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The purpose of this study was to conduct a cross-sectional analysis of the association between hearing aid use and cognitive decline in community-dwelling older adults with hearing impairment, stratified by cardiovascular risk level. This cross-sectional study covers 1857 hearing-impaired individuals selected among 10,674 community-dwelling older adults (≥65 years of age) in Japan. We investigate the association between hearing aid use and cognitive decline stratified by cardiovascular risk level, by assessing self-reported hearing impairment and hearing aid use, absolute cardiovascular risk, cognitive function, and potential confounding factors. The association between hearing impairment severity and increased cardiovascular risk, and the benefit of hearing aid use in preventing cognitive decline, were examined in a binomial logistic regression analysis, with the presence of cognitive decline as the objective variable. In the low cardiovascular risk group, hearing aid users had a lower odds ratio for decline in executive function than non-users (odds ratio = 0.61, 95% confidence interval: 0.39–0.98). However, there was no significant association between hearing aid use and cognitive decline in the high cardiovascular risk group (p > 0.05). Among older adults with hearing impairment, hearing aid use was associated with the maintenance of executive function in individuals of low cardiovascular risk. [ABSTRACT FROM AUTHOR]

We studied frailty and subjective cognitive decline (SCD) trajectories in older Japanese adults and evaluated the influence of various factors on these trajectories. We analyzed data from 1157 non-demented adults aged 70 and above from 2013 to 2019. Frailty was assessed using the self-administered Kihon Checklist (KCL), a Japanese frailty index. SCD was evaluated using the questionnaire of the Subjective Memory Complaints scale. Through group-based joint trajectory models, we discerned three frailty trajectories: non-progressive (n = 775), moderate progressive (n = 312), and rapid progressive (n = 70); and three SCD trajectories: non-progressive (n = 302), moderate progressive (n = 625), and rapid progressive (n = 230). Individuals in the rapid progressive SCD trajectory had a 32.2% probability of also being in the rapid progressive frailty trajectory. In contrast, those in the non-progressive SCD trajectory had zero probability of being in the rapid progressive frailty trajectory. Both the rapid progressive frailty and SCD groups combined had a higher incidence of depressive symptoms and slow gait speed. Our results have found that frailty and SCD share a similar trajectory in Japanese older adults. Additionally, rapid progressive frailty and SCD were associated with the highest risk of depressive symptoms and slow gait speed. Thus, interventions targeting both frailty and cognitive decline should prioritize mental health enhancement and gait speed improvement. [ABSTRACT FROM AUTHOR]

Subjective cognitive decline (SCD) in older adults has been identified as a risk factor for dementia. However, the literature is inconsistent, and the underlying mechanisms are not well understood. We aimed to determine whether older adults with SCD had more modifiable protective factors against the risk of dementia and a lower risk of developing objective cognitive decline (OCD). We included 4363 older adults (71.7 ± 5.3 [mean ± standard deviation] years of age; 2239 women) from the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes. SCD, OCD, and protective factors against dementia, such as lifestyle and activity, were assessed using interviews and objective cognitive-assessment tools. Based on initial cognitive status, participants were categorized into normal cognition, SCD-only, OCD-only, and both SCD and OCD groups. After 4 years, participants were classified as having either no impairment or mild or global cognitive impairment (i.e., OCD). Binomial logistic regression analyses were performed with the cognitive statuses of the groups at follow-up and baseline as the dependent and independent variables, respectively. After adjusting for potential confounding factors, we found that the SCD-only group had more modifiable protective factors against the risk of dementia than the OCD-only group. Community-dwelling older adults with normal cognition or those part of the SCD-only group had a lower risk of developing OCD during the 4-year follow-up, which may have been due to having more modifiable protective factors against the risk of dementia. Additionally, these factors may contribute to the inconsistencies in the literature on SCD outcomes. [ABSTRACT FROM AUTHOR]

The present study developed a simplified decision-tree algorithm for fall prediction with easily measurable predictors using data from a longitudinal cohort study: 2520 community-dwelling older adults aged 65 years or older participated. Fall history, age, sex, fear of falling, prescribed medication, knee osteoarthritis, lower limb pain, gait speed, and timed up and go test were assessed in the baseline survey as fall predictors. Moreover, recent falls were assessed in the follow-up survey. We created a fall-prediction algorithm using decision-tree analysis (C5.0) that included 14 nodes with six predictors, and the model could stratify the probabilities of fall incidence ranging from 30.4% to 71.9%. Additionally, the decision-tree model outperformed a logistic regression model with respect to the area under the curve (0.70 vs. 0.64), accuracy (0.65 vs. 0.62), sensitivity (0.62 vs. 0.50), positive predictive value (0.66 vs. 0.65), and negative predictive value (0.64 vs. 0.59). Our decision-tree model consists of common and easily measurable fall predictors, and its white-box algorithm can explain the reasons for risk stratification; therefore, it can be implemented in clinical practices. Our findings provide useful information for the early screening of fall risk and the promotion of timely strategies for fall prevention in community and clinical settings. [ABSTRACT FROM AUTHOR]

