Topical Diclofenac Reduces Joint Synovitis in Hand Osteoarthritis: A Pilot Investigation Using Fluorescent Optical Imaging.

Purpose: Synovitis, the inflammation of joint synovia, is a prominent feature of osteoarthritis (OA) manifested by enhanced synovial vascularity, endothelial leakage, and perivascular oedema. In this pilot study, we assessed the effect of topical diclofenac in hand OA (HOA) using the established semi-quantitative methods Magnetic Resonance Imaging (MRI) and Ultrasonography (US), and compared them with Fluorescent Optical Imaging (FOI), an emerging imaging modality. Patients and Methods: Ten patients with symptomatic and diagnosed HOA used topical diclofenac for 14 days, with FOI, MRI, US, and subjective pain assessed at Baseline and after 7 (Day 8), and 14 (Day 15) days of treatment. Changes in synovitis were assessed for all 10 joints of the hand (via sum scores), and separately for the two joints most affected by synovitis. A new, fully quantitative approach for objective synovitis assessment based on the FOI images was also developed and applied. Results: The semi-quantitative analysis of the sum scores showed a small decrease in synovitis throughout the treatment duration across the different imaging modalities. The effect of the treatment was more prominent on the two most affected joints, with a synovitis reduction vs Baseline of 21.1% and 34.2% on Day 8 and Day 15, respectively, in the FOI. The quantitative FOI pixel analysis further strengthened the evidence for this effect, with observed reduction of 17.8% and 42.4% for Days 8 and 15, respectively. A similar trend was observed for subjective pain perception, with a reduction of 7.2 and 13.3 mm on Days 8 and 15. Conclusion: This pilot study evidenced the effect of topical diclofenac on reducing synovitis in hand OA in semi- and fully quantitative analyses, with the effect being stronger in the most affected joints. Further, supporting studies are needed to probe the accuracy of the quantitative pixel analysis of FOI images.

The interrelationship between sleep, diet, and glucose metabolism.

Obesity and type 2 diabetes (T2D) are increasingly common worldwide. While these disorders have increased in prevalence over the past several decades, there has been a concomitant reduction in sleep duration. Short sleep duration has been associated with higher rates of obesity and T2D, and the causality of these associations and their directionality, continue to necessitate evaluation. In this review we consider the evidence that sleep is an intrinsic factor in the development of obesity and chronic metabolic disorders, such as insulin resistance and T2D, while evaluating a potential bi-directional association. We consider the evidence that diet and meal composition, which are known to impact glycemic control, may have both chronic and acute impact upon sleep. Moreover, we consider that postprandial nocturnal metabolism and peripheral glycemia may affect sleep quality. We propose putative mechanisms whereby acute effects of nighttime glucose excursions may lead to increased sleep fragmentation. We conclude that dietary manipulations, particularly with respect to carbohydrate quality, may confer sleep benefits. Future research may seek to evaluate the effectiveness of synergistic nutrient strategies to promote sleep quality, with particular attention to carbohydrate quality, quantity, and availability as well as carbohydrate to protein ratio.

Effects of Dietary Carbohydrate Profile on Nocturnal Metabolism, Sleep, and Wellbeing: A Review.

Sleep is a crucial biological function and a well-established driver of health and wellbeing across the lifespan. In this review, we describe how sleep in humans is associated with specific circadian metabolic and physiological changes, and how the organization of sleep-wake states is related to regulation of nocturnal metabolism during fasting. Among the modifiable factors that can contribute to sleep-related benefits, emerging evidence suggests that diet and nocturnal changes in glucose regulation are strong determinants of sleep quality. Here, we review studies that have explored the importance of quantity and quality of dietary carbohydrates and proteins in modulation of sleep and sleep-related health benefits. Future research may guide the creation of nutritional solutions to improve sleep, which could lead to positive changes in health, wellbeing, and overall quality of life.

Gender score development in the Berlin Aging Study II: a retrospective approach.

In addition to biological sex, gender, defined as the sociocultural dimension of being a woman or a man, plays a central role in health. However, there are so far few approaches to quantify gender in a retrospective manner in existing study datasets. We therefore aimed to develop a methodology that can be retrospectively applied to assess gender in existing cohorts. We used baseline data from the Berlin Aging Study II (BASE-II), obtained in 2009-2014 from 1869 participants aged 60 years and older. We identified 13 gender-related variables and used them to construct a gender score by using primary component and logistic regression analyses. Of these, nine variables contributed to a gender score: chronic stress, marital status, risk-taking behaviour, personality attributes: agreeableness, neuroticism, extraversion, loneliness, conscientiousness, and level of education. Females and males differed significantly in the distribution of the gender score, but a significant overlap was also found. Thus, we were able to develop a gender score in a retrospective manner from already collected data that characterized participants in addition to biological sex. This approach will allow researchers to introduce the notion of gender retrospectively into a large number of studies.

Dehydration predicts longitudinal decline in cognitive functioning and well-being among older adults.

Adequate hydration is essential for health, with even mild forms of dehydration often having negative effects on cognition and well-being. Despite evidence of higher risk for dehydration among older adults, links between dehydration and cognitive or well-being outcomes have not been established in old age. In this study, we used longitudinal data from the Berlin Aging Study II (age range 60-89) to investigate whether trajectories of cognitive functioning (digit symbol, N = 1,111) and well-being (Diener satisfaction with life, N = 1,066; Socio-Economic Panel Study life satisfaction, N = 1,067; and Lawton morale, N = 1,067) are associated with objective dehydration (osmolarity; 33% dehydrated). Our results revealed that higher dehydration was associated with steeper decline in cognitive functioning and well-being over time, and lower well-being among those with higher body mass index. These associations were independent of sociodemographic and physical health characteristics. Our findings highlight the importance of adequate hydration for preserved cognition and well-being across old age. We discuss potential mechanisms and consider practical implications arising from our results. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Heart Rate Variability Predicts Older Adults' Avoidance of Negativity.

