Cognitive Function in Normal-Weight, Overweight, and Obese Older Adults: An Analysis of the Advanced Cognitive Training for Independent and Vital Elderly Cohort

PubMed Central

Kuo, Hsu-Ko; Jones, Richard N.; Milberg, William P.; Tennstedt, Sharon; Talbot, Laura; Morris, John N.; Lipsitz, Lewis A.

2010-01-01

OBJECTIVES To assess how elevated body mass index (BMI) affects cognitive function in elderly people. DESIGN Cross-sectional study. SETTING Data for this cross-sectional study were taken from a multicenter randomized controlled trial, the Advanced Cognitive Training for Independent and Vital Elderly trial. PARTICIPANTS The analytic sample included 2,684 normal-weight, overweight, or obese subjects aged 65 to 94. MEASUREMENTS Evaluation of cognitive abilities was performed in several domains: global cognition, memory, reasoning, and speed of processing. Cross-sectional association between body weight status and cognitive functions was analyzed using multiple linear regression. RESULTS Overweight subjects had better performance on a reasoning task (β = 0.23, standard error (SE) = 0.11, P = .04) and the Useful Field of View (UFOV) measure (β = −39.46, SE = 12.95, P = .002), a test of visuospatial speed of processing, after controlling for age, sex, race, years of education, intervention group, study site, and cardiovascular risk factors. Subjects with class I (BMI 30.0–34.9 kg/m2) and class II (BMI>35.0 kg/m2) obesity had better UFOV measure scores (β = −38.98, SE = 14.77, P = .008; β = −35.75, SE = 17.65, and P = .04, respectively) in the multivariate model than normal-weight subjects. The relationships between BMI and individual cognitive domains were nonlinear. CONCLUSION Overweight participants had better cognitive performance in terms of reasoning and visuospatial speed of processing than normal-weight participants. Obesity was associated with better performance in visuospatial speed of processing than normal weight. The relationship between BMI and cognitive function should be studied prospectively. PMID:16420204

Responses of susceptible subpopulations to nitrogen dioxide. Research report, June 1983-January 1988

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morrow, P.E.; Utell, M.J.

1989-02-01

Symptom responses and changes in pulmonary function were investigated in people with asthma or chronic obstructive pulmonary disease (COPD) exposed to 0.3 ppm nitrogen dioxide (NO{sub 2}) for four hours. Nonrespiratory-impaired (normal) subjects of comparable ages constituted the control groups. All exposures included periods of exercise and pulmonary function measurements. No significant symptomatic or physiological responses to NO{sub 2} could be detected in either the young or elderly control group. The asthmatic group did not manifest significant reductions in lung function after exposure to 0.3 ppm NO{sub 2}, compared to their preexposure baseline data or to their responses after amore » comparable four-hour exposure to air. During light exercise, subjects with COPD were progressively responsive to 0.3 ppm NO{sub 2}. Subgroup analyses within the asthmatic, COPD, and elderly normal subject groups and intergroup comparisons yielded significant findings and associations.« less

Association Between Serum Triglycerides and Cerebral Amyloidosis in Cognitively Normal Elderly.

PubMed

Choi, Hyo Jung; Byun, Min Soo; Yi, Dahyun; Choe, Young Min; Sohn, Bo Kyung; Baek, Hye Won; Lee, Jun Ho; Kim, Hyun Jung; Han, Ji Young; Yoon, Eun Jin; Kim, Yu Kyeong; Woo, Jong Inn; Lee, Dong Young

2016-08-01

Although many preclinical studies have suggested the possible linkage between dyslipidemia and cerebral amyloid deposition, the association between serum lipid measures and cerebral amyloid-beta (Aβ) deposition in human brain is still poorly known. We aimed to investigate the association in cognitively normal (CN) elderly individuals. Cross-sectional study. University hospital dementia clinic. 59 CN elderly. The study measures included comprehensive clinical and neuropsychological assessment based on the CERAD protocol, magnetic resonance imaging and (11)C-labelled Pittsburgh Compound B positron emission tomography scans, and quantification for serum lipid biomarkers. Multiple linear regression analyses showed that a higher serum triglycerides level was associated with heavier global cerebral Aβ deposition even after controlling age, sex, and apolipoprotein E ε4 genotype. Serum apolipoprotein B also showed significant positive association with global cerebral Aβ deposition, but the significance disappeared after controlling serum triglycerides level. No association was found between other lipid measures and global cerebral Aβ deposition. The findings suggest that serum triglycerides are closely associated with cerebral amyloidosis, although population-based prospective studies are needed to provide further evidence of the causative effect of triglycerides on cerebral amyloidosis. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Trunk, head, and step characteristics during normal and narrow-based walking under deteriorated sensory conditions.

PubMed

Deshpande, Nandini; Zhang, Fang

2014-01-01

The ability to maintain stability in the frontal plane (medialateral direction) while walking is commonly included as a component of motor performance assessment. Postural control in the frontal plane may deteriorate faster and earlier with increasing age, compared to that in the sagittal plane (anteroposterior direction). Fifteen young (20-30 years old) and 15 older (>65 years old) healthy participants were recruited to investigate age-related differences in postural control during the normal and narrow-based walking when performed under suboptimal vestibular and lower limb somatosensory conditions achieved by galvanic stimulation and compliant surfaces, respectively. Gait speed decreased in the narrow-based walking condition, with larger decrease in the elderly (by 6%). In the elderly head roll increased with perturbed vestibular information in impaired somatosensory condition (by 40.70%). In both age groups trunk roll increased under impaired somatosensation in the narrow-based walking condition (by 43.62%) but not in normal walking condition. Older participants adopted a more cautious strategy characterized by lower walking speed when walking on a narrow base and exhibited deteriorated integrative ability of the CNS for head control. Accurate lower limb somatosensation may play a critical role in narrow-based walking.

Differential age-related decline in conflict-driven task-set shielding from emotional versus non-emotional distracters.

PubMed

Monti, Jim M; Weintraub, Sandra; Egner, Tobias

2010-05-01

While normal aging is associated with a marked decline in cognitive abilities, such as memory and executive functions, recent evidence suggests that control processes involved in regulating responses to emotional stimuli may remain well-preserved in the elderly. However, neither the precise nature of these preserved control processes, nor their domain-specificity with respect to comparable non-emotional control processes, are currently well-established. Here, we tested the hypothesis of domain-specific preservation of emotional control in the elderly by employing two closely matched behavioral tasks that assessed the ability to shield the processing of task-relevant stimulus information from competition by task-irrelevant distracter stimuli that could be either non-emotional or emotional in nature. The efficacy of non-emotional versus emotional task-set shielding, gauged via the 'conflict adaptation effect', was compared between cohorts of healthy young adults, healthy elderly adults, and individuals diagnosed with probable Alzheimer's disease (PRAD), age-matched to the elderly subjects. It was found that, compared to the young adult cohort, the healthy elderly displayed deficits in task-set shielding in the non-emotional but not in the emotional task, whereas PRAD subjects displayed impaired performance in both tasks. These results provide new evidence that healthy aging is associated with a domain-specific preservation of emotional control functions, specifically, the shielding of a current task-set from interference by emotional distracter stimuli. This selective preservation of function supports the notion of partly dissociable affective control mechanisms, and may either reflect different time-courses of degeneration in the neuroanatomical circuits mediating task-set maintenance in the face of non-emotional versus emotional distracters, or a motivational shift towards affective processing in the elderly. 2010 Elsevier Ltd. All rights reserved.

Manipulation of a fragile object by elderly individuals.

PubMed

Gorniak, Stacey L; Zatsiorsky, Vladimir M; Latash, Mark L

2011-08-01

We investigated strategies of healthy elderly participants (74-84 years old) during prehension and transport of an object with varying degrees of fragility. Fragility was specified as the maximal normal force that the object could withstand without collapsing. Specifically, kinetic and kinematic variables as well as and force covariation indices were quantified and compared to those shown by young healthy persons (19-28 years old). We tested three hypotheses related to age-related changes in two safety margins (slip safety margin and crush safety margin) and indices of force covariation. Compared to young controls, elderly individuals exhibited a decrease in object acceleration and an increase in movement time, an increase in grip force production, a decrease in the correlation between grip and load forces, an overall decrease in indices of multi-digit synergies, and lower safety margin indices computed with respect to both dropping and crushing the object. Elderly participants preferred to be at a relatively lower risk of crushing the object even if this led to a higher risk of dropping it. Both groups showed an increase in the index of synergy stabilizing total normal force produced by the four fingers with increased fragility of the object. Age-related changes are viewed as a direct result of physiological changes due to aging, not adaptation to object fragility. Such changes in overall characteristics of prehension likely reflect diminished synergic control by the central nervous system of finger forces with aging. The findings corroborate an earlier hypothesis on an age-related shift from synergic to element-based control.

Differences of muscle co-contraction of the ankle joint between young and elderly adults during dynamic postural control at different speeds.

PubMed

Iwamoto, Yoshitaka; Takahashi, Makoto; Shinkoda, Koichi

2017-08-02

Agonist and antagonist muscle co-contractions during motor tasks are greater in the elderly than in young adults. During normal walking, muscle co-contraction increases with gait speed in young adults, but not in elderly adults. However, no study has compared the effects of speed on muscle co-contraction of the ankle joint during dynamic postural control in young and elderly adults. We compared muscle co-contractions of the ankle joint between young and elderly subjects during a functional stability boundary test at different speeds. Fifteen young adults and 16 community-dwelling elderly adults participated in this study. The task was functional stability boundary tests at different speeds (preferred and fast). Electromyographic evaluations of the tibialis anterior and soleus were recorded. The muscle co-contraction was evaluated using the co-contraction index (CI). There were no statistically significant differences in the postural sway parameters between the two age groups. Elderly subjects showed larger CI in both speed conditions than did the young subjects. CI was higher in the fast speed condition than in the preferred speed condition in the young subjects, but there was no difference in the elderly subjects. Moreover, after dividing the analytical range into phases (acceleration and deceleration phases), the CI was larger in the deceleration phase than in the acceleration phase in both groups, except for the young subjects in the fast speed conditions. Our results showed a greater muscle co-contraction of the ankle joint during dynamic postural control in elderly subjects than in young subjects not only in the preferred speed condition but also in the fast speed condition. In addition, the young subjects showed increased muscle co-contraction in the fast speed condition compared with that in the preferred speed condition; however, the elderly subjects showed no significant difference in muscle co-contraction between the two speed conditions. This indicates that fast movements cause different influences on dynamic postural control in elderly people, particularly from the point of view of muscle activation. These findings highlight the differences in the speed effects on muscle co-contraction of the ankle joint during dynamic postural control between the two age groups.

[Impairment of executive function in elderly patients with major unipolar depression: influence of psychomotor retardation].

PubMed

Baudic, Sophie; Benisty, Sarah; Dalla Barba, Gianfrano; Traykov, Latchezar

2007-03-01

The results from several studies assessing the executive function in depressed patients compared to control subjects varied from significant impairment to normal performance. To assess the executive impairment in elderly patients with major unipolar depression and to evaluate the influence of psychomotor retardation and severity of depression in the executive deficits, the performance of 15 elderly patients with unipolar depression was compared to that of 15 elderly control subjects on executive tasks. The severity of depression was evaluated by the Montgomery and Asberg depressive scale and that of psychomotor retardation by the Widlöcher's scale. In depressed patients, deficits were found on tasks assessing cognitive flexibility (Modified card sorting test (MCST) and Trail making test B), planification and elaboration of strategies (cognitive estimates), motor initiation (graphic sequences), categorisation and hypothesis making (MCST) and interference resistance (Stroop test). However, depressed patients performed normally on the Hayling test assessing the inhibition processes. Intensity of psychomotor retardation was not correlated to the performance of executive tasks. Conversely, severity of depression was related to the scores of MCST (number of errors and perseverations), Stroop and Hayling tests (time taken to complete the end of the sentence). Unipolar depressed patients showed deficits in most tasks assessing executive function. However, inhibition processes appeared to be intact in depressed patients although their implementation was difficult. The severity of depression but not that of psychomotor retardation was associated with executive deficits.

Aging effects in response inhibition: general slowing without decline in inhibitory functioning.

PubMed

Yano, Madoka

2011-12-01

Previous research has examined aging effects on response inhibition using cognitive interference paradigms such as the Stroop task and the Simon task. Performance in these tasks requires participants to inhibit predominant responses. Reduced response inhibition is reflected by poorer performance in incongruent trials where prepotent responses can interfere with other correct responses, than in congruent trials without such interference (i.e., Stroop or Simon congruency effects). It is unclear whether such effects increase with normal aging. Balota et al. (2010) reported that the Stroop effect can be a useful predictor of conversion to Alzheimer's disease in a healthy control sample. Congruency effects are also subject to trial sequencing: They are smaller following an incongruent trial than following a congruent one. The present study determined whether response inhibition was affected by normal aging using the Simon task, with focus on the influence of normal aging on sequence effects. Forty-three young participants and 14 healthy elderly adults performed the Simon task individually. Results indicated that both age groups showed the same magnitude of Simon effects and sequence effects, although overall response latencies were longer in elderly participants than in young participants. Furthermore, the elderly adults tended to make fewer errors than the younger adults. These findings suggest that normal aging may produce reduced processing speed but it does not affect response inhibition itself.

Normal Aging and Linguistic Decrement.

ERIC Educational Resources Information Center

Emery, Olga B.

A study investigated language patterning, as an indication of synthetic mental activity, in comparison groups of normal pre-middle-aged adults (30-42 years), normal elderly adults (75-93), and elderly adults (71-91) with Alzheimer's dementia. Semiotic theory was used as the conceptual context. Linguistic measures included the Token Test, the…

Elderly quality of life impacted by traditional chinese medicine techniques

PubMed Central

Figueira, Helena A; Figueira, Olivia A; Figueira, Alan A; Figueira, Joana A; Giani, Tania S; Dantas, Estélio HM

2010-01-01

Background: The shift in age structure is having a profound impact, suggesting that the aged should be consulted as reporters on the quality of their own lives. Objectives: The aim of this research was to establish the possible impact of traditional Chinese medicine (TCM) techniques on the quality of life (QOL) of the elderly. Sample: Two non-selected, volunteer groups of Rio de Janeiro municipality inhabitants: a control group (36 individuals), not using TCM, and an experimental group (28 individuals), using TCM at ABACO/Sohaku-in Institute, Brazil. Methods: A questionnaire on elderly QOL devised by the World Health Organization, the WHOQOL-Old, was adopted and descriptive statistical techniques were used: mean and standard deviation. The Shapiro–Wilk test checked the normality of the distribution. Furthermore, based on its normality distribution for the intergroup comparison, the Student t test was applied to facets 2, 4, 5, 6, and total score, and the Mann–Whitney U rank test to facets 1 and 3, both tests aiming to analyze the P value between experimental and control groups. The significance level utilized was 95% (P < 0.05). Results: The experimental group reported the highest QOL for every facet and the total score. Conclusions: The results suggest that TCM raises the level of QOL. PMID:21103400

The Effect of Age on Improvements in Vestibulo-Ocular Reflexes and Balance Control after Acute Unilateral Peripheral Vestibular Loss.

PubMed

Scheltinga, Alja; Honegger, Flurin; Timmermans, Dionne P H; Allum, John H J

2016-01-01

An acute unilateral peripheral vestibular loss (aUVL) initially causes severe gaze and balance control problems. However, vestibulo-ocular reflexes (VOR) and balance control are nearly normal 3 months later as a result of peripheral recovery and/or central compensation. As pre-existing vestibular sensory loss is assumed to be greater in the healthy elderly, this study investigated whether improvements in VOR and balance function over time after aUVL are different for the elderly than for the young. Thirty aUVL patients divided into three age-groups were studied (8 age range 23-35, 10 with range 43-58, and 12 with range 60-74 years). To measure VOR function eye movements were recorded during caloric irrigation, rotating chair (ROT), and head impulse tests. Balance control during stance and gait was recorded as lower trunk angular velocity in the pitch and roll planes. Measurements were taken at deficit onset, and 3, 6, and 13 weeks later. There was one difference in VOR improvements over time between the age-groups: Low acceleration ROT responses were less at onset in the elderly group. Deficit side VOR responses and asymmetries in each group improved to within ranges of healthy controls at 13 weeks. Trunk sway of the elderly was greater for stance and gait at onset when compared to healthy age-matched controls and the young and greater than that of the young and controls during gait tasks at 13 weeks. The sway of the young was not different from controls at either time point. Balance control for the elderly improved slower than for the young. These results indicate that VOR improvement after an aUVL does not differ with age, except for low accelerations. Recovery rates are different between age-groups for balance control tests. Balance control in the elderly is more abnormal at aUVL onset for stance and gait tasks with the gait abnormalities remaining after 13 weeks. Thus, we conclude that balance control in the elderly is more affected by the UVL than for the young, and the young overcome balance deficits more rapidly. These differences with age should be taken into account when planning rehabilitation.

Comparison of timing and force control of foot tapping between elderly and young subjects.

PubMed

Takimoto, Koji; Takebayashi, Hideaki; Miyamoto, Kenzo; Takuma, Yutaka; Inoue, Yoshikazu; Miyamoto, Shoko; Okabe, Takao; Okuda, Takahiro; Kaba, Hideto

2016-06-01

[Purpose] To examine the ability of young and elderly individuals to control the timing and force of periodic sequential foot tapping. [Subjects and Methods] Participants were 10 young (age, 22.1 ± 4.3 years) and 10 elderly individuals (74.8 ± 6.7 years) who were healthy and active. The foot tapping task consisted of practice (stimulus-synchronized tapping with visual feedback) and recall trials (self-paced tapping without visual feedback), periodically performed in this order, at 500-, 1,000-, and 2,000-ms target interstimulus-onset intervals, with a target force of 20% maximum voluntary contraction of the ankle plantar-flexor muscle. [Results] The coefficients of variation of force and intertap interval, used for quantifying the steadiness of the trials, were significantly greater in the elderly than in the young individuals. At the 500-ms interstimulus-onset interval, age-related effects were observed on the normalized mean absolute error of force, which was used to quantify the accuracy of the trials. The coefficients of variation of intertap interval for elderly individuals were significantly greater in the practice than in the recall trials at the 500- and 1,000-ms interstimulus-onset intervals. [Conclusion] The elderly individuals exhibited greater force and timing variability than the young individuals and showed impaired visuomotor processing during foot tapping sequences.

[Community acquired bacterial pneumonia and comorbidity in elderly patients].

PubMed

Fatenkov, O V; Kuzmina, T M; Rubanenko, O A; Svetlova, G N; Djubailo, A V

2017-01-01

We analyzed the clinical course of pneumonia in 67 elderly patients (39 females and 28 males, mean age 74,4±5,2 years) with chronic heart failure and chronic obstructive pulmonary disease (COPD). Patients were divided into 2 groups: 1st group - patients with COPD, 2nd group - patients without COPD. Pharmacological treatment was performed according to temperature, oxygen saturation, acute phase proteins and included ampicillin and sulbactam. The normalization of temperature and oxygen saturation was observed on 3-4 day in patients of the 1st group and on 2 day in patients of the 2nd group, normalization of leukocyte count and erythrocyte sedimentation rate - on 12-13 and 7-8 days, acute phase indicators (C-reactive protein, fibrinogen) on 7 and 5 days, correspondingly. Positive dynamics of chest X-ray was observed on 13 day in patients of the 1st group (the second control and the replacement of antibiotic for levofloxacin) and on 8 day in patients of the 2nd group (the first control).

Quality of life and wellbeing of the elderly in Lebanese nursing homes.

PubMed

Doumit, Jacqueline; Nasser, Ramzi

2010-01-01

The purpose of this paper is to assess quality of life in relation to wellbeing among Lebanese nursing home elderly residents. The study attempts to understand the impact of structures, processes and skills on elderly health status. In this paper, 220 normally functioning elderly respondents from 33 nursing homes were studied. A quasi-experimental approach measured psychological and health-related factors using the Geriatric Depression Scale, Activity of Daily Living, EuroQol EQ-5D and the Mini-Nutritional Assessment (MNA) instruments. A relatively high level of mild depression among elderly residents and a lack of mobility were found. Generally, normally functioning elderly residents were well nourished and had moderate daily activity levels. The study is original in the sense that it assesses elderly residents' psychological and physical health status in relation to institutional structures, processes, and skills.

Linguistic Deterioration in Alzheimer's Senile Dementia and in Normal Aging.

ERIC Educational Resources Information Center

Emery, Olga Beattie

A study of language patterning as an indicator of higher cortical process focused on three matched comparison groups: normal pre-middle-aged, normal elderly, and elderly adults with senile dementia Alzheimer's type. In addition to tests of memory, level of cognitive function, and organic deficit, the formal aspects of language were analyzed in…

The Relationship between RUNX3 Expression, Nursing Strategies and Nutritional Status in Elderly Patients with Advanced Gastric Cancer.

PubMed

Song, Wen; Teng, Wenhui; Shi, Xinyan; Liu, Xiaozhen; Cui, Zheng; Tian, Zibin

2017-06-01

The aim of this study was to explore the relationship between nutritional status and expression of RUNX3 in gastric cancer cells and to investigate the effects of nursing strategies on the nutritional status of elderly patients with advanced gastric cancer. Forty-eight elderly patients admitted at Affiliated Hospital of Qingdao University with advanced gastric cancer and 30 healthy controls were selected as subjects from 2014-15. The correlation between RNX3 gene expression and nutritional status of the gastric cancer patients was investigated. The patients with advanced gastric cancer who had low expression of RUNX3 gene were treated with holistic nursing while routine nursing was taken for those patients who had normal or high expression of RUNX3 gene. The nutritional statuses of these patients were evaluated after 3 months of nursing. After a follow-up of 1 year, the influence of different nursing methods on the survival time was evaluated. Compared with normal gastric tissue, the expression of RUNX3 gene and protein in tissues of advanced gastric cancer were significantly decreased ( P <0.01). Compared with patients with normal or high expressions of RUNX3, the nutritional statuses of advanced gastric cancer patients with low expressions of RUNX3 were lower ( P <0.01). The nutritional statuses of patients with low expressions of RUNX3 were notably improved after holistic nursing, becoming equivalent to those with normal or high expression of RUNX3 who received routine nursing ( P >0.05). The survival time of patients with low expression of RUNX3 who received holistic nursing were similar to patients with normal or high expression of RUNX3 who received routine nursing ( P >0.05). RUNX3 is correlated with the occurrence and development of advanced gastric cancer. The low nutritional status of elderly advanced gastric cancer patients with low expressions of RUNX3 can be significantly enhanced by holistic nursing, thereby prolonging survival time.

Effects of Inhalation Aromatherapy on Symptoms of Sleep Disturbance in the Elderly with Dementia

PubMed Central

Watanuki, Emiko

2017-01-01

This study investigated the effects of inhalation aromatherapy on sleep disturbance in elderly individuals with dementia. In 19 subjects, normal sleep was observed for a 20-day control period, inhalation aromatherapy was then applied for a 20-day intervention period, and the control and intervention periods were compared. During the intervention period, essential oils were placed nightly on towels around the subjects' pillows. The measured sleep conditions were sleep latency, total sleep time, sleep efficacy, duration of the longest sustained sleep period, wake time after sleep onset, early morning awakening, total daytime sleep, and the Neuropsychiatric Inventory. Total sleep time was significantly longer in the intervention period than in the control period (p < 0.05). The duration of the longest sustained sleep period was significantly longer in the intervention period than in the control period (p < 0.05). Early morning awakening in the intervention period was significantly less compared to that in the control period (p < 0.05). Total daytime sleep could not be adequately measured and was omitted from the analysis. No significant differences in other sleep conditions were observed. These results indicated positive effects of inhalation aromatherapy on symptoms of sleep disturbance in elderly individuals with dementia. PMID:28400839

Enhanced and bilateralized visual sensory processing in the ventral stream may be a feature of normal aging.

PubMed

De Sanctis, Pierfilippo; Katz, Richard; Wylie, Glenn R; Sehatpour, Pejman; Alexopoulos, George S; Foxe, John J

2008-10-01

Evidence has emerged for age-related amplification of basic sensory processing indexed by early components of the visual evoked potential (VEP). However, since these age-related effects have been incidental to the main focus of these studies, it is unclear whether they are performance dependent or alternately, represent intrinsic sensory processing changes. High-density VEPs were acquired from 19 healthy elderly and 15 young control participants who viewed alphanumeric stimuli in the absence of any active task. The data show both enhanced and delayed neural responses within structures of the ventral visual stream, with reduced hemispheric asymmetry in the elderly that may be indicative of a decline in hemispheric specialization. Additionally, considerably enhanced early frontal cortical activation was observed in the elderly, suggesting frontal hyper-activation. These age-related differences in early sensory processing are discussed in terms of recent proposals that normal aging involves large-scale compensatory reorganization. Our results suggest that such compensatory mechanisms are not restricted to later higher-order cognitive processes but may also be a feature of early sensory-perceptual processes.

Hyperdynamic CSF motion profiles found in idiopathic normal pressure hydrocephalus and Alzheimer's disease assessed by fluid mechanics derived from magnetic resonance images.

PubMed

Takizawa, Ken; Matsumae, Mitsunori; Hayashi, Naokazu; Hirayama, Akihiro; Yatsushiro, Satoshi; Kuroda, Kagayaki

2017-10-18

Magnetic resonance imaging (MRI) does not only ascertain morphological features, but also measures physiological properties such as fluid velocity or pressure gradient. The purpose of this study was to investigate cerebrospinal fluid (CSF) dynamics in patients with morphological abnormalities such as enlarged brain ventricles and subarachnoid spaces. We used a time-resolved three dimensional phase contrast (3D-PC) MRI technique to quantitatively evaluate CSF dynamics in the Sylvian aqueduct of healthy elderly individuals and patients with either idiopathic normal pressure hydrocephalus (iNPH) or Alzheimer's disease (AD) presenting with ventricular enlargement. Nineteen healthy elderly individuals, ten iNPH patients, and seven AD patients (all subjects ≥ 60 years old) were retrospectively evaluated 3D-PC MRI. The CSF velocity, pressure gradient, and rotation in the Sylvian aqueduct were quantified and compared between the three groups using Kolmogorov-Smirnov and Mann-Whitney U tests. There was no statistically significant difference in velocity among the three groups. The pressure gradient was not significantly different between the iNPH and AD groups, but was significantly different between the iNPH group and the healthy controls (p < 0.001), and similarly, between the AD group and the healthy controls (p < 0.001). Rotation was not significantly different between the iNPH and AD groups, but was significantly different between the iNPH group and healthy controls (p < 0.001), and similarly, between the AD group and the healthy controls (p < 0.001). Quantitative analysis of CSF dynamics with time resolved 3D-PC MRI revealed differences and similarities in the Sylvian aqueduct between healthy elderly individuals, iNPH patients, and AD patients. The results showed that CSF motion is in a hyperdynamic state in both iNPH and AD patient groups compared to healthy elderly individuals, and that iNPH patients and AD patients display similar CSF motion profiles.

Serum of myeloproliferative neoplasms stimulates hematopoietic stem and progenitor cells.

PubMed

Lubberich, Richard K; Walenda, Thomas; Goecke, Tamme W; Strathmann, Klaus; Isfort, Susanne; Brümmendorf, Tim H; Koschmieder, Steffen; Wagner, Wolfgang

2018-01-01

Myeloproliferative neoplasms (MPN)-such as polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF)-are typically diseases of the elderly caused by acquired somatic mutations. However, it is largely unknown how the malignant clone interferes with normal hematopoiesis. In this study, we analyzed if serum of MPN patients comprises soluble factors that impact on hematopoietic stem and progenitor cells (HPCs). CD34+ HPCs were cultured in medium supplemented with serum samples of PV, ET, or MF patients, or healthy controls. The impact on proliferation, maintenance of immature hematopoietic surface markers, and colony forming unit (CFU) potential was systematically analyzed. In addition, we compared serum of healthy young (<25 years) and elderly donors (>50 years) to determine how normal aging impacts on the hematopoiesis-supportive function of serum. Serum from MF, PV and ET patients significantly increased proliferation as compared to controls. In addition, serum from MF and ET patients attenuated the loss of a primitive immunophenotype during in vitro culture. The CFU counts were significantly higher if HPCs were cultured with serum of MPN patients as compared to controls. Furthermore, serum of healthy young versus old donors did not evoke significant differences in proliferation or immunophenotype of HPCs, whereas the CFU frequency was significantly increased by serum from elderly patients. Our results indicate that serum derived from patients with MPN comprises activating feedback signals that stimulate the HPCs-and this stimulatory signal may result in a viscous circle that further accelerates development of the disease.

Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people.

PubMed

Svensson, Bengt; Hansson, Lars

2017-06-01

Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Single group pre-test-post-test design. The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.

Lexical priming in Alzheimer's disease and aphasia.

PubMed

Arroyo-Anlló, Eva Maria; Beauchamps, Mireille; Ingrand, Pierre; Neau, Jean Philippe; Gil, Roger

2013-01-01

Lexical priming was examined in patients with Alzheimer's disease and in aphasic patients. Control participants were divided into young and elderly [cf. Arroyo-Anlló et al.: Eur J Cogn Psychol 2004;16:535-553]. For lexical priming, a word-stem completion task was used. Normal elderly participants had lexical priming scores that were significantly lower than those of young individuals. Analysis of covariance with age and educational level as covariates showed that the control participants, aphasic and Alzheimer patients did not differ significantly on the lexical priming task. Our results suggest that performance in the lexical priming task diminishes with physiological aging, but is not significantly affected by mild or moderate Alzheimer's disease or by fluent or non-fluent aphasia. Copyright © 2013 S. Karger AG, Basel.

Effect of normal aging and of Alzheimer's disease on, episodic memory.

PubMed

Le Moal, S; Reymann, J M; Thomas, V; Cattenoz, C; Lieury, A; Allain, H

1997-01-01

Performances of 12 patients with Alzheimer's disease (AD), 15 healthy elderly subjects and 20 young healthy volunteers were compared on two episodic memory tests. The first, a learning test of semantically related words, enabled an assessment of the effect of semantic relationships on word learning by controlling the encoding and retrieval processes. The second, a dual coding test, is about the assessment of automatic processes operating during drawings encoding. The results obtained demonstrated quantitative and qualitative differences between the population. Manifestations of episodic memory deficit in AD patients were shown not only by lower performance scores than in elderly controls, but also by the lack of any effect of semantic cues and the production of a large number of extra-list intrusions. Automatic processes underlying dual coding appear to be spared in AD, although more time is needed to process information than in young or elderly subjects. These findings confirm former data and emphasize the preservation of certain memory processes (dual coding) in AD which could be used in future therapeutic approaches.

Nutritional status and dietary intake of institutionalized elderly in Turkey: a cross-sectional, multi-center, country representative study.

