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BACKGROUND: The drive towards ensuring the sustainability of bioresources has been linked with better valorising primary materials and developing biorefinery pipelines. Seaweeds constitute valuable coastal resources with applications in the bioenergy, biofertiliser, nutrition, pharmaceutical and cosmetic sectors. Owing to the various sought-after metabolites they possess, several seaweed species are commercially exploited throughout Western Europe, including Ireland. Here, four commercially relevant brown (Fucus serratus and Fucus vesiculosus) and red (Chondrus crispus and Mastocarpus stellatus) seaweed species were sampled during a spring tide in July 2021 on moderately exposed shores across three coastal regions in the west of Ireland. RESULTS: Significant regional differences were identified when specimens were analysed for carbohydrates (max. 80.3 µg glucose eq mg-1 DW), proteins (max. 431.3 µg BSA eq. mg-1 DW), lipids (max. 158.6 mg g-1 DW), pigment signature and antioxidant potential. Protein content for F. serratus recorded a twofold difference between northern and southern specimens. The antioxidant potential of F. vesiculosus and M. stellatus returned greater activity compared to F. serratus and C. crispus, respectively. Multivariate analysis showed a clear latitudinal pattern across the three western coastal regions (north, west and south) for both F. vesiculosus and F. serratus. CONCLUSION: F. vesiculosus thalli from the northwest were richer in pigment content while the F. serratus thalli from the northwest were richer in antioxidants. Such biogeographic patterns in the biochemical make-up of seaweeds need consideration for the development of regional integrated aquaculture systems and the optimisation of the biomass content for targeted downstream applications. © 2024 Society of Chemical Industry.
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Antioxidantes , Fucus , Algas Marinas , Algas Marinas/química , Algas Marinas/metabolismo , Antioxidantes/análisis , Antioxidantes/química , Fucus/química , Chondrus/química , Irlanda , Europa (Continente) , Lípidos/análisis , Lípidos/química , Carbohidratos/análisis , Carbohidratos/químicaRESUMEN
Understanding the genomic basis of memory processes may help in combating neurodegenerative disorders. Hence, we examined the associations of common genetic variants with verbal short-term memory and verbal learning in adults without dementia or stroke (N = 53,637). We identified novel loci in the intronic region of CDH18, and at 13q21 and 3p21.1, as well as an expected signal in the APOE/APOC1/TOMM40 region. These results replicated in an independent sample. Functional and bioinformatic analyses supported many of these loci and further implicated POC1. We showed that polygenic score for verbal learning associated with brain activation in right parieto-occipital region during working memory task. Finally, we showed genetic correlations of these memory traits with several neurocognitive and health outcomes. Our findings suggest a role of several genomic loci in verbal memory processes.
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Aprendizaje , Memoria a Corto Plazo , Memoria a Corto Plazo/fisiología , Aprendizaje Verbal , Herencia Multifactorial , EncéfaloRESUMEN
We evaluated 2,865 elderly people to investigate the prevalence of prolonged grief disorder (PGD), examine predictors and mental health correlates. The conditional prevalence of PGD varied between 0.8% and 5.2% (diagnostic algorithm vs. cut-off). PG-13 scores were related to depressive symptoms, sleep disturbances, reduced life satisfaction, and quality of life. Predictors were female gender, less time since death, more losses, having lost a child, partner, or sibling, and less social support. PGD is associated with adverse mental health consequences. Practitioners should pay special attention to elderly women who lost a close loved one and lack social support.
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Aflicción , Adulto , Anciano , Niño , Familia/psicología , Femenino , Pesar , Humanos , Masculino , Prevalencia , Calidad de VidaRESUMEN
To feel guilty can motivate for prosocial behavior but may also lead to negative health-related outcomes. The aim of this study was to provide epidemiological information on guilt feelings in the German general adult population. Based on findings from a nation-wide telephone survey (n=1,003 adultsaged 18+ years), we calculated weighted point prevalence rates for guilt feelings and used multivariable logistic regression analyses to evaluate the association between the guilt feelings and covariates. Prevalence of current guilt feelings was 10.6% (95%-CI=8.7-12.6). About one fourth of the adults with current guilt feelings rated the intensity of their feelings as 'rather strong' or 'very strong'. To feel guilty was unrelated to age, sex and education, but significantly associated with depression. The weighted prevalence of guilt feelings in adults with major depression was 37.4% (95%-CI=26.2-48.7) compared to 8.1% (95%-CI=6.4-9.9) in adults without. A substantial part of the German adult population is confronted with guilt feelings. Feeling guilty seems to be less dependent on rather global socio-demographic characteristics than on others factors like depression. More efforts have to be made to identify those specific circumstances, under which feelings of guilt lead to adverse health-related outcomes and to provide corresponding treatment approaches.
