Search Results (283)

Background: Vascular dysfunction is increasingly recognized as a shared contributor to both cognitive impairment and late-life depression (LLD). However, the combined diagnostic value of cerebral hemodynamics, neuroimaging markers, and neuropsychological outcomes remains underexplored. This study aimed to investigate the associations be-tween transcranial Doppler (TCD) ultrasound parameters, cognitive performance, and depressive symptoms in older adults with mild cognitive impairment (MCI) and LLD. Importantly, we evaluated the integrative value of TCD-derived indices alongside MRI-confirmed white matter lesions (WMLs) and standardized neurocognitive and affective assessments. Methods: In this cross-sectional study, 96 older adults were enrolled including 78 cognitively unimpaired individuals and 18 with MCI. All participants underwent structured clinical, neuropsychological, and imaging evaluations including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15), MRI-based Fazekas scoring of WMLs, and TCD ultrasonography of the middle cerebral artery. Hemodynamic variables included mean blood flow velocity (MBFV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI). Logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of MCI. Results: Participants with MCI showed significantly lower MBFV and EDV, and higher PI and RI (p < 0.05 for all) compared with cognitively unimpaired participants. In multivariate analysis, lower MBFV (OR = 0.64, p = 0.02) and EDV (OR = 0.70, p = 0.03), and higher PI (OR = 3.2, p < 0.01) and RI (OR = 1.9, p < 0.01) remained independently associated with MCI. ROC analysis revealed excellent discriminative performance for RI (AUC = 0.919) and MBFV (AUC = 0.879). Furthermore, PI correlated positively with depressive symptom severity, while RI was inversely related to the GDS-15 scores. Conclusions: Our findings underscore the diagnostic utility of TCD-derived hemodynamic parameters—particularly RI and MBFV—in identifying early vascular contributions to cognitive and affective dysfunction in older adults. The integration of TCD with MRI-confirmed WML assessment and standardized cognitive/mood measures represents a novel and clinically practical multi-modal approach for neurovascular profiling in aging populations. Full article

The present study focuses on the attractiveness and perceived value of differentiated quality labels, such as the Protected Designation of Origin (PDO) and Protected Geographical Indication (PGI), for agri-food products from Extremadura (Spain). In doing so, it addresses a gap in the scientific literature concerning consumer behavior toward products bearing these certifications. The results show that awareness of these quality schemes is significantly higher among middle-aged and older individuals, underscoring the need for more modern and targeted communication strategies. The findings highlight the strategic role of agri-food marketing in promoting certified products and emphasize the importance of bridging the generational gap in consumer education. Overall, differentiated quality schemes are perceived as strategic tools to enhance the competitiveness of local products, strengthen cultural identity, and foster sustainable rural economies. Furthermore, this study identifies a negative relationship between the consumption of certified products and the awareness of certification and a positive relationship with the willingness to pay a premium. Consumers with greater awareness tend consume these products less, although they are more willing to pay higher prices for items bearing quality labels. Full article

Background/Objectives: Understanding the impact of dietary habits in terms of obesity, health outcomes, and functional decline is critical in Europe’s growing elderly population. This study analyzed trends in Mediterranean diet (MD) adherence, obesity prevalence, and grip strength among middle-aged and elderly Europeans using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Methods: Data from four SHARE waves (2015–2022) across 28 countries were analyzed. Dietary patterns were assessed through food frequency questionnaires classifying participants as MD-adherent or non-adherent where adherent implies daily consumption of fruits and vegetables and occasional (3–6 times/week) intake of eggs, beans, legumes, meat, fish, or poultry (an unvalidated definition of the MD pattern). Handgrip strength, a biomarker of functional capacity, was categorized into low, medium, and high groups. Body mass index (BMI), self-perceived health (SPHUS), chronic disease prevalence, and CASP-12 scores (control, autonomy, self-realization, and pleasure evaluated on the 12-item version) were also evaluated. Statistical analyses included descriptive methods, logistic regressions, and multiple imputations to address missing data. Results: A significant majority (74–77%) consumed fruits and vegetables daily, which is consistent with MD principles; however, the high daily intake of dairy products (>50%) indicates limited adherence to the MD, which advocates for moderate consumption of dairy products. Logistic regression indicated that individuals with two or more chronic diseases were more likely to follow the MD (odds ratio [OR] = 1.21, confidence interval [CI] = 1.11–1.32), as were those individuals who rated their SPHUS as very good/excellent ([OR] = 1.42, [CI] = 1.20–1.69). Medium and high maximal handgrip were also strongly and consistently associated with higher odds of MD adherence (Medium: [OR] = 1.44, [CI] = 1.18–1.74; High: [OR] = 1.27, [CI] = 1.10–1.48). Conclusions: The findings suggest that middle-aged and older adults are more likely to adhere to the MD dietary pattern if they have more than two chronic diseases, are physically active, and have a medium or high handgrip. Although an unvalidated definition of the MD dietary pattern was used, the results highlight the importance of implementing targeted dietary strategies for middle-aged and elderly adults. Full article

