NOVEL METHODS AND DATA IN POPULATION AGING RESEARCH

Individual and meteorological factors are associated with cognitive function in older adults. However, how these two factors interact with each other to affect cognitive function in older adults is still unclear. We used mixed effects models to assess the association of individual and meteorological factors with cognitive function among older adults. Individual data in this study were from the database of China Family Panel Studies. A total of 3448 older adults from 25 provinces were included in our analysis. Cognitive functions were measured using a memory test and a logical sequence test. We used the meteorological data in the daily climate dataset of China’s surface international exchange stations, and two meteorological factors (i.e., average temperature and relative humidity) were assessed. The empty model showed significant differences in the cognitive scores of the older adults across different provinces. The results showed a main impact of residence (i.e., urban or rural) and a significant humidity–residence interaction on memory performance in older adults. Specifically, the negative association between humidity and memory performance was more pronounced in urban areas. This study suggested that meteorological factors may, in concert with individual factors, be associated with differences in memory function in older adults.

Background: Memory impairment significantly impacts the quality of life for older adults living with dementia. Non-pharmacological interventions, such as puzzle therapy, have emerged as promising, low-cost strategies for managing cognitive decline and providing environmental enrichment. Objective: To analyze the effectiveness of puzzle therapy as a brain exercise in improving memory function among older adults with moderate dementia. Methods: This case series involved three older adults (aged 74–84 years) residing at the Tresna Werdha Wana Seraya Social Institution in Bali. Participants engaged in puzzle therapy sessions lasting 10–15 minutes, conducted thrice over one week. Cognitive and memory functions were assessed using the Mini-Mental State Examination (MMSE) before and after the intervention. Results: All participants demonstrated measurable cognitive gains. Baseline MMSE scores ranging from 15 to 16 improved to post-intervention scores of 19 to 21, reflecting a consistent mean improvement of 4.0 points. Notable enhancements were observed specifically in the domains of orientation, immediate recall, and concentration. Conclusion: Puzzle therapy serves as a feasible and effective cognitive stimulation tool for improving memory function in older adults with moderate dementia. These findings support the integration of structured brain exercises into routine geriatric nursing care within institutional settings.

P8. Relationship of fornix white matter microstructure and memory function in older adults

Research with veterans, refugees and other trauma-exposed groups has identified a link between post-traumatic stress disorder (PTSD) and deficits in memory. This study sought to determine whether similar associations can be observed in a large, population-representative sample of older adults with high levels of exposure to conflict amongst older adults in Northern Ireland (NI). Using data from the Northern Ireland COhort for the Longitudinal study of Ageing (NICOLA), we assessed whether the presence of PTSD was associated with poorer performance on tasks of global cognition, immediate and delayed verbal recall, executive function, verbal fluency and two tests of prospective memory. Participants were 2142 community dwelling adults, resident in NI and aged 50 and over. The NI weighted prevalence of current PTSD was 4.74%, which is high relative to other international estimates. Nearly 60% of those with PTSD reported the NI Troubles as their self-reported worst traumatic exposure, despite the height of the conflict occurring decades before, suggesting long-term consequences of the civil conflict. Individuals with PTSD recalled approximately half a word less than those without on tests of verbal recall and scored lower on global cognitive assessments: Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), after accounting for sociodemographic characteristics. However, this effect was attenuated after further adjusting for health behaviours and current depression. The findings suggest an effect of trauma on cognitive function at a population level. Future research should explore the nature of this relationship over time.

Effectiveness of multiple mnemonic strategies for improving verbal memory in older adults

Despite evidence supporting the effectiveness of cognitive enhancement interventions in older adults with age-related changes, few if any cognitive enhancement programs are available in the community that can be administered with ease and high quality, and reach a large number of persons. Just as peer-led programs are widely used to promote health awareness, health self-maintenance, and wellness, peers can promote memory awareness and education in community-residing older adults with mild age-related memory concerns. Overall, there has been a gap between the development of effective cognitive intervention programs to help offset the daily minor challenges associated with mild age-related memory loss, and convenient availability to the general population. Given this need, in association with the University of California, Los Angeles (UCLA) Longevity Center our group developed a unique 5-week, peer-led community education/intervention program to improve memory functioning in older adults. In this chapter, we detail the development and implementation, and present preliminary data regarding the effects on memory of this MTP program. We discuss the benefits and challenges associated with administering this kind of peer-led memory enhancement strategy. Given the many older adults experiencing age-related memory decline and the potential benefits of the intervention, the potential impact of peer-led memory training programs could be considerable.

