Posted: April 10, 2019, 11:40 am
Aging is a progressive and complicated bioprocess with overall decline in physiological function. Osteoarthritis (OA) is the most common joint disease in middle-aged and older populations. Since the prevalence of OA increases with age and breakdown of articular cartilage is its major hallmark, OA has long been thought of as “wear and tear” of joint cartilage. Nevertheless, recent studies have revealed that changes in the chondrocyte function and matrix components may reduce the material properties of articular cartilage and predispose the joint to OA. The aberrant gene expression in aging articular cartilage that is regulated by various epigenetic mechanisms plays an important role in age-related OA pathogenesis. This review begins with an introduction to the current understanding of epigenetic mechanisms, followed by mechanistic studies on the aging of joint tissues, epigenetic regulation of age-dependent gene expression in articular cartilage, and the significance of epigenetic mechanisms in OA pathogenesis. Our recent findings on age-dependent expression of 2 transcription factors, nuclear factor of activated T cell 1 (NFAT1) and SOX9, and their roles in the formation and aging of articular cartilage are summarized in the review. Chondrocyte dysfunction in aged mice, which is mediated by epigenetically regulated spontaneous reduction of NFAT1 expression in articular cartilage, is highlighted as an important advance in epigenetics and cartilage aging. Potential therapeutic strategies for age-related cartilage degeneration and OA using epigenetic molecular tools are discussed at the end.
Posted: April 10, 2019, 10:40 am
Benign prostatic hyperplasia (BPH), benign prostatic enlargement (BPE) and lower urinary tract symptoms (LUTS) belong to the most frequent diseases in ageing men. Beyond the 6th decade of life, more than 30% of men suffer from moderate to severe LUTS requiring intervention. The pathophysiology of BPH/BPE is still incompletely understood. The dominant role of the androgen system and the androgen receptor is well defined. Androgen receptors are expressed in BPH tissue in which they are activated by the potent androgen dihydrotestosterone. Synthesis of dihydrotestosterone is under control of the 5α-reductase enzyme, activity of which is antagonized by finasteride and dutasteride. More recently, the impact of prostatic inflammation and metabolic parameters particularly for the development of BPE and LUTS has increasingly been recognized. A better understanding of the pathophysiology is a prerequisite for the development of novel, more effective medical treatment options.
Posted: April 3, 2019, 2:18 pm
Background: Muscle weakness – a biomarker of health – may have its origins in early life and be related to factors such as adverse childhood experiences (ACE), which refer to a set of early-life traumatic and stressful psychosocial events out of the child’s control. To date, evidence of an association between ACE and muscle strength in older age is lacking. Objective: Here, we assessed the associations between ACE during the first 15 years of life and the risk of low muscle strength (LMS) later in life. We also examined whether adult-life socioeconomic circumstances (i.e., educational attainment, main occupational position, and satisfaction with household financial situation) and unhealthy behaviors (i.e., physical inactivity, unhealthy eating, smoking, and high level of alcohol consumption) explained this association. Methods: We used data from the Survey of Health, Ageing, and Retirement in Europe, a 12-year cohort study with 6 repeated measurements between 2004 and 2015. Muscle strength was measured using a handheld dynamometer. Confounder-adjusted logistic mixed-effect models were used to examine the associations between ACE (child in care, parental death, parental mental illness, parental drinking, period of hunger, or property taken away) and the risk of LMS in older age. Results: 24,179 participants (96,372 observations; 13,477 women; aged 50–96 years) living in 14 countries were included. LMS increased with age for both genders. For women, there was a gradual increase in the risk of LMS with the number of experienced ACE (ORs = 1.22 for 1 ACE, 1.74 for ≥2 ACE compared to no ACE). However, there was no significant association among men. This association was only slightly attenuated when adjusting for socioeconomic circumstances and unhealthy behaviors in adulthood. Conclusions: ACE are associated with later-life muscle weakness among women. These associations were not compensated by the adoption of healthy behaviors or an improvement in socioeconomic circumstances in adulthood. These results suggest that tackling these early-life risk factors in women could promote long-term grip strength, a biomarker of aging.
