Search Results (1,882)

Background and Objectives: Sarcopenia, characterized by progressive loss of skeletal muscle mass and function, has increasingly been recognized not only as a physical health concern but also as a potential risk factor for cognitive decline. This study investigates the application of machine learning algorithms to classify cognitive status based on Mini-Mental State Examination (MMSE) scores in community-dwelling sarcopenic women. Materials and Methods: A dataset of 67 participants was analyzed, with MMSE scores categorized into severe (≤17) and mild (>17) cognitive impairment. Eight classification models—MLP, CatBoost, LightGBM, XGBoost, Random Forest (RF), Gradient Boosting (GB), Logistic Regression (LR), and AdaBoost—were evaluated using a repeated holdout strategy over 100 iterations. Hyperparameter optimization was performed via Bayesian optimization, and model performance was assessed using metrics including weighted F1-score (w_f1), accuracy, precision, recall, PR-AUC, and ROC-AUC. Results: Among the models, CatBoost achieved the highest w_f1 (87.05 ± 2.85%) and ROC-AUC (90 ± 5.65%), while AdaBoost and GB showed superior PR-AUC scores (92.49% and 91.88%, respectively), indicating strong performance in handling class imbalance and threshold sensitivity. SHAP (SHapley Additive exPlanations) analysis revealed that moderate physical activity (moderatePA minutes), walking days, and sitting time were among the most influential features, with higher physical activity associated with reduced risk of cognitive impairment. Anthropometric factors such as age, BMI, and weight also contributed significantly. Conclusions: The results highlight the effectiveness of boosting-based models in capturing complex patterns in clinical data and provide interpretable evidence supporting the role of modifiable lifestyle factors in cognitive health. These findings suggest that machine learning, combined with explainable AI, can enhance risk assessment and inform targeted interventions for cognitive decline in older women. Full article

Background: The functional capacity of older adults is a critical determinant of autonomy and quality of life, particularly in low-income populations from remote regions with limited access to health services. This study aimed to characterize the functional fitness (FF) of community-dwelling older adults in the interior of Amazonas, Brazil, stratified by sex and age group. Methods: A cross-sectional study was conducted with 807 older adults (471 females), aged ≥ 60 years, from four municipalities in northern Brazil. The FF was assessed using the Senior Fitness Test (SFT), including measures of strength (30-s Chair Stand Test—CST; 30-s Arm Curl Test—ACT), flexibility (Chair Sit and Reach Test-CSAR, Back Scratch Test-BST), balance/agility (8-Foot Up-and-Go Test—FUG), and aerobic endurance (6-min walk test—6MWT). Descriptive statistics, confidence intervals, and age- and sex-specific percentiles were calculated. Results: Results indicated a progressive decline in FF with advancing age. Males outperformed females in strength and endurance tests, whereas females exhibited better flexibility. Notable reductions in performance were observed after age 75, particularly in CST, ACT, FUG, and 6MWT. Overall, the functional profiles of this population were below international norms, especially among females and individuals aged ≥ 80. The prevalence of overweight was 39.3%, with socioeconomic vulnerability affecting over 90% of participants. Conclusions: Older adults in low-income, remote Amazonian Brazilian communities demonstrate marked functional decline with ageing, influenced by socioeconomic and environmental constraints. These findings highlight the urgency of implementing accessible, community-based interventions focused on physical activity, strength, mobility, and endurance to support healthy ageing in underserved regions. Full article

Background: The rapid aging of China’s population poses significant challenges, particularly in public health and medical services. Frailty, a reversible geriatric syndrome, is a critical intervention target for disability prevention among older adults. Objective: We hypothesize that both intervention groups will demonstrate significant improvements in Short Physical Performance Battery (SPPB) scores compared to the control group, and that these improvements will be accompanied by parallel reductions in inflammatory markers and beneficial alterations in the gut microbiota. Methods: The MultIfaceted NUtrition inTervention for frail Elderly (MINUTE) trial is a randomized, parallel-group controlled trial. In Beijing, China, 315 frail older adults were recruited and randomly assigned to 3 groups: a control group receiving routine community health management only, multifaceted nutrition intervention group, and a multifaceted nutrition and exercise combined intervention group, each comprising 105 participants. The study consists of a three-month intervention period followed by a nine-month follow-up. During the three-month intervention period, the control group receives routine community health management, while the multifaceted nutrition intervention group receives daily dietary guidance, personalized nutrition consultations, and health education. Additionally, the combined intervention group receives exercise interventions in addition to the nutritional components. After the three-month intervention, all three groups will be followed up for nine months to assess the sustainability of the study. Results: The primary outcomes are the changes in the SPPB scores. The secondary outcomes include frailty scores, intrinsic capacity, malnutrition risk, frailty recovery rates, serum differential metabolites, inflammatory factors, and gut microbiota changes. This study aims to establish a scalable and sustainable pathway for frailty prevention among community-dwelling older adults in China and provide valuable insights to inform strategies for healthy aging. Trial registration: This study is conducted in accordance with the Declaration of Helsinki and approved by the Peking University Institutional Review Board (IRB00001052-23178) on February 3, 2024, with all amendments subject to prior review and approval. Informed consent is obtained from participants, and findings will be disseminated through peer-reviewed publications, conference presentations, and summaries for school staff and participants. ClinicalTrials.gov (NCT06547593) registered 30 July 2024. Full article

