BACKGROUND:Cognitive impairment is a significant health concern among older adults, highlighting the need for non-pharmacological interventions, such as mind-body exercises. However, a comprehensive synthesis of the effects of various traditional Chinese exercises (TCEs) on cognitive function in older adults is lacking. METHODS:A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted. Six databases were searched from inception to 2 May 2024 for studies examining the effects of TCEs on cognitive outcomes in adults aged 60 years and older. Studies were included if they were RCTs involving TCEs and reported outcome measures for global cognition, or individual cognitive domains. RESULTS:Twenty-eight RCTs with a total of 2297 participants were included. Meta-analysis revealed that TCEs led to significant improvements in global cognition: Montreal Cognitive Assessment [mean differences (MD) = 1.67; 95% confidence interval (CI): (1.20, 2.14)], Mini-Mental State Examination [MD = 0.76; 95% CI: (0.04, 1.48)]; executive function: Trail Making Test (B-A) [MD = -7.96; 95% CI: (-15.34, -0.59)], Category Fluency for Animals [MD = 2.96, 95% CI (2.08, 3.85)]; working memory: Digit Span-Backwards [MD = 0.48; 95% CI: (0.07, 0.90)]; processing speed: Digit Symbol Coding [MD = 4.16; 95% CI: (1.82, 6.50)]; memory function: Memory Quotient [MD = 13.13; 95% CI: (4.06, 22.20)], Auditory Verbal Learning Test: immediate recall [MD = 1.13; 95% CI: (0.07, 2.20)], short-term delayed recognition [MD = 0.80; 95% CI: (0.28, 1.32)] and long-term delayed recognition [MD = 1.38; 95% CI: (0.68, 2.09)]. CONCLUSIONS:TCEs are effective in improving cognitive function in older adults, particularly in domains such as global cognition, executive function, working memory, processing speed and memory function. However, given the methodological limitations and heterogeneity of the included studies, these findings require confirmation in further large-scale, high-quality RCTs.

OBJECTIVES:Increased cancer survival has led to a growing population of geriatric patients with cancer. The post-acute rehabilitation outcomes of these patients are poorly understood. This study aimed to investigate whether cancer status is associated with functional outcomes, new institutionalization, and mortality in Australian geriatric rehabilitation patients. DESIGN:Observational longitudinal REStORing health of acutely unwell adulTs (RESORT) cohort. SETTING AND PARTICIPANTS:Geriatric rehabilitation patients in a tertiary hospital in Australia. METHODS:Patients were allocated to "no," "past," and "active" cancer status groups. Function was measured at geriatric rehabilitation admission and discharge using Katz Activities of Daily Living (ADL) and Lawton-Brody Instrumental ADL (IADL) scores. Logistic regression and Cox regression were performed to investigate the association between functional change with new institutionalization and 1-year mortality, respectively. RESULTS:Of 1890 patients, 77.7% had "no," 13.3% had "past," and 9.0% had "active" cancer. ADL and IADL scores improved in all groups, with no significant difference between groups in functional outcomes or new institutionalization. Compared with "no" cancer (2.9%), a significantly higher proportion of "active" (8.2%) and "past" (6.0%) cancer patients died during the hospital admission, P < .001. Active cancer was associated with higher 3- and 12-month mortality (20% and 40.6%). ADL and IADL improvement were significantly associated with reduced risk of 12-month mortality in "no" and "active" groups, and lower incidence of institutionalization in all groups. CONCLUSIONS AND IMPLICATIONS:Although inpatient mortality is higher in active cancer patients, older adults with active cancer who survive until inpatient geriatric rehabilitation discharge achieve similar functional gains and rates of discharge to the community. Functional improvement is of prognostic value in active cancer patients.

Understanding the human exposome is now possible with clinics, communities and cities acting as real-world testbeds to understand what drives human healthspan, resilience and flourishing.

