The journals of gerontology. Series A, Biological sciences and medical sciences最新文献

{"title":"Projecting Long-Term Care Costs Among Older Adults With ADL Disabilities and Cognitive Impairment in China.","authors":"Haiyu Jin, Chenkai Wu","doi":"10.1093/gerona/glae140","DOIUrl":"10.1093/gerona/glae140","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence suggests that cognitive impairment is strongly associated with disability in activities of daily living (ADL disability) and long-term care (LTC) costs. However, studies forecasting future LTC costs often overlook these relationships. Consequently, this study aims to more accurately project future LTC costs in China over the next 20 years by considering the intertwined association between disability and cognitive impairment on future LTC costs.</p><p><strong>Methods: </strong>Data were from 10 959 adults ≥65 years from the 2005-2018 waves of the Chinese Longitudinal Healthy Longevity Surveys. We used the Markov model to project the population of China and track the transition of older adults in the next 20 years between 4 disability-cognition states. We employed a 2-part model to estimate LTC costs (direct and indirect LTC costs) per capita.</p><p><strong>Results: </strong>The proportion of disabled older adults with cognitive impairment was projected to increase from 1.4% in 2021 to 3.4% in 2040, while that of those without cognitive impairment was projected to decrease from 4.7% in 2021 to 4.5% in 2040. The direct and indirect LTC costs were projected to increase from 0.3% and 0.2% of gross domestic product (GDP) in 2021 to 1.4% and 0.7% in 2040 for disabled persons without cognitive impairment and from 0.1% and 0.1% of GDP in 2021 to 1.3% and 1.3% in 2040 for those with cognitive impairment, respectively.</p><p><strong>Conclusions: </strong>Policy-makers could include the assessment of cognition in the LTC needs assessment and allocate more compensation to LTC insurance participants with cognitive impairment.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend in Respite Use by Race Among Caregivers for People Living With Dementia.","authors":"Yeunkyung Kim, Jihye Kim, Hyunjee Kim, Sungchul Park, Yue Li","doi":"10.1093/gerona/glae036","DOIUrl":"10.1093/gerona/glae036","url":null,"abstract":"<p><strong>Background: </strong>Respite care provides short-term relief for caregivers. Despite efforts to promote respite use among Black caregivers, little is known if disparities in respite use between Black and White dementia caregivers have decreased over time. We examined a trend nationally to see if more recent efforts may have helped reduce disparities in respite use.</p><p><strong>Methods: </strong>We used a repeated cross-sectional design, with the data from 2015, 2017, and 2021 of the National Health and Aging Trends Study and National Study of Caregiving. Our study sample included 764 (in 2015), 839 (in 2017), and 521 (in 2021) non-Hispanic White and Black caregivers who provided care to older adults living with dementia, representing weighted 5 157 569 (2015), 5 877 997 (2017), and 4 712 144 (2021) dementia caregivers nationally. We conducted logistic regression models to assess the differences in respite use between White and Black caregivers over time.</p><p><strong>Results: </strong>In 2015, Black dementia caregivers had a respite care use rate 11.6 percentage points (95% CI: -16.9 to -6.4) lower than that of White dementia caregivers. However, both in 2017 and 2021, the difference in the use of respite was not statistically significant, leading to a reduced or no gap in respite use between White and Black dementia caregivers. However, respite use remained low in both groups.</p><p><strong>Conclusions: </strong>Although the gap in respite use between Black and White dementia caregivers had been gradually narrowed over time, more efforts are needed to encourage more respite use among both groups through targeted efforts to address factors that hinder respite use.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Memory Function and Memory Impairment Among Older Adults in the United States and Europe, 1996-2018.","authors":"Mikko Myrskylä, Jo Mhairi Hale, Daniel C Schneider, Neil K Mehta","doi":"10.1093/gerona/glae154","DOIUrl":"10.1093/gerona/glae154","url":null,"abstract":"<p><strong>Background: </strong>Single-country studies document varying time trends in memory function and impairment. Comparative analyses are limited.