Sex differences in cognitive decline among middle-aged and older adults: a cohort study in Europe.

OBJECTIVES: Previous studies on sex differences in cognitive decline provide inconsistent findings, with many European countries being underrepresented. We determined the association between sex and cognitive decline in a sample of Europeans and explored differences across birth cohorts and regions. METHODS: Participants 50+ years old enrolled in the Survey of Health, Ageing and Retirement in Europe had their cognition measured by tests of immediate recall, delayed recall and verbal fluency biennially up to 17 years of follow-up (median 6, interquartile range 3-9 years). We used linear mixed-effects models to assess the relationship between sex and the rate of cognitive decline, adjusting for sociodemographic and health-related characteristics. RESULTS: Of 66,670 participants (mean baseline age 63.5 ± standard deviation 9.4), 55% were female. Males and females had similar rates of decline in the whole sample in immediate recall (beta for interaction sex × time B = 0.002, 95% CI -0.001 to 0.006), delayed recall (B = 0.000, 95% CI -0.004 to 0.004), and verbal fluency (B = 0.008, 95% CI -0.005 to 0.020). Females born before World War II had a faster rate of decline in immediate recall and delayed recall compared to males, while females born during or after World War II had a slower rate of decline in immediate recall. Females in Central and Eastern Europe had a slower rate of cognitive decline in delayed recall compared to males. DISCUSSION: Our study does not provide strong evidence of sex differences in cognitive decline among older Europeans. However, we identified heterogeneity across birth cohorts and regions.

A brief version of the Attitudes to Ageing Questionnaire for older Chinese adults: development and psychometric evaluation.

BACKGROUND: Positive attitudes toward aging are considered essential for achieving psychological well-being in later life. However, there is currently a lack of a concise and comprehensive measurement tool specifically designed to assess attitudes toward aging among the elderly population in China. To address this gap, the present study aimed to develop a brief version of the Attitudes to Ageing Questionnaire tailored to older Chinese individuals and evaluate its psychometric properties. METHODS: Initially, a sample of community-dwelling older adults (Sample 1: n = 442, aged 60-88) was utilized to establish a new scale format. Subsequently, two convenience samples (Sample 2: n = 311, aged 60-90; Sample 3: n = 164, aged 60-89) were employed to evaluate the psychometric properties of this scale, including factor structure, internal consistency, test-retest reliability, convergent validity, and discriminant validity. RESULTS: We selected 12 items from the original questionnaire to create the brief scale. The brief scale maintained the three-factor structure of the full-format version, encompassing psychosocial loss, physical change, and psychological growth, and demonstrated adequate psychometric properties. CONCLUSIONS: This development process shortens the administration time of the questionnaire while avoiding excessive loss of information. The newly developed scale serves as a reliable and valid assessment tool for measuring attitudes toward aging among older Chinese individuals and is well-suited for implementation in large-scale surveys that utilize an extensive array of questionnaires. This tool can be applied to assessing the effectiveness of interventions aimed at eliminating ageism.

Association of 8-hydroxy-2'-deoxyguanosine with motoric cognitive risk in elderly Chinese people: RUGAO longevity and aging cross-sectional study.

BACKGROUND: Motor cognitive risk syndrome (MCR) represents a critical pre-dementia and disability state characterized by a combination of objectively measured slow walking speed and subjective memory complaints (SMCs). This study aims to identify risk factors for MCR and investigate the relationship between plasma levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and MCR among Chinese community-dwelling elderly populations. METHODS: A total of 1312 participants were involved in this study based on the data of the Rugao Longevity and Aging Study (RuLAS). The MCR was characterized by SMCs and slow walking speed. The SCCs were defined as a positive answer to the question 'Do you feel you have more problems with memory than most?' in a 15-item Geriatric Depression Scale. Slow walking speed was determined by one standard deviation or more below the mean value of the patient's age and gender group. The plasma of 8-OHdG were measured by a technician in the biochemistry laboratory of the Rugao People's Hospital during the morning of the survey. RESULTS: The prevalence of MCR was found to be 7.9%. After adjusting for covariates, significant associations with MCR were observed in older age (OR 1.057; p = 0.018), history of cerebrovascular disease (OR 2.155; p = 0.010), and elevated 8-OHdG levels (OR 1.007; p = 0.003). CONCLUSIONS: This study indicated the elevated plasma 8-OHdG is significantly associated with increased MCR risk in the elderly, suggesting its potential as a biomarker for early detection and intervention in MCR. This finding underscores the importance of monitoring oxidative DNA damage markers in predicting cognitive and motor function declines, offering new avenues for research and preventive strategies in aging populations.