To achieve international consensus on three key eHealth-related topics in geriatric rehabilitation: the use, domains and scientific evaluation of eHealth. Eighty healthcare professionals participated in an two-round Delphi study. consensus was obtained on 26 statements: three related to the use of eHealth, five to the domains of eHealth and 18 related to the scientific evaluation of eHealth. International consensus on eHealth in geriatric rehabilitation is achievable and essential for promoting a more consistent approach to the development, implementation, scientific and safety evaluation of eHealth. Current evidence on the use of eHealth in geriatric rehabilitation is limited. This aim of this study was to achieve international consensus on three key eHealth-related topics in geriatric rehabilitation: the use, domains, and scientific evaluation of eHealth. Additionally, we developed a model that provides insight into the use of eHealth in geriatric rehabilitation. An international, two-round Delphi study was conducted. Two models served as a framework for the initial statement draft, with a total of 28 statements based on our systematic review results, an international survey, and expert opinion. Eligible healthcare professionals working in geriatric rehabilitation facilities were recruited across 10 countries. Eighty healthcare professionals participated in round one and 47 in round two. In the first round, consensus was obtained for 20 of the 28 statements (71

The geroprotective effects of rapamycin in mitigating frailty and cognitive complications in the perioperative period remains unknown. Of 39 C57BL/6 mice tested, 19 were young (16 weeks), and 20 were old (80 weeks). The interventional group (10 old, 10 young) received daily oral rapamycin for 8 weeks pre-op compared to controls (10 old, 9 young). Sham laparotomy was performed at week 9. Perioperative frailty was assessed using a murine clinical frailty scale, preoperatively and at 1, 4 and 8 weeks postoperatively. Spatial memory was assessed using the Barnes maze preoperatively, and at weeks 1 and 4 post-op. Rapamycin treatment is associated with significantly less decline in postoperative clinical frailty(p < 0.05). Subgroup analysis revealed similar findings for old and young mice. The rapamycin group demonstrated improved cognitive performance at 1-week postoperatively (β 40.18, 95%C.I. 8.70-71.67, p = 0.012), but only in older mice (β 54.51, 95%C.I. 6.77-102.25, p = 0.025). In a pre-clinical animal model of anesthesia and surgery, rapamycin supplementation protected against surgery-induced frailty and short-term postoperative cognitive dysfunction.

Ageing is the primary driver of age-associated chronic diseases and conditions. Asian populations have traditionally been underrepresented in studies understanding age-related diseases. Thus, the Ageing BIOmarker Study in Singaporeans (ABIOS) aims to characterise biomarkers of ageing in Singaporeans, exploring associations between molecular, physiological, and digital biomarkers of ageing. This is a single-centre, cross-sectional study that recruits healthy community-dwelling adults (≥ 21 years) from three different ethnic groups (Chinese, Malay, and Indian). Molecular biomarkers of ageing include multi-omics approaches, such as DNA methylation analysis and metabolic and inflammatory proteomic profiling in blood, saliva, and stool. Physiological biomarkers of ageing include bone density, body composition, skin autofluorescence, arterial stiffness, physical performance (e.g., muscle strength and flexibility), cognition, and nutritional status. Digital biomarkers of ageing include three-dimensional facial morphology and objectively measured physical activity. Additional measures, such as habitual physical activity, dietary patterns, and medical history, are also examined. The associations between the molecular, physiological, and digital phenotypes will be explored. This study is expected to generate a comprehensive profile of molecular, physiological, and digital biomarkers of ageing in Chinese, Malay, and Indian populations in Singapore. By integrating diverse age-related biomarkers, clinical indicators, and lifestyle factors, ABIOS will offer unique insights into the ageing process specific to Southeast Asian populations. These findings can help identify markers of biological ageing, uncover ethnic-specific patterns, and reveal modifiable lifestyle factors for healthier ageing. The results could inform evidence-based health policies, personalized interventions, and future cross-ethnic comparative studies to enhance understanding of ageing biology across diverse populations.

On 1–2 November 2024, the annual Biomarkers of Aging conference welcomed academic and industry scientists, and partners from governmental and nongovernmental organizations, to Harvard Medical School in Boston, USA, to discuss new insights into measuring and monitoring human aging, with the aim of clinical translation. In this Meeting Report, we summarize the conference and offer potential future directions for the Biomarkers of Aging Consortium and the longevity science community at large.