Identifying the relationship between physical and social activity and disability among community-dwelling older adults may provide important information for implementing tailored interventions to prevent disability progression. The aim of this study was to determine the effect of the number of social activities on the relationship between walking habits and disability incidence in older adults. We included 2873 older adults (mean age, 73.1 years; SD, ±5.9 years) from the National Center for Geriatrics and Gerontology—Study of Geriatric Syndromes. Baseline measurements, including frequencies of physical and social activities, health conditions, physical function, cognitive function, metabolic parameters, and other potential disability risk factors (for example, the number of years of education); monthly assessment for disability was monitored through long-term care insurance certification for at least 2 years from baseline. During a mean follow-up of 35.1 months (SD, 6.4 months), 133 participants developed disability. The disability incidence was 19.0 and 27.9 per 1000 person-years for participants who walked more (≥3 times per week) and less (≤3 times per week) frequently, respectively. The potential confounding factor-adjusted disability hazard ratio was 0.67 (95% confidence interval, 0.46 to 0.96; p = 0.030). The relationship between habitual walking and the number of social activities was statistically significant (p = 0.004). The reduction of disability risk by walking was greater among participants with fewer social activities. Habitual walking was associated with disability incidence, with a more pronounced effect among older adults who were less likely to engage in social activities. [ABSTRACT FROM AUTHOR]

Many of the modifiable risk factors for dementia are lifestyle-related, and multidomain interventions tailored to individual lifestyles are recommended to prevent cognitive decline and dementia. However, studies of the relationship between the environment and cognitive function have shown that cognitive disorders and dementia are more prevalent in rural areas than in urban areas. The purpose of this study was to clarify the role of lifestyle activities on the association between neighborhood amenities and cognitive function. Our data were measured between August 2011 and February 2012. Participants comprised 3786 older adults (mean age: 71.5 years, standard deviation (SD) = ±5.2). We categorized neighborhood amenities as institutional resources that promote cognitively beneficial activities such as physical activity. We calculated the Walk Score® for all participants using their home address and divided them into three groups. We assessed their 12 lifestyle activities performed outdoors. Cognitive function was measured via Mini-Mental Status Exam, word list memory, attention, executive function, and processing speed. We found that participants who were more likely to report many lifestyle activities were more likely to have normal cognition, even in areas where neighborhood amenities were scarce. The clinical significance of this study is that increased lifestyle activity contributes to the prevention of cognitive decline. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the association between lifestyle activities, including physical, cognitive, and social activities, and Alzheimer's disease (AD) signature cortical thickness, as well as to examine the mediating role of AD signature cortical thickness in lifestyle activities and cognitive function in community-dwelling healthy older adults. Participants were 1026 older adults who met the study inclusion criteria. The physical, cognitive, and social activities of daily life were assessed using a self-reporting questionnaire. AD signature cortical thickness was determined using FreeSurfer software. Cognitive function was evaluated using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Path analysis (based on structural equation modeling (SEM)) of cognitive activities indicated that the direct path from cognitive activities to cognitive function was significant (p < 0.001), as was the direct path from AD signature cortical thickness to cognitive function (p < 0.001). Physical (p < 0.05) or social activities (p < 0.05) had a direct effect on cognitive function. However, AD signature cortical thickness did not mediate the relationship between physical or social activities and cognitive function. Our findings suggest that higher levels of cognitive activities later in life have a significant and positive direct effect on cognitive function. Additionally, AD signature cortical thickness significantly mediates the relationship between cognitive activities and cognitive function. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine cortical thickness changes associated with a multicomponent exercise intervention combining physical exercise and cognitive training in older adults with cognitive decline. This study involved a secondary analysis of neuroimaging data from a randomized controlled trial with 280 older adults having cognitive decline who were randomly assigned to either a multicomponent exercise group (n = 140) that attended weekly 90-minute exercise and cognitive training sessions or a health education control group (n = 140). The cortical thickness and cognitive performance were assessed at the baseline and at trial completion (10 months). The cortical thickness in the frontal and temporal regions was determined using FreeSurfer software. Cognitive performance was evaluated using the Gerontology-Functional Assessment Tool (NCGG-FAT). The cortical thickness significantly increased in the middle temporal (p < 0.001) and temporal pole (p < 0.001) in the multicomponent exercise group compared with the control group. Cortical thickness changes were significantly associated with change in trail making test (TMT)-A, TMT-B, and story memory after a 10-month multicomponent exercise intervention. This study suggests that multicomponent exercise programs combining physical exercise and cognitive training have important implications for brain health, especially in providing protection from age-related cortical thinning. [ABSTRACT FROM AUTHOR]

