Emily J. Nicklett

Does Accumulation of Advanced Glycation End Products Contribute to the Aging Phenotype

BACKGROUND Aging is a complex multifactorial process characterized by accumulation of deleterious changes in cells and tissues, progressive deterioration of structural integrity and physiological function across multiple organ systems, and increased risk of death. METHODS We conducted a review of the scientific literature on the relationship of advanced glycation end products (AGEs) with aging. AGEs are a heterogeneous group of bioactive molecules that are formed by the nonenzymatic glycation of proteins, lipids, and nucleic acids. RESULTS Humans are exposed to AGEs produced in the body, especially in individuals with abnormal glucose metabolism, and AGEs ingested in foods. AGEs cause widespread damage to tissues through upregulation of inflammation and cross-linking of collagen and other proteins. AGEs have been shown to adversely affect virtually all cells, tissues, and organ systems. Recent epidemiological studies demonstrate that elevated circulating AGEs are associated with increased risk of developing many chronic diseases that disproportionally affect older individuals. CONCLUSIONS Based on these data, we propose that accumulation of AGEs accelerate the multisystem functional decline that occurs with aging, and therefore contribute to the aging phenotype. Exposure to AGEs can be reduced by restriction of dietary intake of AGEs and drug treatment with AGE inhibitors and AGE breakers. Modification of intake and circulating levels of AGEs may be a possible strategy to promote health in old age, especially because most Western foods are processed at high temperature and are rich in AGEs.

Eating Disorder Symptoms Among College Students: Prevalence, Persistence, Correlates, and Treatment-Seeking

Abstract Objective: To examine the prevalence, correlates, persistence, and treatment-seeking related to symptoms of eating disorders (EDs) in a random sample of college students. Participants: A random sample of students at a large university were recruited for an Internet survey in Fall 2005 and a follow-up survey in Fall 2007. Methods: ED symptoms were measured using the SCOFF screen and adjusted for nonresponse using administrative data and a nonresponse survey. Results: 2,822 (56%) students completed the baseline survey. Among undergraduates the prevalence of positive screens was 13.5% for women and 3.6% for men. Among students with positive screens, 20% had received past-year mental health treatment. In the follow-up sample (N = 753), ED symptoms at baseline significantly predicted symptoms 2 years later. Conclusions: Symptoms of EDs were prevalent and persistent among college students in this study. These findings suggest that brief screens can identify a large number of students with untreated EDs.

Social Support from Church and Family Members and Depressive Symptoms Among Older African Americans

OBJECTIVE This study examined the influence of church- and family-based social support on depressive symptoms and serious psychological distress among older African Americans. METHODS The analysis is based on the National Survey of American Life. Church- and family-based informal social support correlates of depressive symptoms (CES-D) and serious psychological distress (K6) were examined. Data from 686 African Americans aged 55 years or older who attend religious services at least a few times a year are used in this analysis. RESULTS Multivariate analysis found that social support from church members was significantly and inversely associated with depressive symptoms and psychological distress. Frequency of negative interactions with church members was positively associated with depressive symptoms and psychological distress. Social support from church members remained significant but negative interaction from church members did not remain significant when controlling for indicators of family social support. Among this sample of churchgoers, emotional support from family was a protective factor and negative interaction with family was a risk factor for depressive symptoms and psychological distress. CONCLUSION This is the first investigation of the relationship between church- and family-based social support and depressive symptoms and psychological distress among a national sample of older African Americans. Overall, the findings indicate that social support from church networks was protective against depressive symptoms and psychological distress. This finding remained significant when controlling for indicators of family social support.

Fruit and vegetable intake among older adults: A scoping review

Older adults are the fastest growing segment of the world population. Older adults are also at heightened risk of chronic conditions (such as diabetes, heart disease, and cancer) and specific geriatric conditions (such as cognitive impairment, frailty, and falls). Research studies have examined the relationship between fruit and vegetable intake and subsequent health outcomes and the correlates of fruit and vegetable intake in the U.S. population. However, relatively few studies have specifically examined health impacts and correlates of fruit and vegetable intake among older adults, who have unique biophysical and socioeconomic circumstances. Evidence is reviewed to (1) describe findings related to consumption and chronic, geriatric, and other health outcomes among older adults and (2) describe patterns in fruit and vegetable consumption among older adults and how these patterns vary within and among populations. This review addresses specific barriers faced by older adults in obtaining and consuming fruits and vegetables in community settings. Recommendations for practice and policy are discussed.

Fruit and Vegetable Intake, Physical Activity, and Mortality in Older Community-Dwelling Women

To examine the relationship between fruit and vegetable intake, physical activity, and all‐cause mortality in older women.

Fat Mass Is Inversely Associated with Serum Carboxymethyl-Lysine, An Advanced Glycation End Product, in Adults

High levels of circulating advanced glycation end products (AGE) are associated with cardiovascular disease, diabetes, chronic kidney disease, and increased mortality, but factors that influence levels of circulating AGE are not well known. Our objective was to characterize the relationship between serum carboxymethyl-lysine (CML), a major circulating AGE, and body composition in adults. In a cross-sectional study, total body DXA was performed and serum CML was measured in 592 adults, aged 26-93 y, from the Baltimore Longitudinal Study of Aging. Median (25th, 75th percentile) CML concentrations were 2.26 (1.86, 2.67) μmol/L. Total fat mass [β = -0.17 (95% CI -0.10, -0.24); P < 0.0001], truncal fat mass [β = -0.17 (95% CI -0.10, -0.25); P < 0.0001], and appendicular fat mass [β = -0.13 (95% CI -0.05, -0.20); P = 0.001] per 1 SD increase were inversely associated with serum CML in separate multivariate linear regression models, adjusting for age, sex, BMI, systolic blood pressure, TG, HDL cholesterol, and renal function. Lean body mass was not independently associated with serum CML. These findings suggest that serum CML concentration is strongly affected by body fat, possibly because CML is preferentially deposited in fat tissue or because adipocytes affect the metabolism of AGE.

