Archives of gerontology and geriatrics最新文献

{"title":"Polygenic hazard score predicts synaptic and axonal degeneration and cognitive decline in Alzheimer's disease continuum","authors":"Mohammad-Erfan Farhadieh ,&nbsp;Mehrdad Mozafar ,&nbsp;Saameh Sanaaee ,&nbsp;Parastoo Sodeifi ,&nbsp;Kiana Kousha ,&nbsp;Yeganeh Zare ,&nbsp;Shahab Zare ,&nbsp;Nooshin Maleki Rad ,&nbsp;Faezeh Jamshidi-Goharrizi ,&nbsp;Mohammad Allahverdloo ,&nbsp;Arman Rahimi ,&nbsp;Mohammad Sadeghi ,&nbsp;Mahan Shafie ,&nbsp;Mahsa Mayeli ,&nbsp;for the Alzheimer's Disease Neuroimaging Initiative","doi":"10.1016/j.archger.2024.105576","DOIUrl":"10.1016/j.archger.2024.105576","url":null,"abstract":"<div><h3>Background</h3><p>Growth associated protein-43 (GAP-43) and neurofilaments light (NFL) are biomarkers of synaptic and axonal injury, and are associated with cognitive decline in Alzheimer's disease (AD) contiuum. We investigated whether Polygenic Hazard Score (PHS) is associated with specific biomarkers and cognitive measures, and if it can predict the relationship between GAP-43, NFL, and cognitive decline in AD.</p></div><div><h3>Method</h3><p>We enrolled 646 subjects: 93 with AD, 350 with mild cognitive impairment (MCI), and 203 cognitively normal controls. Variables included GAP-43, plasma NFL, and PHS. A PHS of 0.21 or higher was considered high risk while a PHS below this threshold was considered low risk. A subsample of 190 patients with MCI with four years of follow-up cognitive assessments were selected for longitudinal analysis . We assessed the association of the PHS with AD biomarkers and cognitive measures, as well as the predictive power of PHS on cognitive decline and the conversion of MCI to AD.</p></div><div><h3>Results</h3><p>PHS showed high diagnostic accuracy in distinguishing AD, MCI, and controls. At each follow-up point, high risk MCI patients showed higher level of cognitive impairment compared to the low risk group. GAP-43 correlated with all follow-up cognitive tests in high risk MCI patients which was not detected in low risk MCI patients. Moreover, high risk MCI patients progressed to dementia more rapidly compared to low risk patients.</p></div><div><h3>Conclusion</h3><p>PHS can predict cognitive decline and impacts the relationship between neurodegenerative biomarkers and cognitive impairment in AD contiuum. Categorizing patients based on PHS can improve the prediction of cognitive outcomes and disease progression.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105576"},"PeriodicalIF":3.5,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based care models for patients with terminal illnesses in low and middle-income countries: A systematic review of randomized and quasi-experimental studies","authors":"Dalhat Khalid Sani ,&nbsp;Umar Yunusa ,&nbsp;Salihu Abdulrahman Kombo ,&nbsp;Attahir Ibrahim ,&nbsp;Hadiza Mohammed Sani ,&nbsp;Shehu Salihu Umar ,&nbsp;Muhammad Awwal Ladan","doi":"10.1016/j.archger.2024.105580","DOIUrl":"10.1016/j.archger.2024.105580","url":null,"abstract":"<div><h3>Background</h3><p>With the increasing lifespan of people and the transition from communicable to non-communicable diseases across the globe, there is an increasing number of people with terminal illnesses requiring home-based care in Low- and Middle-Income Countries (LMICs).</p></div><div><h3>Aim</h3><p>This systematic review evaluated home-based care models for patients with terminal illnesses in LMICs. The primary outcomes measured are quality of life (QoL), adherence to treatment, fatigue, bimanual and related activities.</p></div><div><h3>Methods</h3><p>This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Four databases; Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE (Ovid), Cochrane Library and Scopus, were systematically searched for potentially relevant studies. Screening of records (titles/abstracts from and full-texts) was done and a total of seven studies (four Randomized Control Trials [RCTs] and three quasi-experimental studies) were included in this review.</p></div><div><h3>Results</h3><p>Even though the included studies reported significant increase in the QoL of the studied patients, the studies have quality concerns.</p></div><div><h3>Conclusion</h3><p>Noting the general paucity of existing studies coupled with quality concerns across geographies in LMICs. More studies on home-based care for patients with terminal illness are needed with improved qualities and spread in these regions.