The association between patterns of internet use for older adults’ well-being is unclear. We examined the association between the frequency and purpose of internet use and subjective well-being in older Japanese adults. We analyzed cross-sectional data from 2343 community-dwelling older adults (aged 65–84 years). Subjective well-being was measured using the World Health Organization Well-Being Index as a continuous score, and internet use was categorized by frequency and purpose. Hierarchical linear regression analysis was controlled for sociodemographic and health-related covariates. After full adjustment, only daily (B = 1.04, 95% CI [0.53, 1.56]) and dual-purpose use (i.e., for both practical and social communication purposes; B = 0.80, 95% CI [0.28, 1.31]) were independently associated with higher well-being. The analysis of the combined patterns further suggested that daily use was the primary factor. For older adults, regularity of internet use was more strongly associated with well-being than diversity of purpose. Daily integration appears to be a key factor for realizing benefits, suggesting that sustained practice is the foundational step in building the digital capital necessary for a flourishing later life. Longitudinal studies are needed to confirm these findings and untangle the causal relationship between sustained internet use and improved well-being among older adults. Full article

Background/Objective: This study examined whether a brief measure combining subjective cognitive concerns and financial interference, termed Subjective Cognitive Decline-Financial (SCD-F), is associated with excess spending behavior in older adults. Methods: Community-dwelling older adults, some with early memory loss and some with no cognitive complaints (N = 150, M age = 72.6), provided 12 months of checking account statements and participated in interviews to clarify aspects of their personal financial behaviors. SCD-F was defined by asking if memory decline was interfering with financial decision-making or transactions. A 3-point SCD-F measure was created. Excess spending was determined by checking whether account expenditures exceeded all sources of income. Nonparametric tests (Kruskal–Wallis and Mann–Whitney U) and multiple regression models assessed group differences and predictors. Results: Group differences in excess spending were pronounced (H(2) = 15.75, p < 0.001). Those in the high SCD-F group had a significantly greater likelihood of excess spending (Z = −4.11; r = 0.43) and higher excess spending percentages (Z = −4.11; r = 0.43) compared to those with no memory loss. Regression analyses indicated that SCD-F was the strongest predictor of excessive spending (β = 0.40, t = 5.43, p < 0.001), even after controlling for age, gender, race, and education (R² = 0.235, F(5,144) = 8.86, p < 0.001). Conclusions: A brief self-report measure, SCD-F, effectively identifies older adults at risk of financial mismanagement, even absent formal cognitive impairment. Monitoring subjective cognitive concerns together with financial interference could enable early intervention. This brief measure may be useful in clinical settings as a screening tool, and in large national surveys. Full article

This study examined sarcopenia severity effects on body composition, physical performance, and mechanical properties of gait-related muscles in older women. Forty-one women aged ≥70 years participated and were classified by the following criteria: non-sarcopenia (NS, n = 15), functional sarcopenia (FS, n = 10), sarcopenia (SP, n = 9), and severe sarcopenia (SS, n = 7). Assessments included body composition, physical performance, and muscle tone, stiffness, and elasticity of the tibialis anterior (TA) and gastrocnemius medialis (GM). Group differences were analyzed using one-way ANOVA with Bonferroni post hoc tests (α = 0.05). SP and SS groups had lower body weight, BMI, appendicular skeletal muscle mass, and calf circumference compared with NS. FS demonstrated poorer physical performance than SP across all variables, with six-meter gait speed lower than SS (p < 0.05). SP exhibited significantly higher TA muscle tone, GM muscle tone and GM stiffness than NS (p < 0.05, p < 0.01, p < 0.05, respectively), while TA elasticity was significantly lower in SP (p < 0.01). These findings indicate that sarcopenia severity negatively influences body composition, muscle function, and mechanical properties, with functional sarcopenia showing the greatest impairment in performance. Early detection and targeted interventions are therefore critical to mitigate functional decline in older women. Full article

