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This article is linked to Al‐Ani et al and Garg et al papers. To view these articles, visit https://doi.org/10.1111/apt.15779 and https://doi.org/10.1111/apt.15796.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Perception of our world is proposed to arise from combining multiple sensory inputs according to their relative reliability. We tested multisensory processes in a large sample of 2920 older adults to ...assess whether sensory ability mediates age-related changes in perception. Participants completed a test of audio-visual integration, the Sound Induced Flash Illusion (SIFI), alongside measures of visual (acuity, contrast sensitivity, self-reported vision and visual temporal discrimination (VTD)) and auditory (self-reported hearing and auditory temporal discrimination (ATD)) function. Structural equation modelling showed that SIFI susceptibility increased with age. This was mediated by visual acuity and self-reported hearing: better scores on these measures predicted reduced and stronger SIFI susceptibility, respectively. Unexpectedly, VTD improved with age and predicted increased SIFI susceptibility. Importantly, the relationship between age and SIFI susceptibility remained significant, even when considering mediators. A second model showed that, with age, visual 'gain' (the benefit of congruent auditory information on visual judgements) was predicted by ATD: better ATD predicted stronger visual gain. However, neither age nor SIFI susceptibility were directly associated with visual gain. Our findings illustrate, in the largest sample of older adults to date, how multisensory perception is influenced, but not fully accounted for, by age-related changes in unisensory abilities.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Correspondence to Professor Jonathan Rhodes, Cellular and molecular physiology, University of Liverpool Institute of Translational Medicine, Liverpool L69 3BX, UK; rhodesjm@liverpool.ac.uk Dear ...Editors, We read with interest the review by Dr Kohlmeier in which he reported a correlation between COVID-19 mortality among African-Americans across the USA and northern latitude.1 We previously reported a north–south gradient in global COVID-19 mortality but were conscious that lack of ultraviolet exposure and consequent vitamin D insufficiency was not the only possible explanation.2 We have now investigated the relationships between latitude, age of population, population density and pollution with COVID-19 mortality. Data by country for population %≥65 years, population density and air pollution (particles of matter <2.5 um diameter µg/m3) were obtained from public sources.4–6 Latitude was entered for each country’s capital city. There are exceptions, but COVID-19 mortality correlates with reported vitamin D levels across Europe,7 and in sunnier Brazil, where mortality is rising, 28% prevalence of vitamin D deficiency is reported.8 An association between vitamin D insufficiency and COVID-19 severity is supported by substantial evidence of its impact on cytokine response to pathogens.7 A direct effect of ultraviolet light on the environmental survival of severe acute respiratory syndrome coronavirus 2 is also possible but would not explain the association between mortality and ethnicity,9 whereas people with dark skin need more ultraviolet exposure for equivalent vitamin D synthesis.
Low socioeconomic status (SES) is associated with earlier onset of age-related chronic conditions and reduced life-expectancy, but the underlying biomolecular mechanisms remain unclear. Evidence of ...DNA-methylation differences by SES suggests a possible association of SES with epigenetic age acceleration (AA). We investigated the association of SES with AA in more than 5,000 individuals belonging to three independent prospective cohorts from Italy, Australia, and Ireland. Low SES was associated with greater AA (β = 0.99 years; 95% CI 0.39,1.59; p = 0.002; comparing extreme categories). The results were consistent across different SES indicators. The associations were only partially modulated by the unhealthy lifestyle habits of individuals with lower SES. Individuals who experienced life-course SES improvement had intermediate AA compared to extreme SES categories, suggesting reversibility of the effect and supporting the relative importance of the early childhood social environment. Socioeconomic adversity is associated with accelerated epigenetic aging, implicating biomolecular mechanisms that may link SES to age-related diseases and longevity.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Frailty is an important geriatric syndrome strongly linked to falls risk as well as increased mortality and morbidity. Taken alone, falls are the most common cause of injury and hospitalization and ...one of the principal causes of death and disability in older adults worldwide. Reliable determination of older adults' frailty state in concert with their falls risk could lead to targeted intervention and improved quality of care. We report a mobile assessment platform employing inertial and pressure sensors to quantify the balance and mobility of older adults using three physical assessments (timed up and go (TUG), five times sit to stand (FTSS) and quiet standing balance). This study examines the utility of each individual assessment, and the novel combination of assessments, to screen for frailty and falls risk in older adults. Data were acquired from inertial and pressure sensors during TUG, FTSS and balance assessments using a touchscreen mobile device, from 124 community dwelling older adults (mean age 75.9 ± 6.6 years, 91 female). Participants were given a comprehensive geriatric assessment which included questions on falls and frailty. Methods based on support vector machines (SVM) were developed using sensor-derived features from each physical assessment to classify patients at risk of falls risk and frailty. In classifying falls history, combining sensor data from the TUG, Balance and FTSS tests to a single classifier model per gender yielded mean cross-validated classification accuracy of 87.58% (95% CI: 84.47-91.03%) for the male model and 78.11% (95% CI: 75.38-81.10%) for the female model. These results compared well or exceeded those for classifier models for each test taken individually. Similarly, when classifying frailty status, combining sensor data from the TUG, balance and FTSS tests to a single classifier model per gender, yielded mean cross-validated classification accuracy of 93.94% (95% CI: 91.16-96.51%) for the male model and 84.14% (95% CI: 82.11-86.33%) for the female model (mean 89.04%) which compared well or exceeded results for physical tests taken individually. Results suggest that the combination of these three tests, quantified using body-worn inertial sensors, could lead to improved methods for assessing frailty and falls risk.
