Journals of Gerontology Series A-Biological Sciences and Medical Sciences最新文献

{"title":"Association of Dietary Live Microbes and Nondietary Prebiotic/Probiotic Intake With Cognitive Function in Older Adults: Evidence From NHANES.","authors":"Haoxian Tang, Xuan Zhang, Nan Luo, Jingtao Huang, Yanqiao Zhu","doi":"10.1093/gerona/glad175","DOIUrl":"10.1093/gerona/glad175","url":null,"abstract":"<p><strong>Background: </strong>The current study aims to examine association of dietary live microbes and nondietary prebiotic/probiotic intake with cognitive function among older U.S. adults, examining heterogeneity across demographic characteristics and diseases.</p><p><strong>Methods: </strong>Participants from the National Health and Nutrition Examination Survey 2011-2014 cycles were selected and administered 3 cognitive function tests: the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD W-L, including immediate [CERAD-IRT] and delayed [CERAD-DRT] memory), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Test-specific and global cognition z-score was created. Based on their estimated dietary live microbes intake, participants were categorized into three groups: low, medium, and high. Text mining was employed to identify nondietary prebiotic/probiotic usage by examining the names and ingredients of dietary supplements or drugs.</p><p><strong>Results: </strong>Participants in the medium (including AFT) and high (including global cognition, AFT, DSST, and CERAD-IRT) dietary live microbes intake group had significantly higher z-score of cognitive function compared to those in the low intake group. Among participants with cardiovascular disease history, nondietary prebiotic intake was associated with higher z-score in global cognition and CERAD-DRT compared to those who did not consume prebiotic. Additionally, probiotic intake was linked to higher z-score in global cognition, AFT, and DSST, particularly in participants with diabetes mellitus or hypertension.</p><p><strong>Conclusions: </strong>Our study suggests that the intake of dietary live microbes and nondietary probiotic/prebiotic was associated with better cognitive function in older adults, particularly in specific disease states.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9906940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Associations Between Glucosamine Supplementation and Dementia or Parkinson's Disease: Findings From a Large Prospective Cohort Study.","authors":"Baozhuo Ai, Lan Chen, Miao Cai, Jiaying Fu, Haitao Li, Hualiang Lin, Zilong Zhang","doi":"10.1093/gerona/glad123","DOIUrl":"10.1093/gerona/glad123","url":null,"abstract":"<p><strong>Background: </strong>We investigated the associations between habitual use of glucosamine and incident dementia and Parkinson's disease in a population-based cohort.</p><p><strong>Methods: </strong>Using the UK Biobank data, we included around 0.29 million middle- to old-aged participants free of dementia or Parkinson's disease at baseline. Glucosamine supplementation was measured by questionnaire at baseline. Some participants additionally answered 1-5 rounds of 24-hour dietary recalls afterwards, particularly 112 243 participants (for dementia) and 112 084 (for Parkinson's disease). Incident cases of dementia and Parkinson's disease were identified through linkage to health administrative data sets. We examined the associations of glucosamine supplementation with incident dementia and Parkinson's disease using Cox proportional-hazards regression models with adjustment for various covariates.</p><p><strong>Results: </strong>During the study period (median follow-up: 9.1-10.9 years), 4 404 and 1 637 participants developed dementia and Parkinson's disease, respectively. Glucosamine intake was not associated with incident dementia or Parkinson's disease. In fully adjusted models, the hazard ratios associated with glucosamine intake were 1.06 [95% confidence interval (CI): 0.99, 1.14] for dementia and 0.97(95% CI: 0.86, 1.09) for Parkinson's disease. In the subsample, similar results were found as the frequency of reported glucosamine use over multiple dietary surveys was associated with neither of the 2 conditions.</p><p><strong>Conclusions: </strong>Habitual supplementation of glucosamine was not associated with incident dementia or Parkinson's disease.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9432922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Healthy Aging in Older Veterans Using Computational Audio Analysis.","authors":"Yunting Yin, Douglas William Hanes, Steven Skiena, Sean A P Clouston","doi":"10.1093/gerona/glad154","DOIUrl":"10.1093/gerona/glad154","url":null,"abstract":"<p><strong>Background: </strong>Researchers are increasingly interested in better methods for assessing the pace of aging in older adults, including vocal analysis. The present study sought to determine whether paralinguistic vocal attributes improve estimates of the age and risk of mortality in older adults.</p><p><strong>Methods: </strong>To measure vocal age, we curated interviews provided by male U.S. World War II Veterans in the Library of Congress collection. We used diarization to identify speakers and measure vocal features and matched recording data to mortality information. Veterans (N = 2 447) were randomly split into testing (n = 1 467) and validation (n = 980) subsets to generate estimations of vocal age and years of life remaining. Results were replicated to examine out-of-sample utility using Korean War Veterans (N = 352).