younger counterparts, had similar complication rates after adjusting for their higher rates of age-related ocular and systemic comorbidities. In addition, most very elderly patients gained improvement in visual acuity, enjoyed increased quality of life, and had survival rates that extend beyond 1 year after surgery. Although many of the studies were small and lacked statistical power to exclude clinically important differences in outcome, findings generally supported cataract surgery in the very elderly. Further studies are required to augment evidence-based surgical decision-making in elderly persons with ocular comorbidities and visually significant cataracts. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the epidemiology of insomnia, including demographic and clinical correlates, in older adults. Design: Cross‐sectional. Setting: Community. Participants: Yale Precipitating Events Project participants (N=379; mean age 84.3; 67.8% female; 11.9% African American). Measurements: Insomnia Severity Index (ISI), with scores of 8 and higher indicating insomnia, which was further stratified according to ISI score as mild (8–14), moderate (15–21), or severe (22–28). Baseline characteristics included age, sex, race, education, smoking, obesity, medical conditions, depressive symptoms (Center for Epidemiologic Studies Depression score ≥16), cognitive impairment (Mini‐Mental State Examination score <24), restless legs syndrome (RLS), self‐reported sleep‐disordered breathing (SDB), medications, and daytime sleepiness (Epworth Sleepiness Scale (ESS), range 0–24). Results: Insomnia was established in 163 (43.0%) participants (average ISI score 12.3 (mild)). For the entire sample, average baseline characteristics were as follows: 30.1% did not complete high school, 5% were current smokers, 19.2% were obese, 28.2% had cardiovascular disease, 19.3% had chronic lung disease, 27.2% had depressive symptoms, 16.1% had cognitive impairment, 36.8% had RLS, and 3.4% had self‐reported SDB; mean number of medications was 9.2, and mean ESS was 6.4. In multivariable regression models, only depressive symptoms (adjusted odds ratio (aOR)=8.34, 95% confidence interval (CI)=4.49, 15.47) and RLS (aOR=2.49, 95% CI=1.48, 4.21) were significantly associated with insomnia. Conclusion: In a sample of older adults with high medical burden and polypharmacy, insomnia was highly prevalent but unexpectedly mild and associated only with depressive symptoms and RLS. The discordance of high prevalence but mild severity of insomnia in the oldest adults highlights the need for diagnostic confirmation with objective measures of sleep disturbances, whereas the strong associations with depressive symptoms and RLS inform priorities in managing insomnia. [ABSTRACT FROM AUTHOR]

Background: Globally, the number of people aged 80 years or over, the 'oldest old,' is the fastest growing population group. Because of the strong association between age and gallstone disease, both prevalence and incidence of this disease are increasing. The feasibility of the cholecystectomy in octogenarians has been evaluated in several studies that confirmed the safety of the operation. However, the safety of this procedure in nonagenarians is still controversial. The aim of this study was to evaluate the safety of cholecystectomies in nonagenarians and identify related predictors for postoperative hospital length of stay (LOS) and in-hospital mortality up to 30 days postoperatively. Methods: More than 500 cholecystectomies, both open and laparoscopic, were performed between January 2000 and September 2015 at our institution in patients 80 years and older. These statistics include both elective and emergent admissions. A retrospective review of charts over the last 15 years was conducted to compare mortality and length of postoperative stay among two patient groups: 319 octogenarians and 36 nonagenarians. Parameters evaluated include demographics, surgical presentation, American Society of Anesthesiologists (ASA) score, main diagnosis, comorbidities, type of surgery performed, LOS and in-hospital mortality. All data were analyzed with STATA (v.13) software, using a multivariate logistic regression after determining the statistically significant variables through a stepwise regression. Conclusions: We found out that being nonagenarian, compared to octogenarian, is not a significant risk factor in terms of LOS and in-hospital mortality within 30 days postoperatively. Despite that, the mortality rate among nonagenarians is still remarkably high as almost every patient was admitted in an emergent setting. The most remarkable predictor for mortality among the two groups was an 'afternoon/night emergency' surgical presentation (OR 25.5, CI 1.53-42.35, p = 0.02). Thus, the surgical emergency management for gallbladder disease at our institution should be critically reevaluated. Performing the procedure in laparoscopy predicted a significant reduction (−5 days, CI −8.5 to −1.4, p = 0.006) of LOS, while presenting with 'gallbladder and bile duct stones' (+6.3 days, CI 1.5-11.1, p = 0.01) or 'acalculous cholecystitis' (+4.7 days, CI 0.4-9.2, p = 0.03) had the opposite effect. Despite the remarkable mortality rate of our series, being nonagenarian should not be considered as a reason to avoid gallbladder surgery in case of need. Our study suggests that nonagenarians are more suitable surgical candidates than may have previously expected. [ABSTRACT FROM AUTHOR]

