Trajectories of healthy aging and their association with prodromal parkinson disease: The HELIAD study.

Background: The aim of the present study was to investigate the association of prodromal PD (pPD) with trajectories of healthy aging, according to its latest definition by the WHO.Methods: In a sample of 1,226 older adults (704 women), PD diagnosis was reached through standard clinical research procedures. Probability of pPD was calculated according to the International Parkinson and Movement Disorder Society's research criteria for PD-free participants. A healthy aging metric was introduced using an item response theory approach (IRT) based on information from validated questionnaires assessing functionality. Four trajectories of healthy aging were created based on whether the healthy aging status of participants was above or below the median at baseline and follow up: High-High, High-Low, Low-High and Low-Low.Results: 34.3% belonged to the High-High group, 15.7% to the High-Low, 18.6% to the Low-High and 31.4% to the Low-Low group. Participants with possible/probable pPD were 78% less likely to belong in High-High trajectory of healthy aging as compared to those without pPD (OR = 0.22, 95%CI 0.06-0.79, p-value = 0,02).Conclusion: Our findings suggest an inverse association of pPD probability with healthy aging among older adults; Further research is needed to investigate the clinical implications of this association.

Determinants of verbal fluency trajectories among older adults from the English Longitudinal Study of Aging.

BACKGROUND: Prevalence of dementia and cognitive impairment increase creating the need for identifying modifiable risk factors to reduce their burden. The aim of this study was to identify latent groups following similar trajectories in cognitive performance assessed with the verbal fluency test, as well as their determinants. METHODS: Data from English Longitudinal Study of Aging (ELSA) were studied. Latent groups of similar course through a 6-year period in the outcome variable (verbal fluency) were investigated, along with their determinants, using Group Based Trajectory Modeling (GBTM). RESULTS: Four latent groups of verbal fluency trajectories were revealed. Education was the strongest predictor for a favorable trajectory, while cardiovascular disease and depression symptoms were associated with lower within each trajectory. CONCLUSION: Cardiovascular diseases and depressive symptoms are associated with a worse course of verbal fluency through aging, implying that they might serve as targets for interventions to prevent cognitive decline in the aging population. Contrarily, higher level of education is associated with a more favorable course through aging.

The effect of physical activity interventions on cognitive function of older adults: A systematic review of clinical trials.

Prevalence of dementia or of milder form of cognitive impairment is increasing and a pharmaceutical treatment remains pending. These facts underline the need of identifying modifiable factors and targeted interventions that could reduce the incidence or control disease progression. Physical activity (PA) has been shown to have a beneficial effect on cognitive function, however findings to date remain controversial. The aim of this systematic review is to summarize the most recent data from clinical studies investigating the relationship between cognitive impairment and PA in adults older than 60 years of age. For this purpose, PubMed, Scopus and Google Scholar, search was conducted, and a total of thirty-five studies were selected to review. Eleven studies investigated the effect of PA on individuals without cognitive impairment and seven of them presented some significant improvement, mostly on specific cognitive domains and only one in global cognition. Fourteen studies included populations with mild cognitive impairment (MCI) and twelve of them reported significant improvements in cognitive function. The majority of them presented a beneficial effect on global cognition and executive function. Finally, nine studies investigated interventions on populations with a diagnosis of dementia and only four of them showed any cognitive benefit following their interventions. There was no consistent observed association of a specific type of exercise and greater improvement or improvement in certain domains of cognition nor was there a minimum duration of intervention required for the improvements to take effect. In conclusion, the majority of the latest published literature suggests a protective role of PA on cognitive function. People with MCI seem to benefit the most from PA interventions, benefits in people with normal cognition are more subtle and harder to detect, while findings from studies in people with dementia remain contradictory. As findings are not currently in total agreement, further long-term prospective intervention studies are required in order to elucidate the reasons of this heterogeneity.

Trajectories of healthy aging and their association with the Mediterranean diet: The HELIAD Study.

