Alan J. Gow

High quality evidence on the potential health benefits of intergenerational engagement (IE) for older adults, particularly using relatively moderate exposure, is limited. This pilot randomised controlled trial (RCT) evaluated the impact of a school-based IE intervention designed to engage healthy older adults in real-world activities and provide multimodal (cognitive, social, physical) engagement. Additionally, feasibility of the program was evaluated. The sample comprised 36 participants (29 females, 7 males), aged 60-80 years, who had been randomised to the intervention or a wait-list control group. Intervention participants assisted primary (elementary) school teachers in supporting children’s (4-8 yrs) reading, writing, and numeracy for 8 hours per week over six months, with data collected at baseline and 3- and 6-month follow-up sessions. The intervention was found to be generally feasible and was associated with significant improvements in: cognition (working memory, episodic memory, auditory verbal learning); daytime functioning (staying awake/alert); attitudes towards children; and sense of generative achievement (helping the younger generation). Benefits were typically observed at 3 months and maintained at 6 months. Moderate intensity participation in this school-based IE intervention therefore shows preliminary efficacy as a multimodal health promotion initiative for older adults. Minor intervention modification and full-scale assessment is now warranted.

Positive psychology interventions (PPI) have been applied and demonstrated evidence in various population groups. The present systematic review focused on the types and influence of PPI on the physical and psychological health of pregnant women. Studies that matched the selection criteria were identified on EBSCOhost, PsychINFO, Web of Science, PubMed, Scopus and four positive psychology journals. From the 2528 records identified, finally eight studies were included in the review. PPI in this review were delivered utilising various positive psychology components such as hope, gratitude and optimism based on existing theories, for example, the strengths theory, broaden‐and‐build theory, and hope theory. Most interventions were conducted from 14 gestational weeks onwards and were delivered via virtual platforms or mobile applications. As a result of this systematic review, it was identified that PPIs for maternal well‐being were aimed at improving (1) physical health, including labour pain, nausea and vomiting; (2) psychological health, including stress, emotions, anxiety and depression; and (3) subjective health, including life satisfaction, perceived social support and quality of life. Most of the selected studies provided significant evidence towards improvement of well‐being outcomes from administering PPI. For future studies, in‐depth PPI integrated coping and support approaches should be further evidenced among diverse pregnant populations.

Huntington's disease (HD) presents a heterogeneous neurodegenerative course, with motor, cognitive, and functional symptoms progressing differently across individuals. This atypical progression complicates the definition of discrete disease stages, hindering understanding of disease trajectories, timely pa- tient care, and therapy development. Consequently, current clinical staging systems rely heavily on clinician-defined, domain-specific criteria and fixed clinical measurement boundaries for stage assignment, reducing objectivity and often leading to overlapping clinical measurements across stages. While machine learning methods can help, existing approaches cannot fully capture complex temporal relationships within and across patients. We propose URL- STFN, a dynamic graph-based representation learning model that encodes both inter- and intra-patient temporal patterns from longitudinal clinical measures. We then evaluate disease stages formed through clustering and stability analysis of URL-STFN latent representations, and compare them with representations obtained from conventional embedding approaches. We further benchmark these clustering-based stages against states derived from conventional temporal models, including DHMM. We hypothesize that clustering URL-STFN latent representations enables identification of HD stages with reduced overlap in clinical measurements. The proposed framework is evaluated using 1,477 clinical visits from the Enroll-HD dataset, a large lon- gitudinal cohort with repeated clinical assessments. For staging, we used 44 clinical measurements spanning motor, cognitive, and functional domains. URL-STFN identifies clinically meaningful HD stages consistent with estab- lished disease progression while reducing overlap in clinical feature values compared with DHMM-derived and clinical staging approaches. These find- ings highlight the potential of a dynamic graph-based representation learning and clustering framework to support more objective, data-driven, and precise HD staging.

Background and Objectives: As populations age, extending healthy life expectancy and reducing morbidity are priorities. Cognitive frailty, the co-occurrence of cognitive impairment and physical frailty without dementia, may offer a window for prevention. However, there is limited evidence on how cognitive frailty is understood, which may undermine recognition and risk reduction. This study provides new insights into how cognitive frailty is conceptualized across public and professional contexts by exploring perceptions, causes, and risk factors of cognitive frailty to inform public health and clinical practice. Research Design and Methods: We conducted 22 semi-structured interviews with members of the public and healthcare professionals. Interviews examined perceived definitions, symptoms, and risk factors. Data were analyzed using reflexive thematic analysis. Results: Three analytic domains were identified: conceptualizations, manifestations, and risk factors. Participants often conflated cognitive frailty with cognitive impairment or described it as an early stage of dementia. The physical frailty aspect was under-recognized, particularly among public participants. When presented with the international definition, many reframed cognitive frailty as a transitional and potentially preventable state. Healthcare professionals articulated broader symptom profiles and more integrated risk frameworks, whereas the public emphasized observable physical change. Across both groups, mood changes, social withdrawal, and unhealthy lifestyle were viewed as central risks, though their interplay was described with varying detail. Discussion and Implications: Inconsistent understanding of cognitive frailty may hinder early recognition and prevention. Clearer operational definitions, supportive policy, and targeted education are needed to strengthen detection, risk reduction, and intervention strategies that protect independence in later life.

