Longitudinal associations between C-reactive protein and cognitive performance in normative cognitive ageing and dementia.

BACKGROUND: systemic inflammation appears to play an important role in the pathogenesis and expression of Alzheimer's disease and other dementias. Previous research has found that elevated levels of serum C-reactive protein (CRP) is associated with poorer cognitive functioning and increased risk for dementia. However, most studies are limited by single CRP measurements, which fail to capture long-term inflammatory exposures or dynamic changes in inflammation and cognition which may occur across repeated measurements. METHODS: using data from 3,563 older adults aged 65-101 from the Health and Retirement Study, we examined bivariate changes in CRP and cognition measured repeatedly over a 10-year follow-up. Bivariate multilevel models estimated the effect of time-varying CRP on cognition among cognitively healthy older adults and in a subset of 427 participants who reported incident dementia onset during the follow-up period. RESULTS: in cognitively healthy participants, CRP was associated with lower level of cognitive functioning, but not rate of change over time. This effect was significant in participants under 80 years of age (b = -0.09, standard error (SE) = 0.05, P = 0.04), but not in older participants. In participants with incident dementia, those with higher CRP experienced smaller rates of cognitive decline, leading up to dementia diagnosis. CONCLUSIONS: elevated levels of CRP predict poorer cognition and increased dementia risk in cognitively healthy adults under the age of 80. Conversely, increased CRP may confer protective effects on cognition in the prodromal stage of dementia.

Comparisons of disease cluster patterns, prevalence and health factors in the USA, Canada, England and Ireland.

BACKGROUND: Identification of those who are most at risk of developing specific patterns of disease across different populations is required for directing public health policy. Here, we contrast prevalence and patterns of cross-national disease incidence, co-occurrence and related risk factors across population samples from the U.S., Canada, England and Ireland. METHODS: Participants (n = 62,111) were drawn from the US Health and Retirement Study (n = 10,858); the Canadian Longitudinal Study on Ageing (n = 36,647); the English Longitudinal Study of Ageing (n = 7938) and The Irish Longitudinal Study on Ageing (n = 6668). Self-reported lifetime prevalence of 10 medical conditions, predominant clusters of multimorbidity and their specific risk factors were compared across countries using latent class analysis. RESULTS: The U.S. had significantly higher prevalence of multimorbid disease patterns and nearly all diseases when compared to the three other countries, even after adjusting for age, sex, BMI, income, employment status, education, alcohol consumption and smoking history. For the U.S. the most at-risk group were younger on average compared to Canada, England and Ireland. Socioeconomic gradients for specific disease combinations were more pronounced for the U.S., Canada and England than they were for Ireland. The rates of obesity trends over the last 50 years align with the prevalence of eight of the 10 diseases examined. While patterns of disease clusters and the risk factors related to each of the disease clusters were similar, the probabilities of the diseases within each cluster differed across countries. CONCLUSIONS: This information can be used to better understand the complex nature of multimorbidity and identify appropriate prevention and management strategies for treating multimorbidity across countries.

Cross-lagged relationships between sense of purpose in life, memory performance, and subjective memory beliefs in adulthood over a 9-year interval.

OBJECTIVES: Previous studies have found a positive association between having a sense of purpose in life and memory functioning in old age. We extend these findings by examining the relationships between sense of purpose, memory performance, and subjective memory beliefs over time in a large sample of adults in mid to later adulthood. METHOD: We used data from 3633 participants of the second and third wave of the MIDUS study. Cross-lagged panel analysis investigated the relationships between the variables at the two points, which were approximately 9 years apart, while controlling for gender, age, education, positive and negative affect, and self-rated health. RESULTS: Sense of purpose in life, memory performance, and subjective memory beliefs were all cross-sectionally related to each other at both times. Longitudinally, sense of purpose was a positive predictor of subjective memory beliefs. Memory performance and subjective memory beliefs positively predicted each other over time. Furthermore, all three variables showed correlated changes over time. Exploratory analyses suggest that the covariates of affect and self-rated health are possible mediators or confounders in respectively the relationship between subjective memory beliefs and later sense of purpose, and sense of purpose and later objective memory performance. CONCLUSION: Our findings underscore once more the relevance of sense of purpose in life as a predictor of positive late life functioning, as it is related to both performance-based and subjective cognitive outcomes. More work is needed to understand mechanisms underlying the purpose-memory association in order to develop and implement purpose interventions.

