The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing
Abstract Individuals with anxiety disorders exhibit lower intrinsic functional connectivity between prefrontal cortical areas and subcortical regions. The prefrontal cortex (PFC) is sensitive to the acute and chronic effects of physical activity (PA), while the anxiolytic effects of PA are well know...
Gespeichert in:
Veröffentlicht in: | The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2021-08, Vol.76 (8), p.1391-1397 |
---|---|
Hauptverfasser: | , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 1397 |
---|---|
container_issue | 8 |
container_start_page | 1391 |
container_title | The journals of gerontology. Series A, Biological sciences and medical sciences |
container_volume | 76 |
creator | McDowell, Cillian P Newman, Louise Monroe, Derek C O’Connor, John D Knight, Silvin P Kenny, Rose Anne Herring, Matt P |
description | Abstract
Individuals with anxiety disorders exhibit lower intrinsic functional connectivity between prefrontal cortical areas and subcortical regions. The prefrontal cortex (PFC) is sensitive to the acute and chronic effects of physical activity (PA), while the anxiolytic effects of PA are well known. The current study examined the association of generalized anxiety disorder (GAD) and its interaction with PA, with resting-state, left PFC oxygenation. This cross-sectional study used data from participants (N = 2444) from The Irish Longitudinal Study on Ageing, a nationally representative prospective study of community-living adults aged 50 and older in Ireland. The Composite International Diagnostic Interview Short-Form determined fulfillment of criteria for GAD. The short-form International Physical Activity Questionnaire determined adherence to the World Health Organization PA guidelines. Resting-state, left PFC oxygenation was continuously measured via a Portalite. Tissue saturation index (TSI) was calculated as the ratio of oxygenated hemoglobin to total tissue hemoglobin (expressed as a percentage) for the final minute of a 5-minute supine-rest period. Multivariable linear regression quantified associations of GAD with TSI in the total population and population stratified by PA status. Participants with GAD had lower TSI (b = −1.416, p = .008) compared to those without GAD. However, this association was modified by PA. Among participants who met the PA guidelines, TSI did not differ according to GAD status (b = −0.800, p = .398). For participants who did not meet the guidelines, TSI was significantly lower among those with GAD (b = −1.758, p = .004). These findings suggest that PA may help to protect brain health among older adults with GAD. |
doi_str_mv | 10.1093/gerona/glab090 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8600010</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/gerona/glab090</oup_id><sourcerecordid>2507147362</sourcerecordid><originalsourceid>FETCH-LOGICAL-c452t-d9add9e3847cbaabf71128d2a3be04266b2ef00f0e2f4c07e013efbfcc2bfc6d3</originalsourceid><addsrcrecordid>eNqFkktv1DAQgCMEoqVw5YgscYFDWj_y5FApLLSstKhVt0jcIseeZF1l7cV2yoZfyM_CUZYKuOCDPZI_f5oZTxS9JPiU4JKddWCN5mddzxtc4kfRMcnTIk5Z-vVxiHFexinG2VH0zLk7PK2UPo2OGMsLnLL8OPp5uwFUOWeE4l4Zjd6D_w6g0SVosLxXP0CiSu8V-BF9UM5YCRZxLdENOK90F68994CuLbQhE897tDDWwx5d7ccO9CxdOvTZSNWqIGtGtIa-jW9gN4ESXW9Gp0R4WAmv7pUf303uofcOXVizRVOGS6vcBq2M7pQfpNKBXodgREFedRDyeB49aXnv4MXhPIm-XHy8XXyKV1eXy0W1ikWSUh_LkktZAiuSXDScN21OCC0k5awBnNAsayi0GLcYaJsInAMmDNqmFYKGLZPsJDqfvbuh2YIUoH1oU72zasvtWBuu6r9vtNrUnbmviyx0n-AgeHMQWPNtCE2st8oJ6HuuwQyupinOSZKzjAb09T_onRlsKH6iMhJkRZEE6nSmhDXOhX94SIbgehqSeh6S-jAk4cGrP0t4wH9PRQDezoAZdv-T_QLMAs8W</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2561103884</pqid></control><display><type>article</type><title>The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>McDowell, Cillian P ; Newman, Louise ; Monroe, Derek C ; O’Connor, John D ; Knight, Silvin P ; Kenny, Rose Anne ; Herring, Matt P</creator><contributor>Le Couteur, David</contributor><creatorcontrib>McDowell, Cillian P ; Newman, Louise ; Monroe, Derek C ; O’Connor, John D ; Knight, Silvin P ; Kenny, Rose Anne ; Herring, Matt P ; Le Couteur, David</creatorcontrib><description>Abstract
