The human SMAD9 (GCC) repeat links to natural selection and late-onset neurocognitive disorders.

INTRODUCTION: Whereas (GCC)-repeats are overrepresented in genic regions, and mutation hotspots, they are largely unexplored with regard to their link with natural selection. Across numerous primate species and tissues, SMAD9 (SMAD Family Member 9) reaches highest level of expression in the human brain. This gene contains a (GCC)-repeat in the interval between + 1 and + 60 of the transcription start site, which is in the high-ranking (GCC)-repeats with respect to length. METHODS: Here we sequenced this (GCC)-repeat in 396 Iranian individuals, consisting of late-onset neurocognitive disorder (NCD) (N = 181) and controls (N = 215). RESULTS: We detected two predominantly abundant alleles of 7 and 9 repeats, forming 96.2% of the allele pool. The (GCC)7/(GCC)9 ratio was in the reverse order in the NCD group versus controls (p = 0.005), resulting from excess of (GCC)7 in the NCD group (p = 0.003) and (GCC)9 in the controls (p = 0.01). Five genotypes, predominantly consisting of (GCC)7 and lacking (GCC)9 were detected in the NCD group only (p = 0.008). The patients harboring those genotypes received the diagnoses of Alzheimer's disease (AD) and vascular dementia (VD). Five genotypes consisting of (GCC)9 and lacking (GCC)7 were detected in the control group only (p = 0.002). The group-specific genotypes formed approximately 4% of the genotype pool in the human samples studied. CONCLUSION: We propose natural selection and a novel locus for late-onset AD and VD at the SMAD9 (GCC)-repeat in humans.

Living in urban or rural environments affect the sleep quality of the elderly in Bushehr (Southern Iran): emphasizing the active and inactive of the elderly.

INTRODUCTION: Sleep disorders have a significant negative impact on mental and physical health, especially among the elderly. Various factors can affect the sleep quality of elderly people. The aim of this research to investigate the effect of urban and rural environments on the sleep quality of elderly people with emphasis on physical activity. METHOD: Four hundred and thirty-nine elderly people (226 city residents and 213 village residents) in urban and rural areas of Bushehr (Southern Iran), volunteered to participate in the present study. Information was collected via the General information questionnaire and Petersburg Sleep Questionnaire. RESULT: The results showed that active elderly women (p < 0.001), and total active elderly (male + female) (p < 0.001) living in urban areas compared to inactive elderly and also in rural areas active elderly women (p < 0.001), active elderly men (p < 0.001) and total active elderly (male + female) (p < 0.001) had better overall sleep quality in compared to inactive elderly. Also, elderly men (p < 0.001) and the total elderly (male + female) (p < 0.001) living in urban areas had better sleep quality than the elderly in rural areas. CONCLUSION: Based on the findings, it can be concluded that the way of life (being active) as well as the living environment can affect the sleep quality of elderly people, so that active elderly people and also elderly people living in urban environments had better sleep quality.

Evaluation of oral health status in the population above 50: evidence from the ardakan cohort study on aging (ACSA).

