Psychosocial correlates of flourishing in the late lifespan.

BACKGROUND: Flourishing is a primary dimension of psychological well-being that contributes massively to the development of an active, purposeful, and respectful life, full of meaning, values, and personal interests that nurture social ties. AIMS: This study primarily intended to examine the contribution of satisfaction with family relations, resilience, metacognitive efficiency, and crystallized intelligence in predicting a flourishing measure in cognitively healthy older adults. Moreover, the impact of gender was investigated on flourishing, satisfaction with family ties, resilience, and metacognitive efficiency. METHODS: One hundred and eighty 65-94-year-old community dwellers were recruited in Sardinia (Italy). Participants self-rated their flourishing, satisfaction with their family connections, psychological hardness (i.e., a dimension of resilience), and cognitive function, whereas global cognitive efficiency and vocabulary were assessed through two internationally validated objective tests. RESULTS: A hierarchical regression analysis revealed that 30% of the variance in the flourishing condition was explained by satisfaction with family ties, resilience, and metacognitive efficiency. In addition, males exhibited higher flourishing and satisfaction with family ties than females, and the former group also reported being more autonomous and acting proactively to influence its destiny. CONCLUSION: Emotional support and rewarding relations with family members, the ability to face stressful events, and a good perception of one's cognitive efficiency play a crucial role in promoting flourishing in late adulthood.

Spatially resolved multiomics of human cardiac niches.

The function of a cell is defined by its intrinsic characteristics and its niche: the tissue microenvironment in which it dwells. Here we combine single-cell and spatial transcriptomics data to discover cellular niches within eight regions of the human heart. We map cells to microanatomical locations and integrate knowledge-based and unsupervised structural annotations. We also profile the cells of the human cardiac conduction system1. The results revealed their distinctive repertoire of ion channels, G-protein-coupled receptors (GPCRs) and regulatory networks, and implicated FOXP2 in the pacemaker phenotype. We show that the sinoatrial node is compartmentalized, with a core of pacemaker cells, fibroblasts and glial cells supporting glutamatergic signalling. Using a custom CellPhoneDB.org module, we identify trans-synaptic pacemaker cell interactions with glia. We introduce a druggable target prediction tool, drug2cell, which leverages single-cell profiles and drug-target interactions to provide mechanistic insights into the chronotropic effects of drugs, including GLP-1 analogues. In the epicardium, we show enrichment of both IgG+ and IgA+ plasma cells forming immune niches that may contribute to infection defence. Overall, we provide new clarity to cardiac electro-anatomy and immunology, and our suite of computational approaches can be applied to other tissues and organs.

The contribution of motor efficiency to drawing performance of older people with and without signs of cognitive decline.

In clinical practice, different drawing tests are used for the assessment of cognitive efficiency in the geriatric population. However, so far, the contribution of motor skills to drawing performance has not been sufficiently examined in the late adult life span. This study was aimed at disentangling the role played by motor functioning in three well-known drawing tests that in the clinical field are commonly used to detect some signs of cognitive impairment of older individuals. One hundred and forty-nine community dwellers (Mage = 77.4 years, SD = 5.9 years) completed a battery of tests assessing global cognitive efficiency, drawing skills (i.e., Clock Drawing, Visuo-spatial Drawing ACE-R, Copy Figures Tests), handgrip muscular strength (HGS), and functional mobility (assessed through the Timed-Up-and-Go test). Significant relationships were found among those measures. Moreover, handgrip strength and functional mobility explained 12-19% of the variance in each drawing condition. Finally, participants exhibiting poorer HGS performed worse the drawing tasks and were successively recognized as cognitively deteriorated. In conclusion, these findings highlight that motor skills can significantly impact the assessment of cognitive efficiency in late adulthood. Therefore, in clinical practice, the concurrent assessment of basic motor functions (in terms of muscular strength and functional mobility) and cognitive efficiency of the geriatric population at risk for cognitive decline should be encouraged.

The efficiency of activities of daily living (ADLs) skills in late adulthood: A mediational approach.