</p><p><strong>Methods: </strong>We used self-respondent data on adults aged 50+ years in 13 countries from 3 surveys (United States: Health and Retirement Study, 1998-2018; England: English Longitudinal Study of Ageing, 2002-2018; 11 European countries: Survey of Health, Ageing and Retirement in Europe, 2004-2019). Memory is measured with tests of immediate and delayed word recall. Unweighted age- and gender-adjusted mixed effects regression models as well as models with adjustments for additional sociodemographic characteristics and health behaviors were examined. Heterogeneity in trends by gender, age group, and educational attainment was measured.</p><p><strong>Results: </strong>The age-adjusted 10-year improvement in average test score is 0.04 standard deviations (SDs) (95% confidence interval [CI]: 0.03, 0.05) in the United States, 0.17 SDs (95% CI: 0.15, 0.19) in England, and 0.24 SDs (95% CI: 0.23, 0.25) in SHARE countries. Trends are largely similar across gender, age groups, and educational attainment. Regional differences in trends remain after adjustment for potential mechanisms. The difference between the United States and other countries is particularly large under 75 years of age compared to 75 years and older.</p><p><strong>Conclusions: </strong>Pace of improvement in memory function varies strongly across countries. On average, the 11 European countries studied had the fastest improvement, followed by England. The trend in the United States indicates improvement, but at a much slower pace compared to that in England and other European countries. Uncovering the causes for the cross-country heterogeneity in time trends, and in particular the reasons for the comparatively poor performance of the United States, should be both a research and public health priority.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care Need, Caregiver Availability, and Care Receipt: Variations Across Countries and Over Time in Three Middle-Income Countries.","authors":"Hae Yeun Park, Drystan Phillips, Jenny Wilkens, Zhiyong Lin, Marco Angrisani, Jinkook Lee","doi":"10.1093/gerona/glae141","DOIUrl":"10.1093/gerona/glae141","url":null,"abstract":"<p><strong>Background: </strong>Dementia is expected to increase more rapidly in low- and middle-income countries (LMIC) than in high-income countries (HIC) in the coming decades. Nevertheless, research on dementia care remains limited for LMIC. This study aims to fill this gap by investigating care needs and care receipt in 3 LMIC: China, Mexico, and India.</p><p><strong>Methods: </strong>Using harmonized data from the Gateway to Global Aging Data in China, Mexico, and India and focusing on individuals aged 65 and older with cognitive impairment (N = 15 118), we estimated the proportions of care needs related to difficulties with activities of daily living and instrumental activities of daily living, and care receipt. We then used logistic regressions to examine the association between caregiver availability and informal care receipt.</p><p><strong>Results: </strong>We observed relatively similar patterns in care need measures across countries and over time. In contrast, the association between caregiver availability and informal care receipt showed some cross-country variations. Generally, living with family members was associated with a higher probability of receiving informal care in China and India. However, for Mexico, this association was only evident for men. Additionally, we found that the magnitude of the association between caregiver availability and informal care receipt varied with the care recipient's gender.</p><p><strong>Conclusions: </strong>Although living with family members was generally associated with a higher likelihood of receiving informal care in China, Mexico, and India, there are differences in the association between caregiver availability and informal care receipt across countries and over time.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Practice Effects in Population-Based Studies of Trends in Late-Life Dementia and Cognitive Impairment.","authors":"Vicki A Freedman, Mengyao Hu","doi":"10.1093/gerona/glae198","DOIUrl":"10.1093/gerona/glae198","url":null,"abstract":"","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accumulation of advanced oxidation protein products promotes age-related decline of type H vessels in bone.","authors":"Kai Zhao, Guo-Zheng Zhu, Hong-Zhou Li, Jia-Wen Gao, Chen Tu, Di-Zheng Wu, Yu-Sheng Huang, Dong Han, Xing-Yu Chen, Long-Yan Wu, Zhao-Ming Zhong","doi":"10.1093/gerona/glae271","DOIUrl":"10.1093/gerona/glae271","url":null,"abstract":"<p><p>Type H vessels have been proven to couple angiogenesis and osteogenesis. The decline of type H vessels contributes to bone loss in the aging process. Aging is accompanied by the accumulation of advanced oxidation protein products (AOPPs). However, whether AOPP accumulation is involved in age-related decline of type H vessels is unclear. Here, we show that the increase of AOPP levels in plasma and bone were correlated with the decline of type H vessels and