Limbic‐predominant age‐related TDP‐43 encephalopathy neuropathologic change and microvascular pathologies in community‐dwelling older persons

ABSTRACTA stratified random sample of 400 community-dwelling older persons were asked whether they like or dislike anything about being their age and if they have any worries about growing older. The results of multivariate analysis show significant relationships between the dependent variables and several respondent charaderistics including age, subjective health, expectations of older age, and gender. A negative view of aging appears to be associated with experiencing age-related declines. Overall, despite some diversity, the respondents tend to hold a positive view of old age that is coupled with a realistic appreciation of the shortcomings this stage of life may bring.

Download Full-text

Neocortical‐type Lewy bodies and limbic‐predominant age‐related TDP‐43 encephalopathy neuropathologic change in community‐dwelling older persons

Alzheimer s & Dementia ◽

10.1002/alz.047449 ◽

2020 ◽

Vol 16 (S3) ◽

Author(s):

Sonal Agrawal ◽

Lei Yu ◽

Sukriti Nag ◽

Konstantinos Arfanakis ◽

Lisa L Barnes ◽

...

Keyword(s):

Older Persons ◽

Lewy Bodies ◽

Community Dwelling ◽

Age Related

Download Full-text

The association of Lewy bodies with limbic-predominant age-related TDP-43 encephalopathy neuropathologic changes and their role in cognition and Alzheimer’s dementia in older persons

Acta Neuropathologica Communications ◽

10.1186/s40478-021-01260-0 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Sonal Agrawal ◽

Lei Yu ◽

Sukriti Nag ◽

Konstantinos Arfanakis ◽

Lisa L. Barnes ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Older Persons ◽

Lewy Bodies ◽

Alzheimer’S Dementia ◽

Community Dwelling ◽

Alzheimer's Dementia ◽

Cognitive Domains ◽

Age Related ◽

Global Cognition

AbstractLewy bodies (LBs) and limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) are common in older persons and associated with cognitive impairment. However, little is known about the relationship between LBs and LATE-NC and their combined roles in cognitive impairment and Alzheimer’s dementia in community-dwelling participants. The study included 1670 community-based participants (mean age-at-death, 89.5 years (SD = 6.65); 69% females) who underwent annual assessments of cognition to create summary measures of global cognition and cognitive domains and evaluation for Alzheimer’s dementia. Systematic neuropathologic evaluations were performed to assess LBs, LATE-NC, and Alzheimer’s disease (AD) pathology. We excluded cases with pathologically confirmed frontotemporal lobar degeneration in this study. Logistic and linear regression analyses were used, adjusted for demographics and AD pathology. LBs were present in 428 (25.6%) decedents (29 nigra-predominant, 165 limbic-type, and 234 neocortical-type) while 865 (51.7%) decedents exhibited LATE-NC (307 stage 1, 167 stage 2, and 391 stage 3). LBs combined with LATE-NC were common (15% of all participants) and in those with Alzheimer’s dementia (25%). Neocortical-type, but not nigral-predominant or limbic-type LBs increased the odds of stage 2/3 LATE-NC (odds ratio = 1.70; 95% confidence interval = 1.26–2.30). The association between neocortical-type LBs and stage 2/3 LATE-NC was stronger in those under 90 years of age and in women. In analyses of cognition and Alzheimer’s dementia, LATE-NC and neocortical-type LBs, separately, were related to lower global cognition, five specific cognitive domains, and an increased odds of Alzheimer’s dementia, above and beyond the AD pathology. Limbic-type LBs were related to lower global cognition, and the domains of episodic, working, and semantic memory, and increased odds of Alzheimer’s dementia. Furthermore, there was no interaction between limbic/neocortical-type LBs and LATE-NC on cognitive function, cognitive domains, or Alzheimer’s dementia. These findings suggest that neocortical-type LBs are associated with LATE-NC, specifically in the younger old and in women. Limbic/neocortical-type LBs and LATE-NC have separate and additive effects on cognitive function and odds of Alzheimer’s dementia.

