Hypercapnia-Induced Vasodilation in the Cerebral Circulation is Reduced in Older Adults with Sleep Disordered Breathing

2021 ◽  
Author(s):  
Ruchi Rastogi ◽  
Barbara J. Morgan ◽  
M. Safwan Badr ◽  
Susmita Chowdhuri
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Vascular Function ◽  
Sleep Disordered Breathing ◽  
Age Groups ◽  
Central Apneas ◽  
Cerebral Vasodilation ◽  
End Tidal ◽  
Cerebral Vascular ◽  
Disordered Breathing

The prevalence of sleep disordered breathing (SDB) is higher in older adults compared to young individuals. The increased propensity for ventilatory control instability in older adults may contribute to the increased prevalence of central apneas. Reductions in the cerebral vascular response to CO2 may exacerbate ventilatory overshoots and undershoots during sleep. Thus, we hypothesized that hypercapnia-induced cerebral vasodilation (HCVD) will be reduced in older vs. young adults. In 11 older and 10 young adults with SDB, blood flow velocity in the middle cerebral artery (MCAV) was measured using Doppler transcranial ultrasonography, during multiple steady state hyperoxic hypercapnic breathing trials while awake, interspersed with room air breathing. Changes in ventilation, MCAV and mean arterial pressure (MAP) via finger plethysmography during the trials were compared with baseline eupneic values. For each hyperoxic hypercapnic trial, the change (Δ) in MCAV for a corresponding change in end-tidal CO2 and the HCVD or the change in cerebral vascular conductance (MCAV divided by MAP) for a corresponding change in end-tidal CO2 were determined. The hypercapnic ventilatory response was similar between the age groups, as was ΔMCAV/ΔPETCO2. However, compared with young, older adults had a significantly smaller HCVD (1.3 ± 0.7 vs. 2.1 ± 0.6 units/mmHg, p=0.004). Multivariable analyses demonstrated that age and nadir oxygen saturation during nocturnal polysomnography were significant predictors of HCVD. Thus, our data indicate that older age and SDB-related hypoxia are associated with diminished HCVD. We hypothesize that this impairment in vascular function may contribute to breathing instability during sleep in these individuals.

scholarly journals Opioid Literacy in an Immigrant Group in Rural Area: Use of Social Determinant of Health Framework

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 397-397
Author(s):  
Hee Yun Lee ◽  
Eun Young Choi ◽  
Jieun Song ◽  
Jamie Gajos ◽  
Yan Luo
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Health Literacy ◽  
Rural Area ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Age Groups ◽  
Social Determinant ◽  
Opioid Overdose ◽  
Middle Aged

Abstract Opioid overdose risk is particularly high in immigrant communities partly due to limited English proficiency (Guarino et al., 2015). Previous studies reported that social determinants of health (SDH) have been associated with risk for opioid overdose (Dasgupta et al., 2018). The current study examines the association between SDH and literacy of opioid overdose risk among the immigrant population living in a rural area. Specifically, we examine the association in various age groups including young adults (aged 20 to 34), middle-aged (aged 35 to 49), and older adults (ages 50 to 75). Data were drawn from a sample of Korean American immigrants residing in rural Alabama (N=225). The participants administered the Brief Opioid Knowledge (BOOK) Questionnaire (Dunn et al., 2016). Multiple regression analyses were conducted for three age groups to identify predictors of opioid literacy. Overall, older adults had lower levels of opioid literacy relative to their younger counterparts. Among young adults, low English proficiency, more chronic conditions, and greater depressive symptoms were significant predictors of limited opioid literacy. For the middle-aged adults, lower levels of health literacy and more pain symptoms were associated with limited opioid literacy. Among older adults, women, those with higher English proficiency, and lower health literacy had lower levels of opioid literacy. The findings demonstrated a greater vulnerability of older immigrants to limited opioid literacy. Different predictors based on SDH of limited opioid literacy across age groups have implications for tailored health promotion strategies to reduce opioid overdose risk.

scholarly journals Are the Acute Effects of THC Different in Aging Adults?

