Redefining Aging in HIV Infection Using Phenotypes

Purpose of review: This article critically reviews the utility of “phenotypes” as behavioral descriptors in aging/HIV research that inform biological underpinnings and treatment development. We adopt a phenotypic redefinition of aging conceptualized within a broader context of HIV infection and of aging. Phenotypes are defined as dimensions of behavior, closely related to fundamental mechanisms, and, thus, may be more informative than chronological age. Primary emphasis in this review is given to comorbid aging and cognitive aging, though other phenotypes (i.e., disability, frailty, accelerated aging, successful aging) are also discussed in relation to comorbid aging and cognitive aging. Recent findings: The main findings that emerged from this review are as follows: (1) the phenotypes, comorbid aging and cognitive aging, are distinct from each other, yet overlapping; (2) associative relationships are the rule in HIV for comorbid and cognitive aging phenotypes; and (3) HIV behavioral interventions for both comorbid aging and cognitive aging have been limited. Summary: Three paths for research progress are identified for phenotype-defined aging/HIV research (i.e., clinical and behavioral specification, biological mechanisms, intervention targets), and some important research questions are suggested within each of these research paths

Deveras humano : Teoria do Tópos Musical na obra para piano solo de Claudio Santoro

Dissertação (mestrado) — Universidade de Brasília, Instituto de Artes, Departamento de Música, Programa de Pós-Graduação Música em Contexto, 2016.Esta pesquisa aborda a diversidade estética do discurso musical de Claudio Franco de Sá Santoro em sua obra para piano solo, a qual perpassa a totalidade de todas as influências estético-ideológicas do compositor. A análise de sua obra para piano é compreendida por meio da Teoria dos Topoi de Hatten (1994), Monelle (2002), Plesch (2012) e Narum (2013). Esta metodologia possibilita identificar um thesaurus de loci-commune referenciais e evidenciar como o compositor trabalha a relação significante/significado para gerar efeito de sentido e comunicabilidade. O objetivo é compreender a relação entre a ideologia, idiossincrasias estilísticas em sua obra para piano solo. A possibilidade de compreender as fases composicionais além da análise sistemática, muitas vezes uma análise de superfície, desvela questões deveras imperiosas para a compressão da obra para piano solo de Claudio Santoro, sob o estudo da expressividade e do significado na música.This paperwork addresses the aesthetic diversity of Claudio Franco de Sá Santoro’s musical discourse in his work for solo piano, which permeates the totality of all the aesthetical and ideological influences of the composer. The analysis of his piano solo work is comprehended by Topic Theory studied by Hatten (1994), Monelle (2002), Plesch (2012) and Narum (2013). This methodology makes it possible to identify a thesaurus of referential loci-commune, and it also evidences how composer deals the relationship between significant/signified in order to create meaning effect. The goal is to comprehend the relationship between ideology and idiosyncrasies of style in his work for solo piano. The possibility to understand Santoro’s compositional periods beyond the systematic analysis, which is often a surface analysis, unhides truly compelling issues in order to comprehend the solo piano works of Claudio Santoro in the study of expression and meaning in music

Racial differences in neurocognitive outcomes post-stroke: The impact of healthcare variables

AbstractObjectives:The present study examined differences in neurocognitive outcomes among non-Hispanic Black and White stroke survivors using the NIH Toolbox-Cognition Battery (NIHTB-CB), and investigated the roles of healthcare variables in explaining racial differences in neurocognitive outcomes post-stroke.Methods:One-hundred seventy adults (91 Black; 79 White), who participated in a multisite study were included (age:M=56.4;SD=12.6; education:M=13.7;SD=2.5; 50% male; years post-stroke: 1–18; stroke type: 72% ischemic, 28% hemorrhagic). Neurocognitive function was assessed with the NIHTB-CB, using demographically corrected norms. Participants completed measures of socio-demographic characteristics, health literacy, and healthcare use and access. Stroke severity was assessed with the Modified Rankin Scale.Results:An independent samplesttest indicated Blacks showed more neurocognitive impairment (NIHTB-CB Fluid Composite T-score:M=37.63;SD=11.67) than Whites (Fluid T-score:M=42.59,SD=11.54;p=.006). This difference remained significant after adjusting for reading level (NIHTB-CB Oral Reading), and when stratified by stroke severity. Blacks also scored lower on health literacy, reported differences in insurance type, and reported decreased confidence in the doctors treating them. Multivariable models adjusting for reading level and injury severity showed that health literacy and insurance type were statistically significant predictors of the Fluid cognitive composite (p&lt;.001 andp=.02, respectively) and significantly mediated racial differences on neurocognitive impairment.Conclusions:We replicated prior work showing that Blacks are at increased risk for poorer neurocognitive outcomes post-stroke than Whites. Health literacy and insurance type might be important modifiable factors influencing these differences. (JINS, 2017,23, 640–652)</jats:p

