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.This work was supported by the five-year Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. The ATHLOS project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 635316.ELSA is supported by NationalInstitute on Aging Grants 2R01AG7644–01A1 and2R01AG017644. BO’s work is supported by the PERIS program 2016–2020 “Ajuts per a la Incorporació de Científics i Tecnòlegs” [grant number SLT006/17/00066], with the support of the Health Department of the Generalitat de Cataluny

Υγιής γήρανση: ο αιτιολογικός ρόλος κλινικών χαρακτηριστικών και παραγόντων του τρόπου ζωής στην εμφάνιση νευρολογικών διαταραχών

Background: The aging of global population has increased the scientific interest in the concept of healthy aging and its determinants. Aim: The aim of the present dissertation was to achieve a better understanding of the complex concept of healthy aging, to identify trajectories of healthy aging among older adults and their determinants, to investigate the association of healthy aging and neurological conditions and propose targeted interventions for individuals and public health systems to promote healthy aging. Methods: The dataset of Hellenic Longitudinal Investigation of Aging and Diet two first waves of evaluation was the basis for the present dissertation. A healthy aging metric was introduced using an Item Response Theory approach based on validated questionnaires that assessed functionality. Four healthy aging trajectories were developed based on whether the healthy aging status of the participants was above (High) or below (Low) the median at baseline and follow-up, i.e., High-High, High-Low, Low-High, and Low-Low and they were associated with potential determinants using various regression models. Additionally, data from Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project were used to investigate trajectories of specific domains of cognition (verbal fluency and processing speed) and their determinants. Finally, a systematic review of the literature was conducted to investigate the effect of physical activity and dietary interventions on the cognitive function of older adults. Main findings: Regarding the trajectories of healthy aging observed in the HELIAD study, the distribution among the groups was as follows: 34.3% fell into the High-High group, 15.7% in the High-Low group, 18.6% in the Low-High group, and 31.4% in the Low-Low group. The study revealed that individuals with greater educational attainment, absence of cardiovascular diseases, cognitive impairment, and frailty displayed more favorable trajectories of healthy aging. Regarding lifestyle factors, a notable association was found between higher adherence to the Mediterranean diet and an increased likelihood of belonging to the favorable trajectories. Additionally, substitution analysis indicated that substituting energy intake from proteins and lipids with carbohydrates was linked to a reduced probability of belonging to the favorable trajectories. Furthermore, sleep quality played a significant role, with better sleep quality associated with a higher likelihood of belonging to the High-High group (p-value ώρες) συσχετίστηκε αντίστροφα με την πιθανότητα να ταξινομηθούν στην ομάδα Υψηλή-Υψηλή (p-value <0,05). Τα αποτελέσματά μας υπογράμμισαν επίσης τη σημασία λανθανουσών και συχνά υποδιαγνωσθεισών νευρολογικών καταστάσεων, όπως η προδρομική νόσος του Πάρκινσον (pPD). Οι συμμετέχοντες με πιθανή/πιθανή pPD εμφάνισαν 78% μειωμένη πιθανότητα να ανήκουν στην Υψηλή-Υψηλή τροχιά (OR=0,22, 95%CI 0,06-0,79, p-value=0,02). Όσον αφορά τις τροχιές της παραγωγής λόγου και της ταχύτητας επεξεργασίας, αναγνωρίστηκαν τέσσερις λανθάνουσες ομάδες σε κάθε περίπτωση. Παράγοντες όπως το γυναικείο φύλο, η υψηλότερη εκπαίδευση, η ήπια επίπεδη φυσική δραστηριότητα, το να έχουν παντρευτεί και το υψηλότερο βιοτικό επίπεδο συσχετίστηκαν με μεγαλύτερη πιθανότητα να ανήκουν σε ευνοϊκή τροχιά, ενώ τα καρδιαγγειακά νοσήματα και τα συμπτώματα κατάθλιψης συσχετίστηκαν με χαμηλότερα σκορ εντός κάθε τροχιάς. Συμπεράσματα: Η υγιής γήρανση αποτελεί μία πολύπλοκη έννοια, που επηρεάζεται από διάφορους κοινωνικοοικονομικούς, κλινικούς και παράγοντες του τρόπου ζωής. Με βάση τα ευρήματα της έρευνάς μας, καταδεικνύεται ότι ορισμένες παρεμβάσεις μπορούν να συμβάλουν στην προώθηση μιας πορείας προς την υγιή γήρανση. Αυτές οι παρεμβάσεις περιλαμβάνουν την υιοθέτηση ενός υγιούς διατροφικού προτύπου, την ανάδειξη της σημασίας της ποιότητας ύπνου, την έγκαιρη ανίχνευση και διαχείριση κρυφών νευρολογικών διαταραχών, όπως η προδρομική νόσος του Πάρκινσον (pPD), καθώς και προληπτικά μέτρα για την πρόληψη και διαχείριση χρόνιων νόσων, όπως τα καρδιαγγειακά νοσήματα και η γνωστική έκπτωση. Μέσω αυτών των παρεμβάσεων, είναι πιθανό να βελτιωθούν οι προοπτικές επίτευξης υγιούς γήρανσης

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 &lt; 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