BACKGROUND: The global population is undergoing rapid aging, and older individuals are more susceptible to various health issues, including oral health problems. Despite the increasing attention given to healthy aging, oral health has often been overlooked in discussions related to health problems. This study aims to assess the oral health status of middle-aged and older adults in Iran. METHODS: This cross-sectional study analyzed data from 4970 men and women aged 50 years and above, who participated in the Ardakan Cohort Study on Aging (ACSA) between 2020 and 2022. Trained personnel administered a questionnaire and conducted oral health examinations to determine the oral health status and oral hygiene behaviors of the participants. RESULTS: The mean value (SD) of the total Decayed, Missing, and Filled Teeth (DMFT) index was 21.3 (10.7). Approximately 46% of all participants were completely edentulous (without natural teeth). Moreover, 58.5% of the total sample wore dentures, and the mean age (SD) when they started using dentures was 48.5 (20.7) years. About 71% of participants with natural teeth reported brushing their teeth at least once a day, while about 63% of denture wearers cleaned their dentures daily. In the sample, 28% of individuals had visited a dentist in the last year. The prevalence of difficulty in biting and chewing food among the participants was 48.2% and 44.6%, respectively. Additionally, nearly 68% of all samples reported experiencing at least one difficulty in daily functioning due to oral/dental conditions. The study identified cutoff points of seven (sensitivity = 56.8 and specificity = 77.5) and 10 (sensitivity = 72.1 and specificity = 71.1) missing teeth, indicating the presence of at least one problem in daily functioning due to oral/dental conditions in middle-aged and older adults, respectively. CONCLUSION: The study reveals a high prevalence of edentulism and denture use among participants aged 50 years and above. The majority of samples reported difficulties in daily functioning due to oral and dental conditions, especially in biting and chewing food. These findings highlight the importance of proactive measures to address oral health issues in middle-aged and older adults, thereby enhancing their overall health and well-being.

Low physical activity and depression are the prominent predictive factors for falling in older adults: the Birjand Longitudinal Aging Study (BLAS).

BACKGROUND: Falling in the older adults has many irreparable consequences, including hospitalization to long-term care centers and loss of independence, depression and social isolation, financial burden, and death. The present study was conducted to estimate the incidence of falls and their associated factors among community-dwelling older adults. METHODS: This program is a population-based prospective cohort study (≥ 60 years) in Birjand City from 2019 to 2020. A total of 1418 participants were included in the study, and 1344 participants were analyzed according to the inclusion criteria. Thirty-nine risk factors were evaluated. Basic information included demographic information, lifestyle factors, general health and medical history, and mental and functional health. RESULT: The incidence of falls among community-dwelling older adults in the previous approximately 24 months in the present study was 9.26% in women and 2.65% in men. In the multiple Cox proportional regression model based on fall risk factors, there was a strong significant relationship between male sex (HR = 0.37, CI = 0.21 to 0.64), being physically active (HR = 0.59, CI = 0.36 to 0.96), moderate-to-severe depression (HR = 2.97, CI = 1.47 to 6.01), severe depression (HR = 3.26, CI = 1.24 to 8.54), and high risk of falls according to the TUG test (HR = 1.73, CI = 1.10 to 2.72). CONCLUSIONS: Inactivity and depression were recognized as important factors in falls in older adults. It is recommended for older adults to have an active lifestyle to prevent falls and to prioritize the diagnosis and treatment of depression in older adults. Women as a group at higher risk should be considered in prevention programs. In addition, the use of the TUG test to identify high-risk older adults should be considered.

The Association of Social Support, Depression, and Loneliness with Health-Related Quality of Life in Over 50 Years Adults: Ardakan Cohort Study on Ageing (ACSA).

BACKGROUND AND AIM: Social factors play a crucial role in the quality of life of + 50 adults. This study aimed to investigate the association between social support, depression, and loneliness and the health-related quality of life in + 50 adults of Ardakan. METHODS: This was a cross-sectional study from the first phase of Ardakan Cohort Study on Aging (ACSA) in 2019. Health-Related Quality of Life (HRQoL, SF-16), Duke Social Support Index (DSSI), and Center for Epidemiologic Studies Depression Scale (CES-D10) were used to assess the variables of interest. Multivariable linear regression was used to model the associated factors with the score of the SF-16 tool in two dimensions; physical (PCS) and mental (MCS). FINDINGS: A total of 5197 over 50 years individuals included in this study; The mean age was 62.2 ± 7.3 years old, and 52% were male. The mean score for PCS and MCS subscales was 45.6 (95% CI 45.4 to 45.9) and 49.3 (95% CI 49.0 to 49.5), respectively. Adjusted for other variables, having less feeling level of loneliness, and not having depressive symptoms were related to better PCS and MCS scores. CONCLUSION: The HRQoL for the mental aspect of HRQoL was better than the physical in elder populations. Also, much more focus should be paid to older adults who experience inadequate social support, higher levels of loneliness, and depressive symptoms.