AgeTech, Ethics and Equity:Towards a Cultural Shift in AgeTech Ethical Responsibility

Population ageing is a global phenomenon which presents major challenges for the provision of care at home and in the community (ONS, 2018). Challenges include the human and economic costs associated with increasing numbers of older people with poor physical and mental health, loneliness, and isolation challenges (Mihalopoulos et al., 2020). The global ageing population has led to a growth in the development of technology designed to improve the health, well-being, independence, and quality of life of older people across various settings (Fang, 2022). This emerging field, known as “AgeTech,” refers to “the use of advanced technologies such as information and communications technologies (ICT’s), technologies related to e-health, robotics, mobile technologies, artificial intelligence (AI), ambient systems, and pervasive computing to drive technology-based innovation to benefit older adults” (Sixsmith, et al., 2020 p1; see also Pruchno, 2019; Sixsmith, Sixsmith, Fang, and Horst, 2020).AgeTech has the potential to contribute in positive ways to the everyday life and care of older people by improving access to services and social supports, increasing safety and community inclusion; increasing independence and health, as well as reducing the impact of disability and cognitive decline for older people (Sixsmith et al, 2020). At a societal level, AgeTech can provide opportunities for entrepreneurs and businesses (where funding and appropriate models exist) (Akpan, Udoh and Adebisi, 2022), reduce the human and financial cost of care (Mihalopoulos et al., 2020), and support ageing well in the right place (Golant, 2015)

Demographically-adjusted norms for the paced auditory serial addition test and letter number sequencing test in Spanish-speaking adults: Results from the neuropsychological norms for the U.S.-Mexico border region in Spanish (NP-NUMBRS) Project

ObjectiveThe Paced Auditory Serial Addition Test (PASAT) and Wechsler Adult Intelligence Scale Letter Number Sequencing subtest (LNS) are two commonly used measures of working memory. Demographic variables (age, education, ethnicity, etc.) can impact performance on these measures, underscoring the need for demographically adjusted norms. We aimed to develop normative data for the PASAT and LNS for Spanish-speaking adults living in the U.S.-Mexico border region as part of a larger normative effort.MethodParticipants were native Spanish-speakers from the Neuropsychological Norms for the U.S. Mexico Border Region in Spanish (NP-NUMBRS) project. Two hundred and forty-nine participants completed the PASAT and 202 participants completed LNS. Ages ranged from 19 to 60 and education from 0 to 20 years.ResultsOlder age was associated with lower scores on LNS (p &lt; .01) but not PASAT. Lower education was associated with lower scores on both tests (ps &lt; .001). Women obtained lower raw scores than men on PASAT (ps &lt; .003), and there were no significant main effects of gender on LNS raw scores. Raw-to-scaled score conversions were calculated, and fractional polynomial equations were developed to calculate demographically-adjusted T-scores accounting for age, education, and gender. Published norms for English-speaking non-Hispanic Whites substantially overestimated rates of impairment (defined as T-score &lt; 40) on both the PASAT and LNS.ConclusionsThe use of the population-specific normative data may improve detection of working memory dysfunction in U.S. Spanish-speaking adults and contribute to improved diagnostic accuracy and treatment planning in this population. Whether the norms generalize to U.S. Spanish-speakers from other countries remains to be determined