Posted: March 28, 2019, 11:38 am
Background: In nondemented aging, higher levels of everyday physical activity (EPA) and mobility performance are associated with better executive function (EF) trajectories. However, these associations may be moderated by both sex and Alzheimer’s disease (AD) genetic risk. Objectives: In a longitudinal study, we investigate sex differences in (a) EPA and mobility effects on EF performance (level) and change (slope) and (b) AD genetic risk moderation of these associations. Methods: The longitudinal design included nondemented adults (n = 532, mean age = 70.4 years, range 53–95) from the Victoria Longitudinal Study. Using structural equation analyses on an EF latent variable, we tested (a) sex moderation and (b) interactive effects of sex and APOE on observed EPA-EF and mobility-EF performance and change relationships. Results: First, we observed independent sex effects for the EPA-EF and mobility-EF predictions. Whereas EPA had a significant effect on EF performance and change only for females, mobility had a significant effect for both sexes. Notably, males with lower mobility levels experienced steeper EF decline than females with lower mobility levels. Second, we observed significant sex × APOE interaction effects. The combination of lower genetic risk and higher EPA benefitted females but not males. In contrast, lower genetic risk and higher mobility benefited both sexes, although male APOE no-risk carriers with lower mobility levels had EF decline patterns that were similar to APOE risk carriers. Conclusions: Longitudinal analyses across a broad band of aging show that sex moderates the effects of both EPA and mobility on EF performance and change. Notably, this moderation occurs differentially across the AD genetic risk status. These results point to a precision health approach to observational and interventional research in which effects of physical activity and mobility on EF trajectories and dementia are examined in the personalized and interactive context of sex and AD risk.
Posted: March 25, 2019, 9:54 am
Background: It has often been argued that there is a relationship between oral health and cognitive decline in late adulthood, but a recent systematic review concluded that it was unclear “how or whether” any relationship exists. However, most of the studies that contributed to this review operationalised cognitive function using a brief cognitive screen and/or dementia status. Objective: An updated systematic review was conducted that focused on how oral health relates to specific cognitive abilities in older adults (specifically, the neurocognitive domains specified in the DSM-5: learning and memory, perceptual motor function, language, executive function, complex attention, and social cognition). Methods: A systematic review was undertaken and completed in August 2018. From a total of 1,304 potentially relevant articles, 23 were identified that assessed oral health and at least one of the specific cognitive domains in an older adult cohort. Results: The most consistent relationships were identified with learning and memory, complex attention, and executive function. For each of these cognitive domains, most studies identified significant unadjusted associations with oral health; where adjustments for covariates were made, at least one of the associations with oral health remained significant in half or more of the studies. Results were less clear for the domains of language and perceptual motor function. No study assessed the relationship between social cognition and oral health. Conclusions: This systematic review provides evidence of an association between learning and memory, complex attention, and executive function with oral health in old age. Gaining a detailed picture of how specific types of cognitive decline relate to oral health has potential implications for earlier identification of older adults who experience oral health problems, and may also inform the development of more effective interventions focused on enhancing oral health outcomes in this group.
Posted: March 22, 2019, 8:17 am
Osteoarthritis (OA) is designated the 11th highest contributor of 291 diseases of global disability and the most common cause of chronic disability in elderly people. OA has a devastating impact on quality of life and represents an enormous socio-economic burden. Currently, OA is incurable, and no approved medications, biological therapy, or procedure prevents the progressive destruction of the osteoarthritic knee joint. All current treatments provide symptomatic relief rather than preventative or regenerative results. There is an urgent and compelling need to find, validate, and test new biological therapeutics. Cell-based therapies involving the delivery of mesenchymal stromal cells (MSCs) to the osteoarthritic knee joint have emerged as a potential solution to overcome this clinical shortcoming. In this review, we address the clinical evidence, challenges, and recent advances surrounding MSC treatment in knee OA.
Posted: March 21, 2019, 11:01 am
Some authors have hypothesised that life expectancy at birth could reach 100 years in developed countries in the next decades. Using recent data for French women, it is shown that life expectancy changes from 1993 to 2016 are mainly linked to mortality rates of oldest women. In recent years, it happened that life expectancy of French women oscillated, because of for instance influenza epidemics killing mainly oldest frail people. It is hypothesised that in coming years, life expectancy of French women (and one day of men?) will only very slightly increase and will show oscillations because of increased mortality the years of severe influenza, heatwave and other events threatening the life of frail oldest people. This fate could also be that of the other developed countries in the future, which would mean that life expectancy has begun to plateau.
Posted: March 21, 2019, 7:28 am
Posted: March 14, 2019, 7:59 am
Background: With global aging, robots are considered a promising solution for handling the shortage of aged care and companionships. However, these technologies would serve little purpose if their intended users do not accept them. While the socioemotional selectivity theory predicts that older adults would accept robots that offer emotionally meaningful relationships, selective optimization with compensation model predicts that older adults would accept robots that compensate for their functional losses. Objective: The present study aims to understand older adults’ expectations for robots and to compare older adults’ acceptance ratings for 2 existing robots: one of them is a more human-like and more service-oriented robot and the other one is a more animal-like and more companion-oriented robot. Methods: A mixed methods study was conducted with 33 healthy, community-dwelling Taiwanese older adults (age range: 59–82 years). Participants first completed a semi-structured interview regarding their ideal robot. After receiving information about the 2 existing robots, they then completed the Unified Theory of Acceptance and Use of Technology questionnaires to report their pre-implementation acceptance of the 2 robots. Results: Interviews were transcribed for conventional content analysis with satisfactory inter-rater reliability. From the interview data, a collection of older adults’ ideal robot characteristics emerged with highlights of humanlike qualities. From the questionnaire data, respondents showed a higher level of acceptance toward the more service-oriented robot than the more companion-oriented robot in terms of attitude, perceived adaptiveness, and perceived usefulness. From the mixed methods analyses, the finding that older adults had a higher level of positive attitude towards the more service-oriented robot than the more companion-oriented robot was predicted by higher expectation or preference for robots with more service-related functions. Conclusion: This study identified older adults’ preference toward more functional and humanlike robots. Our findings provide practical suggestions for future robot designs that target the older population.