This research aimed at investigating the utility of a computerized version of a cognitively stimulating activity as a video game intervention for elderly. The study focused on the effect of a 6-week extensive practice intervention on aspects of cognitive functioning (vigilance, working memory (WM), inhibition, reasoning) of old-old participants (N = 29), randomly assigned to trained or active control group. The difference between groups was in the content of the extended video game practice – cognitively complex card game for trained and computerized version of a simple dice-game of chance for control participants. A pretest, posttest and a 4-month follow-up measurement was conducted. Results revealed improvements in both groups, except for improved reasoning found only in trained participants. These results suggest that: (1) improvements are dependent on the complexity of the program, (2) cognitively stimulating activity are a valid training procedure for old-old, (3) novelty of computer use is an important factor in determining training efficacy. [ABSTRACT FROM PUBLISHER]

An editorial is presented which addresses the relationship between late maternal age at childbirth and the likelihood of living to age 90, and it mentions predictors of longevity for women in America. The risk of childhood-related death for older pregnant women is examined, along with the U.S. Women's Health Initiative, leukocyte telomeres, and additional factors such as educational attainment and higher income among women.

Objectives. To explore associations between in utero exposure to the 1918 influenza pandemic and hospitalization rates in old age (≥ 70 years) in the United States. Methods. We identified individuals exposed (mild and deadly waves) and unexposed in utero to the 1918 influenza pandemic (a natural experiment) by using birth dates from the Asset and Health Dynamics Among the Oldest Old survey. We analyzed differences in hospitalization rates by exposure status with multivariate linear regression. Results. In utero exposure to the deadly wave of the 1918 influenza pandemic increased the number of hospital visits by 10.0 per 100 persons. For those exposed in utero to the deadliest wave of the influenza pandemic, high rates of functional limitations are shown to drive the higher rates of hospitalizations in old age. Conclusions. In utero exposure to the influenza pandemic increased functional limitations and hospitalization rates in old age. Public Health Implications. To determine investments in influenza pandemic prevention programs that protect fetal health, policymakers should include long-term reductions in hospitalizations in their cost-benefit evaluations. [ABSTRACT FROM AUTHOR]

Background Treatment of pressure ulcer with necrotic tissue formation is challenging in old patients with severe comorbidities. Although indicated and recommended, surgical debridement cannot always be applied because of general conditions. Simple, convenient, and minimally invasive intervention is required to facilitate chemical debridement of necrotic tissue. Methods Seventeen patients suffering from intractable pressure ulcer complicated with necrotic tissue formation underwent conventional debridement (CD) or mango cut incision (MCI). Feasibility of MCI method was evaluated by comparing clinical outcomes between patients who underwent CD and MCI. Results Between patients undergoing CD and MCI, there was no significant difference in time for necrotic tissue clearance (3.1 ± 2.0 vs. 4.0 ± 1.5 weeks, P = 0.366), nor in time for pressure ulcer cure (14.7 ± 6.2 vs. 12.7 ± 5.6 weeks, P = 0.566). Time required for intervention was significantly longer in CD than that in MCI (173.8 ± 44.5 vs. 29.4 ± 13.3 s, P < 0.001). CD procedure was associated with significantly higher rate of bleeding compared with MCI (38% vs. 0%, P = 0.043). Conclusions MCI allows minimally invasive clearance of necrotic tissue with clinically acceptable outcomes compatible to CD, and can be a choice of method for necrosis-complicated pressure ulcers in patients with severe comorbidities. [ABSTRACT FROM AUTHOR]

