Impact of PM2.5 exposure in old age and its interactive effect with smoking on incidence of diabetes.

PURPOSE: To determine the impact of PM2.5 exposure in old age and its interactive effect with smoking on incident diabetes. METHODS: A total of 2766 participants aged ≥60 years in China were interviewed at baseline for disease risk factors in 2001-03 and were then followed up for 10 years to document incident diabetes. They were assessed for daily PM2.5 exposure in 2005. Multivariate Cox regression models were used to examine the association of PM2.5 exposure with incident diabetes and interactive effect between PM2.5 and smoking on incident diabetes. RESULTS: During the cohort follow-up, 176 participants developed diabetes. The incidence of diabetes increased with PM2.5 exposure; the multiple-adjusted hazard ratio (HR) of diabetes was 2.27 (95 % CI 1.36-3.77) in participants with PM2.5 at ≥62.0 µg/m3 compared to those with <62.0 µg/m3. There was a significant interaction effect of PM2.5 with smoking on increased risk of diabetes. The adjusted HR for participants exposed to PM2.5 levels ≥62.0 µg/m3 who smoked was 4.39 (95 % CI 1.72-11.21), while for non-smokers it was 1.65 (95 % CI 0.88-3.09), compared to those with <62.0 µg/m3. CONCLUSIONS: Exposure to PM2.5 in old age was associated with an increased incidence of diabetes and smoking enhanced the impact of PM2.5 on diabetic risk. These findings underscore the urgent need for air quality improvement measures and smoking cessation programs to mitigate the risk of diabetes in aging populations.

Prevalence of intrinsic capacity decline among community-dwelling older adults: a systematic review and meta-analysis.

BACKGROUND: The concept of intrinsic capacity (IC) was introduced to define healthy aging and active aging based on functional capacity, yet there is limited understanding of the risk of IC decline at a population level. AIMS: To consolidate existing evidence for rates of IC decline and risk factors among community-dwelling adults 60 years or older. METHODS: According to the PRISMA guidelines, the literature search was independently conducted by two researchers in 8 databases from inception to January 2024 without language restrictions using combinations of free words and subject words. Qualities of included studies were assessed using Joanna Briggs Institute's (JBI's) critical appraisal checklist for prevalence studies. To pool the data, a random-effect meta-analysis was performed, followed by subgroup analysis and sensitivity analysis. All analyses were performed by Stata14.0. RESULTS: From 1594 records, 15 studies were extracted with 33,070 participants for meta-analysis. The pooled prevalence of IC decline in community settings was 67.8% (95% CI: 57.0-78.5%; P < 0.001). The prevalence of IC decline in China (66.0%; 95% CI: 53.2-78.9%) was found to be slightly lower than in other countries/regions (73.0%; 95% CI: 59.8-86.3%); however, this difference was not statistically significant. Other subgroup analyses revealed no statistically significant differences in prevalence. Age, hypertension, diabetes, gender, education level, living status, smoking, regular exercise, marital status, and osteoarthritis are associated with IC decline. CONCLUSION: More than two-thirds of older adults in the community are affected by IC decline, and age, hypertension, diabetes, female sex, low education level, living alone, smoking, irregular exercise, unmarried, and osteoarthritis are all risk factors for IC decline.

Conditional survival and the prognostic value of serum carcinoembryonic antigen level in oldest old with colorectal cancer.

BACKGROUND: To evaluate the clinical value of serum CEA levels and their implications on the diagnostic value of the conventional TNM staging system in the oldest-old patients with colorectal cancer (CRC). METHODS: The recruited subjects were colorectal cancer patients aged 85 and older. The cutoff value for normal CEA level is 5 ng/mL. Patients with elevated CEA levels were categorized as stage C1, and those with normal CEA levels as stage C0. A number of Cox proportional hazard regression models were established to evaluate the prognosis of different prognostic factors with hazard ratios (HRs) and 95% confidence intervals (CIs). The Kaplan-Meier method was utilized to display the disparate prognostic impact of multiple clinicopathological factors with the log-rank test. RESULTS: A total of 17,359 oldest-old patients diagnosed with CRC were recruited from the SEER database. The conditional survival of oldest-old patients with CRC was dismal with a 1-year conditional survival of only 11%, 18%, and 30% for patients surviving 1, 3, and 5 years, respectively. Patients with stage C1 exhibited a 48.5% increased risk of CRC-specific mortality compared with stage C0 (HR = 1.485, 95%CI = 1.393-1.583, using stage C0 patients as the reference, P < 0.001). All the stage C0 patients indicated lower HRs relative to the corresponding stage C1 patients. CONCLUSIONS: Dismal conditional survival of oldest-old patients with CRC should be given additional consideration. C stage influences the prognosis of oldest-old patients with CRC.