Download Full-text

ALCOHOL USE AND FRAILTY IN COMMUNITY-DWELLING OLDER PERSONS AGED 65 TO 70 YEARS

Journal of Frailty & Aging ◽

10.14283/jfa.2014.2 ◽

2014 ◽

pp. 1-6

Author(s):

L. SEEMATTER-BAGNOUD ◽

J. SPAGNOLI ◽

C. BULA ◽

B. SANTOS-EGGIMANN

Keyword(s):

At Risk ◽

Alcohol Use ◽

Older Persons ◽

Population Based ◽

Community Dwelling ◽

Cross Sectional ◽

Age Related ◽

J Curve ◽

Heavy Drinkers ◽

Survival Effect

Background:Alcohol use has beneficial as well as adverse consequences on health, but few studiesexamined its role in the development of age-related frailty. Objectives:To describe the cross-sectional andlongitudinal association between alcohol intake and frailty in older persons. Design:The Lausanne cohort 65+population-based study, launched in 2004. Setting:Community. Participants:One thousand five hundred sixty-four persons aged 65-70 years. Measurements:Annual data collection included demographics, health andfunctional status, extended by a physical examination every 3 years. Alcohol use (AUDIT-C), and Fried’s frailtycriteria were measured at baseline and 3-year follow-up. Participants were categorized into robust (0 frailtycriterion) and vulnerable (1+ criteria). Results:Few participants (13.0%) reported no alcohol consumption overthe past year, 57.8% were light-to-moderate drinkers, while 29.3% drank above recommended thresholds (18.7%“at risk” and 10.5% “heavy” drinkers). At baseline, vulnerability was most frequent in non-drinkers (43.0%),least frequent in light-to-moderate drinkers (26.2%), and amounted to 31.9% in “heavy” drinkers showing areverse J-curve pattern. In multivariate analysis, compared to light-to-moderate drinkers, non-drinkers had twicehigher odds of prevalent (adjOR: 2.24; 95%CI:1.39-3.59; p=.001), as well as 3-year incident vulnerability(adjOR: 2.00; 95%CI:1.02-3.91; p=.043). No significant association was observed among “at risk” and “heavy”drinkers. Conclusion:Non-drinkers had two-times higher odds of prevalent and 3-year incident vulnerability,even after adjusting for their baseline poorer health status. Although residual confounding is still possible, theseresults likely reflect a healthy survival effect among drinkers while those who experienced health- or alcohol-related problems stopped drinking earlier.

Download Full-text

Obesity, sarcopenia and their functional consequences in old age

Proceedings of The Nutrition Society ◽

10.1017/s0029665110003939 ◽

2010 ◽

Vol 70 (1) ◽

pp. 114-118 ◽

Cited By ~ 24

Author(s):

Marjolein Visser

Keyword(s):

Muscle Strength ◽

Functional Status ◽

Old Age ◽

Muscle Mass ◽

Older Persons ◽

Functional Decline ◽

Overweight And Obesity ◽

Community Dwelling ◽

Age Related ◽

The Impact

The prevalence of obesity is high in older persons and recent trends show a rapid increase in this prevalence. Results from observational and intervention studies (i.e. weight loss studies) show the strong negative impact of obesity on functional status in old age. There are different potential pathways through which obesity may lead to functional decline in older persons. Furthermore, the presence of overweight and obesity during the life course and trends in medical care are likely to influence the impact of obesity on disability. The concepts sarcopenia (age-related loss of muscle mass) and dynapenia (age-related loss of muscle strength) receive a lot of research attention as potential determinants of functional decline in old age. There is no consensus on the definitions of these concepts. Recent studies conducted in large cohort studies of mainly community-dwelling older persons show that poor muscle strength is strongly associated with functional decline compared to low muscle mass. In several studies, no association between muscle mass and functional status was observed. Current research on the combination of obesity with poor muscle strength (dynapenic-obesity) suggests a potential additive effect of both components on poor functional status in old age which seems independent of the level of physical activity.

Download Full-text

The impact of functional limitations on disability and the moderating effects of psychological attributes in community-dwelling older persons

PsycEXTRA Dataset ◽

10.1037/e536922011-045 ◽

1998 ◽

Author(s):

G. I. J. M. Kempen ◽

M. J. G. van Heuvelen ◽

E. van Sonderen ◽

R. H. S. van den Brink ◽

A. C. Kooijman ◽

...

Keyword(s):

Older Persons ◽

Functional Limitations ◽

Community Dwelling ◽

Moderating Effects ◽

Psychological Attributes ◽

The Impact

Download Full-text

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa254 ◽

2020 ◽

Author(s):

Phoebe Ullrich ◽

Christian Werner ◽

Martin Bongartz ◽

Tobias Eckert ◽

Bastian Abel ◽

...