PubMed

Ongan, Dilek; Rakıcıoğlu, Neslişah

2015-01-01

To evaluate the nutritional status and dietary intake of institutionalized elderly in Turkey. Cross-sectional study. 25 institutions in 19 cities throughout Turkey. Elderly residents aged 65 years and older (n=554). Nutritional status using Mini Nutritional Assessment (MNA), food consumption with 24-h dietary recall and anthropometric measurements (body weight, height, body mass index (BMI), waist circumference (WC), hip circumference, waist/hip ratio, mid-upper arm circumference (MUAC)). The mean age of the elderly was 76.1±7.3 years. BMI of elderly men and women were found to be 26.59±4.58kg/m(2) and 30.07±6.32kg/m(2), respectively. WC of elderly men and women were found to be 98.90±1.33cm and 100.62±1.34cm, respectively. Most of the elderly were overweight based on BMI and at risk of metabolic diseases based on WC. According to MNA, 44.2% had normal nutritional status, 49.1% were at risk of malnutrition, 6.7% had malnutrition. All nutrients intake was favorable according to requirements, except for calcium and magnesium. Energy, protein, carbohydrate, fat, vitamins A, E, B1, B2, B6, C folat, iron, zinc intake of elderly who had normal nutritional status, who were at risk of malnutrition and malnourished were significantly different. Energy and nutrients intake of elderly who had normal nutritional status was found to be better than the others. Nutritional status should be periodically screened in the institutionalized elderly to prevent malnutrition. Also, it was noted that adequate energy and nutrients intake of the elderly played a crucial role in maintaining nutritional status and preventing malnutrition within residential homes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Using virtual reality to distinguish subjects with multiple- but not single-domain amnestic mild cognitive impairment from normal elderly subjects.

PubMed

Mohammadi, Alireza; Kargar, Mahmoud; Hesami, Ehsan

2018-03-01

Spatial disorientation is a hallmark of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease. Our aim was to use virtual reality to determine the allocentric and egocentric memory deficits of subjects with single-domain aMCI (aMCIsd) and multiple-domain aMCI (aMCImd). For this purpose, we introduced an advanced virtual reality navigation task (VRNT) to distinguish these deficits in mild Alzheimer's disease (miAD), aMCIsd, and aMCImd. The VRNT performance of 110 subjects, including 20 with miAD, 30 with pure aMCIsd, 30 with pure aMCImd, and 30 cognitively normal controls was compared. Our newly developed VRNT consists of a virtual neighbourhood (allocentric memory) and virtual maze (egocentric memory). Verbal and visuospatial memory impairments were also examined with Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, respectively. We found that miAD and aMCImd subjects were impaired in both allocentric and egocentric memory, but aMCIsd subjects performed similarly to the normal controls on both tasks. The miAD, aMCImd, and aMCIsd subjects performed worse on finding the target or required more time in the virtual environment than the aMCImd, aMCIsd, and normal controls, respectively. Our findings indicated the aMCImd and miAD subjects, as well as the aMCIsd subjects, were more impaired in egocentric orientation than allocentric orientation. We concluded that VRNT can distinguish aMCImd subjects, but not aMCIsd subjects, from normal elderly subjects. The VRNT, along with the Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, can be used as a valid diagnostic tool for properly distinguishing different forms of aMCI. © 2018 Japanese Psychogeriatric Society.

Pulmonary performance of elderly normal subjects and subjects with chronic obstructive pulmonary disease exposed to 0. 3 ppm nitrogen dioxide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morrow, P.E.; Utell, M.J.; Bauer, M.A.

1992-02-01

Symptoms and changes in pulmonary function of subjects with chronic obstructive pulmonary disease (COPD) and elderly normal subjects, induced by a 4-h exposure to 0.3 ppm NO2, were investigated using a double-blind, crossover design with purified air. The 5-day experimental protocol required approximately 2 wk with at least a 5-day separation between randomized 4-h exposures to either NO2 or air which included several periods of exercise. Over a 2-yr period, COPD subjects, all with a history of smoking, consisting of 13 men and 7 women (mean age of 60.0 yr) and 20 elderly normal subjects of comparable age and sexmore » were evaluated. During intermittent light exercise, COPD subjects demonstrated progressive decrements in FVC and FEV1 compared with baseline with 0.3 ppm NO2, but not with air. Differences in percent changes from baseline data (air-NO2) showed an equivocal reduction in FVC by repeated measures of analysis of variance and cross-over t tests (p less than 0.10). Subgroup analyses suggested that responsiveness to NO2 decreased with severity of COPD; in elderly normal subjects, NO2-induced reduction in FEV1 was greater among smokers than never-smokers. A comparison of COPD and elderly normal subjects also revealed distinctions in NO2-induced responsiveness.« less

The effects of apolipoprotein ε 4 on aging brain in cognitively normal Chinese elderly: a surface-based morphometry study.

PubMed

Lu, Hanna; Ma, Suk Ling; Chan, Sandra Sau Man; Lam, Linda Chiu Wa

2016-09-01

Default mode network (DMN) has been reported to be susceptible to APOE ε 4 genotype. However, the APOE ε 4-related brain changes in young carriers are different from the ones in elderly carriers. The current study aimed to evaluate the cortical morphometry of DMN subregions in cognitively normal elderly with APOE ε 4. 11 cognitively normal senior APOE ε 4 carriers and 27 matched healthy controls (HC) participated the neuropsychological tests, genotyping, and magnetic resonance imaging (MRI) scanning. Voxel-based morphometry (VBM) analysis was used to assess the global volumetric changes. Surface-based morphometry (SBM) analysis was performed to measure regional gray matter volume (GMV) and gray matter thickness (GMT). Advancing age was associated with decreased GMV of DMN subregions. Compared to HC, APOE ε 4 carriers presented cortical atrophy in right cingulate gyrus (R_CG) (GMV: APOE carriers: 8475.23 ± 1940.73 mm3, HC: 9727.34 ± 1311.57 mm3, t = 2.314, p = 0.026, corrected) and left insular (GMT: APOE ε 4 carriers: 3.83 ± 0.37 mm, HC: 4.05 ± 0.25 mm, t = 2.197, p = 0.033, corrected). Our results highlight the difference between different cortical measures and suggest that the cortical reduction of CG and insular maybe a potential neuroimaging marker for APOE 4 ε senior carriers, even in the context of relatively intact cognition.

COMplex Fracture Orthopedic Rehabilitation (COMFORT) - Real-time visual biofeedback on weight bearing versus standard training methods in the treatment of proximal femur fractures in the elderly: study protocol for a multicenter randomized controlled trial.

PubMed

Raaben, Marco; Redzwan, Syaiful; Augustine, Robin; Blokhuis, Taco Johan

2018-04-12

Proximal femur fractures are a common injury after low energy trauma in the elderly. Most rehabilitation programs are based on restoring mobility and early resumption of weight-bearing. However, therapy compliance is low in patients following lower extremity fractures. Moreover, little is known about the relevance of gait parameters and how to steer the rehabilitation after proximal femur fractures in the elderly. Therefore, the aim of this prospective, randomized controlled trial is to gain insight in gait parameters and evaluate if real-time visual biofeedback can improve therapy compliance after proximal femur fractures in the elderly. This is a two-arm, parallel-design, prospective, randomized controlled trial. Inclusion criteria are age ≥ 60 years, a proximal femur fracture following low energy trauma, and unrestricted-weight bearing. Exclusion criteria are cognitive impairment and limited mobility before trauma. Participants are randomized into either the control group, which receives care as usual, or the intervention group, which receives real-time visual biofeedback about weight-bearing during gait in addition to care as usual. Spatiotemporal gait parameters will be measured in 94 participants per group during a 30-m walk with an ambulatory biofeedback system (SensiStep). The progress of rehabilitation will be evaluated by the primary outcome parameters maximum peak load and step duration in relation to the discharge date. Secondary outcome parameters include other spatiotemporal gait parameters in relation to discharge date. Furthermore, the gait parameters will be related to three validated clinical tests: Elderly Mobility Scale; Functional Ambulation Categories; and Visual Analogue Scale. The primary hypothesis is that participants in the intervention group will show improved and faster rehabilitation compared to the control group. The first aim of this multicenter trial is to investigate the normal gait patterns after proximal femur fractures in the elderly. The use of biofeedback systems during rehabilitation after proximal femur fractures in the elderly is promising; therefore, the second aim is to investigate the effect of real-time visual biofeedback on gait after proximal femur fractures in the elderly. This could lead to improved outcome. In addition, analysis of the population may indicate characteristics of subgroups that benefit from feedback, making a differentiated approach in rehabilitation strategy possible. TrialRegister.nl, NTR6794 . Registered on 31 October 2017.

Screening for cognitive impairment in older individuals. Validation study of a computer-based test.

PubMed

Green, R C; Green, J; Harrison, J M; Kutner, M H

1994-08-01

This study examined the validity of a computer-based cognitive test that was recently designed to screen the elderly for cognitive impairment. Criterion-related validity was examined by comparing test scores of impaired patients and normal control subjects. Construct-related validity was computed through correlations between computer-based subtests and related conventional neuropsychological subtests. University center for memory disorders. Fifty-two patients with mild cognitive impairment by strict clinical criteria and 50 unimpaired, age- and education-matched control subjects. Control subjects were rigorously screened by neurological, neuropsychological, imaging, and electrophysiological criteria to identify and exclude individuals with occult abnormalities. Using a cut-off total score of 126, this computer-based instrument had a sensitivity of 0.83 and a specificity of 0.96. Using a prevalence estimate of 10%, predictive values, positive and negative, were 0.70 and 0.96, respectively. Computer-based subtests correlated significantly with conventional neuropsychological tests measuring similar cognitive domains. Thirteen (17.8%) of 73 volunteers with normal medical histories were excluded from the control group, with unsuspected abnormalities on standard neuropsychological tests, electroencephalograms, or magnetic resonance imaging scans. Computer-based testing is a valid screening methodology for the detection of mild cognitive impairment in the elderly, although this particular test has important limitations. Broader applications of computer-based testing will require extensive population-based validation. Future studies should recognize that normal control subjects without a history of disease who are typically used in validation studies may have a high incidence of unsuspected abnormalities on neurodiagnostic studies.

Brain-Derived neurotrophic factor levels in late-life depression and comorbid mild cognitive impairment: a longitudinal study

PubMed Central

Diniz, Breno Satler; Reynolds, Charles F.; Begley, Amy; Dew, Mary Amanda; Anderson, Stewart J.; Lotrich, Francis; Erickson, Kirk I.; Lopez, Oscar; Aizenstein, Howard; Sibille, Etienne L.; Butters, Meryl A.

2014-01-01

Changes in brain-derived neurotrophic factor (BDNF) level are implicated in the pathophysiology of cognitive decline in depression and neurodegenerative disorders in older adults. We aimed to evaluate the longitudinal association over two years between BDNF and persistent cognitive decline in individuals with remitted late-life depression and Mild Cognitive Impairment (LLD+MCI) compared to either individuals with remitted LLD and no cognitive decline (LLD+NCD) or never-depressed, cognitively normal, elderly control participants. We additionally evaluated the effect of double-blind, placebo-controlled donepezil treatment on BDNF levels in all of the remitted LLD participants (across the levels of cognitive function). We included 160 elderly participants in this study (72 LLD+NCD, 55 LLD+MCI and 33 never-depressed cognitively normal elderly participants). At the same visits, cognitive assessments were conducted and blood sampling to determine serum BDNF levels were collected at baseline assessment and after one and two years of follow-up. We utilized repeated measure, mixed effect models to assess: (1) the effects of diagnosis (LLD+MCI, LLD+NCD, and controls), time, and their interaction on BDNF levels; and (2) the effects of donepezil treatment (donepezil vs. placebo), time, baseline diagnosis (LLD+MCI vs. LLD+NCD), and interactions between these contrasts on BDNF levels. We found a significant effect of time on BDNF level (p=0.02) and a significant decline in BDNF levels over 2 years of follow-up in participants with LLD+MCI (p=0.004) and controls (p=0.04). We found no effect of donepezil treatment on BDNF level. The present results suggest that aging is an important factor related to decline in BDNF level. PMID:24290367

Volumetric correlates of memory and executive function in normal elderly, mild cognitive impairment and Alzheimer’s disease

PubMed Central

Duarte, Audrey; Hayasaka, Satoru; Du, Antao; Schuff, Norbert; Jahng, Geon-Ho; Kramer, Joel; Miller, Bruce; Weiner, Michael

2007-01-01

In Alzheimer’s disease (AD), atrophy negatively impacts cognition while in healthy adults, inverse relationships between brain volume and cognition may occur. We investigated correlations between gray matter volume and cognition in elderly controls, AD and mild cognitive impairment (MCI) patients with memory and executive deficits. AD demonstrated substantial loss in temporal, parietal and frontal regions while MCI exhibited moderate volume loss in temporal and frontal regions. In controls, memory and executive function were negatively correlated with frontal regions, while in AD, memory was positively correlated with temporal and frontal gyri, and executive function with frontal regions. The combination of the two patterns may explain the lack of correlations in MCI. Developmental versus pathological contributions to these relationships are discussed. PMID:16904823

Effect of signal to noise ratio on the speech perception ability of older adults

PubMed Central

Shojaei, Elahe; Ashayeri, Hassan; Jafari, Zahra; Zarrin Dast, Mohammad Reza; Kamali, Koorosh

2016-01-01

Background: Speech perception ability depends on auditory and extra-auditory elements. The signal- to-noise ratio (SNR) is an extra-auditory element that has an effect on the ability to normally follow speech and maintain a conversation. Speech in noise perception difficulty is a common complaint of the elderly. In this study, the importance of SNR magnitude as an extra-auditory effect on speech perception in noise was examined in the elderly. Methods: The speech perception in noise test (SPIN) was conducted on 25 elderly participants who had bilateral low–mid frequency normal hearing thresholds at three SNRs in the presence of ipsilateral white noise. These participants were selected by available sampling method. Cognitive screening was done using the Persian Mini Mental State Examination (MMSE) test. Results: Independent T- test, ANNOVA and Pearson Correlation Index were used for statistical analysis. There was a significant difference in word discrimination scores at silence and at three SNRs in both ears (p≤0.047). Moreover, there was a significant difference in word discrimination scores for paired SNRs (0 and +5, 0 and +10, and +5 and +10 (p≤0.04)). No significant correlation was found between age and word recognition scores at silence and at three SNRs in both ears (p≥0.386). Conclusion: Our results revealed that decreasing the signal level and increasing the competing noise considerably reduced the speech perception ability in normal hearing at low–mid thresholds in the elderly. These results support the critical role of SNRs for speech perception ability in the elderly. Furthermore, our results revealed that normal hearing elderly participants required compensatory strategies to maintain normal speech perception in challenging acoustic situations. PMID:27390712

Structural Equation Analysis of the Wechsler Adult Intelligence Scale-Revised in a Normal Elderly Sample.

ERIC Educational Resources Information Center

Burton, D. Bradley; And Others

1994-01-01

A maximum-likelihood confirmatory factor analysis was performed by applying LISREL VII to the Wechsler Adult Intelligence Scale-Revised results of a normal elderly sample of 225 adults. Results indicate that a three-factor model fits best across all sample combinations. A mild gender effect is discussed. (SLD)

Cognitive Change in Elderly Populations: "Normal" Aging, Senile Dementia and Depression.

ERIC Educational Resources Information Center

Bach, Paul J.

Cognitive change in the elderly can be due to several etiological factors which are empirically difficult to separate and clinically problematic to differentiate. Normal aging is accompanied by behavioral slowing. The slowing down of psycho-motor processes results in a lowered intelligence quotient, but cannot be taken as unequivocal evidence for…

Effect of Mild Cognitive Impairment and Alzheimer Disease on Auditory Steady-State Responses

PubMed Central

Shahmiri, Elaheh; Jafari, Zahra; Noroozian, Maryam; Zendehbad, Azadeh; Haddadzadeh Niri, Hassan; Yoonessi, Ali

2017-01-01

Introduction: Mild Cognitive Impairment (MCI), a disorder of the elderly people, is difficult to diagnose and often progresses to Alzheimer Disease (AD). Temporal region is one of the initial areas, which gets impaired in the early stage of AD. Therefore, auditory cortical evoked potential could be a valuable neuromarker for detecting MCI and AD. Methods: In this study, the thresholds of Auditory Steady-State Response (ASSR) to 40 Hz and 80 Hz were compared between Alzheimer Disease (AD), MCI, and control groups. A total of 42 patients (12 with AD, 15 with MCI, and 15 elderly normal controls) were tested for ASSR. Hearing thresholds at 500, 1000, and 2000 Hz in both ears with modulation rates of 40 and 80 Hz were obtained. Results: Significant differences in normal subjects were observed in estimated ASSR thresholds with 2 modulation rates in 3 frequencies in both ears. However, the difference was significant only in 500 Hz in the MCI group, and no significant differences were observed in the AD group. In addition, significant differences were observed between the normal subjects and AD patients with regard to the estimated ASSR thresholds with 2 modulation rates and 3 frequencies in both ears. A significant difference was observed between the normal and MCI groups at 2000 Hz, too. An increase in estimated 40 Hz ASSR thresholds in patients with AD and MCI suggests neural changes in auditory cortex compared to that in normal ageing. Conclusion: Auditory threshold estimation with low and high modulation rates by ASSR test could be a potentially helpful test for detecting cognitive impairment. PMID:29158880

Cognitive stimulation intervention for elders with mild cognitive impairment compared with normal aged subjects: preliminary results.

PubMed

Wenisch, Emilie; Cantegreil-Kallen, Inge; De Rotrou, Jocelyne; Garrigue, Pia; Moulin, Florence; Batouche, Fériel; Richard, Aurore; De Sant'Anna, Martha; Rigaud, Anne Sophie

2007-08-01

Cognitive training programs have been developed for Alzheimer's disease patients and the healthy elderly population. Collective cognitive stimulation programs have been shown to be efficient for subjects with memory complaint. The aim of this study was to evaluate the benefit of such cognitive programs in populations with Mild Cognitive Impairment (MCI). Twelve patients with MCI and twelve cognitively normal elders were administered a cognitive stimulation program. Cognitive performance (Logical Memory, Word paired associative learning task, Trail Making Test, verbal fluency test) were collected before and after the intervention. A gain score [(post-score - pre-score)/ pre-score] was calculated for each variable and compared between groups. The analysis revealed a larger intervention size effect in MCI than in normal elders' performances on the associative learning task (immediate recall: p<0.05, delayed recall: p<0.01). The intervention was more beneficial in improving associative memory abilities in MCI than in normal subjects. At the end of the intervention, the MCI group had lower results than the normal group only for the delayed recall of Logical Memory. Although further studies are needed for more details on the impact of cognitive stimulation programs on MCI patients, this intervention is effective in compensating associative memory difficulties of these patients. Among non-pharmacological interventions, cognitive stimulation therapy is a repeatable and inexpensive collective method that can easily be provided to various populations with the aim of slowing down the rate of decline in elderly persons with cognitive impairment.

Decline of vertical gaze and convergence with aging.

PubMed

Oguro, Hiroaki; Okada, Kazunori; Suyama, Nobuo; Yamashita, Kazuya; Yamaguchi, Shuhei; Kobayashi, Shotai

2004-01-01

Disturbance of vertical eye movement and ocular convergence is often observed in elderly people, but little is known about its frequency. The purpose of this study was to investigate age-associated changes in vertical eye movement and convergence in healthy elderly people, using a digital video camera system. We analyzed vertical eye movements and convergence in 113 neurologically normal elderly subjects (mean age 70 years) in comparison with 20 healthy young controls (mean age 32 years). The range of vertical eye movement was analyzed quantitatively and convergence was analyzed qualitatively. In the elderly subjects, the angle of vertical gaze decreased with advancing age and it was significantly smaller than that of the younger subjects. The mean angle of upward gaze was significantly smaller than that of downward gaze for both young and elderly subjects. Upward gaze impairment became apparent in subjects in their 70s, and downward gaze impairment in subjects in their 60s. Disturbance in convergence also increased with advancing age, and was found in 40.7% of the elderly subjects. These findings indicate that the mechanisms of age-related change are different for upward and downward vertical gaze. Digital video camera monitoring was useful for assessing and monitoring eye movements. Copyright 2004 S. Karger AG, Basel

Serum inflammatory markers in the elderly: are they useful in differentiating sepsis from SIRS?

PubMed

Talebi-Taher, Mahshid; Babazadeh, Shahin; Barati, Mitra; Latifnia, Maryam

2014-01-01

Differentiating sepsis from other noninfectious causes of systemic inflammation is often difficult in the elderly. The aim of this study was to evaluate the ability of C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), procalcitonin (PCT), and Interleukin-6 (IL-6) to identify elderly patients with sepsis. In this single center prospective observational study, we included all consecutive elderly patients admitted with suspected sepsis and systemic inflammatory response syndrome (SIRS) in an emergency department. Blood samples for measuring CRP, PCT, IL-6, ESR and white blood cells (WBC) count were taken at first day of admission. Sensitivity, specificity, positive and negative predictive values were calculated for each inflammatory markers being studied. A total of 150 elderly patients aged 65 and older, 50 with sepsis and 50 with SIRS, and fifty individuals in a normal health status were included. CRP exhibited the greatest sensitivity (98%) and negative predictive value (98.6%) and performed best in differentiating patients with sepsis from those with SIRS. In a receiver operating characteristic curve analysis, IL-6 performed best in distinguishing between SIRS and the control group (AUC 0.75, 95% CI). On the other hand, both CRP and ESR appeared to be a more accurate diagnostic parameter for differentiating sepsis from SIRS among elderly patients.

QT dispersion and rate-corrected QT dispersion during electroconvulsive therapy in elderly patients.

PubMed

Yamaguchi, Shigeki; Nagao, Masaru; Ikeda, Tomohisa; Fukagawa, Daigo; Kimura, Yoshiyuki; Kitajima, Toshimitsu; Minami, Junichi

2011-09-01

Electroconvulsive therapy (ECT) induces increase of QT dispersion (QTD) and the rate-corrected QTD (QTcD), which are associated with increased risk of ventricular arrhythmias and cardiovascular mortality. The effects of electrical stimulus during ECT on QTD and QTcD in elderly patients are of considerable interest. The purpose of this study was to clarify the differential effects of electrical stimulus caused by ECT on interbeat interval, QT interval, the rate-corrected QT (QTc) interval, QTD, and the QTcD under propofol anesthesia between younger and elderly patients with major depression. Twenty younger psychiatric patients (aged 30-40 years) and 20 elderly patients (aged 65-75 years) scheduled for ECT were studied under propofol anesthesia. A 12-lead electrocardiogram was monitored to measure parameters. Muscle paralysis was achieved by administering 1-mg/kg succinylcholine intravenously, and the efficacy of ECT was determined by the tourniquet technique. The mean arterial pressure in the elderly was significantly higher than that of the younger patients from immediately to 2 minutes after electrical stimulus. The interbeat interval in the elderly was significantly lower than that of the younger patients from immediately to 1 minute after electrical stimulus. There was no statistically significant difference in the QT interval between the groups. The baseline value of QTc interval was higher than the normal limits, and the QTc interval in the elderly was significantly lower than that of the younger patients from immediately to 1 minute after electrical stimulus. The baseline value of QTD was higher than the normal limits, and the QTD in the elderly was significantly higher than that of the younger patients from immediately to 7 minutes after electrical stimulus. The baseline value of QTcD was higher than the normal limits, and the QTcD in the elderly was significantly higher than that of the younger patients from immediately to 7 minutes after electrical stimulus. The QTc interval, QTD, and QTcD may be higher than the normal limits before anesthesia in patients with major depression. The QTD and QTcD in the elderly, which are associated with increased risks of ventricular arrhythmias, are higher than those of the younger patients after electrical stimulus during ECT. Electrical stimulus may induce further increased risks of cardiac events in elderly patients.

Depression and Obesity/Overweight Association in Elderly Women: a Community-Based Case-Control Study.

PubMed

Ahmadi, Seyed Mehdi; Keshavarzi, Sareh; Mostafavi, Seyed-Ali; Bagheri Lankarani, Kamran

2015-11-01

Overweight/obesity and depression are common among women especially in the elderly and can lead to unfavorable outcomes. We aimed to determine the association of overweight with depression and also to find any correlation of depression with some anthropometric indices in old women. A total of 94 depressed elderly women were compared with 99 non-depressed controls. The structured diagnostic interview based on DSM-IV were performed to diagnose depression, and Geriatric Depression Scale (GDS) was completed to rate it. Anthropometric indices were measured and compared between groups. Pearson correlation coefficients were determined for linear relations between variables. Odds Ratio of obesity and overweight in depressed subjects comparing with normal participants was 1.45 (95%CI=0.63-3.32). A significant correlation was observed between BMI and GDS score (r=0.231, P-value=0.001). Total body fat (P-value=0.001) and BMI (P-value=0.016) were significantly higher in depressed women than non-depressed women. Despite the significantly higher total body fat and BMI among old women with depression, only a weak correlation was seen between BMI and GDS score.

ERP C250 Shows the Elderly (Cognitively Normal, Alzheimer’s Disease) Store More Stimuli in Short-Term Memory than Young Adults Do

PubMed Central

Chapman, Robert M.; Gardner, Margaret N.; Mapstone, Mark; Klorman, Rafael; Porsteinsson, Anton P.; Dupree, Haley M.; Antonsdottir, Inga M.; Kamalyan, Lily

2016-01-01

Objective To determine how aging and dementia affect the brain’s initial storing of task-relevant and irrelevant information in short-term memory. Methods We used brain Event-Related Potentials (ERPs) to measure short-term memory storage (ERP component C250) in 36 Young Adults, 36 Normal Elderly, and 36 early-stage AD subjects. Participants performed the Number-Letter task, a cognitive paradigm requiring memory storage of a first relevant stimulus to compare it with a second stimulus. Results In Young Adults, C250 was more positive for the first task-relevant stimulus compared to all other stimuli. C250 in Normal Elderly and AD subjects was roughly the same to relevant and irrelevant stimuli in intratrial parts 1–3 but not 4. The AD group had lower C250 to relevant stimuli in part 1. Conclusions Both normal aging and dementia cause less differentiation of relevant from irrelevant information in initial storage. There was a large aging effect involving differences in the pattern of C250 responses of the Young Adult versus the Normal Elderly/AD groups. Also, a potential dementia effect was obtained. Significance C250 is a candidate tool for measuring short-term memory performance on a biological level, as well as a potential marker for memory changes due to normal aging and dementia. PMID:27178862

Sensory-motor relationships in speech production in post-lingually deaf cochlear-implanted adults and normal-hearing seniors: Evidence from phonetic convergence and speech imitation.

PubMed

Scarbel, Lucie; Beautemps, Denis; Schwartz, Jean-Luc; Sato, Marc

2017-07-01

Speech communication can be viewed as an interactive process involving a functional coupling between sensory and motor systems. One striking example comes from phonetic convergence, when speakers automatically tend to mimic their interlocutor's speech during communicative interaction. The goal of this study was to investigate sensory-motor linkage in speech production in postlingually deaf cochlear implanted participants and normal hearing elderly adults through phonetic convergence and imitation. To this aim, two vowel production tasks, with or without instruction to imitate an acoustic vowel, were proposed to three groups of young adults with normal hearing, elderly adults with normal hearing and post-lingually deaf cochlear-implanted patients. Measure of the deviation of each participant's f 0 from their own mean f 0 was measured to evaluate the ability to converge to each acoustic target. showed that cochlear-implanted participants have the ability to converge to an acoustic target, both intentionally and unintentionally, albeit with a lower degree than young and elderly participants with normal hearing. By providing evidence for phonetic convergence and speech imitation, these results suggest that, as in young adults, perceptuo-motor relationships are efficient in elderly adults with normal hearing and that cochlear-implanted adults recovered significant perceptuo-motor abilities following cochlear implantation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Differences in knowledge of dementia among older adults with normal cognition, mild cognitive impairment, and dementia: A representative nationwide sample of Korean elders.

PubMed

Lee, Jun-Young; Park, Soowon; Kim, Ki Woong; Kwon, Ji Eyon; Park, Joon Hyuk; Kim, Moon Doo; Kim, Bong-Jo; Kim, Jeong Lan; Moon, Seok Woo; Bae, Jae Nam; Ryu, Seung-Ho; Yoon, Jong Chul; Lee, Nam-Jin; Lee, Dong Young; Lee, Dong Woo; Lee, Seok Bum; Lee, Jung Jae; Lee, Chang-Uk; Jhoo, Jin Hyeong; Cho, Maeng Je

2016-01-01

Lack of knowledge about a disease could impede early diagnosis and may lead to delays in seeking appropriate medical care. The aim of this study was to explore knowledge of dementia (KOD) and to find the determinants of KOD among three groups: older adults with normal cognition, mild cognitive impairment (MCI), and dementia. A representative nationwide sample of 6141 Korean elders aged 65 years or older participated in face-to-face interviews and answered 14 questions pertaining to general information, etiology, symptoms, and treatment of dementia. Stepwise multiple regressions and path analyses probed the relationships between various sociodemographic variables and KOD. The percentage of correct responses was only 62%. The item 'A person who remembers things that happened in the past does not have dementia' was answered correctly (false) by only 24.8-27% of the respondents in all groups. Older adults with normal cognition had higher KOD scores than those with MCI or dementia. In the normal-cognition group, KOD scores were higher among highly educated, younger, and literate women with no depression and a family history of dementia. In contrast with the determinants in the normal-cognition group, only the ability to read and write predicted KOD scores in the dementia group. Efforts to enhance KOD in elder adults are needed. Public education regarding the differences between dementia and healthy aging may increase KOD among normal elders and those with MCI. Among elders with dementia, educational materials that do not require literacy may be more helpful in increasing KOD with the aim of preventing treatment delay. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The preoperative HbA1c level is an independent prognostic factor for the postoperative survival after resection of non-small cell lung cancer in elderly patients.

PubMed

Motoishi, Makoto; Sawai, Satoru; Hori, Tetsuo; Yamashita, Naoki

2018-05-01

The aim of this study was to investigate the influence of a history of diabetes mellitus (DM) and the glycated hemoglobin (HbA1c) level on the survival in patients who underwent complete resection for non-small cell lung cancer (NSCLC). Of the patients who underwent complete resection for NSCLC between 2007 and 2015, 468 were classified into DM (who were currently taking medication for DM) and no DM groups as well as into high HbA1c (≥ 6.5) and normal HbA1c (< 6.5) groups. The overall survival (OS) did not differ significantly between either pair of groups. Among the elderly patients, the OS did not differ significantly between the DM and no DM groups, but was significantly higher in the normal-HbA1c group than in the high-HbA1c group (5-year survival rate: 84.7 versus 37.2%, respectively, p < 0.01). In the elderly patients, non-adenocarcinoma histology, advanced stage, a high Charlson comorbidity index, and a high preoperative HbA1c level were found to be independent risk factors for the OS. We revealed that a high preoperative HbA1c level was associated with a poor OS in elderly patients who underwent complete resection for NSCLC. This suggests that it is necessary to achieve diabetic control prior to complete resection in NSCLC patients.

