scholarly journals Mild Parkinsonian Signs Are Related to Lower Cortico-Striatal Connectivity in Executive Networks

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 162-162
Author(s):  
Theodore Huppert ◽  
Andrea Rosso ◽  
Caterina Rosano ◽  
James Hengenius

Abstract Mild Parkinsonian signs (MPS) affect up to 24% of community-dwelling older adults. We hypothesize that MPS are associated with Parkinson’s-like alterations of functional connectivity (FC) in sensorimotor, executive, and reward cortico-striatal networks. Participants (N=266; mean age=83; 57% female) without Parkinson’s completed resting-state fMRI and Unified Parkinsonian Disease Rating Scale (UPDRS). FC between striatum and cortex was measured within each network. Logistic regression tested associations of each network’s FC with MPS (UPDRS>0), adjusted for MPS risk factors, then including white matter hyperintensities (WMH). MPS was associated with lower cortical-striatal FC in the left executive cortico-striatal network (OR [95%CI]: 0.188 [0.043,0.824]). Association survived adjusting for risk factors (0.162 [0.030,0.874]) but was attenuated after including WMH (0.209 [0.036, 1.200]). In stratified analyses, left executive cortico-striatal FC was associated with MPS only for those with higher WMH (0.077 [0.010,0.599]). Future work should examine whether higher FC protects against the influence of WMH on MPS.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 185-186
Author(s):  
Rebecca Ehrenkranz ◽  
Qu Tian ◽  
Andrea Rosso ◽  
Nancy W Glynn ◽  
Lana Chahine ◽  
...  

Abstract Mild Parkinsonian Signs (MPS) are common in older adults without overt neurological disease. MPS are often progressive and predict disability and dementia, yet little is known about predictors for MPS. Low self-reported energy is associated with mobility impairment, which is a hallmark of MPS. Yet whether self-reported energy relates to MPS is unknown. We explored the association of changes in self-reported energy with MPS in 293 participants (aged 83 ± 2.8 years, 58% women, 61% White) free of dementia and Parkinson’s Disease in the Health, Aging and Body Composition Study. Self-reported energy was assessed on a 0-10 scale annually between Year 2 and Year 10 (mean follow-up: 8 years) and its slope was estimated via linear mixed effects models. MPS were evaluated at Year 10 based on the Unified Parkinson Disease Rating Scale motor component. On average, self-reported energy declined 0.06 points per year. In a linear regression model adjusted for age, fatigue, and comorbidities, those with MPS had steeper SEL decline (β [Standard Error] = -0.358 [0.119]) in the prior eight years than those without MPS. Thus, declining self-reported energy may be a risk factor for MPS. Self-reported energy is easily evaluated in routine clinic visits, and may be a modifiable risk factor that can be targeted to reduce the incidence of MPS.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246206
Author(s):  
Shahram Oveisgharan ◽  
Lei Yu ◽  
David A. Bennett ◽  
Aron S. Buchman

Background Mobility disability and parkinsonism are associated with decreased survival in older adults. This study examined the transition from no motor impairment to mobility disability and parkinsonism and their associations with death. Methods 867 community-dwelling older adults without mobility disability or parkinsonism at baseline were examined annually. Mobility disability was based on annual measured gait speed. Parkinsonism was based on the annual assessment of 26 items from the motor portion of the Unified Parkinson’s Disease Rating Scale. A multistate Cox model simultaneously examined the incidences of mobility disability and parkinsonism and their associations with death. Results Average age at baseline was 75 years old and 318 (37%) died during 10 years of follow-up. Mobility disability was almost 2-fold more common than parkinsonism. Some participants developed mobility disability alone (42%), or parkinsonism alone (5%), while many developed both (41%). Individuals with mobility disability or parkinsonism alone had an increased risk of death, but their risk was less than the risk in individuals with both impairments. The risk of death did not depend on the order in which impairments occurred. Conclusion The varied patterns of transitions from no motor impairment to motor impairment highlights the heterogeneity of late-life motor impairment and its contribution to survival. Further studies are needed to elucidate the underlying biology of these different transitions and how they might impact survival.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 233-233
Author(s):  
Xiaocao Sun ◽  
Minhui Liu ◽  
Christina E Miyawaki ◽  
Yuxiao Li ◽  
Tianxue Hou ◽  
...  

Abstract Personality is associated with predictors of homebound status like frailty, incident falls, and depression. It has been rarely investigated whether personality predicts homebound status among older adults. Using the combining cross-sectional data of the Year 2013 and Year 2014 data from the National Health and Aging Trends Study (NHATS), this study examined the association between personality traits and homebound status in a sample of community-dwelling older adults aged 65 years and older (N=2,788). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and help of outdoor mobility. Personality traits, including conscientiousness, agreeableness, openness, extraversion, and neuroticism were assessed using the 10-item Midlife Development Inventory on a rating scale from 1 (not at all) to 4 (a lot). Each personality trait was included as a predictor in an ordinal logistic regression model to examine its association with homebound status after adjusting demographic and health-related covariates. The sample was on average 79±7.53 years old, non-Hispanic White (72.0%), female (58.6%), living alone (35.4%) or with spouse/partner only (37.4%). Seventy-four percent, 18%, and 8% of participants were non-homebound, semi-homebound, and homebound, respectively. Homebound participants tended to be less-educated older females. The average scores of conscientiousness, agreeableness, openness, extraversion, and neuroticism were 3.19±0.75, 3.57±0.56, 2.81±0.83, 3.13±0.75, and 2.22±0.86, respectively. Among these five personality traits, high conscientiousness (OR=1.34, p<0.001) and extraversion (OR=1.16, p=.03) were associated with a reduced likelihood of being homebound. These findings provided a basis for potential personality assessment to identify and protect individuals with high homebound risk.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2275
Author(s):  
Razieh Hassannejad ◽  
Hamsa Sharrouf ◽  
Fahimeh Haghighatdoost ◽  
Ben Kirk ◽  
Farzad Amirabdollahian

Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.


Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1061
Author(s):  
Roma Krzymińska-Siemaszko ◽  
Ewa Deskur-Śmielecka ◽  
Arkadiusz Styszyński ◽  
Katarzyna Wieczorowska-Tobis

A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study’s aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7–47.2%) than the PL-MSRA-7 (33.1–34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9–29.5%; PL-MSRA-7: 14.4–25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8–95.9%; PL-MSRA-5: 92.3–98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0–55% vs. 39.4–45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment.


2018 ◽  
Vol 7 (10) ◽  
pp. 373
Author(s):  
Chia-Ter Chao ◽  
Yung-Ming Chen ◽  
Fu-Hui Ho ◽  
Kun-Pei Lin ◽  
Jen-Hau Chen ◽  
...  

Longitudinal changes of renal function help inform patients’ clinical courses and improve risk stratification. Rare studies address risk factors predicting changes in estimated glomerular filtration rate (eGFR) over time in older adults, particularly of Chinese ethnicity. We identified prospectively enrolled community-dwelling older adults (≥65 years) receiving annual health examinations between 2005 and 2015 with serum creatinine available continuously in a single institute, and used linear regression to derive individual’s annual eGFR changes, followed by multivariate logistic regression analyses to identify features associated with different eGFR change patterns. Among 500 elderly (71.3 ± 4.2 years), their mean annual eGFR changes were 0.84 ± 1.67 mL/min/1.73 m2/year, with 136 (27.2%) and 238 (47.6%) classified as having downward (annual eGFR change <0 mL/min/1.73 m2/year) and upward eGFR (≥1 mL/min/1.73 m2/year) trajectories, respectively. Multivariate logistic regression showed that higher age (odds ratio (OR) 1.08), worse renal function (OR 13.2), and more severe proteinuria (OR 9.86) or hematuria (OR 3.39) were predictive of a declining eGFR while greater waist circumference (OR 1.06) and higher leukocyte counts (OR 1.21) were predictive of an uprising 10-year eGFR. These findings elucidate important features associated with geriatric renal function variations, which are expected to improve their renal care.


2021 ◽  
Vol 13 ◽  
Author(s):  
Shuai Guan ◽  
Xiangyu Kong ◽  
Shifei Duan ◽  
Qingguo Ren ◽  
Zhaodi Huang ◽  
...  

White matter hyperintensity (WMH) is common in healthy adults in their 60s and can be seen as early as in their 30s and 40s. Alterations in the brain structural and functional profiles in adults with WMH have been repeatedly studied but with a focus on late-stage WMH. To date, structural and functional MRI profiles during the very early stage of WMH remain largely unexplored. To address this, we investigated multimodal MRI (structural, diffusion, and resting-state functional MRI) profiles of community-dwelling asymptomatic adults with very early-stage WMH relative to age-, sex-, and education-matched non-WMH controls. The comparative results showed significant age-related and age-independent changes in structural MRI-based morphometric measures and resting-state fMRI-based measures in a set of specific gray matter (GM) regions but no global white matter changes. The observed structural and functional anomalies in specific GM regions in community-dwelling asymptomatic adults with very early-stage WMH provide novel data regarding very early-stage WMH and enhance understanding of the pathogenesis of WMH.


Author(s):  
Heeeun Jung ◽  
Miji Kim ◽  
Yunhwan Lee ◽  
Chang Won Won

Frailty is defined as a state of increased vulnerability to stressors, and it predicts the disability and mortality in the older population. This study aimed to investigate standardized prevalence and multidimensional risk factors associated with frailty among the Korean community-dwelling older adults. We analyzed the baseline data of 2,907 adults aged 70&ndash;84 years (mean age 75.8&plusmn;3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and pre-frailty was 7.9% (95% confidence interval [CI] 6.8&ndash;8.9%) and 57.2% (95% CI 45.1&ndash;48.8%), respectively. The following 14 risk factors had a significant association with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer timed up and go, and low short physical performance battery score (p&lt;0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 835-835
Author(s):  
Colette Brown ◽  
Andrea Chirino ◽  
Cristina Cortez ◽  
Cassandra Gearhart

Abstract A recent 12-week intervention study revealed that making conceptual art is linked to improved cognitive health among community-dwelling older adults (Brown et al., 2020). Unknown, however, is whether the intervention experience differed for participants who exhibited more versus less improvement. This pilot study examined 163 excerpts from semi-structured interviews with cognitively normal, older adult participants (N = 11, Mean age = 72.82). Using thematic analysis and data displays on Dedoose, key themes were distilled regarding intervention acceptability. Participants exhibiting less cognitive improvement more often mentioned personally connecting to topics of dementia and aging through art, but more often mentioned scheduling conflicts. Conversely, participants exhibiting greater cognitive improvement more often mentioned experiencing intellectual enrichment, but feeling insecure about their art capabilities. Novel art activities may be personally meaningful and cognitively stimulating for some participants, but emotionally frustrating for others. Future work should explore ways to optimize arts-based interventions for older participants.


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