loss of bone mass in old mice. Exposure of microvascular endothelial cells to AOPPs significantly inhibited cell proliferation, migration, and tube formation, increased NADPH oxidase activity and excessive reactive oxygen species generation, upregulated the expression of vascular cell adhesion molecule-1 and intercellular cell adhesion molecule-1, and eventually impaired angiogenesis, which was alleviated by redox modulator N-acetylcysteine and NADPH oxidase inhibitor apocynin. Furthermore, reduced AOPP accumulation by NAC treatment was able to alleviate significantly the decline of type H vessels, bone mass loss and deterioration of bone microstructure in old mice. Collectively, these findings suggest that AOPPs accumulation contributes to the decline of type H vessels in the aging process, and illuminate a novel potential mechanism underlying age-related bone loss.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Participation in a Digital Health Intervention Study Among Older Adults: Uneven Involvement, Biased Outcomes and the Effect of Weighting.","authors":"Arianna Poli, Ingemar Kåreholt, Susanne Kelfve, Katarina Berg, Andreas Motel-Klingebiel","doi":"10.1093/gerona/glae265","DOIUrl":"https://doi.org/10.1093/gerona/glae265","url":null,"abstract":"<p><strong>Background: </strong>The involvement of older adults in research on digital health is uneven with respect to e.g. age, gender, health status, and digital skills. However, little is known regarding the impact of the uneven involvement of older adults in digital health research on researched outcomes. This study helps to fill this knowledge gap and identifies the effects of uneven involvement of older adults in digital health research on researched outcomes, and also develops a correction for this.</p><p><strong>Methods: </strong>Data are retrieved from a digital health intervention for postoperative monitoring of people who underwent day surgery in Sweden. Based on field information on the recruitment process and researched outcomes for the intervention, this study (1) tested intervention effects by using two standard unweighted procedures in a sample of 281 individuals aged 50 years or older, and then (2) used the information on participants, non-participants and their respective probabilities to be involved in the intervention study to perform a weighting of the intervention effects for each step of selection and for the study group membership.</p><p><strong>Results: </strong>The intervention effects were found to be overestimated due to overrepresentation of groups which gained from receiving the intervention. No intervention effects were found after adjustment for participation bias.</p><p><strong>Conclusions: </strong>Selective participation of older adults in digital health research biases research outcomes and can lead to overestimation of intervention effects. Weighting allows researchers to correct and describe the impact of selective participation on researched outcomes.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metrics of physiological network topology are novel biomarkers to capture functional disability and health.","authors":"Meng Hao, Hui Zhang, Shuai Jiang, Zixin Hu, Xiaoyan Jiang, Jingyi Wu, Yi Li, Li Jin, Xiaofeng Wang","doi":"10.1093/gerona/glae268","DOIUrl":"https://doi.org/10.1093/gerona/glae268","url":null,"abstract":"<p><strong>Background: </strong>Physiological networks are highly complex, integrating connections among multiple organ systems and their dynamic changes underlying human aging. It is unknown whether individual-level network could serve as robust biomarkers for health and aging.</p><p><strong>Methods: </strong>We used personalized network analysis to construct single sample network and examine the associations between network properties and functional disability in the Rugao Longevity and Aging Study (RuLAS), the China Health and Retirement Longitudinal Study (CHARLS), the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Results: </strong>We observed impairments in interconnected physiological systems among long-lived adults in RuLAS. Single sample network analysis was applied to reflect the co-occurrence of these multi-system impairments at the individual level. The ADL-disabled individuals' networks exhibited notably increased connectivity among various biomarkers. Significant associations were found between network topology and functional disability across RuLAS, CHARLS, CLHLS and NHANES. Additionally, network topology served as novel biomarkers to capture risks of incident ADL disability in CHARLS. Furthermore, these metrics of physiological network topology predicted mortality across four cohorts. Sensitivity analysis demonstrated that prediction performance of network topology remained robust, regardless of the chosen biomarkers and parameters.