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Background Quality of life (QoL) is an important component of individuals’ general well-being, particularly in older adults. However, factors influencing QoL among older adults in low- and middle-income countries (LMICs) have not been fully examined. Furthermore, the role of gender differences in relation to QoL in multiple LMICs has also not been examined in detail. Methods This study used data from the World Health Organization’s Study on global AGEing and adult health (SAGE), Wave-1. Based on a literature review of existing works, a set of variables—an independent variable and covariates—were selected. The study sample consisted of 33,019 participants aged 50 years and above from China, Ghana, India, Russia, and South Africa. Multivariate linear regression models were estimated with the World Health Organization QoL scores as the dependent variable. To preserve the analytical sample size, multiple imputation was used to account for missing data. Results The results showed that generally, male older adults reported a better QoL than female older adults across all of the countries. The associations between QoL and sociodemographic factors, health-related factors, and social support factors among older adults differed according to country. Conclusions This study provides a better understanding of QoL among older adults in LMICs, which can help prepare LMICs to better address the QoL of older adults. The results of this study can be used to develop programs to promote better living standards and services to reduce gender disparities and ultimately, to improve the QoL among older adults in LMICs.

To examine the association between the number of teeth remaining and cognitive decline among Chinese older adults over a 13-year period. A large national longitudinal survey of Chinese older adults. The Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998-2011). A total of 8,153 eligible participants aged 60+ interviewed in up to six waves. Cognitive function and teeth number were measured at each interview. Cognitive function was measured by the Mini-Mental Status Examination (MMSE). Number of natural teeth was self-reported. Individuals with severe cognitive impairment were excluded. Covariates included demographic characteristics, adult socioeconomic status characteristics, childhood socioeconomic status, health conditions, and health behaviors. Linear mixed models were applied in the analysis. The mean teeth number at baseline was 17.5(SD = 0.1), and the mean of baseline cognitive function was 27.3(SD = 0.0). Cognitive function declined over time (β = -0.19, P < .001) after controlling covariates. But, regardless of time, more teeth were associated with better cognitive function (β = 0.01, P < .001). The interaction of teeth number and time was significant (β = 0.01, P < .001), suggesting that the participants who had more teeth showed a slower pace of cognitive decline over time than those with fewer teeth after controlling for other covariates. This study showed that tooth loss was associated with cognitive decline among Chinese older adults. Further studies are needed to examine the linkages between cognitive decline and oral health status using clinical examination data.

We aimed to estimate the association of sleep, sedentary activity and physical activity with cognitive function among older adults, with consideration of the competing nature between variables of activity status. Cross-sectional study. A total of 3086 older adults (60 years or older) in the 2011–2014 National Health and Nutrition Examination Survey were included. The Global Physical Activity Questionnaire was used to measure self-reported time for sedentary activity, walking/bicycling and moderate-to-vigorous physical activity (MVPA). Cognitive function was examined using the CERAD Word Learning subtest (memory), Digit Symbol Substitution Test (executive function/processing speed), and Animal Fluency Test (language). Sleep duration was obtained via interview. Isotemporal substitution models using multivariable linear regression were applied to examine the associations of replacing sleep, sedentary activity, walking/bicycling, MVPA with each other and cognitive function, stratified by sleep duration per night (≤7h, >7h). Among participants with sleep duration ≤7h/night, replacing 30min/day of sedentary activity with 30min/day of MVPA or 30min/day was associated with better cognition. Among participants with sleep duration >7h/night, replacing 30min/day of sleep with 30min/day of sedentary activity, walking/bicycling, or MVPA was associated with better cognition. Replacing sedentary activities with MVPA was associated with favorable cognitive function among older adults sleeping no longer than 7h/night, and replacing excessive sleep with sedentary or physical activities was associated with favorable cognition. Future research is expected to examine the associations of replacing different activity status on long-term cognitive outcomes in longitudinal studies.