Active trachoma and associated factors in children aged 1 to 9 years living in Sasiga rural districts, East Wallaga Zone, Ethiopia, in 2022: a community- based cross-sectional study.

BACKGROUND: Trachoma, caused by the bacteria Chlamydia trachomatous, is a contagious eye condition that frequently affects children and quickly spreads from child to child and from child to caregiver. The study aimed to assess the distribution of active trachoma and its associated risk factors among children 1-9 years aged in Households of Sasiga Rural District, Western Ethiopia, in 2022. METHODS: A community-based cross-sectional study was conducted among 577 randomly selected children from March to May 2022. A multistage sampling technique was used. Data was collected through an interviewer-based questionnaire, physical observation, and clinical eye examinations. Epi Data 3.1 was used for data entry. The data were analyzed with SPSS version 24. Bivariate and multivariate binary logistic regressions were performed. In multivariable logistic regression analysis, the adjusted odds ratio with a 95% confidence interval was used to identify factors associated with active trachoma. A P-value of 0.05 was considered statistically significant. RESULTS: The distribution of Active Trachoma among children 1-9 years aged in Households of the study area was 9.5%(95%CI:7.11,11.89). Being from a low-income household with a monthly income of less than 1500 ETB [AOR = 3.49, 95% CI: 1.39, 8.75], Households where the nearest water supply is more than 30 min away [AOR = 8.34, 95%CI: 1.89, 36.73], households with only one room [AOR = 2.98, 95%CI: 1.027, 8.68], and presence of feces in the compound of the households [AOR = 3.08, 95%CI: 1.41, 6.75] were associated with active trachoma in 1-9 years aged children living in the study setting. CONCLUSION: The distribution of Active Trachoma among children 1-9 years aged in Households of the study area was found to be high. Monthly income, the time it took to get water for home use, and the presence of feces in household compounds were all linked to active trachoma in children living in the study area. As a result, continuous sanitary education on trachoma transmission and prevention should be strengthened in the district.

Resilience to AD pathology in Top Cognitive Performers.

Successful cognitive aging is often thought to result from resistance to the accumulation of pathology, resilience to the effects of pathological accumulation, or some combination of the two. While evidence for resilience has been found in typical aging populations, the oldest-old provide us with a unique window into the role of pathological accumulation in impacting cognition. Here, we aimed to assess group differences in measures of amyloid and tau across older age groups using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI age: 60-89) and The 90+ Study (age: 90-101). Additionally, using the ADNI dataset, we performed exploratory analyses of regional cingulate AV-45 SUVRs to assess if amyloid load in particular areas was associated with Top Cognitive Performance (TCP). Consistent with the literature, results showed no group differences in amyloid SUVRs both regionally and in the whole cortex. For tau with AV-1451, we also observed no differences in Braak composite SUVRs. Interestingly, these relationships persisted in the oldest-old. This indicates that Top Cognitive Performance throughout aging does not reflect resistance to amyloid and tau burden, but that other mechanisms may be associated with protection against amyloid and tau related neurodegeneration.

Risk of Death Among Nursing Home Residents: A Cross-National Perspective.

OBJECTIVES: Describe the rate of death over 4 consecutive quarters and determine optimal categorization of residents into risk-of-death categories, expanding the Changes in Health, Endstage Disease, Signs and Symptoms (CHESS) scale. DESIGN: Using secondary analysis design with Minimum Data Set (MDS) data, the CHESS scale provided the base upon which the DeathRisk-NH scale was developed. SETTING AND PARTICIPANTS: Baseline and 4 quarterly follow-up analyses of Canadian (n = 109,145) and US (n = 1,075,611) nursing home resident data were completed. METHODS: Logistic regression analyses identified predictors of death, additive to CHESS, to form the DeathRisk-NH scale. The independent variable set used MDS items, focusing on clinical complexity indicators, diagnostic conditions, and measures of severe clinical distress. RESULTS: Country cohorts had similar percentages of residents with mean activities of daily living hierarchy scores, dependence in mobility, continence, memory, and overall CHESS scores. The percentage of individuals who died increased from 10.5% (3 months) to 30.7% (12 months). The average annual death rate for this cohort was 5.5 times higher than the national annual death rate of approximately 5.6%. CONCLUSIONS AND IMPLICATIONS: The DeathRisk-NH is an effective prediction model to identify residents at risk of death within the first 12 months after admission to the nursing home. The tool may be helpful in patient care planning, resource allocation, and excess death monitoring.