Biological aging of two innate behaviors of Drosophila melanogaster: Escape climbing versus courtship learning and memory.

Motor and cognitive aging can severely affect life quality of elderly people and burden health care systems. In search for diagnostic behavioral biomarkers, it has been suggested that walking speed can predict forms of cognitive decline, but in humans, it remains challenging to separate the effects of biological aging and lifestyle. We examined a possible association of motor and cognitive decline in Drosophila, a genetic model organism of healthy aging. Long term courtship memory is present in young male flies but absent already during mid life (4-8 weeks). By contrast, courtship learning index and short term memory (STM) are surprisingly robust and remain stable through mid (4-8 weeks) and healthy late life (>8 weeks), until courtship performance collapses suddenly at ~4.5 days prior to death. By contrast, climbing speed declines gradually during late life (>8 weeks). The collapse of courtship performance and short term memory close to the end of life occur later and progress with a different time course than the gradual late life decline in climbing speed. Thus, during healthy aging in male Drosophila, climbing and courtship motor behaviors decline differentially. Moreover, cognitive and motor performances decline at different time courses. Differential behavioral decline during aging may indicate different underlying causes, or alternatively, a common cause but different thresholds for defects in different behaviors.

Determination of aging anxiety in middle-aged women.

OBJECTIVE: The aim of this study was to determine the state of aging anxiety in middle-aged women. METHODS: The study was collected from women between the ages of 40 and 59 years by an online survey method. While collecting the data of the participants, the women's personal characteristics diagnostic form and the Aging Anxiety Scale for Middle-Aged Women were used. The data were analyzed with the SPSS 26 statistical software. RESULTS: The aging anxiety of the women was found to be moderate (53.05±16.26). A significant correlation was found between women's menopausal status, household income, education level, and total score of aging anxiety (p<0.05). CONCLUSION: In addition to working outside the home, women are also burdened with duties inside the home. To improve their quality of life, women need to share many of the tasks imposed on them with other family members. To reduce the anxiety experienced by women during the climacteric period, it is recommended to provide psychosocial support to women and consider this issue in health policies. Healthcare professionals, especially nurses, have important duties to reduce anxiety and stress, which constitute the basis of many chronic diseases. It is recommended that nurses, who are health ambassadors, direct women with anxiety to psychological support services through screenings they will conduct for women during this period.

Attitudes to ageing mediates the relationship between perception of age-friendly city and life satisfaction among middle-aged and older people in Macao: a cross-sectional study.

BACKGROUND: Societal attitudes toward ageing play a significant role in shaping one's ageing experience, and an age-friendly environment can potentially enhance the life satisfaction of older individuals. The objective of this study is to examine the role of attitudes to ageing as mediators in the association between the perception of an age-friendly city and life satisfaction among middle-aged and older adults. METHODS: Using the tools of Age-Friendly City (AFC) criteria, Attitudes to Ageing Questionnaire (AAQ) to measure psychosocial loss, psychological growth, and physical change, and Satisfaction with Life Scale (SWLS) to assess the level of life satisfaction among community-dwelling middle-aged and older people in Macao. Multiple mediation analysis was performed to test the mediation effect. RESULTS: A total of 543 participants were included in this study. The average score of AFC was 4.25, the total scores of psychosocial loss, physical change, and psychological growth were 24.06, 29.00, and 26.94 respectively. The total score of SWLS was 24.06. There was a partial mediation of attitudes to ageing in the relationship between perception of age-friendly city and life satisfaction. The mediation effect explained 56.1% of the total effect of AFC to life satisfaction. CONCLUSION: The development of an age-friendly city can help improve the public's view on ageing, and thus improve their life satisfaction. It is important for government to consider the improvement of people's attitudes to ageing when developing policies regarding AFC.

Psychological and physical factors related to social integration of older adults in Ghana.