OBJECTIVES: The ability to produce situation-appropriate cognitive and emotional responses is dependent on autonomic nervous system (ANS) functionality. Heart rate variability (HRV) is an index of ANS functionality, and resting HRV levels have been associated with cognitive control and inhibitory capacity in young adults, particularly when faced with emotional information. As older adults' greater preference for positive and avoidance of negative stimuli (positivity effect) is thought to be dependent on cognitive control, we hypothesized that HRV could predict positivity-effect magnitude in older adults. METHOD: We measured resting-level HRV and gaze preference for happy and angry (relative to neutral) faces in 63 young and 62 older adults. RESULTS: Whereas young adults showed no consistent preference for happy or angry faces, older adults showed the expected positivity effect, which predominantly manifested as negativity avoidance rather than positivity preference. Crucially, older but not young adults showed an association between HRV and gaze preference, with higher levels of HRV being specifically associated with stronger negativity avoidance. DISCUSSION: This is the first study to demonstrate a link between older adults' ANS functionality and their avoidance of negative information. Increasing the efficiency of the cardiovascular system might selectively improve older adults' ability to disregard negative influences.

Poor glucose regulation is associated with declines in well-being among older men, but not women.

Glucose regulation is a key aspect of healthy aging and has been linked to brain functioning and cognition. Here we examined the role of glucose regulation for within-person longitudinal trajectories of well-being. We applied growth models to data from the Berlin Aging Study II (N = 955), using insulin resistance as an index of glucoregulatory capacity. We found that poor glucose regulation (higher insulin resistance) was consistently associated with lower levels of well-being among older men but not women. Our study provides novel evidence for the relevance of glucose regulation for well-being among older men. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood.

The effect of carbohydrate (CHO) consumption on mood is much debated, with researchers reporting both mood improvements and decrements following CHO ingestion. As global consumption of sugar-sweetened products has sharply increased in recent years, examining the validity of claims of an association between CHOs and mood is of high importance. We conducted a systematic review and meta-analysis to evaluate the relationship between acute CHO ingestion and mood. We examined the time-course of CHO-mood interactions and considered the role of moderator variables potentially affecting the CHO-mood relationship. Analysis of 176 effect sizes (31 studies, 1259 participants) revealed no positive effect of CHOs on any aspect of mood at any time-point following their consumption. However, CHO administration was associated with higher levels of fatigue and less alertness compared with placebo within the first hour post-ingestion. These findings challenge the idea that CHOs can improve mood, and might be used to increase the public's awareness that the 'sugar rush' is a myth, inform health policies to decrease sugar consumption, and promote healthier alternatives.

Gain without pain: Glucose promotes cognitive engagement and protects positive affect in older adults.

When faced with a cognitively demanding task, older adults tend to disengage and withdraw effort. At the same time, their usual processing preference for positive information disappears. Providing glucose as an energy resource is known to improve cognitive performance and reinstate older adults' positivity preference. Here, we examined whether glucose can help older adults to exert more effort under high difficulty conditions, and if so, whether such increase is accompanied by a change in positive affect. Fifty-three young and 58 older adults consumed a glucose or a placebo drink and completed a memory-search task at three levels of difficulty. Cognitive engagement was measured through changes in heart rate (HR) and self-reported effort. After each memory-search block, participants completed an implicit emotion-assessment task. In both age groups, glucose produced increased HR (indicating higher task engagement) relative to placebo. In older but not in young adults, glucose also improved cognitive performance and increased positive affect. Subjective effort, in contrast, did not differ between the older-glucose and older-placebo groups. These results suggest that in older adults, glucose improves cognitive performance by promoting higher cognitive engagement while mitigating the subjective costs of effortful exertion. (PsycINFO Database Record

Food for happy thought: Glucose protects age-related positivity effects under cognitive load.

Older adults show a preference for positive information, which disappears under high task demands. We examined whether glucose can help older adults preserve their positivity effect (PE) under high cognitive load. One hundred twenty-two adults (40 young and 42 older in Experiment 1; 40 older in Experiment 2) consumed a glucose (25 g) or a taste-matched placebo drink and completed an immediate recall task of emotional word-lists presented under high- and low-load conditions. Older adults showed PEs for low-load lists. Whereas PEs disappeared for older-placebo participants for high-load lists, older-glucose participants retained their positive preference. Providing the brain with extra energy resources can help older adults achieve PEs even under demanding conditions. (PsycINFO Database Record

Look on the bright side: Positivity bias modulates interference effects in the simon task.

Negative faces are detected more quickly but categorized more slowly than positive faces. Using a Simon task, we examined stimulus- and response-related processes of this dissociation: If negative stimuli are both processed and responded to more quickly than positive ones, they should elicit reduced Simon effects. Conversely, if negative stimuli are processed more quickly but responded to more slowly, enlarged Simon effects should occur. Consistent with the first possibility, negative stimuli showed reduced Simon effects. Unexpectedly, this reduction transferred to neutral stimuli (arrows and pointing hands) requiring the same response as negative faces. This pattern suggests that spatial attention became biased toward the side associated with a positive-face response and away from the side associated with a negative-face response, demonstrating that, similar to higher level cognitive decision processes, even early attentional processes can be subject to a positivity bias ("Pollyanna effect"). (PsycINFO Database Record