The Effects of Lutein and Zeaxanthin Supplementation on Brain Morphology in Older Adults: A Randomized, Controlled Trial

A growing literature emphasizes the importance of lifestyle factors such as nutrition in successful aging. The current study examined if one year of supplementation with lutein (L) and zeaxanthin (Z), two nutrients with known antioxidative properties and cognitive benefits, impacted structural brain outcomes in older adults using a double-blind, randomized, placebo-controlled trial design. Community-dwelling older adults (20 males and 27 females) aged 65–87 years (M = 71.8 years, SD = 6.04 years) were randomized into supplement (N = 33) and placebo groups (N = 14) using simple randomization. The supplement group received 10 mg L + 2 mg Z daily for 12 months while the placebo group received a visually identical, inert placebo. L and Z were measured via retinal concentrations (macular pigment optical density or MPOD). Structural brain outcomes, focusing on global and frontal-temporal lobe regions, were acquired using both T1-weighted and DTI MRI sequences. We hypothesized that the supplement group would increase, maintain, or show attenuated loss in hypothesized regions-of-interest (ROIs) while the placebo group would show age-related declines in brain structural integrity over the course of the trial. While results showed age-related declines for frontal and temporal gray and white matter volumes, as well as fornix white matter microstructure across both groups, only minimal differences were found between the supplement and placebo groups. However, exploratory analyses showed that individuals who responded better to supplementation (i.e., showed greater increases in MPOD) showed less decline in global and prefrontal gray matter volume than supplement “nonresponders.” While results suggest that one year of L and Z supplementation may have limited effects on structural brain outcomes overall, there may be a subsample of individuals for whom supplementation of L and Z provides greater benefits. ClinicalTrials.gov number, NCT02023645.

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Hemodynamic and structural brain measures in high and low sedentary older adults

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x211009382 ◽

2021 ◽

pp. 0271678X2110093

Author(s):

Carlijn M Maasakkers ◽

Dick HJ Thijssen ◽

Silvin P Knight ◽

Louise Newman ◽

John D O'Connor ◽

...

Keyword(s):

Older Adults ◽

White Matter ◽

Cognitive Decline ◽

Sedentary Behaviour ◽

White Matter Hyperintensities ◽

Near Infrared ◽

Community Dwelling ◽

Causal Pathways ◽

Cerebrovascular Function ◽

Structural Brain

Due to its cardiovascular effects sedentary behaviour might impact cerebrovascular function in the long term, affecting cerebrovascular regulatory mechanisms and perfusion levels. Consequently this could underly potential structural brain abnormalities associated with cognitive decline. We therefore assessed the association between sedentary behaviour and brain measures of cerebrovascular perfusion and structural abnormalities in community-dwelling older adults. Using accelerometery (GENEActiv) data from The Irish Longitudinal Study on Ageing (TILDA) we categorised individuals by low- and high-sedentary behaviour (≤8 vs >8 hours/day). We examined prefrontal haemoglobin oxygenation levels using Near-Infrared Spectroscopy during rest and after an orthostatic challenge in 718 individuals (66 ± 8 years, 52% female). Global grey matter cerebral blood flow, total grey and white matter volume, total and subfield hippocampal volumes, cortical thickness, and white matter hyperintensities were measured using arterial spin labelling, T1, and FLAIR MRI in 86 individuals (72 ± 6 years, 55% female). While no differences in prefrontal or global cerebral hemodynamics were found between groups, high-sedentary individuals showed lower hippocampal volumes and increased white matter hyperintensities compared to their low-sedentary counterparts. Since these structural cerebral abnormalities are associated with cognitive decline and Alzheimer’s disease, future work exploring the causal pathways underlying these differences is needed.

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Linking objective measures of physical activity and capability with brain structure in healthy community dwelling older adults

10.1101/2021.01.28.21250529 ◽

2021 ◽

Author(s):

Anne-Marthe Sanders ◽

Geneviève Richard ◽

Knut Kolskår ◽

Kristine M. Ulrichsen ◽

Tobias Kaufmann ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

White Matter ◽

Cognitive Aging ◽

Walking Speed ◽

Community Dwelling ◽

Brain Morphology ◽

Brain Health ◽

Physical Capability ◽

Brain Age

AbstractMaintaining high levels of daily activity and physical capability have been proposed as important constituents to promote healthy brain and cognitive aging. Studies investigating the associations between brain health and physical activity in late life have, however, mainly been based on self-reported data or measures designed for clinical populations. In the current study, we examined cross-sectional associations between physical activity, recorded by an ankle-positioned accelerometer for seven days, physical capability (grip strength, postural control, and walking speed), and neuroimaging based surrogate markers of brain health in 122 healthy older adults aged 65-88 years. We used a multimodal brain imaging approach offering two complementary structural MRI based indicators of brain health: white matter diffusivity and coherence based on diffusion tensor imaging and subcortical and global brain age based on brain morphology inferred from T1-weighted MRI data. The analyses revealed a significant association between global white matter fractional anisotropy (FA) and walking speed, indicating higher white matter coherence in people with higher pace. We also found a significant interaction between sex and brain age on number of daily steps, indicating younger-appearing brains in more physically active women, with no significant associations among men. These results provide insight into the intricate associations between different measures of brain and physical health in old age, and corroborate established public health advice promoting physical activity.