The effect of aerobic exercise on physical function and mental health in various adult age groups (young-old, 65-74; old-old, 75-84; oldest-old, = 85 years) is unclear. The aim of this study was to investigate the effects of the Kohzuki Exercise Program (KEP) on physical function and mental health in these age groups. The KEP consisted of 40-min supervised sessions 3 times per week for 6 months as follows: 5 min of warm-up, 30 min of lower limb aerobic exercise, and 5 min of cool-down. A total of 50 participants (22 young-old, 20 old-old, and 8 oldest-old) who participated in the KEP completed at least 88% of the sessions. In statistical analysis, 3 (group: oldest-old, old-old, young-old) × 2 (time: baseline and after 6 months) analyses of variance were used to determine if there were significant main and interaction effects. Significant interactions were probed using the post-hoc paired t test. The Short Physical Performance Battery (SPPB) score showed significant group × time interactions after 6 months (p = 0.031). In the post-hoc test, oldest-old (p < 0.001), old-old (p < 0.001), and young-old (p < 0.01) groups had significantly better physical function after 6 months. However, none of the mental health measures showed group × time interactions at 6-month. Our results suggest that a 6-month KEP led to improved physical function in oldest-old, old-old, and young-old adults. The KEP was effective for oldest-old adults in particular. The KEP exhibits good adherence, making it suitable for a wide age range in society. [ABSTRACT FROM AUTHOR]

The incidence of osteoporotic fractures increases with age. Consequently, the global prevalence of osteoporotic fractures will increase with the aging of the population. In old age, osteoporosis is associated with a substantial burden in terms of morbidity and mortality. Nevertheless, osteoporosis in old age continues to be underdiagnosed and undertreated. This may, at least partly, be explained by the fact that evidence of the antifracture efficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70-75 years. However, in the last years, subgroup analyses of these landmark trials have been published investigating the efficacy and safety of osteoporosis treatment in the very elderly. Based on this evidence, this narrative review discusses the pharmacological management of osteoporosis in the oldest old (≥80 years). Because of the high prevalence of calcium and/or vitamin D deficiency in old age, these supplements are essential in the management of osteoporosis in the elderly people. Adding antiresorptive or anabolic treatments or combinations, thereof, reduces the risk of vertebral fractures even more, at least in the elderly with documented osteoporosis. The reduction of hip fracture risk by antiresorptive treatments is less convincing, which may be explained by insufficient statistical power in some subanalyses and/or a higher impact of nonskeletal risk factors in the occurrence of hip fractures. Compared with younger individuals, a larger absolute risk reduction is observed in the elderly because of the higher baseline fracture risk. Therefore, the elderly will benefit more of treatment. In addition, current osteoporosis therapies also appear to be safe in the elderly. Although more research is required to further clarify the effect of osteoporosis drugs in the elderly, especially with respect to hip fractures, there is currently sufficient evidence to initiate appropriate treatment in the elderly with osteoporosis and osteoporotic fractures. [ABSTRACT FROM AUTHOR]

Aim A previous study reported that the oral health-related quality of life (OHRQoL) of Japanese individuals dropped sharply as they reached old-old age. The aim of present study was to explore the risk factors of OHRQoL by investigating the association of OHRQoL with oral indices, lifestyle and psychological distress. Methods A questionnaire survey was carried out to assess the OHRQoL, oral indices, lifestyle, and psychological distress of patients who were of ≥75 years of age and who regularly visited a dental clinic for maintenance. OHRQoL and psychological distress were assessed using the General Oral Health Assessment Index (GOHAI) and the General Health Questionnaire, respectively. The relationships between the GOHAI score and related factors were examined by non-parametric bivariate and logistic regression analyses using a GOHAI cut-off score of 45.0. Results A total of 187 old-old patients with a mean age of 77.9 ± 3.0 years participated in the present study. The average GOHAI score was 50.8 ± 8.0. In the bivariate analyses, the average sleeping hours, use of sleep medication, Short Form 8-Item Health Survey (SF-8), General Health Questionnaire score, and the number of teeth present were significantly correlated with the GOHAI score. A logistic regression analysis showed that the number of teeth present, General Health Questionnaire and the use of sleep medication were associated with the GOHAI score. Conclusions The present study found that the OHRQoL was strongly associated with insomnia and depression. It is therefore suggested that oral healthcare professionals take general background information, such as the presence of insomnia and depression, into consideration to improve OHRQoL when they treat old-old patients. Geriatr Gerontol Int 2017; 17: 893-897. [ABSTRACT FROM AUTHOR]