2021 ◽  
Vol 11 (5) ◽  
pp. 590
Author(s):  
Raeghan L. Mueller ◽  
Jarrod M. Ellingson ◽  
L. Cinnamon Bidwell ◽  
Angela D. Bryan ◽  
Kent E. Hutchison
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Age Groups ◽  
Young Group ◽  
Self Administration ◽  
Behavioral Measures ◽  
Younger Adults ◽  
Different Types ◽  
Before And After ◽  
Aging Adults

In recent years of expanding legalization, older adults have reported the largest increase in cannabis use of any age group. While its use has been studied extensively in young adults, little is known about the effects of THC in older adults and whether the risks of cannabis might be different, particularly concerning intoxication and cognition. The current study investigated whether age is associated with the deleterious effects of THC on cognitive performance and other behavioral measures before and after ad libitum self-administration of three different types of cannabis flower (THC dominant, THC + CBD, and CBD dominant). Age groups consisted of young adults (ages 21–25) and older adults (ages 55–70). Controlling for pre-use scores on all measures, the THC dominant chemovar produced a greater deleterious effect in younger adults compared with older adults in tests of learning and processing speed, whereas there were no differences between old and young in the effects of the other chemovars. In addition, the young group reported greater cannabis craving than the older group after using the THC chemovar. Consistent with some reports in the preclinical literature, the findings suggest that older adults may be less sensitive to the effects of THC on cognitive and affective measures.

scholarly journals Amelioration of sleep-disordered breathing with supplemental oxygen in older adults

2020 ◽  
Vol 129 (6) ◽  
pp. 1441-1450
Author(s):  
Ruchi Rastogi ◽  
M. S. Badr ◽  
A. Ahmed ◽  
S. Chowdhuri
Keyword(s):  
Older Adults ◽  
Heart Disease ◽  
Sleep Disordered Breathing ◽  
Supplemental Oxygen ◽  
Vulnerable Population ◽  
Central Apnea ◽  
Elderly Adults ◽  
Chemoreflex Sensitivity ◽  
Central Apneas ◽  
First Time

This study demonstrates for the first time in elderly adults without heart disease that intervention with supplemental oxygen in the clinical range will ameliorate central apneas and hypopneas by decreasing the propensity to central apnea through decreased chemoreflex sensitivity, even in the absence of a reduction in the plant gain. Thus, the study provides physiological evidence for use of supplemental oxygen as therapy for mild-to-moderate SDB in this vulnerable population.

scholarly journals Sleep-Disordered Breathing Is Associated With Impaired Odor Identification in Older U.S. Adults

2020 ◽  
Author(s):  
Jesse K Siegel ◽  
Xiandao Yuan ◽  
Kristen E Wroblewski ◽  
Martha K McClintock ◽  
Jayant M Pinto
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Sleep Apnea ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Sleep Disordered Breathing ◽  
Odor Identification ◽  
Odor Sensitivity ◽  
Disordered Breathing

Abstract Background Sleep-disordered breathing (SDB) is a common, underdiagnosed condition in older adults with major health consequences, including disrupted central nervous system functioning. Whether SDB may affect sensory function is unclear. We sought to address this question by comparing 2 forms of olfactory testing which measure peripheral and central olfactory processing. Methods We assessed SDB (survey-reported snoring frequency, nighttime apneic events, or diagnosis of sleep apnea) in the National Social Life, Health, and Aging Project, a nationally representative sample of older U.S. adults. Odor sensitivity (peripheral) and odor identification (central) were assessed with validated instruments. Logistic regression was used to test the relationship between SDB and olfaction, accounting for relevant covariates, including demographics, cognition, and comorbidity. Results Twenty-nine percent of older U.S. adults reported symptoms of SDB (apneic events or nightly snoring). Of these, only 32% had been diagnosed with sleep apnea. Older adults with SDB (those who reported symptoms or have been diagnosed with sleep apnea) were significantly more likely to have impaired odor identification (odds ratio 2.13, 95% confidence interval 1.19–3.83, p = .012) in analyses that accounted for age, gender, race/ethnicity, education, cognition, comorbidities (including depression), and body mass index. Presence of SDB was not associated with impaired odor sensitivity (odds ratio 1.03, 95% confidence interval 0.75–1.43, p = .84). Conclusion SDB is highly prevalent but underdiagnosed in older U.S. adults and is associated with impaired odor identification but not odor sensitivity. These data support the concept that SDB affects pathways in the central nervous system which involve chemosensory processing.

scholarly journals Slowed sensory reweighting and postural illusions in older adults: the moving platform illusion

2019 ◽  
Vol 121 (2) ◽  
pp. 690-700 ◽  
Author(s):  
Chesney E. Craig ◽  
Michail Doumas
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Postural Sway ◽  
Age Groups ◽  
Age Group ◽  
Sensory Reweighting ◽  
Perceptual Illusion ◽  
Healthy Older Adults ◽  
Stable Conditions ◽  
Illusory Perception