</p><p><strong>Results: </strong>World War II Veterans' average age was 86.08 at the time of recording and 91.28 at the time of death. Overall, 7.4% were prisoners of war, 43.3% were Army Veterans, and 29.3% were drafted. Vocal age estimates (mean absolute error = 3.255) were within 5 years of chronological age, 78.5% of the time. With chronological age held constant, older vocal age estimation was correlated with shorter life expectancy (aHR = 1.10; 95% confidence interval: 1.06-1.15; p < .001), even when adjusting for age at vocal assessment.</p><p><strong>Conclusions: </strong>Computational analyses reduced estimation error by 71.94% (approximately 8 years) and produced vocal age estimates that were correlated with both age and predicted time until death when age was held constant. Paralinguistic analyses augment other assessments for individuals when oral patient histories are recorded.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynapenic Abdominal Obesity Increases Risk for Falls Among Adults Aged ≥50 Years: A Prospective Analysis of the Irish Longitudinal Study on Ageing.","authors":"Lee Smith, Guillermo F López Sánchez, Nicola Veronese, Pinar Soysal, Masoud Rahmati, Louis Jacob, Karel Kostev, Josep Maria Haro, Abdullah Ahmed Alghamdi, Laurie Butler, Yvonne Barnett, Helen Keyes, Mark A Tully, Jae Il Shin, Ai Koyanagi","doi":"10.1093/gerona/glad104","DOIUrl":"10.1093/gerona/glad104","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of studies examining the longitudinal relationship between dynapenic abdominal obesity (DAO; ie, impairment in muscle strength and high waist circumference) and future fall risk. Therefore, we aimed to investigate the prospective association between DAO at baseline and falls occurring during 2 years of follow-up in a nationally representative sample of middle-aged and older individuals from Ireland.</p><p><strong>Methods: </strong>Data from 2 consecutive waves of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as a waist circumference of >88 cm for women and >102 cm for men. DAO was assessed at Wave 1 (2009-2011) and was defined as having both dynapenia and abdominal obesity. Falls occurring between Wave 1 and Wave 2 (2012-2013) were self-reported. Multivariable logistic regression analysis was conducted.</p><p><strong>Results: </strong>Data on 5 275 individuals aged ≥50 years were analyzed (mean [standard deviation {SD}] age 63.2 [8.9] years; 48.8% males). After adjustment for potential confounders, compared to no dynapenia and no abdominal obesity at baseline, DAO was significantly associated with 1.47 (95% confidence interval [CI]: 1.14-1.89) times higher odds for falls at 2-year follow-up. Dynapenia alone (odds ratio [OR] = 1.08; 95% CI: 0.84-1.40) and abdominal obesity alone (OR = 1.09; 95% CI: 0.91-1.29) were not significantly associated with falls at follow-up.</p><p><strong>Conclusions: </strong>DAO increased the risk for falls among middle-aged and older adults in Ireland. Interventions to prevent or reverse DAO may be beneficial for fall reduction.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9673711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Serum Uric Acid and Cognitive Function Among Middle-Aged and Older Adults Without Hyperuricemia: The Mediating Role of Depressive Symptoms.","authors":"Jiajia Zhang, Xiuqin Jia, Yingying Li, Deqiang Zheng, Xiuhua Guo, Haibin Li, Qi Yang","doi":"10.1093/gerona/glad203","DOIUrl":"10.1093/gerona/glad203","url":null,"abstract":"<p><strong>Background: </strong>The association between serum uric acid (SUA) and cognitive function remains unclear, especially among individuals without hyperuricemia. We examined the cross-sectional and longitudinal bidirectional associations between SUA and cognition, as well as the mediating effect of depressive symptoms among Chinese adults.</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). SUA (continuous) and cognitive function (based on mental intactness and episodic memory) were measured at Wave 1 and Wave 3. Depressive symptoms (Center for Epidemiologic Studies Depression scale) were assessed at Wave 1. Bivariate latent change score models and mediation analysis were used to investigate these possible associations.</p><p><strong>Results: </strong>A total of 6 236 participants free of hyperuricemia (aged 58.3 ± 8.5 years) were included. After controlling for potential confounders, the SUA level was associated with cognition at baseline (standardized r = 0.042; p = .001). Higher baseline SUA level was associated with slower subsequent cognitive decline (standardized β = 0.026; p = .027), whereas baseline cognition was not significantly associated with subsequent change in SUA (standardized β = 0.003; p = .817). In mediation analysis, baseline SUA was indirectly associated with subsequent cognition via baseline depressive symptoms (mediation effect 13.3%; p < .001).</p><p><strong>Conclusions: </strong>Higher baseline SUA level is associated with better baseline cognition and less subsequent cognitive decline among Chinese adults without hyperuricemia. Baseline depressive symptoms may partially mediate the association between baseline SUA and later cognition. Continued research is warranted to verify these findings and elucidate the causality and underlying mechanisms.