Background: Stroke recovery is influenced not only by clinical but also sociodemographic factors (SDFs). However, data on how variables such as age, sex, marital status, education, and employment status affect rehabilitation outcomes remain limited, particularly in structured inpatient settings. This study aimed to analyze the impact of key SDFs on functional recovery after stroke. Methods: A retrospective cohort of 289 stroke patients undergoing structured inpatient rehabilitation was analyzed. Functional status was assessed at admission, after three weeks, and at discharge using five standardized outcomes: gait speed (primary outcome), Barthel Index, Berg Balance Scale, Action Research Arm Test, and Ashworth scale. Repeated measures ANOVA and multivariable logistic regression were used to evaluate within-subject changes and associations with SDFs. Results: The cohort consisted predominantly of middle-aged to older adults (58% female, 62% married, 60% retired, 60% with primary education or less). Most patients (88%) had ischemic strokes of moderate severity. Significant improvements were observed across all functional measures. Employed, married, younger, and male patients achieved better outcomes. Interaction models indicated that older and female patients with moderate stroke severity demonstrated greater improvement than younger and male counterparts with milder strokes. Mean gait speed increased by +0.32 m/s, exceeding the minimal clinically important difference (MCID) of 0.16 m/s. Conclusions: Age, sex, marital status, education, and employment status are relevant predictors of stroke rehabilitation outcomes. These findings emphasize the importance of incorporating sociodemographic profiles into individualized rehabilitation planning to optimize functional recovery and reduce disparities among stroke survivors. Full article

Background/Objectives: The use of artificial sweeteners (AS) is increasing globally despite growing evidence suggesting potential health risks. This study investigates the sociodemographic and health-related factors associated with AS use in the Hungarian population. Methods: We conducted a cross-sectional analysis using data from the 2019 European Health Interview Survey (EHIS), comprising 5603 participants. AS users were identified based on self-reported use of AS. Logistic regression models were used to examine associations between regular AS use and demographic, socioeconomic, and health variables. Interaction terms were included to explore potential effect modification. Results: AS use was reported by 20.1% of participants. Older adults, individuals with overweight or obesity, and those reporting poorer self-perceived health were more likely to use AS. AS use was also higher among individuals in lower and middle-income quintiles. Interaction analyses revealed that overweight and obese individuals with the lowest income, as well as older adults in poor health, were particularly likely to use AS. Conclusions: The findings highlight disparities in AS use across age, income, BMI, and health status, raising concerns about the public’s perception of AS as a healthier alternative. Public health strategies should focus on increasing awareness of the potential risks and encourage evidence-based dietary choices. Full article

Background: Falls are a major public health concern among older adults, often resulting in injury, functional decline, and reduced quality of life. While handgrip strength (HGS), fall efficacy, and balance confidence have individually been associated with fall risk, their combined predictive value is still underexplored, particularly in physically active older adults. This study aimed to investigate the relationship between HGS, fall efficacy, and balance confidence and their association with fall risk in community-dwelling older adults engaged in regular exercise programs; A cross-sectional study was conducted with 280 participants aged 55 and over from community exercise programs near Lisbon, Portugal. Fall risk was assessed through self-reported falls in the past 12 months. HGS was measured with a dynamometer, fall efficacy using the Falls Efficacy Scale-International (FES-I), and balance confidence using the Activities-specific Balance Confidence (ABC) Scale. Statistical analyses included Spearman correlations and binary logistic regression. Results: Falls were reported by 26.4% of participants. Fall efficacy and balance confidence were significantly associated with fall history, while HGS was not. Fall efficacy was significantly associated with increased fall risk, as indicated by the odds ratio (OR = 3.37, p < 0.001), while balance confidence was negatively associated (OR = 0.95, p < 0.001). HGS was positively correlated with balance and confidence but not with fall incidence. Conclusions: Psychological factors, particularly fall efficacy and balance confidence, play a critical role in fall risk among physically active older adults. However, this study included physically active middle-aged and older adults living in the community, which should be considered when interpreting the generalizability of the results. These findings support the integration of simple, validated psychological assessments into fall prevention strategies in community settings. Full article