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105580"},"PeriodicalIF":3.5,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141637886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between immune cells, inflammatory cytokines, and sarcopenia: Insights from a Mendelian randomization analysis","authors":"Jinqiu Zhou,&nbsp;Ying Liu,&nbsp;Jinhui Wu","doi":"10.1016/j.archger.2024.105560","DOIUrl":"10.1016/j.archger.2024.105560","url":null,"abstract":"<div><h3>Background</h3><p>Recent studies have suggested a possible link between sarcopenia, immune dysregulation, and chronic inflammation, although the specific immune components implicated remain unclear. This investigation employs Mendelian Randomization (MR) to explore the reciprocal relationship between immune cells, inflammatory markers, and sarcopenia.</p></div><div><h3>Method</h3><p>We performed two-sample and multivariate MR analyses using publicly accessible genome-wide association studies (GWAS) summary statistics. Our analyses included 731 immune cells, 41 inflammatory cytokines, and sarcopenia related traits (appendicular lean mass [ALM], low hand-grip strength [LHS], and walking pace [WP]), with additional sensitivity analyses conducted to confirm the findings.</p></div><div><h3>Results</h3><p>After false discovery rate (FDR) correction, significant associations were found between ten immune traits and ALM, with the CD127 marker in the Treg panel showing consistent positive correlation across four sites. In contrast, NKT%lymphocyte negatively correlated with WP (OR = 0.99, <em>P</em> = 0.023). In terms of inflammatory cytokines, macrophage colony-stimulating factor (MCSF) (OR = 1.03, <em>P</em> = 0.024) and hepatocyte growth factor (HGF) (OR = 1.03, <em>P</em> = 0.002) demonstrated positive associations with ALM, while interleukin-16 (IL-16) (OR = 0.99, <em>P</em> = 0.006) was inversely related. The reverse Mendelian randomization analysis found no direct causal links between sarcopenia traits and immune or inflammatory markers. Sensitivity analyses underscored the findings' resilience to pleiotropy, and adjusting for inter-trait dynamics weakened these relationships in the multivariable MR analysis.</p></div><div><h3>Conclusion</h3><p>Our study reveals causal associations between specific immune phenotypes, inflammatory cytokines, and sarcopenia, providing insight into the development of sarcopenia and potential treatment strategies.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"128 ","pages":"Article 105560"},"PeriodicalIF":3.5,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S016749432400236X/pdfft?md5=da6c71d1c181e04cb6d1aab952b2c001&pid=1-s2.0-S016749432400236X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of involuntary treatment among community-living older persons with dementia: A systematic review","authors":"Minyan Liu ,&nbsp;Yuqiang Wang ,&nbsp;Qinglin Zeng ,&nbsp;Jia Li ,&nbsp;Liping Yang ,&nbsp;Yanli Zeng","doi":"10.1016/j.archger.2024.105574","DOIUrl":"10.1016/j.archger.2024.105574","url":null,"abstract":"<div><h3>Objective</h3><p>This systematic review and meta-analysis aimed to ascertain the prevalence of involuntary treatment among community-living older persons with dementia and explore associated factors.</p></div><div><h3>Methods</h3><p>We comprehensively searched seven electronic databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, and Scopus) from their inception to October 17, 2023, with an update conducted on April 1, 2024. Meta-analysis synthesized prevalence estimates of involuntary treatment and its three subcategories, with 95% confidence intervals.</p></div><div><h3>Results</h3><p>This study included 11 research papers involving 12,136 community-dwelling individuals with cognitive impairment and dementia from 19 countries. The pooled prevalence of involuntary treatment among community-dwelling older persons with dementia was 45.2% (95% CI: 33.7−60.5%). Subcategories included physical restraints (9.8%, 95% CI: 5.1−18.8%), psychotropic medication (19.1%, 95% CI: 13.6−26.9%), and non-consensual care (34.3%, 27.6−42.7%). Factors influencing involuntary treatment were categorized as caregiver-related and care recipient-related.</p></div><div><h3>Conclusion</h3><p>This study underscores the prevalent use of involuntary treatment among community-dwelling older persons with dementia, emphasizing its association with specific caregiver and care recipient factors. Addressing these findings underscores the importance of proactive measures and targeted interventions to improve the quality of care for this vulnerable population.