Background Sarcopenia is the progressive loss of muscle mass and strength that occurs with advancing age and plays a pivotal role in the causal pathway leading to frailty, disability and, eventually, to death among older persons. As oxidative damage of muscle proteins has been shown to be a relevant contributory factor, in this study we hypothesized that uric acid (UA), a powerful endogenous antioxidant, might exert a protective effect on muscle function in the oldest old and we tested our hypothesis in a group of nonagenarians who participated in the Mugello Study. Methods 239 subjects, 73 men and 166 women, mean age 92.8 years ± SD 3.1, underwent the assessment of UA serum level and isometric handgrip strength, a widely used clinical measure of sarcopenia. Results Mean UA serum level was 5.69 mg/dL ± SD 1.70 and mean handgrip strength was 15.0 kg ± SD 6.9. After adjusting for relevant confounders, higher UA serum levels remained independent positive predictors of isometric handgrip strength (β 1.24 ± SE(β) 0.43, p = 0.005). Conclusion Our results show that higher UA serum levels are associated with better muscle function in the oldest old and, accordingly, might slow down the progression of sarcopenia. [ABSTRACT FROM AUTHOR]

The sense of taste plays a pivotal role for personal assessment of the nutritional value, safety and quality of foods. Although it is commonly recognised that taste sensitivity decreases with age, alterations in that sensitivity over time in an old-old population have not been previously reported. Furthermore, no known studies utilised comprehensive variables regarding taste changes and related factors for assessments. Here, we report novel findings from a 3-year longitudinal study model aimed to elucidate taste sensitivity decline and its related factors in old-old individuals. We utilised 621 subjects aged 79-81 years who participated in the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians Study for baseline assessments performed in 2011 and 2012, and then conducted follow-up assessments 3 years later in 328 of those. Assessment of general health, an oral examination and determination of taste sensitivity were performed for each. We also evaluated cognitive function using Montreal Cognitive Assessment findings, then excluded from analysis those with a score lower than 20 in order to secure the validity and reliability of the subjects' answers. Contributing variables were selected using univariate analysis, then analysed with multivariate logistic regression analysis. We found that males showed significantly greater declines in taste sensitivity for sweet and sour tastes than females. Additionally, subjects with lower cognitive scores showed a significantly greater taste decrease for salty in multivariate analysis. In conclusion, our longitudinal study revealed that gender and cognitive status are major factors affecting taste sensitivity in geriatric individuals. [ABSTRACT FROM AUTHOR]

The nondemented old-old over the age of 80 comprise a rapidly increasing population group; they can be regarded as exemplars of successful aging. However, our current understanding of successful aging in advanced age and its neural underpinnings is limited. In this study, we measured the microstructural and network-based topological properties of brain white matter using diffusion-weighted imaging scans of 419 community-dwelling nondemented older participants. The participants were further divided into 230 young-old (between 72 and 79, mean = 76.25 ± 2.00) and 219 old-old (between 80 and 92, mean = 83.98 ± 2.97). Results showed that white matter connectivity in microstructure and brain networks significantly declined with increased age and that the declined rates were faster in the old-old compared with young-old. Mediation models indicated that cognitive decline was in part through the age effect on the white matter connectivity in the old-old but not in the young-old. Machine learning predictive models further supported the crucial role of declines in white matter connectivity as a neural substrate of cognitive aging in the nondemented older population. Our findings shed new light on white matter connectivity in the nondemented aging brains and may contribute to uncovering the neural substrates of successful brain aging., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Exceptional aging, defined as reaching age 85 years, shows geographic inequalities that may depend on local environmental conditions. Links between particulate pollution -- a well-recognized environmental risk factor -- and exceptional aging have not been investigated. Objectives: We conducted a nationwide analysis of ~28 million adults in 3,034 United States counties to determine whether local PM2.5 levels (particulate matter < 2.5 μm in aerodynamic diameter) affected the probability of becoming 85- to 94-year-olds or centenarians (100- to 104-year-olds) in 2010 for individuals who were 55-64 or 70-74 years old, respectively, in 1980. Methods: We used population-weighted regression models including county-level PM 2.5 from hybrid land-use regression and geostatistical interpolation, smoking, obesity, sociodemographic, and age-specific migration variables. Results: On average, 2,295 and 71.4 per 10,000 of the 55- to 64- and 70- to 74-year-olds in 1980, respectively, remained in the 85- to 94- and 100- to 104-year-old population in 2010. An interquartile range (4.19 μg/m3) increase in PM 2.5 was associated with 93.7 fewer 85- to 94-yearolds (p < 0.001) and 3.5 fewer centenarians (p < 0.05). These associations were nearly linear, were stable to model specification, and were detectable below the annual PM2.5 national standard. Exceptional aging was strongly associated with smoking, with an interquartile range (4.77%) increase in population who smoked associated with 181.9 fewer 85- to 94-year-olds (p < 0.001) and 6.4 fewer centenarians (p < 0.001). Exceptional aging was also associated with obesity rates and median income. Conclusions: Communities with the most exceptional aging have low ambient air pollution and low rates of smoking, poverty, and obesity. Improvements in these determinants may contribute to increasing exceptional aging. Citation: Baccarelli AA, Hales N, Burnett RT, Jerrett M, Mix C, Dockery DW, Pope CA III. 2016. Particulate air pollution, exceptional aging, and rates of centenarians: a nationwide analysis of the United States, 1980-2010. Environ Health Perspect 124:1744-1750; http://dx.doi.org/10.1289/EHP197 [ABSTRACT FROM AUTHOR]