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Depresión , Culpa , Adulto , Depresión/epidemiología , Depresión/psicología , Alemania/epidemiología , Humanos , PrevalenciaRESUMEN
OBJECTIVES: To examine the impact of determinants of incident dementia in three different old age groups (75-79, 80-84, 85+years) in Germany. DESIGN: Multicenter prospective AgeCoDe/AgeQualiDe cohort study with baseline and nine follow-up assessments at 1.5-year intervals. SETTING: Primary care medical record registry sample. PARTICIPANTS: General practitioners' (GPs) patients aged 75+years at baseline. MEASUREMENTS: Conduction of standardized interviews including neuropsychological assessment and collection of GP information at each assessment wave. We used age-stratified competing risk regression models (accounting for the competing event of mortality) to assess determinants of incident dementia and age-stratified ordinary least square regressions to quantify the impact of identified determinants on the age at dementia onset. RESULTS: Among 3027 dementia-free GP patients, n = 704 (23.3%) developed dementia during the 13-year study period. Worse cognitive performance and subjective memory decline with related worries at baseline, and the APOE ε4 allele were associated independently with increased dementia risk in all three old age groups. Worse cognitive performance at baseline was also associated with younger age at dementia onset in all three age groups. Other well-known determinants were associated with dementia risk and age at dementia onset only in some or in none of the three old age groups. CONCLUSIONS: This study provides further evidence for the age-specific importance of determinants of incident dementia in old age. Such specifics have to be considered more strongly particularly with regard to potential approaches of early detection and prevention of dementia.
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Apolipoproteína E4/genética , Demencia/epidemiología , Médicos Generales , Distribución por Edad , Anciano , Estudios de Cohortes , Demencia/diagnóstico , Demencia/genética , Alemania/epidemiología , Humanos , Estudios Prospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Hospitalization is a key driver of health care costs. Thus far, there are only a few longitudinal studies investigating whether changes in explanatory variables lead to hospitalization. Moreover, these longitudinal studies did not focus on individuals in highest age. AIM: The purpose of the current study was to examine the correlates of hospitalization among the oldest old in Germany longitudinally. METHODS: A multicenter prospective cohort study ["Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)", AgeQualiDe]. Primary care patients ≥ 85 years took part [n = 861 at follow-up (FU) 7, average age of 89.0 years; 85-100 years]. Two waves were used. Hospitalization in the last 6 months was used as outcome measure. Well-established scales were used to quantify the independent variables such as Instrumental Activities of Daily Living Scale, Global Deterioration Scale or Geriatric Depression Scale. RESULTS: Logistic random effects regressions showed that the probability of hospitalization in the preceding 6 months significantly increased with increases in the social network, more depressive symptoms, functional decline, and increase in chronic conditions, whereas it was not significantly associated with age, sex, marital status, education, and cognitive impairment. Social networks moderate the relationship between functional decline and hospitalization. DISCUSSION: The results of the present longitudinal study emphasize the association of depressive symptoms, functional decline, more social networks, and chronic conditions with hospitalization among the oldest old. CONCLUSIONS: Treatments with the aim to reduce or postpone these factors might also help to reduce hospitalization.
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Hospitalización , Actividades Cotidianas , Anciano de 80 o más Años , Disfunción Cognitiva , Depresión , Femenino , Alemania , Hospitalización/estadística & datos numéricos , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Atención Primaria de Salud , Estudios Prospectivos , Calidad de VidaRESUMEN
The food addiction model suggests neurobiological similarities between substance-related and addictive disorders and obesity. While structural brain differences have been consistently reported in these conditions, little is known about the neuroanatomical correlates of food addiction. We therefore aimed to determine whether symptoms of food addiction related to body mass index (BMI), personality, and brain structure in a large population-based sample. Participants of the LIFE-Adult study (n = 625; 20-59 years old, 45% women) answered the Yale Food Addiction Scale (YFAS) and further personality measures, underwent anthropometric assessments and high-resolution 3T-neuroimaging. A higher YFAS symptom score correlated with higher BMI, eating behavior traits, neuroticism, and stress. Higher BMI predicted significantly lower thickness of (pre)frontal, temporal and occipital cortex and increased volume of left nucleus accumbens. In a whole-brain analysis, YFAS symptom score was not associated with significant differences in cortical thickness or subcortical gray matter volumes. A hypothesis-driven Bayes factor analysis suggested a small, additional contribution of YFAS symptom score to lower right lateral orbitofrontal cortex thickness over the effect of BMI. Our study indicates that symptoms of food addiction do not account for the major part of the structural brain differences associated with BMI in the general population. Yet, symptoms of food addiction might explain additional variance in orbitofrontal cortex, a hub area of the reward network. Longitudinal studies implementing both anatomical and functional MRI could further disentangle the neural mechanisms of addictive eating behaviors.