The double mediating effect of stress regulation and life satisfaction on music use as a coping mechanism and happiness in Chinese older adults during the COVID-19 pandemic.

BACKGROUND: This study investigated the relationship between music use as a coping mechanism and subjective happiness among Chinese older adults (COAs) during Coronavirus disease 2019 (COVID-19); it also focused on the mediating effect of stress regulation by music and life satisfaction in this relationship. METHODS: Participants were 329 male and female Chinese adults aged 60 years or older. Data were collected using the Sojump application for an online survey. The double mediating effect was analyzed using PROCESS Macro 3.5 Model 6. RESULTS: The results revealed that music use as a coping mechanism and stress regulation by music were not significantly correlated with subjective happiness of COAs, whereas these were positively correlated with their life satisfaction. Additionally, life satisfaction of COAs was positively correlated with subjective happiness. Stress regulation by music and life satisfaction completely mediated the relationship between music use as a coping mechanism and subjective happiness of COAs during COVID-19. In the double mediation model, music use as a coping mechanism positively influenced stress regulation by music (ß = 0.704), stress regulation by music positively influenced life satisfaction (ß = 0.162), and life satisfaction positively influenced subjective happiness (ß = 0.498). CONCLUSION: Therefore, music can promote happiness in COAs in stressful situations through stress regulation and life satisfaction.

Causes and Risk Factors of Vitamin B12 Deficiency at the Bookends of Life, From Infancy to Old Age.

The causes and risk factors of vitamin B12 deficiency are many and varied. Importantly, they vary considerably across the lifespan, from infancy to old age. The complexity of the physiology of vitamin B12 bespeaks the myriad of possible causes of deficiency and possible disruptions of its functional integrity. These lead ultimately to the pathobiological effects witnessed in deficiency of this fascinating micronutrient. This brief overview of the multiplicity of mechanisms that can result in vitamin B12 deficiency, and the panoply of its manifestations explores the underlying reasons for the protean presentations of the disease. As the human organism progresses through the chronology and milestones of age, various susceptibility factors arise resulting from the interplay of environmental and genetic factors. Acting independently and in concert, these factors produce the common denominator of vitamin B12 deficiency. However, the rate at which such deficiency develops and the way in which it presents clinically vary widely, subject to such influences as genetic variability, end-organ susceptibility, and concomitant micronutrient status. Some examples of unusual cases of vitamin B12 deficiency are described. Much has been learned about the last of the numbered vitamins in almost a century. Much yet remains to be discovered.

Pet ownership and psychosocial outcomes among the oldest old in Germany during the Covid-19 pandemic. Findings based on the nationally representative "Old Age in Germany (D80+)".

OBJECTIVES: To examine the association between pet ownership and psychosocial outcomes among the oldest old in Germany during the Covid-19 pandemic. METHODS/DESIGN: Data from the "Old Age in Germany (D80+)" study were used, a large, nationwide representative study covering both individuals living at home and individuals in nursing homes aged 80 years and above (n = 2867 individuals). The telephone interviews were conducted from May to October 2021. Established tools (e.g., "Short Form of the Depression in Old Age Scale", DIA-S4) were used to quantify the outcomes. Five groups were generated: (1) no pet ownership, (2) having at least one dog (but no other pets), (3) having at least one cat (but no other pets), (4) having at least one other pet (but neither dogs nor cats), (5) having at least two different types of pets (in any combination). RESULTS: Multiple linear regressions showed that compared to individuals without a pet, individuals having at least one dog had significantly lower loneliness levels (ß = -0.21, p < 0.01). In the fully-adjusted models, other forms of pet ownership were not significantly associated with the outcomes examined. CONCLUSION: Particularly living with a dog was associated with lower loneliness among the oldest old people in Germany. If living with a dog is in line with the preferences and attitudes of the very old, this could be a strategy for reducing loneliness in this age group.

The Global Research Trends on Intrinsic Capacity of Older Adults: A Bibliometric and Visual Analysis of Papers Published During 2015-2023.