Traditional color vision tests lack the sensitivity to detect subtle differences in individuals with normal color vision. The Konan ColorDx Cone Contrast Threshold (CCT) HD test allows the quantitative measurement of color discrimination thresholds for each cone type. This cross-sectional study established normative values for L-, M-, and S-cone contrast sensitivities and evaluated the effects of age and sex on color discrimination thresholds. Participants aged 15–79 years with normal color vision were included (n = 216; 55% female). CCTs were measured monocularly using the Konan ColorDx CCT HD test under standardized conditions, and the influences of age and sex on L-, M-, and S-cone sensitivities were evaluated. In all groups, L-cone sensitivity was the highest, followed by the M- and S-cone sensitivities. Overall contrast sensitivity was significantly higher in females than in males (mean difference = −0.041), especially for adolescents and young adults (20–24 years). Young adults outperformed middle-aged and older adults, with age-related decline most pronounced for S-cone sensitivity in those over 60. The right and left eye sensitivities did not differ. This study provides age- and sex-stratified normative data for the Konan Color Dx CCT HD test, supporting its use for clinical and occupational assessments. Full article

Background/Objectives: Dietary patterns vary with age and sex. The aim of this study was to clarify the differences in dietary patterns among young and middle-aged Japanese individuals by age group and sex via statistical methods such as alpha diversity and beta diversity analyses. Methods: Using data from a dietary survey of 10 food items during health checkups of 2743 Fujita Health University employees, we examined the effects of age and sex on alpha diversity (Shannon index) and beta diversity (nonmetric multidimensional scaling (NMDS) and RDA). Unlike principal component analysis which assumes linear relationships, redundancy analysis (RDA) incorporates explanatory variables to directly assess how external factors shape multivariate patterns. Results: The Shannon index increased with age and was greater in males across age groups. Type III ANOVA revealed significant main effects of age (p < 0.001) and sex (p < 0.001), and the effect of the interaction between age and sex approached significance (p = 0.08). Visualization of the NMDS data revealed that women aged 20–29 years and women aged 30 years and older and men aged 20–39 years and men aged 50–59 years have different dietary patterns. The RDA model accounted for 2.01% of the variance (adjusted R² = 1.94%), with age and sex contributing 56.7% and 43.3%, respectively. RDA1 and RDA2 were correlated with age (r = 0.26, −0.14) and sex (r = 0.15, 0.21). The RDA1 values increased with age and were greater in females, whereas the RDA2 values decreased with age and were greater in females. RDA1 (1.41% of the total variance in food group intake, 70.1% of the constrained variance) was positively associated with fruits, milk, and seaweed and negatively associated with meat and eggs. In RDA2 (0.60% of total variance, 29.9% contribution), fruits, potatoes, and vegetables had positive effects, whereas fish had negative effects. Conclusions: Dietary patterns vary by age and sex, with meat, fish, eggs, and fruit as key determinants. Nutritional guidance must account for variations in dietary patterns influenced by age and sex. Full article

Background: Traditional Male Circumcision (TMC) has been practiced in many parts of the world. However, the impact thereof on reducing HIV transmission is still unclear. This study aimed to examine the prevalence and determinants of TMC and the associated risk of HIV transmission in Lesotho. Method: Using data from the 2023–24 Lesotho Demographic and Health Survey, the analysis included a weighted sample of 3202 men aged 15–59 years. Missing data was addressed through multiple imputations, and multilevel logistic regression was used to assess the factors associated with TMC, incorporating intra-class correlation to evaluate cluster-level variation. Results: The findings revealed that 51.0% (95% CI: 49.3–52.7) of men in Lesotho had undergone TMC. Older men, particularly those aged 35 years and above, were more likely to be circumcised compared to younger men aged 15–24 years (AOR = 1.63; 95% CI: 1.46–1.86). Other individual-level factors positively associated with TMC included smoking, being married to one partner, previous sexual experience, and rural residence. Conversely, men with formal education, unknown or undisclosed HIV status, residing in the Berea or Maseru districts, and those from middle- or high-income households were less likely to undergo TMC. Conclusion: The study highlights significant variation in TMC practices across communities and identifies both individual and contextual factors influencing its uptake. These insights underscore the need for culturally sensitive, voluntary, and medically safe circumcision programs. Public health initiatives should consider these determinants when designing interventions to ensure a safer and more effective implementation of TMC in Lesotho. Full article