The indigenous community of Quisquinchir, in Saraguro (Loja, Ecuador), is facing a process of transformation of the rural Andean landscape associated with internal and external migration, as well as the influence of foreign architectural models. The new buildings symbolize, in the collective imagination, modernity and progress; however, they are alien to the natural environment characterized by the practice of agricultural and livestock activities. Although previous studies have described the loss of Andean vernacular architecture, its recent evolution in clear typologies has not been systematized. The objective of this study is to assess the current state of traditional dwellings and understand how migration reconfigures the landscape, collective memory, building traditions, and cultural identity of their inhabitants. Based on direct observation, photographic and stratigraphic analysis, and secondary sources, five typologies were identified: traditional one-story, traditional two-story, hybrid one-story, hybrid two-story, and eclectic. This classification indicates the replacement of earthen walls with cement blocks in 37% of the dwellings and of tile roofs with zinc roofs in 29%. However, 35% of the houses retain their traditional morphology and materials. These results and their classification are fundamental contributions to the design of local public policies that generate adequate interventions respectful of the environment. Full article

Background/Objectives: The Jiangnan diet—a traditional dietary pattern prevalent in Eastern China—is a newly proposed dietary pattern. This study provides additional epidemiological evidence for the promotion of the Jiangnan diet through examining the association between the Jiangnan diet and mild cognitive impairment (MCI). Methods: A multicenter cross-sectional study was carried out during 2020 among 1084 community-dwelling adults aged 55 years and above across multiple sites in Zhejiang Province, China. Data collection encompassed basic information of the population, cognition (using the Montreal Cognitive Assessment), dietary intake information (using the Food Frequency Questionnaire, FFQ), life pattern, depressive symptoms (using the Mental Health Assessment Scale for the Elderly), and physical examinations (e.g., height, weight). The dietary patterns were assessed using a validated semi-quantitative FFQ. Factor analysis was used to analyze the 16 categories of food intake of the participants, and dietary patterns and the “Jiangnan diet” were extracted. The Jiangnan diet scores were categorized into quartiles: Q1 (lowest) to Q4 (highest). Multivariate logistic regression was employed to examine the association between adherence to the Jiangnan diet and the prevalence of MCI, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: The estimated prevalence of MCI in the study population was 24.6%. The dietary pattern characterized by whole grains, low salt, and low oil was identified as the “Jiangnan diet”. Participants with the highest adherence to the “Jiangnan diet” pattern had 79.2% lower odds of MCI than those with the lowest adherence (odds ratio = 0.208, 95% CI = 0.120~0.362, p < 0.0001) after adjusting for age, frequency of social activities, depression, hypertension, alcohol consumption, and energy intake. Conclusions: High adherence to the Jiangnan diet was associated with lower odds of MCI. To further verify the relationship between the Jiangnan diet and MCI, future studies will focus on longitudinal research exploring different dietary patterns and disease outcomes across various regions. Full article

Background: Many factors associated with constipation have not been sufficiently investigated. The aim of this study was to assess the factors associated with constipation, defined as low stool frequency, in a community-dwelling adult population. Methods: A cross-sectional study was carried out between 2010 and 2012 among adults who live in the Kielce District of Poland. The participants comprised 11,488 persons aged 37–66 years. Data on depressive symptoms, eating frequency, physical activity and smoking, as well as sociodemographic data, were collected using face-to-face interviews. Constipation was defined as < 3 defecations per week. Dietary patterns (DPs) were identified using a factor analysis. Associations between DPs and the likelihood of constipation were assessed using a logistic regression analysis. Results: The factors associated with constipation were moderate and severe depressive symptoms, regular use of antidepressants, a sedentary lifestyle and past smoking (in women) (all p < 0.05). The likelihood of constipation was significantly decreased by male sex and obesity, as well as by a diet belonging to the highest terciles of the ‘Carbohydrates’, ‘Vegetables and Meat’ and ‘Healthy’ DPs (all p < 0.05). For the ‘Unhealthy’ DP, a high level of physical activity (Q4 vs. Q1 of MVPA) decreased the likelihood of constipation (OR = 0.75; 95%CI: 0.57–0.99). Conclusions: Preventing the onset or reoccurrence of depression by improving one’s mental resistance, reducing the risk factors for depression and promoting a healthy lifestyle, primarily a diet high in vegetables and a limited sitting time, reduces the risk of constipation. Further longitudinal studies are needed to better understand which factors are associated with the occurrence of constipation. Full article