Individuals with anxiety disorders exhibit lower intrinsic functional connectivity between prefrontal cortical areas and subcortical regions. The prefrontal cortex (PFC) is sensitive to the acute and chronic effects of physical activity (PA), while the anxiolytic effects of PA are well known. The current study examined the association of generalized anxiety disorder (GAD) and its interaction with PA, with resting-state, left PFC oxygenation. This cross-sectional study used data from participants (N = 2444) from The Irish Longitudinal Study on Ageing, a nationally representative prospective study of community-living adults aged 50 and older in Ireland. The Composite International Diagnostic Interview Short-Form determined fulfillment of criteria for GAD. The short-form International Physical Activity Questionnaire determined adherence to the World Health Organization PA guidelines. Resting-state, left PFC oxygenation was continuously measured via a Portalite. Tissue saturation index (TSI) was calculated as the ratio of oxygenated hemoglobin to total tissue hemoglobin (expressed as a percentage) for the final minute of a 5-minute supine-rest period. Multivariable linear regression quantified associations of GAD with TSI in the total population and population stratified by PA status. Participants with GAD had lower TSI (b = −1.416, p = .008) compared to those without GAD. However, this association was modified by PA. Among participants who met the PA guidelines, TSI did not differ according to GAD status (b = −0.800, p = .398). For participants who did not meet the guidelines, TSI was significantly lower among those with GAD (b = −1.758, p = .004). These findings suggest that PA may help to protect brain health among older adults with GAD.</description><identifier>ISSN: 1079-5006</identifier><identifier>EISSN: 1758-535X</identifier><identifier>DOI: 10.1093/gerona/glab090</identifier><identifier>PMID: 33780537</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Aged ; Aging ; Aging - physiology ; Aging - psychology ; Anxiety ; Anxiety disorders ; Anxiety Disorders - diagnosis ; Anxiety Disorders - epidemiology ; Anxiety Disorders - metabolism ; Anxiety Disorders - physiopathology ; Chronic effects ; Connectome ; Cross-Sectional Studies ; Exercise ; Exercise - physiology ; Exercise - psychology ; Female ; Generalized anxiety disorder ; Hemoglobin ; Hemoglobins - analysis ; Humans ; Ireland - epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Neural networks ; Older people ; Oxygen Consumption ; Oxygenation ; Physical activity ; Physical fitness ; Prefrontal cortex ; Prefrontal Cortex - blood supply ; Prefrontal Cortex - physiopathology ; Protective Factors ; Self Report ; THE JOURNAL OF GERONTOLOGY: Biological Sciences</subject><ispartof>The journals of gerontology. Series A, Biological sciences and medical sciences, 2021-08, Vol.76 (8), p.1391-1397</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>Copyright Oxford University Press Aug 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-d9add9e3847cbaabf71128d2a3be04266b2ef00f0e2f4c07e013efbfcc2bfc6d3</citedby><cites>FETCH-LOGICAL-c452t-d9add9e3847cbaabf71128d2a3be04266b2ef00f0e2f4c07e013efbfcc2bfc6d3</cites><orcidid>0000-0001-7090-9293 ; 0000-0001-7825-1123</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,778,782,883,1581,27913,27914</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33780537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Le