Objective: The concept of intrinsic capacity (IC) revolves around healthy aging and active aging. Since the Introduction of the concept by the World Health Organization in 2015, a series of studies have been conducted by scholars from multiple fields. However, no bibliometric analysis has systematically investigated this issue. We aim to identify the current landscape and frontier trends of scientific achievements on IC in older adults through bibliometric approaches. Methods: Quantitative analysis of publications relating to IC in older adults from 2015 to 2023 was interpreted and graphed through the Web of Science Core Collection database on December 5, 2023. A variety of quantitative variables was analyzed, including publication and citation counts, H-index, and journal citation reports. Co-authorship, citation, co-citation, and co-occurrence analyses were performed for countries/regions, institutions, authors, and keywords using the VOSviewer and CiteSpace. Results: A total of 952 original and review articles in English were identified. The European countries possessed an absolute advantage in this field. The most contributive institution was the University of São Paulo. The most productive author is Cesari Matteo from France, followed by Qaisar Rizwan from the United Arab Emirates. However, a relatively low level of research cooperation existed between institutions and authors. Important topics mainly include the connotations, theoretical framework models, evaluation, screening tools, and application scenarios of IC. Among the promising hotspots, "biological aging", "ICOPE", "Covid-19", "prevention", "inflammation", "caf22", "prevalence", and "randomized controlled trial" displayed relatively latest average appearing year. Conclusion: Global trends indicate a growing scientific output on IC in older adults, and developed countries are leading the way. There is still room for improvement in research team collaboration. The focus gradually shifts from theoretical research to empirical research. It is recommended to pay attention to the latest hot spots, such as "biological aging", "ICOPE implementation", "post-COVID-19 syndrome", and "biomarkers".

Association between dietary riboflavin intake and cognitive decline in older adults: a cross-sectional analysis.

BACKGROUND: Research exploring the link between dietary riboflavin intake and cognitive decline in this demographic is limited. Our aim was to examine the association between riboflavin intake levels and cognitive decline. METHODS: The National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2014 were utilized in this cross-sectional analysis. The Consortium to Establish a Registry for Alzheimer's Disease test Word Learning delayed recall trial (DR), Digit Symbol Substitution Test (DSST), Animal Fluency Test(AFT) and Z test were used to evaluate cognitive performance. Multivariate logistic regression, restricted cubic spline and subgroup analysis were performed to evaluate the associations between riboflavin intake and cognitive decline. RESULTS: The study included a total of 2255 patients, with 47.9% being male. The incidence of cognitive decline was 23.8%. After adjusting for all selected covariates, we found that high riboflavin intake was associated with a lower risk of cognitive impairment in adults in the United States. When riboflavin intake was used as a Categorical variable, compared to those with the lowest intake, the odds ratio (OR) of individuals with the highest riboflavin intake for DR test, AFT test, DSST test and Z test were 0.73 (95% CI: 0.53~1), 0.68(95% CI: 0.49-0.96),0.53(95% CI: 0.37-0.77) and 0.56(95% CI: 0.39-0.8). The study also found an L-shaped association between riboflavin intake and cognitive decline, with an inflection point at approximately 2.984 mg/d. CONCLUSIONS: Our cross-sectional study in a nationwide sample of American old adults suggests that dietary riboflavin intake was negative associated with cognitive decline.

Patterns of multidimensional social exclusion among older home care services recipients.

OBJECTIVES: The guiding principle of current ageing policies has been to promote older adults to live in their private homes, but little attention has been paid to social exclusion of older adults receiving home-based care. The aim of this study is to increase understanding on different patterns of multidimensional social exclusion among older adults receiving formal home care services, and through this to shed light on the possible challenges of current ageing-in-place policies. METHODS: The survey data was collected in 2022 among older adults aged 65 to 102 years receiving home care services in Finland and merged with administrative data (n=733). A latent class analysis was used to identify different types of social exclusion. Multinomial logistic regression modeling examined factors associated with different social exclusion types. RESULTS: Four social exclusion types were identified: (1) not excluded (16.9 %), (2) homebound economically excluded (40.1 %), (3) excluded from social relations (28.6 %), and (4) multidimensionally excluded (14.3 %). Poor self-rated health and poor functional ability significantly increase the risk of being multidimensionally excluded or homebound economically excluded. The group using home care and medical services the most are the most multidimensionally excluded. The group living in urban areas are more likely to be excluded from social relations. DISCUSSION: Different types of social exclusion should be acknowledged when addressing social exclusion among home care clients. Enhanced measures should be developed to support older adults using home and health care services the most, as they are at high risk of severe exclusion.

