Cognitive Health of Nonagenarians in Southern Italy: A Descriptive Analysis from a Cross-Sectional, Home-Based Pilot Study of Exceptional Longevity (Cilento Initiative on Aging Outcomes or CIAO)

Abstract

Background and objectives: Nonagenarians and centenarians (NCs) are an extremely fragile population, particularly in regard to their physical and cognitive function. The aim of this study was to define the neurocognitive profiles among 29 NCs and their 49 younger cohabitants aged 50–75 years from The Cilento Initiative on Aging Outcomes (CIAO) Pilot study in the South of Italy that had provided initial hypotheses regarding positive psychological traits related to exceptional longevity. Materials and Methods: During the home visits, lifestyle information with specific questionnaires, functional autonomy and the neuropsychological Mini Mental Scale Examination (MMSE), and the Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog) scale were obtained by qualified study personnel. The total blood oxidative capacity was also determined by testing the reactive derivative of oxygen metabolites (d-ROM) and by the Biological Antioxidant Potential (BAP). In all individuals, the APOE genotype determination was also performed. Results: All the subjects in both groups showed high adherence to the Mediterranean Diet. None of the NCs had severe cognitive impairment, and a very low incidence of dementia was found. The data obtained on the Activities ed Instrumental Activities of Daily Living (ADL-IADL) scale showed that the majority of NCs (16/29) were autonomous in daily life activities. The comparative assessment of NCs and cohabitants showed no significant differences in the laboratory assessment of oxidative stress and APOE genotype. Conclusions: In the Cilento Region of Southern Italy, NCs seemed to have good cognitive status when compared to younger cohabitants aging 50–65 years without significant differences in oxidative stress markers or APOE genotype. These results might be related to optimal adherence to the Mediterranean diet, although other lifestyle factors and positive personality traits may also contribute to their healthy aging. Further studies on a larger population should be performed to confirm the results of this pilot study.

Extreme Longevity: Analysis of the Direct or Indirect Influence of Environmental Factors on Old, Nonagenarians, and Centenarians in Cilento, Italy

“…Regarding Cilento area, Scelzo et al [14] who studied nonagenarians and centenarians in Cilento, showed that those who lived in the hilly rural area of the territory adopted specific lifestyles, such as hard work, love of the land, family, and religion, which allowed them to maintain mental well-being and made them particularly resilient and optimistic. Moreover, the study by Pizza et al [15] on Cilento nonagenarians also emphasized the importance of lifestyle, diet, but also individual personality factors. However, it is interesting to note that long-lived populations living in the buffer zone seem to be less protected.…”

“…In this area, man has been able to integrate harmoniously with the forms of the landscape [45]. [14,15,44]. Our hypothesis is that some environmental indicators, such as altitude, climate, and rural hinterland may be protective factors for longevity.…”

Study of loneliness and wisdom in 482 middle-aged and oldest-old adults: a comparison between people in Cilento, Italy and San Diego, USA

“…The present investigation was born out of the Cilento Initiative on Aging Outcomes (CIAO) study (Scelzo et al, 2018). We have previously reported that, compared to their younger (age 50-75) cohabitants, people aged !90 exhibited better mental well-being, with resilience, optimism, religiosity, family bonds, and stubbornness (Scelzo et al, 2018), a healthier metabolic and cardiovascular profile (Daniels et al, 2019), and no significant differences in the laboratory assessment of oxidative stress and APOE genotype (Pizza et al, 2020). The people > 90 did not have severe cognitive impairment, and the prevalence of dementia was low.…”

Narrative review of Mediterranean diet in Cilento: longevity and potential prevention for prostate cancer

“…31 These data suggest that genetics, Mediterranean lifestyle (diet and psychosocial habits), could be involved in maintaining this balance unaltered over time, allowing for healthier aging. 32 …”

“…Cilentos’ nonagenarians seemed to have good cognitive status when compared to younger cohabitants aging 50–65 years, without significant differences in oxidative stress markers or apolipoprotein E (ApoE) genotype attributing these results to an optimal adherence to the MD, although other lifestyle factors and positive personality traits may also contribute to their healthy aging. 32 In this scenario a recent study attempted to identify genes/miRNAs involved in life span and health span in LLIs from Cilento. 54 In particular, the authors evaluating the circulating mononuclear cells (MNCs) transcriptome, found that both BPIFB4 andCXCR4 expression in MNCs were powerful classifiers of healthy aging in LLIs.…”