No Effect of New Zealand Blackcurrant Extract on Recovery of Muscle Damage Following Running a Half-Marathon.

New Zealand blackcurrant (NZBC) contains anthocyanins, known to moderate blood flow and display anti-inflammatory properties that may improve recovery from exercise-induced muscle damage. The authors examined whether NZBC extract supplementation enhances recovery from exercise-induced muscle damage after a half-marathon race. Following a randomized, double-blind, independent groups design, 20 (eight women) recreational runners (age 30 ± 6 years, height 1.73 ± 0.74 m, body mass 68.5 ± 7.8 kg, half-marathon finishing time 1:56:33 ± 0:18:08 hr:min:s) ingested either two 300-mg/day capsules of NZBC extract (CurraNZ™) or a visually matched placebo, for 7 days prior to and 2 days following a half-marathon. Countermovement jump performance variables, urine interleukin-6, and perceived muscle soreness and fatigue were measured pre, post, and at 24 and 48 hr after the half-marathon and analyzed using a mixed linear model with statistical significance set a priori at p < .05. The countermovement jump performance variables were reduced immediately post-half-marathon (p < .05), with all returning to pre-half-marathon levels by 48 hr, except the concentric and eccentric peak force and eccentric duration, with no difference in response between groups (p > .05). Urine interleukin-6 increased 48-hr post-half-marathon in the NZBC group only (p < .01) and remained unchanged compared with pre-half-marathon levels in the placebo group (p > .05). Perceived muscle soreness and fatigue increased immediately post-half-marathon (p < .01) and returned to pre-half-marathon levels by 48 hr, with no difference between groups (p > .05). Supplementation with NZBC extract had no effect on the recovery of countermovement jump variables and perceptions of muscle soreness or fatigue following a half-marathon in recreational runners.

Sense of purpose in life and extending the cognitive healthspan: evidence from multistate survival modeling.

Having a sense of purpose in life predicts better maintenance of cognitive function in older adulthood and reduced risk of mild cognitive impairment (MCI) and dementia. However, little research has examined its influence on the rate of cognitive decline and length of cognitive healthspan. This study evaluated the role of sense of purpose on the risk and timing of transitions between normal cognition, MCI, and dementia. Older adults from the Memory and Aging Project (MAP; n = 1821) and the Health and Retirement Study (HRS; n = 10,542) were followed annually for 19 years and biennially for 12 years, respectively. Multistate survival models assessed whether sense of purpose predicted transitions across normal cognition, MCI, dementia, and death. More purposeful older adults had lower risk of developing MCI (HR = 0.82 in MAP; HR = 0.93 in HRS), higher likelihood of cognitive improvement, and longer cognitively healthy life expectancies. Results suggest sense of purpose may extend the cognitive healthspan.

Sense of purpose in life and allostatic load in two longitudinal cohorts.

