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JARLIFE Vol 13, 2024
ASSOCIATION BETWEEN MODIFIABLE RISK FACTORS AND LEVELS OF BLOOD-BASED BIOMARKERS OF ALZHEIMER’S AND RELATED DEMENTIAS IN THE LOOK AHEAD COHORT
K.M. Hayden, M.M. Mielke, J.K. Evans, R. Neiberg, D. Molina-Henry, M. Culkin, S. Marcovina, K.C. Johnson, O.T. Carmichael, S.R. Rapp, B.C. Sachs, J. Ding, H. Shappell, L. Wagenknecht, J.A. Luchsinger, M.A. Espeland
J Aging Res & Lifestyle 2024;13:1-21
Show summaryHide summaryBACKGROUND: Emerging evidence suggests that a number of factors can influence blood-based biomarker levels for Alzheimer’s disease (AD) and Alzheimer’s related dementias (ADRD). We examined the associations that demographic and clinical characteristics have with AD/ADRD blood-based biomarker levels in an observational continuation of a clinical trial cohort of older individuals with type 2 diabetes and overweight or obesity.
METHODS: Participants aged 45-76 years were randomized to a 10-year Intensive Lifestyle Intervention (ILI) or a diabetes support and education (DSE) condition. Stored baseline and end of intervention (8-13 years later) plasma samples were analyzed with the Quanterix Simoa HD-X Analyzer. Changes in Aβ42, Aβ40, Aβ42/Aβ40, ptau181, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) were evaluated in relation to randomization status, demographic, and clinical characteristics.
RESULTS: In a sample of 779 participants from the Look AHEAD cohort, we found significant associations between blood-based biomarkers for AD/ADRD and 15 of 18 demographic (age, gender, race and ethnicity, education) and clinical characteristics (APOE, depression, alcohol use, smoking, body mass index, HbA1c, diabetes duration, diabetes treatment, estimated glomerular filtration rate, hypertension, and history of cardiovascular disease) .
CONCLUSIONS: Blood-based biomarkers of AD/ADRD are influenced by common demographic and clinical characteristics. These factors should be considered carefully when interpreting these AD/ADRD blood biomarker values for clinical or research purposes.
CITATION:
K.M. Hayden ; M.M. Mielke ; J.K. Evans ; R. Neiberg ; D. Molina-Henry ; M. Culkin ; S. Marcovina ; K.C. Johnson ; O.T. Carmichael ; S.R. Rapp ; B.C. Sachs ; J. Ding ; H. Shappell ; L. Wagenknecht ; J.A. Luchsinger ; M.A. Espeland (2024): Association between Modifiable Risk Factors and Levels of Blood-Based Biomarkers of Alzheimer’s and Related Dementias in the Look AHEAD Cohort. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.1
ELLIQ, AN AI-DRIVEN SOCIAL ROBOT TO ALLEVIATE LONELINESS: PROGRESS AND LESSONS LEARNED
E. Broadbent, K. Loveys, G. Ilan, G. Chen, M.M. Chilukuri, S.G. Boardman, P.M. Doraiswamy, D. Skuler
J Aging Res & Lifestyle 2024;13:22-28
Show summaryHide summaryBACKGROUND: Loneliness is a significant issue in older adults and can increase the risk of morbidity and mortality.
OBJECTIVE: To present the development of ElliQ, a proactive, AI-driven social robot with multiple social and health coaching functions specifically designed to address loneliness and support older people.
DEVELOPMENT/IMPLEMENTATION: ElliQ, a consumer robot with a friendly appearance, uses voice, sounds, light, and buttons through a touch screen to facilitate conversation, music, video calls, well-being assessments, stress reduction, cognitive games, and health reminders. The robot was deployed by 15 government agencies in the USA. Initial experience suggests it is not only highly engaging for older people but may be able to improve their quality of life and reduce loneliness. In addition, the development of a weekly report that patients can share with their clinicians to allow better integration into routine care is described.
CONCLUSION: This paper describes the development and real-world implementation of this product innovation and discusses challenges encountered and future directions.
