OBJECTIVE: Digital gait biomarkers collected from body-worn devices can remotely and continuously collect movement types, quantity, and quality in real life. This study assessed whether digital gait biomarkers from a wrist-worn device could identify people with frailty in a large sample of middle-aged and older adults.
METHODS: Cross-sectional study.
METHODS: A total of 5822 middle-aged (43-64 years) and 4344 older adults (65-81 years) who participated in the UK Biobank study.
METHODS: Frailty was assessed using a modified Fried\'s frailty assessment and was defined as having ≥3 of the 5 frailty criteria (weakness, low activity levels, slowness, exhaustion, and weight loss). Fourteen digital gait biomarkers were extracted from accelerometry data collected from wrist-worn sensors worn continuously by participants for up to 7 days.
RESULTS: A total of 238 (4.1%) of the middle-aged group and 196 (4.5%) of the older group were categorized as frail. Multivariable logistic regression analysis revealed that less daily walking (as assessed by step counts), slower maximum walking speed, and increased step time variability best-identified people with frailty in the middle-aged group (area under the curve [95% CI]: 0.70 [0.66-0.73]). Less daily walking, slower maximum walking speed, increased step time variability, and a lower proportion of walks undertaken with a manual task best-identified people with frailty in the older group (0.73 [0.69-0.76]).
CONCLUSIONS: Our findings indicate that measures obtained from wrist-worn wearable devices worn in everyday life can identify individuals with frailty in both middle-aged and older people. These digital gait biomarkers may facilitate screening programs and the timely implementation of frailty-prevention interventions.

BACKGROUND: Currently, there is limited knowledge about the association between a migration background and loneliness among middle-aged and older individuals in Germany. The aim was therefore to examine the association between migration background and loneliness in this group.
METHODS: Data were taken from the German Ageing Survey (Wave 7, November 2020 to March 2021), a representative sample of middle-aged and older individuals. The sample comprised 4145 individuals, and the mean age was 63.8 years. Of the respondents, 93.2% had no migration background, approximately 5.9% had a migration background with personal migration experience, and 0.9% had a migration background but no personal migration experience. The De Jong Gierveld tool was used to quantify loneliness.
RESULTS: Multiple linear regressions showed that individuals with a migration background and their own migration experience have significantly higher levels of loneliness (β = 0.15, 95% confidence interval (CI): 0.004 to 0.30, p < 0.05) compared to individuals without a migration background, whereas individuals with a migration background without their own migration experience have significantly lower levels of loneliness (β = -0.27, 95% CI: -0.52 to -0.02 p < 0.05).
CONCLUSIONS: Individuals with a migration background and their own migration experience appear to represent a risk group for high loneliness among middle-aged and older adults in Germany. In this respect, this group should be given special consideration in corresponding measures. Against the background of current (and potential future) migration movements, the results are of great importance as these groups in particular could be affected by loneliness.
UNASSIGNED: HINTERGRUND: Bisher gibt es nur wenige Erkenntnisse über den Zusammenhang zwischen Migrationshintergrund und Einsamkeit im mittleren und hohen Alter in Deutschland. Ziel war daher, eine Assoziation zwischen Migrationshintergrund und Einsamkeit in dieser Gruppe darzustellen.
METHODS: Die Daten stammen aus dem Deutschen Alterssurvey (Welle 7, November 2020 bis März 2021), einer repräsentativen Stichprobe von zuhause lebenden Personen mittleren und höheren Alters. Die Stichprobe umfasste 4145 Individuen. Das mittlere Alter betrug 63,8 Jahre, 93,2 % der Befragten hatten keinen Migrationshintergrund, wohingegen ungefähr 5,9 % der Befragten einen Migrationshintergrund mit eigener Migrationserfahrung und 0,9 % einen Migrationshintergrund, aber ohne eigene Migrationserfahrung hatten. Zur Quantifizierung der Einsamkeit wurde das etablierte Instrument von De Jong Gierveld verwendet.
UNASSIGNED: Multiple lineare Regressionen zeigten, dass Personen mit Migrationshintergrund und eigener Migrationserfahrung im Vergleich zu Personen ohne Migrationshintergrund eine signifikant höhere Einsamkeit aufweisen (β = 0,15, 95 % Konfidenzintervall (KI): 0,004–0,30, p < 0,05), wohingegen Personen mit Migrationshintergrund, aber ohne eigene Migrationserfahrung eine signifikant niedrigere Einsamkeit aufweisen (β = −0,27, 95 % KI: −0,52 bis −0,02, p < 0,05).
CONCLUSIONS: Personen mit Migrationshintergrund und eigener Migrationserfahrung scheinen eine Risikogruppe für hohe Einsamkeit im mittleren und hohen Alter in Deutschland darzustellen. Insofern sollte diese Gruppe bei entsprechenden Maßnahmen besonders berücksichtigt werden. Vor dem Hintergrund der aktuellen (und potenzieller künftiger) Migrationsbewegungen sind diese Ergebnisse von großer Relevanz, da insbesondere diese Gruppen von Einsamkeit betroffen sein könnten.