Natural Selection at the NHLH2 Core Promoter Exceptionally Long CA-Repeat in Human and Disease-Only Genotypes in Late-Onset Neurocognitive Disorder.

BACKGROUND: Approximately 2% of the human core promoter short tandem repeats (STRs) reach lengths of ≥6 repeats, which may in part be a result of adaptive evolutionary processes and natural selection. A single-exon transcript of the human nescient helix loop helix 2 (NHLH2) gene is flanked by the longest CA-repeat detected in a human protein-coding gene core promoter (Ensembl transcript ID: ENST00000369506.1). NHLH2 is involved in several biological and pathological pathways, such as motivated exercise, obesity, and diabetes. METHODS: The allele and genotype distribution of the NHLH2 CA-repeat were investigated by sequencing in 655 Iranian subjects, consisting of late-onset neurocognitive disorder (NCD) as a clinical entity (n = 290) and matched controls (n = 365). The evolutionary trend of the CA-repeat was also studied across vertebrates. RESULTS: The allele range was between 9 and 25 repeats in the NCD cases, and 12 and 24 repeats in the controls. At the frequency of 0.56, the 21-repeat allele was the predominant allele in the controls. While the 21-repeat was also the predominant allele in the NCD patients, we detected significant decline of the frequency (p < 0.0001) and homozygosity (p < 0.006) of this allele in this group. Furthermore, 12 genotypes were detected across 16 patients (5.5% of the entire NCD sample) and not in the controls (disease-only genotypes; p < 0.0003), consisting of at least one extreme allele. The extreme alleles were at 9, 12, 13, 18, and 19 repeats (extreme short end), and 23, 24, and 25 repeats (extreme long end), and their frequencies ranged between 0.001 and 0.04. The frequency of the 21-repeat allele significantly dropped to 0.09 in the disease-only genotype compartment (p < 0.0001). Evolutionarily, while the maximum length of the NHLH2 CA-repeat was 11 repeats in non-primates, this CA-repeat was ≥14 repeats in primates and reached maximum length in human. CONCLUSION: We propose a novel locus for late-onset NCD at the NHLH2 core promoter exceptionally long CA-STR and natural selection at this locus. Furthermore, there was indication of genotypes at this locus that unambiguously linked to late-onset NCD. This is the first instance of natural selection in favor of a predominantly abundant STR allele in human and its differential distribution in late-onset NCD.

Genome-wide prediction and prioritization of human aging genes by data fusion: a machine learning approach.

BACKGROUND: Machine learning can effectively nominate novel genes for various research purposes in the laboratory. On a genome-wide scale, we implemented multiple databases and algorithms to predict and prioritize the human aging genes (PPHAGE). RESULTS: We fused data from 11 databases, and used Naïve Bayes classifier and positive unlabeled learning (PUL) methods, NB, Spy, and Rocchio-SVM, to rank human genes in respect with their implication in aging. The PUL methods enabled us to identify a list of negative (non-aging) genes to use alongside the seed (known age-related) genes in the ranking process. Comparison of the PUL algorithms revealed that none of the methods for identifying a negative sample were advantageous over other methods, and their simultaneous use in a form of fusion was critical for obtaining optimal results (PPHAGE is publicly available at https://cbb.ut.ac.ir/pphage). CONCLUSION: We predict and prioritize over 3,000 candidate age-related genes in human, based on significant ranking scores. The identified candidate genes are associated with pathways, ontologies, and diseases that are linked to aging, such as cancer and diabetes. Our data offer a platform for future experimental research on the genetic and biological aspects of aging. Additionally, we demonstrate that fusion of PUL methods and data sources can be successfully used for aging and disease candidate gene prioritization.

Link between short tandem repeats and translation initiation site selection.