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105574"},"PeriodicalIF":3.5,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the combination of social isolation and living alone with cognitive impairment in community-dwelling older adults: The IRIDE Cohort Study","authors":"Keigo Imamura ,&nbsp;Hisashi Kawai ,&nbsp;Manami Ejiri ,&nbsp;Takumi Abe ,&nbsp;Mari Yamashita ,&nbsp;Hiroyuki Sasai ,&nbsp;Shuichi Obuchi ,&nbsp;Hiroyuki Suzuki ,&nbsp;Yoshinori Fujiwara ,&nbsp;Shuichi Awata ,&nbsp;Kenji Toba ,&nbsp;IRIDE Cohort Investigators","doi":"10.1016/j.archger.2024.105571","DOIUrl":"10.1016/j.archger.2024.105571","url":null,"abstract":"<div><h3>Background</h3><p>Living alone has been associated with cognitive impairment; however, findings have been inconsistent. Social isolation among older adults who live alone may contribute to cognitive impairment. This study was carried out to examine the association of social isolation and living alone with cognitive impairment in community-dwelling older adults.</p></div><div><h3>Methods</h3><p>In this cross-sectional study, data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which comprises pooled data from five community-based geriatric cohorts, was used. Social isolation was defined as infrequent interactions with others. Participants were categorized into four groups based on their social isolation and living alone statuses. Cognitive function was assessed using the Mini-Mental State Examination, with a score &lt;24 indicating cognitive impairment. The association between social isolation combined with living alone and cognitive impairment was analyzed using logistic regression.</p></div><div><h3>Results</h3><p>Of the 4362 participants included in the analysis (mean age 75.6 years, 44.3% male), 11% had cognitive impairment. Regardless of living alone, social isolation was associated with cognitive impairment (no social isolation x not living alone: reference, social isolation x not living alone; odds ratio (OR): 1.74, 95% confidence interval (CI): 1.29–2.33, social isolation x living alone; OR: 2.10, 95% CI: 1.46–3.01).</p></div><div><h3>Conclusions</h3><p>Social isolation is associated with cognitive impairment; however, living alone is not intrinsically associated with cognitive impairment in older adults. Healthcare providers must focus on social interactions to prevent cognitive impairment in older adults rather than simply focusing on living arrangements.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105571"},"PeriodicalIF":3.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between tooth loss and progression of frailty: Findings from the English longitudinal study of aging","authors":"Takamasa Komiyama ,&nbsp;Jennifer E. Gallagher ,&nbsp;Yoshinori Hattori","doi":"10.1016/j.archger.2024.105572","DOIUrl":"https://doi.org/10.1016/j.archger.2024.105572","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of the present study was to investigate the relationship between indicators of oral health status (number of teeth; denture use) and the progression of frailty amongst adults in England.</p></div><div><h3>Methods</h3><p>The subjects were participants of the English Longitudinal Study of Aging [ELSA] aged 50 years and older. We used panel data from three waves of the study (Waves 7–9). Indicators of oral health comprised the number of teeth (≥20; 10–19; 1–9; 0) and combination of removable denture usage and the number of teeth. Frailty was assessed by the 32-item Frailty Index (FI). Covariates were age, sex, education, marital status, smoking, alcohol, and physical activity. The longitudinal relationship between oral health indicators and change in FI were investigated using linear mixed-effect models considering frailty as a time-varying variable.</p></div><div><h3>Results</h3><p>Among the 7,557 participants, compared to those people with 20 or more teeth, change in frailty over time was significantly higher among those with less than 20 teeth: 10–19 teeth (β: 0.249, 95 %CI: 0.116 to 0.382), and 1–9 teeth (β: 0.238, 95 %CI: 0.053 to 0.423) and being edentate (β: 0.286, 95 %CI: 0.106 to 0.465) when adjusting for co-variates. The rise in frailty over time was significantly higher among those with fewer teeth (&lt;20 teeth), including those using dentures.</p></div><div><h3>Conclusions and implications</h3><p>This longitudinal analysis suggests that tooth loss is associated with accelerated progression of frailty and utilizing dentures did not reduce the trend in frailty. Thus, maintaining a functional natural dentition is important in healthy ageing.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105572"},"PeriodicalIF":3.