Objectives To determine reference values for laboratory tests in individuals aged 85 and older. Design Cross-sectional cohort study. Setting International. Participants Long Life Family Study (LLFS) participants (N~5,000, age: range 25-110, median 67, 45% male). Measurements Serum biomarkers were selected based on association with aging-related diseases and included complete blood count, lipids (triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol), 25-hydroxyvitamin D2 and D3, vitamin D epi-isomer, diabetes mellitus-related biomarkers (adiponectin, insulin, insulin-like growth factor 1, glucose, glycosylated hemoglobin, soluble receptor for advanced glycation endproduct), kidney disease-related biomarkers (albumin, creatinine, cystatin), endocrine biomarkers (dehydroepiandrosterone, sex-hormone binding globulin, testosterone), markers of inflammation (interleukin 6, high-sensitivity C-reactive protein, N-terminal pro b-type natriuretic peptide), ferritin, and transferrin. Results Of 38 measured biomarkers, 34 were significantly correlated with age. Summary statistics were generated for all biomarkers according to sex and 5-year age increments from 50 and up after excluding participants with diseases and treatments that were associated with biomarkers. A biomarker data set was also generated that will be useful for other investigators seeking to compare biomarker levels between studies. Conclusion Levels of several biomarkers change with older age in healthy individuals. The descriptive statistics identified herein will be useful in future studies and, if replicated in additional studies, might also become useful in clinical practice. The availability of the reference data set will facilitate appropriate calibration of biomarkers measured in different laboratories. [ABSTRACT FROM AUTHOR]

Objective To analyze the association between age, substance use, and outcomes in fee-for-service Medicare enrollees with advanced prostate cancer. Methods Retrospective longitudinal cohort study of elderly men diagnosed with advanced prostate cancer using SEER-Medicare data between 2000 and 2009. Substance use disorder was identified using claims for alcoholic psychosis, drug psychoses, alcohol dependence syndrome, drug dependence, and non-dependent use of drugs. We compared health service use, cost, and 5-year mortality across two age-groups: young–old (66–74 years) and old–old (≥ 75 years). Results Cohort consisted of 8484 young–old and 5763 old–old patients with advanced prostate cancer. Prevalence of substance use was 12.4% in young–old and 7.4% in old–old group. For the young–old group, the ‘drug psychoses and related’ category had the highest inpatient, outpatient, and ER usage as well as the highest hazard of mortality (HR = 2.2; CI = 1.5, 3.1), compared to those without substance use. Compared to the no substance use group, those with substance use in the follow-up phase had higher inpatient and ER visits, and those with substance use in treatment phase had higher outpatient visits and highest hazard of mortality (HR = 1.6; CI = 1.4, 1.9). For the old–old group, the ‘drug psychoses and related’ category was associated with highest inpatient and outpatient use; and ‘Non-dependent use of drugs’ were associated with highest ER use, compared to those without substance use. Conclusion Intersection of cancer and substance use disorder in elderly patients with advanced prostate cancer covered by Medicare is age specific. An integrated and multidisciplinary approach to screen, refer, and treat substance use in patients with prostate cancer may improve outcomes and reduce costs. [ABSTRACT FROM AUTHOR]