BACKGROUND: Despite their vast biological implication, the relevance of short tandem repeats (STRs)/microsatellites to the protein-coding gene translation initiation sites (TISs) remains largely unknown. METHODS: We performed an Ensembl-based comparative genomics study of all annotated orthologous TIS-flanking sequences in human and 46 other species across vertebrates, on the genomic DNA and cDNA platforms (755,956 TISs), aimed at identifying human-specific STRs in this interval. The collected data were used to examine the hypothesis of a link between STRs and TISs. BLAST was used to compare the initial five amino acids (excluding the initial methionine), codons of which were flanked by STRs in human, with the initial five amino acids of all annotated proteins for the orthologous genes in other vertebrates (total of 5,314,979 pair-wise TIS comparisons on the genomic DNA and cDNA platforms) in order to compare the number of events in which human-specific and non-specific STRs occurred with homologous and non-homologous TISs (i.e., ≥ 50% and < 50% similarity of the five amino acids). RESULTS: We detected differential distribution of the human-specific STRs in comparison to the overall distribution of STRs on the genomic DNA and cDNA platforms (Mann Whitney U test p = 1.4 × 10-11 and p < 7.9 × 10-11, respectively). We also found excess occurrence of non-homologous TISs with human-specific STRs and excess occurrence of homologous TISs with non-specific STRs on both platforms (p < 0.00001). CONCLUSION: We propose a link between STRs and TIS selection, based on the differential co-occurrence rate of human-specific STRs with non-homologous TISs and non-specific STRs with homologous TISs.

Mental Health and Pain in Older Adults: Findings from Urban HEART-2.

Pain is an important component of disability problems, and plays a key role in mental health of older adults. This study aims to investigate the relationship between mental health and pain in older adults of Tehran, Iran. This was a cross-sectional study using data on 5326 older adults aged ≥60 years old from a large population-based survey (Urban HEART-2). A multistage cluster random sampling method was used to select the participants in Tehran, Iran, in 2011. General Health Questionnaire (GHQ-28), pain questionnaire, and socioeconomic questionnaires were used to collect the data. A total of 5326 older adults, 3811 (71.6%) married and 2797 (52.5%) female, were included into the study. The mean age of the participants was 68.92 ± 7.02 years. Mean of GHQ-28 scores in the sample was 51.08 ± 10.94, which indicates of a good level of mental health. The majority of the older adults had knee and back pain (more than 50%). Regardless of the chronicity, time, and the mode of reaction to it, knee and back pain were the highly reported pains among the participants. There was a statistically significant difference between two groups of older adults, with and without pain, in terms of GHQ-28 scores. Multiple regression analysis revealed that there was a relationship between mental health and the following factors: pain in head, shoulder, teeth, upper and lower limbs, education, gender, age, and marital status. Whatever the explanation, the relation of lowered health status to pain in all body parts among older people is considerable. This renders this matter as a top priority in health policy making.

Risk factors and clinical aspects of delirium in elderly hospitalized patients in Iran.

BACKGROUND: Recognition of the risk factors of delirium has been clearly advantageous in preventing and managing it as it occurs. AIMS: The main aims of this study were to investigate the occurrence of delirium and identify the associated risk factors in a sample of hospitalized elderly in Southwestern Iran. METHODS: A cross-sectional, hospital-based study was performed on a total of 200 elderly patients, admitted to a general hospital for various health reasons. Data were gathered over a 3-month period of time in 2010. Abbreviated Mental Test score (AMTs) used for delirium detection in post-admission days 1, 3, and 5, followed by clinical diagnostic confirmation according to the DSM-IV-TR criteria for delirium. Information regarding physical, cognitive, emotional, and functional states of the participants was collected, too. RESULTS: Delirium developed in 22 % of the participants. The demographic characteristics of the patients with delirium indicated that they were typically single, older men who lived alone and had a lower level of education and poorer functional status. Among other variables, the following were significantly associated with delirium: hemoglobin ≤12 (P < 0.001); Blood urea nitrogen/creatinine ratio ≥1/20 (P < 0.005); and positive C-reactive protein (P = 0.022); depressive symptoms (P < 0.001), and previous cognitive decline (P < 0.001). Patients with more than six different categories of medications were at high risk for delirium as well. CONCLUSIONS: Delirium is a serious and common problem in people over 60 years of age who are admitted to hospitals. Understanding risk factors and clinical aspects of delirium in elderly hospitalized patients will provide us with a better delirium management strategy.