A current perspective on geriatric lower urinary tract dysfunction.

PubMed

Jung, Ha Bum; Kim, Hyung Jee; Cho, Sung Tae

2015-04-01

Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction.

A current perspective on geriatric lower urinary tract dysfunction

PubMed Central

Jung, Ha Bum; Kim, Hyung Jee

2015-01-01

Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction. PMID:25874039

Valuation of Normal Range of Ankle Systolic Blood Pressure in Subjects with Normal Arm Systolic Blood Pressure.

PubMed

Gong, Yi; Cao, Kai-wu; Xu, Jin-song; Li, Ju-xiang; Hong, Kui; Cheng, Xiao-shu; Su, Hai

2015-01-01

This study aimed to establish a normal range for ankle systolic blood pressure (SBP). A total of 948 subjects who had normal brachial SBP (90-139 mmHg) at investigation were enrolled. Supine BP of four limbs was simultaneously measured using four automatic BP measurement devices. The ankle-arm difference (An-a) on SBP of both sides was calculated. Two methods were used for establishing normal range of ankle SBP: the 99% method was decided on the 99% reference range of actual ankle BP, and the An-a method was the sum of An-a and the low or up limits of normal arm SBP (90-139 mmHg). Whether in the right or left side, the ankle SBP was significantly higher than the arm SBP (right: 137.1 ± 16.9 vs 119.7 ± 11.4 mmHg, P<0.05). Based on the 99% method, the normal range of ankle SBP was 94~181 mmHg for the total population, 84~166 mmHg for the young (18-44 y), 107~176 mmHg for the middle-aged(45-59 y) and 113~179 mmHg for the elderly (≥ 60 y) group. As the An-a on SBP was 13 mmHg in the young group and 20 mmHg in both middle-aged and elderly groups, the normal range of ankle SBP on the An-a method was 103-153 mmHg for young and 110-160 mmHg for middle-elderly subjects. A primary reference for normal ankle SBP was suggested as 100-165 mmHg in the young and 110-170 mmHg in the middle-elderly subjects.

Sacubitril/Valsartan in an Elderly Patient with Heart Failure: A Case Report.

PubMed

Cameli, Matteo; Pastore, Maria Concetta; Pagliaro, Antonio; Di Tommaso, Cristina; Reccia, Rosanna; Curci, Valeria; Mandoli, Giulia Elena; Mondillo, Sergio

2017-01-01

Sacubitril/valsartan has recently been approved for the treatment of heart failure with reduced ejection fraction. Given its recent introduction in the armamentarium for the treatment of heart failure (HF), "field-practice" evidence is required to deepen the clinical management of sacubitril/valsartan therapy. We report a relevant case of an elderly patient who achieved major clinical benefits after only 3 months of sacubitril/valsartan therapy. Importantly, in our assessment, we employed speckle tracking echocardiography (STE), a recent echocardiography technique that is non-Doppler and not angle dependent, which analyzes deformations of heart chambers from standard images and allows a fast, reliable, and reproducible assessment of heart function. After 3 months of therapy, NHYA class decreased from III to I-II and hypertension was controlled. Echocardiography examination also showed a marked improvement, with a reduction of left ventricular diameter, improved diastolic function (E = 0.39 m/s; A 0.69 m/s; E/A 0.55), normalized diastolic function index (E/E' TDI = 6.93), normalized atrial volume (63 mL), and improved atrial strain (15.44%). This case report documents the fast clinical and symptom improvement with sacubitril/valsartan in an elderly patient with HF; comprehensive echocardiographic assessment, including STE, also revealed a marked functional improvement with this compound. © 2017 S. Karger AG, Basel.

Objective assessment of leg edema using ultrasonography with a gel pad

PubMed Central

Iuchi, Terumi; Tsuchiya, Sayumi; Ohno, Naoki; Dai, Misako; Matsumoto, Masaru; Ogai, Kazuhiro; Sato, Aya; Sawazaki, Takuto; Miyati, Tosiaki; Tanaka, Shinobu; Sugama, Junko

2017-01-01

Ultrasonography (US) is useful for visual detection of edematous tissues to assess subcutaneous echogenicity. However, visualization of subcutaneous echogenicity is interpreted differently among operators because the evaluation is subjective and individual operators have unique knowledge. This study objectively assessed leg edema using US with a gel pad including fat for normalization of echogenicity in subcutaneous tissue. Five younger adults and four elderly people with leg edema were recruited. We compared assessments of US and limb circumference before and after the intervention of vibration to decrease edema in younger adults, and edema prior to going to sleep and reduced edema in the early morning in elderly people. These assessments were performed twice in elderly people by three operators and reliability, interrater differences, and bias were assessed. For US assessment, echogenicity in subcutaneous tissue was normalized to that of the gel pad by dividing the mean echogenicity of subcutaneous tissue by the mean echogenicity of the gel pad. In younger adults, the normalized subcutaneous echogenicity before the intervention was significantly higher than that after the intervention. In elderly people, echogenicity indicating edema was significantly higher than that after edema reduction. Edema was detected with accuracy rates of 76.9% in younger adults and 75.0% in elderly people. Meanwhile, limb circumference could be used to detect edema in 50.0% of healthy adults and 87.8% of elderly people. The intra-reliability was excellent (intraclass correlation coefficient > 0.9, p < 0.01), and the inter-reliability was good (intraclass correlation coefficient > 0.7, p < 0.01) for normalized subcutaneous echogenicity. Bland-Altman plots revealed that inter-rater differences and systematic bias were small. Normalized subcutaneous echogenicity with the pad can sensitively and objectively assess leg edema with high reliability. Therefore, this method has the potential to become a new gold standard for objective assessment of leg edema in clinical practice. PMID:28792959

Comparing group dehumanization and intra-sexual competition among normally ovulating women and hormonal contraceptive users.

PubMed

Piccoli, Valentina; Foroni, Francesco; Carnaghi, Andrea

2013-12-01

Two studies address the role of hormonal shift across menstrual cycle in female dehumanization of other women. In Study 1, normally ovulating women (NOW) and women who use hormonal contraceptives (HCW) are compared in terms of how much they dehumanize other women and two other control targets (men and elderly people). In NOW, the level of dehumanization of other women, but not of men and elderly people, increases as the conception risk is enhanced. HCW do not show this pattern of results. In Study 2, we investigate the level of dehumanization of other women and of intra-sexual competition. Findings concerning dehumanization replicate those of Study 1. Intra-sexual competition increases with the rise of conception risk only in NOW. In addition, dehumanization is significantly associated with intra-sexual competition in NOW but not in HCW. Together, these studies demonstrate that dehumanization of women is elicited by menstrual cycle-related processes and associated with women's mate-attraction goals.

Salivary protein concentration, flow rate, buffer capacity and pH estimation: A comparative study among young and elderly subjects, both normal and with gingivitis and periodontitis.

PubMed

Shaila, Mulki; Pai, G Prakash; Shetty, Pushparaj

2013-01-01

To evaluate the salivary protein concentration in gingivitis and periodontitis patients and compare the parameters like salivary total protein, salivary albumin, salivary flow rate, pH, buffer capacity and flow rate in both young and elderly patients with simple methods. One hundred and twenty subjects were grouped based on their age as young and elderly. Each group was subgrouped (20 subjects) as controls, gingivitis and periodontitis. Unstimulated whole saliva was collected from patients and flow rate was noted down during collection of the sample. Salivary protein estimation was done using the Biuret method and salivary albumin was assessed using the Bromocresol green method. pH was estimated with a pHmeter and buffering capacity was analyzed with the titration method. Student's t-test, Fisher's test (ANOVA) and Tukey HSD (ANOVA) tests were used for statistical analysis. A very highly significant rise in the salivary total protein and albumin concentration was noted in gingivitis and periodontitis subjects of both young and elderly. An overall decrease in salivary flow rate was observed among the elderly, and also the salivary flow rate of women was significantly lower than that of men. Significant associations between salivary total protein and albumin in gingivitis and periodontitis were found with simple biochemical tests. A decrease in salivary flow rate among elderly and among women was noted.

ERP C250 shows the elderly (cognitively normal, Alzheimer's disease) store more stimuli in short-term memory than Young Adults do.

PubMed

Chapman, Robert M; Gardner, Margaret N; Mapstone, Mark; Klorman, Rafael; Porsteinsson, Anton P; Dupree, Haley M; Antonsdottir, Inga M; Kamalyan, Lily

2016-06-01

To determine how aging and dementia affect the brain's initial storing of task-relevant and irrelevant information in short-term memory. We used brain Event-Related Potentials (ERPs) to measure short-term memory storage (ERP component C250) in 36 Young Adults, 36 Normal Elderly, and 36 early-stage AD subjects. Participants performed the Number-Letter task, a cognitive paradigm requiring memory storage of a first relevant stimulus to compare it with a second stimulus. In Young Adults, C250 was more positive for the first task-relevant stimulus compared to all other stimuli. C250 in Normal Elderly and AD subjects was roughly the same to relevant and irrelevant stimuli in Intratrial Parts 1-3 but not 4. The AD group had lower C250 to relevant stimuli in part 1. Both normal aging and dementia cause less differentiation of relevant from irrelevant information in initial storage. There was a large aging effect involving differences in the pattern of C250 responses of the Young Adult versus the Normal Elderly/AD groups. Also, a potential dementia effect was obtained. C250 is a candidate tool for measuring short-term memory performance on a biological level, as well as a potential marker for memory changes due to normal aging and dementia. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

[Graves' disease in the elderly].

PubMed

Iitaka, Makoto

2006-12-01

Characterization of elderly (> or = 65) patients with Graves' disease (GD) was discussed. Emaciation was the symptom that was most frequently found in elderly patients. The presence of goiter, exophthalmos and increased appetite decreased with age, while weight loss, anorexia and arrhythmia increased. Elderly patients often have serious complications such as congestive heart failure and atrial fibrillation. Serum levels of free T3, free T4 and TSH receptor antibodies were significantly lower in elderly patients. In addition to fewer clinical signs and symptoms of GD in elderly patients, prominent cardiac or gastrointestinal findings may make the diagnosis more difficult. Elderly GD patients should be treated with antithyroid drugs. Radioiodine therapy may be considered after normalization of serum thyroid hormone levels.

Orexin-A is Associated with Increases in Cerebrospinal Fluid Phosphorylated-Tau in Cognitively Normal Elderly Subjects

PubMed Central

Osorio, Ricardo S.; Ducca, Emma L.; Wohlleber, Margaret E.; Tanzi, Emily B.; Gumb, Tyler; Twumasi, Akosua; Tweardy, Samuel; Lewis, Clifton; Fischer, Esther; Koushyk, Viachaslau; Cuartero-Toledo, Maria; Sheikh, Mohammed O.; Pirraglia, Elizabeth; Zetterberg, Henrik; Blennow, Kaj; Lu, Shou-En; Mosconi, Lisa; Glodzik, Lidia; Schuetz, Sonja; Varga, Andrew W.; Ayappa, Indu; Rapoport, David M.; de Leon, Mony J.

2016-01-01

Study Objectives: To evaluate the role of orexin-A with respect to cerebrospinal fluid (CSF) Alzheimer disease (AD) biomarkers, and explore its relationship to cognition and sleep characteristics in a group of cognitively normal elderly individuals. Methods: Subjects were recruited from multiple community sources for National Institutes of Health supported studies on normal aging, sleep and CSF biomarkers. Sixty-three participants underwent home monitoring for sleep-disordered breathing, clinical, sleep and cognitive evaluations, as well as a lumbar puncture to obtain CSF. Individuals with medical history or with magnetic resonance imaging evidence of disorders that may affect brain structure or function were excluded. Correlation and linear regression analyses were used to assess the relationship between orexin-A and CSF AD-biomarkers controlling for potential sociodemographic and sleep confounders. Results: Levels of orexin-A, amyloid beta 42 (Aβ42), phosphorylated-tau (P-Tau), total-tau (T-Tau), Apolipoprotein E4 status, age, years of education, reported total sleep time, number of awakenings, apnea-hypopnea indices (AHI), excessive daytime sleepiness, and a cognitive battery were analyzed. Subjects were 69.59 ± 8.55 years of age, 57.1% were female, and 30.2% were apolipoprotein E4+. Orexin-A was positively correlated with Aβ42, P-Tau, and T-Tau. The associations between orexin-A and the AD-biomarkers were driven mainly by the relationship between orexin-A and P-Tau and were not influenced by other clinical or sleep characteristics that were available. Conclusions: Orexin-A is associated with increased P-Tau in normal elderly individuals. Increases in orexin-A and P-Tau might be a consequence of the reduction in the proportion of the deeper, more restorative slow wave sleep and rapid eye movement sleep reported with aging. Clinical Trial Registration: Clinicaltrials.gov registration number NCT01962779. Citation: Osorio RS, Ducca EL, Wohlleber ME, Tanzi EB, Gumb T, Twumasi A, Tweardy S, Lewis C, Fischer E, Koushyk V, Cuartero-Toledo M, Sheikh MO, Pirraglia E, Zetterberg H, Blennow K, Lu SE, Mosconi L, Glodzik L, Schuetz S, Varga AW, Ayappa I, Rapoport DM, de Leon MJ. Orexin-A is associated with increases in cerebrospinal fluid phosphorylated-tau in cognitively normal elderly subjects. SLEEP 2016;39(6):1253–1260. PMID:26951396

The effects of deanol on cognitive performance and electrophysiology in elderly humans.

PubMed

Marsh, G R; Linnoila, M

1979-01-01

Deanol (900 mg/day for 21 days) had no effect on learning a list of words when tested at weekly intervals. Tests of simple and complex reaction time and a test of continuous serial decoding of digits showed no enhancement with the drug. Several components of evoked potentials recorded from several scalp sites did show enhanced amplitude under drug treatment. These changes were not accompanied by changes in the EEG spectrum as are seen with some other psychoactive drugs. Deanol seems to be an ineffective treatment for the normal slowing of cognitive function seen in the normal elderly person or those elderly with only minimal cognitive decline and free of symptoms of dementia. Contrary to earlier reports, elderly persons were found to be able to benefit from warning signals in a complex reaction time task.

Obstructive Sleep Apnea Severity Affects Amyloid Burden in Cognitively Normal Elderly. A Longitudinal Study.

PubMed

Sharma, Ram A; Varga, Andrew W; Bubu, Omonigho M; Pirraglia, Elizabeth; Kam, Korey; Parekh, Ankit; Wohlleber, Margaret; Miller, Margo D; Andrade, Andreia; Lewis, Clifton; Tweardy, Samuel; Buj, Maja; Yau, Po L; Sadda, Reem; Mosconi, Lisa; Li, Yi; Butler, Tracy; Glodzik, Lidia; Fieremans, Els; Babb, James S; Blennow, Kaj; Zetterberg, Henrik; Lu, Shou E; Badia, Sandra G; Romero, Sergio; Rosenzweig, Ivana; Gosselin, Nadia; Jean-Louis, Girardin; Rapoport, David M; de Leon, Mony J; Ayappa, Indu; Osorio, Ricardo S

2018-04-01

Recent evidence suggests that obstructive sleep apnea (OSA) may be a risk factor for developing mild cognitive impairment and Alzheimer's disease. However, how sleep apnea affects longitudinal risk for Alzheimer's disease is less well understood. To test the hypothesis that there is an association between severity of OSA and longitudinal increase in amyloid burden in cognitively normal elderly. Data were derived from a 2-year prospective longitudinal study that sampled community-dwelling healthy cognitively normal elderly. Subjects were healthy volunteers between the ages of 55 and 90, were nondepressed, and had a consensus clinical diagnosis of cognitively normal. Cerebrospinal fluid amyloid β was measured using ELISA. Subjects received Pittsburgh compound B positron emission tomography scans following standardized procedures. Monitoring of OSA was completed using a home sleep recording device. We found that severity of OSA indices (AHIall [F 1,88  = 4.26; P < 0.05] and AHI4% [F 1,87  = 4.36; P < 0.05]) were associated with annual rate of change of cerebrospinal fluid amyloid β 42 using linear regression after adjusting for age, sex, body mass index, and apolipoprotein E4 status. AHIall and AHI4% were not associated with increases in AD PiB -mask (Alzheimer's disease vulnerable regions of interest Pittsburg compound B positron emission tomography mask) most likely because of the small sample size, although there was a trend for AHIall (F 1,28  = 2.96, P = 0.09; and F 1,28  = 2.32, not significant, respectively). In a sample of cognitively normal elderly, OSA was associated with markers of increased amyloid burden over the 2-year follow-up. Sleep fragmentation and/or intermittent hypoxia from OSA are likely candidate mechanisms. If confirmed, clinical interventions for OSA may be useful in preventing amyloid build-up in cognitively normal elderly.

Rarity of the Alzheimer Disease–Protective APP A673T Variant in the United States

PubMed Central

Wang, Li-San; Naj, Adam C.; Graham, Robert R.; Crane, Paul K.; Kunkle, Brian W.; Cruchaga, Carlos; Gonzalez Murcia, Josue D.; Cannon-Albright, Lisa; Baldwin, Clinton T.; Zetterberg, Henrik; Blennow, Kaj; Kukull, Walter A.; Faber, Kelley M.; Schupf, Nicole; Norton, Maria C.; Tschanz, JoAnn T.; Munger, Ronald G.; Corcoran, Christopher D.; Rogaeva, Ekaterina; Lin, Chiao-Feng; Dombroski, Beth A.; Cantwell, Laura B.; Partch, Amanda; Valladares, Otto; Hakonarson, Hakon; St George-Hyslop, Peter; Green, Robert C.; Goate, Alison M.; Foroud, Tatiana M.; Carney, Regina M.; Larson, Eric B.; Behrens, Timothy W.; Kauwe, John S. K.; Haines, Jonathan L.; Farrer, Lindsay A.; Pericak-Vance, Margaret A.; Mayeux, Richard; Schellenberg, Gerard D.

2015-01-01

IMPORTANCE Recently, a rare variant in the amyloid precursor protein gene (APP) was described in a population from Iceland. This variant, in which alanine is replaced by threonine at position 673 (A673T), appears to protect against late-onset Alzheimer disease (AD). We evaluated the frequency of this variant in AD cases and cognitively normal controls to determine whether this variant will significantly contribute to risk assessment in individuals in the United States. OBJECTIVE To determine the frequency of the APP A673T variant in a large group of elderly cognitively normal controls and AD cases from the United States and in 2 case-control cohorts from Sweden. DESIGN, SETTING, AND PARTICIPANTS Case-control association analysis of variant APP A673T in US and Swedish white individuals comparing AD cases with cognitively intact elderly controls. Participants were ascertained at multiple university-associated medical centers and clinics across the United States and Sweden by study-specific sampling methods. They were from case-control studies, community-based prospective cohort studies, and studies that ascertained multiplex families from multiple sources. MAIN OUTCOMES AND MEASURES Genotypes for the APP A673T variant were determined using the Infinium HumanExome V1 Beadchip (Illumina, Inc) and by TaqMan genotyping (Life Technologies). RESULTS The A673T variant genotypes were evaluated in 8943 US AD cases, 10 480 US cognitively normal controls, 862 Swedish AD cases, and 707 Swedish cognitively normal controls. We identified 3 US individuals heterozygous for A673T, including 1 AD case (age at onset, 89 years) and 2 controls (age at last examination, 82 and 77 years). The remaining US samples were homozygous for the alanine (A673) allele. In the Swedish samples, 3 controls were heterozygous for A673T and all AD cases were homozygous for the A673 allele. We also genotyped a US family previously reported to harbor the A673T variant and found a mother-daughter pair, both cognitively normal at ages 72 and 84 years, respectively, who were both heterozygous for A673T; however, all individuals with AD in the family were homozygous for A673. CONCLUSIONS AND RELEVANCE The A673T variant is extremely rare in US cohorts and does not play a substantial role in risk for AD in this population. This variant may be primarily restricted to Icelandic and Scandinavian populations. PMID:25531812

Combining Exergame Training with Omega-3 Fatty Acid Supplementation: Protocol for a Randomized Controlled Study Assessing the Effect on Neuronal Structure/Function in the Elderly Brain.

PubMed

Schättin, Alexandra; de Bruin, Eling D

2016-01-01

A common problem in the older population is the risk of falling and related injury, immobility, and reduced survival. Age-related neuronal changes, e.g., decline in gray-and white-matter, affect neuronal, cognitive, and motor functioning. The improvement of these factors might decrease fall events in elderly. Studies showed that administration of video game-based physical exercise, a so-called exergame, or omega-3 fatty acid (FA) may improve motor and/or cognitive functioning through neuronal changes in the brain of older adults. The aim of this study is to assess the effects of a combination of exergame training with omega-3 FA supplementation on the elderly brain. We hypothesize that an intervention using a combination approach differently affects on the neuronal structure and function of the elderly's brain as compared to the sole administration of exergame training. The study is a parallel, double-blinded, randomized controlled trial lasting 26 weeks. Sixty autonomous living, non-smoking, and right-handed healthy older (>65 years) adults who live independently or in a senior residency are included, randomized, and allocated to one of two study groups. The experimental group receives a daily amount of 13.5 ml fish oil (including 2.9 g of omega-3 FA), whereas the control group receives a daily amount of 13.5 ml olive oil for 26 weeks. After 16 weeks, both groups start with an exergame training program three times per week. Measurements are performed on three time-points by treatment blinded investigators: pre-intervention measurements, blood sample after 16 week, and post-intervention measurements. The main outcomes are motor evoked potentials of the right M. tibialis anterior (transcranial magnetic stimulation) and response-related potentials (electroencephalography) during a cognitive test. For secondary outcomes, reaction time during cognitive tests and spatio-temporal parameters during gait performance are measured. Statistics will include effect sizes and a 2 × 2-ANOVA with normally distributed data or the non-parametric equivalent for data not fulfilling normal distribution. The randomized controlled study is the first to investigate the effectiveness of exergame training combined with omega-3 FA in counteracting age- and behavioral-dependent neuronal changes in the brain. This study has been registered in the Swiss National Clinical Trials (SNCTP000001623) and the ISRCTN (ISRCTN12084831) Portals.

The salience network in the apathy of late-life depression.

PubMed

Yuen, Genevieve S; Gunning-Dixon, Faith M; Hoptman, Matthew J; AbdelMalak, Bassem; McGovern, Amanda R; Seirup, Joanna K; Alexopoulos, George S

2014-11-01

Apathy is prevalent in late-life depression and predicts poor response to antidepressants, chronicity of depression, disability, and greater burden to caregivers. However, little is known about its neurobiology. Salience processing provides motivational context to stimuli. The aim of this study was to examine the salience network (SN) resting-state functional connectivity (rsFC) pattern in elderly depressed subjects with and without apathy. Resting-state functional MRI data were collected from 16 non-demented, non-MCI, elderly depressed subjects and 10 normal elderly subjects who were psychotropic-free for at least 2 weeks. The depressed group included 7 elderly, depressed subjects with high comorbid apathy and 9 with low apathy. We analyzed the rsFC patterns of the right anterior insular cortex (rAI), a primary node of the SN. Relative to non-apathetic depressed elderly, depressed elderly subjects with high apathy had decreased rsFC of the rAI to dorsal anterior cingulate and to subcortical/limbic components of the SN. Depressed elderly subjects with high apathy also exhibited increased rsFC of the rAI to right dorsolateral prefrontal cortex and right posterior cingulate cortex when compared to non-apathetic depressed elderly. Elderly depressed subjects with high apathy display decreased intrinsic rsFC of the SN and an altered pattern of SN rsFC to the right DLPFC node of the central executive network when compared to elderly non-apathetic depressed and normal, elderly subjects. These results suggest a unique biological signature of the apathy of late-life depression and may implicate a role for the rAI and SN in motivated behavior. Copyright © 2014 John Wiley & Sons, Ltd.

The effects of air pollution on hospitalizations for cardiovascular disease in elderly people in Australian and New Zealand cities.

PubMed

Barnett, Adrian G; Williams, Gail M; Schwartz, Joel; Best, Trudi L; Neller, Anne H; Petroeschevsky, Anna L; Simpson, Rod W

2006-07-01

The goal of this study was to estimate the associations between outdoor air pollution and cardiovascular hospital admissions for the elderly. Associations were assessed using the case-crossover method for seven cities: Auckland and Christchurch, New Zealand; and Brisbane, Canberra, Melbourne, Perth, and Sydney Australia. Results were combined across cities using a random-effects meta-analysis and stratified for two adult age groups: 15-64 years and >/= 65 years of age (elderly). Pollutants considered were nitrogen dioxide, carbon monoxide, daily measures of particulate matter (PM) and ozone. Where multiple pollutant associations were found, a matched case-control analysis was used to identify the most consistent association. In the elderly, all pollutants except O3 were significantly associated with five categories of cardiovascular disease admissions. No associations were found for arrhythmia and stroke. For a 0.9-ppm increase in CO, there were significant increases in elderly hospital admissions for total cardiovascular disease (2.2%) , all cardiac disease (2.8%), cardiac failure (6.0%), ischemic heart disease (2.3%), and myocardial infarction (2.9%). There was some heterogeneity between cities, possibly due to differences in humidity and the percentage of elderly people. In matched analyses, CO had the most consistent association. The results suggest that air pollution arising from common emission sources for CO, NO2, and PM (e.g., motor vehicle exhausts) has significant associations with adult cardiovascular hospital admissions, especially in the elderly, at air pollution concentrations below normal health guidelines. Relevance to clinical and professional practice: Elderly populations in Australia need to be protected from air pollution arising from outdoor sources to reduce cardiovascular disease.

Cortical Iron Reflects Severity of Alzheimer’s Disease

PubMed Central

van Duijn, Sara; Bulk, Marjolein; van Duinen, Sjoerd G.; Nabuurs, Rob J.A.; van Buchem, Mark A.; van der Weerd, Louise; Natté, Remco

2017-01-01

Abnormal iron distribution in the isocortex is increasingly recognized as an in vivo marker for Alzheimer’s disease (AD). However, the contribution of iron accumulation to the AD pathology is still poorly understood. In this study, we investigated: 1) frontal cortical iron distribution in AD and normal aging and 2) the relation between iron distribution and degree of AD pathology. We used formalin fixed paraffin embedded frontal cortex from 10 AD patients, 10 elder, 10 middle aged, and 10 young controls and visualized iron with a modified Perl’s histochemical procedure. AD and elderly subjects were not different with respect to age and sex distribution. Iron distribution in the frontal cortex was not affected by normal aging but was clearly different between AD and controls. AD showed accumulation of iron in plaques, activated microglia, and, in the most severe cases, in the mid-cortical layers along myelinated fibers. The degree of altered iron accumulations was correlated to the amount of amyloid-β plaques and tau pathology in the same block, as well as to Braak stage (p < 0.001). AD and normal aging show different iron and myelin distribution in frontal cortex. These changes appear to occur after the development of the AD pathological hallmarks. These findings may help the interpretation of high resolution in vivo MRI and suggest the potential of using changes in iron-based MRI contrast to indirectly determine the degree of AD pathology in the frontal cortex. PMID:29081415

Mild hypercholesterolemia, normal plasma triglycerides, and normal glucose levels across dementia staging in Alzheimer's disease: a clinical setting-based retrospective study.

PubMed

Ramdane, Said; Daoudi-Gueddah, Doria

2011-08-01

We examined retrospectively the concurrent relationships between fasting plasma total cholesterol, triglycerides, and glucose levels, and Alzheimer's disease (AD), in a clinical setting-based study. Total cholesterol level was higher in patients with AD compared to elderly controls; triglycerides or glucose levels did not significantly differ between the 2 groups. Respective plotted trajectories of change in cholesterol level across age were fairly parallel. No significant difference in total cholesterol levels was recorded between patients with AD classified by the Clinical Dementia Rating (CDR) score subgroups. These results suggest that patients with AD have relative mild total hypercholesterolemia, normal triglyceridemia, and normal fasting plasma glucose level. Mild total hypercholesterolemia seems to be permanent across age, and across dementia severity staging, and fairly parallels the trajectory of age-related change in total cholesterolemia of healthy controls. We speculate that these biochemical parameters pattern may be present long before-a decade at least-the symptomatic onset of the disease.

Clinical outcomes of acute kidney injury developing outside the hospital in elderly.

PubMed

Turgutalp, K; Bardak, S; Horoz, M; Helvacı, I; Demir, S; Kiykim, A A

2017-01-01

Although various studies have improved our knowledge about the clinical features and outcomes of acute kidney injury developing in the hospital (AKI-DI) in elderly subjects, data about acute kidney injury developing outside the hospital (AKI-DO) in elderly patients (age ≥ 65 years) are still extremely limited. This study was performed to investigate prevalence, clinical outcomes, hospital cost and related factors of AKI-DO in elderly and very elderly patients. We conducted a prospective, observational study in patients (aged ≥ 65 years) who were admitted to our center between May 01, 2012, and May 01, 2013. Subjects with AKI-DO were divided into two groups as "elderly" (group 1, 65-75 years old) and "very elderly" (group 2, >75 years old). Control group (group 3) consisted of the hospitalized patients aged 65 years and older with normal serum creatinine level. In-hospital outcomes and 6-month outcomes were recorded. Rehospitalization rate within 6 months of discharge was noted. Hospital costs and mortality rates of each group were investigated. Risk factors for AKI-DO were determined. The incidence of AKI-DO that required hospitalization in elderly and very elderly patients was 5.8 % (136/2324) and 11 % (100/905), respectively (p < 0.001), with an overall incidence of 7.3 % (236/3229). Chronic kidney disease (CKD) was developed in 43.4 % of group 1 and 67 % of group 2 within the 6 months of discharge (p < 0.001). Progression to CKD was significantly lower in the control group than in groups 1 and 2 (p < 0.001). Mortality rates for groups 1, 2 and 3 were 23.5 % (n = 32), 31 % (n = 31) and 4.2 % (n = 8), respectively (p < 0.05). Rehospitalization rate within the 6 months of discharge for the groups with AKI-DO was higher than for the control group (p < 0.001). Hospital cost of groups 1 and 2 was significantly higher than that of the control group (p < 0.001). Nonsteroidal anti-inflammatory drugs (NSAIDs) (OR: 6.839, 95 % CI = 4.392-10.648), angiotensin-converting enzyme inhibitors (ACEI) (OR: 7.846, 95 % CI = 5.161-11.928), angiotensin receptor blockers (ARB) (OR: 6.466, 95 % CI = 4.813-8.917), radiocontrast agents (OR: 8.850, 95 % CI = 5.857-13.372), hypertension (OR: 4.244, 95 % CI = 2.729-6.600), diabetes mellitus (OR: 2.303, 95 % CI = 1.411-3.761), heart failure (OR: 3.647, 95 % CI = 2.276-5.844) and presence of infection (OR: 3.149, 95 % CI = 1.696-5.845) were found as the risk factors for AKI-DO in elderly patients (p < 0.001 for all). Patients with AKI-DO had higher 6-month mortality rate (HR 1.721, 95 % CI: 1.451-2.043, p < 0.001). Mortality risk increased 0.519 times at 20th day. The incidence of AKI-DO requiring hospitalization is higher in very elderly patients than elderly ones, especially in male gender. Use of ACEI, ARB, NSAID and radiocontrast agents is the main risk factors for the development of AKI-DO in the elderly.

