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Serotonergic modulation of vertical gaze control (interstitial nucleus of Cajal, INC) is less understood than that of horizontal gaze control (prepositus hypoglossal nucleus, PHN). Here, we report 5-HT-induced fast inward currents in addition to the previously reported slow inward and outward currents. The distributions of these currents in INC neurons based on neurotransmitter phenotypes differ from those in PHN neurons. These results suggest distinct serotonergic modulation modes in horizontal and vertical gaze control centers.

Ischemic postconditioning (PostC) phenomenon is known as the neuroprotection against ischemic reperfusion (I/R) injury. One of the key processes in PostC is opening of mitochondrial ATP dependent potassium (mito-KATP) channel and depolarization of mitochondrial membrane potential, which triggers the release of calcium ion from mitochondria through the low conductance opening of mitochondrial permeability transition pore (mPTP). Mitochondrial calcium uniporter (MCU) is known as the highly sensitive transporter for uptake of Ca2+ inwardly existed on the inner mitochondrial membrane. Furthermore, it has attracted attention as a new target of treatments in disease such as neurodegenerative disease, cancer, and ischemic stroke. Thus, we considered that MCU may involve in PostC and trigger its mechanism. In this research, we used the whole-cell patch clamp technique to hippocampal CA1 pyramidal cells from C57BL mice and measured changes in spontaneous excitatory post-synaptic currents (sEPSCs), intracellular Ca2+ concentration, mitochondrial membrane potential and N-methyl-D-aspartate receptor (NMDAR) currents under the inhibition of MCU by Ruthenium red 265 (Ru265) in PostC. Inhibition of MCU increased sEPSCs occurrence (p = 0.008), NMDAR currents (p 2+ concentration (p 2+ concentration against I/R injury.

This study compared patterns of association between social relationship measures and levels of loneliness for rural and urban older adults in the Philippines. We analyzed social relationship measures and loneliness scores (UCLA Three-Item Loneliness Scale) of a nationally representative sample of Filipino adults 60 years and older in the baseline survey of the 2018 Longitudinal Study of Ageing and Health in the Philippines (LSAHP) (n=4,704). The loneliness score was slightly higher for rural older adults (5.8) than for their urban counterparts (5.1; p=.0001). A significantly larger proportion of older adults in rural areas (12.7%) lived alone than in urban areas (5.4%; p=.0008). The overall pattern of association between social relationship measures and loneliness scores for the two groups was mostly similar. For both groups, living alone, having less active social involvement, and seeing friends less frequently were related to higher levels of loneliness. Poorer subjective financial well-being (e.g., the perception of considerable difficulty in making ends meet) was also significantly associated with higher loneliness scores. These findings suggest that the prevention of loneliness for older adults in countries in the early stages of population aging such as the Philippines requires a broad range of public health initiatives.

This study contributes to previous initiatives examining healthy and active aging in the Philippines.We employed the Sullivan method to calculate healthy life expectancy (HLE) and active life expectancy (ALE) using the 2007 Philippine Survey on Aging and the 2018 Longitudinal Study of Ageing and Health. We compared the estimates at two time points, providing evidence of change over time.There was no statistically significant change in the relative proportion of HLE over time for both sexes, suggesting dynamic equilibrium. For men, the increase in life expectancy was mainly an increase in unhealthy state (UHLE). The slight increases in HLE for all ages were not statistically significant. The differences in relative increase in HLE were not statistically significant. HLE for women increased over time, with statistically significant increases at ages 60 and 70 years. ALE declined in all age groups for both sexes, but the decline was statistically significant only among women in their 60s and 70s. There was also a statistically significant decline in the proportion of remaining life in an active state for all ages among both men and women, suggesting an expansion of morbidity.Findings suggest no evidence of compression of morbidity in the Philippines from 2007 to 2018. The HLE results suggest a dynamic equilibrium, while ALE results indicate an expansion of morbidity. The findings emphasize the need for the government to promote life course interventions that foster healthy choices and conduct further research to understand the factors influencing longevity and active aging in the Philippines. Geriatr Gerontol Int 2022; 22: 511-515.