This study clarified the patterns of possessing modifiable risk factors of dementia that can be corrected by the elderly who were primarily determined to have mild cognitive impairment (MCI), and then determined the relationship between retention patterns and outcomes from MCI through a 4-year follow-up study. The participants were 789 community-dwelling elders who were ≥65 years old with MCI at baseline. After 4 years, participants were classified into reverters and nonreverters, according to their cognitive function. Repeated measures analysis was performed after imputing missing values due to dropout. Nine modifiable risk factors at baseline were classified by latent class analysis. Subsequently, we performed binomial logistic regression analysis. The reversion rate of 789 participants was 30.9%. The possession patterns of modifiable risk factors among the elderly with MCI were classified into five patterns: low risk, psychosocial, health behavior, educational, and smoking factors. According to logistic regression analysis, the low risk factors class was more likely to recover from MCI to normal cognitive than the other classes (p < 0.05). These results may provide useful information for designing interventions to prevent cognitive decline and dementia in individuals with MCI. [ABSTRACT FROM AUTHOR]

Depressive symptoms and memory problems are risk factors for dementia. Exercise can reduce these in older people, and horticultural activity can benefit people with dementia. This study assessed the efficacy of exercise and horticultural interventions for community-dwelling older adults with depressive symptoms and mild memory decline. In this randomized controlled trial, older adults (n = 89) were assigned to exercise, horticultural, or control groups. Exercise and horticultural programs included 20 weekly 90-min sessions. The control group attended two 90-min classes. Outcomes were assessed at baseline, and then 6- and 12-months post-intervention. Primary outcome measures were the Geriatric Depression Scale-15 (GDS-15) and Wechsler Memory Scale-Revised. Walking speed, two-minute walking test scores, social network, life space, and subjective daily physical activity were secondary outcome measures. Compared with the control group, the exercise group obtained higher immediate and delayed recall logical memory scores, and the increase in immediate recall scores remained 12-months post-intervention. Two-minute walking performance improved in the exercise group, but not after 12 months. GDS-15 scores showed no significant improvements. The horticultural and control groups showed no differences. Exercise may improve memory, while horticultural activity may not. The effects of exercise and horticultural interventions on depressive symptoms remain unclear. [ABSTRACT FROM AUTHOR]

Social frailty domains may play an important role in preventing physical decline and disability. The aim of this study is to examine the impact of social frailty as a risk factor for the future development of physical frailty among community-dwelling older adults who are not yet physically frail. A total of 1226 physically non-frail older adults were analyzed to provide a baseline. Participants completed a longitudinal assessment of their physical frailty 48 months later. Their baseline social frailty was determined based on their responses to five questions, which identified participants who went out less frequently, rarely visited friends, felt less like helping friends or family, lived alone and did not talk to another person every day. Participants with none of these characteristics were considered not to be socially frail; those with one characteristic were considered socially pre-frail; and those with two or more characteristics were considered socially frail. At the four-year follow-up assessment, 24 participants (2.0%) had developed physical frailty and 440 (35.9%) had developed physical pre-frailty. The rates of developing physical frailty and pre-frailty were 1.6% and 34.2%, respectively, in the socially non-frail group; 2.4% and 38.8%, respectively, in the socially pre-frail group; and 6.8% and 54.5%, respectively, in the socially frail group. Participants classified as socially frail at the baseline had an increased risk of developing physical frailty, compared with participants who were not socially frail (OR = 3.93, 95% CI = 1.02-15.15). Participants who were socially frail at the baseline also had an increased risk of developing physical pre-frailty (OR = 2.50, 95% CI = 1.30-4.80). Among independent community-dwelling older adults who are not physically frail, those who are socially frail may be at greater risk of developing physical frailty in the near future. Social frailty may precede (and lead to the development of) physical frailty., Competing Interests: The authors declare no conflicts of interest.