We examined single muscle fiber contractile function of the oldest-old (3F/2M, 89 ± 1 yr old) enrolled in The Health, Aging, and Body Composition Study (The Health ABC Study). Vastus lateralis muscle biopsies were obtained and single muscle fiber function was determined (n = 105) prior to myosin heavy chain (MHC) isoform identification with sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Cross-sectional area of MHC I muscle fibers (5,576 ± 333 μm2; n = 58) was 21% larger (P < 0.05) than MHC IIa fibers (4,518 ± 386 μm2; n = 47). Normalized power (an indicator of muscle fiber quality incorporating size, strength, and speed) of MHC I and IIa muscle fibers was 2.3 ± 0.1 and 17.4 ± 0.8 W/l, respectively. Compared with previous research from our lab using identical procedures, MHC I normalized power was 28% higher than healthy 20 yr olds and similar to younger octogenarians (∼80 yr old). Normalized power of MHC IIa fibers was 63% greater than 20 yr olds and 39% greater than younger octogenarians. These comparative data suggest that power output per unit size (i.e., muscle quality) of remaining muscle fibers improves with age, a phenomenon more pronounced in MHC IIa fibers. Age-related single muscle fiber quality improvements may be a compensatory mechanism to help offset decrements in whole muscle function. [ABSTRACT FROM AUTHOR]

Given the global increase in the number of people over the age of 85, there is a growing body of work concerning this group, termed the oldest old. Much of this work is confined to the literature specialising in geriatrics and the more generic health care papers refer to 'older people' with little definition of what is meant by 'older'. Iatrogenesis (ill health caused by doctors) is a major issue and general practitioners (GPs) need practical help in prescribing for the oldest old. This paper presents a narrative review of the literature on prescribing and the oldest old. The results showed that all papers sourced referred to prescribing for the 'old' as those aged over 65, with only scant mention of oldest old. Yet prescribing for the oldest old involves clinical judgement and knowledge of the patient. It includes weighing up what will do good, cause no harm and is acceptable to the individual. GPs have to make treatment choices mostly in isolation from colleagues, during time-limited consultations and with few relevant guidelines on managing multi-morbidities in the oldest old. A major issue in prescribing for people over the age of 85 is that guidelines for diseases are based on trials with younger adults, outline the best practice for one disease in isolation (i.e. not in the presence of other diseases) and take little account of the interactions between the drugs used in managing several diseases in frail older people. There is a growing body of work, however, calling for specialist services for the oldest old. [ABSTRACT FROM AUTHOR]

Subjective well-being (SWB) of older adults could be affected by both individual and community characteristics. However, the effect of community characteristics, such as population aging in local areas, remains unclear. This study examined the cross-sectional and longitudinal associations between the area-level population aging and SWB of older individuals from two distinct surveys. Those analyzed were 572 respondents aged 75 years and older for a cross-sectional survey in a metropolitan area in Tokyo, Japan (Study 1) and 1,257 and 859 respondents for a cross-sectional and longitudinal analysis, respectively, for a 2-year longitudinal survey project in urban and rural areas of Fukui Prefecture (Study 2). Area-level population aging was assessed by the number of people aged 65 years or older per 100 residents. SWB was assessed with the Life Satisfaction Index-A (LSIA). Multilevel analysis was performed to examine unconditional and conditional associations between the area-level number of older adults per 100 residents and the individual-level LSIA scores. The area-level number of older adults per 100 residents was significantly and positively associated with the LSIA scores in Study 1 (p = 0.042), even after controlling for the area- and individual-level covariates. In Study 2, we also found a significant effect of the area-level number of older adults per 100 residents on LSIA scores in the longitudinal multivariate analysis (p = 0.049). Findings from two survey projects suggested cross-validity in the positive effect of area-level population aging on older adults' SWB. Policymakers should consider older citizens' SWB in the recent urban-to-rural migration governmental policy as well as in urban renovation planning. [ABSTRACT FROM AUTHOR]