BACKGROUND: Globally, older adults aged 60 years and over are outnumbering children under 5 and young people aged 15-24. Much evidence exists on the importance of high social integration and positive quality of life and health outcomes. However, evidence on how older adults are socially integrated in Ghanaian communities is limited. This study examined how self-reported well-being and quality of life (psychological and physical (psycho-physical) factors) predict the social integration of older adults in Ghana. METHODS: A secondary analysis of longitudinal survey data of the 2014/15 Study on Global Ageing and Adult Health (SAGE Wave 2) conducted by the World Health Organization was applied. Older adults aged 60 years and older (n = 1,927) were included in this study. Multilevel logistic regression analyses were used to examine psycho-physical factors associated with high social integration among older adults. The output was reported as odds ratios (OR). RESULTS: In general, social integration varied based on older adults' demographic characteristics. Those in rural communities had lower odds of having high social integration (OR = 0.76, 95% CI = 0.56,1.03) when compared with older adults in urban areas. Having high physical and psychological well-being was associated with high social integration (OR = 1.90, 95% CI = 1.41, 2.57), (OR = 2.05, 95% CI = 1.56, 2.69). However, older adults with high levels of emotional and spiritual well-being were 9% and 7% (respectively) less likely to experience a high level of social integration (OR = 0.94, 95% CI = 0.71,1.24), (OR = 0.79, 95% CI = 0.60,1.04). CONCLUSION: The higher the level of self-reported psychological and physical well-being, the higher the social integration for older adults aged 60 years and over. However, the higher the level of self-reported emotional well-being and spiritual well-being, the less likely to have high social integration. Improved social integration or participation in society for older adults with high emotional and spiritual well-being is needed. The findings of this study highlight the need for policymakers and stakeholders to consider psycho-physical factors as an important public health tool and metric to encourage more research on the well-being of older adults in Ghana.

Strategies for Recruiting Older Black Men into Aging and Alzheimer's Research.

BACKGROUND: Despite their high risks for Alzheimer's disease, older Black men are minimally represented in Alzheimer's research and clinical trials. The absence of older Black men in Alzheimer's research limits our ability to characterize the changes associated with cognitive impairments in older Black men-a key health disparity concern. METHODS: Drawing on lessons we learned from years of community-based participatory research in Newark, NJ, we highlight recruitment strategies developed alongside community partners to guide our enrollment and retention efforts for Black men. RESULTS: We identified seven recruitment strategies: provide indirect health education through social programming, target older men through the younger men in their lives, go beyond Black churches, use older Black men as trained community ambassadors, enlist the women in Black men's lives, frame research participation as a legacy to leave their sons, and use past and current Black men participants as role models. CONCLUSIONS: These recruitment strategies help us address many barriers to recruiting older Black men. They can be easily implemented by researchers conducting aging and brain health research or interested in working with older Black men and under-represented populations.

Spatial context scaffolds long-term episodic richness of weaker real-world autobiographical memories in both older and younger adults.

Remembering life experiences involves recalling not only what occurred (episodic details), but also where an event took place (spatial context), both of which decline with age. Although spatial context can cue episodic detail recollection, it is unknown whether initially recalling an event alongside greater reinstatement of spatial context protects memory for episodic details in the long term, and whether this is affected by age. Here, we analysed 1079 personally-experienced, real-world events from 29 older adults and 12 younger adults. Events were recalled first on average 6 weeks after they occurred and then again on average 24 weeks after they occurred. We developed a novel scoring protocol to quantify spatial contextual details and used the established Autobiographical Interview to quantify episodic details. We found improved recall of episodic details after a delay if those details had initially been recalled situated in greater spatial context. Notably, for both older and younger adults, this preservation was observed for memories initially recalled with low, but not high, numbers of episodic details, suggesting that spatial context aided episodic retrieval for memories that required more support. This work supports the notion that spatial context scaffolds detail-rich event recollection and inspires memory interventions that leverage this spatial scaffold.