Couteur, David</contributor><creatorcontrib>McDowell, Cillian P</creatorcontrib><creatorcontrib>Newman, Louise</creatorcontrib><creatorcontrib>Monroe, Derek C</creatorcontrib><creatorcontrib>O’Connor, John D</creatorcontrib><creatorcontrib>Knight, Silvin P</creatorcontrib><creatorcontrib>Kenny, Rose Anne</creatorcontrib><creatorcontrib>Herring, Matt P</creatorcontrib><title>The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing</title><title>The journals of gerontology. Series A, Biological sciences and medical sciences</title><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><description>Abstract
Individuals with anxiety disorders exhibit lower intrinsic functional connectivity between prefrontal cortical areas and subcortical regions. The prefrontal cortex (PFC) is sensitive to the acute and chronic effects of physical activity (PA), while the anxiolytic effects of PA are well known. The current study examined the association of generalized anxiety disorder (GAD) and its interaction with PA, with resting-state, left PFC oxygenation. This cross-sectional study used data from participants (N = 2444) from The Irish Longitudinal Study on Ageing, a nationally representative prospective study of community-living adults aged 50 and older in Ireland. The Composite International Diagnostic Interview Short-Form determined fulfillment of criteria for GAD. The short-form International Physical Activity Questionnaire determined adherence to the World Health Organization PA guidelines. Resting-state, left PFC oxygenation was continuously measured via a Portalite. Tissue saturation index (TSI) was calculated as the ratio of oxygenated hemoglobin to total tissue hemoglobin (expressed as a percentage) for the final minute of a 5-minute supine-rest period. Multivariable linear regression quantified associations of GAD with TSI in the total population and population stratified by PA status. Participants with GAD had lower TSI (b = −1.416, p = .008) compared to those without GAD. However, this association was modified by PA. Among participants who met the PA guidelines, TSI did not differ according to GAD status (b = −0.800, p = .398). For participants who did not meet the guidelines, TSI was significantly lower among those with GAD (b = −1.758, p = .004). These findings suggest that PA may help to protect brain health among older adults with GAD.</description><subject>Aged</subject><subject>Aging</subject><subject>Aging - physiology</subject><subject>Aging - psychology</subject><subject>Anxiety</subject><subject>Anxiety disorders</subject><subject>Anxiety Disorders - diagnosis</subject><subject>Anxiety Disorders - epidemiology</subject><subject>Anxiety Disorders - metabolism</subject><subject>Anxiety Disorders - physiopathology</subject><subject>Chronic effects</subject><subject>Connectome</subject><subject>Cross-Sectional Studies</subject><subject>Exercise</subject><subject>Exercise - physiology</subject><subject>Exercise - psychology</subject><subject>Female</subject><subject>Generalized anxiety disorder</subject><subject>Hemoglobin</subject><subject>Hemoglobins - analysis</subject><subject>Humans</subject><subject>Ireland - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neural networks</subject><subject>Older people</subject><subject>Oxygen Consumption</subject><subject>Oxygenation</subject><subject>Physical activity</subject><subject>Physical fitness</subject><subject>Prefrontal cortex</subject><subject>Prefrontal Cortex - blood supply</subject><subject>Prefrontal Cortex - physiopathology</subject><subject>Protective Factors</subject><subject>Self Report</subject><subject>THE JOURNAL OF GERONTOLOGY: Biological