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On the Impact of Interhemispheric White Matter: Age, Executive Functioning, and Dedifferentiation in the Frontal Lobes

10.1101/226845 ◽

2017 ◽

Author(s):

Abigail B. Waters ◽

Kayle S. Sawyer ◽

David A. Gansler

Keyword(s):

Older Adults ◽

White Matter ◽

Executive Functioning ◽

Significant Relationship ◽

Grey Matter ◽

Middle Age ◽

Neural Substrates ◽

Community Dwelling ◽

Equation Modeling ◽

Age Related

AbstractIntroductionIn middle age, declines in executive functioning (EF) are associated with decrements in the quality and/or quantity of white and grey matter. Recruitment of homologous regions has been identified as a compensatory mechanism for cognitive decline in later middle age, however research into neural substrates of EF has yet to be guided by dedifferentiation models. We hypothesized that frontal-parietal grey matter volume, interhemispheric white matter and intrahemispheric white matter fractional anisotropy (FA) will be predictive of EF. Further, we hypothesized that the comparative association between interhemispheric white matter and EF will increase with age, because of compensatory recruitment.MethodsNeurocognitive test data, DTI, and T1 MPRAGE scans (n = 444) were obtained from the NKI-Rockland Sample. Structural equation modeling was used to examine the relationship between age, EF, interhemispheric white matter (forceps minor; FM), intrahemispheric white matter (superior longitudinal fasciculus; SLF), and a frontal-parietal grey matter network. EF and grey matter were modelled as latent variables, with EF examined as the criterion. Additionally, a subsample of participants aged 55-85 (n = 168) was analyzed to examine the influence of age related compensatory mechanisms.ResultsThere was a significant relationship between FM, grey matter, and EF, which was fully mediated by age. There was a significant relationship between SLF and EF, which was not mediated by age. For older adults, only the age-mediated pathway from FM to EF was significant.DiscussionUsing structural imaging data, support was found for age-related interhemispheric mechanisms of compensation, but not intrahemispheric mechanisms.Key points(1) Neural substrates of executive functioning are not static across the lifespan. (2) In older adults, white matter becomes more salient as a structural correlate of executive functioning, as recruitment needs increase. (3) While the importance of interhemispheric white matter is mediated by age, intrahemispheric recruitment remains consistent across the lifespan, and is not the primary mechanism of age-based compensation in community dwelling older adults.

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Participation in life-review playback theater enhances mental health of community-dwelling older adults: A randomized controlled trial.

Psychology of Aesthetics Creativity and the Arts ◽

10.1037/aca0000354 ◽

2020 ◽

Author(s):

Shoshi Keisari ◽

Yuval Palgi ◽

Dani Yaniv ◽

Anat Gesser-Edelsburg

Keyword(s):

Mental Health ◽

Older Adults ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Life Review ◽

Community Dwelling ◽

Randomized Controlled ◽

Community Dwelling Older Adults

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A 12-week Intervention With Motivational Interviewing and Physical Activity Monitoring, to Enhance the Daily Amount of Physical Activity in Community Dwelling Older Adults - a Randomized Controlled Trial

Case Medical Research ◽

10.31525/ct1-nct03906162 ◽

2019 ◽

Author(s):

Keyword(s):

Physical Activity ◽

Older Adults ◽

Randomized Controlled Trial ◽

Motivational Interviewing ◽

Controlled Trial ◽

Community Dwelling ◽

Daily Amount ◽

Randomized Controlled ◽

Physical Activity Monitoring ◽

Community Dwelling Older Adults

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Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

Prevention Science ◽

10.1007/s11121-021-01221-y ◽

2021 ◽

Author(s):

Nien Xiang Tou ◽

Shiou-Liang Wee ◽

Wei Ting Seah ◽

Daniella Hui Min Ng ◽

Benedict Wei Jun Pang ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Controlled Trial ◽

Community Dwelling ◽

Controlled Study ◽

Power Training ◽

Frail Older Adults ◽

Frailty Status ◽

Randomized Controlled ◽

Community Dwelling Older Adults

AbstractTranslation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.

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Comparison of Lateral Perturbation-Induced Step Training and Hip Muscle Strengthening Exercise on Balance and Falls in Community-Dwelling Older Adults: A Blinded Randomized Controlled Trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glab017 ◽

2021 ◽

Author(s):

Mark W Rogers ◽

Robert A Creath ◽

Vicki Gray ◽

Janice Abarro ◽

Sandy McCombe Waller ◽

...