Background: Although there is evidence of improvements in health expectancy among the Japanese population, existing estimates are based on the prevalence of morbidity taken from cross-sectional survey data. Objectives: This study employed a multistate life table approach to compute incidence-based health expectancy measures, namely active and inactive life expectancy (LE), for two longitudinal survey cohorts from 1990 to 2009. Methods: This study used data from two longitudinal surveys of older adults in Japan: the National Survey of the Japanese Elderly (1990–1999) and the Nihon University Japanese Longitudinal Study of Aging (1999–2009). We employed the Interpolation of Markov Chains technique to compute the number of years at age 65 years to be spent with and without difficulty in performing activities of daily living (ADLs) or instrumental ADLs. Results: We documented significant increases in active LE for men and women at age 65 years over the 10-year study period. There were significant changes in total LE for men and in the percentage of active life for women. Inactive LE did not significantly change across the two survey cohorts during the study period. Conclusions: Our results show that the health status of older adults in Japan has largely improved over the 10-year study period, with increases in both the duration of life and time spent in an active state. This finding offers evidence of compression of morbidity among older men and women in Japan.

The nucleus accumbens (NAc) receives cortical projections principally from the insular cortex (IC) and medial prefrontal cortex (mPFC). Among NAc neurons, cholinergic interneurons (ChNs) regulate the activities of medium spiny neurons (MSNs), which make up ~ 95% of NAc neurons, by modulating their firing and synaptic properties. However, little is known about the synaptic mechanisms, including their cell-type-dependent corticoaccumbal projection properties and cholinergic effects on the NAc core. Here, we performed whole-cell patch-clamp recordings from NAc MSNs and ChNs in acute brain slice preparations obtained from rats that received an AAV5-hSyn-ChR2(H134R)-mCherry injection into the IC or mPFC. Light stimulation of IC or mPFC axons induced comparable phase-locked excitatory postsynaptic currents (EPSCs) in MSNs. On the other hand, ChNs showed consistent EPSCs evoked by light stimulation of mPFC axons, whereas light stimulation of IC axons evoked much smaller EPSCs, which often showed failure in ChNs. Light-evoked EPSCs were abolished by tetrodotoxin and were recovered by 4-aminopyridine, suggesting that corticoaccumbal projections monosynaptically induce EPSCs in MSNs and ChNs. Carbachol effectively suppressed the amplitude of EPSCs in MSNs and ChNs evoked by light stimulation of IC or mPFC axons and in ChNs evoked by stimulating mPFC axons. The carbachol-induced suppression was recovered by atropine or pirenzepine, while preapplication of gallamine, J104129, PD102807, or AF-DX384 did not block the carbachol-induced EPSC suppression. These results suggest that NAc MSNs and ChNs are differentially regulated by excitatory projections from the IC and mPFC and that these corticoaccumbal excitatory inputs are modulated by M1 receptor activation.

Background and ObjectivesExisting research has suggested that older adults in Japan enjoy phenomenal physical health status, but they have poor subjective well-being (SWB). Limited empirical evidence exists, however, on how physical health and SWB intersect and are linked to the lives of older men and women in Japan. Using the concept of health expectancy, this study examines the role of SWB, as measured by life satisfaction, in the mortality and morbidity experiences of Japanese adults aged 65 years and older.Research Design and MethodsWe used the nationally representative Nihon University Japanese Longitudinal Study of Aging, 1999–2009. Our measurement of morbidity is disability, based on difficulty in activities in daily living (ADLs) and instrumental ADLs. We use the Interpolation of Markov Chains approach to compute life expectancy (LE), LE without disability (active LE), and LE with differing severity of disability for those who are satisfied with life and for those who are not.ResultsWe documented significant differences in LE and active LE by the state of life satisfaction among older adults in Japan. Men and women who are satisfied with life are expected to live longer and spend more years without having disability compared to those who are not satisfied. We found no differences in the length of life with disability of differing severity by the state of life satisfaction.Discussion and ImplicationsOur results highlight the important role of SWB at older ages in Japan, because it is directly related to the physical health of its aging population. Fully understanding the health of the older population requires research that focuses on both objective and subjective dimensions of well-being.

