Background:
The MOVE project longitudinally examines cognitive and physical trajectories in older adults with subjective cognitive decline (SCD) or pre-mild cognitive impairment (pre-MCI), populations at heightened risk for future cognitive deterioration. Given established associations between executive cognitive deficits and increased fall risk, this research aims to evaluate the effectiveness of targeted interventions to mitigate these risks.

Methods:
Ninety older adults will be randomly assigned to one of three groups: motor training (MOT), cognitive training (COG), or a control waiting group (WAIT). Primary outcome measures include changes in prospective memory and fall risk, while secondary outcomes involve neuroimaging (MRI) data, executive functioning, and psychological aspects such as subjective cognitive complaints, emotional well-being, and loneliness.

Results:
It is hypothesized that the MOT group will demonstrate significant improvements in physical measures, whereas the COG group is expected to show enhanced cognitive outcomes. Cross-domain effects between cognitive and motor improvements are also expected.

As of now, 59 individuals have been screened (n=11 excluded), thus, 48 have been recruited, and 41 are currently randomized (MOT=15; COG=16; WAIT=10). The baseline cohort does not present significant differences in primary nor secondary outcomes.

Discussion:
The MOVE project will provide insights into early trajectories of cognitive and physical decline and evaluate the potential of specific interventions. These findings could inform future preventive approaches aimed at minimizing cognitive and physical decline among aging populations.

Sedentary behavior and inactivity have a profound impact on human ageing. This study, conducted within the Age-It project, investigated the effects of chronic inactivity on neuromuscular health in young and older men. We hypothesized that experimentally-induced inactivity would impair neuromuscular integrity, leading to significant muscle atrophy and weakness, neuromuscular junction (NMJ) instability, and signs of denervation and axonal dysfunction.

Methods
Ten older males (OM, 64–71 years) and nine younger males (YM, 18–29 years) were enrolled following ethical approval and screening. Chronic inactivity was induced by horizontal bed rest (BR): 10 days in OM and 21 days in YM. Assessments were performed at baseline, after 10 days (OM & YM), and after 21 days of BR (YM only), and included: 1) thigh muscle MRI, 2) intramuscular EMG (iEMG) for motor unit and NMJ function, 3) maximal knee extensor strength, 4) blood biomarkers, and 5) NMJ morphology from biopsies.

Results
Muscle mass and strength: BR caused significant muscle atrophy and weakness. After 10 days, quadriceps CSA declined by 4.5%±2.1% in OM (p<0.001) and 6.1%±2.0% in YM (p<0.001). After 21 days, YM showed an 11.9%±1% reduction (p<0.0001). Quadriceps MVC strength dropped by 23.1%±8.3% in YM (p<0.0001) and 6.74%±5.7% in OM (p<0.01).

Motor unit properties and NMJ transmission: MUP area at 25% MVC decreased in YM (-6.3%, p<0.01) and OM (-6.7%, p<0.01), with firing rates reduced by 11.74% (YM) and 7.75% (OM), both p<0.0001. NMJ transmission was impaired in both groups: Jiggle increased ~15% (p<0.01 YM; p<0.001 OM), while Jitter rose by 8.4% (YM, p=0.059) and 10.7% (OM, p<0.01).

NMJ stability: Serum c-terminal agrin fragment (CAF) increased by 12.8% in YM (p<0.01) and 9% in OM (p<0.01). In OM, NMJ morphology showed reduced pre/post-synaptic overlap (p<0.001), increased denervated NMJs, and larger AChR area and perimeter (both p<0.001). In YM, denervated NMJs increased after 21 days.

Conclusions
These findings demonstrate that even short-term inactivity has a rapid and detrimental effect on neuromuscular health in both young and older adults. Inactivity triggers muscle atrophy, impairs motor unit function, destabilizes NMJ transmission, and promotes structural signs of denervation. This underscores the importance of physical activity not only in preserving muscle mass and strength but also in maintaining neuromuscular connectivity and function with age.

The Novara Cohort Study (NCS) is an observational, longitudinal study conducted by the Università del Piemonte Orientale investigating aging trajectories in the general population of the Novara province. It includes assessments of anthropometric and functional parameters, biological sampling (blood, saliva, urine), and questionnaires on lifestyle, habits, and cognitive functioning.

This study aimed to describe participants’ experiences in the NCS to revise retention strategies. Specifically, it sought to evaluate: (i) the impact of participation on health awareness and behaviors, and (ii) the appreciation of the study, by identifying both criticalities and positive aspects experienced by participants, to introduce possible improvements.

A mixed-methods approach was adopted. The first phase involved survey administration to explore associations between (1) motivation and experience, (2) personality traits and experience, and (3) personality traits, motivation, and experience. Invitations were sent to 423 participants who had already completed their visit round; 220 individuals were enrolled after data cleaning (response rate: 54.17%), stratified by sex, age group (21–64 and 65+), income, and occupation.

In the second phase, 20 participants were selected from the survey respondents by gender and age for semi-structured interviews. The interviews continued until the topic of experience and motivation to participate reached saturation.

Respondents (n=218) rated their experience on a 1–10 Likert scale, achieving a mean score of 9.22 (±0.85). Due to the low variance, no significant associations emerged. However, interviews highlighted minor criticalities, providing insights to revise retention strategies and support the long-term observation of aging trajectories.

Background and aim The Novara Cohort Study (NCS) is a longitudinal, observational study conducted by the University of Piemonte Orientale to investigate aging trajectories in the general population of the Novara province. Over 800 participants have been enrolled and subjected to assessments, including anthropometric and functional measurements, biological sampling (e.g., blood, saliva, urine), and comprehensive test batteries evaluating lifestyle, habits, and cognitive functioning.

