Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

Background: Lifestyle interventions have been shown to improve physical function over the short term; however, whether these benefits are sustainable is unknown. The long-term effects of an intensive lifestyle intervention on physical function were assessed using a randomized post-test design in the Look AHEAD trial. Methods: Overweight and obese (BMI ≥25 kg/m 2) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes enrolled in Look AHEAD, a trial evaluating an intensive lifestyle intervention (ILI) designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including a 4- and 400-m walk, lower extremity physical performance (expanded Short Physical Performance Battery, SPPBexp), and grip strength approximately 11 years post-randomization and 1...

Background: Plasma metabolites such as phosphatidylcholines (PCs) and sphingomyelins (SMs) are associated with in age-related cognitive decline. However, their relations to age-related physical function decline remain largely unknown. Methods: We examined the cross-sectional relations of 12 plasma metabolites (including 4 PCs and 4 SMs) with physical function in 383 older adults in the Atherosclerosis Risk in Communities study at the fifth exam (2011-13, mean age [standard deviation (SD)]: 78...

Background: The hormone klotho, encoded by the gene klotho, is primarily expressed in the kidney and choroid plexus of the brain. Higher klotho concentrations have been linked to better physical performance; however, it is unknown whether klotho relates to frailty status in older adults. Methods: Plasma klotho was measured in 774 participants aged ≥ 65 years enrolled in InCHIANTI, a prospective cohort study comprising Italian adults. Frailty status was assessed at three and six years after enrollment...

Background: Aspiration of oral debris, containing dense oral bacteria, is a major cause of pneumonia in elderly adults. This study investigated the relationship between tongue microbiota composition and incidence of pneumonia-related deaths, in nursing home residents. Methods: The subjects were assessed for health conditions, including their tongue microbiota, at baseline. We determined tongue microbiota profiles by 16S ribosomal RNA gene sequencing and clustering approach...

Metallothionein (MT) family are cysteine-rich proteins that regulate zinc (Zn) homeostasis and protect against oxidative damage. Studies in transgenic mice have shown that MT favourably influence longevity, although their role in human aging is not completely understood.Within the European multicenter study MARK-AGE, we analysed MT induction after Zn treatment in peripheral blood mononuclear cells (PBMCs) and its relation with redox biomarkers in 2936 age-stratified subjects (35-75 years) including the general population (RASIG), centenarian offspring (GO) and their spouses (SGO)...

Mitochondrial dysfunction is prevalent in the ageing gastrointestinal tract. We investigated whether mitochondrial function in ageing colonic crypts and exercise influence microbial gut communities in mice. Twelve PolgAmut/mut mice were randomly divided into a sedentary and exercise group at 4 months. Seven aged matched PolgA+/+ mice remained sedentary throughout. Stool samples were collected at 4, 7 and 11 months, and bacterial profiling was achieved through 16S rDNA sequencing profiling. Mitochondrial enzyme activity was assessed in colonic epithelial crypts at 11 months for PolgAmut/mut and PolgA+/+ mice...

Background: Fall injuries are a major cause of morbidity and mortality among older adults. We describe the design of a pragmatic trial to compare the effectiveness of an evidence-based, patient-centered multifactorial fall injury prevention strategy to an enhanced usual care. Methods: Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) is a 40-month cluster-randomized, parallel-group, superiority, pragmatic trial being conducted at 86 primary care practices in 10 healthcare systems across USA...

Background: Incident disability rates enable the comparison of risk across populations. Understanding these by age, sex and race is important for planning for the care of older adults and targeting prevention. Methods: We calculated incident disability rates among older adults in the Cardiovascular Health Study, a study of 5,888 older adults aged ≥ 65 years over 6 years of follow-up. Disability was defined in 2 ways: 1) self-report of disability (severe difficulty or inability) in any of 6 ADLs, and 2) mobility difficulty (any difficulty walking half a mile or climbing 10 steps)...

Background: Current evidence that links "healthier" dietary patterns to better measured physical performance is mainly from older populations; little is known about the role of earlier diet. We examined adult diet quality in relation to physical performance at age 60-64 years. Methods: Diet quality was defined using principal component analysis of dietary data collected at age 36, 43, 53, and 60-64. Throughout adulthood, diets of higher quality were characterized by higher consumption of fruit, vegetables, and wholegrain bread...

Whether changes in internal body environment affect kidney aging remains unclear. Specifically, it is unknown whether transplanted kidneys from older donors recover from tissue damage after placement in younger recipients. In this study, a parabiosis animal model was established to investigate the effects of a young internal body environment on aged kidneys. The animals were divided into six groups: young (Ycon) and old (Ocon) control groups, isochronic youth-youth group (Y-IP), elderly-elderly group (O-IP) and heterochronic youth (Y-HP) elderly (O-HP) group...