Auditory Temporal Processing Deficits in Chronic Stroke: A Comparison of Brain Damage Lateralization Effect.

BACKGROUND: There have been a few reports about the effects of chronic stroke on auditory temporal processing abilities and no reports regarding the effects of brain damage lateralization on these abilities. Our study was performed on 2 groups of chronic stroke patients to compare the effects of hemispheric lateralization of brain damage and of age on auditory temporal processing. METHODS: Seventy persons with normal hearing, including 25 normal controls, 25 stroke patients with damage to the right brain, and 20 stroke patients with damage to the left brain, without aphasia and with an age range of 31-71 years were studied. A gap-in-noise (GIN) test and a duration pattern test (DPT) were conducted for each participant. RESULTS: Significant differences were found between the 3 groups for GIN threshold, overall GIN percent score, and DPT percent score in both ears (P ≤ .001). For all stroke patients, performance in both GIN and DPT was poorer in the ear contralateral to the damaged hemisphere, which was significant in DPT and in 2 measures of GIN (P ≤ .046). Advanced age had a negative relationship with temporal processing abilities for all 3 groups. CONCLUSIONS: In cases of confirmed left- or right-side stroke involving auditory cerebrum damage, poorer auditory temporal processing is associated with the ear contralateral to the damaged cerebral hemisphere. Replication of our results and the use of GIN and DPT tests for the early diagnosis of auditory processing deficits and for monitoring the effects of aural rehabilitation interventions are recommended.

A novel 6-item screening questionnaire for Parkinsonism: validation and comparison between different instruments.

BACKGROUND: Several instruments have been developed to screen Parkinson's disease (PD); yet, there is no consensus on the items, number of questions, and diagnostic accuracy. We aimed to develop a new questionnaire combining the best items with highest validity to screen parkinsonism and to compare its diagnostic value with that of the previous instruments using the same database. METHODS: 157 patients with parkinsonism and 110 healthy controls completed a comprehensive screening questionnaire consisting of 25 items on different PD symptoms used in previous studies. To select the optimal items, clinical utility index (CUI) was calculated and those who met at least good negative utility (CUI ≥0.64) were selected. Receiver operating characteristics (ROC) curves analysis was used to compare the area under the curve (AUC) of different screening instruments. RESULTS: Six items on 'stiffness & rigidity', 'tremor & shaking', 'troublesome buttoning', 'troublesome arm swing', 'feet stuck to floor' and 'slower daily activity' demonstrated good CUI. The new screening instrument had the largest AUC (0.977) compared to other instruments. CONCLUSIONS: We selected a new set of six items to screen parkinsonism, which showed higher diagnostic values compared to the previously developed questionnaires. This screening instrument could be used in population-based PD surveys in poor-resource settings.

Psychometric study of the Persian short-form eight-item Parkinson's disease questionnaire (PDQ-8) to evaluate health related quality of life (HRQoL).