The flow behavior of the SnSbCu alloy is studied experimentally by the compression tests in the range of the strain rates from 0.0001 to 0.1 s−1 and temperature from 293 to 413 K. Based on the experimental data, three constitutive models including the Johnson–Cook (J–C), modified Zerilli–Armstrong (Z–A), and Arrhenius-type (A-type) models are compared to find out an optimum model to describe the flow behavior of the SnSbCu alloy. The results show that the J–C model could predict the flow behavior of the SnSbCu alloy accurately only at some specific strain rates and temperature near the reference values. The modified Z–A and A-type constitutive models can give better fitting results than the J–C model. While, at high strains, the predictive values of the modified Z–A model have larger errors than those at low strains, which means this model has limitations at high strains. By comparison, the A-type model could predict the experimental results accurately at the whole strain range, which indicates that it is a more suitable choice to describe the flow behavior of the SnSbCu alloy in the focused range of strain rates and temperatures. The work is beneficial to solve the tribological problem of the bearing of the marine engine by integrating the accurate constitutive model into the corresponding numerical model.

Background This study aimed to synthesize the current literature examining the association between migration and cognitive function among middle-aged and older adults. Methods We used the PRISMA as a guideline for this systematic review and searched the following databases: PubMed, CINAHL, EMBASE, and Global Health. Results Twenty-five published studies were included. Twenty-two studies were focused on international migrants, while only 3 studied internal migrants. Fourteen studies were conducted in the United States, followed by UK ( n  = 2), Israel ( n  = 2), India ( n  = 2) and other countries like Canada and Australia. Some studies showed that middle-aged and older migrants demonstrated poorer cognitive function comparing to non-migrants in hosting places; while other studies indicated no association between migration and cognitive function. A higher level of acculturation was associated with better performance on cognitive function tests among migrants. Conclusion It is unclear how or whether migration and cognitive function are related. The quality of current literature suffered from methodological deficiencies. Additional research is needed to examine the linkages using more comprehensive measures of migration and cognitive function.

ObjectiveTo assess the level of caregiver burden and factors associated with it among family caregivers of persons with dementia (PWD) living in communities of Shanghai, China.DesignCross-sectional study.SettingCommunities in Hongkou District of Shanghai, China.ParticipantsA random sample of 109 older adults with dementia and their primary family caregivers.Main outcome measureCaregiver burden measured by the Caregiver Burden Inventory (CBI), and the Caregivers’ depressive symptom measured by the simplified Chinese version of Self-rating Depression Scale was the outcome variable of the study. The independent variables, including the cognitive function (measured by Montreal Cognitive Assessment (MoCA), sleep quality assessed by the Pittsburgh Sleep Quality Index, abilities of daily life assessed by the Activities of Daily Living Scale, and behavioural and psychological symptoms assessed by the Neuropsychiatric Inventory of PWDs, the community service utilisation (measured by the Community Service Utilisation Measurement), perceived social support (assessed by three questions), positive aspects of caregiving (PAC) (assessed by the PAC) of dementia caregivers, were analysed. Multivariate linear regression was employed to determine the factors related to caregiver burden.ResultsThe average level of CBI was 65.92±16.74. The score of MoCA, PAC and perceived social support of caregivers were negatively associated with caregiver burden (β=−0.84, p<0.001, β=−3.61, p=0.03 and β=−1.22, p=0.001, respectively). Community service utilisation was positively associated (β=3.46, p<0.001) with caregiver burden. Perceived social support by the caregiver moderated the relationship between caregiver burden and caregivers’ depression symptoms.ConclusionDementia caregivers experienced a high level of caregiver burden. The cognitive function of PWD, PAC, social support and community service utilisation were factors associated with caregiver burden. Strengthening social support, providing more high-quality home care services, promoting PAC are imperative to reduce caregiver burden.

Background: Recovery of cognitive function after stroke has inter-individual variability. The theory of cognitive reserve offers a potential explanation of the variability in cognitive function after stroke. Objective: This study aimed to investigate the moderating effect of cognitive reserve on the relationship between the stroke severity and cognitive function after stroke. Methods: A total of 220 patients with Acute Ischemic Stroke (AIS) were recruited in 2021 from two stroke centers in Nanjing, China. The National Institutes of Health Stroke Scale (NIHSS) was used to assess stroke severity upon admission. Cognitive Reserve Index questionnaire (CRIq) and validated Montreal Cognitive Assessment, Changsha version (MoCA-CS) were used to assess cognitive reserve and cognitive function within 7 days after stroke onset, respectively. A series of multivariate linear regression models were applied to test the moderating effect of cognitive reserve. Results: Patients with a higher level of cognitive reserve had better cognitive function after stroke compared with those with a lower level of cognitive reserve (β=4.024, p =0.002). The interaction of NIHSS and cognitive reserve was statistically significant (β= -0.01, p=0.045) after adjusting for some key covariates (e.g., age, marital status, OCSP classification, TOAST classification，cerebral vascular stenosis, diabetes and atrial fibrillation). Conclusions: Cognitive reserve may help to buffer the effect of stroke-related pathology on cognitive decline in Chinese acute stroke patients. Enhancing cognitive reserve in stroke patients may be one of the potential strategies for preventing vascular dementia.