Acetylcholine plays a pivotal role in the regulation of functions such as pain and the sleep and wake cycle by modulating neural activities of the ventrolateral periaqueductal gray (vlPAG). Electrophysiological studies have shown that cholinergic effects are inconsistent among recorded neurons, particularly in the depolarization and hyperpolarization of the resting membrane potential (RMP). This discrepancy may be due to the neural subtype-dependent cholinergic modulation of the RMP. To examine this possibility, we performed whole-cell patch-clamp recordings from subtype-identified neurons using vesicular GABA transporter (VGAT)-Venus × ChAT-TdTomato rats and elucidated cellular mechanisms of cholinergic effects on the RMP. The application of carbachol hyperpolarized the RMP of cholinergic neurons in a dose-dependent manner but had much less of an effect on other neural subtypes, including GABAergic/glycinergic and glutamatergic neurons. Cholinergic hyperpolarization was accompanied by a decrease in input resistance. These cholinergic effects were blocked by AF-DX384 or gallamine and were mimicked by arecaidine but-2-ynyl ester tosylate, suggesting that the carbachol-induced hyperpolarization of the RMP in cholinergic neurons is mediated via M

Research on religiosity and health has generally focussed on the United States, and outcomes of health or mortality but not both. Using the European Values Survey 2008, we examined cross-sectional associations between four dimensions of religiosity/spirituality: attendance, private prayer, importance of religion, belief in God; and healthy life expectancy (HLE) based on self-reported health across 47 European countries (n = 65,303 individuals). Greater levels of private prayer, importance of religion and belief in God, at a country level, were associated with lower HLE at age 20, after adjustment for confounders, but only in women. The findings may explain HLE inequalities between European countries.

Background The population health impact of loneliness remains unknown. We quantified the impact of loneliness on total life expectancy (TLE) and health expectancy (the duration of remaining life lived in different health states) among older adults, aged ≥60 years. Design Multistate life table analysis of a nationally representative longitudinal survey. Setting Singapore. Participants Survey participants (n = 3449) interviewed in 2009, 2011-12, and 2015. Measurements Health states were defined using self-rated health (SRH) status and activity of daily living (ADL)/instrumental ADL (IADL) status. Participants with somewhat or very unhealthy SRH were considered as unhealthy. Those reporting health-related difficulty with any ADL/IADL were considered to have limitation in ADLs/IADLs. TLE and health expectancy (healthy and unhealthy life expectancy (HLE and UHLE) in the context of SRH, and active and inactive life expectancy (ALE and IALE) in the context of ADLs/IADLs) were estimated using the multistate life table method with a microsimulation approach, considering loneliness as time varying. Results At age 60, 70, and 80, those sometimes lonely or mostly lonely generally had shorter TLE, HLE and ALE, similar UHLE and IALE, and a higher proportion of remaining life with unhealthy SRH or with ADL/IADL limitations versus those never lonely. For example, at the age of 60, those sometimes lonely versus never lonely had shorter TLE (by 5.4 [95% Confidence Interval: 3.4-7.9] years), shorter HLE (by 5.9 [4.1-8.6] years), similar UHLE (difference: 0.6 [-0.7-1.7] years), and higher proportion of remaining life with unhealthy SRH (by 6.2 [1.2-10.8] percentage points). For those mostly lonely versus never lonely, TLE was shorter by 3.6 (0.7-6.6) years, HLE was shorter by 4.8 (2.3-8.2) years, UHLE was similar (difference: 1.2 [-0.1-4.0] years), and proportion of remaining life with unhealthy SRH was higher by 7.2 (2.1-18.1) percentage points. Conclusion Identification and management of loneliness may increase years of life with healthy SRH and without limitation in ADLs/IADLs among older adults.

