INTRODUCTION:
Taiwan’s aging population faces a high socioeconomic burden due to chronic diseases like hypertension and dementia, which impact body composition, cognition, life satisfaction, metabolism, and gut microbiota. This study explores strategies to improve health outcomes for older adults with different chronic conditions.
METHODS:
A total of 129 elderly participants were included: 16 with dementia, 27 with early cognitive impairment, 28 with hypertension, and 58 healthy controls. Participants provided medical history, demographics, and anthropometric data and completed fitness, cognitive, depression, and quality-of-life assessments. Cognitive function was evaluated using the 10-item Short Portable Mental Status Questionnaire (SPMSQ), depression with the 15-item Geriatric Depression Scale (GDS-15), and quality of life with a QoL questionnaire. Urinary metabolomics and oxidative stress markers (8-OHdG, 8-isoprostanes, and AD7c-NTP) were analyzed to identify dementia biomarkers. Stool samples were collected for DNA extraction and gut microbiota analysis via next-generation sequencing (NGS).
RESULTS:
Dementia patients had significantly lower physical fitness than other groups (p < .05), except in aerobic endurance (p > .05). Hypertensive individuals had weaker lower extremity strength than healthy controls (p < .05). Dementia patients scored lower on SPMSQ and higher on depression scales (p < .05). Although QoL scores did not differ significantly (p > .05), healthier individuals had higher scores. Dementia patients showed significantly elevated urinary 8-OHdG and AD7c-NTP, while 8-isoprostanes increased in all chronic disease groups. Five urinary metabolites increased, while 14 decreased in dementia patients. Gut microbiota analysis showed distinct differences, with healthy individuals exhibiting higher abundances of Prevotella, Odoribacter, and Muribaculaceae, while early cognitive impairment patients had increased Alistipes, Akkermansia, and Escherichia-Shigella. α- and β-diversity analyses confirmed gut microbiota alterations in early dementia.
CONCLUSION:
Dementia patients exhibited the most severe declines in physical fitness and depression. The study identified dementia-related metabolic changes, oxidative stress, and gut microbiota dysbiosis, suggesting these factors as potential biomarkers for early dementia assessment.