Yangjiatang Village traces its origins to the late Ming and early Qing dynasties. It has evolved over more than 400 years of history. There are 78 rammed-earth buildings left, making it one of the most complete and largest rammed-earth building complexes in East China. This study investigated the traditional rammed-earth houses in Yangjiatang Village, Songyang County, Zhejiang Province. By combining field investigation, microscopic characterization, and experimental simulation, we systematically revealed the erosion resistance of rammed earth in a subtropical humid climate was systematically revealed. Using a combination of advanced techniques including drone aerial photography, X-ray diffraction (XRD), microbial community analysis, scanning electron microscopy (SEM), and soil leaching simulations, we systematically revealed the anti-erosion mechanisms of rammed-earth surfaces in Yangjiatang Village. The study found that (1) rammed-earth walls are primarily composed of Quartz, Mullite, lepidocrocite, and Nontronite, with quartz and lepidocrocite being the dominant minerals across all orientations. (2) Regulating the community structure of specific functional microorganisms enhanced the erosion resistance of rammed-earth buildings. (3) The surface degradation of rammed-earth walls is mainly caused by four factors: structural cracks, surface erosion, biological erosion and roof damage. These factors work together to cause surface cracking and peeling (depth up to 3–5 cm). (4) This study indicates that the microbial communities in rammed-earth building walls show significant differences in various orientations. Microorganisms play a dual role in the preservation and deterioration of rammed-earth buildings: they can slow down weathering by forming protective biofilms or accelerating erosion through acid production. Full article

Background: Fall injury is a sentinel event for mortality among older adults, and activity intensity may play a role in mitigating this outcome. This study assessed the relationship between activity intensity and all-cause mortality following fall injury among community-dwelling U.S. older adults. Methods: For this retrospective cohort study, we pooled 12 years of data from the National Health Interview Survey and identified older adults (aged 65 years and older) who sustained fall injuries (N = 2454). The outcome variable was time to death following a fall injury. We defined activity intensity as a binary variable, none-to-low and normal-to-high, using the American Heart Association’s weekly 500 Metabolic Equivalent of Task (MET) as a cutoff. We controlled for sociodemographic, healthcare access, and health characteristics; performed survey-weighted Cox proportional hazard regression analysis; and reported the adjusted mortality risks (plus 95% confidence interval (CI)). Results: The survey comprised 2454 older adults with fall injuries, representing 863,845 US older adults. The population was predominantly female (68%), non-Hispanic White (85%), and divorced/separated (54%). During the follow-up period, 45% of the study population died. Approximately 81% of the study population had low activity levels. However, between 2006 and 2017, the proportion of the study population with low physical activity decreased from 90% to 67%. After adjusting for sociodemographic, healthcare access, and health characteristics, none-to-low activity intensity was associated with 50% increased mortality risk (aHR: 1.50; 95% CI: 1.20–1.87). Conclusions: Promoting higher physical activity levels may significantly reduce the all-cause mortality risk following fall injury among older adults. Full article

Use of anticholinergic and sedative medications is potentially inappropriate in older adults due to associated adverse effects, including impaired cognitive and physical function. This study evaluated anticholinergic and sedative burden in Croatian community-dwelling older adults using the Drug Burden Index (DBI) and examined its association with self-reported health and healthcare utilization over 12 months. This observational, cross-sectional study, part of the EuroAgeism H2020 ESR 7 project, included conveniently sampled adults ≥ 65 years from community pharmacies in three Croatian regions. Data were collected using a standardized research questionnaire. DBI was used to quantify exposure to anticholinergic and sedative medications. Multivariate regression analyses examined associations between DBI and health outcomes, using logistic regression for binary outcomes and linear regression for self-reported health. Among 388 participants (63.7% female, median age 73), most had multimorbidity (median five diagnoses) and polypharmacy (63.9%), while 57% used at least one DBI medication—most commonly diazepam (15.5%) and tramadol (14.7%). High DBI (≥1) independently predicted more emergency department (ED) visits (OR = 2.45) and worse self-rated health (B = −0.26), but not hospitalization. High DBI in older adults was associated with more ED visits and poorer self-rated health, highlighting the need for targeted interventions to reduce anticholinergic and sedative use in this vulnerable population. Full article