Individual Patient Diagnosis of AD and FTD via High-Dimensional Pattern Classification of MRI

PubMed Central

Davatzikos, C.; Resnick, S. M.; Wu, X.; Parmpi, P.; Clark, C. M.

2008-01-01

The purpose of this study is to determine the diagnostic accuracy of MRI-based high-dimensional pattern classification in differentiating between patients with Alzheimer’s Disease (AD), Frontotemporal Dementia (FTD), and healthy controls, on an individual patient basis. MRI scans of 37 patients with AD and 37 age-matched cognitively normal elderly individuals, as well as 12 patients with FTD and 12 age-matched cognitively normal elderly individuals, were analyzed using voxel-based analysis and high-dimensional pattern classification. Diagnostic sensitivity and specificity of spatial patterns of regional brain atrophy found to be characteristic of AD and FTD were determined via cross-validation and via split-sample methods. Complex spatial patterns of relatively reduced brain volumes were identified, including temporal, orbitofrontal, parietal and cingulate regions, which were predominantly characteristic of either AD or FTD. These patterns provided 100% diagnostic accuracy, when used to separate AD or FTD from healthy controls. The ability to correctly distinguish AD from FTD averaged 84.3%. All estimates of diagnostic accuracy were determined via cross-validation. In conclusion, AD- and FTD-specific patterns of brain atrophy can be detected with high accuracy using high-dimensional pattern classification of MRI scans obtained in a typical clinical setting. PMID:18474436

Prediction of Elderly Anthropometric Dimension Based On Age, Gender, Origin, and Body Mass Index

NASA Astrophysics Data System (ADS)

Indah, P.; Sari, A. D.; Suryoputro, M. R.; Purnomo, H.

2016-01-01

Introduction: Studies have indicated that elderly anthropometric dimensions will different for each person. To determine whether there are differences in the anthropometric data of Javanese elderly, this study will analyze whether the variables of age, gender, origin, and body mass index (BMI) have been associated with elderly anthropometric dimensions. Age will be divided into elderly and old categories, gender will divide into male and female, origins were divided into Yogyakarta and Central Java, and for BMI only use the normal category. Method: Anthropometric studies were carried out on 45 elderly subjects in Sleman,Yogyakarta. Results and Discussion: The results showed that some elderly anthropometric dimensions were influenced by age, origin, and body mass index but gender doesn't significantly affect the elderly anthropometric dimensions that exist in the area of Sleman. The analysis has provided important aid when designing products that intended to the Javanese elderly Population.

Effects of Noise Level and Cognitive Function on Speech Perception in Normal Elderly and Elderly with Amnestic Mild Cognitive Impairment.

PubMed

Lee, Soo Jung; Park, Kyung Won; Kim, Lee-Suk; Kim, HyangHee

2016-06-01

Along with auditory function, cognitive function contributes to speech perception in the presence of background noise. Older adults with cognitive impairment might, therefore, have more difficulty perceiving speech-in-noise than their peers who have normal cognitive function. We compared the effects of noise level and cognitive function on speech perception in patients with amnestic mild cognitive impairment (aMCI), cognitively normal older adults, and cognitively normal younger adults. We studied 14 patients with aMCI and 14 age-, education-, and hearing threshold-matched cognitively intact older adults as experimental groups, and 14 younger adults as a control group. We assessed speech perception with monosyllabic word and sentence recognition tests at four noise levels: quiet condition and signal-to-noise ratio +5 dB, 0 dB, and -5 dB. We also evaluated the aMCI group with a neuropsychological assessment. Controlling for hearing thresholds, we found that the aMCI group scored significantly lower than both the older adults and the younger adults only when the noise level was high (signal-to-noise ratio -5 dB). At signal-to-noise ratio -5 dB, both older groups had significantly lower scores than the younger adults on the sentence recognition test. The aMCI group's sentence recognition performance was related to their executive function scores. Our findings suggest that patients with aMCI have more problems communicating in noisy situations in daily life than do their cognitively healthy peers and that older listeners with more difficulties understanding speech in noise should be considered for testing of neuropsychological function as well as hearing.

Management and risk factor control of coronary artery disease in elderly versus nonelderly: a multicenter registry.

PubMed

Phrommintikul, Arintaya; Krittayaphong, Rungroj; Wongcharoen, Wanwarang; Boonyaratavej, Smonporn; Wongvipaporn, Chaiyasith; Tiyanon, Woraporn; Dinchuthai, Pakaphan; Kunjara-Na-Ayudhya, Rapeephon; Tatsanavivat, Pyatat; Sritara, Piyamitr

2016-12-01

Coronary artery disease (CAD) is a leading cause of death in elderly because aging is the important non-modifiable risk factors of atherosclerosis and also a predictor of poor outcomes. Underuse of guideline directed therapy may contribute to suboptimal risk factor control and worse outcomes in the elderly. We aimed to explore the management of CAD, risk factors control as well as goal attainment in elderly compared to nonelderly CAD patients. The CORE-Thailand is an ongoing multicenter, prospective, observational registry of patients with high atherosclerotic risk in Thailand. The data of 4120 CAD patients enrolled in this cohort was analyzed comparing between the elderly (age ≥ 65 years) vs. nonelderly (age < 65 years). There were 2172 elderly and 1948 nonelderly patients. The elderly CAD patients had higher prevalence of hypertension, dyslipidemia, atrial fibrillation and chronic kidney disease. The proportion of patients who received coronary revascularization was not different between the elderly and nonelderly CAD patients. Antiplatelets were prescribed less in the elderly while statin was prescribed in the similar proportion. Goal attainments of risk factor control of glycemic control, low density lipoprotein cholesterol, and smoking cessation except the blood pressure goal were higher in the elderly CAD patients. The CORE-Thailand registry showed the equity in the treatment of CAD between elderly and non-elderly. Elderly CAD patients had higher rate of goal attainment in risk factor control except blood pressure goal. The effects of goal attainment on cardiovascular outcomes will be demonstrated from ongoing cohort.

The Influence of Very Low Illumination on the Postural Sway of Young and Elderly Adults

PubMed Central

Rugelj, Darja; Gomišček, Gregor; Sevšek, France

2014-01-01

The purpose of the present study was to evaluate the influence of very low ambient illumination and complete darkness on the postural sway of young and elderly adults. Eighteen healthy young participants aged 23.8±1.5 years and 26 community-dwelling elderly aged 69.8±5.6 years were studied. Each participant performed four tests while standing on a force platform in the following conditions: in normal light (215 lx) with open eyes and with closed eyes, in very low illumination (0.25 lx) with open eyes, and in complete darkness with open eyes. The sequences of the tests in the altered visual conditions were determined by random blocs. Postural sway was assessed by means of the force platform measurements. The centre of pressure variables: the medio-lateral and antero-posterior path lengths, mean velocities, sway areas, and fractal dimensions were analysed. Very low illumination resulted in a statistically significant increase in postural sway in both the young and elderly groups compared to normal light, although the increase was significantly smaller than those observed in the eyes closed and complete darkness condition, and no significant effects of illumination on fractal dimensions were detected. The gains of the sways in the very low or no illumination conditions relative to the normal light condition were significantly larger in the group of young participants than in the group of elderly participants (up to 50% and 25%, respectively). However, the response patterns to changes in illumination were similar in the young and elderly participants, with the exception of the short-range fractal dimension of the medio-lateral sway. In conclusion, very low illumination resulted in increased postural sway compared to normal illumination; however, in the closed eye and complete darkness conditions, postural sway was significantly higher than in the very low illumination condition regardless of the age of the participants. PMID:25084015

Cognitive function in elderly marathon runners: cross-sectional data from the marathon trial (APSOEM).

PubMed

Winker, Robert; Lukas, Ina; Perkmann, Thomas; Haslacher, Helmut; Ponocny, Elisabeth; Lehrner, Johann; Tscholakoff, Dimiter; Dal-Bianco, Peter

2010-12-01

Cognitive impairment of the elderly contributes to morbidity, loss of quality of life, and impairment of work ability in aging western societies. Thus strategies to maintain cognitive function at an advanced age imply a great challenge to Occupational Medicine. To study whether intensive endurance exercise training is associated with better cognitive performance and increases brain-derived neurotrophic factor (BDNF) and insulin-like growth factor (IGF). Active elderly marathon runners or bicyclists older than 60 years were recruited and matched with an inactive control group according to age, sex, and education years. After exclusion of various diseases according to the study protocol 56 athletes and 58 controls could be selected for follow-up studies. The influence of endurance training on cognitive function was assessed by the use of the Vienna Neuropsychological Test Battery and the CERAD test battery. Other relevant outcomes were the levels of BDNF, IGF-1, Apo e4 carrier state, and self-ratings. The elderly marathon group performed better only in one specific cognitive task (the Five Point Test, p = 0.04) and almost significantly better in one additional test (the NAI Stroop Test, p = 0.08). Neither BDNF nor IGF-1 was related to the duration of daily exercise and no differences in the basal levels of these humoral growth factors in the exercise and the control cohort were found. Interestingly, we also found significantly decreased BDNF levels in subjects with Alzheimer's disease in the family in spite of the maintained normal cognitive performance (p = 0.01). These results suggest that extensive endurance exercise training might be beneficial for maintaining cognitive function in elderly persons. Our data demonstrate that beneficial endurance training effects are not linked to the upregulation of the examined neurotrophins. Since we found reduced BDNF-levels in subjects with a positive family history of Alzheimer's disease, we speculate that BDNF-reduction might precede cognitive impairment.

The design and development of a long-term fall detection system incorporated into a custom vest for the elderly.

PubMed

Bourke, Alan K; van de Ven, Pepijn W J; Chaya, Amy E; OLaighin, Gearóid M; Nelson, John

2008-01-01

A fall detection system and algorithm, incorporated into a custom designed garment has been developed. The developed fall detection system uses a tri-axial accelerometer, microcontroller, battery and Bluetooth module. This sensor is attached to a custom designed vest, designed to be worn by the elderly person under clothing. The fall detection algorithm was developed and incorporates both impact and posture detection capability. The vest and fall algorithm was tested on young healthy subjects performing normal activities of daily living (ADL) and falls onto crash mats, while wearing the best and sensor. Results show that falls can de distinguished from normal activities with a sensitivity >90% and a specificity of >99%, from a total data set of 264 falls and 165 normal ADL. By incorporating the fall-detection sensor into a custom designed garment it is anticipated that greater compliance when wearing a fall-detection system can be achieved and will help reduce the incidence of the long-lie, when falls occur in the elderly population. However further long-term testing using elderly subjects is required to validate the systems performance.

Wavelet-based multiscale analysis of minimum toe clearance variability in the young and elderly during walking.

PubMed

Khandoker, Ahsan H; Karmakar, Chandan K; Begg, Rezaul K; Palaniswami, Marimuthu

2007-01-01

As humans age or are influenced by pathology of the neuromuscular system, gait patterns are known to adjust, accommodating for reduced function in the balance control system. The aim of this study was to investigate the effectiveness of a wavelet based multiscale analysis of a gait variable [minimum toe clearance (MTC)] in deriving indexes for understanding age-related declines in gait performance and screening of balance impairments in the elderly. MTC during walking on a treadmill for 30 healthy young, 27 healthy elderly and 10 falls risk elderly subjects with a history of tripping falls were analyzed. The MTC signal from each subject was decomposed to eight detailed signals at different wavelet scales by using the discrete wavelet transform. The variances of detailed signals at scales 8 to 1 were calculated. The multiscale exponent (beta) was then estimated from the slope of the variance progression at successive scales. The variance at scale 5 was significantly (p<0.01) different between young and healthy elderly group. Results also suggest that the Beta between scales 1 to 2 are effective for recognizing falls risk gait patterns. Results have implication for quantifying gait dynamics in normal, ageing and pathological conditions. Early detection of gait pattern changes due to ageing and balance impairments using wavelet-based multiscale analysis might provide the opportunity to initiate preemptive measures to be undertaken to avoid injurious falls.

Repeat haematinic requests in patients with previous normal results: the scale of the problem in elderly patients at a district general hospital.

PubMed

Ganiyu-Dada, Z; Bowcock, S

2011-12-01

Repeating normal laboratory tests can waste resources. This study aimed to quantify unnecessary repeat haematinic tests taken from the elderly in a district general hospital. Haematinic tests (ferritin, B12, serum folate) from patients age ≥ 70 years were reviewed for repeat tests during an 8-week period. Questionnaires were given to doctors to establish when the considered repeating a 'borderline low normal' result to be clinically justifiable. 7.7% of all haematinic tests were repeat tests and of these, the majority (83%) was performed following a previously normal result. Thirteen of 24 doctors believed repeating a normal result at the bottom of the normal range ('borderline low normal') was justifiable. After excluding 'borderline low normal' results, 6.0% (at minimum) of repeat tests were done following a previous normal result and were unnecessary. This audit showed that there are a significant number of unnecessary repeat haematinic tests being performed. © 2011 Blackwell Publishing Ltd.

Functional decline in the elderly with MCI: Cultural adaptation of the ADCS-ADL scale.

PubMed

Cintra, Fabiana Carla Matos da Cunha; Cintra, Marco Túlio Gualberto; Nicolato, Rodrigo; Bertola, Laiss; Ávila, Rafaela Teixeira; Malloy-Diniz, Leandro Fernandes; Moraes, Edgar Nunes; Bicalho, Maria Aparecida Camargos

2017-07-01

Translate, transcultural adaptation and application to Brazilian Portuguese of the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) scale as a cognitive screening instrument. We applied the back translation added with pretest and bilingual methods. The sample was composed by 95 elderly individuals and their caregivers. Thirty-two (32) participants were diagnosed as mild cognitive impairment (MCI) patients, 33 as Alzheimer's disease (AD) patients and 30 were considered as cognitively normal individuals. There were only little changes on the scale. The Cronbach alpha coefficient was 0.89. The scores were 72.9 for control group, followed by MCI (65.1) and by AD (55.9), with a p-value < 0.001. The ROC curve value was 0.89. We considered a cut point of 72 and we observed a sensibility of 86.2%, specificity of 70%, positive predictive value of 86.2%, negative predictive value of 70%, positive likelihood ratio of 2.9 and negative likelihood ratio of 0.2. ADCS-ADL scale presents satisfactory psychometric properties to discriminate between MCI, AD and normal cognition.

The Earliest Stage of Cognitive Impairment in Transition From Normal Aging to Alzheimer Disease Is Marked By Prominent RNA Oxidation in Vulnerable Neurons

PubMed Central

Nunomura, Akihiko; Tamaoki, Toshio; Motohashi, Nobutaka; Nakamura, Masao; McKeel, Daniel W.; Tabaton, Massimo; Lee, Hyoung-gon; Smith, Mark A.; Perry, George; Zhu, Xiongwei

2012-01-01

Although neuronal RNA oxidation is a prominent and established feature in age-associated neurodegenerative disorders such as Alzheimer disease (AD), oxidative damage to neuronal RNA in aging and in the transitional stages from normal elderly to the onset of AD has not been fully examined. In this study, we used an in situ approach to identify an oxidized RNA nucleoside 8-hydroxyguanosine (8OHG) in the cerebral cortex of 65 individuals without dementia ranging in age from 0.3 to 86 years. We also examined brain samples from 20 elderly who were evaluated for their premortem clinical dementia rating score and postmortem brain pathological diagnoses to investigate preclinical AD and mild cognitive impairment. Relative density measurements of 8OHG-immunoreactivity revealed a statistically significant increase in neuronal RNA oxidation during aging in the hippocampus and the temporal neocortex. In subjects with mild cognitive impairment but not preclinical AD, neurons of the temporal cortex showed a higher burden of oxidized RNA compared to age-matched controls. These results indicate that although neuronal RNA oxidation fundamentally occurs as an age-associated phenomenon, more prominent RNA damage than in normal aging correlates with the onset of cognitive impairment in the prodromal stage of AD. PMID:22318126

High serum bicarbonate level within the normal range prevents the progression of chronic kidney disease in elderly chronic kidney disease patients

PubMed Central

2013-01-01

Background Metabolic acidosis leads to chronic kidney disease (CKD) progression. The guidelines recommend a lower limit of serum bicarbonate level, but no upper limit. For serum bicarbonate level to be clinically useful as a therapeutic target marker, it is necessary to investigate the target serum bicarbonate level within the normal range to prevent CKD progression. Methods One hundred and thirteen elderly CKD patients, whose serum bicarbonate level was controlled within the normal range, were enrolled in this retrospective cohort study in Ibaraki, Japan. Outcome was defined as a decrease of 25% or more in estimated glomerular filtration rate (eGFR) or starting dialysis. We used Cox proportional hazard models adjusted for patients’ characteristics to examine the association between serum bicarbonate level and the outcome. Results Female patients were 36.3%: average age (SD), 70.4 (6.6) years; eGFR, 25.7 (13.6) ml/min/1.73 m2; serum bicarbonate level, 27.4 (3.2) mEq/l. Patients with the lowest quartile of serum bicarbonate levels [23.4 (1.8) mEq/l] showed a high risk of CKD progression compared with patients with high serum bicarbonate levels [28.8 (2.3) mEq/l]: adjusted hazard ratio (HR), 3.511 (95% CI, 1.342-9.186). A 1 mEq/l increase in serum bicarbonate level was associated with a low risk of CKD progression: adjusted HR, 0.791 [95% confidence interval (CI), 0.684-0.914]. Conclusions In elderly CKD patients, our findings suggest that serum bicarbonate level is independently associated with CKD progression, and that a high serum bicarbonate level is associated with a low risk of CKD progression. A high target serum bicarbonate level within the normal range may be effective for preventing CKD progression. PMID:23298330

Orexin-A is Associated with Increases in Cerebrospinal Fluid Phosphorylated-Tau in Cognitively Normal Elderly Subjects.

PubMed

Osorio, Ricardo S; Ducca, Emma L; Wohlleber, Margaret E; Tanzi, Emily B; Gumb, Tyler; Twumasi, Akosua; Tweardy, Samuel; Lewis, Clifton; Fischer, Esther; Koushyk, Viachaslau; Cuartero-Toledo, Maria; Sheikh, Mohammed O; Pirraglia, Elizabeth; Zetterberg, Henrik; Blennow, Kaj; Lu, Shou-En; Mosconi, Lisa; Glodzik, Lidia; Schuetz, Sonja; Varga, Andrew W; Ayappa, Indu; Rapoport, David M; de Leon, Mony J

2016-06-01

To evaluate the role of orexin-A with respect to cerebrospinal fluid (CSF) Alzheimer disease (AD) biomarkers, and explore its relationship to cognition and sleep characteristics in a group of cognitively normal elderly individuals. Subjects were recruited from multiple community sources for National Institutes of Health supported studies on normal aging, sleep and CSF biomarkers. Sixty-three participants underwent home monitoring for sleep-disordered breathing, clinical, sleep and cognitive evaluations, as well as a lumbar puncture to obtain CSF. Individuals with medical history or with magnetic resonance imaging evidence of disorders that may affect brain structure or function were excluded. Correlation and linear regression analyses were used to assess the relationship between orexin-A and CSF AD-biomarkers controlling for potential sociodemographic and sleep confounders. Levels of orexin-A, amyloid beta 42 (Aβ42), phosphorylated-tau (P-Tau), total-tau (T-Tau), Apolipoprotein E4 status, age, years of education, reported total sleep time, number of awakenings, apnea-hypopnea indices (AHI), excessive daytime sleepiness, and a cognitive battery were analyzed. Subjects were 69.59 ± 8.55 years of age, 57.1% were female, and 30.2% were apolipoprotein E4+. Orexin-A was positively correlated with Aβ42, P-Tau, and T-Tau. The associations between orexin-A and the AD-biomarkers were driven mainly by the relationship between orexin-A and P-Tau and were not influenced by other clinical or sleep characteristics that were available. Orexin-A is associated with increased P-Tau in normal elderly individuals. Increases in orexin-A and P-Tau might be a consequence of the reduction in the proportion of the deeper, more restorative slow wave sleep and rapid eye movement sleep reported with aging. Clinicaltrials.gov registration number NCT01962779. © 2016 Associated Professional Sleep Societies, LLC.

Prevalence of sarcopenia among older community-dwelling people with normal health and nutritional state.

PubMed

Hedayati, Kerstin Khalaj; Dittmar, Manuela

2010-01-01

This study analyzed whether sarcopenia, a risk factor for disability in the aged, also occurs in healthy community-dwelling elders with normal nutritional state. As indicators, body cell mass (BCM) and lean body mass (LBM) were determined in 110 Germans (ages 60-83) using bioimpedance analysis. Nutritional status, muscle function, anthropometry, and physical activity level were investigated. Sarcopenia was already present in well nourished healthy elders. Its prevalence depended on the measure of muscle mass used (BCM percent, 22 percent males, 20 percent females; LBM percent, 4 percent males, 11 percent females). In conclusion, screening for presence of sarcopenia is needed in healthy, well-nourished elderly populations requiring an international standardization. Copyright © Taylor & Francis Group, LLC

Stereotactic body radiotherapy for very elderly patients (age, greater than or equal to 85 years) with stage I non-small cell lung cancer.

PubMed

Hayashi, Shinya; Tanaka, Hidekazu; Kajiura, Yuuichi; Ohno, Yasushi; Hoshi, Hiroaki

2014-06-16

Stereotactic body radiotherapy (SBRT) for non-small cell lung cancer (NSCLC) is primarily a treatment option for medically inoperable patients, who are often elderly. However, few studies report the effects of SBRT in elderly patients. Thus, we retrospectively analyzed clinical outcomes and feasibility following treatment of very elderly patients (age ≥ 85 years) with stage Ι NSCLC and younger patients (age < 85 years) with SBRT in our institution. From January 2006 to December 2012, 81 patients (20 very elderly; median age, 80 years; age range 64-93 years) with stage Ι NSCLC received SBRT. Prescription doses of 48 Gy were delivered in 4 fractions over 2 weeks or doses of 60 Gy were delivered in 10 fractions over 3 weeks. Local control was achieved in 91.8% of all patients at 3 years (83.1% and 93.8% of very elderly and younger patients, respectively), and the 3-year overall survival (OS) rate was 69.4% (40.7% and 75.0% of very elderly and younger patients, respectively). OS rates were significantly shorter for the very elderly group than for the younger group, with a 3-year cause-specific survival (CSS) rate of 77.9% (50.4% and 81.6% of very elderly and younger patients, respectively) and a 3-year progression-free survival (PFS) rate of 59.5% (44.7% and 63.5% in very elderly and younger groups, respectively). Multivariate analysis revealed a significant correlation between T stage and OS. Grades 2 and 3 radiation pneumonitis (RP) occurred in 7 (8.6%) and 2 (2.5%) patients, respectively. Among patients of very elderly and younger groups, grade 2 RP occurred in 4 (20%) and 3 (4.9%) patients, and grade 3 occurred in 2 (10%) and 0 (0%) patients, respectively. No grade 4 or 5 toxicity was observed, RP was significantly more severe among very elderly patients. SBRT for stage Ι NSCLC was well tolerated and feasible in very elderly patients. The efficacy of SBRT was comparable to that achieved in younger patients, although very elderly patients experienced significantly more severe RP. Although this study cohort included only 20 very elderly patients, the present data suggest that decreasing volumes of normal lung tissues exposed to ≥ 20 Gy and mean lung doses reduces the risk of RP in very elderly patients. The present data warrant studies of larger very elderly cohorts.

Stereotactic body radiotherapy for very elderly patients (age, greater than or equal to 85 years) with stage I non-small cell lung cancer

PubMed Central

2014-01-01

Background Stereotactic body radiotherapy (SBRT) for non-small cell lung cancer (NSCLC) is primarily a treatment option for medically inoperable patients, who are often elderly. However, few studies report the effects of SBRT in elderly patients. Thus, we retrospectively analyzed clinical outcomes and feasibility following treatment of very elderly patients (age ≥ 85 years) with stage Ι NSCLC and younger patients (age < 85 years) with SBRT in our institution. Methods From January 2006 to December 2012, 81 patients (20 very elderly; median age, 80 years; age range 64–93 years) with stage Ι NSCLC received SBRT. Prescription doses of 48 Gy were delivered in 4 fractions over 2 weeks or doses of 60 Gy were delivered in 10 fractions over 3 weeks. Results Local control was achieved in 91.8% of all patients at 3 years (83.1% and 93.8% of very elderly and younger patients, respectively), and the 3-year overall survival (OS) rate was 69.4% (40.7% and 75.0% of very elderly and younger patients, respectively). OS rates were significantly shorter for the very elderly group than for the younger group, with a 3-year cause-specific survival (CSS) rate of 77.9% (50.4% and 81.6% of very elderly and younger patients, respectively) and a 3-year progression-free survival (PFS) rate of 59.5% (44.7% and 63.5% in very elderly and younger groups, respectively). Multivariate analysis revealed a significant correlation between T stage and OS. Grades 2 and 3 radiation pneumonitis (RP) occurred in 7 (8.6%) and 2 (2.5%) patients, respectively. Among patients of very elderly and younger groups, grade 2 RP occurred in 4 (20%) and 3 (4.9%) patients, and grade 3 occurred in 2 (10%) and 0 (0%) patients, respectively. No grade 4 or 5 toxicity was observed, RP was significantly more severe among very elderly patients. Conclusions SBRT for stage Ι NSCLC was well tolerated and feasible in very elderly patients. The efficacy of SBRT was comparable to that achieved in younger patients, although very elderly patients experienced significantly more severe RP. Although this study cohort included only 20 very elderly patients, the present data suggest that decreasing volumes of normal lung tissues exposed to ≥ 20 Gy and mean lung doses reduces the risk of RP in very elderly patients. The present data warrant studies of larger very elderly cohorts. PMID:24935216

Abundant immunoglobulin E-positive cells in skin lesions support an allergic etiology of atopic dermatitis in the elderly

PubMed Central

Tanei, R; Hasegawa, Y; Sawabe, M

2013-01-01

Background/Objectives Atopic dermatitis (AD) in the elderly is gradually increasing in industrialized countries in association with the aging of society. We report herein four cases of elderly AD {three extrinsic [immunoglobulin (Ig)E-mediated allergy]; one intrinsic (non-IgE-allergy)} in which we investigated the presence of IgE+ cells in lesional skin. Methods/Results Single immunohistochemical and double immunofluorescence stainings were performed for skin biopsy specimens from AD patients and non-atopic control subjects with chronic eczema. In the lesional lichenified skin of patients with extrinsic elderly AD, numerous IgE+ cells were found among inflammatory cells infiltrates in the upper dermis. Comparative analysis of single immunohistochemistry results using serial paraffin and/or frozen sections found that many IgE+ cells showed identical distributions to tryptase+ mast cells. IgE+ cells coincident with CD1a+ Langerhans cells in the epidermis were found in small numbers only in frozen sections. Double immunofluorescence staining for IgE and CD11c revealed cells coexpressing IgE and CD11c with a dendritic morphology in the papillary and upper dermis. These IgE+ mast cells and IgE+ CD11c+ cells were also found in cured normal-looking skin from a patient with extrinsic elderly AD after successful treatment. Although only a few weakly positive IgE+ cells were detected, no IgE+CD11c+ cells were found in specimens from patients with intrinsic elderly AD or non-atopic chronic eczema. Conclusion IgE-mediated allergic inflammation may play an important role in the pathobiology of elderly AD, similar to other age groups of AD. PMID:22702954

Physiologic changes as patients get older.

PubMed

Perlman, P E; Adams, W

1989-02-01

As the population ages, primary care physicians are treating increasing numbers of elderly patients. Although certain physiologic changes are known to be age-related, they do not occur uniformly in elderly persons, and it may be difficult to distinguish signs of normal aging from those of disease. Thus, individualized care is important, and with thoughtful diligence, primary care physicians can often improve the quality of life for their elderly patients.

Predictors of asthma control in elderly patients.

PubMed

Ban, Ga-Young; Trinh, Tu H K; Ye, Young-Min; Park, Hae-Sim

2016-06-01

We are in the era of rapid aging of the global population. Elderly asthmatic patients have an increased frequency of hospitalization and a high mortality rate. In this review, we focus on comorbidities and treatment issues in terms of the predictors of asthma control in the elderly. Some frequent comorbidities, such as chronic obstructive pulmonary disease, chronic sinusitis, obesity, and depression, are associated with uncontrolled asthma in elderly asthmatic patients. Smoking status in elderly asthmatic patients was associated with more frequent exacerbations. Management of comorbidities should be taken into account when we treat elderly asthmatic patients. Low treatment adherence, which is common in elderly asthmatic patients, predicts poor asthma control status. A poor knowledge about asthma, cognitive function impairment, and inappropriate inhaler technique result in low treatment adherence. Polypharmacy is associated with low treatment adherence, adverse drug reactions, and drug-drug interactions, and it is supposed to be a predictor of asthma control. Multifactorial assessments, including comorbidities, treatment adherence, and polypharmacy, are important for better asthma control in elderly asthmatic patients. Further studies on the strategy for the management of elderly asthmatic patients in a real-world setting are warranted.

Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia.

PubMed

Díaz-Leines, Sergio; Peñaloza-López, Yolanda R; Serrano-Miranda, Tirzo A; Flores-Ávalos, Blanca; Vidal-Ixta, Martha T; Jiménez-Herrera, Blanca

2013-01-01

Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=.049) and more protracted latency in P300 (P=.000). Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Nutritional situation of a Chinese community.