We investigated whether postural aftereffects witnessed during transitions from a moving to a stable support are accompanied by a delayed perception of platform stabilization in older adults, in two experiments. In experiment 1, postural sway and muscle cocontraction were assessed in 11 healthy young, 11 healthy older, and 11 fall-prone older adults during blindfolded stance on a fixed platform, followed by a sway-referenced platform and then by a fixed platform again. The sway-referenced platform was more compliant for young adults, to induce similar levels of postural sway in both age groups. Participants were asked to press a button whenever they perceived that the platform had stopped moving. Both older groups showed significantly larger and longer postural sway aftereffects during platform stabilization compared with young adults, which were pronounced in fall-prone older adults. In both older groups elevated muscle cocontraction aftereffect was also witnessed. Importantly, these aftereffects were accompanied by an illusory perception of prolonged platform movement. After this, experiment 2 examined whether this illusory perception was a robust age effect or an experimental confound due to greater surface compliance in young adults, which could create a larger perceptual discrepancy between moving and stable conditions. Despite exposure to the same surface compliance levels during sway-reference, the perceptual illusion was maintained in experiment 2 in a new group of 14 healthy older adults compared with 11 young adults. In both studies, older adults took five times longer than young adults to perceive platform stabilization. This supports that sensory reweighting is inefficient in older adults. NEW & NOTEWORTHY This is the first paper to show that postural sway aftereffects witnessed in older adults after platform stabilization may be due to a perceptual illusion of platform movement. Surprisingly, in both experiments presented it took older adults five times longer than young adults to perceive platform stabilization. This supports a hypothesis of less efficient sensory reintegration in this age group, which may delay the formation of an accurate postural percept.

scholarly journals Negative Effects of Embodiment in a Visuo-Spatial Working Memory Task in Children, Young Adults, and Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Gianluca Amico ◽  
Sabine Schaefer
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Young Adults ◽  
Spatial Information ◽  
Spatial Working Memory ◽  
Cognitive Task ◽  
Memory Performance ◽  
Age Groups ◽  
Memory Task ◽  
Negative Effects

Studies examining the effect of embodied cognition have shown that linking one’s body movements to a cognitive task can enhance performance. The current study investigated whether concurrent walking while encoding or recalling spatial information improves working memory performance, and whether 10-year-old children, young adults, or older adults (Mage = 72 years) are affected differently by embodiment. The goal of the Spatial Memory Task was to encode and recall sequences of increasing length by reproducing positions of target fields in the correct order. The nine targets were positioned in a random configuration on a large square carpet (2.5 m × 2.5 m). During encoding and recall, participants either did not move, or they walked into the target fields. In a within-subjects design, all possible combinations of encoding and recall conditions were tested in counterbalanced order. Contrary to our predictions, moving particularly impaired encoding, but also recall. These negative effects were present in all age groups, but older adults’ memory was hampered even more strongly by walking during encoding and recall. Our results indicate that embodiment may not help people to memorize spatial information, but can create a dual-task situation instead.

scholarly journals Aging is associated with increased propensity for central apnea during NREM sleep

2018 ◽  
Vol 124 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Susmita Chowdhuri ◽  
Sukanya Pranathiageswaran ◽  
Hillary Loomis-King ◽  
Anan Salloum ◽  
M. Safwan Badr
Keyword(s):  
Carbon Dioxide ◽  
Older Adults ◽  
Young Adults ◽  
Nrem Sleep ◽  
The Elderly ◽  
Central Apnea ◽  
Elderly Adults ◽  
Rapid Eye Movement Sleep ◽  
Controller Gain ◽  
Central Apneas

The reason for increased sleep-disordered breathing with predominance of central apneas in the elderly is unknown. We hypothesized that the propensity to central apneas is increased in older adults, manifested by a reduced carbon-dioxide (CO2) reserve in older compared with young adults during non-rapid eye movement sleep. Ten elderly and 15 young healthy adults underwent multiple brief trials of nasal noninvasive positive pressure ventilation during stable NREM sleep. Cessation of mechanical ventilation (MV) resulted in hypocapnic central apnea or hypopnea. The CO2 reserve was defined as the difference in end-tidal CO2 ([Formula: see text]) between eupnea and the apneic threshold, where the apneic threshold was [Formula: see text] that demarcated the central apnea closest to the eupneic [Formula: see text]. For each MV trial, the hypocapnic ventilatory response (controller gain) was measured as the change in minute ventilation (V̇e) during the MV trial for a corresponding change in [Formula: see text]. The eupneic [Formula: see text] was significantly lower in elderly vs. young adults. Compared with young adults, the elderly had a significantly reduced CO2 reserve (−2.6 ± 0.4 vs. −4.1 ± 0.4 mmHg, P = 0.01) and a higher controller gain (2.3 ± 0.2 vs. 1.4 ± 0.2 l·min−1·mmHg−1, P = 0.007), indicating increased chemoresponsiveness in the elderly. Thus elderly adults are more prone to hypocapnic central apneas owing to increased hypocapnic chemoresponsiveness during NREM sleep. NEW & NOTEWORTHY The study describes an original finding where healthy older adults compared with healthy young adults demonstrated increased breathing instability during non-rapid eye movement sleep, as suggested by a smaller carbon dioxide reserve and a higher controller gain. The findings may explain the increased propensity for central apneas in elderly adults during sleep and potentially guide the development of pathophysiology-defined personalized therapies for sleep apnea in the elderly.