BACKGROUND: The aim of the present study was to investigate the association of adherence to the Mediterranean diet with trajectories of healthy aging. METHODS: The dataset of the Hellenic Longitudinal Investigation of Aging and Diet was the basis for the present longitudinal analysis. In a sample of 1226 older (> 65 years) adults (704 women), adherence to the Mediterranean diet was assessed through the calculation of the MedDietScore. A healthy aging metric was introduced using an item response theory (IRT) approach based on information from validated questionnaires assessing functionality and cognition. Four trajectories of healthy aging were created based on whether the healthy aging status of participants was above or below the median at baseline and follow-up: High-High, High-Low, Low-High and Low-Low. The association of adherence to the Mediterranean diet with the trajectories was investigated using a multinomial logistic regression with the Low-Low group set as reference, while adjusting for potential confounders. RESULTS: 34.3% of participants belonged to the High-High group, 15.7% to the High-Low, 18.6% to the Low-High and 31.4% to the Low-Low group. Greater adherence to the Mediterranean diet was significantly associated with the probability of having one of the healthier trajectories (i.e., Low-High or High-High). Substitution analysis revealed that substituting energy intake from proteins and lipids with carbohydrates was associated with a lower probability of having one of the favorable trajectories. CONCLUSION: Greater adherence to the Mediterranean diet was associated with more favorable trajectories of aging and policies to raise awareness about its significance should be implemented.

Determinants of Processing Speed Trajectories among Middle Aged or Older Adults, and Their Association with Chronic Illnesses: The English Longitudinal Study of Aging.

The aim of this study was to identify latent groups of similar trajectories in processing speed through aging, as well as factors that are associated with these trajectories. In the context of the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project, data from the English Longitudinal Study of Aging (ELSA) (n = 12099) were analyzed. Latent groups of similar trajectories in the processing scores as well as their predictors and covariates were investigated, using group-based trajectory models (GBTM). The coefficient estimates for potential group predictors correspond to parameters of multinomial logit functions that are integrated in the model. Potential predictors included sex, level of education, marital status, level of household wealth, level of physical activity, and history of smoking, while time-varying covariates included incidence of cardiovascular disease (CVD), diabetes mellitus, depressive symptoms, and sleep disturbances. Four trajectories were identified and named after their baseline scores and shapes: High (4.4%), Middle/Stable (31.5%), Low/Stable (44.5%), and Low Decline (19.6%). Female sex, higher levels of education, mild level of physical activity, having been married, and higher level of wealth were associated with a higher probability of belonging to any of the higher groups compared to the Low/Decline that was set as reference, while presence of CVD, diabetes mellitus, and depressive symptoms were associated with lower processing speed scores within most trajectories. All the aforementioned factors might be valid targets for interventions to reduce the burden of age-related cognitive impairment.

The Association of Healthy Aging with Multimorbidity: IKARIA Study.

The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimorbidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled in the IKARIA study. Multimorbidity was defined as the combination of at least two of the following chronic diseases: hypertension; hypercholesterolemia; diabetes; obesity; cancer; CVD; osteoporosis; thyroid, renal, and chronic obstructive pulmonary disease. A healthy aging index (HAI) ranging from 0 to 100 was constructed using 4 attributes, i.e., depression symptomatology, cognitive function, mobility, and socializing. The prevalence of multimorbidity was 51% among men and 65.5% among women, while the average number of comorbidities was 1.7 ± 1.4 for men and 2.2 ± 1.4 for women. The most prevalent chronic diseases among men with multimorbidity were hypertension, hypercholesterolemia, and obesity while among women they were hypertension, hypercholesterolemia, and thyroid disease. Multimorbidity was correlated with HAI (Spearman's rho = -0.127, p < 0.001) and for every 10-unit increase in HAI, participants had 20% lower odds of being multimorbid. Multimorbidity in relation to HAI revealed a different trend across aging among men and women, coinciding only in the seventh decade of life. Aging is usually accompanied by chronic diseases, but multimorbidity seems to also be common among younger adults. However, healthy aging is a lifelong process that may lead to limited co-morbidities across the lifespan.