Background: Although a fall is a necessary prerequisite to a fall-related injury, previous studies suggest that frequent fallers are at lower injury risk for a given fall. We tested the hypotheses that differences in protective responses or the circumstances of falls underlie differences in injury risk with fall frequency. Methods: We analyzed video footage of 897 falls experienced by 220 long-term care residents (mean age 82±9 yrs) to identify the cause of imbalance, activity leading to falling, direction of fall initiation, balance recovery and fall protective responses, and occurrence of impact to the head or hip...

BACKGROUND: As the population lives longer, end of life (EOL) is emerging as a distinct life phase, about which there is still limited understanding. Characterizing this important period is vital for clarifying issues regarding trajectory and decline at EOL and for health service planning on an institutional, communal, and societal level. In this paper we aim to characterize the EOL period, examining the duration and number of EOL stages, as well as the functional, attitudinal and emotional trajectories...

Nutritional ketosis is induced by high fat/low carbohydrate dietary regimens, which produce high levels of circulating ketone bodies, shifting metabolism away from glucose utilization. While ketogenic diets (KD) were initially introduced to suppress seizures, they are garnering attention for their potential to treat a myriad of neurodegenerative and metabolic disorders that are associated with advanced age. The feasibility and physiological impact of implementing a long-term KD in old animals, however, has not been systematically examined...

Background: Epidemiological studies suggest that lower total cholesterol (TC) may be associated with higher mortality. This study aimed to evaluate whether a decline in total cholesterol before death might account for the association of TC with mortality over age 80 years. Methods: Cohort study using primary care electronic health records of 99,758 participants aged 80 to 105 years from the UK Clinical Practice Research Datalink (CPRD). Hazard ratios (HR) for all-cause mortality were adjusted for age, gender, frailty, comorbidity, blood pressure and smoking...

Background: It is unclear whether physical activity (PA) could predict all-cause mortality independently of cardiorespiratory fitness, and there are relatively few studies evaluating the combined effect of PA and cardiorespiratory fitness on mortality. Methods: We invited 1,242 Chinese older adults aged 69 to 94 years from the MrOs and MsOs cohort (Hong Kong) study for a 7-year follow-up. PA was measured by the Physical Activity Scale of the Elderly (PASE). Cardiorespiratory fitness, expressed as maximal oxygen uptake (VO2max), was assessed by performing symptom-limited maximal exercise testing on an electrically braked bicycle ergometer and 6-meter walk test...

Background: Fatigability, defined as fatigue in relation to a standardized task, predicts functional decline in older adults independent of reported tiredness or energy level. Although the sensation of fatigue, tiredness, and energy level adversely affect physical activity (PA), the association between fatigability and objectively measured PA is unknown. Methods: Participants in the Baltimore Longitudinal Study of Aging (n=557, 50% women, aged 50-97) were instructed to wear an Actiheart accelerometer for 7 consecutive days in the free-living environment...

Background: High impact physical activity (PA) is thought to improve skeletal health but its relation to other health outcomes are unclear. We investigated associations between PA impact magnitude and body mass index (BMI) in older adults. Methods: Data were from the Cohort for Skeletal Health in Bristol and Avon (COSHIBA), Hertfordshire Cohort Study and MRC National Survey of Health and Development. Vertical accelerations peaks from seven-day hip-worn accelerometer recordings were used to classify PA as low (0...

BACKGROUND: Positive affect (PA) and negative affect (NA) reflect subjective emotional experiences. Although related to depression and anxiety, these dimensions are distinct constructs representing affective states and patterns. Prior studies suggest that elevated depressive symptoms are associated with risk of mild cognitive impairment (MCI) and probable dementia, but whether affective states are associated with cognitive impairment is still unknown. The present study examined relationships between baseline affective states and cognitive impairment (MCI, probable dementia) in non-depressed women...

Background: Data collected by wearable accelerometry devices can be used to identify periods of sustained harmonic walking. This report aims to establish whether the features of walking identified in the laboratory and free-living environments are associated with each other as well as measures of physical function, mobility, fatigability, and fitness. Methods: Fifty-one older adults (mean age 78.31) enrolled in the Developmental Epidemiologic Cohort Study were included in the analyses...

Multimorbidity is a common and burdensome condition that may affect quality of life, increase medical needs and make people live more years of life with disability. Negative outcomes related to multimorbidity occur beyond what we would expect from the summed effect of single conditions, as chronic diseases interact with each other, mutually enhancing their negative effects, and eventually leading to new clinical phenotypes. Moreover, multimorbidity mirrors an accelerated global susceptibility and a loss of resilience, which are both hallmarks of aging...