PubMed

Suriah, A R; Chong, T J; Yeoh, B Y

1998-08-01

To evaluate the anthropometric measurements and dietary intake of the free-living elderly in a Chinese community. A survey was carried out on 48 male and female subjects aged 60 to 96 years using anthropometric, dietary intake and questionnaire techniques. The study indicated female subjects to have more health problems, like pain at the joints (33%), hypertension (17%) and diabetes (27%) as compared to the male subjects. Dietary intake analysis showed the Chinese male subjects to have a higher energy intake (1,623 kcal) compared to the females (1,197 kcal) even though they did not fulfill the recommended dietary intake. The intake for energy, fats and carbohydrates, was found to be significantly different (p < 0.05) between both sexes. Anthropometric measurements indicated male elderly subjects to be significantly heavier (p < 0.05, 55.4 kg) and taller (161.8 cm) than female elderly subjects (49.5 kg; 146.2 cm respectively). About half of the elderly were normal in their BMI (male 55.6%; female 50%) and only 6.6% of the female subjects were obese. More male subjects were found to be underweight (33%) compared to female subjects (17%). Waist hip ratio was 0.92 for male and 0.87 for female. Our study showed that female elderly subjects had more health problems compared to male elderly subjects. On the whole, the elderly did not fulfill the recommended amount for energy intake while the percentage for carbohydrates, fats and protein from the total calorie intake were not in accordance with the healthy diet guidelines. Anthropometrically, male subjects were heavier and taller than female subjects. Looking at body mass index, most of the male elderly subjects were in the normal to underweight range. With these results, more research is warranted to give a clearer picture of the Chinese elderly in the country.

Mapping White Matter Integrity in Elderly People with HIV

PubMed Central

Nir, Talia M.; Jahanshad, Neda; Busovaca, Edgar; Wendelken, Lauren; Nicolas, Krista; Thompson, Paul M.; Valcour, Victor G.

2013-01-01

People with HIV are living longer as combination antiretroviral therapy (cART) becomes more widely available. However, even when plasma viral load is reduced to untraceable levels, chronic HIV infection is associated with neurological deficits and brain atrophy beyond that of normal aging. HIV is often marked by cortical and subcortical atrophy, but the integrity of the brain’s white matter (WM) pathways also progressively declines. Few studies focus on older cohorts where normal aging may be compounded with HIV infection to influence deficit patterns. In this relatively large diffusion tensor imaging (DTI) study, we investigated abnormalities in WM fiber integrity in 56 HIV+ adults with access to cART (mean age: 63.9 ± 3.7 years), compared to 31 matched healthy controls (65.4 ± 2.2 years). Statistical 3D maps revealed the independent effects of HIV diagnosis and age on fractional anisotropy (FA) and diffusivity, but we did not find any evidence for an age by diagnosis interaction in our current sample. Compared to healthy controls, HIV patients showed pervasive FA decreases and diffusivity increases throughout WM. We also assessed neuropsychological (NP) summary z-score associations. In both patients and controls, fiber integrity measures were associated with NP summary scores. The greatest differences were detected in the corpus callosum and in the projection fibers of the corona radiata. These deficits are consistent with published NP deficits and cortical atrophy patterns in elderly people with HIV. PMID:23362139

Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial.

PubMed

Emmelot-Vonk, M H; Verhaar, H J J; Nakhai-Pour, H R; Grobbee, D E; van der Schouw, Y T

2009-01-01

Serum testosterone levels decline significantly with aging and this has been associated with reduced sexual function. We have conducted a double-blind, randomized, placebo-controlled trial to investigate the effect of testosterone supplementation on sexual function in 237 elderly men with a testosterone level <13.7 nmol l(-1). Participants were randomly assigned to receive oral testosterone undecanoate or a placebo for 6 months. A total of 207 men completed the study. After treatment, there were no differences in scores on sexual function between the groups. Subanalysis showed that although a baseline testosterone level in the lowest tertile was associated with significantly lower scores for sexual fantasies, desire of sexual contact and frequency of sexual contact, supplementation of testosterone did not result in improvement on any of these items in this group. In conclusion, the findings do not support the view that testosterone undecanoate supplementation for 6 months to elderly men with low-normal testosterone concentrations favorably affects sexual function.

Predicting the time of conversion to MCI in the elderly: role of verbal expression and learning.

PubMed

Oulhaj, Abderrahim; Wilcock, Gordon K; Smith, A David; de Jager, Celeste A

2009-11-03

Increasing awareness that minimal or mild cognitive impairment (MCI) in the elderly may be a precursor of dementia has led to an increase in the number of people attending memory clinics. We aimed to develop a way of predicting the period of time before cognitive impairment occurs in community-dwelling elderly. The method is illustrated by the use of simple tests of different cognitive domains. A cohort of 241 normal elderly volunteers was followed for up to 20 years with regular assessments of cognitive abilities using the Cambridge Cognitive Examination (CAMCOG); 91 participants developed MCI. We used interval-censored survival analysis statistical methods to model which baseline cognitive tests best predicted the time to convert to MCI. Out of several baseline variables, only age and CAMCOG subscores for expression and learning/memory were predictors of the time to conversion. The time to conversion was 14% shorter for each 5 years of age, 17% shorter for each point lower in the expression score, and 15% shorter for each point lower in the learning score. We present in tabular form the probability of converting to MCI over intervals between 2 and 10 years for different combinations of expression and learning scores. In apparently normal elderly people, subtle measurable cognitive deficits that occur within the normal range on standard testing protocols reliably predict the time to clinically relevant cognitive impairment long before clinical symptoms are reported.

Regional Fluid-Attenuated Inversion Recovery (FLAIR) at 7 Tesla correlates with amyloid beta in hippocampus and brainstem of cognitively normal elderly subjects

PubMed Central

Schreiner, Simon J.; Liu, Xinyang; Gietl, Anton F.; Wyss, Michael; Steininger, Stefanie C.; Gruber, Esmeralda; Treyer, Valerie; Meier, Irene B.; Kälin, Andrea M.; Leh, Sandra E.; Buck, Alfred; Nitsch, Roger M.; Pruessmann, Klaas P.; Hock, Christoph; Unschuld, Paul G.

2014-01-01

Background: Accumulation of amyloid beta (Aβ) may occur during healthy aging and is a risk factor for Alzheimer Disease (AD). While individual Aβ-accumulation can be measured non-invasively using Pittsburgh Compund-B positron emission tomography (PiB-PET), Fluid-attenuated inversion recovery (FLAIR) is a Magnetic Resonance Imaging (MRI) sequence, capable of indicating heterogeneous age-related brain pathologies associated with tissue-edema. In the current study cognitively normal elderly subjects were investigated for regional correlation of PiB- and FLAIR intensity. Methods: Fourteen healthy elderly subjects without known history of cognitive impairment received 11C-PiB-PET for estimation of regional Aβ-load. In addition, whole brain T1-MPRAGE and FLAIR-MRI sequences were acquired at high field strength of 7 Tesla (7T). Volume-normalized intensities of brain regions were assessed by applying an automated subcortical segmentation algorithm for spatial definition of brain structures. Statistical dependence between FLAIR- and PiB-PET intensities was tested using Spearman's rank correlation coefficient (rho), followed by Holm–Bonferroni correction for multiple testing. Results: Neuropsychological testing revealed normal cognitive performance levels in all participants. Mean regional PiB-PET and FLAIR intensities were normally distributed and independent. Significant correlation between volume-normalized PiB-PET signals and FLAIR intensities resulted for Hippocampus (right: rho = 0.86; left: rho = 0.84), Brainstem (rho = 0.85) and left Basal Ganglia vessel region (rho = 0.82). Conclusions: Our finding of a significant relationship between PiB- and FLAIR intensity mainly observable in the Hippocampus and Brainstem, indicates regional Aβ associated tissue-edema in cognitively normal elderly subjects. Further studies including clinical populations are necessary to clarify the relevance of our findings for estimating individual risk for age-related neurodegenerative processes such as AD. PMID:25249977

Association between cognitive impairment and eating habits in elderly Chinese subjects over 90 years of age.

PubMed

Gao, Lingyun; Dong, Birong; Hao, Qiu Kui; Ding, Xiang

2013-08-01

Eating habits may have a key influence on cognitive function, however, the relationship between dietary intake and cognitive impairment in the elderly Chinese population has not been explored. The present study investigated the association between cognitive impairment and eating habits in elderly Chinese subjects >90 years of age. This study comprised data from subjects included in the 2005 Project of Longevity and Ageing in Dujiangyan, China. Subjects were divided into two groups: cognitive impairment group and normal group. Sociodemographic and dietary habit data were collected and cognitive function was assessed in all subjects using the Mini-Mental State Examination. Data from 763 subjects (249 men, 514 women) were included. There was no statistically significant difference in eating habits between the two groups. Education level in the cognitive impairment group was significantly lower than in the normal group. Significant between-group differences were detected in factors relating to subjects' professions. Eating habits were not related to cognitive impairment in elderly Chinese people >90 years of age.

Cambridge Cognitive Examination: performance of healthy elderly Brazilians with low education levels.

PubMed

Moreira, Irene de Freitas Henriques; Lourenço, Roberto Alves; Soares, Claudia; Engelhardt, Eliasz; Laks, Jerson

2009-08-01

This study aimed to estimate the quartile distribution on the cognitive assessment of normal elderly with low education as measured by the Cambridge Cognitive Examination (CAMCOG). A sample of 292 elderly (> 65 years of age), screened for dementia and depression, were assessed using the CAMCOG. The CAMCOG scores of normal subjects (n = 206) were stratified according to age (65-69, 70-74, 75-79, > 80) and schooling (illiterate, 1-4, and > 5 years of formal education). Mean age was 72.8 (+/- 3.5) and mean schooling was 3.5 years (+/- 3). The mean score on the CAMCOG was 71 (+/- 12.7). The scores at the first quartile for illiterate/1-4 years of schooling were 58/62 (65-69 years), 52/63 (70-74 years), 48/67 (75-79 years) and 46/64 (> 80 years), respectively. There was a significant difference in the CAMCOG quartiles according to education and age. This study provides normative data on the CAMCOG of elderly people with low educational levels which may be clinically useful.

Association of regular walking and body mass index on metabolic syndrome among an elderly Korean population.

PubMed

Kim, Soonyoung; Kim, Dong-Il

2018-06-01

Aging is associated with increased body fat and lower lean body mass, which leads to increased prevalence of obesity and metabolic syndrome. This study aimed to investigate the association of regular participation in walking and body mass index (BMI) with metabolic syndrome and its 5 criteria in elderly Koreans. A total of 3554 (male = 1581, female = 1973) elderly subjects (age ≥ 65 years), who participated in the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) were analyzed in this cross-sectional study. Participation in walking activity, BMI, metabolic syndrome and its 5 criteria; waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG) levels, triglyceride (TG) levels, and high-density lipoprotein cholesterol (HDLC) levels, were measured. Subjects were categorized into four groups based on the duration and regularity of their walks and BMI. In the regular walking (≥30 min of continuous walking a day, on ≥5 days a week) and normal weight (BMI < 23 kg/m 2 ) group, WC, SBP, DBP, FG, and TG levels were significantly lower, and HDL-C levels were significantly higher, compared to the non-regular walking and overweight (BMI ≥ 23 kg/m 2 ) group. Furthermore, the odds of metabolic syndrome was 4.36 times higher (Odds ratio [OR]: 4.36, 95% confidence interval [CI]: 3.37-5.63) in the non-regular walking and overweight group than that of the regular walking and normal weight group after controlling for the influence of age, sex, and smoking status. Moreover, The BMI (β = 0.328, R 2  = 0.152) were more contributing factors than Regular walking (β = -0.011) for metabolic syndrome. In conclusions, regular participation in walking activity and implementing weight control may reduce the incidence rate of metabolic syndrome in elderly Koreans, with weight management serving as the greater influences of the two. Copyright © 2018. Published by Elsevier Inc.

Generalized arteriosclerosis and changes of the cochlea in young adults.

PubMed

Nomiya, Rie; Nomiya, Shigenobu; Kariya, Shin; Okano, Mitsuhiro; Morita, Norimasa; Cureoglu, Sebahattin; Schachern, Patricia A; Nishizaki, Kazunori; Paparella, Michael M

2008-12-01

To disclose the histopathologic findings of the cochlea in young adults with generalized arteriosclerosis. It is well known that arteriosclerosis begins and progresses during childhood. Although the relationship between arteriosclerosis and auditory function in elderly people was examined in many reports, the histopathologic effect of arteriosclerosis on the cochlea in young adults has not been studied. This study involved quantitative analysis, including the number of spiral ganglion cells, the loss of cochlear outer hair cells, and the areas of stria vascularis and spiral ligament. It included 10 temporal bones from 6 subjects with generalized arteriosclerosis and 10 age-matched normal control temporal bones from 7 subjects. The mean number of spiral ganglion cells in the cochlea with generalized arteriosclerosis was significantly lower than that in normal controls in the basal turn. The mean loss of outer hair cells in the cochlea with generalized arteriosclerosis was significantly greater than that of normal controls in the basal and apical turns. The stria vascularis and spiral ligament were severely atrophic, with generalized arteriosclerosis in the basal turn. There was no significant difference in the thickness of the spiral modiolar artery between generalized arteriosclerosis and normal controls. Degeneration of the cochlea, especially in the basal turn, was already apparent in young adults with generalized arteriosclerosis.

Lymphocyte responses to phytohaemagglutinin: age-related effects.

PubMed Central

Fernandez, L A; MacSween, J M; Langley, G R

1976-01-01

Cell-mediated immunity is depressed in elderly individuals compared to young individuals, and lymphocytes from elderly individuals have been reported to have impaired lymphocyte responsiveness to stimulation by PHA after 4 days of culture. We have confirmed this observation. However, after 8 days of culture, the lymphocyte responses were greater in elderly normal individuals than in young normal individuals. Responses of lymphocytes from young individuals decreased with time from 4 to 8 days in culture, while there were increased responses with time when lymphocytes from elderly individuals were studied. When adherent cells from lymphocytes of young individuals were removed by passage through protein-coated Degalan-bead columns, the lymphocyte responses to PHA were significantly increased at 8 days. Passage of lymphocytes from elderly individuals through coated Degalan bead columns did not alter the lymphocyte responses. Removal of macrophages from the mononuclear cells obtained from young individuals did not result in increased lymphocyte responses to PHA after 8 days in culture. Removal of adherent cells appeared to have the same effect regardless of the efficiency of removing B cells. The adherent cells removed by the protein coated columns, therefore, appear to be nonphagocytic mononuclear cells which are not B lymphocytes. PMID:1086285

Regional frontal gray matter volume associated with executive function capacity as a risk factor for vehicle crashes in normal aging adults.

PubMed

Sakai, Hiroyuki; Takahara, Miwa; Honjo, Naomi F; Doi, Shun'ichi; Sadato, Norihiro; Uchiyama, Yuji

2012-01-01

Although low executive functioning is a risk factor for vehicle crashes among elderly drivers, the neural basis of individual differences in this cognitive ability remains largely unknown. Here we aimed to examine regional frontal gray matter volume associated with executive functioning in normal aging individuals, using voxel-based morphometry (VBM). To this end, 39 community-dwelling elderly volunteers who drove a car on a daily basis participated in structural magnetic resonance imaging, and completed two questionnaires concerning executive functioning and risky driving tendencies in daily living. Consequently, we found that participants with low executive function capacity were prone to risky driving. Furthermore, VBM analysis revealed that lower executive function capacity was associated with smaller gray matter volume in the supplementary motor area (SMA). Thus, the current data suggest that SMA volume is a reliable predictor of individual differences in executive function capacity as a risk factor for vehicle crashes among elderly persons. The implication of our results is that regional frontal gray matter volume might underlie the variation in driving tendencies among elderly drivers. Therefore, detailed driving behavior assessments might be able to detect early neurodegenerative changes in the frontal lobe in normal aging adults.

Absence of nocturnal fall in blood pressure in elderly persons with Alzheimer-type dementia.

PubMed

Otsuka, A; Mikami, H; Katahira, K; Nakamoto, Y; Minamitani, K; Imaoka, M; Nishide, M; Ogihara, T

1990-09-01

Circadian changes of the blood pressure and heart rate in elderly normotensive bedridden patients with severe dementia of the Alzheimer type (group D) were compared with those in elderly normotensive bedridden patients without dementia (group R), normotensive subjects with normal daily activity (group N), and hypertensive patients with normal daily activity (group H). In groups R, N, and H, the blood pressure increased in the afternoon and decreased at midnight; in group D, however, although it increased in the afternoon, it did not decrease at night. The circadian changes of the heart rate were similar in all four groups, showing maxima in the afternoon and minima at midnight. Thus, a specific alteration was found in the circadian rhythm of the blood pressure in patients with Alzheimer-type dementia.

Hyperpotassemia and bradycardia in a bedridden elderly woman with selective hypoaldosteronism associated with low renin activity.

PubMed

Inada, Mitsuo; Iwasaki, Keiko; Imai, Chihiro; Hashimoto, Satoshi

2010-01-01

A bedridden 85-year-old woman had hyperpotassemia (7.7 mEq/L) and bradycardia (30/min). Endocrinologic findings revealed a decrease in the renin-aldosterone system and normal adrenoglucocorticoid function. The results were consistent with the abnormalities seen in selective hypoaldosteronism with low renin activity. In addition, 9 of 11 patients, selected randomly from 72 bedridden elderly patients with normal serum sodium and potassium levels in our hospital, had diminished plasma renin activity (PRA) and plasma aldosterone concentration (PAC). The present patient was prescribed nonsteroidal anti-inflammatory drug (NSAID). NSAID reduces renal potassium excretion through the inhibition of renal prostaglandin synthesis. Therefore, the use of NSAID in bedridden elderly patients might intensify the underlying asymptomatic hypoaldosteronism and cause life-threatening hyperpotassemia.

Prevention of cardiovascular events in elderly people.

PubMed

Andrawes, Wafik Farah; Bussy, Caroline; Belmin, Joël

2005-01-01

Cardiovascular disease has been identified as the leading cause of morbidity and mortality in developed countries. Given the increase in life expectancy and the development of cardiovascular preventive measures, it has become increasingly important to detect and prevent cardiovascular diseases in the elderly. We reviewed the scientific literature concerning cardiovascular prevention to assess the importance of cardiovascular preventive measures in old (> or =65 years of age) individuals. We undertook a systematic search for references relating to prevention of cardiovascular disease in the elderly, mainly ischaemic stroke, coronary artery disease and heart failure, on the MEDLINE database 1962-2005. For cardiovascular prevention by drugs or surgery, emphasis was placed on randomised controlled trials, review articles and meta-analyses. For cardiovascular prevention by lifestyle modification, major cohort studies were also considered. Stroke, coronary heart disease and heart failure were found to be the main targets for cardiovascular prevention in published studies. Antihypertensive treatment has proven its efficacy in primary prevention of fatal or nonfatal stroke in hypertensive and high-risk patients >60 years of age, particularly through treatment of systolic hypertension. Systolic blood pressure reduction is equally important in the secondary prevention of stroke. Similarly, in nonvalvular atrial fibrillation, an adjusted dose of warfarin with a target International Normalized Ratio (INR) of between 2 to 3 prevents ischaemic stroke in elderly patients with an acceptable haemorrhagic risk but is still under prescribed. Antiplatelet agents are indicated in elderly patients with nonembolic strokes. Few large-scale studies have investigated the effect of HMG-CoA reductase inhibitors (statins) on stroke prevention in old individuals. To date, the largest trials suggest a beneficial effect for stroke prevention with use of statins in high-risk elderly subjects < or =82 years of age. Carotid endarterectomy is indicated in carotid artery stenosis >70% and outcomes are even better in elderly than in younger patients. However, medical treatment is still the first-line treatment in asymptomatic elderly patients with <70% stenosis. In ischaemic heart disease, different trials in elderly individuals have shown that use of statins, antithrombotic agents, beta-adrenoceptor antagonists and ACE inhibitors plays an important role either in primary or in secondary cardiovascular prevention. Hormone replacement therapy has been used to treat climacteric symptoms and postmenopausal osteoporosis and was thought to confer a cardiovascular protection. However, controlled trials in elderly individuals changed this false belief when it was found that there was no benefit and even a harmful cardiovascular effect during the first year of treatment. Smoking cessation, regular physical activity and healthy diet are, as in younger individuals, appropriate and effective measures for preventing cardiovascular events in the elderly. Finally, antihypertensive treatment and influenza vaccination are useful for heart failure prevention in elderly individuals. Cardiovascular prevention should be more widely implemented in the elderly, including individuals aged > or =75 years, and this might contribute to improved healthy status and quality of life in this growing population.

Lack of biochemical hypogonadism in elderly Arab males with low bone mineral density disease.

PubMed

Al Attia, Haider M; Jaysundaram, Krishnasamy; Saraj, Fouad

2010-01-01

The aim of the study is to study the relationship between androgen levels and bone mineral density (BMD) in elderly Arab males. Forty-five elderly Arab males underwent Dual X-ray absorptiometry for measurement of BMD. The outcomes were defined as per WHO description. Assays for testosterone (T), gonadotropins (LH and FSH) and estradiol (E2), in the serum were carried out. The ratio of T/LH was used as a surrogate for the cFT assay. We excluded patients receiving hormonal ablation for prostatic neoplasm and patients with chronic liver or renal disease and patients receiving corticosteroids. Twelve were osteoporotic (26.5%); 22 osteopenic (49%); and 11(24.5%) had normal outcome. Osteoporotic patients were significantly older (78.17 +/- 7.59 years) than the osteopenic (70.14 +/- 5.92, P

Health relevance of the modification of low grade inflammation in ageing (inflammageing) and the role of nutrition.

PubMed

Calder, Philip C; Bosco, Nabil; Bourdet-Sicard, Raphaëlle; Capuron, Lucile; Delzenne, Nathalie; Doré, Joel; Franceschi, Claudio; Lehtinen, Markus J; Recker, Tobias; Salvioli, Stefano; Visioli, Francesco

2017-11-01

Ageing of the global population has become a public health concern with an important socio-economic dimension. Ageing is characterized by an increase in the concentration of inflammatory markers in the bloodstream, a phenomenon that has been termed "inflammageing". The inflammatory response is beneficial as an acute, transient reaction to harmful conditions, facilitating the defense, repair, turnover and adaptation of many tissues. However, chronic and low grade inflammation is likely to be detrimental for many tissues and for normal functions. We provide an overview of low grade inflammation (LGI) and determine the potential drivers and the effects of the "inflamed" phenotype observed in the elderly. We discuss the role of gut microbiota and immune system crosstalk and the gut-brain axis. Then, we focus on major health complications associated with LGI in the elderly, including mental health and wellbeing, metabolic abnormalities and infections. Finally, we discuss the possibility of manipulating LGI in the elderly by nutritional interventions. We provide an overview of the evidence that exists in the elderly for omega-3 fatty acid, probiotic, prebiotic, antioxidant and polyphenol interventions as a means to influence LGI. We conclude that slowing, controlling or reversing LGI is likely to be an important way to prevent, or reduce the severity of, age-related functional decline and the onset of conditions affecting health and well-being; that there is evidence to support specific dietary interventions as a strategy to control LGI; and that a continued research focus on this field is warranted. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Aerobic Physical Exercise Improved the Cognitive Function of Elderly Males but Did Not Modify Their Blood Homocysteine Levels

PubMed Central

Antunes, Hanna Karen M.; De Mello, Marco Túlio; de Aquino Lemos, Valdir; Santos-Galduróz, Ruth Ferreira; Camargo Galdieri, Luciano; Amodeo Bueno, Orlando Francisco; Tufik, Sergio; D'Almeida, Vânia

2015-01-01

Background Physical exercise influences homocysteine (Hcy) concentrations, cognitive function and the metabolic profile. The purpose of this study was to investigate the influence of regular physical exercise on Hcy levels, the metabolic profile and cognitive function in healthy elderly males before and after an endurance exercise program. Methods Forty-five healthy and sedentary volunteers were randomized into 2 groups: (1) a control group asked not to change their normal everyday activities and not to start any regular physical exercise program and (2) an experimental group trained at a heart rate intensity corresponding to ventilatory threshold 1 (VT-1) for 60 min/day 3 times weekly on alternate days for 6 months using a cycle ergometer. All volunteers underwent cognitive evaluations, blood sample analyses and ergospirometric assessments. Results A significant improvement in cognitive function was observed in the experimental group compared with the control group (p < 0.05). No significant changes in Hcy levels were observed in the experimental group (p > 0.05), but there was a significant increase in peak oxygen consumption and workload at VT-1 as well as a significant improvement in cholesterol, triglycerides, HDL, glucose, alkaline phosphatase, urea, T3, T4 and prostate-specific antigen compared with the control group (p < 0.05). Conclusion The data suggest that a physical exercise program does not reduce Hcy levels in healthy elderly males, although it improves the cardiovascular and metabolic profile as well as cognitive function. PMID:25759715

The Management of Urinary Incontinence by Community-Living Elderly.

ERIC Educational Resources Information Center

Mitteness, Linda S.

1987-01-01

Explored ways elderly people (N=30) manage urinary incontinence. Subjects tended to dismiss their urinary incontinence as a normal part of aging and used various behavioral and psychological strategies to maintain their independence, usually without any assistance from the health professions. Management strategies commonly involved some degree of…

Hippocampal Region-Specific Contributions to Memory Performance in Normal Elderly

ERIC Educational Resources Information Center

Chen, Karren H. M.; Chuah, Lisa Y. M.; Sim, Sam K. Y.; Chee, Michael W. L.

2010-01-01

To investigate the relationship between regional hippocampal volume and memory in healthy elderly, 147 community-based volunteers, aged 55-83 years, were evaluated using magnetic resonance imaging, the Groton Maze Learning Test, Visual Reproduction and the Rey Auditory Verbal Learning Test. Hippocampal volumes were determined by interactive…

[Thermoregulation in hypertensive elderly patients during physiotherapy].

PubMed

Abramovich, S G

2002-01-01

Effects of therapeutic physical factors on thermoregulation and thermoreactivity of skin were studied in 222 elderly patients with hypertension. It is shown that sodium chloride half-baths, "dry" carbon dioxide baths and general magnetotherapy correct thermal asymmetry and normalize skin thermoreactivity, i.e. produce a positive effect on microcirculation.

Cardiorespiratory fitness modulates the acute flow-mediated dilation response following high-intensity but not moderate-intensity exercise in elderly men.

PubMed

Bailey, Tom G; Perissiou, Maria; Windsor, Mark; Russell, Fraser; Golledge, Jonathan; Green, Daniel J; Askew, Christopher D

2017-05-01

Impaired endothelial function is observed with aging and in those with low cardiorespiratory fitness (V̇o 2peak ). Improvements in endothelial function with exercise training are somewhat dependent on the intensity of exercise. While the acute stimulus for this improvement is not completely understood, it may, in part, be due to the flow-mediated dilation (FMD) response to acute exercise. We examined the hypothesis that exercise intensity alters the brachial (systemic) FMD response in elderly men and is modulated by V̇o 2peak Forty-seven elderly men were stratified into lower (V̇o 2peak = 24.3 ± 2.9 ml·kg -1 ·min -1 ; n = 27) and higher fit groups (V̇o 2peak = 35.4 ± 5.5 ml·kg -1 ·min -1 ; n = 20) after a test of cycling peak power output (PPO). In randomized order, participants undertook moderate-intensity continuous exercise (MICE; 40% PPO) or high-intensity interval cycling exercise (HIIE; 70% PPO) or no-exercise control. Brachial FMD was assessed at rest and 10 and 60 min after exercise. FMD increased after MICE in both groups {increase of 0.86% [95% confidence interval (CI), 0.17-1.56], P = 0.01} and normalized after 60 min. In the lower fit group, FMD was reduced after HIIE [reduction of 0.85% (95% CI, 0.12-1.58), P = 0.02] and remained decreased at 60 min. In the higher fit group, FMD was unchanged immediately after HIIE and increased after 60 min [increase of 1.52% (95% CI, 0.41-2.62), P < 0.01, which was correlated with V̇o 2peak , r = 0.41; P < 0.01]. In the no-exercise control, FMD was reduced in both groups after 60 min ( P = 0.05). Exercise intensity alters the acute FMD response in elderly men and V̇o 2peak modulates the FMD response following HIIE but not MICE. The sustained decrease in FMD in the lower fit group following HIIE may represent a signal for vascular adaptation or endothelial fatigue. NEW & NOTEWORTHY This study is the first to show that moderate-intensity continuous cycling exercise increased flow-mediated dilation (FMD) transiently before normalization of FMD after 1 h, irrespective of cardiorespiratory fitness level in elderly men. Interestingly, we show increased FMD after high-intensity cycling exercise in higher fit men, with a sustained reduction in FMD in lower fit men. The prolonged reduction in FMD after high-intensity cycling exercise may be associated with future vascular adaptation but may also reflect a period of increased cardiovascular risk in lower fit elderly men. Copyright © 2017 the American Physiological Society.

A flexed posture in elderly patients is associated with impairments in postural control during walking.

PubMed

de Groot, Maartje H; van der Jagt-Willems, Hanna C; van Campen, Jos P C M; Lems, Willem F; Beijnen, Jos H; Lamoth, Claudine J C

2014-02-01

A flexed posture (FP) is characterized by protrusion of the head and an increased thoracic kyphosis (TK), which may be caused by osteoporotic vertebral fractures (VFs). These impairments may affect motor function, and consequently increase the risk of falling and fractures. The aim of the current study was therefore to examine postural control during walking in elderly patients with FP, and to investigate the relationship with geriatric phenomena that may cause FP, such as increased TK, VFs, frailty, polypharmacy and cognitive impairments. Fifty-six elderly patients (aged 80 ± 5.2 years; 70% female) walked 160 m at self-selected speed while trunk accelerations were recorded. Walking speed, mean stride time and coefficient of variation (CV) of stride time were recorded. In addition, postural control during walking was quantified by time-dependent variability measures derived from the theory of stochastic dynamics, indicating smoothness, degree of predictability, and local stability of trunk acceleration patterns. Twenty-five patients (45%) had FP and demonstrated a more variable and less structured gait pattern, and a more irregular trunk acceleration pattern than patients with normal posture. FP was significantly associated with an increased TK, but not with other geriatric phenomena. An increased TK may bring the body's centre of mass forward, which requires correcting responses, and reduces the ability to respond on perturbation, which was reflected by higher variation in the gait pattern in FP-patients. Impairments in postural control during walking are a major risk factor for falling: the results indicate that patients with FP have impaired postural control during walking and might therefore be at increased risk of falling. Copyright © 2013 Elsevier B.V. All rights reserved.

Exoskeleton plantarflexion assistance for elderly.

PubMed

Galle, S; Derave, W; Bossuyt, F; Calders, P; Malcolm, P; De Clercq, D

2017-02-01

Elderly are confronted with reduced physical capabilities and increased metabolic energy cost of walking. Exoskeletons that assist walking have the potential to restore walking capacity by reducing the metabolic cost of walking. However, it is unclear if current exoskeletons can reduce energy cost in elderly. Our goal was to study the effect of an exoskeleton that assists plantarflexion during push-off on the metabolic energy cost of walking in physically active and healthy elderly. Seven elderly (age 69.3±3.5y) walked on treadmill (1.11ms 2 ) with normal shoes and with the exoskeleton both powered (with assistance) and powered-off (without assistance). After 20min of habituation on a prior day and 5min on the test day, subjects were able to walk with the exoskeleton and assistance of the exoskeleton resulted in a reduction in metabolic cost of 12% versus walking with the exoskeleton powered-off. Walking with the exoskeleton was perceived less fatiguing for the muscles compared to normal walking. Assistance resulted in a statistically nonsignificant reduction in metabolic cost of 4% versus walking with normal shoes, likely due to the penalty of wearing the exoskeleton powered-off. Also, exoskeleton mechanical power was relatively low compared to previously identified optimal assistance magnitude in young adults. Future exoskeleton research should focus on further optimizing exoskeleton assistance for specific populations and on considerate integration of exoskeletons in rehabilitation or in daily life. As such, exoskeletons should allow people to walk longer or faster than without assistance and could result in an increase in physical activity and resulting health benefits. Copyright © 2016 Elsevier B.V. All rights reserved.