Living arrangements of older adults have often been studied as a measure of the support available to them. Given the rapidly ageing and low fertility context of Singapore where the prevalence of older adults living alone and without children is expected to increase, we construct multistate life tables to estimate the number of years that older persons can expect to live in different living arrangements at a population level (population-based) as well as based on their initial living arrangement (status-based). We focus particularly on whether there are gender differences in the expected years of life in different living arrangement states. We use the Panel on Health and Ageing of Singaporean Elderly, a 2009 nationally representative survey of 4990 Singaporeans aged 60 years and older, with follow-up surveys in 2011 and 2015. In calculating the probabilities of transition between different states, we control for number of children, housing type, and time-varying ADL limitations. We find that at age 60, women can expect to spend more than twice the proportion (18%) of their remaining lives living alone compared to men (7%). Status-based estimates indicate that the proportion of remaining years living with a child is higher for women initially living alone, with a spouse only or already with a child, compared to males. Our results indicate that while older women are more likely to live alone compared to their male counterparts, older women living alone are also more likely to transition to living with children. Our research sheds light on the importance of expanding research on life expectancy beyond health, to consider analysis using other forms of social stratification, particularly gender differences in states of living arrangement. SUPPLEMENTARY INFORMATION: The online version of this article contains supplementary material available at 10.1007/s10433-020-00594-3.

Objectives: Later-life re-partnership has been linked to healthy aging, but little is known about Philippine older adults’ perception of love and remarriage in older age. Methods: Using two nationally representative surveys on aging in the Philippines, we estimated the proportion of older adults reporting acceptance. Using weighted logistic regression, we assessed sociodemographic and health factors associated with acceptance as well as the relationship of this acceptance with social activity and health behaviors. Results: Only seventeen percent of respondents reported acceptance. Per multivariable analyses, unmarried men and married women reported acceptance, and acceptance was associated with increased social activity and smoking in men, less smoking in women, and more drinking in both genders. Discussion: Most older adults in the Philippines reported love and remarriage in old age as unacceptable. Through these results, we can understand how attitudes toward later-life relationship impact older adults’ health and well-being.

Ischemic postconditioning (PostC) is known to reduce cerebral ischemia/reperfusion (I/R) injury; however, whether the opening of mitochondrial ATP-dependent potassium (mito-KATP) channels and mitochondrial permeability transition pore (mPTP) cause the depolarization of the mitochondrial membrane that remains unknown. We examined the involvement of the mito-KATP channel and the mPTP in the PostC mechanism. Ischemic PostC consisted of three cycles of 15 s reperfusion and 15 s re-ischemia, and was started 30 s after the 7.5 min ischemic load. We recorded N-methyl-d-aspartate receptors (NMDAR)-mediated currents and measured cytosolic Ca2+ concentrations, and mitochondrial membrane potentials in mouse hippocampal pyramidal neurons. Both ischemic PostC and the application of a mito-KATP channel opener, diazoxide, reduced NMDAR-mediated currents, and suppressed cytosolic Ca2+ elevations during the early reperfusion period. An mPTP blocker, cyclosporine A, abolished the reducing effect of PostC on NMDAR currents. Furthermore, both ischemic PostC and the application of diazoxide potentiated the depolarization of the mitochondrial membrane potential. These results indicate that ischemic PostC suppresses Ca2+ influx into the cytoplasm by reducing NMDAR-mediated currents through mPTP opening. The present study suggests that depolarization of the mitochondrial membrane potential by opening of the mito-KATP channel is essential to the mechanism of PostC in neuroprotection against anoxic injury.