CITATION:
E. Broadbent ; K. Loveys ; G. Ilan ; G. Chen ; M.M. Chilukuri ; S.G. Boardman ; P.M. Doraiswamy ; D. Skuler (2024): ElliQ, an AI-Driven Social Robot to Alleviate Loneliness: Progress and Lessons Learned. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.2
ERRATUM TO: ASSOCIATION BETWEEN MODIFIABLE RISK FACTORS AND LEVELS OF BLOOD-BASED BIOMARKERS OF ALZHEIMER’S AND RELATED DEMENTIAS IN THE LOOK AHEAD COHORT
K.M. Hayden, M.M. Mielke, J.K. Evans, R. Neiberg, D. Molina-Henry, M. Culkin, S. Marcovina, K.C. Johnson, O.T. Carmichael, S.R. Rapp, B.C. Sachs, J. Ding, H. Shappell, L. Wagenknecht, J.A. Luchsinger, M.A. Espeland
J Aging Res & Lifestyle 2024;13:29
Show summaryHide summary
CITATION:
K.M. Hayden ; M.M. Mielke ; J.K. Evans ; R. Neiberg ; D. Molina-Henry ; M. Culkin ; S. Marcovina ; K.C. Johnson ; O.T. Carmichael ; S.R. Rapp ; B.C. Sachs ; J. Ding ; H. Shappell ; L. Wagenknecht ; J.A. Luchsinger ; M.A. Espeland ; (2024): Erratum to: Association between Modifiable Risk Factors and Levels of Blood-Based Biomarkers of Alzheimer’s and Related Dementias in the Look AHEAD Cohort. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.3
LIFESTYLE PLANNING IN THE TRANSITION TO RETIREMENT
S.L. Hutchinson
J Aging Res & Lifestyle 2024;13:30-32
Show summaryHide summaryBACKGROUND: There is a further need to examine the types of planning people do for their lives in retirement and to examine goals and challenges in relation to planning efforts.
OBJECTIVES: This report summarizes highlights from a study that examined retirement planning and explored personal retirement experiences.
DESIGN: An online survey included quantitative and qualitative questions about retirement preparedness and satisfaction and open-ended questions about retirement goals, fears, challenges, and advice.
PARTICIPANTS: Canadians (n = 748) fully or partly retired responded to questions.
RESULTS: Quantitative results determined that while both financial and lifestyle planning were significant predictors of higher perceived preparedness, only lifestyle planning was a significant predictor for perceived satisfaction. Qualitative comments highlighted the importance of goal-setting, including planning for meaningful time use and strategies to address anticipated or existing challenges.
CONCLUSION: Lifestyle planning is an essential component of planning for the transition to retirement.
CITATION:
S.L. Hutchinson (2024): Lifestyle Planning in the Transition to Retirement. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.4
DESIGN AND RATIONALE OF A TWO-ARMED RANDOMIZED CONTROLLED TRIAL ON YOGA/BRISK WALKING-BASED LIFESTYLE MODIFICATION ON DEMENTIA RISK REDUCTION, AND INFLUENCE OF APOE GENOTYPES ON THE INTERVENTION
M. Singh, V. Majumdar
J Aging Res & Lifestyle 2024;13:33-42
Show summaryHide summaryBACKGROUND/INTRODUCTION: Though considered a late-onset disease, the 2020 report of the Lancet Commission emphasizes the necessity of conducting primary prevention trials with an approach of never too early in the life course for dementia prevention. Driven by the same notion, we hereby aim to compare the dementia risk reduction potential of two potential interventions, 48 weeks (12 months) of yoga and brisk walking, in middle-aged high-risk subjects.
DESIGN: A randomized controlled trial.
SETTING: Community in India.
PARTICIPANTS: In total, 323 at-risk dementia subjects will be recruited from community settings through health awareness camps and door-to-door surveys across Delhi, India. Participants will be randomized into yoga or brisk-walking groups (1:1). The yoga intervention group will receive 60 contact yoga sessions per 60-min/day at the community parks, followed by continued tele-supervised home practice, further followed by at-home self-practice, and will be tested at 3-time points (baseline, 24-week and 48-week, post-randomization) to test the efficacy of the intervention. The control group will be asked to do brisk walking daily for 45 minutes at their convenience, followed by weekly telephone follow-ups. Applying the intention-to-treat principle, the primary endpoint will be the change from baseline at the 12th month in the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) Scores. Secondary outcomes will include the composite scores derived from a comprehensive neuropsychology battery, comprising the Trail Making Test, Digit Span Test, N Back, Color Trail, Animal Fluency Test, COWA (Controlled Oral Word Association Test), and Digit Symbol Substitution. The primary outcome will be analyzed using mixed-effect models for repeated measures, adjusted for covariates as fixed effects. The study has been prospectively registered (CTRI/2023/02/049746) on February 15, 2023. The protocol was conceptualized in 2021 and approved by the Institutional Ethics Committee of SVYASA. Recruitment began in February 2023 and is underway with patient enrollment.