Indirect calorimetry (IC) provides an accurate measure of energy expenditure, which informs energy requirements. Achieving energy and protein requirements is fundamental in nutrition care. This study aims to determine if the energy requirements informed by IC and estimated protein requirements are met in geriatric rehabilitation inpatients receiving dietitian-led individualized nutrition care. Geriatric rehabilitation inpatients referred to dietitians were included. Resting metabolic rate was measured using IC at inclusion in the study and within 48 h before discharge. Food intake was assessed using plate waste observation. The patient's energy requirement was calculated using the resting metabolic rate and physical activity factor and adjusted for the weight goal. Protein requirements were estimated by the dietitian. The energy and protein intake adequacy was calculated as a percentage of the individual requirement and defined “adequate” if ≥100%. Fifty-three patients were included (mean age, 84.3 [standard deviation, 8.44] years; 22 [41.5%] women). The median energy and protein intake adequacy was 101.7% (interquartile range [IQR], 76.4–112.9) and 87.6% (IQR, 71.9–122.2) at the start of the nutrition care ( n  = 53) and 99.9% (IQR, 63.9–113.8) and 80.1% (IQR, 65.1–99.6) at discharge ( n  = 29), respectively. Only 15 of 53 (28.3%) patients at the start of nutition care and 6 of 29 (20.7%) patients at discharge achieved both energy and protein intake adequacy. Energy requirements were met, but the protein requirements were not met in geriatric rehabilitation inpatients receiving nutrition care. However, less than one-third of patients achieved both energy and protein intake adequacy.

BACKGROUND:Cellular senescence (CS) is a hallmark of ageing and age-related diseases. While dietary interventions are often explored to reduce CS, less is known about dietary ingredients that induce it. This study systematically reviews the evidence on dietary ingredients that promote CS in animal models and humans. METHODS:Following PRISMA guidelines (PROSPERO: CRD42022338885), PubMed and Embase were searched for studies on dietary ingredients administered via the gastrointestinal tract affecting CS markers in animal models or adults. Risk of bias was assessed using SYRCLE's and Cochrane's tools. RESULTS:From 10,806 articles, 80 studies (77 animal, 3 human) were included. In animals, high-fat diets commonly induced CS across tissues. The plant extract Teng Long Bu Zhong Tang and certain bioactives promoted CS in tumor tissues, potentially offering anti-cancer benefits. Excessive ethanol intake caused CS in the liver and other organs. In humans, increased CS load was linked to red meat-based meals, high protein intake, and DHA-enriched fish oil. Most studies showed unclear risk of bias. CONCLUSIONS:High-fat diets and anti-cancer natural products promote CS in animal models. Preliminary human evidence suggests similar effects from high-protein, red meat-based diets, or DHA-enriched fish oil. Further research is needed to clarify mechanisms and guide dietary and public health recommendations.

OBJECTIVES:To evaluate adherence to lifestyle intervention activities in the SINgapore GERiatric Intervention Study to Reduce Cognitive Decline and Physical Frailty (SINGER) study's intensive intervention arm over one year, as part of ongoing process evaluation. The analysis identifies sociodemographic, psychosocial, and vascular risk factors associated with adherence to optimize intervention strategies and improve participant engagement. METHODS:Adherence was categorised as non-adherent, low, moderate and high adherence based on participants' attendance. Total adherence was assessed in two ways, i) a composite of all attendance and ii) Latent Class Analysis (LCA) to identify distinct participant subgroups based on adherence to the SINGER study activities. Regression models assessed associations between individual factors with adherence to each type of intervention component and adherence profiles derived from LCA. RESULTS:More than 70 % of participants achieving moderate to high adherence. LCA identified three distinct adherence profiles: Low, Moderate and High adherence. Participants showed higher adherence to vascular and diet components, followed by exercise components, and lower adherence to cognitive components. Factors such as being female and having higher education were associated with higher adherence while living alone was associated with lower adherence. Participants with hypertension had higher overall adherence but lower adherence to vascular management sessions. The complexity, delivery mode and frequency of the activities influenced adherence, with more complex and frequent activities showing lower adherence. CONCLUSION:The intensive intervention arm showed satisfactory adherence. A comprehensive analysis highlighted the relationship between adherence, sociodemographic factors, and vascular risks, emphasizing the need for targeted strategies to support subgroups with lower adherence and optimize engagement. PRACTICE IMPLICATIONS:The study team should enhance participant engagement by simplifying complex activities and tailoring strategies for subgroups with lower adherence. Ongoing monitoring of adherence patterns and participant feedback will be crucial for making timely adjustments to the intervention.