OBJECTIVE: Sense of purpose in life has been linked with better physical health, longevity, and reduced risk for disability and dementia, but the mechanisms linking sense of purpose with diverse health outcomes are unclear. Sense of purpose may promote better physiological regulation in response to stressors and health challenges, leading to lower allostatic load and disease risk over time. The current study examined the association between sense of purpose in life and allostatic load over time in adults over age 50. METHODS: Data from the nationally representative US Health and Retirement Study (HRS) and English Longitudinal Study of Ageing (ELSA) were used to examine associations between sense of purpose and allostatic load across 8 and 12 years of follow-up, respectively. Blood-based and anthropometric biomarkers were collected at four-year intervals and used to compute allostatic load scores based on clinical cut-off values representing low, moderate, and high risk. RESULTS: Population-weighted multilevel models revealed that sense of purpose in life was associated with lower overall levels of allostatic load in HRS, but not in ELSA after adjusting for relevant covariates. Sense of purpose in life did not predict rate of change in allostatic load in either sample. CONCLUSIONS: The present investigation supports sense of purpose predicting preserved differentiation of allostatic regulation, with more purposeful individuals demonstrating consistently lower allostatic load over time. Persistent differences in allostatic burden may account for divergent health trajectories between individuals low and high in sense of purpose.

Transitions Between Mild Cognitive Impairment, Dementia, and Mortality: The Importance of Olfaction.

BACKGROUND: The existing literature suggests that impaired olfaction may be an early marker for cognitive decline. Tracking the earliest stages of the progression to dementia is paramount, and yet the importance of olfactory ability throughout cognitive states and death remains unclear. METHODS: Drawing data from the Rush Memory and Aging Project (N = 1 501; 74% female), olfactory ability was assessed using the Brief Smell Identification Test (range = 0-16), while cognitive states (unimpaired, mild cognitive impairment [MCI], and dementia) were determined using a 3-step neuropsychological diagnostic protocol at up to 15 annual occasions. Multistate survival models simultaneously estimated the association of olfactory ability on transitions through cognitive states and death, while multinomial regression models estimated cognitively unimpaired and total life expectancies. RESULTS: Higher olfactory scores were associated with a reduced risk of transitioning from unimpaired cognition to MCI (hazard ratio [HR] = 0.86, 95% confidence interval [CI] = 0.82-0.88) and from MCI to dementia (HR = 0.89, 95% CI = 0.86-0.93), indicating that 1-unit increase in olfactory scores was associated with an approximate 14% and 11% reduction in risk, respectively. Additionally, higher olfactory scores were associated with a greater likelihood of transitioning backward from MCI to unimpaired cognition (HR = 1.07, 95% CI = 1.02-1.12). Furthermore, higher baseline olfactory scores were associated with more years of longevity without cognitive impairment. However, olfaction was not associated with the transition to death when accounting for transitions through cognitive states. CONCLUSIONS: Findings suggest that higher olfactory identification scores are associated with a decreased risk of transitioning to impaired cognitive states and that associations between olfaction and mortality may occur primarily through the pathway of neurodegeneration.

Availability of Cognitive Resources in Early Life Predicts Transitions Between Cognitive States in Middle and Older Adults From Europe.

Background and Objectives: The existing literature highlights the importance of reading books in middle-to-older adulthood for cognitive functioning; very few studies, however, have examined the importance of childhood cognitive resources for cognitive outcomes later in life. Research Design and Methods: Using data from 11 countries included in the Survey of Health, Ageing, and Retirement in Europe (SHARE) data set (N = 32,783), multistate survival models (MSMs) were fit to examine the importance of access to reading material in childhood on transitions through cognitive status categories (no cognitive impairment and impaired cognitive functioning) and death. Additionally, using the transition probabilities estimated by the MSMs, we estimated the remaining years of life without cognitive impairment and total longevity. All models were fit individually in each country, as well as within the pooled SHARE sample. Results: Adjusting for age, sex, education, and childhood socioeconomic status, the overall pooled estimate indicated that access to more books at age 10 was associated with a decreased risk of developing cognitive impairment (adjusted hazard ratio = 0.79, confidence interval: 0.76-0.82). Access to childhood books was not associated with risk of transitioning from normal cognitive functioning to death, or from cognitive impairment to death. Total longevity was similar between participants reporting high (+1 standard deviation [SD]) and low (-1 SD) number of books in the childhood home; however, individuals with more access to childhood books lived a greater proportion of this time without cognitive impairment. Discussion and Implications: Findings suggest that access to cognitive resources in childhood is protective for cognitive aging processes in older adulthood.