The term "Activities of Daily Living" (ADLs) refers to a set of fundamental tasks (i.e., toileting, bathing, personal care, eating, grooming, and getting dressed) considered necessary for living and being autonomous in everyday life. Although in the clinical setting ADLs efficiency is a marker to diagnose dementia, limited evidence on the mechanism implicating muscular function and cognitive alterations in ADLs skills in late adulthood exists. This study primarily intended to determine the extent to which executive functions mediate between muscular strength, as assessed through handgrip strength (HGS) measurement, and ADLs skills of older community-dwellers. A further goal was to explore the impact of gender and cognitive status on ADLs and HGS scores, using education as a covariate. Three hundred and thirty-four older participants, 199 females and 135 males (Mage = 77.5 years, SD = 5.6 years, age range = 63-93 years) completed a battery of tests assessing ADLs, HGS, and executive functions. The results showed that 34-56% of the variance in the ADLs condition was explained by HGS and executive functioning. Furthermore, cognitively healthy participants exhibited better ADLs skills, whereas cognitively impaired individuals, both males and females, exhibited poorer HGS efficiency. In conclusion, in clinical settings, the concurrent evaluation of ADLs skills, motor, and higher-order cognitive processes should be encouraged to detect individuals needing a person-tailored intervention to boost their quality of life.

Executive and Motor Functions in Older Individuals with Cognitive Impairment.

BACKGROUND: A current research trend is the examination of the interplay between cognitive functioning, higher-order processes, and motor efficiency in late adulthood. However, the association between motor and cognitive functions when cognitive decline occurs has not been extensively explored. This study investigated whether gait features, functional mobility, and handgrip strength were associated with executive functions in older people with mild cognitive impairment (MCI) or dementia. METHODS: 127 older participants (Mage = 77.9 years, SD = 5.8 years) who had received a diagnosis of MCI and dementia voluntarily took part in the study. A battery of tests assessing global cognitive function, executive functions, muscular strength, functional mobility, and spatio-temporal parameters of gait was completed by the participants. RESULTS: Statistically significant correlations were obtained between global cognitive function, executive functions, and motor efficiency measures. Moreover, a series of regression analyses showed that 8-13% of the variance of several motor parameters was predicted by several executive functions. Additionally, walking, functional mobility, and global cognitive function predicted 53-71% of the variance relative to the occurrence of dementia. In conclusion, motor functioning is closely related to cognitive functioning in late adulthood. CONCLUSIONS: The assessment of muscular strength and functional mobility should be promoted in clinical settings.

Associations between migration experience and perceived mental health in optimal ageing: Evidence from the Sardinian Blue Zone.

The effect of migration on perceived mental health has not been examined in older migrants after their return to their places of origin. This study was mainly aimed at evaluating the perceived mental health of older people who experienced migration and permanent resident peers living in the Sardinian Blue Zone (i.e. one of the four areas of exceptional longevity in the world). Forty-eight community-based older participants (32 males and 16 females) with and without a migration experience were recruited in two villages of the Sardinian Blue Zone and completed a battery of self-report inventories assessing psychological well-being, negative mood, and ego resilience. Older individuals who experienced migration reported higher ego resilience and exhibited greater resources used to manage positive emotionality (i.e. openness to life experiences). Moreover, compared to the normative data, both the groups reported higher psychological well-being and fewer depressive symptoms. Finally, no significant associations were found between the length of migration and each mental health index. In conclusion, resilience seems to represent a psychological trait that helps to manage stressful events and contributes to the preservation of perceived mental health in late adulthood.

Motor proficiency as a correlate of coping in late adult lifespan. An exploratory study.

BACKGROUND AND OBJECTIVES: A body of studies suggests that coping resources may represent a protective factor against functional and cognitive losses associated with advanced ageing. This study intended to examine the contributions of global cognition, functional mobility, and muscular strength on self-reported coping strategies in late adulthood. METHODS: One hundred and thirty-seven community-based older individuals (Mage = 77.2 years, SD = 5.8 years, age range: 63-92 years), 48 males and 89 females with and without signs of cognitive decline completed a battery of tools assessing global cognitive function, problem-focused coping, muscular strength (assessed by handgrip strength, HGS) and functional mobility (assessed using the instrumented Timed-Up-and-Go test). RESULTS: Significant associations were found between problem-focused coping, global cognitive function, HGS, functional mobility parameters, age, and education. Moreover, when the effects of education and gender were controlled for, HGS, functional mobility, and global cognitive function scores accounted for 44% of the variance in coping. CONCLUSIONS: In clinical practice, the use of functional mobility and muscular strength measures to screen the physical health of older individuals should be encouraged.

The Impact of SARS-CoV-2 (COVID-19) and its Lockdown Measures on the Mental and Functional Health of Older Individuals.