Introduction Few randomized controlled trials (RCTs) have investigated the effects of choral singing (CS) on older adults at-risk of cognitive decline and dementia. Extant RCTs on CS also lack an active control arm controlling for non-intervention-specific active components. Methods In this parallel-arm, open-label RCT, 200 community-dwelling older adults at-risk of cognitive decline were randomized to the treatment arm, i.e., CS, or the active control arm (i.e., health education program, i.e., HEP, matched with non-intervention-specific components). Both arms involved weekly 1-h group sessions held continuously for two years. We examined the a priori registered secondary outcomes, positive screens for depressive and anxiety disorders, at baseline, 1-year, and 2-year time-points, using linear-mixed models with intention-to-treat. Results Compared to the HEP, CS participants experienced similar decreased odds of positive screens for depressive and anxiety disorders throughout all the time-points, though different trajectories. Discussion In contrary to previous studies using passive controls reporting positive outcomes, compared to HEP as an active comparator, CS is as effective as HEP in delaying progression to clinically significant depressive and anxiety disorders in at-risk community-dwelling older adults. Our findings highlight the critical importance of incorporating an intervention-components-matched comparison arm in non-pharmacological interventions. Trial registration Choral Singing For the Prevention of Dementia, https://clinicaltrials.gov/study/NCT02919748; Trial Registration: NCT02919748.

The global population is ageing and the gap between lifespan (total years lived) and healthspan (years lived free of diseases) is increasing. Healthy Longevity Medicine (HLM) is an approach to optimise health and healthspan, and it has substantial public health implications. Despite those implications, the understanding of public perspectives on this field is lacking. The HEalthy LOngevity (HELO) framework was developed through a literature review guided by expert discussions across disciplines to include evidence-based concepts of health-related decision-making, ageing, and HLM. The framework organises concepts into three components. The first two components, awareness and knowledge, explore public perception and understanding of the healthy longevity field, respectively. The third component, motivations, reflects factors underlying motivations towards healthy longevity. These include personality, current behaviours, personal values and beliefs, and health-related perceptions. The framework outlines the theoretical foundation to explore public knowledge and interest in healthy longevity. The framework will be refined based on findings from qualitative focus groups in Singapore and then applied to quantitative population surveys globally. These HELO initiatives aim to inform strategies for integrating HLM into public healthcare, promoting health and healthspan.

BACKGROUND:Gerotherapeutic interventions that optimize the health and healthspan of biologically older, yet generally healthy adults are importance for reducing healthcare costs associated with ageing populations. It remains unclear whether recruiting middle-aged individuals with an older biological age is feasible in gerotherapeutic trials. The aim is to evaluate feasibility of recruiting biologically older yet generally healthy middle-aged adults for Alpha-ketoglutarate Supplementation and BiologicaL agE in middle-aged adults (ABLE) trial. METHODS:ABLE is a double-blind, placebo-controlled randomized trial assessing the effects of 1 g sustained-release calcium alpha-ketoglutarate versus placebo over 6 months, followed by 3 months of follow up visit, in 120 generally healthy adults (with at most one chronic condition) aged 40-60 years with a higher biological age (assessed by DNA methylation clocks) than chronological age living in Singapore. Feasibility analyses were done using the recruitment metrics; recruitment rate, consent rate, eligibility rate, recruitment conversion rate, and the effectiveness of recruitment strategies. RESULTS:Among 467 individuals who expressed interest in participation, 120 participants were enrolled in the study. The recruitment period was 223 working days. Eligibility rates were 80.3 % at pre-screening and 67.3 % at screening, with a consent rate of 66.1 %. Conversion rates were 25.7 % and 48.4 % from pre-screening and screening to enrolment, respectively. The biological age was exceeding the chronological age in 80.2 % of participants and 54.3 % reported no pre-existing health conditions. Word-of-mouth was the most effective recruitment method (36.2 %). CONCLUSION:ABLE demonstrated the feasibility of recruiting biologically older yet generally healthy middle-aged adults for gerotherapeutic interventions.

The prevailing focus of lifespan health research has predominantly centered on "healthy aging". This oversight may hinder the understanding of health across the lifespan, as disorders in earlier stages can substantially impact overall health and longevity. Aging, conceptually, begins at gestation. The trajectory of an individual's health is influenced from the earliest stages of life, where adverse conditions can set a foundation for lifelong health challenges. For example, suboptimal conditions during gestation leading to premature birth can predispose individuals to various health issues later in life. Additionally, precocious puberty defined as the onset of sexual maturity before eight years of age or early menopause-occurring before 50 years of age requires medical intervention and is indicative of atypical aging processes. To address these critical gaps in lifespan health research, the expansion of medical lexicons and research categorizations is advocated to include "healthy gestation," "healthy development," and "healthy reproduction" alongside "healthy aging." This broader terminology will enable a more comprehensive investigation of disorders at all life stages. An integrative approach underscores the interconnectedness of all life stages and the continuous nature of aging, advocating for a seamless continuum in health research and interventions from gestation through late adulthood.