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Índice de Masa Corporal , Corteza Cerebral/patología , Adicción a la Comida/patología , Adicción a la Comida/fisiopatología , Sustancia Gris/patología , Núcleo Accumbens/patología , Adulto , Corteza Cerebral/diagnóstico por imagen , Estudios de Cohortes , Femenino , Adicción a la Comida/diagnóstico por imagen , Sustancia Gris/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Núcleo Accumbens/diagnóstico por imagen , Adulto JovenRESUMEN
OBJECTIVE: Subjective cognitive decline (SCD), the earliest symptom in preclinical Alzheimer's disease (AD), is insufficient to identify individuals at risk for AD dementia. Therefore, we aimed to investigate whether function in instrumental activities of daily living (IADL) contributes to identification. METHODS: We analysed data of cognitively unimpaired participants of the prospective German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe) and its extension, the Study on Needs, Health Service Use, Costs and Health-related Quality of Life in a Large Sample of Oldest-old Primary Care Patients (AgeQualiDe), collected over 10.5 years. Development of AD dementia was quantified as incidence rates (IRs) per 1000 person-years. Cox regression was used to assess the association of SCD and IADL function in regard to incident AD dementia. RESULTS: Of 1467 included individuals, 792 (54.0%) reported SCD at baseline. Impaired IADL were present in 50 (3.4%) individuals. IR for AD dementia was highest in individuals with SCD and impaired IADL (49.7; 95% CI, 24.8-99.3). Unadjusted and adjusted Cox analyses revealed an increased AD dementia risk for individuals with SCD and impaired IADL (uHR = 6.1; 95% CI, 2.9-13.0; P < 0.001; aHR = 2.5; 95% CI, 1.1-5.7; P < 0.05). CONCLUSIONS: Consistent with the SCD concept, IADL function was largely well preserved in the majority of individuals with SCD. However, if difficulties in IADL were present, risk for AD dementia was increased. Therefore, screening for IADL impairment could serve as an economically viable indicator to assess AD dementia risk above and beyond SCD.
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Actividades Cotidianas/psicología , Enfermedad de Alzheimer/psicología , Disfunción Cognitiva/psicología , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Alemania , Humanos , Estudios Longitudinales , Masculino , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Calidad de VidaRESUMEN
BACKGROUND: In the absence of treatment options, the WHO emphasizes the identification of effective prevention strategies as a key element to counteract the dementia epidemic. Regarding the complex nature of dementia, trials simultaneously targeting multiple risk factors should be particularly effective for prevention. So far, however, only few such multi-component trials have been launched, but yielding promising results. In Germany, comparable initiatives are lacking, and translation of these complex interventions into routine care was not yet done. Therefore, AgeWell.de will be conducted as the first multi-component prevention trial in Germany which is closely linked to the primary care setting. METHODS: AgeWell.de will be designed as a multi-centric, cluster-randomized controlled multi-component prevention trial. Participants will be older community-dwelling general practitioner (GP) patients (60-77 years; n = 1,152) with increased dementia risk according to CAIDE (Cardiovascular Risk Factors, Aging, and Incidence of Dementia) Dementia Risk Score. Recruitment will take place at 5 study sites across Germany. GP practices will be randomized to either intervention A (advanced) or B (basic). GPs will be blinded to their respective group assignment, as will be the statistician conducting the randomization. The multi-component intervention (A) includes nutritional counseling, physical activity, cognitive training, optimization of medication, management of vascular risk factors, social activity, and, if necessary, further specific interventions targeting grief and depression. Intervention B includes general health advice on the intervention components and GP treatment as usual. We hypothesize that over the 2-year follow-up period the intervention group A will benefit significantly from the intervention program in terms of preserved cognitive function/delayed cognitive decline (primary outcome), and other relevant (secondary) outcomes (e.g. quality of life, social activities, depressive symptomatology, cost-effectiveness). DISCUSSION: AgeWell.de will be the first multi-component trial targeting risk of cognitive decline in older adults in Germany. Compared to previous trials, AgeWell.de covers an even broader set of interventions suggested to be beneficial for the intended outcomes. The findings will add substantial knowledge on modifiable lifestyle factors to prevent or delay cognitive decline. TRIAL REGISTRATION: German Clinical Trials Register (reference number: DRKS00013555 ).