BACKGROUND: To assess validation and reliability of the Persian version of the short-form 8-item Parkinson's disease questionnaire (PDQ-8) and to compare its psychometric properties with that of the long-form questionnaire (PDQ-39) in order to evaluate the health-related quality of life (HRQoL) in patients with Parkinson's disease (PD). METHODS: This cross-sectional study was conducted on 114 non-demented idiopathic PD (IPD) patients consecutively recruited from an outpatient referral movement disorder clinic. Patients were interviewed to fill in the Persian version of PDQ-39 and PDQ-8 questionnaires and clinical examination was performed to measure disease severity indices. RESULTS: The Cronbach's alpha coefficient of the entire PDQ-8 was 0.740 (95% CI: 0.661-0.806). Replacement of PDQ-8 items with other questions with the highest internal consistency within each dimension of the original PDQ-39 did not improve Cronbach's alpha coefficient [0.723 (95% CI: 0.639-0.794)]. The scores from both PDQ-8 and PDQ-39 had significant correlation with the Hoehn & Yahr (rPDQ-8 = 0.376, rPDQ-39 = 0.442), and Schwab & England (rPDQ-8 = -0.503, rPDQ-39 = -0.598) disease severity scales and disease duration (rPDQ-8 = 0.342, rPDQ-39 = 0.396). CONCLUSIONS: Persian version of the short-form PDQ (PDQ-8) was shown to be a valid and reliable instrument to assess disease-specific HRQoL in a PD population when used independently. Although the PDQ-8 items were not necessarily those with the highest internal consistency in the components of PDQ-39, they entirely showed proper psychometric properties especially in mental and behavioral aspects. PDQ-8 is a practical and informative instrument in daily clinical practice where clinicians are in shortage of time and when a validated self-reported brief questionnaire is of value.

Iranian community-dwelling older adults' perceptions of prosociality: A qualitative study.

BACKGROUND: The world population is aging at an accelerating rate, and prosociality aspects increase in people with age. This study aimed to explore Iranian community-dwelling older adults' perspectives of the prosociality concept. MATERIALS AND METHODS: This qualitative study was conducted among older adults aged 60 years and older in Qom City, Iran. A purposive sampling method was used to collect data between July and October 2022. Semi-structured interviews were conducted with 25 older adults engaged in various types of prosocial activities. Data were analyzed applying a directed content analysis approach. All interviews were audio recorded, transcribed verbatim, and coded using MAXQDA 20 software. RESULTS: Overall, 5 main categories and 19 subcategories emerged from the content data analysis. The two emerged categories were related to the predetermined dimensions of the prosociality concept, namely, "prosocial behaviors" and "prosocial dispositions." The remaining three newly emerged categories included "egocentric motives," "facilitators," and "barriers" to prosocial behaviors. As participants reported, "informal spontaneous helping" was the most prevalent subcategory of prosocial behaviors. "Prosocial norms" and "social reward-seeking" were identified as the most common subcategories of prosocial dispositions and egocentric motives, respectively. Likewise, participants mentioned "religious and metaphysic beliefs" and "social distrust" as important facilitators and barriers, respectively. CONCLUSIONS: The results of this qualitative study provide a new understanding of the prosociality concept among older adults in the context of Iran. In conclusion, to improve prosocial behaviors in this population, the interaction between all factors that influence it such as motives, facilitators, and barriers must be considered.

The Concept of Prosociality in Later Life and Its Dimensions: A Scoping Review.

Objective: The aim of this study was to clarify various aspects and dimensions of the prosociality concept in later life as an important concept that gains significance in people as they age. This concept has been expressed through a variety of dimensions in different studies. Method : This is a scoping review of the relevant literature on the concept of prosociality and its dimensions in later life, including quantitative and qualitative studies. The required data were collected from Web of Science, Scopus, PubMed, ProQuest, and Google Scholar databases between the years 1987 and 2022. Results: First, 877 articles were identified, and after the screening phase, 57 eligible studies were reviewed. Two main categories, prosocial dispositions and prosocial behaviors, and seven subcategories were extracted. The subcategories of prosocial dispositions include empathy, prosocial norms, innate tendencies, and generative desires. Prosocial behaviors subcategories include informal spontaneous helping, formal planned helping, and pro-environmental behaviors. Conclusion: The various aspects and dimensions of the prosociality concept in later life identified in this study can be used as a basis for assessing and planning the promotion of prosociality among older adults.

CRISPR/Cas9-mediated deletion of a GA-repeat in human GPM6B leads to disruption of neural cell differentiation from NT2 cells.