Sciences</subject><issn>1079-5006</issn><issn>1758-535X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkktv1DAQgCMEoqVw5YgscYFDWj_y5FApLLSstKhVt0jcIseeZF1l7cV2yoZfyM_CUZYKuOCDPZI_f5oZTxS9JPiU4JKddWCN5mddzxtc4kfRMcnTIk5Z-vVxiHFexinG2VH0zLk7PK2UPo2OGMsLnLL8OPp5uwFUOWeE4l4Zjd6D_w6g0SVosLxXP0CiSu8V-BF9UM5YCRZxLdENOK90F68994CuLbQhE897tDDWwx5d7ccO9CxdOvTZSNWqIGtGtIa-jW9gN4ESXW9Gp0R4WAmv7pUf303uofcOXVizRVOGS6vcBq2M7pQfpNKBXodgREFedRDyeB49aXnv4MXhPIm-XHy8XXyKV1eXy0W1ikWSUh_LkktZAiuSXDScN21OCC0k5awBnNAsayi0GLcYaJsInAMmDNqmFYKGLZPsJDqfvbuh2YIUoH1oU72zasvtWBuu6r9vtNrUnbmviyx0n-AgeHMQWPNtCE2st8oJ6HuuwQyupinOSZKzjAb09T_onRlsKH6iMhJkRZEE6nSmhDXOhX94SIbgehqSeh6S-jAk4cGrP0t4wH9PRQDezoAZdv-T_QLMAs8W</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>McDowell, Cillian P</creator><creator>Newman, Louise</creator><creator>Monroe, Derek C</creator><creator>O’Connor, John D</creator><creator>Knight, Silvin P</creator><creator>Kenny, Rose Anne</creator><creator>Herring, Matt P</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7090-9293</orcidid><orcidid>https://orcid.org/0000-0001-7825-1123</orcidid></search><sort><creationdate>20210801</creationdate><title>The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing</title><author>McDowell, Cillian P ; Newman, Louise ; Monroe, Derek C ; O’Connor, John D ; Knight, Silvin P ; Kenny, Rose Anne ; Herring, Matt P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-d9add9e3847cbaabf71128d2a3be04266b2ef00f0e2f4c07e013efbfcc2bfc6d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Aging</topic><topic>Aging - physiology</topic><topic>Aging - psychology</topic><topic>Anxiety</topic><topic>Anxiety disorders</topic><topic>Anxiety Disorders - diagnosis</topic><topic>Anxiety Disorders - epidemiology</topic><topic>Anxiety Disorders - metabolism</topic><topic>Anxiety Disorders - physiopathology</topic><topic>Chronic effects</topic><topic>Connectome</topic><topic>Cross-Sectional Studies</topic><topic>Exercise</topic><topic>Exercise - physiology</topic><topic>Exercise - psychology</topic><topic>Female</topic><topic>Generalized anxiety disorder</topic><topic>Hemoglobin</topic><topic>Hemoglobins - analysis</topic><topic>Humans</topic><topic>Ireland - epidemiology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neural networks</topic><topic>Older people</topic><topic>Oxygen Consumption</topic><topic>Oxygenation</topic><topic>Physical activity</topic><topic>Physical fitness</topic><topic>Prefrontal cortex</topic><topic>Prefrontal Cortex - blood supply</topic><topic>Prefrontal Cortex - physiopathology</topic><topic>Protective Factors</topic><topic>Self Report</topic><topic>THE JOURNAL OF GERONTOLOGY: Biological Sciences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McDowell, Cillian P</creatorcontrib><creatorcontrib>Newman, Louise</creatorcontrib><creatorcontrib>Monroe, Derek C</creatorcontrib><creatorcontrib>O’Connor, John D</creatorcontrib><creatorcontrib>Knight, Silvin P</creatorcontrib><creatorcontrib>Kenny, Rose Anne</creatorcontrib><creatorcontrib>Herring, Matt P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The journals of gerontology. Series A, Biological sciences and medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McDowell, Cillian P</au><au>Newman, Louise</au><au>Monroe, Derek C</au><au>O’Connor, John D</au><au>Knight, Silvin P</au><au>Kenny, Rose Anne</au><au>Herring, Matt P</au><au>Le Couteur, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing</atitle><jtitle>The journals of gerontology. Series A, Biological sciences and medical sciences</jtitle><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>76</volume><issue>8</issue><spage>1391</spage><epage>1397</epage><pages>1391-1397</pages><issn>1079-5006</issn><eissn>1758-535X</eissn><abstract>Abstract