UNASSIGNED: Short- and midterm evaluations of arthroscopic meniscal surgery have shown little or no effect in favor of surgery, although long-term effects, including radiographic changes, are unknown.
UNASSIGNED: To compare the 10-year outcomes in middle-aged patients with meniscal symptoms between a group that received an exercise program alone and a group that received knee arthroscopy in addition to the exercise program with respect to the prevalence of radiographic and symptomatic osteoarthritis (OA), patient-reported outcomes, and clinical status.
UNASSIGNED: Randomized controlled trial; Level of evidence, 1.
UNASSIGNED: Of 179 eligible patients aged 45 to 64 years, 150 were randomized to undergo either 3 months of exercise therapy (nonsurgery group) or knee arthroscopy in addition to the exercise therapy (surgery group). Surgery usually consisted of partial meniscectomy (n = 56) or diagnostic arthroscopy (n = 8). Radiographs were assessed according to the Kellgren-Lawrence score at the baseline and 5- and 10-year follow-ups. Patient-reported outcome measures were reported at the baseline and 1-, 3-, 5-, and 10-year follow-ups. Clinical status was assessed at a 10-year follow-up. The primary outcomes were radiographic OA and changes in the Knee injury and Osteoarthritis Outcome Score Pain subscale (KOOSPAIN) from the baseline to the 10-year follow-up. The primary analysis was performed using the intention-to-treat approach.
UNASSIGNED: At the time of the 10-year follow-up, eight patients had died, leaving 142 eligible patients. Radiographic OA was assessed for 95 patients (67%), questionnaires were answered by 110 (77%), and the clinical status was evaluated for 95 (67%). Radiographic OA was present in 67% of the patients in each group (P≥ .999); symptomatic OA was present in 47% of the nonsurgery group and 57% of the surgery group (P = .301). There were no differences between groups regarding changes from baseline to 10 years in any of the KOOS subscales.
UNASSIGNED: Knee arthroscopic surgery, in most cases consisting of partial meniscectomy or diagnostic arthroscopy, in addition to exercise therapy in middle-aged patients with meniscal symptoms, did not increase the rates of radiographic or symptomatic OA and resulted in similar patient-reported outcomes at the 10-year follow-up compared with exercise therapy alone. Considering the short-term benefit and no long-term harm from knee arthroscopic surgery, the treatment may be recommended when first-line treatment-including exercise therapy for ≥3 months-does not relieve patient\'s symptoms.
UNASSIGNED: Clinical Trials NCT01288768 (ClinicalTrials.gov identifier).

UNASSIGNED: There is growing interest in the intersection of frailty and heart failure (HF); however, large-sample longitudinal studies in the general population are lacking.
UNASSIGNED: The goal of this study was to examine the longitudinal relationship between frailty and incident HF, and whether age and genetic predisposition could modify this association.
UNASSIGNED: This prospective cohort study included 340,541 participants (45.7% male; mean age 55.9 ± 8.1 years) free of HF at baseline in the UK Biobank. Frailty was assessed by using the Fried frailty phenotype and included weight loss, exhaustion, low physical activity, slow gait speed, and low grip strength. The weighted polygenetic risk score was calculated. Cox models were used to estimate these associations and the interaction between the 2 factors.
UNASSIGNED: During a median 14.1 years of follow-up, 7,590 patients with HF were documented. Compared with nonfrail participants, both prefrail and frail participants had a positive association with the risk of incident HF (prefrail HR: 1.40 [95% CI: 1.17-1.67]; frail HR: 2.07 [95% CI: 1.67-2.57]). Exhaustion (HR: 1.21; 95% CI: 1.03-1.43), slow gait speed (HR: 1.62; 95% CI: 1.39-1.90), and low grip strength (HR: 1.31; 95% CI: 1.14-1.51) were associated with a greater risk of incident HF. Furthermore, genetic susceptibility did not significantly modify the associations (P interaction = 0.094), and the association was significantly strengthened in younger participants (P interaction = 0.008).
UNASSIGNED: Frailty status was associated with a higher risk of incident HF independent of genetic risk. A younger population may be more susceptible to HF when exposed to frailty. Whether the modification of frailty status represents another avenue for preventing HF warrants further investigation.