Functionality and loneliness in older people: Model of mediation by positive affect / Funcionalidad y soledad en personas mayores: Modelo de mediación por el afecto positivo

Objetivo: La soledad se asocia a la discapacidad funcional en la población mayor, aunque se sabe poco sobre el papel de la afectividad en esta relación. Nos proponemos explorar el efecto mediador de la afectividad en la relación entre funcionalidad y soledad, controlando el efecto de las variables relevantes. Métodos: Se administró la Escala de Soledad de la Universidad de California-16, la Escala de Funcionalidad Geriátrica, las Escalas de Afecto Positivo y Negativo-14 y la Escala de Depresión Geriátrica-8 a 489 adultos mayores (65–100 años), 428 de residencias geriátricas y 61 de la comunidad. Resultados: Los residentes en una institución, mujeres, viudos, con baja educación, más discapacidad funcional, más afecto negativo, menos afecto positivo y más síntomas depresivos reportaron más soledad. Controlando el efecto de los síntomas depresivos, género, situación residencial, estado civil y educación, solo el afecto positivo medió, parcialmente, la relación entre funcionalidad y soledad. Conclusión: Se sugieren intervenciones para aumentar la concienciación por parte de los adultos mayores en los perfiles personalizados de afecto positivo, aliviando así los sentimientos de soledad en los que sufren limitaciones funcionales (especialmente mujeres, con síntomas depresivos, viudos, residiendo en una institución y con bajo nivel educativo).(AU)

Objective: Research has shown that loneliness is associated with functional disability in the older population. However, little is known about the role of affectivity in this relationship. The present study explored a mediation model in which affectivity was hypothesized to mediate the re-lationship between functionality and loneliness, controlling for the effect of relevant variables.Methods:The University of California Loneliness Scale-16 items, Geriatric Functionality Scale, Positive and Negative AffectSchedule-14, and Geriatric Depression Scale-8 were administered to 489 old adults (65–100 years old), 428 from social care homes (SCH), and 61 from the community.Results:Those from SCH, women, widowed, withlow education, more functional disability, more negative affect, less posi-tive affect, and more depressive symptoms reported more loneliness. Con-trolling for the effect of depressive symptoms, gender, residential status, marital status, and education, only positive affect mediated, partially, the relationship between functionality and loneliness.Conclusion:We suggest implementing interventions that increase older adults' insights in personal-ized patterns of positive affect and, consequently, ease feelings of loneli-ness in older people suffering from functional limitations (especially wom-en, with depressive symptoms, widowed, residing in an institution, and with low educational level).(AU)

Social connection and end-of-life outcomes among older people in 19 countries: a population-based longitudinal study.

BACKGROUND: Social connection is a key determinant of health, but its role in shaping end-of-life outcomes is poorly understood. We examined changes in structure, function, and quality components of social connection in older people's last years of life, and the extent to which social connection predicts end-of-life outcomes (ie, symptoms, health-care utilisation, and place of death). METHODS: This study used longitudinal data of representative samples from across 18 European countries and Israel in the Survey of Health, Ageing, and Retirement in Europe (SHARE), the largest European cohort study of people aged 50 years or older. We included deceased participants of waves 4 and 6 (which contained social network modules) for whom a proxy provided an end-of-life interview. We did paired sample t-tests (for continuous variables), Wilcoxon signed-rank tests (for ordinal variables), and McNemar's tests (for non-ordinal categorical variables) to assess changes in structure, function, and quality components of social connection between waves 4 and 6. To examine social connection as a predictor of end-of-life outcomes, we used social connection data from wave 6 core interviews and end-of-life interviews from wave 7, conducted with a proxy respondent covering the deceased participant's last year of life. End-of-life outcomes included symptoms (pain, breathlessness, and anxiety or sadness) in the last month of life, health-care utilisation in the last year of life, and place of death. We conducted a mixed-effects logistic regression analysis per social connection measure, for each end-of-life outcome. FINDINGS: Data were collected in 2011-12 for wave 4, 2015-16 for wave 6, and 2017-18 for wave 7. We studied 3356 individuals (mean age at death was 79·7 years [SD 10·2]), with interviews conducted, on average, 4·6 (1·2) years (wave 4) and 1·1 (0·7) years (wave 6) before death. From wave 4 to wave 6, the following changes in social connection were observed: proportion of married or partnered participants (from 1406 [60·9%] of 2310 to 1438 [57·1%] of 2518; p<0·0001), receiving personal care or practical help (from 781 [37·2%] of 2099 to 1334 [53·1%] of 2512; p<0·0001), loneliness (from mean 1·4 [SD 0·5] to 1·5 [0·6]; p<0·0001; scale 1-3), satisfaction with social network (from 8·8 [1·67] to 8·7 [1·7]; p=0·037; scale 0-10), and emotional closeness to social network (eg, from 1883 [88·8%] of 2121 to 1710 [91·3%] of 1872 participants who indicated being either very close or extremely close to social network members; p<0·0001). Higher levels of loneliness at wave 6 predicted a greater likelihood of experiencing symptoms in the last month of life (odds ratio range across symptoms: 1·29 [95% CI 1·08-1·55] to 1·58 [1·32-1·89]). Being married (1·32 [1·03-1·68]) or receiving personal care or practical help (1·25 [1·04-1·49]) predicted death in hospital. INTERPRETATION: Social connection undergoes multifaceted changes towards older people's end of life, countering prevalent ideas of generally declining social trajectories. Loneliness in the final months of life might be a risk factor for end-of-life symptoms. Further research is needed to substantiate a causal relationship and to identify underpinning mechanisms, which could inform screening and prevention measures. FUNDING: Research Foundation-Flanders and European Union.