Keyword(s):

Cognitive Impairment ◽

Older Persons ◽

Controlled Trial ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Life Space ◽

Home Based ◽

Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

Download Full-text

Incidence and multidimensional predictors of occasional and recurrent falls among Malaysian community‐dwelling older persons

BMC Geriatrics ◽

10.1186/s12877-021-02103-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Theng Choon Ooi ◽

Devinder Kaur Ajit Singh ◽

Suzana Shahar ◽

Nor Fadilah Rajab ◽

Divya Vanoh ◽

...

Keyword(s):

Incidence Rate ◽

Older Persons ◽

Test Score ◽

Community Dwelling ◽

Chair Stand ◽

Stand Test ◽

Chair Stand Test ◽

Recurrent Falls ◽

History Of

Abstract Background Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. Methods Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. Results Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04–2.36), being single (OR: 5.31; 95 % CI: 3.36–37.48), having history of fall (OR: 1.86; 95 % CI: 1.19–2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02–1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45–5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12–34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01–1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77–0.97) appeared as recurrent falls predictors. Conclusions Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.

Download Full-text

The Longitudinal Association of Walking Efficiency With Brain Volumes in Community-Dwelling Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.2834 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 783-783

Author(s):

Jennifer Schrack ◽

Fangyu Liu ◽

Amal Wanigatunga ◽

Yang An ◽

Christos Davatzikos ◽

...

Keyword(s):

Region Of Interest ◽

Cognitive Status ◽

Community Dwelling ◽

Intracranial Volume ◽

Brain Volumes ◽

Age Related ◽

Lower Baseline ◽

Longitudinal Association ◽

Mri Scans ◽

Walking Efficiency

Abstract Walking efficiency (WE) predicts mobility decline and is linked with higher fatigability. Fatigability is associated with cognitive decline and reduced brain volumes (BV), but the link between WE and BV is undefined. We examined associations between WE and BV in 860 participants of the BLSA (mean age 66.4(14.4) years, 54.5% women). WE was assessed during 2.5-minutes of usual-paced walking using indirect calorimetry and standardized per meter (ml/kg/m). BV measures were derived using MRI scans and an automated multi-atlas region-of-interest approach. In linear mixed models adjusted for demographics, education, BMI, intracranial volume, and cognitive status, lower baseline WE was associated with lower total, white, and gray matter, primarily in the frontal and temporal lobes (all p<0.05). Longitudinally, declining WE was associated with increasing ventricular and decreasing hippocampal volumes over follow-up (all p<0.01). Findings suggest rising age-related inefficiencies may reflect underlying brain atrophy and serve as a novel indicator for future interventions.

Download Full-text

A Preliminary Analysis of Hearing Loss and Its Association With Mild Cognitive Impairment

Innovation in Aging ◽

10.1093/geroni/igaa057.1461 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 451-452

Author(s):

Mary Caroline Yuk ◽

Rebecca Allen ◽

Marcia Hay-McCutcheon ◽

Dana Carroll ◽

Anne Halli-Tierney

Keyword(s):

Hearing Loss ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Emotional Health ◽

Medical Center ◽

Pearson Correlation ◽

Well Being ◽

Hearing Screening ◽

Community Dwelling ◽

Age Related

Abstract Age related hearing loss, or presbycusis, is a global condition that is increasing in its prevalence. Despite being one of the most common chronic conditions among the older population, there is much more to understand about its association with other aspects of physical and emotional health and well-being. Current research is suggesting that hearing loss is more prevalent in those with cognitive impairment compared to those without cognitive impairment. This study analyzed the incidence of hearing loss and its linkage to mild cognitive impairment in a community-dwelling geriatric population. With the increasing prevalence of this condition in both rural and urban communities of Alabama, it becomes a more pressing matter to understand comorbidities and risk factors for future decline in functioning. This study was conducted in an interdisciplinary geriatrics primary care outpatient clinic in a Family, Internal, and Rural Medicine department affiliated with a university medical center in the Deep South. Ninety-one participants completed the Montreal Cognitive Assessment (MoCA) and a hearing screening. Hearing screenings were conducted in quiet rooms in the medical center using Phonak hearing screening cards. Detection of 500, 1000, 2000, and 4000 Hz tones was assessed. Pearson correlation analyses demonstrated an association between hearing loss mild cognitive impairment. Poorer hearing was significantly associated with lower scores on the MoCA. Conducting behavioral health screenings like this in other primary geriatrics clinics and community settings could improve care and identification of patient needs by integrating important data regarding comorbidities and independent living.

Download Full-text