Direct Social Support and Long-term Health Among Middle-Aged and Older Adults With Type 2 Diabetes Mellitus

OBJECTIVES This study examined whether or not direct social support is associated with long-term health among middle-aged and older adults with diabetes mellitus. METHOD Direct social support was assessed at baseline (2003) for 1,099 adults with type 2 diabetes mellitus from the Health and Retirement Study. Self-reported health status was examined at baseline and in 4 biennial survey waves (2003-2010). A series of ordinal logistic regression models examined whether or not the 7-item Diabetes Care Profile scale was associated with a subsequent change in health status over time. Additional analyses examined whether or not individual components of direct social support were associated with health status change. RESULTS After adjusting for baseline covariates, greater direct social support as measured by the Diabetes Care Profile was associated with improved health outcomes over time; however, this trend was not significant (p = .06). The direct social support measures that were associated with improved health over follow-up were support for taking medicines (odds ratio [OR] = 1.22), physical activity (OR = 1.26), and going to health care providers (OR = 1.22; all p < .05). DISCUSSION Interventions that specifically target improving specific aspects of diabetes social support may be more effective in improving long-term health than less targeted efforts.

Racial/ethnic predictors of falls among older adults: The Health and Retirement Study

Objective: The objective of this study was to examine racial/ethnic differences in the probability and frequency of falls among adults aged 65 and older. Method: Using data from the Health and Retirement Study (HRS) from 2000 to 2010, the authors conducted random-intercept logistic and Poisson regression analyses to examine whether race/ethnicity predicted the likelihood of a fall event and the frequency of falls. Results: The analytic sample included 10,484 older adults. Baseline analyses showed no significant racial/ethnic differences in the probability or number of falls. However, in the longitudinal random-intercept models, African Americans had significantly lower odds (0.65) of experiencing at least one fall compared with non-Hispanic Whites. Among fallers, African Americans had significantly fewer falls (24%) than non-Hispanic Whites, controlling for health and sociodemographic covariates (all ps < .05). Latinos did not differ from non-Hispanic Whites in the likelihood or number of falls. Discussion: African Americans are less likely to experience initial or recurrent falls than non-Hispanic Whites.

Socioeconomic status and race/ethnicity independently predict health decline among older diabetics.

BackgroundThere are pervasive racial and socioeconomic differences in health status among older adults with type 2 diabetes. The extent to which racial/ethnic and socioeconomic disparities unfold to differential health outcomes has yet to be investigated among older adults with diabetes. This study examines whether or not race/ethnicity and SES are independent predictors of steeper rates of decline in self-rated health among older adults in the U.S. with type 2 diabetes.MethodsThe study population was a subset of diabetic adults aged 65 and older from the Health and Retirement Study. Respondents were followed up to 16 years. Multilevel cumulative logit regression models were used to examine the contributions of socioeconomic indicators, race/ethnicity, and covariates over time. Health decline was measured as a change in self-reported health status over the follow-up period.ResultsRelative to whites, blacks had a significantly lower cumulative odds of better health status over time (OR: 0.61, p < .0001). Hispanics reported significantly lower cumulative odds better health over time relative to whites (OR: 0.59, p < .05). Although these disparities narrowed when socioeconomic characteristics were added to the model, significant differences remained. Including socioeconomic status did not remove the health effects of race/ethnicity among blacks and Hispanics.ConclusionsThe author found that race/ethnicity and some socioeconomic indicators were independent predictors of health decline among older adults with diabetes.

Neighborhood Socioeconomic Status Is Associated with Serum Carotenoid Concentrations in Older, Community-Dwelling Women

A high dietary intake of fruit and vegetables has been shown to be protective for health. Neighborhood socioeconomic differences may influence the consumption of carotenoid-rich foods, as indicated by serum carotenoid concentrations. To test this hypothesis, we examined the relationship between neighborhood socioeconomic status (SES) and serum carotenoid concentrations in a population-based sample of community-dwelling women, aged 70-79 y, who participated in the Womens Health and Aging Study II in Baltimore, Maryland. Neighborhood socioeconomic Z-scores were derived from characteristics of the census block of the participants. Serum carotenoid concentrations were measured at baseline and at 18, 36, 72, 98, and 108 mo follow-up visits. Neighborhood Z-scores were positively associated with serum α-carotene (P = 0.0006), β-carotene (P = 0.07), β-cryptoxanthin (P = 0.03), and lutein+zeaxanthin (P = 0.004) after adjusting for age, race, BMI, smoking, inflammation, and season. There was no significant association between neighborhood Z-score and serum lycopene. Older, community-dwelling women from neighborhoods with lower SES have lower serum carotenoid concentrations, which reflect a lower consumption of carotenoid-rich fresh fruits and vegetables.