[Reliability of static posturography in elderly persons].

PubMed

Bauer, C M; Gröger, I; Rupprecht, R; Tibesku, C O; Gassmann, K G

2010-08-01

Static posturography is used to quantify body sway. It is used to assess the balance of elderly persons who are prone to falls. There is still no general opinion concerning the reliability of force platform measurements. The aim of this study was to test the reliability of force platform parameters when measuring elderly persons. The reliability of 11 force platform parameters was tested measuring 30 elderly persons. The following parameters were calculated: mean speed of center of pressure displacement in mm/s, length of sway in mm, sway area in mm(2), amplitudes of center of pressure movement, the axis of oscillation in degrees and the person's angles of inclination in degrees. Three measurements were taken on the same day, with a resting period of 2 min. Four different test conditions were used: normal standing and narrow stand with eyes open and eyes closed, respectively. Reliability was determined by using intraclass correlation coefficients. Six parameters had excellent reliability with a correlation coefficient of >0.9: mean speed of center of pressure movement during narrow stand, area of sway during narrow stand, length of sway during normal and narrow stand, and the angle of inclination in the sagittal plane during normal stand and narrow stand. The condition "narrow stand eyes closed" proved to be the most reliable test position. Six parameters proved to have excellent reliability and are recommended to be used in further investigations. Narrow stand with eyes closed should be used as the test position. The tested protocol proved to be reliable. Whether these parameters can be used to predict falls in elderly persons remains to be investigated.

Depression in the elderly.

PubMed Central

Wasylenki, D.

1980-01-01

Depression in the elderly is very common and may be difficult to diagnose. Because of its varied presentation and its frequent association with physical illness it will be encountered increasingly by all physicians as the elderly population expands. Depression, though treatable, is often not treated, and suicide rates are high among depressed elderly persons. Diagnostic difficulties lie in distinguishing depression from organic brain syndromes, from so-called masked depressions and from normal grief reactions. Pharmacologic treatment is effective, but care must be taken to recognize side effects and to use adequate doses. Psychologic approaches should focus on reducing feelings of helplessness and failing self-esteem. The importance of the losses borne by elderly persons in the pathogenesis of depression continues to be of theoretical and practical interest. PMID:6989463

Association Between Subjective Obesity Status and Smoking Behavior Among Normal-Weight Women.

PubMed

Kim, Dae-Hwan

2018-06-01

Smoking and obesity are chief causes of mortality, morbidity, and medical expenditure. However, few studies have investigated the linkage between subjective obesity status and smoking behavior. This study examines whether females in a normal body mass index range who perceive themselves as obese are more likely to smoke than those who do not perceive themselves as obese. Stratifying by age-group, I employed the propensity score matching analysis to control for selection bias. Although body mass index is lower for younger females aged 20 to 39, they are more likely than elder females to consider themselves as obese. Based on a logistic regression, my findings show that younger females who perceive themselves as obese are 21.2% more likely to smoke than females who do not perceive themselves as obese. The positive relationship between perceived obesity status and smoking behavior is also found in the propensity score matching analysis. However, the disparity in smoking prevalence is not detected between elder females who perceive themselves as obese and those who do not. Public education that fosters accurate perception of body shape is imperative in inducing healthy lifestyles and improving social welfare.

Orthostatic Hypotension: Mechanisms, Causes, Management

PubMed Central

Tomalia, Victoria A.

2015-01-01

Orthostatic hypotension (OH) occurs when mechanisms for the regulation of orthostatic BP control fails. Such regulation depends on the baroreflexes, normal blood volume, and defenses against excessive venous pooling. OH is common in the elderly and is associated with an increase in mortality rate. There are many causes of OH. Aging coupled with diseases such as diabetes and Parkinson's disease results in a prevalence of 10-30% in the elderly. These conditions cause baroreflex failure with resulting combination of OH, supine hypertension, and loss of diurnal variation of BP. The treatment of OH is imperfect since it is impossible to normalize standing BP without generating excessive supine hypertension. The practical goal is to improve standing BP so as to minimize symptoms and to improve standing time in order to be able to undertake orthostatic activities of daily living, without excessive supine hypertension. It is possible to achieve these goals with a combination of fludrocortisone, a pressor agent (midodrine or droxidopa), supplemented with procedures to improve orthostatic defenses during periods of increased orthostatic stress. Such procedures include water bolus treatment and physical countermaneuvers. We provide a pragmatic guide on patient education and the patient-orientated approach to the moment to moment management of OH. PMID:26174784

Altered center of mass control during sit-to-walk in elderly adults with and without history of falling.

PubMed

Chen, Tzurei; Chou, Li-Shan

2013-09-01

Sit-to-walk (STW) is a commonly performed activity of daily living that requires a precise coordination between momentum generation and balance control. However, there is a lack of biomechanical data demonstrating how the center of mass (COM) momentum and balance control interact. This study examines COM kinetic energy distribution in three movement directions and COM-Ankle inclination angles during STW among 15 healthy young adults, 15 elderly non-fallers, and 15 elderly fallers. We found that elderly adults, especially elderly fallers, chose a COM control strategy that provided more stability than mobility to perform STW. A smaller forward COM velocity, a more upward COM momentum distribution, and a smaller anterior-posterior COM-Ankle angle characterize this strategy. Healthy elderly adults modified their STW movement around seat-off so that they achieved a more upright position before walking. Elderly fallers not only altered COM control around seat-off but also showed limitation in COM control during gait initiation. Furthermore, their COM control in the medial-lateral direction might be perturbed at swing-off due to an increased distribution of kinetic energy. Examining COM momentum distribution in different movement directions and the relationship between positions of the COM and supporting foot during STW could enhance our ability to identify elderly adults who are at risk of falling. Copyright © 2013 Elsevier B.V. All rights reserved.

Could linear MRI measurements of hippocampus differentiate normal brain aging in elderly persons from Alzheimer disease?

PubMed

Tarroun, Abdullah; Bonnefoy, Marc; Bouffard-Vercelli, Juliette; Gedeon, Claire; Vallee, Bernard; Cotton, François

2007-02-01

Although mild progressive specific structural brain changes are commonly associated with normal human aging, it is unclear whether automatic or manual measurements of these structures can differentiate normal brain aging in elderly persons from patients suffering from cognitive impairment. The objective of this study was primarily to define, with a standard high resolution MRI, the range of normal linear age-specific values for the hippocampal formation (HF), and secondarily to differentiate hippocampal atrophy in normal aging from that occurring in Alzheimer disease (AD). Two MRI-based linear measurements of the hippocampal formation at the level of the head and of the tail, standardized by the cranial dimensions, were obtained from coronal and sagittal T1-weighted MR images in 25 normal elderly subjects, and 26 patients with AD. In this study, dimensions of the HF have been standardized and they revealed normal distributions for each side and each sex: the width of the hippocampal head at the level of the amygdala was 16.42 +/- 1.9 mm, and its height 7.93 +/- 1.4 mm; the width of the tail at the level of the cerebral aqueduct was 8.54 +/- 1.2 mm, and the height 5.74 +/- 0.4 mm. There were no significant differences in standardized dimensions of the HF between sides, sexes, or in comparison to head dimensions in the two groups. In addition, the median inter-observer agreement index was 93%. In contrast, the dimensions of the hippocampal formation decreased gradually with increasing age, owing to physiological atrophy, but this atrophy is more significant in the group of AD.

[Sleep health education for elderly people].

PubMed

Miyazaki, Soichiro; Nishiyama, Akiko

2015-06-01

Successful aging is characterized by minimal age-associated loss of the physiological functions of sleep and circadian clock. Sleep health education is necessary to have normal, quality nighttime sleep and full daytime alertness. Elderly people show changes of sleep parameters, accompanied by increased napping. Many studies have reported that daytime sleepiness or napping in elderly people could have potentially serious effects such as dementia and life-style related diseases. The main topics of sleep health education for elderly people are as follows: Right knowledge of sleep mechanism, understanding the bad influence of excessive napping, the effects of light on the circadian rhythm and negative effects of caffeine, alcohol and television.

The Dementia and Disability Project in Thai Elderly: rational, design, methodology and early results.

PubMed

Senanarong, Vorapun; Harnphadungkit, Kamolthip; Poungvarin, Niphon; Vannasaeng, Sathit; Chongwisal, Samut; Chakorn, Tipa; Jamjumrus, Piyanuch; Raksthaput, Atthapon; Chaichanettee, Sinisa; Aoonkaew, Nattapol; Udompunthurak, Suthipol; Doody, Rachelle S; Cummings, Jeffrey L

2013-01-10

A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004-2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects were free of chronic diseases. Treatment gap (indicating those who have untreated or inadequate treatment) of diabetes mellitus and hypertension in Thai elders in this study was 37% and 55.5% respectively. 62.6% of Thai elders have ApoE3E3 allele. Prevalence of positive ApoE4 gene in this study is 22.85%. 38.6% of Thai elders who had MRI brain study have moderate to severe white matter lesions. The large and comprehensive set of measurements in DDP allows a wide-ranging explanation of the functional and clinical features to be investigated in relation to white matter lesions or cortical atrophy of the brain in Thai elderly population. An almost 2 year follow up was made available to those with MCI and dementia and some of the cognitively normal elderly. The longitudinal design will provide great understanding of the possible contributors to disability in the elderly and to the progression of cognitive decline in Thai elders.

The dementia and disability project in Thai elderly: rational, design, methodology and early results

PubMed Central

2013-01-01

Background A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. Methods The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004–2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. Results The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects were free of chronic diseases. Treatment gap (indicating those who have untreated or inadequate treatment) of diabetes mellitus and hypertension in Thai elders in this study was 37% and 55.5% respectively. 62.6% of Thai elders have ApoE3E3 allele. Prevalence of positive ApoE4 gene in this study is 22.85%. 38.6% of Thai elders who had MRI brain study have moderate to severe white matter lesions. Conclusion The large and comprehensive set of measurements in DDP allows a wide-ranging explanation of the functional and clinical features to be investigated in relation to white matter lesions or cortical atrophy of the brain in Thai elderly population. An almost 2 year follow up was made available to those with MCI and dementia and some of the cognitively normal elderly. The longitudinal design will provide great understanding of the possible contributors to disability in the elderly and to the progression of cognitive decline in Thai elders. PMID:23305293

Measures of Working Memory, Sequence Learning, and Speech Recognition in the Elderly.

ERIC Educational Resources Information Center

Humes, Larry E.; Floyd, Shari S.

2005-01-01

This study describes the measurement of 2 cognitive functions, working-memory capacity and sequence learning, in 2 groups of listeners: young adults with normal hearing and elderly adults with impaired hearing. The measurement of these 2 cognitive abilities with a unique, nonverbal technique capable of auditory, visual, and auditory-visual…

Is Tai Chi Chuan effective in improving lower limb response time to prevent backward falls in the elderly?

PubMed

Wong, Alice M K; Pei, Yu-Cheng; Lan, Ching; Huang, Shu-Chun; Lin, Yin-Chou; Chou, Shih-Wei

2009-06-01

To evaluate the training effect of Tai Chi Chuan (TCC) in postural control and backward fall prevention in the elderly, balance assessment and visually guided lower limb response time were analyzed in a case-control study conducted in a community setting. Thirty-one elderly subjects (mean age: 68.2 +/- 6.8 years) participated in the TCC group, 30 community-dwelling elderly subjects with matched age and body composition served as the elderly control group, with 13 young adults (mean age: 27.5 +/- 3.8 years) serving as young controls. The TCC group had practiced TCC regularly five times per week, for over 30 min per day for at least 4 years. Lower limb response time were measured using a computerized dance machine that we developed, which contains two blocks during testing: single and dual feet. The motor planning of the latter is more complex than the former. Postural control was assessed by computerized posturography (Smart Balance Master). Compared to the elderly controls, the TCC group demonstrated significantly better balance performance in sway-referenced support, which is more challenging. Moreover, the TCC group had better dual feet response than the elderly controls in the forward-backward, forward-right and forward-left directions. Practicing TCC may improve motor responses and postural control in the elderly, particularly in more challenging situations. Subjects showed better postural responses to unexpected perturbation in the forward-backward and forward-sideways direction than sideways or backward-sideways directions, which may have clinical relevance.

Detection of Mild Cognitive Impairment and early stage dementia with an audio-recorded cognitive scale

PubMed Central

Sewell, Margaret C.; Luo, Xiaodong; Neugroschl, Judith; Sano, Mary

2014-01-01

BACKGROUND Physicians often miss a diagnosis of Mild Cognitive Impairment (MCI) or early dementia and screening measures can be insensitive to very mild impairments. Other cognitive assessments may take too much time or be frustrating to seniors. This study examined the ability of an audio-recorded scale, developed in Australia, to detect MCI or mild Alzheimer’s disease and compared cognitive domain specific performance on the audio-recorded scale to in-person battery and common cognitive screens. METHOD Seventy-six subjects from the Mount Sinai Alzheimer’s Disease Research Center were recruited. Subjects were 75 years or older, with clinical diagnosis of AD or MCI (n=51) or normal control (n=25). Participants underwent in-person neuropsychological testing followed by testing with the Audio-recorded Cognitive Screen (ARCS). RESULTS ARCS provided better discrimination between normal and impaired elders than either the Mini-Mental Status Exam (MMSE) or the clock drawing test. The in-person battery and ARCS analogous variables were significantly correlated, most in the .4 to .7 range, including verbal memory, executive function/attention, naming, and verbal fluency. The area under the curve generated from ROC curves indicated high and equivalent discrimination for ARCS and the in-person battery (0.972 vs. 0.988; p=0.23). CONCLUSION The ARCS demonstrated better discrimination between normal controls and those with mild deficits than typical screening measures. Performance on cognitive domains within the ARCS was well correlated with the in-person battery. Completion of the ARCS was accomplished despite mild difficulty hearing the instructions even in very elderly subjects, indicating that it may be a useful measure in primary care settings. PMID:23635663

Relationship between brain R(2) and liver and serum iron concentrations in elderly men.

PubMed

House, Michael J; St Pierre, Timothy G; Milward, Elizabeth A; Bruce, David G; Olynyk, John K

2010-02-01

Studies of iron overload in humans and animals suggest that brain iron concentrations may be related in a regionally specific way to body iron status. However, few quantitative studies have investigated the associations between peripheral and regional brain iron in a normal elderly cohort. To examine these relationships, we used MRI to measure the proton transverse relaxation rate (R(2)) in 13 gray and white matter brain regions in 18 elderly men (average age, 75.5 years) with normal cognition. Brain R(2) values were compared with liver iron concentrations measured using the FerriScan MRI technique and serum iron indices. R(2) values in high-iron gray matter regions were significantly correlated (positively) with liver iron concentrations (globus pallidus, ventral pallidum) and serum transferrin saturation (caudate nucleus, globus pallidus, putamen) measured concurrently with brain R(2), and with serum iron concentrations (caudate nucleus, globus pallidus) measured three years before the current study. Our results suggest that iron levels in specific gray matter brain regions are influenced by systemic iron status in elderly men.

Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial

PubMed Central

Peri, Kathy; Robinson, Elizabeth; Wilkinson, Tim; von Randow, Martin; Kiata, Liz; Parsons, John; Latham, Nancy; Parsons, Matthew; Willingale, Jane; Brown, Paul; Arroll, Bruce

2008-01-01

Objective To assess the effectiveness of an activity programme in improving function, quality of life, and falls in older people in residential care. Design Cluster randomised controlled trial with one year follow-up. Setting 41 low level dependency residential care homes in New Zealand. Participants 682 people aged 65 years or over. Interventions 330 residents were offered a goal setting and individualised activities of daily living activity programme by a gerontology nurse, reinforced by usual healthcare assistants; 352 residents received social visits. Main outcome measures Function (late life function and disability instruments, elderly mobility scale, FICSIT-4 balance test, timed up and go test), quality of life (life satisfaction index, EuroQol), and falls (time to fall over 12 months). Secondary outcomes were depressive symptoms and hospital admissions. Results 473 (70%) participants completed the trial. The programme had no impact overall. However, in contrast to residents with impaired cognition (no differences between intervention and control group), those with normal cognition in the intervention group may have maintained overall function (late life function and disability instrument total function, P=0.024) and lower limb function (late life function and disability instrument basic lower extremity, P=0.015). In residents with cognitive impairment, the likelihood of depression increased in the intervention group. No other outcomes differed between groups. Conclusion A programme of functional rehabilitation had minimal impact for elderly people in residential care with normal cognition but was not beneficial for those with poor cognition. Trial registration Australian Clinical Trials Register ACTRN12605000667617. PMID:18845605

Strength of Structural and Functional Frontostriatal Connectivity Predicts Self-Control in the Healthy Elderly

PubMed Central

Hänggi, Jürgen; Lohrey, Corinna; Drobetz, Reinhard; Baetschmann, Hansruedi; Forstmeier, Simon; Maercker, Andreas; Jäncke, Lutz

2016-01-01

Self-regulation refers to the successful use of executive functions and initiation of top-down processes to control one's thoughts, behavior, and emotions, and it is crucial to perform self-control. Self-control is needed to overcome impulses and can be assessed by delay of gratification (DoG) and delay discounting (DD) paradigms. In children/adolescents, good DoG/DD ability depends on the maturity of frontostriatal connectivity, and its decline in strength with advancing age might adversely affect self-control because prefrontal brain regions are more prone to normal age-related atrophy than other regions. Here, we aimed at highlighting the relationship between frontostriatal connectivity strength and DoG performance in advanced age. We recruited 40 healthy elderly individuals (mean age 74.0 ± 7.7 years) and assessed the DoG ability using the German version of the DoG test for adults in addition to the delay discounting (DD) paradigm. Based on diffusion-weighted and resting-state functional magnetic resonance imaging data, respectively, the structural and functional whole-brain connectome were reconstructed based on 90 different brain regions of interest in addition to a 12-node frontostriatal DoG-specific network and the resulting connectivity matrices were subjected to network-based statistics. The 90-nodes whole-brain connectome analyses revealed subnetworks significantly associated with DoG and DD with a preponderance of frontostriatal nodes involved suggesting a high specificity of the findings. Structural and functional connectivity strengths between the putamen, caudate nucleus, and nucleus accumbens on the one hand and orbitofrontal, dorsal, and ventral lateral prefrontal cortices on the other hand showed strong positive correlations with DoG and negative correlations with DD corrected for age, sex, intracranial volume, and head motion parameters. These associations cannot be explained by differences in impulsivity and executive functioning. This pattern of correlations between structural or functional frontostriatal connectivity strength and self-control suggests that, in addition to the importance of the frontostriatal nodes itself, the structural and functional properties of different connections within the frontostriatal network are crucial for self-controlled behaviors in the healthy elderly. Because high DoG/low DD is a significant predictor of willpower and wellbeing in the elderly population, interventions aiming at strengthening frontostriatal connectivity to strengthen self-controlled behavior are needed in the future. PMID:28105013

Communication in dental medicine: importance in motivating elderly dental patients.

PubMed

Scutariu, Mihaela Monica; Forna, Norina

2013-01-01

Dental services for elderly patients are characterized by a series of particularities related to the vulnerability of this age group, which is affected by various co morbidities, and the diminished physical, cognitive and financial capacities. Finding ways to keep elderly patients coming to a dental office is possible by improving the dentist-patient relationship and implicitly the quality of care by increasing the self-esteem of the elderly and their place in society, by increasing the role of oral health in the quality of life, and here we refer to the pleasure of eating, the pleasant physical aspect and normal diction. The present paper presents the psychological aspects that interfere in the communication process between the dentist and the elderly patient and the changes motivation undergoes when people are in pain. These data can sometimes change the reticent attitude of the dentist towards the elderly patient which is often considered to be a risk patient.

Loneliness and self-management abilities in the visually impaired elderly.

PubMed

Alma, Manna A; Van der Mei, Sijrike F; Feitsma, W Nathalie; Groothoff, Johan W; Van Tilburg, Theo G; Suurmeijer, Theo P B M

2011-08-01

To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly. In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively. The prevalence of loneliness among the visually impaired elderly was higher compared with the reference group (50% vs. 29%; p < .001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness. The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, as SMAs can be learned through training. Consequently, self-management training may reduce feelings of loneliness.

Sensory Interactions for Head and Trunk Control in Space in Young and Older Adults During Normal and Narrow-Base Walking.

PubMed

Zhang, Fang; Deshpande, Nandini

2016-01-01

Fifteen young (20-30 years old) and 15 older (>65 years old) healthy participants were recruited to investigate age-related differences in head and trunk control under suboptimal vestibular conditions (galvanic vestibular stimulation, or GVS) and vision conditions during normal and narrow-based walking. Head-roll velocity decreased in the blurred-vision condition and marginally increased with GVS in older but not in young participants. Head pitch increased, whereas head-roll velocity decreased in narrow-base walking. Trunk pitch, trunk-pitch velocity, and gait speed increased with GVS, whereas trunk-pitch velocity and gait speed decreased in narrow-base walking. Marginally increased head-roll velocity in the older participants possibly suggests decreased integrative ability of the central nervous system in elderly people. The changes in head control during narrow-base walking may be an attempt to simplify the interpretation of the vestibular signal and increase otolith sensitivity. The complexity of controlling the trunk in the mediolateral direction was suggested by different strategies used for trunk control in different conditions.

FDG metabolism associated with tau-amyloid interaction predicts memory decline

PubMed Central

Hanseeuw, Bernard J.; Betensky, Rebecca A.; Schultz, Aaron P.; Papp, Kate V.; Mormino, Elizabeth C.; Sepulcre, Jorge; Bark, John S.; Cosio, Danielle M.; LaPoint, Molly; Chhatwal, Jasmeer P.; Rentz, Dorene M.; Sperling, Reisa A.; Johnson, Keith

2017-01-01

Objective To evaluate in normal older adults and preclinical Alzheimer’s disease (AD) the impact of amyloid and regional tauopathy on cerebral glucose metabolism and subsequent memory decline. Methods We acquired positron emission tomography using F18 Flortaucipir (tau), C11 Pittsburgh Compound B (amyloid) and F18 Fluorodeoxyglucose in 90 clinically normal elderly of the Harvard Aging Brain Study. Results Posterior cingulate metabolism decreased when both amyloid and neocortical tau were high and predicted subsequent memory decline in a larger sample of normal elderly. In contrast, frontal hypometabolism related to the common age-related entorhinal tauopathy, but this dysfunction was independent of amyloid, and did not predict significant memory decline. Neocortical tauopathy was positively associated with metabolism in individuals with sub-threshold amyloid, suggesting that glucose metabolism increases before decreasing in the course of preclinical AD. Interpretation Our study identified a synergistic effect of amyloid and tau deposits and demonstrated for the first time in normal elderly its link to AD-like hypometabolism and to AD-like memory decline. The amyloid effect was seen with tau in neocortex, but not with tau in entorhinal cortex, which is the common site of age-related tauopathy. Entorhinal tau was associated with frontal hypometabolism, but this dysfunction was not associated with memory loss. PMID:28253546

Lower cognitive performance in 81-year-old men with greater nocturnal blood pressure dipping

PubMed Central

Axelsson, Johan; Reinprecht, Faina; Siennicki-Lantz, Arkadiusz; Elmståhl, Sölve

2008-01-01

Abnormal day-to-night blood pressure (BP) pattern have been found to be associated with cerebrovascular damage, yet studies of the elderly 80 years of age and above, for whom the risk pattern may be different due to ageing and age-associated diseases, are lacking. Ninety-seven 81-year-old men underwent ambulatory BP monitoring and were given six cognitive tests, 79 of the men completing the cognitive test battery. The odds ratio (OR) for performing one standard deviation below the mean on any cognitive test was calculated using a forward stepwise logistic regression model, confounding factors being controlled for. Groups defined in terms of day-to-night changes in BP were compared in this respect. Cognitive performance was lower (OR 3.6; P = 0.017) in the group usually described as dippers (10%–20% nocturnal drop in systolic BP [SBP]) as compared with nondippers (<10% drop). The tertile with the greatest SBP fall (10.6%–19.8%, a range considered as normal among middle aged) showed lowest cognitive performance (OR 4.7; P = 0.008) as compared with the middle tertile (5.1%–10.5% drop). The mean nocturnal fall in SBP was 7.4%, significantly greater in those with lower rather than higher cognitive performance. A nocturnal drop in SBP of ≥10% was associated with lower cognitive performance in these elderly men. The limits to normal dipping appear to be shifted in the direction of a lesser drop in the very elderly. PMID:20428409

Dyshomeostasis of Serum Oxidant/Antioxidant Status and Copper, Zinc, and Selenium Levels in Elderly Physically Disabled Persons: an AHAP-Based Study.

PubMed

Younesi, Simin; Parsian, Hadi; Hosseini, Seyed Reza; Noreddini, Hajighorban; Mosapour, Abbas; Bijani, Ali; Halalkhor, Sohrab

2015-08-01

The percentage of elderly persons is rapidly growing. Physical disability is one of the main age-related diseases which affect life quality. There are some studies that suggest the oxidative stress and trace elements are involved in physical disability in elderly persons, but the results are inconclusive. Therefore, the aim of this study was to investigate the status of aforementioned parameters in elderly physically disabled patients vs. healthy ones. According to the Katz questionnaire form, 44 subjects with physical disability and 66 age-gender-matched healthy subjects were selected from Amirkola Health and Aging Project (AHAP). The results indicated that patient group had lower serum Zn, Se, and total antioxidant levels than the control group (p < 0.001), whereas serum total oxidant level and Cu to Zn ratio (CZr) were higher in control group than in healthy one (p < 0.001). A positive correlation was found between Zn, Se, total antioxidant, and bone mineral density of femur (BMD.F) with activities of daily living (ADL) score (p < 0.01); meanwhile, a negative correlation between CZr and total oxidant with ADL score was observed (p < 0.01). Serum total oxidant level and CZr index had the highest area under the curve in receiver operating characteristic (ROC) analysis among the included parameters for discrimination of physically disabled patients than the normal ones. Decrease in serum Zn and Se levels, low BMD, and increase in CZr and oxidative stress were observed in physically disabled patients. It seems that CZr is more reliable parameter than the others to discriminate the physically disabled patients than the healthy persons.

Do older t'ai chi practitioners have better attention and memory function?

PubMed

Man, David W K; Tsang, William W N; Hui-Chan, Christina W Y

2010-12-01

Cognitive declines are common in older people and can be a major health issue in an aging world. One type of body-mind exercises, t'ai chi, can be a possible means to help maintaining older adults' cognitive abilities, in addition to beneficial effects of physical exercises. The purpose of this study was to investigate whether t'ai chi practitioners had better attention and memory functions than older people with or without regular exercises. A cross-sectional study examining the relationship between t'ai chi practice and age-, gender- and education-similar older peoples' attention and memory functions. Forty-two (42) community-dwelling elderly subjects, aged 60 or older, recruited from t'ai chi clubs in Hong Kong formed the t'ai chi group. Another 49 elderly having regular exercise habits were recruited from community centers for inclusion in the exercise group. A nonexercise group (normal healthy control) consisting of 44 subjects were also recruited by random selection and through contacting local elderly centers. They were also screened by the Modified Barthel Index, Chinese Mini-mental Status Examination, Geriatric Depression Scale, and evaluated by attention tests (Color Trail Form A-1 and 2) and memory tests (including Rivermead Behavioral Memory Test and The Hong Kong List Learning Test). The main finding was that the three groups differed in attention and memory functions, and the t'ai chi group had demonstrated better performance than the other two groups in most subtests. As a causal relationship cannot be assumed in the present cross-sectional study, future research is required to examine how t'ai chi can improve cognitive function using a randomized control trial as well as determining whether t'ai chi practice can lead to better health status among elderly people.

Severe obesity increases the prevalence but not the incidence of depressive symptoms in the elderly-population-based cohort in Southern Brazil.

PubMed

Goes, Vanessa Fernanda; Wazlawik, Elisabeth; D'Orsi, Eleonora; González-Chica, David Alejandro

2017-08-01

The relation between body weight status and depressive symptoms in the elderly differs according to age and country of origin. The goal of this study was to analyze the cross-sectional and longitudinal relationship between body mass index (BMI), waist circumference (WC) and depressive symptoms in the elderly. A population-based cohort study of 1,702 elderly individuals (70.6+8.0 years) in Southern Brazil evaluated in 2009/10 and 2013/14 was accessed. The body weight status was assessed using measured data of BMI and WC. The Geriatric Depression Scale (GDS-15) was used to determine depressive symptoms. Logistic regression analysis adjusted for sociodemographic and behavioral variables was performed. The prevalence of depressive symptoms in 2009/10 was 23.3% (95% CI 20.3-26.6) and the cumulative incidence in the 4-years period was 10.9% (95% CI 8.7-13.6). Elderly people with obesity class II-III and WC in the highest quartile had higher prevalence odds ratio of being depressed than individuals with normal weight or WC in the lower quartile (OR 2.34; 95% CI 1.42-3.87 and OR 1.73; 95% CI 1.13-2.65, respectively). Meanwhile, intermediary values of BMI and WC were associated with a lower prevalence. When evaluating the incidence of depressive symptoms, overweight individuals and those in the second quartile of WC had a lower risk (58% and 57%, respectively), but severely obese individuals had the same risk compared to those with normal BMI/WC. Severely obese individuals presented a similar incidence of depressive symptoms compared to those with normal BMI/WC, but higher prevalence. Intermediary values of body weight status decrease the risk of depressive symptoms.

Pharmacokinetics and Tolerability of Lorcaserin in Special Populations: Elderly Patients and Patients with Renal or Hepatic Impairment.