Cognition in older age bipolar disorder: An analysis of archival data across the globe.

BACKGROUND: Cognitive deficits in bipolar disorder (BD) impact functioning and are main contributors to disability in older age BD (OABD). We investigated the difference between OABD and age-comparable healthy comparison (HC) participants and, among those with BD, the associations between age, global cognitive performance, symptom severity and functioning using a large, cross-sectional, archival dataset harmonized from 7 international OABD studies. METHODS: Data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database, spanning various standardized measures of cognition, functioning and clinical characteristics, were analyzed. The sample included 662 euthymic to mildly symptomatic participants aged minimum 50years (509 BD, 153 HC), able to undergo extensive cognitive testing. Linear mixed models estimated associations between diagnosis and global cognitive performance (g-score, harmonized across studies), and within OABD between g-score and severity of mania and depressive symptoms, duration of illness and lithium use and of global functioning. RESULTS: After adjustment for study cohort, age, gender and employment status, there was no significant difference in g-score between OABD and HC, while a significant interaction emerged between employment status and diagnostic group (better global cognition associated with working) in BD. Within OABD, better g-scores were associated with fewer manic symptoms, higher education and better functioning. LIMITATIONS: Cross-sectional design and loss of granularity due to harmonization. CONCLUSION: More research is needed to understand heterogenous longitudinal patterns of cognitive change in BD and understand whether particular cognitive domains might be affected in OABD in order to develop new therapeutic efforts for cognitive dysfunction OABD.

Effects of chronic intranasal oxytocin on visual attention to faces vs. natural scenes in older adults.

Aging is associated with changes in face processing, including desensitization to face cues like gaze direction and an attentional preference to faces with positive over negative emotional valence. A parallel line of research has shown that acute administration of oxytocin (OT) increases visual attention to social stimuli such as human faces. The current study examined effects of chronic OT administration among older adults on fixation duration to faces that varied in emotional expression, gaze direction, age, and sex. One hundred and twelve generally healthy older adults (aged 55-95 years) underwent a randomized, placebo-controlled, double-blind, between-subject clinical trial in which they self-administered either OT or placebo (P) intranasally twice a day for 4 weeks. The behavioral task involved rating the trustworthiness of faces (i.e., social stimuli) and natural scenes (i.e., non-social control stimuli) during eye tracking and was conducted before and after the intervention. Fixation duration to both the faces and the natural scenes declined from pre- to post-intervention, however this decline was less pronounced among older adults in the OT compared to the P group for faces but not scenes. Further, face cues (emotional expression, gaze direction, age, sex) did not moderate the treatment effect. This study provides first evidence that chronic intranasal OT maintains salience of social cues over time in older adults, perhaps buffering effects of habituation. These findings enhance understanding of OT effects on social cognition among older adults, and would benefit from follow up with a young adult comparison group to directly speak to specificity of observed effects to older adults and reflection of the aging process.

Sex differences in cognitive function trajectories and their determinants in older adults: Evidence from the Chinese longitudinal healthy longevity survey.

