effect of physical activity on independent living ability among community-dwelling elderly in urban areas of Liaoning Province in China: a population-based study

Microvascular Disease Associates with Larger Osteocyte Lacunae in Cortical Bone in Type 2 Diabetes Mellitus

Clinical studies indicate that microvascular disease (MVD) affects bone microstructure and decreases bone strength in type 2 diabetes mellitus (T2D). Osteocytes are housed in small voids within the bone matrix and lacunae and act as sensors of mechanical forces in bone. These cells regulate osteoclastic bone resorption and osteoblastic bone formation as well as osteocytic perilacunar remodeling. We hypothesized that MVD changes morphometric osteocyte lacunar parameters in individuals with T2D. We collected iliac crest bone biopsies from 35 individuals (10 female, 25 male) with T2D with MVD (15%) or without MVD (21%) with a median age of 67 years (interquartile range [IQR] 62-72 years). The participants were included based on c-peptide levels >700 pmol L-1, absence of anti-GAD65 antibodies, and glycated hemoglobin (HbA1c) levels between 40 and 82 mmol mol-1 or 5.8% and 9.7%, respectively. We assessed osteocyte lacunar morphometric parameters in trabecular and cortical bone regions using micro-computed tomography (micro-CT) at a nominal resolution of 1.2 μm voxel size. The cortical osteocyte lacunar volume (Lc.V) was 7.7% larger (p = 0.05) and more spherical (Lc.Sr, p < 0.01) in the T2D + MVD group. Using linear regression, we found that lacunar density (Lc.N/BV) in trabecular but not cortical bone was associated with HbA1c (p < 0.05, R 2 = 0.067) independently of MVD. Furthermore, Lc.V was larger and Lc.Sr higher in the center than in the periphery of the trabecular and cortical bone regions (p < 0.05). In conclusion, these data imply that MVD may impair skeletal integrity, possibly contributing to increased skeletal fragility in T2D complicated by MVD. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

The association between the interaction of migration background and physical activity with loneliness in middle-aged and older adults living in Germany

BACKGROUND

Reduced physical activity and having a migration background are both associated with higher loneliness; however, the moderating role of migration background in the association between loneliness and physical activity remains largely unknown.

METHODS

We used cross-sectional data from the sixth wave (year 2017) of the German Ageing Survey (DEAS). Loneliness was measured using the De Jong Gierveld tool and physical activity was dichotomised into either of the following (i.e., at least 150 min of moderate physical activity per week) or not following physical activity recommendations of the World Health Organization (WHO). For evaluation of the associations we applied adjusted linear regression models with robust standard errors.

RESULTS

We included 6257 (average age = 67 years, 50% female) and 285 (average age = 63 years, 51% female) participants without and with migration background, respectively. In multiple linear regressions both migration background (ß = 0.13, P = 0.001), as well as not following the WHO physical activity recommendations (ß = 0.06, P < 0.001) were associated with increased loneliness. Moreover, the respective interaction term reached statistical significance (ß = -0.27, P = 0.013). Participants with migration background have a more pronounced association between following the WHO physical activity recommendations and reduced loneliness compared to participants without migration background.

CONCLUSION

Among middle-aged and older individuals, those with migration background benefit to a larger extent from following physical activity recommendations than the population without migration background regarding loneliness. Thus, motivating individuals with migration background to follow the WHO physical activity guidelines could particularly assist in reducing loneliness.

Community intervention programs prolong the onset of functional disability among older Japanese

Aim

This study examined the effects of a “community‐based center” intervention to prevent the onset of functional disability among residents in disaster‐affected areas.

Methods

We used data from a prospective cohort study conducted from 2010 to 2016 in Iwanuma City, Japan. Participants were community‐dwelling independent adults aged ≥65 years. The exposure variable was the experience of using a community‐based center. The outcome variable was functional disability onset. The average treatment effect on the treated (ATET) was estimated by adjusting for possible confounders. Additional analysis stratified by sex was conducted considering the sex differences in social participation rates.

Results

Among 3794 participants (mean ± SD age = 72.9 ±5.3 years, 46.0% men), 196 (5.2%) used the community‐based center, and 849 (22.4%) exhibited disability onset. Of those with functional disabilities, 40 (20.4%) used the community‐based center, while 809 (22.5%) did not. The ATET for functional disability onset with community‐based center activities across all participants were not significant (ATET: 0.51 years [95% confidence interval [CI] = −0.23; 1.27]). However, the direction of the effect of community‐based center activities differed by sex (ATET: −0.14, 95% CI = −2.59; 2.31 for men [n = 18], and 0.66, 95% CI = 0.18; 1.16 for women [n = 178]). Women exhibited a 15.63% (95% CI = 3.58; 27.68) increase in the time until functional disability onset.

Conclusions

The use of community‐based centers was associated with a longer period without functional disability in women. Geriatr Gerontol Int 2022; 22: 465–470.