UNASSIGNED: Brain-derived neurotrophic factor levels are higher in those who are physically active and lower in people with cognitive dysfunction. This study investigated whether brain-derived neurotrophic factor mediated or modified the association of sedentary time to MRI-estimated brain volumes in midlife.
UNASSIGNED: Baseline (n = 612) and five-year follow-up (n = 418) data were drawn from the multicenter Coronary Artery Risk Development in Young Adults Brain MRI sub-study, including Black and White participants (aged 50.3 years, 51.6% females, 38.6% Black). Sedentary time (hours per day) was categorized into quartiles with low ≤ 4.3 (reference) and high > 8.4. Outcomes of the study were total brain, white matter, gray matter, hippocampal volumes, and white matter fractional anisotropy at baseline and 5-year percent change from baseline. The study used general linear regression models to examine the mediation and moderation effects of brain-derived neurotrophic factor (natural log transformed) on the associations of sedentary time to brain outcomes. The authors adjusted the regression model for age, sex, race, intracranial volume, education, and vascular factors.
UNASSIGNED: Cross-sectionally, baseline participants with the highest sedentary time had a lower total brain (-12.2 cc; 95%CI: -20.7, -3.7), gray matter (-7.8 cc; 95%CI: -14.3, -1.3), and hippocampal volume (-0.2 cc; 95%CI: -0.3, 0.0) compared with populations with the lowest sedentary time. The brain-derived neurotrophic factor levels did not mediate the associations between brain measures and sedentary time. Brain-derived neurotrophic factor was found to moderate associations of sedentary time to total brain and white matter volume such that the brain volume difference between high and low sedentary time decreased as brain-derived neurotrophic factor levels increased. Longitudinally, higher baseline brain-derived neurotrophic factor level was associated with less brain volume decline. The longitudinal associations did not differ by sedentary time, and brain-derived neurotrophic factor did not mediate or moderate the association of sedentary time to brain measure changes.
UNASSIGNED: Higher brain-derived neurotrophic factor levels may buffer the negative effects of sedentary time on the brain.

OBJECTIVE: This cohort study\'s aim was to assess the association between the weight-adjusted waist index (WWI) and frailty among middle-aged and elderly individuals in China.
METHODS: Seven-year complete follow-up data from 10,349 adults aged ≥45 years, initially surveyed in 2 011 in the China Health and Retirement Longitudinal Study, were analyzed, including clinical demographic characteristics, anthropometric indices, frailty scores, and relevant covariates. The WWI was calculated as waist circumference divided by the square root of the body weight. Frailty was evaluated using the Frailty Index. Relationships between the WWI and frailty were evaluated via Cox proportional hazards modeling. Receiver operating characteristic curve analyses assessed the effectiveness of obesity-related indicators in predicting frailty.
RESULTS: Over a median 84-month follow-up period, frailty occurred in 23.7% (2453/10,349) of participants. After potential confounder adjustment, the WWI positively correlated with frailty (adjusted hazard ratio: 1.14; 95% confidence interval: 1.08-1.20; p < 0.001). After WWI-stratification into quartiles based on frailty and covariate adjustment, regression analyses were conducted; the adjusted hazard ratios exhibited a significant upward trend (p < 0.001). The subgroup analyses revealed higher positive correlations between the WWI and frailty in males and those aged ≥65 years and lower correlations in those with a high school or higher educational level and in married or cohabiting individuals. The strong positive correlation was unaltered in the other subgroup analyses. The WWI outperformed all other obesity-related indicators as a frailty predictor.
CONCLUSIONS: The WWI is a dependable and innovative obesity-related predictor of frailty and could help in mitigating its development.