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10414953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Disadvantage Moderates Late Midlife Default Mode Network Cortical Microstructure and Visual Memory Association.","authors":"Rongxiang Tang, Jeremy A Elman, Anders M Dale, Stephen M Dorros, Lisa T Eyler, Christine Fennema-Notestine, Daniel E Gustavson, Donald J Hagler, Michael J Lyons, Matthew S Panizzon, Olivia K Puckett, Chandra A Reynolds, Carol E Franz, William S Kremen","doi":"10.1093/gerona/glad114","DOIUrl":"10.1093/gerona/glad114","url":null,"abstract":"<p><strong>Background: </strong>Childhood disadvantage is a prominent risk factor for cognitive and brain aging. Childhood disadvantage is associated with poorer episodic memory in late midlife and functional and structural brain abnormalities in the default mode network (DMN). Although age-related changes in DMN are associated with episodic memory declines in older adults, it remains unclear if childhood disadvantage has an enduring impact on this later-life brain-cognition relationship earlier in the aging process. Here, within the DMN, we examined whether its cortical microstructural integrity-an early marker of structural vulnerability that increases the risk for future cognitive decline and neurodegeneration-is associated with episodic memory in adults at ages 56-66, and whether childhood disadvantage moderates this association.</p><p><strong>Methods: </strong>Cortical mean diffusivity (MD) obtained from diffusion magnetic resonance imaging was used to measure microstructural integrity in 350 community-dwelling men. We examined both visual and verbal episodic memory in relation to DMN MD and divided participants into disadvantaged and nondisadvantaged groups based on parental education and occupation.</p><p><strong>Results: </strong>Higher DMN MD was associated with poorer visual memory but not verbal memory (β = -0.11, p = .040 vs β = -0.04, p = .535). This association was moderated by childhood disadvantage and was significant only in the disadvantaged group (β = -0.26, p = .002 vs β = -0.00, p = .957).</p><p><strong>Conclusions: </strong>Lower DMN cortical microstructural integrity may reflect visual memory vulnerability in cognitively normal adults earlier in the aging process. Individuals who experienced childhood disadvantage manifested greater vulnerability to cortical microstructure-related visual memory dysfunction than their nondisadvantaged counterparts who exhibited resilience in the face of low cortical microstructural integrity.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9395766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological Dysregulation Proceeds and Predicts Health Outcomes Similarly in Chinese and Western Populations.","authors":"Qing Li, Véronique Legault, Sewanou Hermann Honfo, Emmanuel Milot, Qingzhou Jia, Fuqing Wang, Luigi Ferrucci, Stefania Bandinelli, Alan A Cohen","doi":"10.1093/gerona/glad146","DOIUrl":"10.1093/gerona/glad146","url":null,"abstract":"<p><strong>Background: </strong>A decade ago, we proposed an index of physiological dysregulation based on Mahalanobis distance (DM) that measures how far from the norm an individual biomarker profile is. While extensive validation has been performed, focus was mostly on Western populations with little comparison to developing countries, particularly at a physiological system level. The degree to which the approach would work in other sociocultural contexts and the similarity of dysregulation signatures across diverse populations are still open questions.</p><p><strong>Methods: </strong>Using 2 data sets from China and 3 from Western countries (United States, United Kingdom, and Italy), we calculated DM globally and per physiological system. We assessed pairwise correlations among systems, difference with age, prediction of mortality and age-related diseases, and sensitivity to interchanging data sets with one another as the reference in DM calculation.</p><p><strong>Results: </strong>Overall, results were comparable across all data sets. Different physiological systems showed distinct dysregulation processes. Association with age was moderate and often nonlinear, similarly for all populations. Mahalanobis distance predicted most health outcomes, although differently by physiological system. Using a Chinese population as the reference when calculating DM for Western populations, or vice versa, led to similar associations with health outcomes, with a few exceptions.</p><p><strong>Conclusions: </strong>While small differences were noticeable, they did not systematically emerge between Chinese and Western populations, but rather diffusively across all data sets. These findings suggest that DM presents similar properties, notwithstanding sociocultural backgrounds, and that it is equally effective in capturing the loss of homeostasis that occurs during aging in diverse industrial human populations.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Roles of Lifestyle, Psychosocial Characteristics, and Sleep Status in Sarcopenia: A Mendelian Randomization Study.","authors":"Mingchong Liu, Daqian Yu, Yutao Pan, Shengchao Ji, Ning Han, Chensong Yang, Guixin Sun","doi":"10.1093/gerona/glad191","DOIUrl":"10.1093/gerona/glad191","url":null,"abstract":"<p><strong>Background: </strong>Many studies reported that lifestyle, psychosocial characteristics, and sleep status related to sarcopenia, although few studies provided evidence of causal relationships between them.