Posted: March 7, 2019, 1:10 pm
Table of Contents for Quality in Ageing and Older Adults. List of articles from both the latest and ahead of print issues.
Quality in Ageing and Older Adults, Volume 20, Issue 1, Page 34-35, April 2019. <br/>
Posted: April 5, 2019, 12:10 pm
Quality in Ageing and Older Adults, Volume 20, Issue 1, Page 1-1, April 2019. <br/>
Posted: April 5, 2019, 12:10 pm
Quality in Ageing and Older Adults, Volume 20, Issue 1, Page 20-33, April 2019. <br/> Purpose The purpose of this paper is to review marketing materials of surveillance products for people with dementia and their carers in three ageing countries, as part of a dementia-technology media analysis. Design/methodology/approach An online environmental scan was conducted using search terms for surveillance technologies (STs) and dementia through a Google search focussed on the UK, Sweden and the Netherlands. Data were extracted on the products’ and websites’ marketing messages from consumer and marketer perspectives. Findings Information was gathered for 382 product websites, of which 242 met eligibility criteria. The majority of products come from the UK. In the UK and Sweden, the companies behind the websites appeared to be mainly “cottage industries” which focus on selling ST. In contrast, sellers in the Netherlands included a more balanced mixture of small, medium and large companies. In all three countries, the website messaging focussed on the need to manage safety concerns, without considering privacy or consent. Social implications Contrary to the perception of future dependence on technology, the ST sector seems to be a niche market. The media messages, equating people with dementia with animals and children, are at odds with initiatives that strive for dignity and dementia friendliness. Originality/value No previous study is known to have explored media messages from websites that market ST for people with dementia.
Posted: November 8, 2018, 3:42 am
Quality in Ageing and Older Adults, Volume 20, Issue 1, Page 10-19, April 2019. <br/> Purpose The purpose of this paper is to examine how formal navigators interpret their roles supporting families of older adults. Design/methodology/approach This study was an interpretive inquiry informed by critical gerontology and discourse analytic methods. Interview data were collected and analyzed from 22 formal service providers who helped older adults and their families navigate health and social care resources in one Western Canadian city. Findings Although acknowledging structural barriers to service access, participants emphasized individual empowerment as their dominant strategy, interpreting their roles as providing information and education about services. In part, these interpretations may reflect the limited nature of their ability to help broker access or advocate; in part, they may also reflect the broader political and economic discourses surrounding care in Canada. Research limitations/implications When providers position navigation and access to care as individual problems, this can obscure structural burden as well as potential inequities among older adults. Future research should examine whether navigational role interpretations are similar or different to those of navigators in other regions. Navigators in other health and social care contexts may enact differing meanings in their work. Practical implications Although formal public navigators can play an important role, approaches that go beyond providing information may better meet families’ needs for support. Originality/value This is one of the first studies focused specifically on providers’ interpretations of the meaning of navigational work in health and social care for older adults, and to extend a critical gerontological gaze toward the issue of system navigation.
Posted: November 1, 2018, 9:34 am
Quality in Ageing and Older Adults, Volume 20, Issue 1, Page 2-9, April 2019. <br/> Purpose Suicidal attempts and thoughts are particularly relevant to the health of the elderly and can impact not only the individual, but family, friends and spouses as well. This topic is important for the gerontological research community, particularly as it relates to social isolation and the feeling of loneliness, common in this population group. The purpose of this paper is to investigate new knowledge about the relationship between an increased risk of suicide in the elderly and social isolation or loneliness. Design/methodology/approach An extensive search was conducted to find relevant studies to answer the research question. Database research was done in PubMed and PsycINFO for relevant studies within the last 10 years. The title and abstract of relevant articles were screened before the full-text was acquired. Findings In PubMed 163 studies were identified, and in PsycINFO 66 studies were identified. After a thorough screening, nine studies were found to be appropriate for this study. Originality/value It is not clear which risk factor leads to an increase in suicidal thoughts and attempts, however most studies contemplated loneliness and isolation as a covariant. A causal link between the concepts is not simple. Nevertheless, loneliness and isolation seem to be relevant factors for suicidal ideations.
Posted: November 1, 2018, 9:31 am