PubMed

Christopher, Ronald J; Morgan, Michael E; Tang, Yong; Anderson, Christen; Sanchez, Matilde; Shanahan, William

2017-04-01

To determine whether dosage adjustment is likely to be necessary for effective and well-tolerated use of a pharmaceutical agent, guidance documents from the US Food and Drug Administration recommend pharmacokinetics studies in patients with impaired renal or impaired hepatic function and in the elderly population. Three studies were conducted to evaluate the pharmacokinetic properties and tolerability of lorcaserin in these populations. Lorcaserin was evaluated in single-dose pharmacokinetics studies of 3 overweight/obese populations: (1) elderly (aged >65 years) patients; (2) patients with impaired renal function; and (3) those with impaired hepatic function. In elderly patients, C max was lower (geometric mean ratio [GMR], 0.83; 90% CI, 0.71-0.97), but AUC was unchanged versus adult patients. In patients with renal impairment, C max was reduced versus that in patients with normal renal function (GMR: mild impairment, 0.99 [90% CI, 0.76-1.29]; moderate, 0.70 [90% CI, 0.54-0.90]; and severe, 0.69 [90% CI, 0.53-0.89]); no trend in AUC was observed in this group versus renal impairment. In patients with hepatic impairment, C max was decreased (GMR: mild impairment, 0.92 [90% CI, 0.76-1.11]; moderate, 0.86 [90% CI, 0.71-1.04]), and AUC was increased versus patients with normal hepatic function. Based on these findings, no lorcaserin dose adjustments are necessary in elderly patients with normal renal function or in patients with mild/moderate renal or hepatic impairment. ClinicalTrials.gov identifiers: NCT00828581, NCT00828438, and NCT00828932. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in Japan.

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Tsuda, Yuko; Kimura, Motoshi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

2012-01-01

This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as "normal." Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Cerebral control of the bladder in normal and urge-incontinent women

PubMed Central

Griffiths, Derek; Tadic, Stasa D.; Schaefer, Werner; Resnick, Neil M.

2007-01-01

Aim: To identify age-related changes in the normal brain/bladder control system, and differences between urge incontinence in younger and older women, as shown by brain responses to bladder filling; and to use age, bladder volume, urge incontinence and detrusor overactivity (DO) as probes to reveal control-system function. Functional MRI was used to examine regional brain responses to bladder infusion in 21 females (26 – 85 years): 11 “cases” with urge incontinence and DO (proven previously) and 10 normal “controls”. Responses and their age dependence were determined at small and large bladder volumes, in whole brain and in regions of interest representing right insula and anterior cingulate (ACG). In “controls”, increasing bladder volume/sensation led to increasing insular responses; with increasing age, insular responses became weaker. In younger “cases”, ACG responded abnormally strongly at large bladder volumes/strong sensation. Elderly “cases” showed strong ACG responses even at small bladder volume, but more moderate responses at larger volumes; if DO occurred, pontine micturition center (PMC) activation did not increase. Conclusion: Among normal “controls”, increasing age leads to decreased responses in brain regions involved in bladder control, including right insula, consistent with its role in mapping normal bladder sensations. Strong ACG activation occurs in urge-incontinent “cases” and may be a sign of urgency, indicating recruitment of alternative pathways when loss of bladder control is feared. Easier ACG provocation in older “cases” reflects lack of physiological reserve or different etiology. ACG responses seem associated with PMC inhibition: reduced ACG activity accompanies failure of inhibition (DO). PMID:17574871

Time for a change to assess and evaluate body temperature in clinical practice.

PubMed

Sund-Levander, Märtha; Grodzinsky, Ewa

2009-08-01

The definition of normal body temperature as 37 degrees C still is considered the norm worldwide, but in practice there is a widespread confusion of the evaluation of body temperature, especially in elderly individuals. In this paper, we discuss the relevance of normal body temperature as 37 degrees C and consequences in clinical practice. Our conclusion is that body temperature should be evaluated in relation to the individual variability and that the best approach is to use the same site, and an unadjusted mode without adjustments to other sites. If the baseline value is not known, it is important to notice that frail elderly individuals are at risk of a low body temperature. In addition, what should be regarded as fever is closely related to what is considered as normal body temperature. That is, as normal body temperature shows individual variations, it is reasonable that the same should hold true for the febrile range.

Age-associated decrease in GDNF and its cognate receptor GFRα-1 protein expression in human skin.

PubMed

Adly, Mohamed A; Assaf, Hanan A; Hussein, Mahmoud Rezk Abdelwahed

2016-06-01

Glial cell line-derived neurotrophic factor (GDNF) and its cognate receptor (GFRα-1) are expressed in normal human skin. They are involved in murine hair follicle morphogenesis and cycling control. We hypothesize that 'GDNF and GFRα-1 protein expression in human skin undergoes age-associated alterations. To test our hypothesis, the expression of these proteins was examined in human skin specimens obtained from 30 healthy individuals representing three age groups: children (5-18 years), adults (19-60 years) and the elderly (61-81 years). Immunofluorescent and light microscopic immunohistologic analyses were performed using tyramide signal amplification and avidin-biotin complex staining methods respectively. GDNF mRNA expression was examined by RT-PCR analysis. GDNF mRNA and protein as well as GFRα-1 protein expressions were detected in normal human skin. We found significantly reduced epidermal expression of these proteins with ageing. In the epidermis, the expression was strong in the skin of children and declined gradually with ageing, being moderate in adults and weak in the elderly. In children and adults, the expression of both GDNF and GFRα-1 proteins was strongest in the stratum basale and decreased gradually towards the surface layers where it was completely absent in the stratum corneum. In the elderly, GDNF and GFRα-1 protein expression was confined to the stratum basale. In the dermis, both GDNF and GFRα-1 proteins had strong expressions in the fibroblasts, sweat glands, sebaceous glands, hair follicles and blood vessels regardless of the age. Thus there is a decrease in epidermal GDNF and GFRα-1 protein expression in normal human skin with ageing. Our findings suggest that the consequences of this is that GFRα-1-mediated signalling is altered during the ageing process. The clinical and therapeutic ramifications of these observations mandate further investigations. © 2016 The Authors. International Journal of Experimental Pathology © 2016 International Journal of Experimental Pathology.

Tremor in the Elderly: Essential and Aging-Related Tremor

PubMed Central

Deuschl, Günthe; Petersen, Inge; Lorenz, Delia; Christensen, Kaare

2016-01-01

Isolated tremor in the elderly is commonly diagnosed as essential tremor (ET). The prevalence of tremor increases steeply with increasing age, whereas hereditary tremor is becoming less common. Moreover, late-manifesting tremor seems to be associated with dementia and earlier mortality. We hypothesize that different entities underlie tremor in the elderly. Two thousand four hundred forty-eight subjects from the Longitudinal Study of Aging Danish Twins older than 70 y answered screening questions for ET in 2001. Two thousan fifty-six (84%) participants drew Archimedes spirals to measure their tremor severity, and classical aging phenotypes were assessed. A subgroup of 276 individuals fulfilling either screening criteria for ET or being controls were personally assessed. Medications and mortality data are available. The spiral score increased with age. The spiral score correlated with tremor severity. For the whole cohort, mortality was significantly correlated with the spiral score, and higher spiral scores were associated with lower physical and cognitive functioning. Multivariate analysis identified higher spiral scores as an independent risk factor for mortality. In contrast, the ET patients did not show an increased but rather a lower mortality rate although it was not statistically significant. Consistent with a slower than normal aging, they were also physically and cognitively better functioning than controls. Because incident tremors beyond 70 y of age show worse aging parameters and mortality than controls and ET, we propose to label it ‘aging-related tremor’ (ART). This tremor starts later in life and is accompanied by subtle signs of aging both cognitively and physically. More detailed clinical features and pathogenesis warrant further assessment. PMID:26095699

Dorsomedial SCN neuronal subpopulations subserve different functions in human dementia.

PubMed

Harper, David G; Stopa, Edward G; Kuo-Leblanc, Victoria; McKee, Ann C; Asayama, Kentaro; Volicer, Ladislav; Kowall, Neil; Satlin, Andrew

2008-06-01

The suprachiasmatic nuclei (SCN) are necessary and sufficient for the maintenance of circadian rhythms in primate and other mammalian species. The human dorsomedial SCN contains populations of non-species-specific vasopressin and species-specific neurotensin neurons. We made time-series recordings of core body temperature and locomotor activity in 19 elderly, male, end-stage dementia patients and 8 normal elderly controls. Following the death of the dementia patients, neuropathological diagnostic information and tissue samples from the hypothalamus were obtained. Hypothalamic tissue was also obtained from eight normal control cases that had not had activity or core temperature recordings previously. Core temperature was analysed for parametric, circadian features, and activity was analysed for non-parametric and parametric circadian features. These indices were then correlated with the degree of degeneration seen in the SCN (glia/neuron ratio) and neuronal counts from the dorsomedial SCN (vasopressin, neurotensin). Specific loss of SCN neurotensin neurons was associated with loss of activity and temperature amplitude without increase in activity fragmentation. Loss of SCN vasopressin neurons was associated with increased activity fragmentation but not loss of amplitude. Evidence for a circadian rhythm of vasopressinergic activity was seen in the dementia cases but no evidence was seen for a circadian rhythm in neurotensinergic activity. These results provide evidence that the SCN is necessary for the maintenance of the circadian rhythm in humans, information on the role of neuronal subpopulations in subserving this function and the utility of dementia in elaborating brain-behaviour relationships in the human.

Neuropathological and neuropsychological changes in "normal" aging: evidence for preclinical Alzheimer disease in cognitively normal individuals.

PubMed

Hulette, C M; Welsh-Bohmer, K A; Murray, M G; Saunders, A M; Mash, D C; McIntyre, L M

1998-12-01

The presence of diffuse or primitive senile plaques in the neocortex of cognitively normal elderly at autopsy has been presumed to represent normal aging. Alternatively, these patients may have developed dementia and clinical Alzheimer disease (AD) if they had survived. In this setting, these patients could be subjects for cognitive or pharmacologic intervention to delay disease onset. We have thus followed a cohort of cognitively normal elderly subjects with a Clinical Dementia Rating (CDR) of 0 at autopsy. Thirty-one brains were examined at postmortem according to Consortium to Establish a Registry for Alzheimer Disease (CERAD) criteria and staged according to Braak. Ten patients were pathologically normal according to CERAD criteria (1a). Two of these patients were Braak Stage II. Seven very elderly subjects exhibited a few primitive neuritic plaques in the cortex and thus represented CERAD 1b. These individuals ranged in age from 85 to 105 years and were thus older than the CERAD la group that ranged in age from 72 to 93. Fourteen patients displayed Possible AD according to CERAD with ages ranging from 66 to 95. Three of these were Braak Stage I, 4 were Braak Stage II, and 7 were Braak Stage III. The Apolipoprotein E4 allele was over-represented in this possible AD group. Neuropsychological data were available on 12 individuals. In these 12 individuals, Possible AD at autopsy could be predicted by cognitive deficits in 1 or more areas including savings scores on memory testing and overall performance on some measures of frontal executive function.

Higher Fasting Plasma Glucose Levels, within the Normal Range, are Associated with Decreased Processing Speed in High Functioning Young Elderly.

PubMed

Raizes, Meytal; Elkana, Odelia; Franko, Motty; Ravona Springer, Ramit; Segev, Shlomo; Beeri, Michal Schnaider

2016-01-01

We explored the association of plasma glucose levels within the normal range with processing speed in high functioning young elderly, free of type 2 diabetes mellitus (T2DM). A sample of 41 participants (mean age = 64.7, SD = 10; glucose 94.5 mg/dL, SD = 9.3), were examined with a computerized cognitive battery. Hierarchical linear regression analysis showed that higher plasma glucose levels, albeit within the normal range (<110 mg/dL), were associated with longer reaction times (p <  0.01). These findings suggest that even in the subclinical range and in the absence of T2DM, monitoring plasma glucose levels may have an impact on cognitive function.

Microheterogeneity of alpha 1-acid glycoprotein in healthy elderly subjects: patterns obtained by crossed affino-immunoelectrophoresis.

PubMed

Kawerk, N; Succari-Aderschlag, M; Foglietti, M J

1991-10-14

Total serum alpha 1-acid glycoprotein (AGP) concentration and concanavalin A-dependent microheterogeneity were studied in 31 healthy elderly subjects (18 men, 13 women, 71 to 76 yr old). Crossed affino-immunoelectrophoresis (CAIE) revealed three microheterogeneity variants of AGP: non-reactive, weakly reactive and strongly reactive with ConA. Two patterns were found in both elderly men and women, i.e. a normal pattern and one with an increase in the non-reactive form. Mean serum AGP levels in the elderly subjects with slightly higher than in a reference group of younger subjects. The Con A non-reactive form of AGP was increased in 42% of the elderly population. An increase in the non-reactive form of AGP in CAIE should be considered as general expression of chronic inflammation which is of no clinical relevance.

Comparison of Gated Audiovisual Speech Identification in Elderly Hearing Aid Users and Elderly Normal-Hearing Individuals

PubMed Central

Lidestam, Björn; Rönnberg, Jerker

2016-01-01

The present study compared elderly hearing aid (EHA) users (n = 20) with elderly normal-hearing (ENH) listeners (n = 20) in terms of isolation points (IPs, the shortest time required for correct identification of a speech stimulus) and accuracy of audiovisual gated speech stimuli (consonants, words, and final words in highly and less predictable sentences) presented in silence. In addition, we compared the IPs of audiovisual speech stimuli from the present study with auditory ones extracted from a previous study, to determine the impact of the addition of visual cues. Both participant groups achieved ceiling levels in terms of accuracy in the audiovisual identification of gated speech stimuli; however, the EHA group needed longer IPs for the audiovisual identification of consonants and words. The benefit of adding visual cues to auditory speech stimuli was more evident in the EHA group, as audiovisual presentation significantly shortened the IPs for consonants, words, and final words in less predictable sentences; in the ENH group, audiovisual presentation only shortened the IPs for consonants and words. In conclusion, although the audiovisual benefit was greater for EHA group, this group had inferior performance compared with the ENH group in terms of IPs when supportive semantic context was lacking. Consequently, EHA users needed the initial part of the audiovisual speech signal to be longer than did their counterparts with normal hearing to reach the same level of accuracy in the absence of a semantic context. PMID:27317667

[Hyperthyroidism in the elderly: aspecific signs may cause a delay in diagnosis].

PubMed

Rozendaal, F P

2005-05-01

The clinical manifestations of thyroid diseases in the elderly are often atypical and can easily be attributed to other medical conditions or 'normal aging'. Two nursing home patients with hyperthyroidism are described. Due to the atypical presentation of the thyroid disease their complaints were attributed to other conditions. In both patients there was a significant delay in diagnosis and treatment of hyperthyroidism. In elder patients signs and symptoms of thyreotoxicosis are frequently related to cardiovascular, gastrointestinal and neuropsychiatric disorders. Most often occur atrial fibrillation, worsening of cardiac failure and angina pectoris, weight loss, anorexia, constipation, cognitive impairment and delirium. Delay of diagnosis and treatment of hyperthyroidism may be potentially harmful to the patient. Untreated thyreotoxicosis may lead to serious cardiovasculair complications (particularly cardiac failure and cerebrovascular accidents), mental deterioration and osteoporosis. In elder people with unexplained and vague signs and symptoms thyroid function should always be checked. The TSH assay is a very accurate diagnostic test for screening thyroid function. A normal TSH indicates euthyroidism with an accuracy of almost 100%. The medical treatment for hyperthyreoidism in the elderly are antithyroid drugs. When an euthyroid state is rendered, suppletion with L-thyroxine may be nessecary. Radioactive iodine treatment is preferred in some cases though there may be practical difficulties with the application of this treatment in nursing home patients because temporary isolation is necessary.

Testing of a long-term fall detection system incorporated into a custom vest for the elderly.

PubMed

Bourke, Alan K; van de Ven, Pepijn W J; Chaya, Amy E; OLaighin, Gearóid M; Nelson, John

2008-01-01

A fall detection system and algorithm, incorporated into a custom designed garment has been developed. The developed fall detection system uses a tri-axial accelerometer to detect impacts and monitor posture. This sensor is attached to a custom designed vest, designed to be worn by the elderly person under clothing. The fall detection algorithm was developed and incorporates both impact and posture detection capability. The vest and fall algorithm was tested by two teams of 5 elderly subjects who wore the sensor system in turn for 2 week each and were monitored for 8 hours a day. The system previously achieved sensitivity of >90% and a specificity of >99%, using young healthy subjects performing falls and normal activities of daily living (ADL). In this study, over 833 hours of monitoring was performed over the course of the four weeks from the elderly subjects, during normal daily activity. In this time no actual falls were recorded, however the system registered a total of the 42 fall-alerts however only 9 were received at the care taker site. A fall detection system incorporated into a custom designed garment has been developed which will help reduce the incidence of the long-lie, when falls occur in the elderly population. However further development is required to reduce the number of false-positives and improve the transmission of messages.

Yogurt supplemented with probiotics can protect the healthy elderly from respiratory infections: A randomized controlled open-label trial.

PubMed

Pu, Fangfang; Guo, Yue; Li, Ming; Zhu, Hong; Wang, Shijie; Shen, Xi; He, Miao; Huang, Chengyu; He, Fang

2017-01-01

To evaluate whether yogurt supplemented with a probiotic strain could protect middle-aged and elderly people from acute upper respiratory tract infections (URTI) using a randomized, blank-controlled, parallel-group design. Two hundred and five volunteers aged ≥45 years were randomly divided into two groups. The subjects in the intervention group were orally administered 300 mL/d of yogurt supplemented with a probiotic strain, Lactobacillus paracasei N1115 (N1115), 3.6×10 7 CFU/mL for 12 weeks, while those in the control group retained their normal diet without any probiotic supplementation. The primary outcome was the incidence of URTI, and changes in serum protein, immunoglobulins, and the profiles of the T-lymphocyte subsets (total T-cells [CD3 + ], T-helper cells [CD4 + ], and T-cytotoxic-suppressor cells [CD8 + ]) during the intervention were the secondary outcomes. Compared to the control group, the number of persons diagnosed with an acute URTI and the number of URTI events significantly decreased in the intervention group ( P =0.038, P =0.030, respectively). The risk of URTI in the intervention group was evaluated as 55% of that in the control group (relative risk =0.55, 95% CI: 0.307-0.969). The change in the percentage of CD3 + cells in the intervention group was significantly higher than in the control group ( P =0.038). However, no significant differences were observed in the total protein, albumin, globulin, and prealbumin levels in both groups ( P >0.05). The study suggested that yogurt with selected probiotic strains such as N1115 may reduce the risk of acute upper tract infections in the elderly. The enhancement of the T-cell-mediated natural immune defense might be one of the important underlying mechanisms for probiotics to express their anti-infective effects.

Yogurt supplemented with probiotics can protect the healthy elderly from respiratory infections: A randomized controlled open-label trial

PubMed Central

Pu, Fangfang; Guo, Yue; Li, Ming; Zhu, Hong; Wang, Shijie; Shen, Xi; He, Miao; Huang, Chengyu; He, Fang

2017-01-01

Purpose To evaluate whether yogurt supplemented with a probiotic strain could protect middle-aged and elderly people from acute upper respiratory tract infections (URTI) using a randomized, blank-controlled, parallel-group design. Patients and methods Two hundred and five volunteers aged ≥45 years were randomly divided into two groups. The subjects in the intervention group were orally administered 300 mL/d of yogurt supplemented with a probiotic strain, Lactobacillus paracasei N1115 (N1115), 3.6×107 CFU/mL for 12 weeks, while those in the control group retained their normal diet without any probiotic supplementation. The primary outcome was the incidence of URTI, and changes in serum protein, immunoglobulins, and the profiles of the T-lymphocyte subsets (total T-cells [CD3+], T-helper cells [CD4+], and T-cytotoxic-suppressor cells [CD8+]) during the intervention were the secondary outcomes. Results Compared to the control group, the number of persons diagnosed with an acute URTI and the number of URTI events significantly decreased in the intervention group (P=0.038, P=0.030, respectively). The risk of URTI in the intervention group was evaluated as 55% of that in the control group (relative risk =0.55, 95% CI: 0.307–0.969). The change in the percentage of CD3+ cells in the intervention group was significantly higher than in the control group (P=0.038). However, no significant differences were observed in the total protein, albumin, globulin, and prealbumin levels in both groups (P>0.05). Conclusion The study suggested that yogurt with selected probiotic strains such as N1115 may reduce the risk of acute upper tract infections in the elderly. The enhancement of the T-cell-mediated natural immune defense might be one of the important underlying mechanisms for probiotics to express their anti-infective effects. PMID:28848330

Self-Control and Coping Skills as Factors in Pain Perception, Perceived Health and Psychological Adjustment in the Elderly.

ERIC Educational Resources Information Center

Dietrich, Coralie; And Others

Self-control and self-efficacy have played a central role in recent behavioral medicine work on the control of chronic physical pain. Little work investigating the concepts of self-control and self-efficacy has been done with the elderly in spite of the fact that coping strategies in the elderly have been associated with a variety of health and…

Informed Consent and Cognitive Dysfunction After Noncardiac Surgery in the Elderly.

PubMed

Hogan, Kirk J; Bratzke, Lisa C; Hogan, Kendra L

2018-02-01

Cognitive dysfunction 3 months after noncardiac surgery in the elderly satisfies informed consent thresholds of foreseeability in 10%-15% of patients, and materiality with new deficits observed in memory and executive function in patients with normal test performance beforehand. At present, the only safety step to avoid cognitive dysfunction after surgery is to forego surgery, thereby precluding the benefits of surgery with removal of pain and inflammation, and resumption of normal nutrition, physical activity, and sleep. To assure that consent for surgery is properly informed, risks of both cognitive dysfunction and alternative management strategies must be discussed with patients by the surgery team before a procedure is scheduled.

Facial recognition: a cognitive study of elderly dementia patients and normal older adults.

PubMed

Zandi, T; Cooper, M; Garrison, L

1992-01-01

Dementia patients' and normal elderlies' recognition of familiar, ordinary emotional and facial expressions was tested. In three conditions subjects were required to name the emotions depicted in pictures and to produce them while presented with the verbal labels of the expressions. The dementia patients' best performance occurred when they had access to the verbal labels while viewing the pictures. The major deficiency in facial recognition was found to be dysnomia related. Findings of this study suggest that the connection between the gnostic units of expression and the gnostic units of verbal labeling is not impaired significantly among the dementia patients.

Selective attention skills in differentiating between Alzheimer's disease and normal aging.

PubMed

Solfrizzi, Vincenzo; Panza, Francesco; Torres, Francesco; Capurso, Cristiano; D'Introno, Alessia; Colacicco, Anna Maria; Capurso, Antonio

2002-01-01

We determined the reliability and validity of a cancellation test of symbols (Symbol Cancellation Test [SCT]), designed to assess visual selective attention deficits in the elderly, on 34 Alzheimer's disease (AD) patients from Bari University Hospital Center, Bari, Italy, and 232 nondemented elderly subjects, aged 68 to 87 years, from the second prevalence survey (1995 through 1996) of the Italian Longitudinal Study on Aging (Casamassima, Bari, Italy). To assess convergent and discriminant validity, the Digit Cancellation Test (DCT), Mini-Mental State Examination (MMSE), and Babcock Story Recall Test (BSRT) were administered. Finally, discriminant accuracy of SCT between AD patients and nondemented elderly subjects was assessed. Inter-rater and test-retest reliability for P1 and P2 was excellent for both AD patients and the normal population, with a high degree of internal consistency. The SCT was significantly correlated with the DCT (0.67), MMSE (0.60), and BSRT (0.33). The classification accuracies of overall performance on the SCT for subjects with and without AD were 0.62 and 0.91, respectively. The SCT is a valid and reliable test to assess selective attention in elderly subjects, in whom dementing illness must be diagnosed and clinically distinct from age-related cognitive decline.

The influence of gait speed on the stability of walking among the elderly.

PubMed

Fan, Yifang; Li, Zhiyu; Han, Shuyan; Lv, Changsheng; Zhang, Bo

2016-06-01

Walking speed is a basic factor to consider when walking exercises are prescribed as part of a training programme. Although associations between walking speed, step length and falling risk have been identified, the relationship between spontaneous walking pattern and falling risk remains unclear. The present study, therefore, examined the stability of spontaneous walking at normal, fast and slow speed among elderly (67.5±3.23) and young (21.4±1.31) individuals. In all, 55 participants undertook a test that involved walking on a plantar pressure platform. Foot-ground contact data were used to calculate walking speed, step length, pressure impulse along the plantar-impulse principal axis and pressure record of time series along the plantar-impulse principal axis. A forward dynamics method was used to calculate acceleration, velocity and displacement of the centre of mass in the vertical direction. The results showed that when the elderly walked at different speeds, their average step length was smaller than that observed among the young (p=0.000), whereas their anterior/posterior variability and lateral variability had no significant difference. When walking was performed at normal or slow speed, no significant between-group difference in cadence was found. When walking at a fast speed, the elderly increased their stride length moderately and their cadence greatly (p=0.012). In summary, the present study found no correlation between fast walking speed and instability among the elderly, which indicates that healthy elderly individuals might safely perform fast-speed walking exercises. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical Practices and Outcomes in Elderly Hemodialysis Patients: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)

PubMed Central

Tong, Lin; Tentori, Francesca; Akiba, Takashi; Karaboyas, Angelo; Gillespie, Brenda; Akizawa, Tadao; Pisoni, Ronald L.; Bommer, Juergen; Port, Friedrich K.

2011-01-01

Summary Background and objectives Demand for hemodialysis among elderly patients is increasing worldwide. Although clinical care of this high-risk group is complex and challenging, no guidelines exist to inform hemodialysis practices. The Dialysis Outcomes and Practice Patterns Study (DOPPS) provides a unique opportunity to assess dialysis practices and associated outcomes among elderly versus younger patients on chronic in-center hemodialysis in 12 countries. Design, setting, participants, & measurements Clinical characteristics, dialysis practices, and outcomes of elderly versus younger patients were compared among participants in four DOPPS regions in 2005 through 2007. Results Although participant mean age increased over time in all DOPPS countries, the percentage of elderly varied widely. Overall, comorbidities and malnutrition were more common in the elderly. Fistulae were used less frequently among elderly versus younger patients in Europe and North America but not in Australia, New Zealand, and Japan. No difference in treatment time was observed between elderly and younger patients after normalizing for body weight. In all regions, ultrafiltration rates were lower among elderly patients. Elderly patients reported poorer quality of life with respect to the physical but not mental component scores. Mortality risk was three- to sixfold higher in the elderly group, whereas causes of death overall were similar for elderly and younger patients. Conclusions Elderly patients represent a different proportion of DOPPS participants across countries, possibly reflecting differences in policies and clinical practices. In general, hemodialysis practices in the elderly reflected each region's clinical patterns, with some variation by age group depending upon the practice. PMID:21734085

Misperception among rural diabetic residents: a cross-sectional descriptive study.

PubMed

Huang, Tzu-Ting; Guo, Su-Er; Chang, Chia-Hao; Huang, Jui-Chu; Lin, Ming-Shyan; Lee, Chia-Mou; Chen, Mei-Yen

2013-04-01

To evaluate the self-perception of diabetes control associated with physical indicators and with practicing exercise and a healthy diet, among rural residents. It remains unclear whether a subject's self-perception of diabetes control increases its deleterious effects. Cross-sectional, correlational. We recruited 715 participants from 18 primary healthcare centres in the rural regions of Chiayi County, Taiwan. Data were collected between 1 January 2009-30 June 2010. Logistic regression was conducted to identify the determinant factors associated with perceptions of diabetes control. A high percentage of participants overestimated their fasting blood glucose and HbA1 C status. Total cholesterol, triglyceride, low density lipoprotein cholesterol, blood pressure, and waist circumference exceeded the medical standard in the 'feel good' group, and many did not adopt a healthy diet and undertake physical activity. The final logistic regression model demonstrated that residents with diabetes who exercised frequently had normal fasting glucose, and normal HbA1 C tended to perceive 'feel good' control. Misperception and unawareness of diabetes control were prevalent among rural residents. Addressing misperceptions among rural residents with diabetes and increasing their knowledge of professional advice could be important steps in improving diabetes control in an elder population. © 2012 Blackwell Publishing Ltd.

INFLUENCE OF AGE ON NEUROMUSCULAR CONTROL DURING A DYNAMIC WEIGHT BEARING TASK

PubMed Central

Madhavan, Sangeetha; Burkart, Sarah; Baggett, Gail; Nelson, Katie; Teckenburg, Trina; Zwanziger, Mike; Shields, Richard K.

2009-01-01

Neuromuscular control strategies may change with age and predispose elderly to knee joint injury. The purposes of this study were to determine if long latency responses (LLR), muscle activation patterns, and movement accuracy differs between the young and elderly during a novel single limb squat (SLS) task. Ten young and ten elderly subjects performed a series of resistive SLS (~0–30 degrees) while matching a computer-generated sinusoidal target. The SLS device provided a 16% body weight resistance to knee movement. Both young and elderly showed significant overshoot error when the knee was perturbed (p < 0.05). Accuracy of the tracking task was similar between the young and elderly (p=0.34), but the elderly required more muscle activity compared to the younger subjects (p < 0.05). The elderly group had larger long latency responses (LLRs) than the younger group (p < 0.05). These results support that neuromuscular control of the knee changes with age, and may contribute to injury. PMID:19799103

Influence of age, sex, and education on the Visual Object and Space Perception Battery (VOSP) in a healthy normal elderly population.

PubMed

Herrera-Guzmán, I; Peña-Casanova, J; Lara, J P; Gudayol-Ferré, E; Böhm, P

2004-08-01

The assessment of visual perception and cognition forms an important part of any general cognitive evaluation. We have studied the possible influence of age, sex, and education on a normal elderly Spanish population (90 healthy subjects) in performance in visual perception tasks. To evaluate visual perception and cognition, we have used the subjects performance with The Visual Object and Space Perception Battery (VOSP). The test consists of 8 subtests: 4 measure visual object perception (Incomplete Letters, Silhouettes, Object Decision, and Progressive Silhouettes) while the other 4 measure visual space perception (Dot Counting, Position Discrimination, Number Location, and Cube Analysis). The statistical procedures employed were either simple or multiple linear regression analyses (subtests with normal distribution) and Mann-Whitney tests, followed by ANOVA with Scheffe correction (subtests without normal distribution). Age and sex were found to be significant modifying factors in the Silhouettes, Object Decision, Progressive Silhouettes, Position Discrimination, and Cube Analysis subtests. Educational level was found to be a significant predictor of function for the Silhouettes and Object Decision subtests. The results of the sample were adjusted in line with the differences observed. Our study also offers preliminary normative data for the administration of the VOSP to an elderly Spanish population. The results are discussed and compared with similar studies performed in different cultural backgrounds.

Sex hormones and the elderly male voice.