The human neuron-specific gene, GPM6B (Glycoprotein membrane 6B), is considered a key gene in neural cell functionality. This gene contains an exceptionally long and strictly monomorphic short tandem repeat (STR) of 9-repeats, (GA)9. STRs in regulatory regions, may impact on the expression of nearby genes. We used CRISPR-based tool to delete this GA-repeat in NT2 cells, and analyzed the consequence of this deletion on GPM6B expression. Subsequently, the edited cells were induced to differentiate into neural cells, using retinoic acid (RA) treatment. Deletion of the GA-repeat significantly decreased the expression of GPM6B at the RNA (p < 0.05) and protein (40%) levels. Compared to the control cells, the edited cells showed dramatic decrease of the astrocyte and neural cell markers, including GFAP (0.77-fold), TUBB3 (0.57-fold), and MAP2 (0.2-fold). Subsequent sorting of the edited cells showed an increased number of NES (p < 0.01), but a decreased number of GFAP (p < 0.001), TUBB3 (p < 0.05), and MAP2 (p < 0.01), compared to the control cells. In conclusion, CRISPR/Cas9-mediated deletion of a GA-repeat in human GPM6B, led to decreased expression of this gene, which in turn, disrupted differentiation of NT2 cells into neural cells.

The Role of Childhood Circumstances on Social Conditions and Health of Middle-Aged and Older Adults: Ardakan Cohort Study on Aging (ACSA).

Some studies suggest that childhood can affect some later outcomes. This cross-sectional study of the first phase of the Ardakan Cohort Study on Aging (ACSA) on 5,197 individuals examined the effects of childhood socioeconomic and health on aging well. Childhood socioeconomic status (SES) was measured using parents' education and self-expressed family's financial status. Quality of Life (SF-12), Satisfaction with Life Scale (SWLS), WHO well-being scale, and self-reported health questionnaire were used. All data, including childhood experiences, was collected at a single time point. Poor childhood health was associated with lower well-being, life satisfaction, and mental quality of life (OR: .53, p = .032, OR: 0.49, p = .019, and ß: -3.51, p = .008, respectively). The family's financial status during childhood was associated with the mental and physical quality of life, satisfaction, well-being, and health (all p < .05). Fathers and mothers who had some level of education increased the odds of being healthy by 1.20 and 1.49 times, respectively. Childhood circumstances affect older adults' health and social conditions. Policies to improve childhood health and SES should be prioritized.

The Relation of Sleep Characteristics and Cognitive Impairment in Community-Dwelling Middle-Aged and Older Adults: Ardakan Cohort Study on Aging (ACSA).

Introduction: The rise in the elderly population has brought attention to mild cognitive impairment (MCI). Sleep disorders also affect many older adults, indicating an important area of research for disturbed sleep and faster brain aging. This population-based study aimed to investigate the association of several sleep indicators with cognitive performance. Methods: This cross-sectional study focused on adults over 50 in the Ardakan Cohort Study on Aging (ACSA). MCI was evaluated using the Mini-Mental State Examination (MMSE) and the Abbreviated Mental Test score (AMTS) in literate and illiterate individuals. Sleep characteristics were collected using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, and Berlin questionnaire. The logistic regression models were used to analyze the data. Results: Overall, 3,380 literate and 1,558 illiterate individuals were included. In both groups, participants with MCI had a significantly higher PSQI global score (p < 0.05). Also, among the literate individuals, a significantly higher risk of having sleep-disordered breathing and poor sleep quality was observed in participants with MCI (p < 0.05). In illiterate individuals, higher sleep latency than 15 min increased odds of MCI (p < 0.05). However, after adjusting for all variables, only literate individuals with a sleep duration of more than 8 h had 66 percent increased odds of having MCI (p = 0.033). Conclusion: Sleep duration might be associated with cognitive function in the older Iranian population. Our findings underscore the importance of considering sleep patterns in relation to cognitive health.

Prevalence and associated factors of mild cognitive impairment among middle-aged and older adults: Results of the first phase of Ardakan Cohort Study on Aging.