UNIVERSIDADE ABERTA DA MATURIDADE

O fenômeno do envelhecimento populacional provoca impactos, intensa discussão, planejamento e construção de políticas públicas para que este seja, de fato, um ganho real. Cumprindo o papel e a responsabilidade de contribuição o projeto de extensão “Universidade Aberta da Maturidade” apresenta como escopo: a) resgatar o valor social do idoso de forma articulada e interdisciplinar, o que passa por assegurar sua cidadania plena; b) contribuir para um melhor desenvolvimento mental, físico e social de idosos, num espaço de exercício e construção da interdisciplinaridade, com a inserção de docentes e discentes da UFPR; c) oportunizar aos acadêmicos e docentes da UFPR a condição de ter uma nova percepção da comunidade universitária quanto ao seu papel social; d) fomentar a observação que a atividade extensionista possui um caráter educativo, no sentido de levar ao público alvo informações técnicas obtidas na universidade para tornar o mesmo apto a utilizar o conhecimento adquirido em suas atividades diárias; e) incentivar discussões sobre o planejamento e a realização de políticas públicas para indivíduos da terceira idade. No biênio 2018/2019 o projeto contou com a participação de 70 idosos, com 6h aulas semanais. Os temas abordados nas aulas foram Direito do Idoso, Processo de Envelhecimento, Saúde do Idoso, Atividades Físicas, Atividades Expressivas e Corporais, Inclusão Digital, Treino Cognitivo (Oficina de Memória), Arte e Cultura, visando atender ao princípio da interdisciplinaridade. As atividades/aulas (teórico-prático) realizadas com os idosos apresentaram características lúdica e didática, as quais divertiram e instruíram os idosos. Em contrapartida as acadêmicas e as docentes da UFPR que participaram do projeto, tiveram a oportunidade de ter uma nova percepção da comunidade universitária quanto ao seu papel social. É possível concluir que o projeto tem realizado ação efetiva de responsabilidade social e, desta forma, acreditamos que a extensão universitária, associada às dimensões do ensino e pesquisa, contribui para que a universidade pública se constitua em um legado e em um projeto de educação inclusiva

Demographically-adjusted norms for selected tests of verbal fluency: Results from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project

ObjectiveVerbal fluency tests are sensitive to various disorders affecting the central nervous system and are commonly included in neuropsychological evaluations. We aimed to develop normative data for two verbal fluency tests in a sample of native Spanish-speakers living in the US-Mexico border region.MethodParticipants included 254 adults from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) Project (Age: range = 19-60; Education: range = 0-20, 59% female). Participants completed two verbal fluency tests (i.e., letter [PMR] and semantic/category fluency [Animal Naming]) as part of a larger neuropsychological test battery. We examined linear and nonlinear effects of demographic factors (age, education, and gender) on verbal fluency raw scores, and developed T-scores using fractional polynomial equations controlling for demographics. We also calculated the rates of "impairment" (T-scores &lt; 40) that would be obtained by applying the newly developed norms and available norms for non-Hispanic English-speakers on comparable tests.ResultsThere were positive small effects of age and medium effects of education on verbal fluency raw scores. The normalized distribution of T-scores with the new norms showed expected psychometric properties. However, rates of impairment for both letter and semantic fluency were significantly higher when applying non-Hispanic White norms, and significantly lower when applying non-Hispanic Black norms.ConclusionsWe provide norms for Spanish-speakers living along the US-Mexico border region for two verbal fluency tests that are co-normed with a more extensive neuropsychological battery. These regional norms will improve interpretation of verbal fluency test performance in Spanish-speakers living in the US-Mexico borderland

INCLUSÃO DIGITAL E PARTICIPAÇÃO SOCIAL DE IDOSOS

Introdução: O envelhecimento demográfico apresenta desafios para a sociedade, dentre estes a necessidade de criar oportunidades de engajamento do idoso em atividade sociais e produtivas. Estudos nacionais apontam que a capacitação para o uso de tecnologias, como o smartphone, aumenta as possibilidades de interação com outros, melhora a qualidade de vida, sensação de pertencimento e envolvimento social. A inclusão digital do idoso pode contribuir para integração, ampliação e formação de redes sociais e aumentar a participação social. Objetivo: Analisar as percepções de idosos participantes de um projeto de inclusão digital sobre a relação entre participação social e aprendizado de tecnologia. Método: Estudo de abordagem qualitativa-quantitativa, realizado com 38 idosos inscritos em um Projeto de Inclusão Digital de Adultos e Idosos. Os participantes foram submetidos à Escala de Depressão Geriátrica, para rastreamento de possíveis desordens psiquiátricas. Para a caracterização da amostra, foi aplicado um questionário socioeconômico. Os dados sobre a participação social foram coletados através de questionários estruturados e grupos focais. Para análise dos dados, utilizaram-se técnicas de estatística descritiva, análise de conteúdo e o teste de McNemar. Resultados: Prevaleceu na amostra o sexo feminino (76,3%), idade média de 69 anos (DP = 7,48). Observou-se que, após a oficina de telefone celular, houve aumento na frequência de utilização do smartphone para interação com amigos e familiares e agendamento de eventos de participação social. Conclusão: Projetos de inclusão digital oferecidos a pessoas idosas podem contribuir para o aumento da participação social desta parcela da população, em seus contextos cultural, pessoal e virtual

Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association

Purpose: Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study. Methods: We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus. Results: PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management