JOURNAL OF GERONTOLOGY AND GERIATRICS

Progression of cognitive decline in older adult patients with dementia: the role of atrial fibrillation and oral anticoagulant therapy

Giulia Tasso — 2025-06-25

Background/aim. The pathophysiology of dementia remains incompletely understood, and there are conflicting findings regarding the contribution of atrial fibrillation (AF) to cognitive decline. Additionally,
oral anticoagulants may influence the progression of dementia. This study aims to explore whether AF is associated with the progression of cognitive decline and functional deterioration in older adults with dementia. Additionally, it seeks to evaluate the potential impact of anticoagulant therapy on cognitive and functional decline.
Methods. This observational retrospective study involved 179 older adults with dementia under the care of the University of Padua from 2015 to 2020. Each participant underwent a two-year observation period, during which cognitive function was assessed using the Mini-Mental State Examination (MMSE), and functional abilities were measured with the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales.
Results. AF patients made up 29.6% of the sample. According to ANOVA test for repeated measures, no significant differences in MMSE scores were observed over time between the AF and nAF groups or across the three time points based on anticoagulant therapy type. However, individuals with nAF showed a more pronounced decline in IADL and ADL scores over time. Linear mixed model analysis revealed that Alzheimer’s dementia (-1.98, 95% CI: -3.16, -0.79; p = 0.001) and age (-0.09, 95% CI: -0.18, -0.00; p = 0.044) were significantly associated with MMSE decline. Significant predictors of IADL decline included male sex (-1.20, 95% CI: -1.77, -0.64, p < 0.001), MMSE (0.15, 95% CI: 0.06, 0.25, p = 0.002), and age (-0.08, 95% CI: -0.13, -0.04, p < 0.001), with a notable interaction between nAF and time (-0.48, 95% CI: -0.86, -0.12, p = 0.010). For ADL, MMSE (0.15, 95% CI: 0.09, 0.22, p < 0.001), and age (-0.03, 95% CI: -0.07, -0.003, p < 0.001) were the main predictors.
Conclusions. AF was not identified as a factor associated with cognitive decline when accounting for other variables. Instead, age and the presence of Alzheimer’s disease emerged as key factors linked to functional and cognitive deterioration.

Differential physical activity patterns in cognitively impaired vs healthy older adults using accelerometers

Massimiliano Pau — 2025-08-04

Objective. Physical Activity (PA) plays a pivotal role as a protective factor against the development of dementia and is associated with cognitive performance. However, quantitative data collected on older adults under ecological conditions remain limited. In the present study, a continuous longitudinal assessment of PA parameters was performed to clarify if differences in daily and hourly patterns of PA exist in older adults who differ by cognitive status.
Methods. Seventy-two adults aged 65+ were categorized by cognitive status (cognitively impaired [CI] vs healthy controls [HC]) and monitored using wrist-worn accelerometers to assess daily and hourly PA levels, including the percentage of time spent in PA at different intensities.
Results. In those of CI group, a significant reduction in overall PA volume and intensity was observed. This was evidenced by lower step counts, increased time spent in sedentary behavior and decreased engagement in PA of light and moderate-to-vigorous intensity.
Conclusions. The objective analysis of daily PA patterns using wearable accelerometers holds significant promise for quantifying changes associated with cognitive disorders and may optimize interventions to enhance their activity, thus reducing the impact of cognitive decline.

Chronic effects of resistance training in women with low bone mineral density associated with medication use: a systematic review

Thayane Sarmento de Souza — 2025-08-04

Objective. To analyze the chronic effects of resistance training in women with low bone mineral density associated with medication use.
Methods. This systematic review followed the recommendations outlined by PRISMA. The databases searched included PubMed, Scopus, Web of Science, SportDiscus, and Scielo.
Results. Six studies met the eligibility criteria and were included in the analysis, covering a total of 233 participants. Three studies incorporated jump exercises in addition to resistance training. Five studies implemented training models with progressive load increases over the intervention weeks, including reassessments for intensity adjustments.
Conclusions. It was concluded that moderate-to-vigorous intensity resistance training programs, when combined with medication use, can be recommended as an accessible, effective, and safe therapeutic strategy for increasing and maintaining bone mineral density in postmenopausal women with osteopenia or osteoporosis.

The longevity of blue zones: myth or reality

Calogero Caruso — 2025-08-04

The concept of Blue Zones (BZs) refers to regions characterized by an exceptionally high concentration of centenarians, many of whom maintain good health well into advanced age. To date, five such regions have been identified and validated: Sardinia (Italy), Okinawa (Japan), Nicoya (Costa Rica), Ikaria (Greece), and Martinique (a French overseas territory). Despite their widespread recognition, BZs have faced scrutiny over the reliability of demographic data, particularly regarding the accuracy of age reporting. Nevertheless, irrespective of their demographic authenticity, which, as discussed in the review, holds true for the majority of cases, the lifestyle patterns observed in these communities remain highly relevant for the promotion of healthy ageing. Their behavioural and environmental practices provide a robust framework for informing public health strategies aimed at strengthening resilience against non-communicable diseases. Interventions centred on environment and lifestyle and the encouragement of meaningful social engagement have the potential to markedly enhance population health. In fact, minimizing exposure to air pollution and ultra-processed foods, while supporting anti-inflammatory diets, consistent physical activity, and stress management, may significantly reduce the incidence of age-related chronic conditions. As urbanization and modernization continue to reshape daily life, preserving and adapting traditional health-promoting behaviours becomes increasingly important. Policies that support local food production, and enforce regulations to limit environmental degradation may be critical to sustaining the longevity benefits observed in BZs. Ultimately, the exceptional longevity observed in these communities underscores the need for prevention models based on personalized, context-sensitive approaches that integrate ecological and sociocultural factors.

Community-based dementia screening initiative in Brunei: pilot study

Shyh Poh Teo — 2025-08-04

Objective. To screen older people and /or those with risk factors for dementia in the community to identify risk factors and possible symptoms of dementia
Methods. A community-based cross-sectional survey was conducted among older people aged 60 years and older or aged 50 years and older with non-communicable diseases or risk factors for developing dementia. Participants were recruited from Senior Citizen Activity Centres and other areas where older people meet in the community, such as marketplaces. Participants completed a structured, self-administered questionnaire regarding self-reported dementia risk factors, cognitive symptoms, concerns regarding symptoms and a brief cognitive assessment tool (Mini-COG). This approach was piloted in the Senior Citizen Activity Centres.
Results. There were 178 participants, median age 67 years with two-thirds being female. Two-thirds had hypertension and over 40% had hypercholesterolaemia. The most commonly reported symptoms were misplacing things (41.6%), visuospatial difficulties (22.7%) and forgetfulness (20.8%). Among those with symptoms, 7.3% reported worsening symptoms, 5.1% had impaired activities of daily living, and 22.5% thought they should get their cognition assessed. For the Mini-COG, 65% recalled all 3 words, while a quarter made at least one error in the clock-drawing test.
Conclusions. Community-based dementia screening using a questionnaire on risk factors, cognitive symptoms and the Mini-COG was feasible and acceptable in Brunei. Despite participants being socially active, there was a surprisingly high prevalence of risk factors for dementia and symptoms of possible cognitive impairment. Further roll-out of the community screening is planned in other locations.