The effects of age on prototype- and exemplar-based categorization

2021 ◽  
Author(s):  
Caitlin Bowman ◽  
Takako Iwashita ◽  
Dagmar Zeithamova
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Concept Learning ◽  
Age Groups ◽  
Central Tendency ◽  
Concepts And Categories ◽  
New Concepts ◽  
Category Labels

The need to learn new concepts and categories persists through the lifespan, yet little is known about how aging affects concept learning and generalization. Here, we trained young and older adults to classify typical and boundary category members and then tested category generalization to new stimuli. During training, older adults had increased difficulty compared to young adults learning category labels for boundary items, but not typical items. At test, categorization performance that included new items at all levels of typicality was comparable across age groups, but formal categorization models indicated that older adults relied to a greater degree on generalized (prototype) category representations than young adults. These findings align with the proposal that older adults are able to form category representations based on central tendency even when they have difficulty learning and remembering individual category members. More broadly, the results contribute to our understanding of multiple categorization strategies and the limited strategy flexibility in older adults. They also highlight how reliance on

scholarly journals 0890 Sleep Disordered Breathing is Associated With Endothelial Dysfunction and Atherosclerosis in Young Adults: Preliminary Longitudinal Findings in the Penn State Child Cohort

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A339-A339
Author(s):  
J Fernandez-Mendoza ◽  
Z Gao ◽  
K Brandt ◽  
L Houser ◽  
S L Calhoun ◽  
...  
Keyword(s):  
Young Adults ◽  
Endothelial Dysfunction ◽  
Young Adulthood ◽  
Sleep Disordered Breathing ◽  
Population Based ◽  
Apnea Hypopnea Index ◽  
Penn State ◽  
State Child ◽  
Disordered Breathing

Abstract Introduction Sleep disordered breathing (SDB) in middle-age is an established risk factor for cardiovascular disease. However, population-based studies supporting its cardiovascular contribution at earlier stages of development are lacking, particularly with long-term follow-ups. Methods The Penn State Child Cohort is a population-based longitudinal sample of 700 children (8.7±1.7y), of whom 421 were followed-up 8.3 years later during adolescence (17.0±2.3y) with in-lab polysomnography (PSG). To date, 425 have been followed-up another 7.4 years later during young adulthood (24.4±2.6y) via a standardized survey and 136 of them (55.1% female, 21.3% racial/ethnic minority) have undergone a repeat of their PSG to ascertain apnea/hypopnea index. Subjects (n=121) also underwent Doppler ultrasounds to assess flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT). Linear regression models stratified by body mass index in young adulthood. Results SDB was cross-sectionally associated with lower FMD (β=-0.239, p=0.008) and greater CIMT (β=0.330, p<0.001) in young adulthood. Longitudinally, childhood (n=121) and adolescence (n=90) SDB were significantly associated with CIMT (β=0.327, p<0.001 and β=0.286, p=0.006, respectively), but not with FMD (β=-0.158, p=0.08 and β=-0.101, p=0.35, respectively). These associations, particularly longitudinal ones between childhood and adolescence SDB with CIMT in young adulthood, were stronger in overweight than normal weight subjects (e.g., β=0.310, p=0.030 and β =0.089, p=0.582, respectively). Conclusion SDB and obesity appear to be synergistically associated with endothelial dysfunction and atherosclerosis in young adults from the general population. These data suggest that a childhood exposure to chronic SDB is associated with long-term atherosclerosis, while endothelial dysfunction may be a short-term outcome. This ongoing 16-year longitudinal study will test whether the natural history of SDB from childhood through adolescence into young adulthood shows differential trajectories for cardiovascular morbidity. Support National Institutes of Health (R01HL136587, R01HL97165, R01HL63772, UL1TR000127)

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