Social Interaction, Lifestyle, and Depressive Status: Mediators in the Longitudinal Relationship between Cognitive Function and Instrumental Activities of Daily Living Disability among Older Adults

(1) Background: Cognitive decline is associated with instrumental activities of daily living (IADL) disability. Intervention targeting the mediators of this association will provide a path to avoid cognition-related IADL disability. (2) Methods: This study used data of wave 2008 (baseline) and wave 2014 of Chinese Longitudinal Healthy Longevity Surveys. Structural equation modeling was conducted to examine the mediating effect of social interaction, lifestyle (fruit and vegetable intake; exercise habits), and depressive status on the association between four baseline cognitive function dimensions (measured by the Chinese version of the Mini-Mental State Examination) and five (2014) IADL dimensions (visiting neighbors, shopping, preparing meals, washing clothes, and taking public transportation). (3) Results: Among 1976 older adults, 29.1% developed IADL disability 6 years later. The cognition−disability association was completely mediated by social interaction (estimate = −0.095, p < 0.001), lifestyle (estimate = −0.086, p < 0.001), and depressive status (estimate = −0.017, p = 0.003). The mediating effects of social interaction (46.3% variances explained) and lifestyle (42.0% variances explained) were both larger than that of depressive status (8.3% variances explained). (4) Conclusions: The development of interventions aimed at improving social interaction, depression, and lifestyle could be of value to prevent cognition-related IADL disability.

Impact of Religious Activities on Quality of Life and Cognitive Function Among Elderly

Religiosity and spirituality have previously been found to have significant effects on mental and physical health. This study aimed to compare elderly people utilizing different types of religious activities in their daily routine and the effects upon their quality of life and cognitive function. A cross-sectional study was conducted among elderly people dwelling in suburban areas of Malaysia. The Malay version of Short Form (36) Health Survey (SF-36), Geriatric Depression Scale (GDS-15), Older Americans Resources and Services's Instrumental Activities of Daily Living (OARS's IADL), and the Montreal Cognitive Assessment (MoCA) questionnaires were used in this study. Independent t test was utilized to determine the difference in the quality of life and the cognitive function between groups of elderly people that were categorized based on their level of participation in different religious activities. The study involved 432 participants. The mean score for all domain of SF-36 was significantly higher among those who engaged in the religious activities as compared to those elderly who were either less engaged or did not practice religious activities. The mean score of GDS-15, OARS's IADL, and MoCA was also significantly higher among those who participated in religious activities. There was a significant impact on the quality of life and cognitive function among elderly people practicing religious activities. This study proved the importance of practicing religious activities among the elderly in achieving healthy aging.

Successful Aging Among Community-Dwelling Older Adults in Urban Areas of Liaoning Province: The Crucial Effect of Visual Ability

Purpose

Successful aging is an effective approach to coping with population aging; however, the definition and associated factors vary due to culture and demographic distribution differences. This study was designed to assess successful aging of the older adults in China and explore the associated factors.

Methods

A community-based cross-sectional study was performed in Liaoning, China. After double-cognitive function screening, 3558 older adults (1656 males and 1902 females) ≥65 years of age served as our subjects. Successful aging was assessed based on the following: physical disability; cognitive function; activities of daily living; and self-rated psychological/mood status.

Results

The rate of successful aging was 31.7% in males and 29.4% in females. After adjustment for age, multivariate logistic regression showed that successful aging was significantly associated with, in odds ratio sequence, visual ability, self-rated chronic disease, marital status, and filial piety in males, and with visual ability, self-rated chronic disease, watching television, and ethnicity in females.

Conclusion

The level of successful aging in China is lower than in other countries. Demographic characteristics, health status, individual behavior, and social-psychological factors are all associated with successful aging. Overall, visual ability had the most crucial role in successful aging for the older adults, whether males or females.

Relationship between executive dysfunction and neuropsychiatric symptoms and impaired instrumental activities of daily living among patients with very mild Alzheimer's disease

OBJECTIVES

Patients with Alzheimer's disease (AD) experience a gradual loss in their ability to perform instrumental activities of daily living (IADLs) from the early stage. A better understanding of the possible factors associated with IADL decline is important for the development of effective rehabilitation and support programs for patients with AD. Thus, we examined the relationships between comprehensive cognitive functions and neuropsychiatric symptoms and IADLs in patients with very mild AD.

METHODS

In total, 230 outpatients with probable AD were recruited from the Memory Clinic at Kumamoto University Hospital between May 2007 and October 2016. All patients scored ≥21 points on the Mini-Mental State Examination at the first assessment. Relationships between the subdomains of the Lawton IADL scale and neuropsychological/neuropsychiatric tests were examined by multiple regression analysis. All analyses were performed separately in men and women.

RESULTS

In female patients, scores on the Frontal Assessment Battery were significantly associated with telephone use ability, shopping, and ability to handle finances. Apathy scores in the Neuropsychiatric Inventory (NPI) were associated with telephone use ability, housekeeping, responsibility for own medications, and ability to handle finances. NPI agitation scores were associated with food preparation and housekeeping. Geriatric Depression Scale scores were associated with telephone use ability and ability to handle finances. In male patients, only NPI apathy scores were associated with telephone use ability.

CONCLUSIONS

These results suggest the importance of properly assessing executive function, depression, and apathy at interventions for impaired IADLs among female patients with very mild AD.