BACKGROUND: Intrinsic capacity refers to a broad range of health traits, including the physiological and psychological changes brought on by aging. Previous research has shown that intrinsic capacity, as an independent emerging construct, is a highly effective predictor of several health outcomes.
OBJECTIVE: We aimed to summarise the predictive effect of intrinsic capacity at baseline on health outcomes among middle-aged and older adults.
METHODS: A systematic review and meta-analysis.
METHODS: Middle-aged and older adults.
METHODS: We systematically searched up to 3 April 2024 in 10 electronic databases. Studies investigating the predictive effect of baseline composite intrinsic capacity and health outcomes were included. Publications that had reported hazard ratios (HRs) or odd ratios (ORs) and 95% confidence intervals (CIs) as effect size were considered.
RESULTS: A total of 23 publications were included. The sample size ranged from 100 to 17 031. The results of the meta-analysis showed statistically significant prediction of adverse health outcomes such as disability (OR = 1.84, 95% CI: 1.68-2.03, I2 = 41%, Pheterogeneity=.10), falls (OR = 1.38, 95% CI: 1.19-1.60, I2 = 45%, Pheterogeneity=.11), hospitalisation (OR = 2.25, 95% CI: 1.17-4.3, I2 = 68%, Pheterogeneity=.08), mortality (OR = 1.72, 95% CI: 1.54-1.91, I2 = 32%, Pheterogeneity=.12) and frailty (OR = 1.57, 95% CI: 1.45-1.70, I2 = 2%, Pheterogeneity=.31) by the baseline composite intrinsic capacity.
CONCLUSIONS: Declined intrinsic capacity has potential predictive value for adverse health outcomes, further high-quality study is needed to validate these findings and strengthen their cumulative impact. Attention to health outcomes should also focus on both breadth and category precision.

This article shares the findings from survey conducted between November 2021 and April 2022 across the three senatorial districts of Kwara state, Nigeria. The survey was carried out across 1120 households with information on the head of households, individuals in the households, household demographic characteristics, education, work experience, household youth and middle-aged employment status. The survey included both open-ended and close-ended questions, and the resulting data in excel format. The coding explanation/ interpretation is also depicted in a table. This data is valuable for research on employment, empowerment, community development and studies on United Nations Sustainable Development Goals, precisely goal eight (UNSDG8).

OBJECTIVE: The oral health characteristics of middle-aged and older adults exhibit variations. This study identifies the various factors associated with oral health among middle-aged and older adults through a subgroup analysis by age group of data representative of the South Korean population.
METHODS: We examined influencing factors: demographic, socioeconomic, dental, physical attributes, psychological, and mental attributes. Oral health was assessed using the Geriatric Oral Health Assessment Index. The participants were divided into two groups: those under 65 years of age (middle-aged) and those over 65 years of age (older adults). We used multiple linear regression analysis and dominance analysis to determine the dominant factors associated with oral health.
RESULTS: A total of 6369 participants were aged 69.2 ± 9.8 years on average, and 57.5% were women. Dominance analysis revealed that lower educational levels and activity difficulty caused by diseases were significantly associated with both groups. Moreover, depressive symptoms were the foremost adverse factor linked to oral health in the middle-aged (P < .001, standardized beta [β] = -4.30, general dominance index [GDI] = 19.00) and older (P < .001, β = -0.30, GDI = 10.70) adults. The number of teeth exhibited the most positive association with oral health in both middle-aged (P < .001, β = 0.20, GDI = 5.30) and older (P < .001, β = 0.23, GDI = 7.40) adults. However, cognitive function, dental visits, body mass index, severe pain, functional limitations, and cognitive function exhibited distinct patterns between the age groups.
CONCLUSIONS: Depressive symptoms and the number of teeth significantly influence oral health in middle-aged and older adults, though the impact varies by age. These findings stress the importance of tailored strategies considering age-specific attributes for effective oral health improvement.
CONCLUSIONS: Enhancing oral health requires healthcare providers to prioritize monitoring age-specific risk factors. Further, educational plans should highlight the importance of preventive oral care and regular dental visits.

UNASSIGNED: Adults with spinal cord injury (SCI) are often sedentary, increasing their risk of cardiometabolic diseases. Leisure-time Physical Activity (LTPA) is physical activity completed during recreation time for enjoyment. We aimed to quantify LTPA in people ≥45 years with SCI and to explore its relationship with participants\' characteristics.
UNASSIGNED: This is a secondary analysis on a subset of the Australian International SCI Survey in participants ≥45 years, at least 12 months post-injury. We described levels of LTPA and used multivariable regressions to estimate the associations between participant characteristics and LTPA.
UNASSIGNED: Of 1,281 participants (mean age: 62.7 years, mean time since injury: 18.7 years; 74% males) 44% reported no participation in LTPA. The average LTPA participation was 197 (SD 352) minutes per week (median: 50). Females (β = -62.3, 95% CI [-112.9, -11.7]), and participants with non-traumatic injuries (β = -105.2, 95% CI [-165.9, -44.6]) performed less LTPA. Time since injury was not associated with moderate-to-heavy LTPA (LR: Probability > F = 0.785).
UNASSIGNED: LTPA promotion in the SCI population ≥45 years focusing on females and non-traumatic injuries is warranted.