OBJECTIVES: To examine sex differences in the cognitive trajectories of a nationally representative sample of older people living in China and to explore potential determinants of these trajectories. METHODS: The study included 2230 women and 2171 men who were cognitively healthy and aged over 60 at the first observation from the Chinese Longitudinal Healthy Longevity Survey based on the 2008-2018 cohort. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 10 years in each gender. Logistic regression was used to investigate associations between baseline characteristics (age, education, fertility history, sleep length, physical activity, and health status and behaviors) and trajectory classes. RESULTS: Three trajectories (labeled stable, slow decline, and rapid decline) were identified according to the changes in MMSE scores for both women and men. For the women, both the slow and rapid decline groups accounted for a larger proportion (14.7% and 11.0%, respectively) than the male decline groups (8.1% and 6.6%, respectively), and the women had a lower baseline MMSE score with a faster decline. In the multivariable logistic regression analyses, older age, less education, older age at first birth, poorer functional abilities, hearing impairment, and lower baseline MMSE scores were significantly associated with cognitive decline in both the female and male groups compared to the stable group. For the women, sleeping over 9 h was also associated with a rapid cognitive decline trajectory, while current exercise and being overweight/obese were protective factors against cognitive decline. CONCLUSIONS: The women had an overall more serious cognitive decline than men. The potential determinants of cognitive decline identified in this study could be considered for developing specific intervention strategies aimed at promoting a healthy brain and preventing cognitive decline in different sexes, especially in low-income and developing countries.

Perceived social position, active engagement with life, and depressive symptoms among older adults.

RATIONALE: Despite the existing literature on the relationship between perceived social position (PSP) and depressive symptoms, there remain gaps in our understanding, particularly regarding the potential for asymmetric effects of increases and decreases in PSP and the underlying mechanisms involved. OBJECTIVE: This study aims to examine whether increases and decreases in PSP are differentially associated with depressive symptoms and to explore the potential mediating role of active engagement with life in these associations. METHODS: This study utilized data from the Korean Longitudinal Study of Aging (KLoSA), collected between 2008 and 2018, involving a sample of 3506 individuals aged 65 or older. Asymmetric fixed effects (FE) models were employed, which enable the estimation of differential effects for increases and decreases in PSP, while accounting for unobserved individual-level heterogeneity. To assess the mediating role of active engagement in life, Sobel mediation tests were conducted. RESULTS: The asymmetric FE estimates revealed a stronger association between decreases in PSP and increases in depressive symptoms compared to the association between increases in PSP and decreases in depressive symptoms. The Sobel mediation tests indicated that formal social activities had the most substantial mediating effect, explaining 14% and 9% of the total effect mediated for increased and decreased PSP and depressive symptoms, respectively. Leisure/hobby activities explained 10% and 4% of the total effect mediated for increased and decreased PSP and depressive symptoms, respectively. CONCLUSION: This study provides evidence that increases and decreases in PSP have differential effects on depressive symptoms among older adults in Korea. Policy interventions aimed at improving the psychological well-being of older adults should prioritize efforts to both enhance PSP and minimize declines, as the latter can have a stronger negative impact on depressive symptoms. Active engagement in life may serve as a potential pathway for achieving the desired effects.

e-VITA study protocol: EU-Japan virtual coach for smart aging.

Aim: The aim of this study is to report a trial protocol for assessing the improvement of older adults' well-being, promoting active and healthy aging, and reducing the risks of social exclusion, using a virtual coach. Background: Increased longevity brings with it reduced autonomy and independence, and it is therefore necessary to act with preventive measures that can promote active and healthy aging. With the development of technology, new tools have appeared, including virtual coaches, which can enable people to lead a healthy lifestyle by identifying individual needs and goals and providing personalized recommendations and advice. However, it is important that these coaches take into consideration the inter-individual and cross-cultural differences of each person. Design: A randomized controlled trial is proposed. Methods: This study will recruit 240 healthy subjects aged 65 years and older. Participants will be assigned to an experimental group that will receive the e-VITA system or to the control group that will receive an information booklet only. The primary outcome measure is the person's quality of life (QoL). Data will be collected at baseline, 3 months after the trial, and at the end of the trial, after 6 months. Discussion: This study will evaluate the effectiveness of the e-VITA system, consisting of a virtual coach, several sensors for monitoring, a smartphone for use at home, and a booklet, in improving the older person's quality of life. The increased perceived well-being will also be linked to improvements in other areas of the person's life, psychological and cognitive status, the area of sociality, nutrition, and eHealth literacy.

Cognitive Functioning and the Quality of Survey Responses: An Individual Participant Data Meta-Analysis of 10 Epidemiological Studies of Aging.