The SIRT3/GSK-3ß/GLUT4 axis might be involved in maternal hypoxia-induced skeletal muscle insulin resistance in old male rat offspring.

Maternal hypoxia is strongly linked to insulin resistance (IR) in adult offspring, and altered insulin signaling for muscle glucose uptake is thought to play a central role. However, whether the SIRT3/GSK-3ß/GLUT4 axis is involved in maternal hypoxia-induced skeletal muscle IR in old male rat offspring has not been investigated. Maternal hypoxia was established from Days 5 to 21 of pregnancy by continuous infusion of nitrogen and air. The biochemical parameters and levels of key insulin signaling molecules of old male rat offspring were determined through a series of experiments. Compared to the control (Ctrl) old male rat offspring group, the hypoxic (HY) group exhibited elevated fasting blood glucose (FBG) (∼30%), fasting blood insulin (FBI) (∼35%), total triglycerides (TGs), and low-density lipoprotein cholesterol (LDL-C), as well as results showing impairment in the glucose tolerance test (GTT) and insulin tolerance test (ITT). In addition, hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) revealed impaired cellular structures and mitochondria in the longitudinal sections of skeletal muscle from HY group mice, which might be associated with decreased SIRT3 expression. Furthermore, the expression of insulin signaling molecules, such as GSK-3ß and GLUT4, was also altered. In conclusion, the present results indicate that the SIRT3/GSK-3ß/GLUT4 axis might be involved in maternal hypoxia-induced skeletal muscle IR in old male rat offspring.

Minimum acceptable diet and associated factors among 6-23 months old children enrolled in outpatient therapeutic program in the Tulla district, Sidama region, Ethiopia: a community-based cross-sectional study.

BACKGROUND: Improving the minimum acceptable diet (MAD) is essential for ensuring optimal growth and development of children, as well as preventing malnutrition and its consequences. Previous studies in Ethiopia have focused on the magnitude and determinants of a minimum acceptable diet. However, much emphasis was not given to minimum acceptable diet and its associated factors among 6-23 months old children enrolled in Outpatient therapeutic programs (OTP), particularly, in the study area. This study determines the minimum acceptable diet and associated factors among 6-23-month-old children enrolled in OTP. METHODS: A community-based cross-sectional study was conducted among 346 randomly selected mothers with children aged 6-23 months who were admitted to the OTP. The data were collected using interviewer-administered structured questionnaires. The data were entered, cleaned, coded into Epidata version 4.6, and exported to SPSS version 26 for further analysis. Multivariate logistic regression was used to assess the determinants of MAD. RESULTS: The overall prevalence of minimum Acceptable diet among children aged 6-23 months enrolled to OTP was 14.5% (95% CI: 12.02-19%). The odds of MAD were 1.9 times higher among children aged 18-23 months compared to children aged 6-11 months (AOR = 1.9, 95% CI ((1.2 3.9). The odds of MAD were 2.9times higher in children whose mothers had a good knowledge on recommended feeding (AOR = 2.9, 95% CI (1.2, 6.35). Mothers who had no formal education were 81% less likely to provide minimum acceptable diets for their children compared to their counterpart.(AOR = 1.94, 95% CI = 1.24, 4.19). CONCLUSION: The practice of a minimum acceptable diet is inadequate. Nutrition education should be emphasized to improve the mothers' nutrition knowledge regarding infant and young child feeding recommendations, to support mothers in overcoming barriers to feeding their children with adequate diets, and to foster complementary feeding practices for malnourished children.

Variations in the oxidation potential of PM2.5 in an old industrial city in China from 2015 to 2018.