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167494324002486/pdfft?md5=c62dff4ffd1b63a9b9cc7c9e2ab0fcc5&pid=1-s2.0-S0167494324002486-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review on attitudes towards death and dying in adults 50 years and older living in countries with community transmission of COVID -19.","authors":"Alana Officer ,&nbsp;Sophie Pautex ,&nbsp;Andreea Badache ,&nbsp;Barbara Broers ,&nbsp;Matthew Prina","doi":"10.1016/j.archger.2024.105573","DOIUrl":"10.1016/j.archger.2024.105573","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has underscored older adults’ vulnerability to severe illness or death. Increased public awareness of mortality, with daily reminders of preventive measures, spurred interest in understanding the impact on death-related thoughts. This systematic review analyses existing literature on death attitudes among individuals aged 50 and older during the COVID-19 pandemic and focuses on associated factors.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted using the WHO COVID database without any language limit, up until April 2023. The review protocol was registered in PROSPERO and PRISMA guidelines were followed. Included studies were systematically analysed and summarized using a predefined data extraction sheet.</p></div><div><h3>Results</h3><p>Of the 2297 studies identified, 9 met inclusion criteria. The review showed moderate to high levels of death anxiety during the pandemic, linked to direct health risks from COVID-19 rather than mitigation measures. The impact of health and personal factors on older people's death anxiety was complex, with a range of health and personal factors such as chronic conditions, loss of capacity, loneliness, occupation, and resilience associated with it, suggesting potential intervention avenues.</p></div><div><h3>Conclusion</h3><p>The systematic review shows a significant link between COVID-19 and heightened death anxiety among individuals aged 50 and above. Negative attitudes to death can harm physical and mental health, diminish life satisfaction, increase avoidance behaviour, impair coping mechanism and undermine end-of-life decision making. Findings underscore the need for further research into risk and protective factors (personal, health, and environmental) and the importance of standardized data collection to guide interventions and public health strategies aimed at mitigating death anxiety.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105573"},"PeriodicalIF":3.5,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167494324002498/pdfft?md5=5e1605da1d95f58acf0ea8d9e6368994&pid=1-s2.0-S0167494324002498-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can an active lifestyle offset the relationship that poor lifestyle behaviours have on frailty?","authors":"A. Mayo ,&nbsp;M.W. O'Brien ,&nbsp;J. Godin ,&nbsp;D.S. Kehler ,&nbsp;D.S. Kimmerly ,&nbsp;O. Theou","doi":"10.1016/j.archger.2024.105556","DOIUrl":"10.1016/j.archger.2024.105556","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the association of lifestyle behaviours (LSB) with physical activity (PA) and frailty; also, to examine if associations differ by sex and age.</p></div><div><h3>Methods</h3><p>24,828 individuals [49.6 ± 17.6 years (range: 20–85), 51.6 % female] from the National Health and Nutrition Examination Survey (cycles 2009–2018) were included. Individuals were divided into Active (≥150 min/week of moderate-to-vigorous physical activity (MVPA)) and Inactive (&lt;150 min/week MVPA) based on self-reported PA. Frailty was measured by a 46-item Frailty Index (FI). LSB consisted of stationary time, sleep, diet quality, and alcohol and smoking habits. LSB was summed into a score [0–5]. Linear regression models were used with each LSB in isolation and the summed LSB with frailty.</p></div><div><h3>Results</h3><p>There were 7,495 (30.1 %) Active and 17,333 (69.8 %) Inactive individuals. The FI was lower in the Active participants (Active: 0.10 ± 0.08; Inactive: 0.15 ± 0.12; <em>p</em> &lt; 0.01). A worse LSB score was associated with an increased FI in all behaviours but females who binge drink and smoke (p-all&gt;0.14). For inactive individuals, all LSBs were associated with an increased FI except those who binge drink and male smokers (<em>p</em> = 0.08). There was a significant association between increased summed LSB and an increased FI (β range: Active, 0.024–0.037; Inactive, 0.028, 0.046. p-all&lt;0.01); the Active group had a lower FI at every age group than the Inactive group (<em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>PA was associated with a lower FI even among those with a poor LSB score. This association is dependent on age, with older individuals reporting a stronger association.