Background: Autistic people often experience difficulties in accessing support from social care. Autism-specific and age-related needs are likely to interact, leading to older autistic people being at risk of poor outcomes. There is a paucity of research involving older Autistic people. This paper brings together data and perspectives from Autistic people aged 50+ along with input from social care workers regarding priorities and gaps in social care support for older Autistic people. Methods: We used a range of data collection methods to allow participants to engage in their preferred format, including interview via video conferencing, messaging, and questionnaires. We explicitly stated researcher positionality, and have engaged with theory, taking a human rights approach. Through reflexive thematic analyses we developed themes from both the older Autistic people’s and social care professionals’ perspectives. Results: The five themes developed from Autistic people were “We’re … human beings like everyone else, but just have different needs”; “Bruised and battered, ..less able to cope”; “Wow, I don’t know where that leaves me” (Navigating ageing); “Always done unto”; and “Sharing power, … there's equal power in what is designed” P7. The two themes from social care staff were: Carrying the burden of care, “overburdened staff”; and Trying to make the system fit the individual.Conclusions: From these themes we developed recommendations that highlighted the need to: reduce the burden to navigate the care system for both older Autistic people and professionals; co-design care and care systems with older Autistic people, professionals, and policy makers to address how care is designed, delivered, and accessed; and equip professionals in social care with the knowledge and understanding to engage, work with, and support older Autistic people. We call attention to the need to raise awareness and understanding of older Autistic people with the public and highlight the paucity of research with this group.

This study examined the relationship between lifelong musical experience and cognitive function in older adulthood. To address inconsistencies in the extant literature an analytical approach in which three analytical approaches, binary groupings, categorical groupings, and continuous latent variables were directly compared. Older adults taking part in the Intervention Factory study completed the Edinburgh Lifetime Musical Experience Questionnaire (ELMEQ), and baseline cognitive data, which included a comprehensive battery assessing domains measured by the Wechsler Adult Intelligence Scale (WAIS) and Wechsler Memory Scale (WMS) were used. Analyses included ANCOVA models comparing musicians (≥6 years of musical experience) with non-musicians, followed by categorical groupings of both singers and instrument players, instrument players only , singers only, and non-musicians. Finally, multivariate multiple regression models using latent musical experience variables derived from responses to the ELMEQ were conducted. Across binary and categorical group analyses, musician status was not significantly associated with cognitive performance in any WAIS or WMS domain. Education and National Adult Reading Test (NART) scores were the strongest predictors across most outcomes. However, when musical experience was modelled as latent constructs, instrument playing was significantly associated with Working Memory, even after controlling for all covariates. Singing experience, music listening, and perceived musicality were not significantly related to cognitive outcomes in fully adjusted models. These findings suggest that while lifelong musical experience may not broadly predict cognitive ability independently of key covariates, instrument playing may provide domain-specific benefits in later life. Latent variable modelling may better capture these associations than traditional group-based methods.

Current evidence suggests that older adults with musical experience demonstrate better cognitive functioning than those without. However, this difference is poorly characterized, and findings are mixed, possibly due to variations in definitions of musical experience, cognitive measurements, and analytical approaches. To address this, the current study used a coordinated analysis approach to investigate whether there were differences in performance in certain cognitive domains between older adults with musical experience and those without. Two datasets were analyzed: the Einstein Aging Study (EAS) and the Gothenburg H70 Birth Cohort Studies (H70). Employing stringent matching procedures and combining frequentist and Bayesian approaches, the analysis provided a nuanced view of the data. Domain-level analyses compared cognitive performance in visuospatial abilities, processing speed, and memory (H70), and memory and vocabulary (EAS), as well as executive functions. Years of education and Mini-Mental State Examination (MMSE) scores predicted cognitive performance across measures in both datasets. In H70, those with musical experience significantly outperformed those without in visuospatial abilities, processing speed, memory, and executive function. No significant differences were observed in EAS. These findings reaffirm the complexity and variability of the music-cognition relationship. Given that education and MMSE consistently predicted cognitive outcomes, differences between datasets were likely due to group characteristics rather than cognitive measures. Instrument playing, for example, may offer stronger cognitive benefits than singing, which was the primary difference between music groups across datasets. This research highlights the need for comprehensive musical experience measures to uncover whether specific musical activities enhance cognitive ability in older adults.

Objective Older adults may require additional support to comprehend written information due to inadequate health literacy, which involves components of cognitive function including reaction time. This study tested the acceptability of web-based reaction time testing in the UK Women’s Cohort Study and possible sources of bias. Additionally, it assessed the association between health literacy and reaction time. Design A cross-sectional analysis was conducted using data from the UK Women’s Cohort Study, a prospective cohort study. Participants The study involved women aged 48–85 without cancer registration who participated in the 2010/2011 follow-up (n=768). Setting Postal questionnaires and web-based cognitive function tests were administered in participants’ homes. Methods and analysis Logistic regression identified predictors of volunteering for reaction time testing, used to calculate inverse probability weights for the primary analysis. Associations between health literacy and reaction time were estimated with linear regression models, adjusting for volunteer effects. Poisson regression models assessed associations between health literacy and choice reaction time errors. Primary and secondary outcome measures The primary outcome was acceptability of web-based testing (response rate, task distress, task difficulty). Secondary outcomes were sources of volunteer bias and the association between health literacy and reaction time. Results Web-based testing of cognitive function was attempted by 67% of women (maximum age 80), with little distress or difficulty reported. There was substantive volunteer bias. Women providing data on cognitive function were younger, had higher educational attainment and were higher in self-rated intelligence. Inadequate health literacy was associated with making fewer choice reaction time errors among those providing valid data but was also associated with not providing valid data. Health literacy was not associated with other aspects of reaction time (speed, variability). Additionally, selection bias may have restricted range on study variables, given that 2010/2011 volunteers were younger and more educated compared with those at recruitment in 1995/1998. Conclusion Brief web-based measures of cognitive function in the home are acceptable to women aged 48–80, but there are substantive selection effects and volunteer biases. Additionally, there are potentially vulnerable subgroups who provide poorer quality data.