Cerebellar functions are modulated by cholinergic inputs, the density of which varies among cerebellar regions. Although the prepositus hypoglossi nucleus (PHN), a brainstem structure involved in controlling gaze holding, is known as one of the major sources of these cholinergic inputs, the proportions of cholinergic neurons in PHN projections to distinct cerebellar regions have not been quantitatively analyzed. In this study, we identified PHN neurons projecting to the cerebellum by applying retrograde labeling with dextran-conjugated Alexa 488 in choline acetyltransferase (ChAT)-tdTomato transgenic rats and compared the proportion of cholinergic PHN neurons in the PHN projections to four different regions of the cerebellum, namely the flocculus (FL), the uvula and nodulus (UN), lobules III-V in the vermis (VM), and the hemispheric paramedian lobule and crus 2 (PC). In the PHN, the percentage of cholinergic PHN neurons was lower in the projection to the FL than in the projection to the UN, VM or PC. Preposito-cerebellar neurons, except for preposito-FL neurons, included different proportions of cholinergic neurons at different rostrocaudal positions in the PHN. These results suggest that cholinergic PHN neurons project to not only the vestibulocerebellum but also the anterior vermis and posterior hemisphere and that the proportion of cholinergic neurons among projection neurons from the PHN differs depending on cerebellar target areas and the rostro-caudal regions of the PHN. This study provides insights regarding the involvement of cerebellar cholinergic networks in gaze holding.

This study investigated gender differences in the association between older adults’ social relationships and their self-reported feelings of loneliness in Singapore. Using the 2009 Social Isolation, Health, and Lifestyles Survey, we analysed the data of a nationally representative sample of community-dwelling older adults in Singapore aged 60 years and older (n = 4316). Older men and women who either lived alone or lived with only a child were more likely to report higher levels of loneliness compared to those who lived with only a spouse. Older men who lived with someone other than a spouse or a child tended to report higher levels of loneliness. Older women who had relatively strong social networks with relatives and friends outside the household generally reported higher levels of loneliness. The gender difference found in this study suggests that interventions to mitigate older adults’ loneliness need to address the sociocultural and demographic conditions that are unique to older men and women in Singapore.

Mitochondrial membrane potential regulation through the mitochondrial permeability transition pore (mPTP) is reportedly involved in the ischemic postconditioning (PostC) phenomenon. Melatonin is an endogenous hormone that regulates circadian rhythms. Its neuroprotective effects via mitochondrial melatonin receptors (MTs) have recently attracted attention. However, details of the neuroprotective mechanisms associated with PostC have not been clarified. Using hippocampal CA1 pyramidal cells from C57BL mice, we studied the involvement of MTs and the mPTP in melatonin-induced PostC mechanisms similar to those of ischemic PostC. We measured changes in spontaneous excitatory postsynaptic currents (sEPSCs), intracellular calcium concentration, mitochondrial membrane potential, and N-methyl-D-aspartate receptor (NMDAR) currents after ischemic challenge, using the whole-cell patch-clamp technique. Melatonin significantly suppressed increases in sEPSCs and intracellular calcium concentrations. The NMDAR currents were significantly suppressed by melatonin and the MT agonist, ramelteon. However, this suppressive effect was abolished by the mPTP inhibitor, cyclosporine A, and the MT antagonist, luzindole. Furthermore, both melatonin and ramelteon potentiated depolarization of mitochondrial membrane potentials, and luzindole suppressed depolarization of mitochondrial membrane potentials. This study suggests that melatonin-induced PostC via MTs suppressed the NMDAR that was induced by partial depolarization of mitochondrial membrane potential by opening the mPTP, reducing excessive release of glutamate and inducing neuroprotection against ischemia-reperfusion injury.