Residential exposure to radon and environmental gamma radiation poses a significant public health concern in uranium-rich regions. The Akmola Region of Kazakhstan, home to one of the world’s largest uranium tailings sites, lacks localized data on seasonal exposure variations and associated health risks. This study assessed indoor radon progeny concentrations and gamma dose rates in 62 dwellings across two settlements—Aqsu and Zavodskoy—in the Akmola Region during autumn 2023 through summer 2024. Using RAMON-02 and Alpharad Plus detectors, seasonal equivalent equilibrium volumetric activity (EEVA) of radon progeny and effective doses were calculated, stratified by presence of a cellar. In Aqsu, ambient dose equivalent rates reached up to 0.55 µSv/h, and winter median EEVA levels exceeded 130 Bq/m³ in some non-cellar homes. Seasonal effective doses peaked in spring (up to 8.82 mSv) in cellar dwellings, with annual doses reaching 23.5 mSv—substantially higher than in Zavodskoy. Although mitigation efforts have reduced exposure in some homes, several cellar dwellings in Aqsu exhibited persistently elevated EEVA, suggesting potential structural vulnerabilities or residual contamination. These findings underscore significant seasonal and structural disparities in radiation exposure and highlight the need for targeted, site-specific interventions to reduce long-term health risks in affected communities. Full article

Older adults are vulnerable to changes in sleep with age. Poor sleep quality is associated with self-reported cognitive changes, which can occur before the onset of objective cognitive decline associated with Mild Cognitive Impairment and Alzheimer’s disease. The objective of this study was to examine associations between self-reported sleep complaints, objective sleep quality, and self-reported cognitive changes and their relations to symptoms of depression and anxiety in a group of community-dwelling older adults. Adults aged ≥ 50 without dementia (n = 45) were recruited and completed 1–2 weeks of rest-activity monitoring using a wrist-worn device, underwent a test of global cognitive functioning (Mini-Mental State Examination; MMSE), and completed questionnaires assessing insomnia (Insomnia Severity Index; ISI), subjective sleep quality (Pittsburgh Sleep Quality Index; PSQI), self-reported cognitive changes (Cognitive Function Instrument; CFI), and symptoms of depression and anxiety (Beck Depression Inventory-II; BDI-II and Generalized Anxiety Disorder 7-item assessment; GAD-7). Pearson partial correlations assessed relations among subjective and objective sleep quality, insomnia ratings, CFI ratings, and global cognition, while controlling for BDI-II and GAD-7 ratings. Exploratory analyses examined the correlation between PSQI component scores and CFI ratings and global cognition. Greater ISI (r = 0.50, p ≤ 0.001) ratings significantly correlated with higher CFI scores. PSQI total ratings and actigraphy-based measures (n = 41) did not significantly correlate with CFI scores. Exploratory PSQI subscale analyses revealed that worse subjective sleep quality (r = 0.31, p = 0.048), shorter sleep duration (r = 0.32, p = 0.04), and greater use of sleep medications (r = 0.31, p = 0.048) correlated with higher CFI scores. Poorer sleep quality due to less time spent asleep, fragmented or disturbed sleep, and requiring medications to sleep, may be associated with greater memory concerns. Alternatively, worries about cognition may deleteriously affect sleep. Subjective measures of sleep quality may be useful to identify older adults at increased risk of cognitive decline. Full article

Access to home- and community-based services (HCBSs) varies substantially between states. Yet, it is unknown how state-level policies and administrative factors impact consumer-reported unmet service needs, an important indicator of HCBS access and quality. Using the National Core Indicators—Aging and Disability Adult Consumer Survey (2016–2019; n = 13,654 community-dwelling older adults, 13 states), we examined associations between unmet HCBS needs with four state-level factors: HCBS spending relative to institutional care spending, HCBS spending per client, percentage of Medicaid beneficiaries in managed care, and Medicaid expansion; and funding program. In the adjusted logistic regression model, the odds of overall unmet HCBS needs were lower with higher percentage Medicaid beneficiaries in managed care (adjusted odds ratio [aOR], 0.92; 95% confidence interval [CI], 0.89–0.96) and Medicaid expansion (aOR, 0.80; 95% CI, 0.73–0.87) but greater with higher HCBS spending relative to institutional care spending (aOR, 1.19; 95% CI, 1.11–1.28). Compared to Medicaid waiver, odds of unmet HCBS needs were significantly lower among consumers in Managed Long-Term Services and Supports (aOR, 0.67; 95% CI, 0.61–0.74) and Program of All-Inclusive Care for the Elderly (PACE; aOR, 0.39; 95% CI, 0.31–0.49). State policies and administrative factors are important place-based determinants of HCBS consumers’ unmet HCBS needs/access; and warrant consideration in HCBS quality assurance and improvement. Full article