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105556"},"PeriodicalIF":3.5,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167494324002322/pdfft?md5=490f12e9944b9af6021ba7825f31a618&pid=1-s2.0-S0167494324002322-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and effectiveness of a 6-month, home-based, resistance exercise delivered by a remote technological solution in healthy older adults","authors":"Luca Ferrari ,&nbsp;Gianluca Bochicchio ,&nbsp;Alberto Bottari ,&nbsp;Alessandra Scarton ,&nbsp;Valentina Cavedon ,&nbsp;Chiara Milanese ,&nbsp;Francesco Lucertini ,&nbsp;Silvia Pogliaghi","doi":"10.1016/j.archger.2024.105559","DOIUrl":"10.1016/j.archger.2024.105559","url":null,"abstract":"<div><h3>Background</h3><p>Aging is characterized by a physiological decline in physical function, muscle mass, strength, and power. Home-based resistance training interventions have gained increasing attention from scientists and healthcare system operators, but their efficacy is yet to be fully determined.</p></div><div><h3>Aims</h3><p>to verify the safety, feasibility, and efficacy of a home-based resistance training program delivered by innovative technological solution in healthy older adults.</p></div><div><h3>Methods</h3><p>73 participants (36 females) were randomly allocated to either a control (C) or an intervention (I) group consisting of a 6-months home-based resistance training program delivered through an innovative technological solution, which included a wearable inertial sensor and a dedicated tablet. The safety and feasibility of the intervention were assessed by recording training-related adverse events and training adherence. Body composition, standing static balance, 10-meter walking, and loaded 5 sit-to-stand tests were monitored to quantify efficacy.</p></div><div><h3>Results</h3><p>No adverse events were recorded. Adherence to the training program was relatively high (61 % of participants performed the target 3 sessions) in the first trimester, significantly dropping during the second one. The intervention positively affected walking parameters (<em>p</em> &lt; 0.05) and maximal force (<em>p</em> = 0.009) while no effect was recorded on body composition, balance, and muscle power.</p></div><div><h3>Conclusions</h3><p>The home-based device-supported intervention was safe and feasible, positively affecting walking parameters and lower limbs' maximal force. This approach should be incentivized when barriers to participation in traditional resistance exercise programs are present.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105559"},"PeriodicalIF":3.5,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167494324002358/pdfft?md5=bb8abe1ed6e5b15b9fdd162268cc13fb&pid=1-s2.0-S0167494324002358-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of bottom-up versus top-down digital cognitive training in older adults: A randomized controlled trial","authors":"Erica Woodruff ,&nbsp;Bruno Costa Poltronieri ,&nbsp;Luisa Pedrosa de Albuquerque Sousa ,&nbsp;Yasmin Guedes de Oliveira ,&nbsp;Marcos Alexandre Reis ,&nbsp;Linda Scoriels ,&nbsp;Rogério Panizzutti","doi":"10.1016/j.archger.2024.105552","DOIUrl":"10.1016/j.archger.2024.105552","url":null,"abstract":"<div><h3>Introduction</h3><p>Impairments in bottom-up perceptual processing have been associated to the age-related cognitive decline. Digital cognitive training focusing on bottom-up and/or top-down processes have been studied as a tool to remediate age-related cognitive decline. However, the most effective training type and order of application remain unclear.</p></div><div><h3>Methods</h3><p>One hundred and fifteen older adults were randomly assigned to 40 h of bottom-up then top-down or top-down then bottom-up digital cognitive training or an active control group. We evaluated cognition at baseline, after 20 h and 40 h of training and at follow-up using a mixed-model analysis.</p></div><div><h3>Results</h3><p>Global cognition improved, for the top-down group, after 20 h of training (<em>p</em> = 0.04; <em>d</em> = 0.7) and for all three groups after 40 h. The improvement in global cognition remained five months after the bottom-up/ top-down training (<em>p</em> = 0.009; <em>d</em> = 4.0). There were also improvements in the recall cognitive domain, after 20 h of training, for the bottom-up group and, after 40 h, for all three groups. Gains were observed in verbal fluency after 40 h of training for both therapeutic groups. Processing speed was significantly slower, after 20 h of training, for the control and bottom-up groups and, after 40 h, only for the control group. Emotion recognition improved, after 20 h, for the control group as compared to the therapeutic groups.</p></div><div><h3>Conclusions</h3><p>These results indicate that the bottom-up/top-down training has the most endurable effects, which reveals the importance of the order of application of the exercises for gains in cognition in older adults.</p></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"127 ","pages":"Article 105552"},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}