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Envejecimiento/psicología , Disfunción Cognitiva/psicología , Disfunción Cognitiva/terapia , Ejercicio Físico/psicología , Atención Primaria de Salud/métodos , Conducta de Reducción del Riesgo , Anciano , Envejecimiento/fisiología , Terapia Conductista/métodos , Disfunción Cognitiva/epidemiología , Ejercicio Físico/fisiología , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida/psicologíaRESUMEN
PURPOSE: The Sniffin' Sticks Screening 12 test is a test of olfactory performance based on pen-like odor dispensing devices. The aims of this study were to analyze the performance of this test in a general population sample and to explore associations between olfactory dysfunction and quality of life. METHODS: A large community sample (n = 7267) completed the Sniffin' Sticks Screening 12 test and several questionnaires measuring quality of life, anxiety, dispositional optimism, social support, and satisfaction with life. RESULTS: According to the criteria recommended by the test manufacturer, 5.1% of the participants were anosmic (score ≤ 6), 52.4% were dysosmic (7 ≤ score ≤ 10), and 42.5% were normosmic (score ≥ 11). While frequencies of correct identification differed between the 12 sticks, all sticks contributed positively to the test results. The associations between olfactory functioning and quality of life variables were negligible. In the multivariate analyses, none of the associations reached the 1% significance level. CONCLUSIONS: While studies with patients in otorhinolaryngological clinics often report substantial detriments to their quality of life in relation to olfactory dysfunction, the present epidemiological study cannot confirm this association for the general population.
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Trastornos del Olfato/diagnóstico , Trastornos del Olfato/psicología , Calidad de Vida , Adulto , Anciano , Ansiedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Odorantes , Satisfacción Personal , Apoyo SocialRESUMEN
INTRODUCTION: In this multicenter study on subjective cognitive decline (SCD) in community-based and memory clinic settings, we assessed the (1) incidence of Alzheimer's disease (AD) and non-AD dementia and (2) determinants of progression to dementia. METHODS: Eleven cohorts provided 2978 participants with SCD and 1391 controls. We estimated dementia incidence and identified risk factors using Cox proportional hazards models. RESULTS: In SCD, incidence of dementia was 17.7 (95% Poisson confidence interval 15.2-20.3)/1000 person-years (AD: 11.5 [9.6-13.7], non-AD: 6.1 [4.7-7.7]), compared with 14.2 (11.3-17.6) in controls (AD: 10.1 [7.7-13.0], non-AD: 4.1 [2.6-6.0]). The risk of dementia was strongly increased in SCD in a memory clinic setting but less so in a community-based setting. In addition, higher age (hazard ratio 1.1 [95% confidence interval 1.1-1.1]), lower Mini-Mental State Examination (0.7 [0.66-0.8]), and apolipoprotein E ε4 (1.8 [1.3-2.5]) increased the risk of dementia. DISCUSSION: SCD can precede both AD and non-AD dementia. Despite their younger age, individuals with SCD in a memory clinic setting have a higher risk of dementia than those in community-based cohorts.