CONCLUSION: To our knowledge, this is the first controlled trial to investigate the longitudinal effects of a yoga-based intervention on dementia risk reduction using the CAIDE risk score. The findings of this trial will also provide insight into a better understanding of genotype-dependent responses to yoga intervention and open up avenues for understanding the implications of gene-intervention interactions for precision prevention using yoga.
CITATION:
M. Singh ; V. Majumdar ; (2024): Design and Rationale of a Two-Armed Randomized Controlled Trial on Yoga/Brisk Walking-Based Lifestyle Modification on Dementia Risk Reduction, and Influence of ApoE Genotypes on the Intervention. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.4
MACHINE LEARNING-BASED PREDICTION MODELS FOR COGNITIVE DECLINE PROGRESSION: A COMPARATIVE STUDY IN MULTILINGUAL SETTINGS USING SPEECH ANALYSIS
B. Ceyhan, S. Bek, T. Önal-Süzek
J Aging Res & Lifestyle 2024;13:43-50
Show summaryHide summaryBACKGROUND: Mild cognitive impairment (MCI) is a condition commonly associated with dementia. Therefore, early prediction of progression from MCI to dementia is essential for preventing or alleviating cognitive decline. Given that dementia affects cognitive functions like language and speech, detecting disease progression through speech analysis can provide a cost-effective solution for patients and caregivers.
DESIGN-PARTICIPANTS: In our study, we examined spontaneous speech (SS) and written Mini Mental Status Examination (MMSE) scores from a 60-patient dataset obtained from the Mugla University Dementia Outpatient Clinic (MUDC) and a 153-patient dataset from the Alzheimer’s Dementia Recognition through Spontaneous Speech (ADRess) challenge. Our study, for the first time, analyzed the impact of audio features extracted from SS in distinguishing between different degrees of cognitive impairment using both an Indo-European language and a Turkic language, which exhibit distinct word order, agglutination, noun cases, and grammatical markers.
RESULTS: When each machine learning model was tested on its respective trained language, we attained a 95% accuracy using the random forest classifier on the ADRess dataset and a 94% accuracy on the MUDC dataset employing the multilayer perceptron (MLP) neural network algorithm. In our second experiment, we evaluated the effectiveness of each language-specific machine learning model on the dataset of the other language. We achieved accuracies of 72% for English and 76% for Turkish, respectively.
CONCLUSION: These findings underscore the cross-language potential of audio features for automated tracking of cognitive impairment progression in MCI patients, offering a convenient and cost-effective option for clinicians or patients.
CITATION:
B. Ceyhan ; S. Bek ; T. Önal-Süzek ; (2024): Machine Learning-Based Prediction Models for Cognitive Decline Progression: A Comparative Study in Multilingual Settings Using Speech Analysis. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.6
MEDICAL-GRADE HONEY IS A VERSATILE WOUND CARE PRODUCT FOR THE ELDERLY
D. Chrysostomou, A. Pokorná, N.A.J. Cremers, L.J.F. Peters
J Aging Res & Lifestyle 2024;13:51-59
Show summaryHide summaryINTRODUCTION: Ageing of the global population has led to an increase in the demand for the treatment of wounds, especially considering the challenges of managing wounds in the elderly. Therefore, more effective treatment strategies need to be explored. In this article, we aimed to compare medical-grade honey (MGH) products with other wound care products and to provide guidelines on using MGH in wounds commonly found in the elderly.
METHODS: Based on literature research and expert opinion, an overview of commonly used wound care products and their wound healing characteristics is provided. In addition, literature-based classification of wounds in the elderly and the recommendations for treatments are provided.
RESULTS: Frequently used wound care products include povidone-iodine, enzymatic products, absorbing dressings, larvae, silver dressings, and MGH dressings. Supported by systematic reviews and meta-analyses, MGH dressings were identified as the most potent and all-round wound care product compared to the others. Next, we provided basic guidelines for managing the most common wounds in the elderly, both acute and chronic, and specified how and which MGH products can be used in these wounds.
CONCLUSION: MGH is a widely applicable, safe, easy-to-use, and cost-effective product to manage wounds in the elderly. In case of doubt, refer to a trained wound care specialist who can support the treatment of difficult-to-heal wounds.
CITATION:
D. Chrysostomou ; A. Pokorná ; N.A.J. Cremers ; L.J.F. Peters ; (2024): Medical-Grade Honey Is a Versatile Wound Care Product for the Elderly. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.7
COGNITIVE INTERVENTIONS: SYMPTOMATIC OR DISEASEMODIFYING TREATMENTS IN THE BRAIN?