Mandatory fortification of staple grains with folic acid and/or vitamin B12 (B12) is under debate in many countries including Ireland, which has a liberal, but voluntary, fortification policy. Older ...adults can be at risk of both deficiency and high folate status, although little is known on the actual prevalence and the major predictors. Population prevalence estimates from older adults (n 5290 ≥50 years) from the Irish Longitudinal Study on Ageing (TILDA) (Wave 1) are presented here. Measures included plasma total vitamin B12 and folate, whereas predictors included detailed demographic, socio-economic, geographic, seasonal and health/lifestyle data. The prevalence of deficient or low B12 status (<185 pmol/l) was 12 %, whereas the prevalence of deficient/low folate status was 15 %. High folate status (>45 nmol/l) was observed in 8·9 %, whereas high B12 status was observed in 3·1 % (>601 pmol/l). The largest positive predictor of B12 concentration was self-reported B12 injection and/or supplement use (coefficient 51·5 pmol/; 95 % CI 9·4, 93·6; P=0·016) followed by sex and geographic location. The largest negative predictor was metformin use (−33·6; 95 % CI −51·9, −15·4; P<0·0001). The largest positive predictor of folate concentration was folic acid supplement use (6·0; 95 % CI 3·0, 9·0 nmol/l; P<0·001) followed by being female and statin medications. The largest negative predictor was geographic location (−5·7; 95 % CI −6·7, −4·6; P<0·0001) followed by seasonality and smoking. B-vitamin status in older adults is affected by health and lifestyle, medication, sampling period and geographic location. We observed a high prevalence of low B12 and folate status, indicating that the current policy of voluntary fortification is ineffective for older adults.
This was a longitudinal study utilising the Irish Longitudinal Study on Ageing (n 3849 aged ≥ 50 years) and investigated the relationship between blood plasma folate and B
levels at baseline (wave 1) ...and incident depressive symptoms at 2 and 4 years (waves 2 and 3). A score ≥ 9 on the Center for Epidemiological Studies Depression Scale-8 at wave 2 or 3 was indicative of incident depressive symptoms. B
status profiles (pmol/l) were defined as < 185, deficient low; 185 to < 258, low normal; > 258-601, normal and > 601 high. Folate status profiles (nmol/l) were defined as ≤ 10·0, deficient low; > 10-23·0, low normal; > 23·0-45·0, normal; >45·0, high. Logistic regression models were used to analyse the longitudinal associations. Both B
and folate plasma concentrations were lower in the group with incident depressive symptoms v. non-depressed (folate: 21·4 v. 25·1 nmol/l; P = 0·0003; B
:315·7 v. 335·9 pmol/l; P = 0·0148). Regression models demonstrated that participants with deficient-low B
status at baseline had a significantly higher likelihood of incident depression 4 years later (OR 1·51, 95 % CI 1·01, 2·27, P = 0·043). This finding remained robust after controlling for relevant covariates. No associations of folate status with incident depression were observed. Older adults with deficient-low B
status had a 51 % increased likelihood of developing depressive symptoms over 4 years. The findings highlight the need to further explore the low-cost benefits of optimising vitamin B
status for depression in older adults.
This was a longitudinal study utilising the Irish Longitudinal Study on Ageing (n 3849 aged ≥ 50 years) and investigated the relationship between blood plasma folate and B12 levels at baseline (wave ...1) and incident depressive symptoms at 2 and 4 years (waves 2 and 3). A score ≥ 9 on the Center for Epidemiological Studies Depression Scale-8 at wave 2 or 3 was indicative of incident depressive symptoms. B12 status profiles (pmol/l) were defined as < 185, deficient low; 185 to < 258, low normal; > 258–601, normal and > 601 high. Folate status profiles (nmol/l) were defined as ≤ 10·0, deficient low; > 10–23·0, low normal; > 23·0–45·0, normal; >45·0, high. Logistic regression models were used to analyse the longitudinal associations. Both B12 and folate plasma concentrations were lower in the group with incident depressive symptoms v. non-depressed (folate: 21·4 v. 25·1 nmol/l; P = 0·0003; B12:315·7 v. 335·9 pmol/l; P = 0·0148). Regression models demonstrated that participants with deficient-low B12 status at baseline had a significantly higher likelihood of incident depression 4 years later (OR 1·51, 95 % CI 1·01, 2·27, P = 0·043). This finding remained robust after controlling for relevant covariates. No associations of folate status with incident depression were observed. Older adults with deficient-low B12 status had a 51 % increased likelihood of developing depressive symptoms over 4 years. The findings highlight the need to further explore the low-cost benefits of optimising vitamin B12 status for depression in older adults.
Geographical variations in cognitive health have been extensively explored, but the evidence on adult individuals with disabilities is inconclusive. While urban living is suggested as more ...cognitively stimulating than rural dwelling in epidemiological research, both rurality and urbanity can present barriers that may negatively impact cognitive health, the former due to limited accessibility to stimulation, and the latter because presenting environmental stressors.
To bridge this gap in the literature, we investigated geographical variations in multiple cognitive skills in adult age based on neighbourhood urbanity and having disabilities.
Data on global cognition, memory, speed of processing and executive functions, as well as reported functional limitations, was taken from 4127 individuals aged 50 + participating in the first wave of The Irish Longitudinal Study on Ageing (TILDA). Neighbourhood urbanity was measured using Census data on population density. Multivariate regression analyses controlled for socio-demographic, health and lifestyle covariates.
Residence in medium-high densely populated areas was significantly associated with better cognitive performance across all measures, after controlling for covariates. However, having disabilities was linked to worse global cognitive functioning (MoCA, p = .005), immediate recall (p = .022) and executive functions (CTT2, p = .009) in the least and most densely populated areas.
Living in urbanised areas may provide more mental stimulation than rural places; however, functional limitations moderate this association, suggesting potential environmental challenges both in rural and urban areas. Considering both individual and environmental circumstances can enrich investigations of geographical variations in cognitive health.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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