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Disfunción Cognitiva/epidemiología , Demencia/epidemiología , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/psicología , Estudios de Cohortes , Demencia/psicología , Autoevaluación Diagnóstica , Progresión de la Enfermedad , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , AutoimagenRESUMEN
Obesity has been linked with structural and functional brain changes. However, the impact of obesity on brain and cognition in aging remains debatable, especially for white matter. We therefore aimed to determine the effects of obesity on white matter microstructure and potential implications for cognition in a well-characterized large cohort of healthy adults. In total, 1255 participants (50% females, 19-80 years, BMI 16.8-50.2â¯kg/m2) with diffusion-weighted magnetic resonance imaging at 3T were analysed. Tract-based spatial statistics (TBSS) probed whether body mass index (BMI) and waist-to-hip ratio (WHR) were related to fractional anisotropy (FA). We conducted partial correlations and mediation analyses to explore whether obesity or regional FA were related to cognitive performance. Analyses were adjusted for demographic, genetic, and obesity-associated confounders. Results showed that higher BMI and higher WHR were associated with lower FA in multiple white matter tracts (pâ¯<â¯0.05, FWE-corrected). Mediation analyses provided evidence for indirect negative effects of higher BMI and higher WHR on executive functions and processing speed through lower FA in fiber tracts connecting (pre)frontal, visual, and associative areas (indirect paths, |ß|â¯≥â¯0.01; 99% |CI|â¯>â¯0). This large cross-sectional study showed that obesity is correlated with lower FA in multiple white matter tracts in otherwise healthy adults, independent of confounders. Moreover, although effect sizes were small, mediation results indicated that visceral obesity was linked to poorer executive functions and lower processing speed through lower FA in callosal and associative fiber tracts. Longitudinal studies are needed to support this hypothesis.
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Encéfalo/patología , Cognición/fisiología , Obesidad/patología , Sustancia Blanca/patología , Adulto , Anciano , Anciano de 80 o más Años , Anisotropía , Índice de Masa Corporal , Estudios Transversales , Imagen de Difusión Tensora/métodos , Femenino , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Relación Cintura-Cadera , Adulto JovenRESUMEN
Lack of social support has shown to be a major risk factor for poor health, mortality, and dementia. We analyzed what factors drive the likelihood of having restricted social networks and to what extent those factors then influence the risk of developing dementia. Our results from the Leipzig Longitudinal Study of the Aged (LEILA75+) indicate that older age (odds ratio [OR]: 1.04) and living with other people (OR: 2.12) was associated with a greater likelihood of having a restricted social network. A better cognitive status (OR: 0.84) was associated with a smaller likelihood of having a restricted social network. The risk of developing dementia over the follow-up period was significantly higher among individuals with restricted (hazard ratio: 2.11) than with integrated social networks. Our findings suggest that integrating elderly individuals in the wider community is a crucial indicator for dementia risk.
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Demencia/diagnóstico , Red Social , Apoyo Social , Anciano , Anciano de 80 o más Años , Envejecimiento , Femenino , Humanos , Estudios Longitudinales , Masculino , Factores de RiesgoRESUMEN
BACKGROUND: Previous studies have shown that higher education may reduce dementia risk and promote a better cognitive functioning in older age. OBJECTIVE: The study investigated to what extent higher education leads to compression of cognitive morbidity, and thus a shorter lifetime affected by cognitive impairment and dementia, in individuals aged 75 years and older living in Germany. METHODS: Our sample included n = 742 individuals of the population-based Leipzig Longitudinal Study of the Aged (LEILA75+; 1998-2013), who were free of dementia at baseline. The impact of higher education on compression of cognitive morbidity was studied by analyzing the association between education and (1) cognitive functioning over the study period and age at dementia onset, (2) age at death, and (3) the cumulative lifetime cognitive morbidity. RESULTS: Individuals with more years of education had a higher cumulative cognitive functioning over the lifetime period 75 to 100 years (weighted for survival probability), but not a later age of dementia onset nor a later age at death. CONCLUSION: Our results suggest, in individuals aged 75 years and older, higher education only compresses cognitive morbidity prior to dementia onset. Findings may be specific to countries where education is not a necessary requirement for access to good quality health care services.
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Trastornos del Conocimiento/prevención & control , Cognición/fisiología , Escolaridad , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva , Femenino , Alemania , Humanos , Estudios Longitudinales , MasculinoRESUMEN
OBJECTIVE: The purpose of this study was to examine the impact of falls on depressive symptoms among the oldest old in Germany longitudinally. METHODS: Data were used from 2 waves of the multicenter prospective cohort "Study on needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe). This study covers primary care patients ≥85 years (at baseline: n = 547, average age of 88.9 ± 3.0 years; ranging from 85 to 100 years). General practitioner-diagnosed falls were used as explanatory variable. The Geriatric Depression Scale was used as outcome measure. RESULTS: Linear fixed effects regressions showed that the occurrence of falls is associated with an increase in depressive symptoms (ß = .60, P = .02), whereas changes in marital status, ageing, social support, functional decline (instrumental activity of daily living), cognitive impairment, and an increase in chronic diseases did not affect depressive symptoms. In sensitivity analysis, an increase in depressive symptoms was associated with functional impairment (basic activities of daily living; Barthel index; ß = -.04, P = .005). CONCLUSIONS: Based on a large, population-based longitudinal study, this study underlined the impact of falls on depressive symptoms and consequently extended previous knowledge about an association between falls and depressive symptoms in the oldest old. Developing strategies to prevent falls might also help to prevent depressive symptoms.