Physical exercise is effective in protecting against age-related neurodegeneration and cognitive decline. Although there are many neuroimaging studies to evaluate the effect of physical exercise on aging brains, consistent conclusions are limited due to the wide variety of measuring techniques and small sample sizes. Identify brain regions that show exercise-induced neuroplasticity consistently across various imaging modalities and correlate regional neuroplasticity with cognitive changes in older adults. An electronic literature search for randomized controlled trials with magnetic resonance imaging measures was performed. We conducted a series of quantitative meta-analyses using activation likelihood estimation on included studies with voxel-based neuroimaging findings. Nonvoxelbased findings were summarized as a descriptive review. Out of 839 publications identified from the literature search, 30 experiments including 2670 participants from 22 papers met the criteria of meta-analyses. Overall, physical exercise consistently results in structural and functional changes in the hippocampus/parahippocampusl area and a cluster within the cerebellum. Although changes of medial/superior prefrontal cortex did not pass the stringent threshold, they were associated with cognitive changes. This study highlights the effectiveness of physical exercise in inducing hippocampus plasticity, which may be crucially relevant for maintaining memory function in older adults.

A better understanding of the impact of lifestyle factors on cognitive function in older adults is critical for developing intervention strategies to achieve successful aging. Moreover, older adults who fulfill the World Health Organization criteria for anemia have a significantly higher risk of developing dementia. In the current study, we aimed to assess the buffering effects of lifestyle on cognitive function in older Chinese adults through a nationally representative survey. The sample consisted of 1201 participants (mean age: 82.39 ± 12.08 years, 52.1% female) from the 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Multiple linear regression analyses were used to explore the relationship between changes in lifestyle factors and the rate of cognitive function changes, as well as the effects of the interaction between lifestyle factors and anemia on cognitive function changes. Increased levels of participation in leisure activities, social activities, and dietary diversity delayed cognitive decline. Persistent anemia accelerated cognitive decline, while frequent participation in leisure activities delayed cognitive decline due to anemia. The increased levels of participation in leisure activities, social activities, and dietary diversity can alleviate the cognitive decline caused by aging itself, and more frequently participation in leisure activities can also alleviate the adverse effects of anemia on cognitive function in older adults.

Combining physical exercise and repetition-lag training to improve everyday memory function in older adults

Depression, a widespread mental health disorder, presents significant challenges in diagnosis and treatment. Amidst the myriad treatments, non-invasive Transcranial Electric Stimulation (tES), encompassing Transcranial Alternating Current Stimulation (tACS) and Transcranial Direct Current Stimulation (tDCS), has emerged as a promising intervention for Major Depressive Disorder (MDD). This review delineates the mechanisms of these modalities, their distinctions, and their potential to modulate neural oscillations and influence cognitive functions. Studies showcased the efficacy of these techniques in ameliorating depressive symptoms, with EEG and fNIRS employed to gauge their neurological impact. Observations suggest the potential in modulating for specific brain rhythms to enhance memory functions in older adults and influence working memory processes. The dynamic interplay between tDCS and tACS in altering cortical activities and their interaction with neurotransmitters like GABA further underscores their potential. However, the need for extensive research, particularly double-blind randomized control trials, remains paramount to ascertain their safety and efficacy. This review provides a comprehensive insight into the prospective role of tES in the clinical landscape of MDD treatment.

In many developed countries, cognitive functioning (as measured by neuropsychological tests) appears to be improving over time in the population at large, in parallel with the declining age-specific incidence of dementia. Here, we investigated cohort effects in the age-associated trajectories of verbal memory function in older adults. We sought to determine whether they varied by decade of birth and, if so, whether the change would be explained by increasing educational attainment. Pooling data from two prospective US population-based studies between 1987 and 2015, we identified four birth cohorts born 1902-1911, 1912-1921, 1922-1931, and 1932-1943. Among these cohorts, we compared age-associated trajectories both of performance and of practice effects on immediate and delayed recall of a 10-item Word List. We used mixed effects models, first including birth cohorts and cohort X age interaction terms, and then controlling for education and education X age interaction. We observed significant cohort effects in performance (baseline and age-associated trajectories) in both immediate recall and delayed recall, with function improving between the earliest- and latest-born cohorts. For both tests, we also observed cohort effects on practice effects with the highest levels in the latest-born cohorts. Including education in the models did not attenuate these effects. In this longitudinal population study, across four decade-long birth cohorts, there were significant improvements in test performance and practice effects in verbal memory tests, not explained by education. Whether this reflects declining disease incidence or other secular trends awaits further investigation.