Multimorbidity increases the risks of disability and death and are prevalent among older adults. Evidence shows that sleep might play an important role in multimorbidity. However, previous research studies sleep quality and quantity in isolated manners, where in reality sleep quality and quantity are likely to affect each other. Besides, no study has been done to understand such relationship among older adults in low- and middle- income counties where the prevalence of multimorbidity increases rapidly. This study investigated the relationship between sleep deficiency (i.e., poor and insufficient sleep) and multimorbidity among community-dwelling older adults in the Philippines and Vietnam. Cross-sectional data were obtained from the Longitudinal Study of Ageing and Health in the Philippines (N = 3,562) and the Longitudinal Study of Ageing and Health in Vietnam (N = 3,936). Multimorbidity was defined by having two or more of chronic conditions (i.e., heart disease, heart attack, cardiovascular disease, hypertension, diabetes, lung diseases, renal diseases, liver diseases, and arthritis). Sleep deficiency was conceptualized as self-reported short sleep duration (< 6 hours), having trouble with falling asleep or maintaining sleep, and/or experiencing non-restorative sleep. Logistic regression was used to analyze the data adjusting for demographics, body mass index, sleep medications, naps, mental health, and lifestyle. The results showed that having deficient sleep was significantly related to increased odds of experiencing multimorbidity by about 81% in the Philippines and Vietnam. Our findings revealed that treating sleep deficiency among older adults in the Philippines and Vietnam can potentially reduce the risks of multimorbidity.

Although research has shown that food insecurity may lead to sleep problems due to mental illness, it remains unclear whether physical health also mediates this relationship in addition to poor mental health. We investigated whether frailty and depressive symptoms mediated the association of food insecurity with sleep deficiency (i.e., inadequate and poor sleep) among community-dwelling older adults. We analyzed the baseline data of the Longitudinal Study of Ageing and Health in the Philippines, a study with national representative sample of adults aged 60 years or older (Nf5,187). Sleep deficiency was conceptualized as self-reported sleeping less than 6 hours, complaining about trouble with falling asleep and staying asleep, and/or having non-restorative sleep. Food insecurity was defined as being hungry and not having enough food in the past three months in the household. Frailty was operationalized using modified definitions under Fried’s criteria. Depressive symptoms were assessed using the Center for Epidemiological Studies-Depression Scale. Covariates included socio-demographics (age,sex,education,wealth,insurance,living arrangement,urbanity), health (pain,chronic diseases), and lifestyles (smoking,drinking). Mediation analysis was performed using PROCESS macro. The results from bootstrapping showed that the indirect effects from food insecurity through frailty (b=.024,SE=.009,95%CI=.009-.043) and depressive symptoms (b =.118,SE=.022,95% CI=.078-.166) onto sleep deficiency were significant, but the direct effect from food insecurity to sleep deficiency was not (b=.243,SE=.134,95% CI=-.018-.505). The results suggested that the effects of food insecurity on sleep deficiency were fully mediated through frailty and depressive symptoms among community-dwelling older Filipinos. Preventing frailty and depression may help improve sleep health among individuals being food insecure.

Objectives: This study aimed to identify the prevalence and correlates of depressive symptomatology among Vietnamese older people. Method: We used baseline survey data collected in 2018 from the Longitudinal Study of Ageing and Health in Vietnam (LSAHV) conducted across seven regions and comprising 6,050 people aged 60 years and over of whom 4962 completed the brief 11-item Center for Epidemiological Studies-Depression (CES-D) scale. Clinically significant depressive symptomatology was a CES-D score of 8.8 or higher. The association between demographic, physical, and mental factors with depressive symptomatology was examined using univariate and multivariable logistic regression. Results: The prevalence of depressive symp-tomatology was 31.3% (95% CI 29.8% -32.9%). Depressive symptomatology was highest among people living in the Central Coast region (46.8%, 95% CI 44.5% -49.2%). Factors associated with depressive symptomatology from the multivariable model included female sex (OR 1.3, 95% CI: 1.1-1.6), rural residence (OR 1.4, 95%CI: 1.1-1.7), not having a partner (OR 1.6, 95% CI: 1.3-1.9), low income (OR 1.8, 95% CI: 1.5-2.1), and health-limitations on activities (OR 1.3, 95% CI: 1.1-1.6). Poorer self -rated mental health (OR 2.1, 95% CI:1.8-2.5) or general health status (OR 1.5, 95% CI: 1.3-1.9) was associated with a higher prevalence of depressive symptomatology, as was poorer function with respect to different activities of daily living, and dissatisdaction with current life (OR 6.1, 95% CI: 4.4-8.4). Conclusions: Depressive symptomatology was frequent among older Vietnamese. Efforts to improve mental health in older persons in Vietnam, including prevention, early intervention and better medical care, appear warranted. Refereed/Peer-reviewed