PM2.5 pollution in China has decreased dramatically, but how its health effects change is not clear. There are 120 old industrial cities in China, where the sources, composition, and health effects of PM2.5 may be significantly different with other cities. Huangshi, an old industrial city in central China, underwent intense green transformations from 2015 to 2018. In this study, we collected ambient PM2.5 samples in 2015 and 2018 at an urban site in Huangshi. The average PM2.5 concentration decreased from 83.44 ± 48.04 µg/m3 in 2015 to 68.03 ± 39.41 µg/m3 in 2018. However, the average volume-normalized dithiothreitol (DTTv) of PM2.5 increased from 1.38 ± 0.45 nmol/min/m3 to 2.14 ± 1.31 nmol/min/m3 and the DTT normalized by particulate mass (DTTm) increased from 20.6 ± 10.1 pmol/min/µg to 40.07 ± 21.9 pmol/min/µg, indicating increased exposure risk and inherent toxicity. The increased toxicity of PM2.5 might be related to the increased trace elements (TEs) concentrations. The positive matrix factorization and multiple linear regression methods were employed to quantify the contributions of emission sources to PM2.5 and DTTv. The results showed that the contribution of coal combustion, industry, and dust to PM2.5 decreased significantly from 2015 to 2018, while that of vehicle emission and secondary sources increased. Despite the decreased fraction of coal combustion and industry sources, their contribution to DTTv increased slightly, which was caused by the increased intrinsic toxicity. The increased intrinsic toxicity was possibly caused by increased TEs, such as Pb, Cu, and V. Besides, the contribution of vehicle emission to DTTv also increased. Overall, these results provide valuable insights into the effectiveness of controlling strategies in reducing particulate health impacts in old industrial cities, and stress the necessity of formulating toxicity-oriented controlling strategies, with special attention to TEs from coal combustion and industry sources as well as vehicle emissions.

Prevalence of depressive disorders among the very old in the 21st century.

BACKGROUND: The aim of this study is to explore the prevalence of depressive disorders in very old adults over time, in rural/urban environments, between men/women, as well as to explore other factors associated with depressive disorders. METHODS: This study was conducted utilizing the GERDA-database data, which consists of four cohorts of 85, 90 and 95+ year olds living in Northern Sweden. Participants could reside independently or in residential care. Data collections took place between 2000 and 2017. Descriptive data and logistic regression models were utilized to explore data. RESULTS: The prevalence of depressive disorders increased between 2000/02 and 2015/17 in all age groups, with the highest percentages observed in the 95+ age group, reaching 53.6 % in 2015/17. The prevalence varied from 20.3 % in those without dementia to 65.1 % in those with dementia. Sex or living in an urban/rural environment was not associated with an increased risk of depression in the fully adjusted models. Dementia and reduced capacity in activities of daily living were associated with depressive disorders among 85 and 90-year-olds, while living alone was associated with depressive disorders in the 95+ age group. LIMITATIONS: Potentially limited generalizability, as this study took place in northern Sweden. CONCLUSIONS: The prevalence of depressive disorders among very old adults increases with age and the prevalence also increases throughout cohorts and time. These alarming rates of depressive disorders among the very old require immediate measures and further investigation. Future studies are needed to explore and monitor trends and to plan and design tailored interventions.

TICS-M scores in an oldest-old normative cohort identified by computable phenotype.

Objective: To (1) examine the distribution of Telephone Interview for Cognitive Status modified (TICS-m) scores in oldest-old individuals (age 85 and above) identified as cognitively healthy by a previously validated electronic health records-based computable phenotype (CP) and (2) to compare different cutoff scores for cognitive impairment in this population. Method: CP identified 24,024 persons, 470 were contacted and 252 consented and completed the assessment. Associations of TICS-m score with age, sex, and educational categories (<10 years, 11-15 years, and >16 years) were examined. The number of participants perceived as impaired was studied with commonly used cutoff scores (27-31). Results: TICS-m score ranged from 18 to 44 with a mean of 32.6 (SD = 4.7) in older adults aged 85-99 years old. A linear regression model including (range-restricted) age, education, and sex, showed beta estimates comparable to previous findings. Different cutoff scores (27 to 31) generated slightly lower MCI and dementia prevalence rates of participants meeting the criteria for the impairments than studies of younger elderly using traditional recruitment methods. Conclusions: The use of validated computable phenotype to identify a normative cohort generated a normative distribution for the TICS-m consistent with prior findings from more effortful approaches to cohort identification and established expected TICS-m performance in the oldest-old population.

