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Abstract Sedentary behavior (SB) is a significant health risk. Emerging research suggests that mentally active SB (such as computer use and reading) were associated with better health than mentally passive SB (such as watching TV). However, this has not been examined among the oldest old (age ≥80). The aims of this study were to (1) identify distinct profiles of oldest old adults based on six domains of SB (watching TV, using a computer/tablet, talking to friends or family members, doing hobby or other activities, transportation, and resting/napping); and (2) compare health-related outcomes across identified profiles, using the National Health and Aging Trends Study (NHATS) dataset. Latent profile analysis was used to identify distinct profiles of SB. Design-based linear and logistic regressions were used to examine associations between different profiles and health outcomes, accounting for sociodemographic characteristics. We identified four profiles and named them based on total sedentary time (ST) and passive/active pattern (n=852, \"Low ST\", \"High ST-passive\", \"Medium ST-TV\", \"High total ST-mentally active\"). Compared to the \"High ST-passive\" group, \"Low ST\" group was associated with fewer difficulties with activities of daily living, fewer problems limiting activities and higher cognitive function; \"High ST-mentally active\" group was associated with the above outcomes, as well as lower anxiety and depression. This study, with a national representative sample of the oldest old population, suggests that both total ST and SB pattern matter when evaluating health outcomes of being sedentary. Interventions should encourage oldest old adults to reduce ST and especially target mentally passive ST.

Background There is little evidence of the influence of dietary patterns on mortality risk among adults 80 years or older (“oldest-old”). We evaluated the association between the Simplified Healthy Eating index (SHE-index) and mortality among Chinese oldest-old. Methods Population-based cohort study from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 1998–2014, n  = 35 927), conducted in 22 Chinese provinces, were pooled for analysis. The first seven waves of the CLHLS (1998, 2000, 2002, 2005, 2008–09, 2011–12, and 2013–2014) were utilized, with follow-up to the last wave (2018) (range 0–21 years). The SHE-index was collected in each wave, and was constructed from intake frequency of nine dietary variables, with a higher score indicating better diet quality. Cox proportional hazards model with dietary patterns as a time-varying exposure was employed to analyze the relationship between SHE-index and mortality. Results At baseline, the median age of all participants was 92 years (25th percentile, 85 years; 75th percentile, 100 years). In multivariable models, the hazard ratios (95% confidence intervals) for SHE-index quartile 2, quartile 3 and quartile 4 versus quartile1 were 0.91 (0.88, 0.93), 0.89 (0.86, 0.92) and 0.82 (0.78, 0.85), respectively. Results were generally consistent for men and women and in a large number of sensitivity analyses. Conclusions Healthier eating patterns were associated with a significant reduction in the risk of all-cause mortality among Chinese oldest-old, lending support to the importance of life-long adherence to healthy diet into advanced old age.

While many diseases of aging have been linked to the immunological system, immune metrics capable of identifying the most at-risk individuals are lacking. From the blood immunome of 1,001 individuals aged 8-96 years, we developed a deep-learning method based on patterns of systemic age-related inflammation. The resulting inflammatory clock of aging (iAge) tracked with multimorbidity, immunosenescence, frailty and cardiovascular aging, and is also associated with exceptional longevity in centenarians. The strongest contributor to iAge was the chemokine CXCL9, which was involved in cardiac aging, adverse cardiac remodeling and poor vascular function. Furthermore, aging endothelial cells in human and mice show loss of function, cellular senescence and hallmark phenotypes of arterial stiffness, all of which are reversed by silencing CXCL9. In conclusion, we identify a key role of CXCL9 in age-related chronic inflammation and derive a metric for multimorbidity that can be utilized for the early detection of age-related clinical phenotypes.