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Accidentes por Caídas/estadística & datos numéricos , Trastorno Depresivo/etiología , Actividades Cotidianas , Anciano de 80 o más Años , Disfunción Cognitiva , Femenino , Alemania , Humanos , Estudios Longitudinales , Masculino , Estado Civil , Estudios Prospectivos , Calidad de Vida , Análisis de Regresión , Factores de Riesgo , Apoyo SocialRESUMEN
BACKGROUND: Oldest-old persons frequently receive potentially inappropriate medication. Medication use takes place under the patients' informal caregivers' influence. We explored informal caregivers' perspectives on medication of (relatively) independent oldest-old persons to identify starting points for safer medication prescription/handling. METHODS: In this exploratory qualitative interview study we interviewed 45 informal caregivers of 45 oldest-old persons (23 with potentially inappropriate medication/22 without potentially inappropriate medication). Interviews were recorded, transcribed and content analyzed (deductive/inductive coding). RESULTS: Interviewees had little knowledge about/influence on oldest-old persons' medication, but declared to monitor oldest-old persons' needs for assistance. They were unaware of the concept of potentially inappropriate medication but sometimes sensitive to substance dependency. Most informal caregivers were satisfied with the oldest-old persons' medication and viewed medication as increasing the patients' quality of life. Inadequate communication was found between informal caregivers and general practitioners. CONCLUSIONS: Influence of informal caregivers on (relatively) independent oldest-old persons' medication seems low. Stakeholders need to be aware that there is a transitional period where independency of oldest-old persons decreases and support needs increase which may be missed by (in-)formal caregivers or concealed by oldest-old persons. Monitoring patients' medication competencies; measures supporting communication between informal caregivers and health care professionals; provision of educational and support resources for informal caregivers and the acceptance of oldest-old persons' increasing assistance needs may increase medication safety.
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Cuidadores/psicología , Estado de Salud , Lista de Medicamentos Potencialmente Inapropiados/normas , Investigación Cualitativa , Encuestas y Cuestionarios , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Lista de Medicamentos Potencialmente Inapropiados/tendencias , Calidad de Vida/psicologíaRESUMEN
BACKGROUND: The prevalence of pain is very common in the oldest age group. Managing pain successfully is a key topic in primary care, especially within the ageing population. Different care settings might have an impact on the prevalence of pain and everyday life. METHODS: Participants from the German longitudinal cohort study on Needs, Health Service Use, Costs and Health-related Quality of Life in a large Sample of Oldest-old Primary Care Patients (85+) (AgeQualiDe) were asked to rate their severity of pain as well as the impairment with daily activities. Besides gender, age, education, BMI and use of analgesics we focused on the current housing situation and on cognitive state. Associations of the dependent measures were tested using four ordinal logistic regression models. Model 1 and 4 consisted of the overall sample, model 2 and 3 were divided according to no cognitive impairment (NCI) and mild cognitive impairment (MCI). RESULTS: Results show a decline in pain at very old age but nonetheless a high prevalence among the 85+ year olds. Sixty-three per cent of the participants report mild to severe pain and 69% of the participants mild to extreme impairment due to pain with daily activities. Use of analgesics, depression and living at home with care support are significantly associated with higher and male gender with lower pain ratings. CONCLUSIONS: Sufficient pain management among the oldest age group is inevitable. Outpatient care settings are at risk of overlooking pain. Therefore focus should be set on pain management in these settings.