Objective: To investigate the predictive value of functional impairment, chronic conditions, and laboratory biomarkers of aging for predicting 5-year mortality in the elderly aged 85 years. Methods: Predictive value for mortality of different geriatric assessments carried out during the OCTABAIX study was evaluated after 5 years of follow-up in 328 subjects aged 85 years. Measurements included assessment of functional status comorbidity, along with laboratory tests on vitamin D, cholesterol, CD4/CD8 ratio, hemoglobin, and serum thyrotropin. Results: Overall, the mortality rate after 5 years of follow-up was 42.07%. Bivariate analysis showed that patients who survived were predominantly female (P=0.02), and they showed a significantly better baseline functional status for both basic (P<0.001) and instrumental (P<0.001) activities of daily living (Barthel and Lawton index), better cognitive performance (Spanish version of the Mini-Mental State Examination) (P<0.001), lower comorbidity conditions (Charlson) (P<0.001), lower nutritional risk (Mini Nutritional Assessment) (P<0.001), lower risk of falls (Tinetti gait scale) (P<0.001), less percentage of heart failure (P=0.03) and chronic obstructive pulmonary disease (P=0.03), and took less chronic prescription drugs (P=0.002) than nonsurvivors. Multivariate Cox regression analysis identified a decreased score in the Lawton index (hazard ratio 0.86, 95% confidence interval: 0.78-0.91) and higher comorbidity conditions (hazard ratio 1.20, 95% confidence interval: 1.08-1.33) as independent predictors of mortality at 5 years in the studied population. Conclusion: The ability to perform instrumental activities of daily living and the global comorbidity assessed at baseline were the predictors of death, identified in our 85-year-old community-dwelling subjects after 5 years of follow-up. [ABSTRACT FROM AUTHOR]

Objectives To determine whether simple functional indicators are predictors of survival prognosis in very old adults. Design In-person survey conducted over a 3-month period in 1998; assessment of survival over a 15-year follow-up period. Setting Denmark. Participants All 3,600 Danes born in 1905 and living in Denmark in 1998, were invited to participate regardless of residence and health; 2,262 (63%) participated in the survey: 1,814 (80.2%) in person and 448 (19.8%) through a proxy. Measurements Socioeconomic factors, medications and diseases, activities of daily living, physical performance, cognition, depression symptomatology, self-rated health, and all-cause mortality, evaluated as average remaining lifespan and chance of surviving to 100 years. Results Men aged 92 to 93 had an overall 6.0% chance of surviving to 100 years, whereas the chance for women was 11.4%. Being able to rise without use of hands increased the chance for men to 11.2% (95% confidence interval (CI) = 7.7-14.7) and for women to 22.0% (95% CI = 18.9-25.1). When combining this with a Mini-Mental State Examination (MMSE) scores from 28 to 30, the chances were 21.7% (95% CI = 11.5-31.9) for men and 34.2% (95% CI = 24.8-43.5) for women. Conclusion Chair stand score combined with MMSE score is a quick and easy way to estimate overall chance of survival in very old adults, which is particularly relevant when treatment with potential side effects for nonacute diseases is considered. [ABSTRACT FROM AUTHOR]

Objectives:Previous research on age-related changes in Theory of Mind (ToM) showed a decline in older adults, particularly pronounced over 75 years of age. Evidence that ToM may be enhanced in healthy aging people has been demonstrated, but no study has focused on the role of age on the effects of ToM training for elderly people. The present study was designed to examine the efficacy of a ToM training on practiced (ToM Strange Stories) and transfer tasks (ToM Animations) in both young and older adults. Method:The study involved 127 older adults belonging to two age groups: young–old (Mage= 64.41; SD = 2.49; range: 60–69 years) and old–old (Mage= 75.66; SD = 4.38; range: 70–85 years), randomly assigned to either a ToM group or a control group condition. All participants took part in two 2-hour testing sessions and four 2-hour training sessions. Results:Results showed that both young–old and old–old adults in the ToM group condition improved their ability to reason on complex-mental states significantly more than participants in the control group condition. This positive effect of the training was evident on practiced and transfer ToM tasks. Crucially, age did not moderate the effect of the ToM training. Conclusion:These findings demonstrate that young–old and old–old adults equally benefit from the ToM training. Implications for the positive effect of the ToM training in old–old adults are discussed. [ABSTRACT FROM PUBLISHER]