Abstract Centenarian studies have come of age. With the first comprehensive centenarian studies conducted more than 35 years ago, there are now centenarian databases in the United States, in Europe, and in Asian countries. The major focus of these studies has been on genetic and family longevity factors, on support systems, personality, and on health behaviors. Another emphasis has been on various health components, such as physical health, mental health, frailty, and psychological well-being. In recent years, a second generation of centenarian studies has been initiated, comparing earlier born cohorts with later born cohorts. Among the first studies conducting a cohort comparison, the Danish centenarian studies, the Georgia centenarian studies, and the Tokyo centenarian studies showed inconsistent results. Whereas some studies indicated that later born cohorts enjoyed higher levels of functioning (e.g., Denmark, U.S. Georgia), other studies showed poorer performance (e.g., Japan). The current symposium sheds additional light on cohort comparisons with recently collected data from the second Hong Kong Centenarian Study, the Kyotango centenarian cohort, and the Health and Retirement Study. This presentation summarizes major findings from centenarian studies conducted around the world and highlights activities of the International Consortium of Centenarian Studies (ICC).

The immune system is the most important protective physiological system of the organism. It has many connections with other systems and is, in fact, often considered as part of the larger neuro-endocrine-immune axis. Most experimental data on immune changes with aging show a decline in many immune parameters when compared to young healthy subjects. The bulk of these changes is termed immunosenescence. Immunosenescence has been considered for some time as detrimental because it often leads to subclinical accumulation of pro-inflammatory factors and inflamm-aging. Together, immunosenescence and inflamm-aging are suggested to stand at the origin of most of the diseases of the elderly, such as infections, cancer, autoimmune disorders, and chronic inflammatory diseases. However, an increasing number of immune-gerontologists have challenged this negative interpretation of immunosenescence with respect to its significance in aging-related alterations of the immune system. If one considers these changes from an evolutionary perspective, they can be viewed preferably as adaptive or remodeling rather than solely detrimental. Whereas it is conceivable that global immune changes may lead to various diseases, it is also obvious that these changes may be needed for extended survival/longevity. Recent cumulative data suggest that, without the existence of the immunosenescence/inflamm-aging duo (representing two sides of the same phenomenon), human longevity would be greatly shortened. This review summarizes recent data on the dynamic reassessment of immune changes with aging. Accordingly, attempts to intervene on the aging immune system by targeting its rejuvenation, it may be more suitable to aim to maintain general homeostasis and function by appropriately improving immune-inflammatory-functions.

Sarcopenia is an age-related geriatric syndrome and is associated with numerous adverse outcomes. Although there is preponderance of studies on sarcopenia in community setting, few studies focused on the oldest old. We investigated the prevalence of sarcopenia in Chinese community-dwelling oldest old and examined the socio-demographic and lifestyle factors of sarcopenia. We also investigated the association between sarcopenia and disability in activities of daily living (ADL) and physical function among the oldest old. Cross-sectional study. Urban community in Beijing, China. 664 community-dwelling older adults aged 80 years or older. The presence of sarcopenia and the relationship between sarcopenia and physical function and disability were examined in 582 adults aged 80 years and older. we used the backward stepwise logistic regression model to explore socio-demographic and lifestyle correlates of sarcopenia. Sarcopenia was assessed by an algorithm recommended by the Asian Working Group for Sarcopenia (AWGS). The overall prevalence of sarcopenia was 26.6% (female 21.7%; male 33.3%). Age (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.06–1.22), body mass index (OR = 0.80, 95% CI: 0.73–0.89), and Mini-nutritional assessment (MNA) scores (OR = 0.78, 95% CI: 0.64–0.96) were independently associated with sarcopenia. The Odds of disability in ADL was approximately two times greater in oldest old with sarcopenia than those without. Sarcopenia was associated with poor lower extremity strength. Oldest old with sarcopenia have higher odds to reported difficulty in stooping, kneeing, or crouching, carrying weights over 5 kilograms, and walking 400 meters. We found over a quartile of the community-dwelling oldest old in China had sarcopenia. Older age, lower BMI, and worse nutritional status were significantly associated with the presence of sarcopenia. Sarcopenia was independently associated with disability and poor physical function.