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Actividades Cotidianas , Disfunción Cognitiva/epidemiología , Manejo del Dolor/métodos , Dolor , Calidad de Vida , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Alemania/epidemiología , Humanos , Masculino , Evaluación de Necesidades , Dolor/diagnóstico , Dolor/epidemiología , Dolor/psicología , Dimensión del Dolor , Prevalencia , Mejoramiento de la Calidad , Características de la Residencia/estadística & datos numéricos , Factores de RiesgoRESUMEN
The disparity between the chronological age of an individual and their brain-age measured based on biological information has the potential to offer clinically relevant biomarkers of neurological syndromes that emerge late in the lifespan. While prior brain-age prediction studies have relied exclusively on either structural or functional brain data, here we investigate how multimodal brain-imaging data improves age prediction. Using cortical anatomy and whole-brain functional connectivity on a large adult lifespan sample (N=2354, age 19-82), we found that multimodal data improves brain-based age prediction, resulting in a mean absolute prediction error of 4.29 years. Furthermore, we found that the discrepancy between predicted age and chronological age captures cognitive impairment. Importantly, the brain-age measure was robust to confounding effects: head motion did not drive brain-based age prediction and our models generalized reasonably to an independent dataset acquired at a different site (N=475). Generalization performance was increased by training models on a larger and more heterogeneous dataset. The robustness of multimodal brain-age prediction to confounds, generalizability across sites, and sensitivity to clinically-relevant impairments, suggests promising future application to the early prediction of neurocognitive disorders.
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Encéfalo/diagnóstico por imagen , Encéfalo/crecimiento & desarrollo , Disfunción Cognitiva/diagnóstico por imagen , Imagen Multimodal/métodos , Adulto , Anciano , Anciano de 80 o más Años , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/crecimiento & desarrollo , Disfunción Cognitiva/psicología , Femenino , Movimientos de la Cabeza , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Modelos Neurológicos , Pruebas Neuropsicológicas , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
Obesity is a complex neurobehavioral disorder that has been linked to changes in brain structure and function. However, the impact of obesity on functional connectivity and cognition in aging humans is largely unknown. Therefore, the association of body mass index (BMI), resting-state network connectivity, and cognitive performance in 712 healthy, well-characterized older adults of the Leipzig Research Center for Civilization Diseases (LIFE) cohort (60-80 years old, mean BMI 27.6 kg/m2 ± 4.2 SD, main sample: n = 521, replication sample: n = 191) was determined. Statistical analyses included a multivariate model selection approach followed by univariate analyses to adjust for possible confounders. Results showed that a higher BMI was significantly associated with lower default mode functional connectivity in the posterior cingulate cortex and precuneus. The effect remained stable after controlling for age, sex, head motion, registration quality, cardiovascular, and genetic factors as well as in replication analyses. Lower functional connectivity in BMI-associated areas correlated with worse executive function. In addition, higher BMI correlated with stronger head motion. Using 3T neuroimaging in a large cohort of healthy older adults, independent negative associations of obesity and functional connectivity in the posterior default mode network were observed. In addition, a subtle link between lower resting-state connectivity in BMI-associated regions and cognitive function was found. The findings might indicate that obesity is associated with patterns of decreased default mode connectivity similar to those seen in populations at risk for Alzheimer's disease. Hum Brain Mapp 38:3502-3515, 2017. © 2017 Wiley Periodicals, Inc.
RESUMEN
OBJECTIVE: The DSM-5 introduces mild neurocognitive disorder (miNCD) as a syndrome that recognizes the potential clinical importance of acquired cognitive deficits being too mild to qualify for diagnosis of dementia. We provide new empirical data on miNCD including total, age-, and sex-specific prevalence rates; number and types of neurocognitive domains being impaired; and diagnostic overlap with the well-established mild cognitive impairment (MCI) concept. DESIGN: Cross-sectional results of an observational cohort study (LIFE-Adult-Study). SETTING: General population. PARTICIPANTS: A total of 1,080 dementia-free individuals, aged 60-79 years. MEASUREMENTS: We calculated weighted point prevalence rates with confidence intervals (95% CI) for miNCD and analyzed diagnostic overlap between miNCD and MCI by calculating overall percentage agreement and Cohen's kappa coefficient. RESULTS: Weighted total prevalence of miNCD was 20.3% (95% CI: 17.8-23.0). Prevalence was similar in both sexes, but significantly higher in older age. Two-thirds (66.2%) of the individuals with miNCD showed impairment restricted to only one out of six possible neurocognitive domains. Learning and memory was the most frequently (38.3%) impaired domain in all miNCD-cases, followed by social cognition (26.1%). Analysis of diagnostic overlap with MCI yielded an overall agreement of 98.6% and a kappa of 0.959. CONCLUSIONS: By considering all six predefined neurocognitive domains, our study observed a substantial proportion of dementia-free older adults having miNCD. Provision of information on the underlying etiology/ies may be of prime importance in future studies aiming at evaluating the clinical relevance of the miNCD syndrome.