</p><p><strong>Methods: </strong>The data used in our study were from UK Biobank, FinnGen Release 8, and large genome-wide association study meta-analyses. Two-sample Mendelian randomization was conducted to identify the causal associations of 21 traits of lifestyle, psychosocial characteristics, and sleep status with 6 traits of sarcopenia. Benjamini-Hochberg correction was performed to reduce the bias caused by multiple tests. Risk factor analyses were performed to explore the potential mechanism behind the exposures.</p><p><strong>Results: </strong>Mendelian randomization analyses after adjustment proved the causal roles of coffee intake, education years, smoking, leisure screen time, and moderate-to-vigorous intensity physical activity during leisure time in sarcopenia was proven although providing no significant evidence for causal roles for carbohydrates intake, protein intake, alcohol, and sleep status in sarcopenia.</p><p><strong>Conclusions: </strong>Our results strongly support that coffee intake, education years, smoking, leisure screen time, and moderate-to-vigorous intensity physical activity during leisure time played significantly causal roles in sarcopenia, which may provide new intervention strategies for preventing the development of sarcopenia.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10325925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Loss and Physical Activity Among Older Adults in the United States.","authors":"Sahar Assi, Erica Twardzik, Jennifer A Deal, Kathleen Martin Ginis, Priya Palta, Jennifer A Schrack, Nicholas S Reed, Pablo Martinez-Amezcua","doi":"10.1093/gerona/glad186","DOIUrl":"10.1093/gerona/glad186","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss is associated with adverse health outcomes among older adults. Lower physical activity levels may partly explain these observations, yet the association between hearing loss, hearing aid use, and physical activity among older adults is understudied.</p><p><strong>Methods: </strong>Cross-sectional analysis of National Health and Aging Trends Study (2021) participants. The better-hearing ear pure-tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled continuously (10-dB increments) and categorically (no: ≤25 dB, mild: 26-40 dB, moderate or greater: >40 dB hearing loss). Activity measures were wrist accelerometry-derived (Actigraph) total activity counts, daily active minutes, activity fragmentation (using active-to-sedentary transition probability), and self-reported participation in vigorous activities and walking for exercise in the last month. We used multivariable regression adjusted for sociodemographic and health covariates.</p><p><strong>Results: </strong>Among 504 participants excluding hearing aid users (mean age = 79 years, 57% female, 9% Black), 338 (67%) had hearing loss. Worse hearing (continuously and categorically) was associated with fewer counts and active minutes, more fragmented activity, and greater odds of not reporting recent vigorous activities. Among 472 participants with hearing loss including hearing aid users, nonusers (n = 338) had more fragmented activity and greater odds of not reporting walking for exercise compared to users.</p><p><strong>Conclusions: </strong>Older adults with hearing loss are less physically active. This may mediate the association between hearing loss and other adverse outcomes. Recognition of this potential association is essential for providers to better support older adults in maintaining an active lifestyle. Future research is warranted to understand the impact of hearing interventions.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9917169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terminal Decline in Physical Function in Older Adults.","authors":"Erwin Stolz, Hannes Mayerl, Graciela Muniz-Terrera, Thomas M Gill","doi":"10.1093/gerona/glad119","DOIUrl":"10.1093/gerona/glad119","url":null,"abstract":"<p><strong>Background: </strong>It is currently unclear whether (and when) physical function exhibits a terminal decline phase, that is, a substantial acceleration of decline in the very last years before death.</p><p><strong>Methods: </strong>702 deceased adults aged 70 years and older from the Yale PEP Study provided 4 133 measurements of physical function (Short Physical Performance Battery, SPPB) up to 20 years before death. In addition, continuous gait and chair rise subtest scores (in seconds) were assessed. Generalized mixed regression models with random change points were used to estimate the onset and the steepness of terminal decline in physical function.</p><p><strong>Results: </strong>Decline accelerated in the last years of life in all 3 measures of physical function. The onset of terminal decline occurred 1 year before death for the SPPB, and at 2.5 and 2.6 years before death for chair rise and gait speed test scores, respectively. Terminal declines in physical function were 6-8 times steeper than pre-terminal declines. Relative to those whose condition leading to death was frailty, participants who died from dementia and cancer had an up to 6 months earlier and 3 months later onset of terminal decline in SPPB, respectively.</p><p><strong>Conclusions: </strong>Terminal decline in physical function among older adults is comparable to the more established terminal decline phenomenon in cognition. Our results provide additional evidence of late-life rapid decline in physical function due to impending death.</p>","PeriodicalId":49953,"journal":{"name":"Journals of Gerontology Series A-Biological Sciences and Medical Sciences","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9767851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}