The safety and efficacy of transfusing red blood cells stored for different durations: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The aim of this work was to resolve the uncertainty of whether transfusion of fresher red blood cells (RBCs) is better or not with regard to the safety and efficacy. METHODS: This systematic review was performed in accordance with our protocol registered on PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022379183). RESULTS: After a literature search, 13,247 records were identified, and 26 randomized controlled trials (RCTs) involving 53,859 participants were eligible and included in this review. The results in our review suggested that there was no significant effect of fresher vs older RBCs on mortality (relative risk [RR] = 1.04; 95% CI, 0.99-1.09; P = .39; I2 = 0%), transfusion reactions (RR = 0.87; 95% CI, 0.57-1.33; P = .64; I2 = 0%). However, the transfusion of fresher RBCs might increase the risk of nosocomial infection (RR = 1.11; 95% CI, 1.02-1.20; P = .02; I2 = 0%), whereas there was no significant difference in the fresh vs old subgroup (RR = 0.87; 95% CI, 0.68 to 1.12; P = .28; I2 = 0%). CONCLUSION: Our study updated and reinforced the evidence of previously published systematic reviews that support the safety and efficiency of current practice of issuing the oldest available RBCs in the blood bank inventory.

Temporal dynamics of depressive symptoms and cognitive decline in the oldest old: dynamic time warp analysis of the Leiden 85-plus study.

BACKGROUND: The prevalence of depressive symptoms and cognitive decline increases with age. We investigated their temporal dynamics in individuals aged 85 and older across a 5-year follow-up period. METHODS: Participants were selected from the Leiden 85-plus study and were eligible if at least three follow-up measurements were available (325 of 599 participants). Depressive symptoms were assessed at baseline and at yearly assessments during a follow-up period of up to 5 years, using the 15-item Geriatric Depression Scale (GDS-15). Cognitive decline was measured through various tests, including the Mini Mental State Exam, Stroop test, Letter Digit Coding test and immediate and delayed recall. A novel method, dynamic time warping analysis, was employed to model their temporal dynamics within individuals, in undirected and directed time-lag analyses, to ascertain whether depressive symptoms precede cognitive decline in group-level aggregated results or vice versa. RESULTS: The 325 participants were all 85 years of age at baseline; 68% were female, and 45% received intermediate to higher education. Depressive symptoms and cognitive functioning significantly covaried in time, and directed analyses showed that depressive symptoms preceded most of the constituents of cognitive impairment in the oldest old. Of the GDS-15 symptoms, those with the strongest outstrength, indicating changes in these symptoms preceded subsequent changes in other symptoms, were worthlessness, hopelessness, low happiness, dropping activities/interests, and low satisfaction with life (all P's < 0.01). CONCLUSION: Depressive symptoms preceded cognitive impairment in a population based sample of the oldest old.

Impact of neighborhood context on self-rated health among very old adults living in Germany: a cross-sectional representative study.

BACKGROUND: Increasingly, evidence has shown that different aspects of neighborhood context play a significant role in self-rated health, one of the key health indicators in advanced age. Nevertheless, very old adults are often under represented or excluded from such research. Therefore, the first aim of this study was to examine whether social, socioeconomic, and physical neighborhood context is associated with self-rated health in the very old population of Germany. The second objective was to explore whether the link of socioeconomic and physical neighborhood context with self-rated health is moderated by availability of social resources in neighborhoods. METHODS: Data from the representative survey, "Old Age in Germany" (D80+) were employed. In total, the study sample of D80+ included 10,578 individuals aged 80 years and over. Additionally, the D80+ data were matched with the freely accessible regional dataset of the Federal Institute for Research on Building, Urban Affairs, and Spatial Development. Two self-rated items (place attachment and social cohesion) were used to assess social neighborhood context. Socioeconomic context of neighborhoods was operationalized by German index of socioeconomic deprivation. To evaluate physical context, perceived measures of building conditions and walkability were included. Using the maximum likelihood estimator with robust standard errors, logistic regression models were estimated to analyze the relationship between neighborhood context (social, socioeconomic, and physical context, as well as their interactions) and self-rated health. RESULTS: Including 8,066 participants in the analysis, the findings showed that better condition of residential building, higher walkability, being closely attached to outdoor places, and higher social cohesion were associated with higher chance to report good self-rated health of very old adults. In the adjusted models, the German socioeconomic deprivation index was not related to self-rated health. The effect of socioeconomic and physical neighborhood context on self-rated health did not differ according available neighborhood social resources. CONCLUSIONS: The results indicate that especially more favorable conditions in social and physical neighborhood context are associated with good self-rated health in the very old population of Germany. Further studies should consider multiple aspects of neighborhood context as well as their interplay when examining the neighborhood impact on self-rated health in older populations.