Plasma uptake of selected phenolic acids following New Zealand blackcurrant extract supplementation in humans.

New Zealand blackcurrant (NZBC) extract is a rich source of anthocyanins and in order to exert physiological effects, the anthocyanin-derived metabolites need to be bioavailable in vivo. We examined the plasma uptake of selected phenolic acids following NZBC extract supplementation alongside maintaining a habitual diet (i.e. not restricting habitual polyphenol intake). Twenty healthy volunteers (nine females, age: 28 ± 7 years, height 1.73 ± 0.09 m, body mass 73 ± 11 kg) consumed a 300 mg NZBC extract capsule (CurraNZ®; anthocyanin content 105 mg) following an overnight fast. Venous blood samples were taken pre and 1, 1.5, 2, 3, 4, 5, and 6 h post-ingestion of the capsule. Reversed-phase high-performance liquid chromatography (HPLC) was used for analysis of two dihydroxybenzoic acids [i.e. vanillic acid (VA) and protocatechuic acid (PCA)] and one trihydroxybenzoic acid [i.e. gallic acid (GA)] in plasma following NZBC extract supplementation. Habitual anthocyanin intake was 168 (95%CI:68-404) mg⋅day-1 and no associations were observed between this and VA, PCA, and GA plasma uptake by the NZBC extract intake. Plasma time-concentration curves revealed that GA, and PCA were most abundant at 4, and 1.5 h post-ingestion, representing a 261% and 320% increase above baseline, respectively, with VA remaining unchanged. This is the first study to demonstrate that an NZBC extract supplement increases the plasma uptake of phenolic acids GA, and PCA even when a habitual diet is followed in the days preceding the experimental trial, although inter-individual variability is apparent.

Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies.

BACKGROUND AND OBJECTIVES: There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education. RESEARCH DESIGN AND METHODS: We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term. RESULTS: Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves. DISCUSSION AND IMPLICATIONS: Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.

Within-Couple Personality Concordance Over Time: The Importance of Personality Synchrony for Perceived Spousal Support.

OBJECTIVES: Within-couple similarities in personality traits tend to be positively associated with relationship well-being. However, research in this area is typically based on cross-sectional designs, thereby limiting examination of longitudinal personality concordance. Given that life experiences shape within-person change in personality, and that partners within a couple often experience similar life events, investigation of within-couple personality synchrony and associations with marital outcomes is warranted. METHODS: Using data from 3,988 couples (mean age at baseline = 67.0 years, SD = 9.6), multilevel dyadic growth models estimated within-couple similarity in baseline levels, change, and occasion-to-occasion variability for each of the Big Five personality traits over an 8-year follow-up. Bivariate growth models examined the effect of within-couple similarity on perceived spousal support, accounting for dependency within couples. RESULTS: Adjusting for baseline age, education, functional ability, and relationship length, analyses revealed within-couple concordance between baseline levels of all 5 personality traits, as well as correlated within-couple fluctuations in neuroticism, extraversion, and openness over time. Similarity in openness, agreeableness, and neuroticism trajectories predicted spousal support. Couples were most similar in openness, showing correlated intercepts, change, and variability, and this longitudinal synchrony was particularly important for perceived spousal support in women. DISCUSSION: These findings provide evidence for longitudinal personality synchrony over time within older adult couples. Further, concordance in neuroticism, extraversion, and openness predicted perceived spousal support, though there may be some gender differences in personality dynamics and relationship well-being. Effects of similarity were relatively small compared to actor and partner effects of these traits.

Within-couple health behavior trajectories: The role of spousal support and strain.