</p><p><strong>Conclusion: </strong>These findings showed that metrics of network topology were sensitive and robust biomarkers to capture risks of functional disability and mortality, highlighting the role of single sample physiological networks as novel biomarker for health and aging.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the upper limb in limiting head impact during laboratory-induced falls in at fall-risk older adults.","authors":"Lingjun Chen, Tobia Zanotto, James Fang, Ethan Scharf, Nathanael Garcia, Andrew Luzania, Rishav Mukherjee, Neil B Alexander, Jacob J Sosnoff","doi":"10.1093/gerona/glae267","DOIUrl":"https://doi.org/10.1093/gerona/glae267","url":null,"abstract":"<p><strong>Background: </strong>Fall-related head impact is the leading cause of traumatic brain injury in older adults. There is limited understanding of factors related to fall-related head impact. This investigation examined characteristics of upper limb movements during standing-height falls and examined their association with fall-related head impact in older adults at risk for falls.</p><p><strong>Methods: </strong>Older adults (n=29) at risk for fall-related injuries underwent experimentally induced falls in multiple directions (backwards and sideways). To characterize the upper limb movements and their association with head impact, a standardized analysis tool was used to analyze a total of 164 video-recorded falls. The association between upper limb movements (and their characteristics) and head impact was analyzed through logistic regression.</p><p><strong>Results: </strong>Nearly 80% of falls involved upper limb movements. Absence of upper limb movements significantly increased head impact odds by approximately 4-fold. The odds of head impact were reduced in falls with energy absorption at the forearm (0.013-fold) and upper arm (0.018-fold), compared to falls without upper limb energy absorption. Backwards falls showed significantly higher odds of head impact (more than 4-fold).</p><p><strong>Conclusion: </strong>Upper limb movements are common during fall descent and are associated with lower odds of experiencing head impact. Energy absorption with the upper limb seems to be an important protective mechanism. Future work should explore if these movements can be augmented with targeted training.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Psychotropic Medication Use and Gait and Mobility Impairment in Community-Dwelling Older People. Data from The Irish Longitudinal Study on Ageing (TILDA).","authors":"Desmond O' Donnell, Frank Moriarty, Amanda Lavan, Rose Anne Kenny, Robert Briggs","doi":"10.1093/gerona/glae263","DOIUrl":"https://doi.org/10.1093/gerona/glae263","url":null,"abstract":"<p><strong>Background: </strong>Little work to date has quantified the effect of psychotropic medications (antidepressants, benzodiazepines, 'Z' drugs, antipsychotics, anticholinergics) on mobility and gait in later life. The aim of this study is to examine the relationship between these medications and mobility/gait parameters in a large cohort of community-dwelling older people.</p><p><strong>Methods: </strong>Participants were included if they were ≥60 years at TILDA Wave 1 and underwent gait and mobility assessment (Gaitrite system), with follow-up at Wave 3 (4 years). Medication lists were examined for psychotropic medications. Regression models assessed the relationship between psychotropic medications and mobility, using the following parameters: Timed Up and Go (TUG), gait speed, step length / width, double support phase. Multilevel modelling assessed trajectories of mobility/gait variables over time by psychotropic use.</p><p><strong>Results: </strong>Of 2620 patients, 12% were prescribed ≥1 psychotropic medication, 3% prescribed ≥2 psychotropics. Cross-sectionally, psychotropic medication was independently associated with prolonged TUG (β=0.50 (95% CI 0.27-0.73); p<0.001), slower gait speed (β=-5.65 (95% CI -7.92 - -3.38); p<0.001), shorter step length (β=-2.03 (95% CI -2.93 - -1.42); p<0.001) and increased double support phase (β=0.47 (95% CI 0.19-0.75); p=0.001).Longitudinally, psychotropic use was independently associated with transition to abnormal TUG (OR 2.68 (95% CI 1.55-4.64), p<0.001), while using ≥2 psychotropics was associated with transition to slower gait speed (OR 2.59 (95% CI 1.01-6.68); p=0.048).</p><p><strong>Conclusions: </strong>Psychotropic use was associated with significantly poorer mobility and gait performance, both cross-sectionally and longitudinally. It is imperative that psychotropic medication use is reviewed as part of comprehensive geriatric assessment.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}