Racial and ethnic disparities in cardiovascular disease (CVD) risk factors are well-documented. However, racial and ethnic differences in the longitudinal changes among multiple CVD risk factors are unknown. We used prospective cohort data of U.S. adults aged ≥50 in the 2006-2016 Health and Retirement Study. Group-based multi-trajectory models characterized age-related trajectories of systolic blood pressure ([BP] mmHg), non-HDL cholesterol (mg/dL), diabetes mellitus (DM), and smoking. Racial and ethnic differences in the multi-trajectory profiles were examined using multinomial logistic regression. Karlson-Holm-Breen methods were used to assess factors contributing to these associations. Among 10,292 participants (median age: 61), approximately 32% had an overall favorable profile of CVD risk factors. Compared with non-Hispanic White adults, non-Hispanic Black adults were more likely to exhibit elevated systolic BP with high risks of DM (relative risk ratio [RRR] = 3.36; 95% CI, 2.69-4.21; P < .001) and with low risks of DM (RRR = 3.23; 95% CI, 2.38-4.38; P < .001). Non-Hispanic Black adults were also more likely to exhibit high rates of smoking with and without other co-occurring risk factors. Hispanic adults were most likely to exhibit high risks of DM with elevated systolic BP (RRR = 1.74; 95% CI, 1.28-2.38; P < .001) and without elevated systolic BP (RRR = 1.90; 95% CI, 1.50-2.40; P < .001). Education, income, and country-of-origin were significantly associated with the excess CVD risks observed among racial and ethnic minority groups. Significant racial and ethnic disparities were observed in trajectories of CVD risk factors in U.S. adults. Social determinants largely contributed to these associations in non-Hispanic Black adults and Hispanic adults.

Background Residential status has been linked to numerous determinants of health and well-being. However, the influence of residential status on cognitive decline remains unclear. The purpose of this research was to assess the changes of cognitive function among older adults with different residential status (urban residents, rural-to-urban residents, rural residents, and urban-to-rural residents), over a 12-year period. Methods We used five waves of data (2002, 2005, 2008/2009, 2011/2012, and 2014) from the Chinese Longitudinal Healthy Longevity Survey with 17,333 older adults age 65 and over who were interviewed up to five times. Cognitive function was measured by the Mini Mental State Examination (MMSE). Multilevel models were used regarding the effects of residential status after adjusting for demographic characteristics, socioeconomic factors, family support, health behaviors, and health status. Results After controlling for covariates, significant differences in cognitive function were found across the four groups: rural-to-urban and rural residents had a higher level of cognition than urban residents at baseline. On average, cognitive function decreased over the course of the study period. Rural-to-urban and rural residents demonstrated a faster decline in cognitive function than urban residents. Conclusions This study suggests that residential status has an impact on the rate of changes in cognition among older adults in China. Results from this study provide directions for future research that addresses health disparities, particularly in countries that are undergoing significant socioeconomic transitions.

Despite the significant advances in the treatment of multiple myeloma (MM), this disease is still considered incurable because of relapse and chemotherapy resistance, underscoring the need to seek novel therapies with different mechanisms. Anlotinib, a novel multi-targeted tyrosine kinase inhibitor (TKI), has exhibited encouraging antitumor activity in several preclinical and clinical trials, but its effect on MM has not been studied yet. In this study, we found that anlotinib exhibits encouraging cytotoxicity in MM cells, overcomes the protective effect of the bone marrow microenvironment and suppresses tumor growth in the MM mouse xenograft model. We further examined the underlying molecular mechanism and found that anlotinib provokes cell cycle arrest, induces apoptosis and inhibits multiple signaling pathways. Importantly, we identify c-Myc as a novel direct target of anlotinib. The enhanced ubiquitin proteasomal degradation of c-Myc contributes to the cell apoptosis induced by anlotinib. In addition, anlotinib also displays strong cytotoxicity against bortezomib-resistant MM cells. Our study demonstrates the extraordinary anti-MM effect of anlotinib both in vitro and in vivo, which provides solid evidence and a promising rationale for future clinical application of anlotinib in the treatment of human MM.