The prepositus hypoglossi nucleus (PHN) and the interstitial nucleus of Cajal (INC) are oculomotor neural integrators involved in the control of horizontal and vertical gaze, respectively. We previously reported that local application of adenosine 5'-trisphosphate (ATP) to PHN neurons induced P2X receptor-mediated fast inward currents, P2Y receptor-mediated slow inward currents, and/or adenosine P1 receptor-mediated slow outward currents. In contrast to the findings on PHN neurons, the expression of functional purinergic receptors in INC neurons has not been examined. In this study, we investigated ATP-induced current responses in INC neurons and the distributions of the three current types across distinct firing patterns in PHN and INC neurons using whole cell recordings of rat brainstem slices. The application of ATP induced all three current types in INC neurons. Pharmacological analyses indicated that the fast inward and slow outward currents were mainly mediated by the P2X and P1 subtypes, respectively, corresponding to the receptor subtypes in PHN neurons. However, agonists of the P2Y subtype did not induce the slow inward current in INC neurons, suggesting that other subtypes or mechanisms are responsible for this current. Analysis of the distribution of the three current types in PHN and INC neurons revealed that the proportions of the currents were distinctly dependent on the firing patterns of PHN neurons whereas the proportion of the fast inward current was higher during all firing patterns of INC neurons. The different distributions of ATP-induced currents suggest distinct modes of purinergic modulation specific to horizontal and vertical integrators.

Aim This study examines how the association between older adults' family relationships and all-cause mortality differs among different household contexts: living alone, living with only a spouse and living with adult children. Methods We carried out a discrete-time event history analysis on all-cause mortality with measures of family relationships for each group of older adults. The study analyzed person-wave data from the Nihon University Japanese Longitudinal Study of Aging, including 11 225 longitudinal episodes between consecutive waves and 555 deaths reported in total. Results The family relationship measures were significantly associated with mortality only for older adults who resided with children. While providing support to children was negatively related to mortality, receiving support from children was positively associated with mortality. Feelings of loneliness were associated with higher mortality for older adults in intergenerational coresidence arrangements, but not for those in other living arrangements. Conclusion The extent of support exchange between older adults and adult children tends to be associated with older adults' mortality only within the household context where parents and children live together. In other types of living arrangements (i.e. living alone and living with only a spouse), the association between family relationship measures and mortality is limited. Geriatr Gerontol Int 2019; ••: ••-••. Geriatr Gerontol Int 2020; 20: 156-160.

Objective To compare cognitive performance among Japanese and American persons, aged 68 years and older, using two nationally representative studies and to examine whether differences can be explained by differences in the distribution of risk factors or in their association with cognitive performance. Design Nationally representative studies with harmonized collection of data on cognitive functioning. Setting Nihon University Japanese Longitudinal Study of Aging and the US Health and Retirement Study. Participants A total of 1953 Japanese adults and 2959 US adults, aged 68 years or older. Measurements Episodic memory and arithmetic working memory are measured using immediate and delayed word recall and serial 7s. Results Americans have higher scores on episodic memory than Japanese people (0.72 points on a 20-point scale); however, when education is controlled, American and Japanese people did not differ. Level of working memory was higher in Japan (0.36 on a 5-point scale) than in the United States, and the effect of education on working memory was stronger among Americans than Japanese people. There are no differences over the age of 85 years. Conclusion Even with large differences in educational attainment and a strong effect of education on cognitive functioning, the overall differences in cognitive functioning between the United States and Japan are modest. Differences in health appear to have little effect on national differences in cognition. J Am Geriatr Soc 68:354-361, 2020.