The effect of the COVID-19 on the physical and mental health of Italian older individuals displaying signs of cognitive deterioration has not been deeply investigated. This longitudinal study examined the impact of COVID-19 lockdown measures on the psychological well-being and motor efficiency of a sample of Italian community-dwellers with and without cognitive decline. Forty-seven participants underwent instrumental gait analysis performed in ecological setting using wearable sensors, and completed a battery of tasks assessing cognitive functioning and psychological well-being, before and after the full lockdown due to the COVID-19 spreading. A series of Multivariate Analyses of Variance (MANOVAs) documented that the superior gait performance of the cognitively healthy participants exhibited before the COVID-19 spread, vanished when they were tested at the end of the lockdown period. Moreover, before the outbreak of the COVID-19, cognitively healthy participants and those with signs of cognitive decline reported similar levels of psychological well-being, whereas, after the lockdown, the former group reported better coping, emotional competencies, and general well-being than the participants displaying signs of cognitive decline. In conclusion, the full COVID-19 outbreak had a significant impact on the mental and motor functioning of older individuals with and without signs of cognitive deterioration living in Italy.

Mental Health and Religiosity in the Sardinian Blue Zone: Life Satisfaction and Optimism for Aging Well.

This study evaluated the impact of the sociocultural context on dispositional optimism and resilience, life satisfaction, and religiosity in late adulthood. Moreover, the associations between those psychological measures and religiosity were investigated. Ninety-five older individuals recruited in the Sardinian Blue Zone and Cagliari completed a battery of tools assessing cognitive and mental health, and religiosity. Life satisfaction correlated with resilience and religiosity, whereas resilience correlated with optimism. Furthermore, participants of the rural area reported greater optimism and life satisfaction than peers living in the urban area. In conclusion, optimism and hedonic well-being favor optimal aging in the Blue Zone.

Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors.

AIM: The main purpose of the present study was to verify the feasibility of wearable inertial sensors (IMUs) in a clinical setting to screen gait and functional mobility in Italian older persons. In particular, we intended to verify the capability of IMUs to discriminate individuals with and without cognitive impairments and assess the existence of significant correlations between mobility parameters extracted by processing trunk accelerations and cognitive status. METHODS: This is a cross-sectional study performed on 213 adults aged over 65 years (mean age 77.0 ± 5.4; 62% female) who underwent cognitive assessment (through Addenbrooke's Cognitive Examination Revised, ACE-R) instrumental gait analysis and the Timed Up and Go (TUG) test carried out using a wearable IMU located in the lower back. RESULTS: Individuals with cognitive impairments exhibit a peculiar gait pattern, characterized by significant reduction of speed (- 34% vs. healthy individuals), stride length (- 28%), cadence (- 9%), and increase in double support duration (+ 11%). Slight, but significant changes in stance and swing phase duration were also detected. Poorer performances in presence of cognitive impairment were observed in terms of functional mobility as overall and sub-phase TUG times resulted significantly higher with respect to healthy individuals (overall time, + 38%, sub-phases times ranging from + 22 to + 34%), although with some difference associated with age. The severity of mobility alterations was found moderately to strongly correlated with the ACE-R score (Spearman's rho = 0.58 vs. gait speed, 0.54 vs. stride length, 0.66 vs. overall TUG time). CONCLUSION: The findings obtained in the present study suggest that wearable IMUs appear to be an effective solution for the clinical assessment of mobility parameters of older persons screened for cognitive impairments within a clinical setting. They may represent a useful tool for the clinician in verifying the effectiveness of interventions to alleviate the impact of mobility limitations on daily life in cognitively impaired individuals.

The role of cognitive reserve as mediator for addition and multiplication skills in late adulthood.

BACKGROUND: The role played by cognitive reserve for the maintenance of numeracy skills in late adulthood is still not sufficiently explored. AIMS: This study mainly investigated whether cognitive reserve (i.e., vocabulary) mediates on the relationship between non-verbal reasoning and addition and multiplication skills of older individuals. Moreover, the impact of schooling and gender on written calculation was examined, controlling for the effect of cognitive decline. METHODS: One hundred and six 68-94-year-old participants completed a battery of tests assessing numeracy, executive functions, and cognitive reserve skills. RESULTS: Significant correlations were found between age, cognitive reserve, numeracy, and executive functions measures. Besides, mediation analyses indicated that cognitive reserve and non-verbal reasoning explain 23% and 29% of the variance in written addition and multiplication conditions, respectively. Finally, more educated individuals performed better numeracy tasks, whereas the solution of additions and multiplications was not impact by gender. CONCLUSIONS: Cognitive reserve impacts numeracy in late adulthood.