Background and Aims: Data on mild cognitive impairment (MCI) in low- to middle-income countries are still being determined, despite the fact that most future older adults are expected to reside in these regions. This study aimed to investigate the prevalence and associated factors of MCI in Iran. Methods: A cross-sectional study was conducted on 4938 community-dwelling subjects aged 50 years or above in the first wave of the Ardakan Cohort Study on Aging. MCI was evaluated using the Mini-Mental State Examination (MMSE) and the Abbreviated Mental Test Score (AMTS) in literate and illiterate individuals. The relationship between factors associated with the odds of MCI was assessed through logistic regression. Results: The prevalence of MCI among all participants, the literates and illiterates, was 15.8%, 6.3%, and 36.4%, respectively. It was found that failure to accomplish any of the MMSE or AMTS items was significantly related to MCI (p < 0.001). Age ([odds ratio (OR): 1.05; p < 0.001 in the literates], [OR: 1.06; p < 0.001 in the illiterates]), sex (OR: 0.13; p < 0.001 in the illiterates), history of stroke ([OR: 2.86; p = 0.006 in the literates], [OR: 2.04; p = 0.045 in the illiterates]), and depression ([OR: 1.87; p < 0.001 in the literates], [OR: 1.41; p = 0.008 in the illiterates]) were significantly associated with MCI. Conclusion: This study highlights the significant associations between age, education, depression, stroke, and MCI in Iranian participants. These findings emphasize the need for targeted interventions in low-literacy populations, mental health screening, and stroke prevention strategies to mitigate the burden of MCI and enhance cognitive health.

Prevalence, Complications, and Risk Factors of Falls and Fear of Falling Among Older Adults; Based on Ardakan Cohort Study on Aging (ACSA).

Introduction: The objective of this study was to assess the prevalence of falls, fear of falling (FOF), complications arising from falls, and identify possible sociodemographic and health-related factors associated with these outcomes among older adults. Methods: This cross-sectional study was based on the first wave of the Ardakan Cohort Study on Aging (ACSA), which includes participants over 50 years of age residing in Ardakan, Iran. Fall history, number of fall events, FOF, hospitalizations, and fractures in the past 12 months were assessed through a face-to-face interview. Health-related factors were recorded on a self-expressed basis. Associations were assessed using multiple logistic regression. Results: Among the 4,990 participants, fall history in the past 12 months was prevalent in 19.9%, with 10.1% reporting more than two fall events. Women (p < 0.001) and older participants (p< 0.001) had a higher prevalence. In females, 28.8% reported moderate to severe FOF, while 21% experienced disruptions in their daily activities as a result of this fear. The prevalence of fractures following falls was 5.1% in males and 8.6% in females. After adjusting for confounding factors, FOF (OR: 1.59, 95% CI: 1.33-1.91, p<0.001), imbalance (OR: 2.45, 95% CI: 1.68-3.58, p<0.001), urinary incontinence (OR: 1.44, 95% CI: 1.04-1.9, p=0.025), cognitive impairment (OR: 1.21, 95% CI: 1.01-1.46, p=0.049), vertigo or dizziness (OR: 1.39, 95% CI: 1.15-1.68, p<0.001), osteoporosis (OR: 1.24, 95% CI: 1.03-1.50, p=0.023), osteoarthritis (OR: 1.33, 95% CI: 1.13-1.56, p=0.001), depression (OR: 1.30, 95% CI: 1.06-1.60, p=0.010), and Central Nervous System (CNS)-affecting diseases (OR: 1.99, 95% CI: 1.33-2.97, p=0.001) were found to have positive associations with falls. Conclusion: This study showed that about one-fifth of those over 50 in Iran have experienced at least one fall within a year. Self-expressed imbalance, FOF, and urinary incontinence were the most prominent risk factors. Due to resulting in hospitalization and fractures, falls also lead to fear of falling and the associated limitation of activities.