Objective: The current study sought to examine the associations between long-term health behavior engagement within couples and to test whether perceiving support or strain from a spouse impacts one's own health behaviors. Method: Data from 5,233 couples in the English Longitudinal Study of Ageing were used to examine trajectories of physical activity, smoking, fruit and vegetable consumption, and alcohol use over a period of up to 12 years. Dyadic multilevel models examined patterns of change in each health behavior while allowing male and female partners to covary in intercepts, slopes, and occasion-specific residuals. The influence of perceived spousal support and relationship strain on each behavior was examined, adjusting for age, health, household income, and relationship length. Results: Male and female partners reported similar initial levels of each health behavior and tended to show similar occasion-to-occasion changes as their partner. Higher spousal support predicted increased engagement in physical activity and fruit and vegetable consumption in men. Relationship strain appeared to be more impactful to female health behaviors, being associated with alcohol and tobacco use for female but not male partners. Conclusions: Despite romantic partners reporting similar baseline health habits, the long-term trajectories of most health behaviors were not similar for romantic partners. However, spouses did exhibit similar occasion-to-occasion variability. Spousal support and relationship strain differentially impacted men and women's health behavior engagement. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sense of Purpose Promotes Resilience to Cognitive Deficits Attributable to Depressive Symptoms.

OBJECTIVE: Individuals higher in depressive symptoms commonly present with neuropsychological deficits including poorer memory performance. Sense of purpose in life has been shown to promote resilience to cognitive impairment in older adulthood, but it is unclear whether it may also protect against cognitive deficits associated with higher depressive symptoms. METHOD: Cognitive functioning among 4599 older American adults (M age = 74.33 years, range = 65-104 years, 56.84% female) was examined across a 12-year follow-up period. Depressive symptomatology was assessed at each wave using the 8-item Center for Epidemiologic Studies Depression Scale. Multilevel models assessed the influence of depressive symptoms and the interaction with sense of purpose in life on changes in memory performance and mental status. RESULTS: Higher depressive symptoms were associated with poorer memory performance at baseline, but did not predict rate of change over time. A negative interaction was observed between sense of purpose in life and depressive symptoms such that individuals higher in purpose experienced a less negative association between depressive symptoms and baseline memory performance. No significant interaction of sense of purpose and depressive symptoms was observed on mental status. CONCLUSION: Having a sense of purpose in life may help protect older adults from memory deficits associated with higher depressive symptoms. The present findings underscore the potential for sense of purpose to promote cognitive reserve in older adulthood, allowing individuals to maintain cognitive performance in the face of accruing neurological insults.

The Association Between Alterations in Redox Homeostasis, Cortisol, and Commonly Used Objective and Subjective Markers of Fatigue in American Collegiate Football.

PURPOSE: To assess associations between a free oxygen radical test (FORT), free oxygen radical defense test (FORD), oxidative stress index, urinary cortisol, countermovement jump (CMJ), and subjective wellness in American college football. METHODS: Twenty-three male student athlete American college football players were assessed over 10 weeks: off-season conditioning (3 wk), preseason camp (4 wk), and in season (3 wk). Assessments included a once-weekly FORT and FORD blood sample, urinary cortisol sample, CMJ assessment including flight time, reactive strength index modified and concentric impulse, and a daily subjective wellness questionnaire. Linear mixed models analyzed the effect of a 2 within-subject SD change in the predictor variable on the dependent variable. The effects were interpreted using magnitude-based inference and are presented as standardized effect size (ES) ± 90% confidence intervals. RESULTS: Small negative associations were observed between FORT-flight time, FORT-fatigue, FORT-soreness (ES range = -0.30 to -0.48), FORD-sleep (ES = 0.42 ± 0.29), and oxidative stress index soreness (ES = 0.56 ± 0.29). Small positive associations were observed between FORT-cortisol (ES = 0.36 ± 0.35), FORD-flight time, FORD reactive strength index modified and FORD-soreness (0.37-0.41), oxidative stress index concentric impulse (ES = 0.37 ± 0.28), and with soreness-concentric impulse, soreness-flight time, and soreness reactive strength index modified (0.33-0.59). Moderate positive associations were observed between cortisol-concentric impulse and cortisol-sleep (0.57-0.60). CONCLUSION: FORT/FORD was associated with CMJ variables and subjective wellness. Greater amounts of subjective soreness were associated with decreased CMJ performance, increased FORT and cortisol, and decreased FORD.