F. Bellelli
J Aging Res & Lifestyle 2024;13:60-64
Show summaryHide summaryRecent findings suggest that brain-stimulating activities may have beneficial effects on both Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD). However, whether cognitive interventions merely enhance cognitive reserve or truly attenuate, or even reverse, the disease’s pathophysiology is still controversial. The aim of the present article is to discuss the potential for brain-stimulating activities, including cognitive stimulation (CS), cognitive rehabilitation (CR), and cognitive training (CT), to be symptomatic or disease-modifying interventions in the context of cognitive decline. While emerging evidence indicates that CT can enhance synaptic plasticity, suggesting a potential role in augmenting cognitive reserve, its impact on AD pathology remains uncertain. Small-scale studies suggest that CT and CS may slow down neurodegeneration in MCI patients and that multidomain interventions combining physical activity with CT may benefit Aβ pathology. However, the considerable heterogeneity across studies limits the comparability of findings. It underscores the necessity for a more standardized approach to cognitive interventions in future guidelines for preventing and managing cognitive decline.
CITATION:
F. Bellelli (2024): Cognitive Interventions: Symptomatic or Disease-Modifying Treatments in the Brain?. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.8
EFFECTS OF MULTIDOMAIN INTERVENTIONS ON SARCOPENIA
M. Nunes-Pinto, R.G. Bandeira de Mello
J Aging Res & Lifestyle 2024;13:65-72
Show summaryHide summarySarcopenia, a complex muscular condition driven by multi-systemic dysregulation and its interactions with lifestyle, physical attributes, and mental health, lacks effective drug treatments, relying primarily on non-pharmacological interventions. Fragmented approaches may prove suboptimal due to its complexity, underscoring the potential for multidomain interventions—a combination of two or more strategies to improve individual health—as a promising treatment option. This review examines the possible roles of multidomain interventions in sarcopenia, specifically addressing their effects on muscle mass and quality, muscle strength, and physical performance in older adults. While the updated literature highlights the beneficial consequences of multidomain interventions in enhancing physical performance outcomes, gaps persist in understanding their influence on the biological aspects of sarcopenia. Promising initial findings suggest changes in plasma inflammatory markers or muscle turnover networks, but further research is necessary to clarify the disease-modifying effects of multidomain intervention in sarcopenic patients.
CITATION:
M. Nunes-Pinto ; R.G. Bandeira de Mello ; (2024): Effects of Multidomain Interventions on Sarcopenia. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.9
DOES NUTRITIONAL SUPPLEMENTATION HAVE A DISEASEMODIFYING EFFECT ON THE ALZHEIMER’S DISEASE NEURODEGENERATIVE PROCESS?
K.V. Giudici
J Aging Res & Lifestyle 2024;13:73-76
Show summaryHide summaryBecause nutrition is one of the main factors related to Alzheimer’s disease (AD), questions arise about how taking nutrients as supplements can affect its pathophysiological process. In the present study, an overview of the potential effects of nutritional supplementation on the main biomarkers related to the AD pathophysiology (i.e., amyloid-β and tau) is explored. Trials testing the supplementation of single or combined nutrients versus placebo identified effects on some AD biomarkers, but changes were not always accompanied by positive effects on cognitive function. Differences in characteristics of studied populations (cognitive status, age, educational level), choice of nutrient combinations and doses, duration of intervention, and adjustments for potential confounders are some factors that may explain discrepancies in findings.
CITATION:
K.V. Giudici (2024): Does Nutritional Supplementation Have a Disease-Modifying Effect on the Alzheimer’s Disease Neurodegenerative Process?. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.10
DOES PHYSICAL EXERCISE MODIFY THE PATHOPHYSIOLOGY OF ALZHEIMER’S DISEASE IN OLDER PERSONS?
J. Raffin
J Aging Res & Lifestyle 2024;13:77-81
Show summaryHide summaryPhysical exercise is well known for its benefits on brain health. However, the mechanisms through which these benefits occur remain discussed, especially in the context of cognitive conditions such as Alzheimer’s disease. The present short review summarizes the findings of interventional studies that examined the effects of exercise training on the specific and non-specific biomarkers of Alzheimer’s disease. Controlled exercise intervention studies published in the English language were selected if they assessed the effects of a physical exercise intervention of at least 2 weeks in middle-aged or older adults on one of the following biomarkers measured either in the brain, the cerebrospinal fluid or the blood: beta-amyloid, tau, neurofilament light chain, and glial fibrillary acidic protein. Overall, there was no strong evidence of significant effects of exercise interventions on any of the selected biomarkers. However, in specific populations, such as women with obesity, pre-diabetes, or depression, favorable changes in blood beta-amyloid concentrations were reported. Further benefits on cerebrospinal fluid beta-amyloid were also demonstrated in APOE-ε4 allele carriers with Alzheimer’s disease. In conclusion, the current evidence suggests that physical exercise does not modulate the pathophysiology of Alzheimer’s disease in the overall population of middle-aged and older adults. Nonetheless, some specific populations, such as women with metabolic disorders and Alzheimer’s disease patients with APOE-ε4 genotype, seem to be favorably affected. Further studies, including long follow-ups, large sample sizes, and concomitantly assessing the effects of other factors such as sedentary behavior and diet, are required to bring further evidence to the field.