Objectives Vision and hearing impairment may impact both life expectancy (LE) and health expectancy, that is, duration of life with and without health problems, among older adults. We examined the impact of self-reported vision and hearing impairment on years of life with and without limitation in physical function and in activities of daily living (ADLs). Design Life table analysis, using a nationally representative longitudinal survey of community-dwelling older adults aged 60 years or older, Panel on Health and Ageing of Singaporean Elderly. Setting Singapore. Participants Survey participants (n = 3452) who were interviewed in 2009 and followed up in 2011-2012 and 2015. Measurements Participants reporting difficulty with any of nine tasks involving upper or lower extremities were considered to have a limitation in physical function. Those reporting health-related difficulty with any of six basic ADLs or seven instrumental ADLs were considered to have a limitation in ADLs. We used the multistate life table method with a microsimulation approach to estimate health expectancy, considering self-reported sensory impairment status as time varying. Results Either or both impairments, vs neither, were associated with less years without limitation in physical function and in ADLs and more years with limitation in physical function and in ADLs, with the greatest impact on health expectancy among those with both impairments, who also had the lowest LE. For example, at age 60, those with both impairments, vs neither, could expect not only shorter LE (4.2 [95% confidence interval [CI] = 1.9-5.7] less years; 20.7 [95% CI = 18.9-22.5] vs 24.9 [95% CI = 23.8-26.0]) but also more years of life with limitations in physical function (3.3 [95% CI = .9-5.8] more years; 12.8 [95% CI = 10.7-14.8] [about 61.7% of LE] vs 9.5 [95% CI = 8.4-10.5] [about 38.0% of LE]). Conclusion Timely and appropriate management of vision and hearing impairment, especially when coexisting, among older adults has the potential to reduce the years of life they live with limitation in physical function and in ADLs. J Am Geriatr Soc 67:2528-2536, 2019.

Background The rise in the number and earlier age of onset of obese persons has raised critical concerns about consequences of obesity; however, recent evidence suggests that the impact of obesity on health outcomes may have changed. This study aims to assess the change of the impact of obesity on active life expectancy among Americans aged 70 years and older over almost two decades, 1993–1998 to 2010–2014. Methods For each period, we use three waves of data from the Health and Retirement Study to estimate age-specific transition probabilities between health states. The average number of years active and disabled is calculated with Interpolated Markov Chain software based on estimated transition probabilities. Results Overall obesity and severe obesity increased markedly over time yet active life expectancy expanded for all individuals and the increases are greater among the obese and women. Increases in total and active life expectancy occurred because of the changing association of obesity with disability and mortality. Conclusions Individuals at age 70 years in the later period in each weight group could expect to live a smaller proportion of remaining life with activities of daily living disability than those in the earlier period. High levels of obesity continue to have significant adverse effects on the quality of life. The increasing prevalence of severe obesity and the growing number of older persons may result in substantial additional health care needs and costs. Continued effort to improve cardiovascular health is required to control the burden of obesity in later life in an era of rising obesity.

Objectives: Eight years of panel data are used to investigate the association between three dimensions of religiosity and total and disability-free life expectancy (TLE/DFLE) in Taiwan. Method: Data come from the 1999 “Taiwan Longitudinal Study on Aging” (TLSA; N = 4,440; Age 55+). Dimensions of religiosity are public, private, belief, and coping. Mortality is linked to a national database. Disability is activities of daily living (ADLs). TLE/DFLE estimates use the Stochastic Population Analysis for Complex Events (SPACE) software. Results: Those who engage in public and private religiosity live longer and more years disability-free than others, but proportion of life disability-free does not differ across levels of religiosity. Coping is less associated with TLE and DFLE. Coping however associates with more years disabled among men. Findings are robust to model specifications. Discussion: The way in which religiosity associates with health depends upon the definition. When it does associate, religiosity increases TLE and DFLE proportionately.