OBJECTIVES: Self-reported survey data are essential for monitoring the health and well-being of the population as it ages. For studies of aging to provide precise and unbiased results, it is necessary that the self-reported information meets high psychometric standards. In this study, we examined whether the quality of survey responses in panel studies of aging depends on respondents' cognitive abilities. METHODS: Over 17 million survey responses from 157,844 participants aged 50 years and older in 10 epidemiological studies of aging were analyzed. We derived 6 common statistical indicators of response quality from each participant's data and estimated the correlations with participants' cognitive test scores at each study wave. Effect sizes (correlations) were synthesized across studies, cognitive tests, and waves using individual participant data meta-analysis methods. RESULTS: Respondents with lower cognitive scores showed significantly more missing item responses (overall effect size ρ^ = -0.144), random measurement error (ρ^ = -0.192), Guttman errors (ρ^ = -0.233), multivariate outliers (ρ^ = -0.254), and acquiescent responses (ρ^ = -0.078); the overall effect for extreme responses (ρ^ = -0.045) was not significant. Effect sizes were consistent across studies, modes of survey administsration, and different cognitive functioning domains, although some cognitive domain specificity was also observed. DISCUSSION: Lower-quality responses among respondents with lower cognitive abilities add random and systematic errors to survey measures, reducing the reliability, validity, and reproducibility of survey study results in aging research.

The Neurobiology of Life Course Socioeconomic Conditions and Associated Cognitive Performance in Middle to Late Adulthood.

Despite major advances, our understanding of the neurobiology of life course socioeconomic conditions is still scarce. This study aimed to provide insight into the pathways linking socioeconomic exposures-household income, last known occupational position, and life course socioeconomic trajectories-with brain microstructure and cognitive performance in middle to late adulthood. We assessed socioeconomic conditions alongside quantitative relaxometry and diffusion-weighted magnetic resonance imaging indicators of brain tissue microstructure and cognitive performance in a sample of community-dwelling men and women (N = 751, aged 50-91 years). We adjusted the applied regression analyses and structural equation models for the linear and nonlinear effects of age, sex, education, cardiovascular risk factors, and the presence of depression, anxiety, and substance use disorders. Individuals from lower-income households showed signs of advanced brain white matter (WM) aging with greater mean diffusivity (MD), lower neurite density, lower myelination, and lower iron content. The association between household income and MD was mediated by neurite density (B = 0.084, p = 0.003) and myelination (B = 0.019, p = 0.009); MD partially mediated the association between household income and cognitive performance (B = 0.017, p < 0.05). Household income moderated the relation between WM microstructure and cognitive performance, such that greater MD, lower myelination, or lower neurite density was only associated with poorer cognitive performance among individuals from lower-income households. Individuals from higher-income households showed preserved cognitive performance even with greater MD, lower myelination, or lower neurite density. These findings provide novel mechanistic insights into the associations between socioeconomic conditions, brain anatomy, and cognitive performance in middle to late adulthood.

Association Between Self-Perception of Aging and Long-Term Mortality in Elderly Patients with Hypertension in Rural China: A Possible Beneficial Effect of Nut Intake.

Purpose: Previous research has consistently shown that self-perception of aging (SPA) is an important predictor of health and longevity, while Chinese rural elderly patients with hypertension had poorer SPA. Whether it was associated with their mortality kept unknown. The objective of this study was to investigate the long-term mortality and analyze the association between SPA and this mortality in the specific context of rural elderly patients with hypertension. Patients and Methods: This study is a longitudinal investigation of the mortality in elderly patients with hypertension in rural Suzhou, China. Sociodemographic and clinical data, SPA, and six-year mortality were investigated. We used binary logistic regression and subgroup analyses to assess the effect of SPA at baseline on six-year mortality. Results: A total of 280 hypertensive patients aged 60 years and older participated in the study, of whom 21 died, with a six-year mortality rate of 7.5%. After controlling for covariates, the "Emotional representation" dimension (OR=2.824, 95% CI:1.034-7.712) in SPA remained a risk factor for death. In subgroup analyses of the group aged 75 years and older, high scores on the "Timeline cyclical" (OR=14.125, 95% CI: 1.258-158.593) and "Emotional representations" (OR=2.567, 95% CI:1.066-6.182) dimensions were associated with a higher risk of death, while weekly nut intake may have mitigated the negative SPA effect on mortality. Conclusion: Poorer self-perception of aging was associated with a high risk of mortality in rural elderly patients with hypertension, while the habit of weekly nut intake might help reduce this risk in the group aged 75 years or older.