Individuals with anxiety disorders exhibit lower intrinsic functional connectivity between prefrontal cortical areas and subcortical regions. The prefrontal cortex (PFC) is sensitive to the acute and chronic effects of physical activity (PA), while the anxiolytic effects of PA are well known. The current study examined the association of generalized anxiety disorder (GAD) and its interaction with PA, with resting-state, left PFC oxygenation. This cross-sectional study used data from participants (N = 2444) from The Irish Longitudinal Study on Ageing, a nationally representative prospective study of community-living adults aged 50 and older in Ireland. The Composite International Diagnostic Interview Short-Form determined fulfillment of criteria for GAD. The short-form International Physical Activity Questionnaire determined adherence to the World Health Organization PA guidelines. Resting-state, left PFC oxygenation was continuously measured via a Portalite. Tissue saturation index (TSI) was calculated as the ratio of oxygenated hemoglobin to total tissue hemoglobin (expressed as a percentage) for the final minute of a 5-minute supine-rest period. Multivariable linear regression quantified associations of GAD with TSI in the total population and population stratified by PA status. Participants with GAD had lower TSI (b = −1.416, p = .008) compared to those without GAD. However, this association was modified by PA. Among participants who met the PA guidelines, TSI did not differ according to GAD status (b = −0.800, p = .398). For participants who did not meet the guidelines, TSI was significantly lower among those with GAD (b = −1.758, p = .004). These findings suggest that PA may help to protect brain health among older adults with GAD.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>33780537</pmid><doi>10.1093/gerona/glab090</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7090-9293</orcidid><orcidid>https://orcid.org/0000-0001-7825-1123</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1079-5006 |
ispartof | The journals of gerontology. Series A, Biological sciences and medical sciences, 2021-08, Vol.76 (8), p.1391-1397 |
issn | 1079-5006 1758-535X |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8600010 |
source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
subjects | Aged Aging Aging - physiology Aging - psychology Anxiety Anxiety disorders Anxiety Disorders - diagnosis Anxiety Disorders - epidemiology Anxiety Disorders - metabolism Anxiety Disorders - physiopathology Chronic effects Connectome Cross-Sectional Studies Exercise Exercise - physiology Exercise - psychology Female Generalized anxiety disorder Hemoglobin Hemoglobins - analysis Humans Ireland - epidemiology Longitudinal Studies Male Middle Aged Neural networks Older people Oxygen Consumption Oxygenation Physical activity Physical fitness Prefrontal cortex Prefrontal Cortex - blood supply Prefrontal Cortex - physiopathology Protective Factors Self Report THE JOURNAL OF GERONTOLOGY: Biological Sciences |
title | The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T08%3A14%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Association%20Between%20Generalized%20Anxiety%20Disorder%20and%20Resting-State%20Prefrontal%20Cortex%20Oxygenation%20Is%20Modified%20by%20Self-Reported%20Physical%20Activity:%20Results%20From%20The%20Irish%20Longitudinal%20Study%20on%20Ageing&rft.jtitle=The%20journals%20of%20gerontology.%20Series%20A,%20Biological%20sciences%20and%20medical%20sciences&rft.au=McDowell,%20Cillian%20P&rft.date=2021-08-01&rft.volume=76&rft.issue=8&rft.spage=1391&rft.epage=1397&rft.pages=1391-1397&rft.issn=1079-5006&rft.eissn=1758-535X&rft_id=info:doi/10.1093/gerona/glab090&rft_dat=%3Cproquest_pubme%3E2507147362%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2561103884&rft_id=info:pmid/33780537&rft_oup_id=10.1093/gerona/glab090&rfr_iscdi=true |