The oldest old population has become the fastest growing segment with excess need of care and social support, it is crucial to improve the health-related quality of life (HRQoL) of these populations. This study seeks to evaluate the health status and to investigate modifiable factors associated with health-related quality of life for oldest old adults in China. A cross-sectional population-based study. Hainan Province in the south of China. 1,278 adults aged 80 years or older. HRQoL was assessed by three-level EuroQol-5D scale (EQ-5D-3L) and a visual analogue scale (VAS). Demographic and health-related variables were analysed by estimating mean values and standard deviations for continuous variables, percentages and standard deviations for categorical variables. Tobit regressions, ordinary least Squared (OLS) regressions and ordered probit regressions were adopted to determine the associated factors for overall HRQoL and for each health dimension. Anxiety/depression was the least reported problem while mobility was the most frequently reported with problem. Female respondents had lower EQ-5D score (0.76 vs. 0.86) and VAS score (66.55 vs. 69.84) than male respondents. Better health-related quality of life was significantly associated with higher BMI, no drinking habit, more leisure activities, living with family members, good sleeping quality, closer social and family connections, fewer numbers of drugs consumed per day, without having hearing or visual impairment, and fewer chronic conditions, after controlling for potential confounders. Findings from this study suggested that quality of life was not only associated with age-related diseases, but also correlated with a range of health-related lifestyles, and factors indicating social and family support.

Purpose Improved life expectancy imposes new challenges for policy-makers. The growing oldest-old age group (defined as 80 and over) is often characterised by increased support needs. Greater attention to wellbeing in this population group is necessary, and may well require a shift in social policy focus. The current review seeks to explore current research on determinants of mental wellbeing for the oldest old. Methods An iterative rapid review approach was used to review existing literature in line with four dimensions of mental wellbeing defined by the European Welfare Models and Mental Wellbeing in Final Years of Life (EMMY) study; functional, social, personal and environmental. A specific focus on articles employing multidimensional definitions of mental wellbeing was adopted. Results Multidimensional indicators reflect the multifaceted and multidirectional dynamics of wellbeing in very old age. Considerable variety in both measures and terminology was found within the literature making precise comparison difficult. The current review takes steps towards comparability by focusing on studies implementing multiple measures of mental wellbeing including evaluative, hedonistic and eudaimonic factors. Clearly defined and multifaceted measures of mental wellbeing are needed to sharpen evidence used in policy development, appraisal and evaluation in light of the considerable diversity of health and functional states experienced in later life. Conclusions Previous studies appear to line up the four main dimensions of mental wellbeing identified in the EMMY study. Actively improving opportunities for older adults to produce benefits to society can be done via a stronger focus on resources such as mental wellbeing.

Centenarians have a decreased susceptibility to ageing-associated illnesses, chronic inflammation and infectious diseases 1 – 3 . Here we show that centenarians have a distinct gut microbiome that is enriched in microorganisms that are capable of generating unique secondary bile acids, including various isoforms of lithocholic acid (LCA): iso-, 3-oxo-, allo-, 3-oxoallo- and isoallolithocholic acid. Among these bile acids, the biosynthetic pathway for isoalloLCA had not been described previously. By screening 68 bacterial isolates from the faecal microbiota of a centenarian, we identified Odoribacteraceae strains as effective producers of isoalloLCA both in vitro and in vivo. Furthermore, we found that the enzymes 5α-reductase (5AR) and 3β-hydroxysteroid dehydrogenase (3β-HSDH) were responsible for the production of isoalloLCA. IsoalloLCA exerted potent antimicrobial effects against Gram-positive (but not Gram-negative) multidrug-resistant pathogens, including Clostridioides difficile and Enterococcus faecium . These findings suggest that the metabolism of specific bile acids may be involved in reducing the risk of infection with pathobionts, thereby potentially contributing to the maintenance of intestinal homeostasis. The microbiota of centenarians (aged 100 years and older) comprise gut microorganisms that are capable of generating unique secondary bile acids, including isoallolithocholic acid, a bile acid with potent antimicrobial effects against Gram-positive—but not Gram-negative—multidrug-resistant pathogens.