Given the long-term nature of the study, participant retention is essential to ensure the continuity and validity of data collection over time. For this reason, a focused evaluation was carried out to explore the impact of participation on individuals, with particular attention to their lived experience within the study.

Methods. To this end, a mixed-methods approach was adopted. The quantitative component consisted of a questionnaire designed to explore associations between participants’ experiences and two key dimensions: motivation to participate and personality traits. Specifically, the analysis aimed to investigate the following relationships: (1) motivation–experience, (2) personality traits–experience, and (3) personality traits–motivation–experience. The instruments used included: the ultra-short version of the Research Participant's Perception Survey (RPPS-U) to assess experience; an ad hoc tool developed to measure motivation, inspired by the work of Almeida and Carr; and the Big Five Inventory (BFI-10) to assess personality traits.

The qualitative component involved in-depth, face-to-face semi-structured interviews to further explore participants motivations and perceptions of their experience. All interviews were audio-recorded, transcribed verbatim, and analyzed using an abductive approach, allowing for the integration of predefined and new themes that emerged spontaneously from participants narratives.

The application of the method was structured in two phases:

• Phase 1—Survey: 423 participants who had previously completed the visit round, lifestyle questionnaires, and Montreal Cognitive Assessment (MoCA) were invited to complete the NCS impact questionnaire. The response rate was 54.17%, partly affected by technical issues (e.g., emails ending up in spam). After data cleaning, 220 participants were enrolled and stratified by sex, age group (21–64 and 65+), income, and occupation.

• Phase 2 – Semi-structured interviews: Based on survey responses, 48 participants were selected by gender and age. Interviews continued until thematic saturation on experience and motivation was reached, resulting in 20 completed interviews that explored both positive and negative aspects of participation.

This mixed-methods design enabled the integration of quantitative precision with the depth of qualitative insight. The use of the abductive method in analyzing interviews allowed the emergence of themes not originally anticipated in the study design. Understanding participants' experiences offers valuable guidance for revising retention strategies and mitigating dropouts, a common challenge in longitudinal research like the NCS.

Results Respondents were asked to rate their overall experience with the study using a Likert scale from 1 (worst possible experience) to 10 (best possible experience). The mean score was 9.22 (±0.85), with a coefficient of variation (CV) of 9.21%. This limited variability constrained the ability to detect statistically significant associations.

The analysis underscored the relevance of the human relationship between participants and research staff, often described in terms of kindness and competence, especially regarding the information about the experience and access to test results (e.g., blood tests). This positive perception was further supported by the fact that 87.67% of respondents (n=192) stated they would recommend participation in the study to family or friends.

Regarding motivation, three primary reasons emerged among the sample (n=220): (1) contributing to scientific progress (84.09%), (2) better understanding one’s health status (63.64%), and (3) engaging in something new (28.64%). These motivations reflect a mix of altruistic and self-oriented drivers.

Social influence played a marginal role in the decision to participate. When asked to rate how much others influenced their choice on a scale from 1 (not at all) to 10 (very much), respondents reported a mean score of 3.18 (±3.08), indicating that participation was primarily driven by individual motivation rather than external persuasion.

Findings The interviews analysis confirmed the quantitative data's conclusions, while offering deeper insight into participants’ perspectives. A recurring theme was a sense of trust, fostered by the professionalism and attentiveness of the research staff, often illustrated through small gestures, such as offering a snack after blood collection.

Some minor criticalities also emerged, though mentioned by a limited number of participants and generally perceived as acceptable. These included: the desire for personalized advice on lifestyle and health; the suggestion to improve communication regarding study progress (e.g., via newsletters); limited parking availability; interest in incorporating more psychomotor testing to monitor aging trajectories better; and the need for clearer signage or additional staff to facilitate transitions across the different phases of participation.

Discussion. Overall, the impact of participation in the NCS was perceived as highly positive, which, paradoxically, limited the ability to identify areas for improving retention. Nonetheless, the climate of trust established during the interviews allowed participants to express minor criticalities, which, if addressed, could help maintain or even enhance long-term retention. In this regard, the findings effectively support the primary objective of the NCS impact evaluation: identifying actionable elements to strengthen participant engagement and ensure the sustainability of follow-up in a long-term cohort study.

Background: Biomarkers for the diagnosis of Alzheimer's disease (AD) have demonstrated high diagnostic accuracy, but their use in the 80+ age group has been limited due to uncertainties about the clinical significance in the presence of age-related comorbidities. This study aims to evaluate the prognostic value of AD biomarkers – in particular tau protein phosphorylated on residue 217 (pTau217) measured in cerebrospinal fluid (CSF) and plasma – in patients with Mild Cognitive Impairment (MCI) aged ≥80 years, investigating progression to dementia.

Methods: Participants were recruited between October 2013 and May 2024, including individuals aged ≥80 years with mild cognitive impairment with a complete neuropsychological assessment and AD biomarkers in CSF and ptau217 in plasma. Participants were grouped on the presence of positive or negative AD status, based on the value of biomarkers. Demographics, clinical features, and cognitive performance were compared.

Results: 167 participants were included, 111 AD+ and 56 AD–. No significant differences were seen in age, education, comorbidities at the first visit or medications used. Neuropsychological profiles differed between the groups. Considering the progression to any form of dementia, the AD+ group presented a significantly increased risk compared to AD– even after adjustment for some covariates and plasma pTau217 has high diagnostic accuracy in discriminating AD status.

Conclusions: Our findings suggest that positive AD biomarkers have a significant impact on clinical presentation and prognosis in cognitively impaired individuals more than 80 years old. Plasma pTau 217 is confirmed to be a highly accurate and minimally invasive surrogate.