Acute hospitalization can have catastrophic consequences for physical function and independence in older adults. The inability to regain function following a hospital stay is a strong predictor of re‐hospitalization and mortality. We have shown that nutritional interventions, exercise, and anabolic steroids independently increase muscle size and function, thus representing promising therapeutic strategies.The goal of this pilot study was to test the feasibility of interventions (placebo supplement (P), nutrition supplement (N, whey protein), progressive in‐home exercise + placebo (E+P), exercise + nutrition (E+N), or single testosterone injection (T)) to improve physical function in older adults following acute hospitalization.Subjects (>65 years) were recruited during hospitalization at UTMB Acute Care for Elders unit. Demographics and short physical performance battery (SPPB) were collected at hospital discharge and 1‐month post discharge.Mean baseline SPPB score was 6.6. At 1‐mo testing, interventions tended to enhance improvement in raw SPPB score (P: 1.3, N: 3.3, E+P: 2.2, E+N: 3.2, T: 2.3) and percent of subjects with a clinically meaningful improvement (蠅1 point) (P: 50%, N: 100%, E+P: 80%, E+N: 80%, T: 88%). Gait speed was low in all groups at baseline (0.60‐ 0.71 m/s). Interventions tended to augment gait speed at 1‐mo (P: 25%, N: 50%, E+P: 45%, E+N: 44%, T: 21%).These preliminary data (n=4‐8), from an ongoing clinical trial, indicate that interventions after acute hospitalization are feasible and can improve physical function in older adults.Dairy Research Institute (1229) and UTMB Claude D. Pepper OAIC (5P30‐ AG024832).

This study investigated the effects of an interactive multitouch game-based cognitive intervention (ICI) on cognitive function in community-dwelling older adults. Thirty-two older adults (19 women) between 65 and 84 years of age (mean age, 74.47 ± 4.30 years) without a history of neurological disease participated. They were randomized into two groups: intervention and control. The intervention group took part in ICI sessions using HAPPYTABLE® (Spring Soft Co. Ltd, Seoul, Korea) (ICI group), and the control group underwent a traditional paper-and-pencil-based cognitive intervention (TCI group). Both groups completed 10 intervention sessions over four consecutive weeks. Cognitive function was assessed before (pre-intervention) and after (post-intervention) intervention. Executive function was evaluated through the Color-Word Stroop Test (CWST) and Controlled Oral Word Association Test (COWAT). Memory was assessed through the Verbal Learning Test (VLT) and Rey Complex FigureTest (RCFT). The ICI and TCI groups showed significant improvements in some cognitive functions after the intervention. Both groups showed substantial improvements in VLT and RCFT (P < 0.05), reflecting memory function. Regarding the executive role, the ICI group showed significant post-intervention improvements in the conditions of the CWST incongruent (ICI 76.31 ± 23.82; P = 0.004) compared to the pre-intervention scores. ANCOVA with pre-intervention scores and gender as covariates revealed improved results in the ICI group compared with the VLT delayed (ICI 9.18 ± 1.68, TCI 7.56 ± 2.13; P = 0.015) and VLT recognition task (ICI 22.81 ± 1.22, TCI 21.38 ± 1.09; P = 0.035). These findings revealed that both ICI and TCI helped increase cognitive performance in community-dwelling older persons; nevertheless, ICI showed better improvement in memory function than TCI. Thus, the ICI can be used to improve cognitive performance among older adults living in the community.

Validity and reliability of a video questionnaire to assess physical function in older adults

The mechanisms underlying the relationship between obesity and cognitive function remain unclear, particularly among older adults, where reliable evidence is limited. This study aimed to explore whether the relationship between obesity and cognitive function is mediated by sleep quality and blood pressure (BP) in older Chinese adults. We conducted an observational study using data from a cluster randomized controlled trial (RCT) with 5 follow-up periods involving older adults in rural China. The trial took place in Sichuan, China, from May 2021 to May 2023. Telephone Interview for Cognitive Status (TICS- 10) was used to assess the participants' cognitive function. Additionally, linear mixed-effects models and mediation analyses were performed. The mean age of participants was 70.89, and 225 out of 506 participants were males. Weight, waist circumference (WC), and hip circumference (HC) were positively associated with cognitive function, while compared to normal/underweight participants, participants with overweight had a significant association with cognitive function. Sleep quality mediated the association between weight and cognitive function (β = 0.01, (95% CI: 0.00 to 0.01), P < 0.001), accounting for a mediating effect proportion of 4.04% (95% CI: 2.19% to 8.00%). Diastolic blood pressure (DBP) mediated the association between overweight (β = 0.02, (95% CI: 0.00 to 0.05), P < 0.001), HC (β = 0.01, (95% CI: 0.00 to 0.01), P = 0.02), and WC (β = 0.01, (95% CI: 0.00, 0.01), P <0.001) and cognitive function, explaining approximately 4.46% (95% CI: 0.41% to 12.00%), 7.16% (95% CI: 0.36%, 17.00%), and 9.60% (95% CI: 1.11%, 25.00%) mediating proportion of the total effect, respectively. Our study highlights the potential mediating roles of sleep quality and DBP in the relationship between obesity and cognitive function. The findings contribute to understanding the obesity-cognition link in older adults, particularly in rural settings. However, limitations, such as self-reported sleep measures and unmeasured confounders, warrant caution. Further research is needed to clarify the underlying mechanisms and inform targeted interventions. Our study demonstrates a significant positive association between weight, body mass index (BMI), HC, and WC and cognitive function in older adults. These findings suggest that maintaining a moderately high level of overweight may be protective against cognitive decline in this population. Additionally, the study also provides insights into optimizing cognitive function through factors, such as sleep and BP management.