Estimated Incidence of Hospitalizations and Deaths Attributable to Respiratory Syncytial Virus Infections Among Adults in Germany Between 2015 and 2019.

INTRODUCTION: Respiratory syncytial virus (RSV) burden in adults is underestimated mainly due to unspecific symptoms and limited standard-of-care testing. We estimated the population-based incidence of hospitalization and mortality attributable to RSV among adults with and without risk factors in Germany. METHODS: Weekly counts of hospitalizations and deaths for respiratory, cardiovascular, and cardiorespiratory diseases were obtained (Statutory Health Insurance database, 2015-2019). A quasi-Poisson regression model was fitted to estimate the number of hospitalizations and deaths attributable to RSV as a function of periodic and aperiodic time trends, and viral activity while allowing for potential overdispersion. Weekly counts of RSV and influenza hospitalizations in children < 2 years and adults ≥ 60 years, respectively, were used as viral activity indicators. Models were stratified by age group and risk status (defined as presence of selected comorbidities). RESULTS: Population-based RSV-attributable hospitalization incidence rates were high among adults ≥ 60 years: respiratory hospitalizations (236-363 per 100,000 person-years) and cardiorespiratory hospitalizations (584-912 per 100,000 person-years). RSV accounted for 2-3% of all cardiorespiratory hospitalizations in this age group. The increase in cardiorespiratory hospitalization risk associated with underlying risk factors was greater in 18-44 year old persons (five to sixfold higher) than in ≥ 75 year old persons (two to threefold higher). CONCLUSIONS: This is a first model-based study to comprehensively assess adult RSV burden in Germany. Estimated cardiorespiratory RSV hospitalization rates increased with age and were substantially higher in people with risk factors compared to those without risk factors. Our study indicates that RSV, like other respiratory viruses, contributes to both respiratory and cardiovascular hospitalizations. Effective prevention strategies are needed, especially among older adults ≥ 60 years and among adults with underlying risk factors.

Age Differences in Encoding-Related Alpha Power Reflect Sentence Comprehension Difficulties.

When sentence processing taxes verbal working memory, comprehension difficulties arise. This is specifically the case when processing resources decline with advancing adult age. Such decline likely affects the encoding of sentences into working memory, which constitutes the basis for successful comprehension. To assess age differences in encoding-related electrophysiological activity, we recorded the electroencephalogram from three age groups (24, 43, and 65 years). Using an auditory sentence comprehension task, age differences in encoding-related oscillatory power were examined with respect to the accuracy of the given response. That is, the difference in oscillatory power between correctly and incorrectly encoded sentences, yielding subsequent memory effects (SME), was compared across age groups. Across age groups, we observed an age-related SME inversion in the alpha band from a power decrease in younger adults to a power increase in older adults. We suggest that this SME inversion underlies age-related comprehension difficulties. With alpha being commonly linked to inhibitory processes, this shift may reflect a change in the cortical inhibition-disinhibition balance. A cortical disinhibition may imply enriched sentence encoding in younger adults. In contrast, resource limitations in older adults may necessitate an increase in cortical inhibition during sentence encoding to avoid an information overload. Overall, our findings tentatively suggest that age-related comprehension difficulties are associated with alterations to the electrophysiological dynamics subserving general higher cognitive functions.

Adult age differences in the benefit of syntactic and semantic constraints for sentence processing.

Verbal working memory-intensive sentence processing declines with age. This might reflect older adults' difficulties with reducing the memory load by grouping single words into multiword chunks. Here we used a serial order task emphasizing syntactic and semantic relations. We evaluated the extent to which older compared with younger adults may differentially use linguistic constraints during sentence processing to cope with verbal working memory limitations. Probing syntactic-semantic interactions, age differences were hypothesized to be confined to the use of syntactic constraints and to be accompanied by an increased reliance on semantic information. Two experiments varying in verbal working memory demands were conducted: the sequence length was increased from eight items in Experiment 1 to 11 items in Experiment 2. We found the use of syntactic constraints to be compromised with aging, while the benefit of semantic information for sentence processing was comparable across age groups. Hence, we suggest that semantic information processing may become relatively more important for successful sentence processing with advancing adult age, possibly inducing a syntactic-to-semantic-processing strategy shift. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Alignment of alpha-band desynchronization with syntactic structure predicts successful sentence comprehension.

Sentence comprehension requires the encoding of phrases and their relationships into working memory. To date, despite the importance of neural oscillations in language comprehension, the neural-oscillatory dynamics of sentence encoding are only sparsely understood. Although oscillations in a wide range of frequency bands have been reported both for the encoding of unstructured word lists and for working-memory intensive sentences, it is unclear to what extent these frequency bands subserve processes specific to the working-memory component of sentence comprehension or to general verbal working memory. In our auditory electroencephalography study, we isolated the working-memory component of sentence comprehension by adapting a subsequent memory paradigm to sentence comprehension and assessing oscillatory power changes during successful sentence encoding. Time-frequency analyses and source reconstruction revealed alpha-power desynchronization in left-hemispheric language-relevant regions during successful sentence encoding. We further showed that sentence encoding was more successful when source-level alpha-band desynchronization aligned with computational measures of syntactic-compared to lexical-semantic-difficulty. Our results are a preliminary indication of a domain-general mechanism of cortical disinhibition via alpha-band desynchronization superimposed onto the language-relevant cortex, which is beneficial for encoding sentences into working memory.

Temporally and spatially distinct theta oscillations dissociate a language-specific from a domain-general processing mechanism across the age trajectory.

The cognitive functionality of neural oscillations is still highly debated, as different functions have been associated with identical frequency ranges. Theta band oscillations, for instance, were proposed to underlie both language comprehension and domain-general cognitive abilities. Here we show that the ageing brain can provide an answer to the open question whether it is one and the same theta oscillation underlying those functions, thereby resolving a long-standing paradox. While better cognitive functioning is predicted by low theta power in the brain at rest, resting state (RS) theta power declines with age, but sentence comprehension deteriorates in old age. We resolve this paradox showing that sentence comprehension declines due to changes in RS theta power within domain-general brain networks known to support successful sentence comprehension, while low RS theta power within the left-hemispheric dorso-frontal language network predicts intact sentence comprehension. The two RS theta networks were also found to functionally decouple relative to their independent internal coupling. Thus, both temporally and spatially distinct RS theta oscillations dissociate a language-specific from a domain-general processing mechanism.