Mental health and motor efficiency of older adults living in the Sardinia's Blue Zone: a follow-up study.

OBJECTIVES: The main aim of this study was to examine the impact of age-related changes on mental health, metacognitive, and motor functioning in late adulthood, while controlling for the effect of gender. Additionally, this investigation intended to study the association between motor efficiency indexes and self-reported psychological well-being, depression and cognitive failures over a period of 24 months. DESIGN: Prospective longitudinal study: post hoc analysis. PARTICIPANTS: Ninety-one community-dwelling older participants (mean age = 78.7 years, SD = 5.6) were recruited in a rural village of the Sardinian Blue Zone - an area of exceptional longevity located in the central-eastern region of Sardinia, an Italian island in the Mediterranean Sea. MEASUREMENTS: All respondents completed a battery of tests and questionnaires assessing motor and general cognitive efficiency, self-reported psychological well-being, negative affect, and cognitive failures. RESULTS: The adoption of a multilevel modeling approach highlighted the significative impact of time on psychological well-being, as well as on mobility parameters like gait speed and cadence, while controlling for the gender effect. Overall, psychological well-being and motor swing significantly increase at follow-up, whereas the further above-mentioned measures decreased after 24 months. Moreover, compared to the national cut-off, at baseline and follow-up, participants reported higher perceived emotional well-being. Finally, significant relationships between motor scores and self-reported mental health and metacognitive measures were found both at baseline and follow-up. CONCLUSIONS: The maintenance of motor efficiency and preserved mental health seems to contribute to the successful aging of older people living in the Sardinian Blue Zone.

Smoothness of Gait in Healthy and Cognitively Impaired Individuals: A Study on Italian Elderly Using Wearable Inertial Sensor.

The main purpose of the present study was to compare the smoothness of gait in older adults with and without cognitive impairments, using the harmonic ratio (HR), a metric derived from trunk accelerations. Ninety older adults aged over 65 (age: 78.9 ± 4.8 years; 62% female) underwent instrumental gait analysis, performed using a wearable inertial sensor and cognitive assessment with the Mini Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination Revised (ACE-R). They were stratified into three groups based on their MMSE performance: healthy controls (HC), early and advanced cognitive decline (ECD, ACD). The spatio-temporal and smoothness of gait parameters, the latter expressed through HR in anteroposterior (AP), vertical (V) and mediolateral (ML) directions, were derived from trunk acceleration data. The existence of a relationship between gait parameters and degree of cognitive impairment was also explored. The results show that individuals with ECD and ACD exhibited significantly slower speed and shorter stride length, as well as reduced values of HR in the AP and V directions compared to HC, while no significant differences were found between ECD and ACD in any of the investigated parameters. Gait speed, stride length and HR in all directions were found to be moderately correlated with both MMSE and ACE-R scores. Such findings suggest that, in addition to the known changes in gait speed and stride length, important reductions in smoothness of gait are likely to occur in older adults, owing to early/prodromal stages of cognitive impairment. Given the peculiar nature of these metrics, which refers to overall body stability during gait, the calculation of HR may result in being useful in improving the characterization of gait patterns in older adults with cognitive impairments.

Resilience in Elders of the Sardinian Blue Zone: An Explorative Study.

Background: older adults from the Sardinian Blue Zone self-report low depressive symptoms and high psychological well-being. However, the role of dispositional resilience as a determinant of these characteristics is unknown. Objectives: the current study had three aims. First, to investigate associations among several putative predictors, including dispositional resilience and three established markers of positive and negative mental health. Second, to determine if gender differences in dispositional resilience, independent of age and cognitive impairment, are present in this population. Third, to examine the relative importance of the predictors of self-reported mental health and well-being. Methods: 160 elders were recruited in the Sardinian Blue Zone. The participants completed self-report measures of dispositional resilience, satisfaction with social ties, physical health, depressive symptoms, and psychological well-being. Results: trait resilience was significantly associated with predictors and markers of mental health. Males had significantly greater trait resilience. In regression analyses, dispositional resilience and satisfaction with social ties were significant predictors of all markers of mental health. Other factors were significantly associated only with certain markers. Conclusions: trait resilience and strong social ties appear to be key determinants of the high mental health of Sardinian Blue Zone older adults.