Cohort and Period Effects as Explanations for Declining Dementia Trends and Cognitive Aging.

Studies have reported that the age-adjusted incidence of cognitive impairment and dementia may have decreased over the past two decades. Aging is the predominant risk factor for Alzheimer's disease and related dementias and for neurocognitive decline. However, aging cannot explain changes in overall age-adjusted incidence of dementia. The objective of this position paper was to describe the potential for cohort and period effects in cognitive decline and incidence of dementia. Cohort effects have long been reported in demographic literature, but starting in the early 1980s, researchers began reporting cohort trends in cognitive function. At the same time, period effects have emerged in economic factors and stressors in early and midlife that may result in reduced cognitive dysfunction. Recognizing that aging individuals today were once children and adolescents, and that research has clearly noted that childhood cognitive performance is a primary determinant of old-age cognitive performance, this is the first study that proposes the need to connect known cohort effects in childhood cognition with differences in late-life functioning.

COVID-19-Considerations for the Female Athlete.

The SARS CoV-2 virus (COVID-19) caused the whole sporting calendar to be paused. As we embark on the challenge of navigating through the return to play (RTP) process, there is a necessity to consider the needs of all athletes. This commentary specifically considers recommendations and requirements for the female athlete with a physiological emphasis during and following the COVID-19 pandemic, however, it will be relevant for any similar future scenarios that may present. It is important to acknowledge that there remain many unknowns surrounding COVID-19 and the female athlete both in the short- and long-term.

The Importance of Engaging in Physical Activity in Older Adulthood for Transitions Between Cognitive Status Categories and Death: A Coordinated Analysis of 14 Longitudinal Studies.

BACKGROUND: Given increasing incidence of cognitive impairment and dementia, further understanding of modifiable factors contributing to increased healthspan is crucial. Extensive literature provides evidence that physical activity (PA) delays the onset of cognitive impairment; however, it is unclear whether engaging in PA in older adulthood is sufficient to influence progression through cognitive status categories. METHOD: Applying a coordinated analysis approach, this project independently analyzed 14 longitudinal studies (NTotal = 52 039; mean baseline age across studies = 69.9-81.73) from North America and Europe using multistate survival models to estimate the impact of engaging in PA on cognitive status transitions (nonimpaired, mildly impaired, severely impaired) and death. Multinomial regression models were fit to estimate life expectancy (LE) based on American PA recommendations. Meta-analyses provided the pooled effect sizes for the role of PA on each transition and estimated LEs. RESULTS: Controlling for baseline age, sex, education, and chronic conditions, analyses revealed that more PA is significantly associated with decreased risk of transitioning from nonimpaired to mildly impaired cognitive functioning and death, as well as substantially longer LE. Results also provided evidence for a protective effect of PA after onset of cognitive impairment (eg, decreased risk of transitioning from mild-to-severe cognitive impairment; increased likelihood of transitioning backward from severe-to-mild cognitive impairment), though between-study heterogeneity suggests a less robust association. CONCLUSIONS: These results yield evidence for the importance of engaging in PA in older adulthood for cognitive health, and a rationale for motivating older adults to engage consistently in PA.

Adjusting after stroke: Changes in sense of purpose in life and the role of social support, relationship strain, and time.

It is unclear how the onset of a major health condition, such as a stroke, may impact sense of purpose long-term and whether social factors influence this change. We examined changes in purpose in 716 stroke patients (Mage = 72.09 years, 52.5% female) who participated in the Health and Retirement Study between 2006 and 2014. Multilevel growth modeling indicated that recent stroke patients' sense of purpose declined over time relative to pre-stroke purpose, whereas those suffering stroke prior to baseline demonstrated relative stability. Furthermore, social support was associated with initial levels but not change in sense of purpose.