Cervical cancer remains one of the main causes of female mortality, especially in middle- and low-income countries, despite efforts towards the implementation of global vaccination against human papillomavirus (HPV). The aim of this study was to review and compare the most recently published international guidelines providing recommendations on cervical cancer screening strategies among average and high-risk women. Thus, a comparative review of guidelines by the US Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the American Society of Clinical Oncology (ASCO), the World Health Organization (WHO), the Canadian Task Force on Preventive Health Care (CTFPHC), the Cancer Council Australia (CCA), and the European Guidelines (EG) was conducted. There is an overall agreement regarding the suggestions made for women younger than 21 and those older than 65, with all guidelines stating against routine screening, with the exceptions of CTFPHC and CCA that expand the age group to up to 70 and 75 years, respectively. Continuation of screening in older women is also suggested in those with a history of a precancerous lesion and those with inadequate screening. Most guidelines recommend routine screening at 30–65 years, while the WHO advises that screening should be prioritized at 30–49 years. HPV DNA testing is the method of choice recommended by most guidelines, followed by cytology as an alternative, except for CTFPHC, which refers to cytology only, with self-sampling being an acceptable method by most medical societies. Agreements exist regarding recommendations for specific groups, such as women with a history of total hysterectomy for benign reasons, women with a complete vaccination against HPV, individuals from the lesbian, gay, bisexual, transgender, and queer communities and women with multiple sexual partners or early initiation of sexual activity. On the other hand, the age group of 21–29 is addressed differently by the reviewed guidelines, while differentiations also occur in the screening strategies in cases of abnormal screening results, in women with immunodeficiency, those with in utero exposure to diethylstilbestrole and pregnant women. The development of consistent practice protocols for the most appropriate cervical cancer screening programs seems to be of major importance to reduce mortality rates and safely guide everyday clinical practice. Full article

This study aimed to explore the independent and interactive effects of varying squat depths and movement speeds on dynamic postural stability during the Part the Wild Horse’s Mane (PWHM) movement. Thirteen male participants (age: 25.86 ± 1.35 years; height: 174.26 ± 6.09 cm; body mass: 68.64 ± 8.15 kg) performed the PWHM movement at three different squat heights, high squat (HS), middle squat (MS), low squat (LS), and two different speeds, fast and slow. Dynamic postural stability (DPSI) was assessed through the center-of-mass (CoM) trajectory and the center-of-pressure (CoP) trajectory. The analyses used two-factor repeated-measures ANOVA and statistical nonparametric mapping, with key metrics including anteroposterior stability (APSI), mediolateral stability (MLSI), vertical stability (VSI), DPSI indices, and the path lengths of the CoP and CoM. LS exhibited significantly greater CoP and CoM path lengths compared with MS and HS (p < 0.01). Furthermore, fast movements demonstrated higher VSI and DPSI than slow movements (p < 0.05). Tai Chi with different squat depths and speeds can affect postural stability. To reduce the fall risk, older adults and individuals with balance impairments should prioritize slower Tai Chi movements, particularly when using high squat postures. Full article

NAD⁺ is a fundamental molecule participating as a redox cofactor in several metabolic reactions and has a neuroprotective role associated with oxidate stress. Despite its critical role, NAD⁺ levels sharply decline with age, contributing to the pathogenesis of aging-related diseases. Supplementation with nicotinamide riboside (NR), also known as a form of vitamin B3, a biochemical precursor of NAD⁺, may replenish this depletion. Background/Objectives: Mounting evidence suggests that dietary supplementation with NR, a form of vitamin B3 and a biochemical precursor of NAD⁺, enhances NAD⁺ bioavailability and prevents the detrimental effects on sleep, cognitive function, mitochondrial function, and insulin sensitivity. However, there is a paucity of studies focused on how NR administration affects sleep patterns. This narrative review summarizes the current state of scientific knowledge on the effects of nicotinamide riboside supplementation on sleep. Results: Pre-clinical studies indicate that NR enhances the performance of the clock genes BMAL1 and PER2, and ameliorates chronic sleep deprivation-induced cognitive impairment, potentially by alleviating oxidative stress and mitochondrial impairment in microglia. NR supplementation also increased REM sleep and reduced NREM sleep by approximately 17%. In human studies, NR improved sleep efficiency in young and middle-aged male individuals with insomnia. It also improved sleep quality and reduced fatigue and drowsiness in older adults. More research is warranted to understand the impacts of NR on sleep for women. Conclusions: NR supplementation is a reliable and effective alternative to boost NAD⁺ levels and may ameliorate sleep patterns. Full article