CITATION:
J. Raffin (2024): Does Physical Exercise Modify the Pathophysiology of Alzheimer’s Disease in Older Persons? The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.11
METABOLIC SYNDROME AND POSITIVE FRAILTY SCREENING: A CROSS-SECTIONAL STUDY WITH COMMUNITY-DWELLING OLDER ADULTS
M.C.B. de Souza, G. da Silva Rocha, E. de Souza Sampaio, P.C. de Oliveira Garcia Rodrigues, R.A. Vieira, A.F. Souza Gomes, T.R. Pereira de Brito
J Aging Res & Lifestyle 2024;13:82-87
Show summaryHide summaryBACKGROUND: Metabolic Syndrome is a set of disorders that characterized by the association of three or more risk factors, like the obesity central, dyslipidemia, borderline blood pressure, hyperglycemia, and the increase of triglycerides. However, these factors also can be associated with pathophysiology of frailty.
OBJECTIVES: verifying whether the metabolic syndrome is associated to the positive frailty screening in the older people.
DESIGN: Cross-sectional study. Participants: 443 older people living in Rio Branco, Brazil.
SETTING: Data collection was carried out in two stages: a personal interview and blood collection.
MEASUREMENTS: The diagnosis of metabolic syndrome was based on the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. The frailty screening was performed using subjective questions validated in a previous study. Descriptive statistics and multinomial logistic regression were used for data analyses.
RESULTS: There was a predominance of female older people (69.07%), aged between 60 and 79 years (87.13%), with an income greater than or equal to one minimum wage (72.09%), no cognitive decline (75.94%) and depressive symptoms (63.31%), independent for BADL (86.46%) and dependent for IADL (51.69%). From the total sample, 56.88% of the older people were identified as frail, 34.09% pre-frail and 9.03% non frail. The prevalence of metabolic syndrome was 51.69%. After adjusting by the independent variables, an association between metabolic syndrome and pre-frailty was observed, and older people with metabolic syndrome were more likely to be prefrail (RRR=2.36; 95%CI=1.08-5.18).
CONCLUSION: The metabolic syndrome was associated to the increase chance of screening for prefrailty in the older people evaluated, which reinforces the needy to establish preventive measures in relation to the metabolic syndrome to avoid frailty in the older people.
CITATION:
M.C.B. de Souza ; G. da Silva Rocha ; E. de Souza Sampaio ; P.C. de Oliveira Garcia Rodrigues ; R.A. Vieira ; A.F. Souza Gomes ; T.R. Pereira de Brito (2024): Metabolic Syndrome and Positive Frailty Screening: A Cross-Sectional Study with Community-Dwelling Older Adults. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.12
EFFECT OF MODIFIABLE LIFESTYLE FACTORS ON BIOLOGICAL AGING
W.-H. Lu
J Aging Res & Lifestyle 2024;13:88-92
Show summaryHide summaryBiological age is a concept that uses bio-physiological parameters to account for individual heterogeneity in the biological processes driving aging and aims to enhance the prediction of age-related clinical conditions compared to chronological age. Although engaging in healthy lifestyle behaviors has been linked to a lower mortality risk and a reduced incidence of chronic diseases, it remains unclear to what extent these health benefits result from slowing the pace of the biological aging process. This short review summarized how modifiable lifestyle factors — including diet, physical activity, smoking, alcohol consumption, and the aggregate of multiple healthy behaviors — were associated with established estimates of biological age based on clinical or cellular/molecular markers, including Klemera-Doubal Method biological age, homeostatic dysregulation, phenotypic age, DNA methylation age, and telomere length. In brief, the available studies tend to show a consistent association of lifestyle factors with physiological measures of biological age, while findings regarding molecular-based metrics vary. The limited evidence highlights the need for further research in this field, particularly with a life-course approach.
CITATION:
W.-H. Lu ; (2024): Effect of Modifiable Lifestyle Factors on Biological Aging. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2024.13