BACKGROUND:Cognitive impairment is a growing public health concern, particularly in aging populations. While trends in CI prevalence in China were studied up to 2018, no previous research has explored how the COVID-19 pandemic has affected these trends. OBJECTIVES:This study aims to extend the analysis to 2022, examining the impact of the pandemic on cognitive impairment prevalence. PARTICIPANTS:The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data across multiple waves (2002 to 2022) was used (n=64,872). MEASUREMENTS:Cognitive impairment was assessed using a Chinese version of the Mini-Mental State Examination (MMSE). The rural/urban-sex-single age-specific prevalence of cognitive impairment across different waves were estimated using the DemoRates R package. Cognitive impairment trends before and after the onset of the COVID-19 pandemic were compared to identify any significant changes. RESULTS:In 2018 and previous waves, an average of 16,191 participants per wave were surveyed (four waves), with a cognitive impairment prevalence of 4.3%. In 2022, post-COVID-19, the survey included 14,022 participants and showed a significant increase in CI prevalence to 6.8%. The observed trends were independent of gender, age group, and residential environment (P-trend < 0.001). However, a significant decrease in mean calf circumference, increase in proportion of overweight participants, and increases in daily fruit and vegetable intake and regular physical activity were notable after the pandemic. CONCLUSION:The study suggests that the COVID-19 pandemic may have contributed to the observed increase in cognitive impairment prevalence in China, underscoring the importance of further research into the long-term cognitive effects of global health crises. These findings highlight the need to strengthen healthcare systems to support cognitive health in an aging population, while considering both pandemic-related and ongoing factors in the management of cognitive impairment.

Aging remains the foremost risk factor for cardiovascular and cerebrovascular diseases, surpassing traditional factors in epidemiological significance. This review elucidates the cellular and molecular mechanisms underlying vascular aging, with an emphasis on sex differences that influence disease progression and clinical outcomes in older adults. We discuss the convergence of aging processes at the macro- and microvascular levels and their contributions to the pathogenesis of vascular diseases. Critical analysis of both preclinical and clinical studies reveals significant sex-specific variations in these mechanisms, which could be pivotal in understanding the disparity in disease morbidity and mortality between sexes. The review highlights key molecular pathways, including oxidative stress, inflammation, and autophagy, and their differential roles in the vascular aging of males and females. We argue that recognizing these sex-specific differences is crucial for developing targeted therapeutic strategies aimed at preventing and managing age-related vascular pathologies. The implications for personalized medicine and potential areas for future research are also explored, emphasizing the need for a nuanced approach to the study and treatment of vascular aging.

The global population is ageing rapidly. While genetics, lifestyle, and environment are known contributors to healthspan, most insights are drawn from Western cohorts, leaving Asian populations underrepresented despite unique biological, lifestyle, and cultural factors. The SG90 cohort study aimed to fill knowledge gaps in healthy ageing by identifying modifiable medical, biological, lifestyle, psychological, behavioural, and social factors that contribute to longevity in the oldest-old. The study recruited 1,158 participants aged 85 and above from the Singapore Chinese Health Study (SCHS) and Singapore Longitudinal Aging Study (SLAS) between 2015 and 2021. Data collection involved face-to-face interviews to obtain sociodemographic, lifestyle, sleep, functional status, quality of life, medical conditions and healthcare economics information, along with clinical assessments covering physical examinations, anthropometry, physical performance, cognition, and mental health. Biospecimens, including blood, saliva, stool, urine, toenails, hair, and skin tape strips were collected to support extensive multi-omic and cellular analyses. Participants, primarily female (64.5%) and Chinese (97.5%) with a median age of 87 years [interquartile range (IQR): 86-89], were mostly non-smokers (72.1%) and infrequent alcohol consumers (94.9%), with 66.5% exercising regularly. Functional assessments indicate high independence, with median Basic activities of daily living (BADL) and Instrumental ADL (IADL) scores of 20 (IQR: 19-20) and 14 (IQR: 11-16), respectively. 36% of participants rated their self-reported health as good to excellent. The SG90 cohort study offers a comprehensive clinical and biological data resource on healthy ageing among Asia's oldest-old, laying a foundation for targeted interventions to promote healthy longevity and quality of life.