Background/Objectives: Chronic kidney disease (CKD) is a major global public health issue, affecting over 690 million individuals worldwide. The prevalence, diagnosis, and treatment of kidney disease vary considerably across different geographical regions. However, comprehensive and in-depth research on CKD remains limited due to its diverse etiologies. Methods: This study provides a detailed assessment of the disease burden of CKD, considering its etiological basis and utilizing the latest data reflecting changing trends. This research synthesizes findings from previous studies, with the necessary literature sourced from online platforms such as Google Scholar, EMBASE, and PubMed/MEDLINE databases, as well as Global Burden of Disease (GBD), to compare visualizations of the world’s CKD levels and trends from 1990 to 2021. Results: The study results demonstrated that eating patterns are affected by historical and industrial factors, which likely contribute to the high prevalence of CKD in Western countries. The data also indicated that the global number of new CKD cases increased from just over 7.8 million in 1990 to nearly 19 million after 30 years. Additionally, the results showed that age and sex together accounted for the observed prevalence and disease-attributable disability-adjusted life year (DALY) rates in CKD, with the highest rates seen in older age groups, except for CKD attributed to type 1 diabetes, where the incidence was higher in children, and the burden was greater in middle-aged adults. Conclusions: Overall, these findings are a valuable addition to the existing literature and provide evidence that CKD studies over a similar time frame reveal notable global trends and regional differences in highlighting this increasing burden. Full article

Background/Objectives: Evidence on associations between nutrients and dementia risk is limited and inconsistent. We aimed to systematically examine associations between 101 dietary nutrients and dementia incidence with a nutrient-wide association study (EWAS). Methods: We analyzed data from 6280 participants aged 50 years and older from the Health and Retirement Study. Levels of nutrient intake were measured with the food frequency questionnaire. Dementia status was assessed with the Lang–Weir Classification of Cognitive Function. In the EWAS analysis, the Cox proportional hazards regression model was used to estimate associations between each nutrient and dementia incidence, adjusting for multiple comparisons with a false discovery rate (FDR) of 0.05. Nutrients passing the EWAS selection were simultaneously included in the elastic net (ENET) regression model to construct a composite nutrient score (CNS), which was calculated as a weighted sum of the nutrients in the ENET regression model. Results: Over a mean (SD) follow-up of 6.76 (2.14) years, 495 individuals with incident dementia were identified. The results suggested that six nutrients were associated with increased dementia risks and five with decreased dementia risks. Compared with participants at the first tertile of CNS, individuals at the second (hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.11 to 1.84) and third tertiles (HR = 1.80, 95% CI = 1.42 to 2.27) had increased risks of dementia. Furthermore, CNS-dementia associations were stronger in females than in males. Conclusions: We found that 11 dietary nutrients and their combinations were associated with dementia risks in middle-aged and older adults. Interventional studies with nutrients were warranted to confirm our findings. Full article

Although the relationship between grandparent and grandchild is often unique due to the supportive and foundational roles grandparents can have in the lives of young or youthful grandchildren, the extent of grandparent–grandchild coresidence globally is under-researched. We harmonized household roster survey data on grandchild coresidence using population-based data on adults 55+ years across 24 countries. Grandchild coresidence rates ranged from 41.1% in Mexico to 0.1% in Sweden. Across contexts, grandchild coresidence was more common among women (compared to men), non-partnered individuals (compared to partnered individuals), those who reported difficulty with activities of daily living (compared to those without such difficulties), and those with education levels below the median (compared to those above the median). Logit regressions indicated gaps in rates of grandchild coresidence by partner status, ADL status, and education were generally not driven by income or other socio-demographic variables. Coresidence with adult grandchildren was not uncommon in most countries with non-negligible rates of grandchild coresidence. In about 25% of households of middle-aged and older adults coresiding with grandchildren, grandchildren ages 0–5 years were present. Future research should consider the meaning of grandparent–grandchild coresidence for the health outcomes of middle-aged and older adults globally, particularly when grandparents are not caregivers of grandchildren. Full article