Keyword(s):

Older Adults ◽

Controlled Trial ◽

Step Length ◽

Community Dwelling ◽

Controlled Study ◽

Balance Performance ◽

Muscle Strengthening ◽

Hip Muscle ◽

Hip Abduction ◽

Community Dwelling Older Adults

Abstract Background This factorial, assessor-blinded, randomized, and controlled study compared the effects of perturbation-induced step training (lateral waist-pulls), hip muscle strengthening, and their combination, on balance performance, muscle strength, and prospective falls among older adults. Methods Community-dwelling older adults were randomized to 4 training groups. Induced step training (IST, n = 25) involved 43 progressive perturbations. Hip abduction strengthening (HST, n = 25) utilized progressive resistance exercises. Combined training (CMB, n = 25) included IST and HST, and the control performed seated flexibility/relaxation exercises (SFR, n = 27). The training involved 36 sessions for a period of 12 weeks. The primary outcomes were the number of recovery steps and first step length, and maximum hip abduction torque. Fall frequency during 12 months after training was determined. Results Overall, the number of recovery steps was reduced by 31% and depended upon the first step type. IST and CMB increased the rate of more stable single lateral steps pre- and post-training than HST and SFR who used more multiple crossover and sequential steps. The improved rate of lateral steps for CMB exceeded the control (CMB/SFR rate ratio 2.68). First step length was unchanged, and HST alone increased hip torque by 25%. Relative to SFR, the fall rate ratios (falls/person/year) [95% confidence interval] were CMB 0.26 [0.07–0.90], IST 0.44 [0.18–1.08], and HST 0.30 (0.10–0.91). Conclusions Balance performance through stepping was best improved by combining perturbation and strength training and not strengthening alone. The interventions reduced future falls by 56%–74% over the control. Lateral balance perturbation training may enhance traditional programs for fall prevention.

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Quality of Diet Among Community-Dwelling Elders Participating in the Mobility and Vitality Lifestyle Program

Innovation in Aging ◽

10.1093/geroni/igaa057.3081 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 841-841

Author(s):

Jessica Cheng

Keyword(s):

Older Adults ◽

Disease Prevention ◽

Diet Quality ◽

Group Intervention ◽

Health Workers ◽

Effective Means ◽

Quality Score ◽

Community Dwelling ◽

Total Quality ◽

One Year

Abstract Dietary choices play an important role in disease prevention both through its effect on weight and independent of it. Improving diet can be an effective means of disease prevention among older adults. Participants (n=303) were recruited from the Allegheny County, PA area and received nutritional education in group sessions led by trained community health workers over one year. Diet quality was captured at baseline and final endpoint (either 9 or 13 months) using the Rate Your Plate (RYP) instrument for assessing healthfulness of diet and includes 24 items that can be summed to generate a total quality score. The mean RYP diet quality score improved from baseline (RYP=50.87) to endpoint (RYP=54.85) (p<.001). Over the course of the intervention, 30.9% of participants made enough improvement in diet to move to a better RYP category. A community-based group intervention for older adults was effective in inducing improvements in diet quality.

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Effects of Aerobic, Resistance, or Combined Exercise Training Among Older Adults with Subjective Memory Complaints: A Randomized Controlled Trial

Journal of Alzheimer s Disease ◽

10.3233/jad-210047 ◽

2021 ◽

pp. 1-17

Author(s):

Taeko Makino ◽

Hiroyuki Umegaki ◽

Masahiko Ando ◽

Xian Wu Cheng ◽

Koji Ishida ◽

...

Keyword(s):

Older Adults ◽

Exercise Training ◽

Controlled Trial ◽

Community Dwelling ◽

Control Group ◽

Subjective Memory ◽

Logical Memory ◽

Randomized Controlled ◽

Community Dwelling Older Adults

Background: Physical exercise is suggested to be effective for preventing cognitive decline in older adults, but the relative efficacy of different types of exercise have yet to be clarified. Objective: This single-blinded randomized controlled trial was designed to investigate the differential effects of aerobic exercise training (AT), resistance exercise training (RT), and combined exercise training (CT) on cognition in older adults with subjective memory complaints (SMC). Methods: Community-dwelling older adults with SMC (n = 415; mean age = 72.3 years old) were randomly assigned to one of the four groups: AT, RT, CT, or control group. The study consisted of two phases: a 26-week intervention and a 26-week follow-up. The participants were evaluated at baseline, 26 weeks (postintervention), and 52 weeks (follow-up). The primary outcome of this study was memory function, which was assessed using the Logical Memory II subtest of the Wechsler Memory Scale-Revised (WMS-R) score. The secondary outcomes included global cognitive function, verbal fluency, working memory, processing speed, and executive functions. Results: Intention-to-treat analysis by a mixed-effect model repeated measure showed that the AT group had significantly improved performance on the WMS-R Logical Memory II test (2.74 [1.82–3.66] points) than the control group (1.36 [0.44–2.28] points) at the postintervention assessment (p = 0.037). The effect was more pronounced in those without amnesia than those with amnesia. No significant improvement was observed in the RT and CT groups. Conclusion: This study suggests that AT intervention can improve delayed memory in community-dwelling older adults, particularly in individuals without objective memory decline.

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