PubMed

Gugatschka, Markus; Kiesler, Karl; Obermayer-Pietsch, Barbara; Schoekler, Bernadette; Schmid, Christoph; Groselj-Strele, Andrea; Friedrich, Gerhard

2010-05-01

The objective was to describe influences of sex hormones on the male voice in an elderly cohort. Sixty-three elderly males were recruited to undergo assessment of voice parameters, stroboscopy, voice-related questionnaires, a blood draw, and an ultrasound examination of the laryngeal skeleton. The group was divided into men with normal hormonal status and men with lowered levels of sex hormones, called hypogonades. Depending on the level of androgens, voice parameters did not differ. In subjects with decreased levels of estrogens, a significant increase in mean fundamental frequency, as well as changes of highest and lowest frequency plus a shift of the frequency range could be detected. We could detect significant changes of voice parameters depending on status of estrogens in elderly males. Androgens appear to have no impact on the elderly male voice. To our knowledge, this is the first prospective study that correlates sex hormones with voice parameters in elderly men. (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Enhancing vestibular function in the elderly with imperceptible electrical stimulation.

PubMed

Serrador, Jorge M; Deegan, Brian M; Geraghty, Maria C; Wood, Scott J

2018-01-10

Age-related loss of vestibular function can result in decrements in gaze stabilization and increased fall risk in the elderly. This study was designed to see if low levels of electrical stochastic noise applied transcutaneously to the vestibular system can improve a gaze stabilization reflex in young and elderly subject groups. Ocular counter-rolling (OCR) using a video-based technique was obtained in 16 subjects during low frequency passive roll tilts. Consistent with previous studies, there was a significant reduction in OCR gains in the elderly compared to the young group. Imperceptible stochastic noise significantly increased OCR in the elderly (Mean 23%, CI: 17-35%). Increases in OCR gain were greatest for those with lowest baseline gain and were negligible in those with normal gain. Since stimulation was effective at low levels undetectable to subjects, stochastic noise may provide a new treatment alternative to enhance vestibular function, specifically otolith-ocular reflexes, in the elderly or patient populations with reduced otolith-ocular function.

Correlation between hypertension and cognitive function in elderly

NASA Astrophysics Data System (ADS)

Fitri, F. I.; Rambe, A. S.

2018-03-01

Hypertension and cognitive impairment are common disorders among elderly adults, and their prevalences tend to rise as the population ages. This study aimed to determine the correlation between hypertension and cognitive function in elderly. It was a cross-sectional study involving 62 elderly subjects. All subjects underwent physical and neurologic examination and Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) to assess cognitive function. This study included 62 subjects consisted of 26 males (41.9%) and 36 females (58.1%). There were 24 subjects (38.2%) with hypertension and 38 (61.3%) normal elderly subjects. The mean age was 65.71±4.49 years old. There were no significant differences in demographic characteristics, total MoCA-INA scores, and scores based on cognitive domains between two groups, except for visuospatial and executive function (p=0.026). There was a significant correlation between hypertension and visuospatial and executive function (r=0.301, p=0.017). Hypertension is correlated with cognitive impairment mainly on visuospatial and executive function in elderly.

[Loneliness and self-management abilities in the visually impaired elderly].

PubMed

Alma, M A; Van der Mei, S F; Feitsma, W N; Groothoff, J W; Van Tilburg, T G; Suurmeijer, T P B M

2013-06-01

To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly. In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively. The prevalence of loneliness among the visually impaired elderly was higher compared to the reference group (50% vs 29%; p < .001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness. The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, since SMAs can be learned through training. Consequently, self-management training may reduce feelings of loneliness. An adapted version of this paper was published in Journal of Aging and Health, doi: 10.1177/0898264311399758.

Balance Training Enhances Vestibular Function and Reduces Overactive Proprioceptive Feedback in Elderly

PubMed Central

Wiesmeier, Isabella K.; Dalin, Daniela; Wehrle, Anja; Granacher, Urs; Muehlbauer, Thomas; Dietterle, Joerg; Weiller, Cornelius; Gollhofer, Albert; Maurer, Christoph

2017-01-01

Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training program on these postural control impairments using a brain network model based on system identification techniques. Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model. Results: With balance training, the elderly subjects significantly reduced their overly large postural reactions and approximated those of younger subjects. Less significant differences between elderly and young subjects' postural control, namely larger spontaneous sway amplitudes, velocities, and frequencies, larger overall time delays and a weaker motor feedback compared to young subjects were not significantly affected by the balance training. Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits. PMID:28848430

Being single in old age.

PubMed

Gubrium, J F

1975-01-01

The routine, everyday life of single elders differs from that of other old people. On the basis of interview date both about themselves and some aspects of the quality of their everyday lives, it is proposed that single elders constitute a distinct type of social personality in old age. Interviews provide subjective and methodological evidence to support this. The "normal", taken-for-granted social world of single elders is: relatively isolated; but not perceived in terms of loneliness, at present or anticipated; and considered an ordinary extension of their past. Death is conceived as "just another" event of their ongoing experiences.

Greater regional brain atrophy rate in healthy elders with a history of cigarette smoking

PubMed Central

Durazzo, Timothy C.; Insel, Philip S.; Weiner, Michael W.; Initiative, the Alzheimer Disease Neuroimaging

2011-01-01

Background Little is known about the effects of cigarette smoking on brain morphological changes in the elderly. This study investigated the effects of a history of cigarette smoking on changes in regional brain volumes over 2-years in healthy, cognitively-intact elderly individuals. We predicted individuals with a history of cigarette smoking, compared to never smokers, demonstrate greater rate of atrophy over 2-years in regions that manifest morphological abnormalities in the early stages of Alzheimer Disease (AD), as well as the extended brain reward system (BRS), which is implicated in the development and maintenance of substance use disorders. Methods Participants were healthy, cognitively normal elderly controls (75.9±4.8 years of age) with any lifetime history of cigarette smoking (n = 68) and no history of smoking (n = 118). Data was obtained via the Alzheimer Disease Neuroimaging Initiative from 2005–2010. Participants completed four magnetic resonance scans over 2-years. A standardized protocol employing high resolution 3D T1-weighted sequences at 1.5 Tesla was used for structural imaging and regional brain volumetric analyses. Results Smokers demonstrated significantly greater rate atrophy over 2-years than non-smokers in multiple brain regions associated with the early stages of AD as well as in the BRS. Groups were not different on rate of global cortical atrophy. Conclusions A history of cigarette smoking in this healthy elderly cohort was associated with decreased structural integrity of multiple brain regions, which was manifest as a greater rate of atrophy over 2-years in regions specifically affected by incipient AD as well as chronic substance abuse. PMID:23102121

Kyphoplasty for vertebral augmentation in the elderly with osteoporotic vertebral compression fractures: scenarios and review of recent studies.

PubMed

Bednar, Timothy; Heyde, Christoph E; Bednar, Grace; Nguyen, David; Volpi, Elena; Przkora, Rene

2013-11-01

Vertebral compression fractures caused by osteoporosis are among the most common fractures in the elderly. The treatment focuses on pain control, maintenance of independence, and management of the osteoporosis. Elderly patients often encounter adverse effects to pain medications, do not tolerate bed rest, and are not ideal candidates for invasive spinal reconstructive surgery. Percutaneous vertebral augmentation (vertebroplasty or kyphoplasty) has become popular as a less-invasive alternative. However, studies have questioned the effectiveness of these procedures. The authors conducted a MEDLINE search using relevant search terms including osteoporosis, osteoporotic vertebral compression fracture, elderly, kyphoplasty and vertebroplasty. Two elderly patients presented with a fracture of their third and first lumbar vertebral body, respectively. One patient progressed well with conservative treatment, whereas the other patient was hospitalized secondary to pain after conservative measures failed to offer improvement. The hospitalized patient subsequently opted for a kyphoplasty and was able to resume his normal daily activities after the procedure. Selecting patients on an individual case-by-case basis can optimize the effectiveness and outcomes of a vertebral augmentation. This process includes the documentation of an osteoporotic vertebral compression fracture with the aide of imaging studies, including the acuity of the fracture as well as the correlation with the physical examination findings. Patients who are functional and improving under a conservative regimen are not candidates for kyphoplasty. However, if the conservative management is not successful after 4 to 6 weeks and the patient is at risk to become bedridden, an augmentation should be considered. A kyphoplasty procedure may be preferred over vertebroplasty, given the lower risk profile and better outcomes regarding spinal alignment. Published by Elsevier HS Journals, Inc.

Potential contribution of the neurodegenerative disorders risk loci to cognitive performance in an elderly male gout population.

PubMed

Han, Lin; Jia, Zhaotong; Cao, Chunwei; Liu, Zhen; Liu, Fuqiang; Wang, Lin; Ren, Wei; Sun, Mingxia; Wang, Baoping; Li, Changgui; Chen, Li

2017-09-01

Cognitive impairment has been described in elderly subjects with high normal concentrations of serum uric acid. However, it remains unclear if gout confers an increased poorer cognition than those in individuals with asymptomatic hyperuricemia. The present study aimed at evaluating cognitive function in patients suffering from gout in an elderly male population, and further investigating the genetic contributions to the risk of cognitive function.This study examined the cognitive function as assessed by Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in 205 male gout patients and 204 controls. The genetic basis of these cognitive measures was evaluated by genome-wide association study (GWAS) data in 102 male gout patients. Furthermore, 7 loci associated with cognition in GWAS were studied for correlation with gout in 1179 male gout patients and 1848 healthy male controls.Compared with controls, gout patients had significantly lower MoCA scores [22.78 ± 3.01 vs 23.42 ± 2.95, P = .023, adjusted by age, body mass index (BMI), education, and emotional disorder]. GWAS revealed 7 single-nucleotide polymorphisms (SNPs) associations with MoCA test at a level of conventional genome-wide significance (P < 9.6 × 10). The most significant association was observed between rs12895072 and rs12434554 within the KTN1 gene (Padjusted = 4.2 × 10, Padjusted = 4.7 × 10) at 14q22. The next best signal was in RELN gene (rs155333, Padjusted = 1.3 × 10) at 7q22, while the other variants at rs17458357 (Padjusted = 3.98 × 10), rs2572683 (Padjusted = 8.9 × 10), rs12555895 (Padjusted = 2.6 × 10), and rs3764030 (Padjusted = 9.4 × 10) were also statistically significant. The 7 SNPs were not associated with gout in further analysis (all P > .05).Elderly male subjects with gout exhibit accelerated decline in cognition performance. Several neurodegenerative disorders risk loci were identified for genetic contributors to cognitive performance in our Chinese elderly male gout population. Larger prospective studies of the cognitive performance and genetic analysis in gout subjects are recommended.

[Risk factors on anemia among rural elderly women aged 50-75 y in Xinning county, Anhui province, China].

PubMed

Zhang, Jian; Wang, Chun-Rong; Jin, Shao-Hua; Song, Peng-Kun; Meng, Li-Ping; Man, Qing-Qing; Jia, Shang-Chun

2009-03-01

To study the risk factors on anemia among elderly women in rural areas of Xiuning county, Anhui province, China. Xiuning county was selected as working field and elderly women aged 50-75 y were selected as subjects. Finger hemoglobin (Hb) was measured and basic health survey was face-to-face interviewed. 220 elderly women with anemia entered into the case group; and matched by age, another 220 women with normal Hb concentration entered the control group. Survey on diet, questionnaire regarding health and lifestyle and related blood indexes were studied and tested. When comparing the data from both case and control groups, weight was (49.4 +/- 7.3) kg vs. (52.5 +/- 8.4) kg (t = 3.97, P < 0.01), waist circumference was (75.8 +/- 7.8) cm vs. (79.1 +/- 9.3) cm (t = 3.85, P < 0.01), BMI was (21.8 +/- 2.6) kg/m2 vs. (22.9 +/- 3.2) kg/m2 (t = 3.775, P < 0.01), respectively. The total protein was (76.4 +/- 5.0) g/L vs. (78.4 +/- 5.6)g/L (t = 3.83, P < 0.01), albumin was (45.7 +/- 3.1) g/L vs. (47.3 +/- 2.9)g/L (t = 5.24, P < 0.01), serum iron was ( 10.3 +/- 4.1) micromol/L vs. (12.7 +/- 4.6) micromol/L (t = 5.48, P < 0.01), and saturation of transferrin was (19.0 +/- 7.6)% vs. (23.1 +/- 9.1) % (t = 4.90, P < 0.01), respectively. Results from multifactor conditioned logistic regression analysis showed that the odd ratios (OR) for anemia with staple food, BMI and vitamin A were 1.54, 1.89, 1.69, and the OR for anemia with BMI, staple food, animal food, carbohydrate and vitamin A were 2.0, 1.6, 1.6, 1.4, 1.6, with their confidence intervals (CI) as 1.3-2.9, 1.1-2.3, 1.0-2.3, 1.0-2.1, 1.1-2.4, respectively. The quality of diet, health status and related blood indexes on anemia among elderly women were lower than that in control group. Lower BMI, less staple food and animal food, less carbohydrate and vitamin A intake appeared to be risk factors of anemia.

Current prevention and control of health care-associated infections in long-term care facilities for the elderly in Japan.

PubMed

Kariya, Naoko; Sakon, Naomi; Komano, Jun; Tomono, Kazunori; Iso, Hiroyasu

2018-05-01

Residents of long-term care facilities for the elderly are vulnerable to health care-associated infections. However, compared to medical institutions, long-term care facilities for the elderly lag behind in health care-associated infection control and prevention. We conducted a epidemiologic study to clarify the current status of infection control in long-term care facilities for the elderly in Japan. A questionnaire survey on the aspects of infection prevention and control was developed according to SHEA/APIC guidelines and was distributed to 617 long-term care facilities for the elderly in the province of Osaka during November 2016 and January 2017. The response rate was 16.9%. The incidence rates of health care-associated infection outbreaks and residents with health care-associated infections were 23.4 per 100 facility-years and 0.18 per 1,000 resident-days, respectively. Influenza and acute gastroenteritis were reported most frequently. Active surveillance to identify the carrier of multiple drug-resistant organisms was not common. The overall compliance with 21 items selected from the SHEA/APIC guidelines was approximately 79.2%. All facilities had infection control manuals and an assigned infection control professional. The economic burdens of infection control were approximately US$ 182.6 per resident-year during fiscal year 2015. Importantly, these data implied that physicians and nurses were actively contributed to higher SHEA/APIC guideline compliance rates and the advancement of infection control measures in long-term care facilities for the elderly. Key factors are discussed to further improve the infection control in long-term care facilities for the elderly, particularly from economic and social structural standpoints. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Case Report of Serratus Plane Catheter for Pain Management in a Patient With Multiple Rib Fractures and an Inferior Scapular Fracture.

PubMed

Fu, Peter; Weyker, Paul D; Webb, Christopher A J

2017-03-15

We placed a superficial serratus anterior plane catheter in an elderly woman with dementia and elevated clotting times who presented with multiple rib fractures after a mechanical fall. She was not a surgical candidate, and treatment consisted of conservative management with physical therapy and pain control. She was not a candidate for a patient-controlled analgesia regimen because of her dementia. Given her elevated international normalized ratio, thoracic epidural and paravertebral analgesia was also contraindicated. We placed an ultrasound-guided serratus anterior plane catheter, allowing titratable continuous infusion in a trauma patient, resulting in excellent analgesia without adverse effects.

Quantitative neuropathological study of Alzheimer-type pathology in the hippocampus: comparison of senile dementia of Alzheimer type, senile dementia of Lewy body type, Parkinson's disease and non-demented elderly control patients.

PubMed

Ince, P; Irving, D; MacArthur, F; Perry, R H

1991-12-01

A Lewy body dementing syndrome in the elderly has been recently described and designated senile dementia of Lewy body type (SDLT) on the basis of a distinct clinicopathological profile. The pathological changes seen in SDLT include the presence of cortical Lewy bodies (LB) frequently, but not invariably, associated with senile plaque (SP) formation. Whilst neocortical neurofibrillary tangles (NFT) are sparse or absent, a proportion of these cases show involvement of the temporal archicortex by lesions comprising Alzheimer-type pathology (ATP, i.e. NFT, SP and granulovacuolar degeneration [GVD]). Thus the relationship between SDLT and senile dementia of Alzheimer type (SDAT) is complex and controversial. In this study quantitative neuropathology was used to compare the intensity and distribution of ATP in the hippocampus and entorhinal cortex of 53 patients from 3 disease groups (SDLT, SDAT, Parkinson's disease (PD)) and a group of neurologically and mentally normal elderly control patients. For most brain areas examined the extent of ATP between the patient groups followed the trend SDAT greater than SDLT greater than PD greater than control. Statistical comparison of these groups revealed significant differences between the mean densities of NFT, SP and GVD although individual cases showed considerable variability. These results confirm additional pathological differences between SDAT and SDLT regarding the intensity of involvement of the temporal archicortex by ATP. Many patients with Lewy body disorders (LBdis) show a predisposition to develop ATP albeit in a more restricted distribution (e.g. low or absent neocortical NFT) and at lower densities than is found in SDAT. Some cases of SDLT show minimal SP and NFT formation in both neocortex and archicortex supporting previously published data distinguishing this group from Alzheimer's disease.

Food intake in the real world: implications for nutrition and aging.

PubMed

de Castro, John M; Stroebele, Nanette

2002-11-01

Nutrient intakes are affected by two classes of factors, physiological and environmental. In the real world, environmental variables such as social factors, palatability, and the time of eating appear to have large influences on amounts ingested in the short-term. Physiological control mechanisms also operate to regulate intake, and they induce compensatory responses to deviations from the norm. These physiological influences only appear to have weak influences on short-term intake unless there are large deviations from the normal state, but over the long-term they act patiently and persistently to rectify the excesses produced by environmental fluctuations and thereby tend to maintain a relative balance between energy intake and expenditure. As individuals age there is a progressive decline in physiological function including the mechanisms that act to control intake in the young. This should not produce a problem in a healthy individual in a stable environment: however, if that situation should change due to illness or an environmental change such as the death of a spouse, which produces decline in intake, elderly individuals would not have the physiological mechanisms present to compensate. Thus, the deficit in energy intake would not be replaced, and the lower level of intake would be maintained as long as the new health condition or environment remains stable. Hence, the decline in the effectiveness of the physiological systems with age makes the elderly particularly vulnerable and unable to rebound from deficits. Although the elderly have difficulty compensating for deficits automatically by physiologically-induced adjustments, the studies of real world intake reviewed in this article suggest that compensation can be produced by adjustments to the environment. The elderly appear to be as responsive to environmental factors as younger individuals. In particular, they appear to increase intake in response to social facilitation, diurnal rhythms, the eating environment, and palatability to the same extent as their juniors. These data suggest that alterations in the social, temporal, environmental, or hedonic conditions of eating could induce desired alterations in the nutrient intakes of the elderly. The study of real world eating behavior has produced evidence that suggests that this strategy can work. It remains for future applied investigations to ascertain whether or not this strategy is effective in treating undernutrition in the elderly.

Comparison of Gated Audiovisual Speech Identification in Elderly Hearing Aid Users and Elderly Normal-Hearing Individuals: Effects of Adding Visual Cues to Auditory Speech Stimuli.

PubMed

Moradi, Shahram; Lidestam, Björn; Rönnberg, Jerker

2016-06-17

The present study compared elderly hearing aid (EHA) users (n = 20) with elderly normal-hearing (ENH) listeners (n = 20) in terms of isolation points (IPs, the shortest time required for correct identification of a speech stimulus) and accuracy of audiovisual gated speech stimuli (consonants, words, and final words in highly and less predictable sentences) presented in silence. In addition, we compared the IPs of audiovisual speech stimuli from the present study with auditory ones extracted from a previous study, to determine the impact of the addition of visual cues. Both participant groups achieved ceiling levels in terms of accuracy in the audiovisual identification of gated speech stimuli; however, the EHA group needed longer IPs for the audiovisual identification of consonants and words. The benefit of adding visual cues to auditory speech stimuli was more evident in the EHA group, as audiovisual presentation significantly shortened the IPs for consonants, words, and final words in less predictable sentences; in the ENH group, audiovisual presentation only shortened the IPs for consonants and words. In conclusion, although the audiovisual benefit was greater for EHA group, this group had inferior performance compared with the ENH group in terms of IPs when supportive semantic context was lacking. Consequently, EHA users needed the initial part of the audiovisual speech signal to be longer than did their counterparts with normal hearing to reach the same level of accuracy in the absence of a semantic context. © The Author(s) 2016.

Moderating Effects of Cortisol on Neural-Cognitive Association in Cognitively Normal Elderly Subjects

PubMed Central

Lau, Way K. W.; Leung, Mei Kei; Law, Andrew C. K.; Lee, Tatia M. C.

2017-01-01

Cortisol homeostasis is important for healthy brain and cognitive aging. The aim of the current study is to investigate the role of serum cortisol levels in the relationship between regional brain volumes and cognitive processing speed in a group of cognitively normal elderly subjects. Forty-one healthy elderly participants were from a parallel longitudinal study. The reported data in this study reflects baseline measurements. Whole-brain anatomical scanning was performed using a 3.0 Tesla Philips Medical Systems Achieva scanner. Cognitive processing speed was assessed by the digit-symbol and symbol search tests, from the Chinese version of the Wechsler Adult Intelligence Scale—third edition (WAIS-III). Serum cortisol levels (sampled in the late morning) were measured by ELISA kits. Whole-brain regression analysis revealed that serum cortisol levels positively predicted the white matter volumes (WMV) of the right thalamus, the gray matter volumes (GMV) of the left thalamus and right cerebellar tonsil, and negatively predicted the WMV and GMV of the left middle temporal gyrus (MTG) in 41 healthy elderly participants. Furthermore, serum cortisol significantly moderated the relationship between the GMV of the left MTG and processing speed, as well as the GMV of the left thalamus and processing speed. This study provided the first piece of evidence supporting serum cortisol levels in moderating the relationship between regional brain volumes and processing speed in healthy elderly subjects. This observation enriches our understanding of the role of cortisol in brain morphology and cognitive functioning. PMID:28596732

Oral Health-Related Quality of Life in the Elderly in Israel--Results from the National Health and Nutrition Survey of the Elderly 2005-2006.

PubMed

Zusman, Shlomo Paul; Kushnir, Daniel; Natapov, Lena; Goldsmith, Rebecca; Dichtiar, Rita

2016-01-01

To assess the oral health-related quality of life of the Israeli elderly. Data were collected from a subsample of those interviewed for the cross-sectional Mabat Zahav National Health and Nutrition Survey of the Elderly, carried out in 2005 and 2006 by the Ministry of Health in Israel. In-person interviews were conducted in the interviewees' homes using a structured questionnaire which included 7 questions on subjective dental health status and the 14 questions of the Oral Health Impact Profile 14 (OHIP-14). Statistical significance of continuous variables was assessed with the Student t-test; categorical variables with normal distribution were analysed using the chi-square test and those with non-normal distribution with the Wilcoxon Mann-Whitney two-sample test. 828 Jews and 159 Arabs from the total survey population of 1852 elderly (1536 Jews and 316 Arabs) completed the OHIP-14 questionnaire. An impact of oral health on the quality of life was reported by 16.6% of the respondents, 19.2% of females and 13.9% of males (p<0.05). There were statistically significant differences in impact prevalence by gender, place of birth and economic status. No such differences were found by age group, population group or education. Significant statistical correlation was found between subjective assessment of general and dental health and OHIP impact prevalence, with poorer assessment correlated with increased prevalence of impact. The quality of life of 17% of Israeli elderly is affected by oral health. The OHIP-14 findings emphasise the importance of including basic dental treatment (treatment of dental pain and infections) in the range of services covered by the National Health Insurance Law.

Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among the elderly: the EXERNET multi-center study.

PubMed

Pedrero-Chamizo, R; Gómez-Cabello, A; Meléndez, A; Vila-Maldonado, S; Espino, L; Gusi, N; Villa, G; Casajús, J A; González-Gross, M; Ara, I

2015-02-01

To evaluate the associations between physical fitness levels, health related quality of life (HRQoL) and sarcopenic obesity (SO) and to analyze the usefulness of several physical fitness tests as a screening tool for detecting elderly people with an increased risk of suffering SO. Cross-sectional analysis of a population-based sample. Non-institutionalized Spanish elderly participating in the EXERNET multi-centre study. 2747 elderly subjects aged 65 and older. Body weight, height and body mass index were evaluated in each subject. Body composition was measured by bioelectrical impedance. Four SO groups were created based on percentage of body fat and relative muscle mass; 1) normal group, 2) sarcopenic group, 3) obesity group and 4) SO group. Physical fitness was evaluated using 8 tests (balance, lower and upper body strength, lower and upper body flexibility, agility, walking speed and aerobic capacity). Three tertiles were created for each test based on the calculated scores. HRQoL was assessed using the EuroQol visual analogue scale. Participants with SO showed lower physical fitness levels compared with normal subjects. Better balance, agility, and aerobic capacity were associated to a lower risk of suffering SO in the fittest men (odds ratio < 0.30). In women, better balance, walking speed, and aerobic capacity were associated to a lower risk of suffering SO in the fittest women (odds ratio < 0.21) Superior perceived health was associated with better physical fitness performance. Higher levels of physical fitness were associated with a reduced risk of suffering SO and better perceived health among elderly. SO elderly people have lower physical functional levels than healthy counterparts.

Normal aging affects movement execution but not visual motion working memory and decision-making delay during cue-dependent memory-based smooth-pursuit.

PubMed

Fukushima, Kikuro; Barnes, Graham R; Ito, Norie; Olley, Peter M; Warabi, Tateo

2014-07-01

Aging affects virtually all functions including sensory/motor and cognitive activities. While retinal image motion is the primary input for smooth-pursuit, its efficiency/accuracy depends on cognitive processes. Elderly subjects exhibit gain decrease during initial and steady-state pursuit, but reports on latencies are conflicting. Using a cue-dependent memory-based smooth-pursuit task, we identified important extra-retinal mechanisms for initial pursuit in young adults including cue information priming and extra-retinal drive components (Ito et al. in Exp Brain Res 229:23-35, 2013). We examined aging effects on parameters for smooth-pursuit using the same tasks. Elderly subjects were tested during three task conditions as previously described: memory-based pursuit, simple ramp-pursuit just to follow motion of a single spot, and popping-out of the correct spot during memory-based pursuit to enhance retinal image motion. Simple ramp-pursuit was used as a task that did not require visual motion working memory. To clarify aging effects, we then compared the results with the previous young subject data. During memory-based pursuit, elderly subjects exhibited normal working memory of cue information. Most movement-parameters including pursuit latencies differed significantly between memory-based pursuit and simple ramp-pursuit and also between young and elderly subjects. Popping-out of the correct spot motion was ineffective for enhancing initial pursuit in elderly subjects. However, the latency difference between memory-based pursuit and simple ramp-pursuit in individual subjects, which includes decision-making delay in the memory task, was similar between the two groups. Our results suggest that smooth-pursuit latencies depend on task conditions and that, although the extra-retinal mechanisms were functional for initial pursuit in elderly subjects, they were less effective.

Effect of dance exercise on cognitive function in elderly patients with metabolic syndrome: a pilot study.

PubMed

Kim, Se-Hong; Kim, Minjeong; Ahn, Yu-Bae; Lim, Hyun-Kook; Kang, Sung-Goo; Cho, Jung-Hyoun; Park, Seo-Jin; Song, Sang-Wook

2011-01-01

Metabolic syndrome is associated with an increased risk of cognitive impairment. The purpose of this prospective pilot study was to examine the effects of dance exercise on cognitive function in elderly patients with metabolic syndrome. The participants included 38 elderly metabolic syndrome patients with normal cognitive function (26 exercise group and 12 control group). The exercise group performed dance exercise twice a week for 6 months. Cognitive function was assessed in all participants using the Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K). Repeated-measures ANCOVA was used to assess the effect of dance exercise on cognitive function and cardiometabolic risk factors. Compared with the control group, the exercise group significantly improved in verbal fluency (p = 0.048), word list delayed recall (p = 0.038), word list recognition (p = 0.007), and total CERAD-K score (p = 0.037). However, no significance difference was found in body mass index, blood pressure, waist circumference, fasting plasma glucose, triglyceride, and HDL cholesterol between groups over the 6-month period. In the present study, six months of dance exercise improved cognitive function in older adults with metabolic syndrome. Thus, dance exercise may reduce the risk for cognitive disorders in elderly people with metabolic syndrome. Key pointsMetabolic syndrome (MS) is associated with an increased risk of cognitive impairment.Aerobic exercise improves cognitive function in elderly people and contributes to the prevention of degenerative neurological disease and brain damage. Dance sport is a form of aerobic exercise that has the additional benefits of stimulating the emotions, promoting social interaction, and exposing subjects to acoustic stimulation and music.In the present study, dance exercise for a 6-month period improved cognitive function in older adults with MS. In particular, positive effects were observed in verbal fluency, word list delayed recall, word list recognition, and the total CERAD-K score.Our data suggest that the implementation of dance exercise programs may be an effective means of prevention and treatment of cognitive disorders.

Frequent Amyloid Deposition Without Significant Cognitive Impairment Among the Elderly

PubMed Central

Aizenstein, Howard Jay; Nebes, Robert D.; Saxton, Judith A.; Price, Julie C.; Mathis, Chester A.; Tsopelas, Nicholas D.; Ziolko, Scott K.; James, Jeffrey A.; Snitz, Beth E.; Houck, Patricia R.; Bi, Wenzhu; Cohen, Ann D.; Lopresti, Brian J.; DeKosky, Steven T.; Halligan, Edythe M.; Klunk, William E.

2009-01-01

Objective To characterize the prevalence of amyloid deposition in a clinically unimpaired elderly population, as assessed by Pittsburgh Compound B (PiB) positron emission tomography (PET) imaging, and its relationship to cognitive function, measured with a battery of neuropsychological tests. Design Subjects underwent cognitive testing and PiB PET imaging (15 mCi for 90 minutes with an ECAT HR + scanner). Logan graphical analysis was applied to estimate regional PiB retention distribution volume, normalized to a cerebellar reference region volume, to yield distribution volume ratios (DVRs). Setting University medical center. Participants From a community-based sample of volunteers, 43 participants aged 65 to 88 years who did not meet diagnostic criteria for Alzheimer disease or mild cognitive impairment were included. Main Outcome Measures Regional PiB retention and cognitive test performance. Results Of 43 clinically unimpaired elderly persons imaged, 9 (21%) showed evidence of early amyloid deposition in at least 1 brain area using an objectively determined DVR cutoff. Demographic characteristics did not differ significantly between amyloid-positive and amyloid-negative participants, and neurocognitive performance was not significantly worse among amyloid-positive compared with amyloid-negative participants. Conclusions Amyloid deposition can be identified among cognitively normal elderly persons during life, and the prevalence of asymptomatic amyloid deposition may be similar to that of symptomatic amyloid deposition. In this group of participants without clinically significant impairment, amyloid deposition was not associated with worse cognitive function, suggesting that an elderly person with a significant amyloid burden can remain cognitively normal. However, this finding is based on relatively small numbers and needs to be replicated in larger cohorts. Longitudinal follow-up of these subjects will be required to support the potential of PiB imaging to identify preclinical Alzheimer disease, or, alternatively, to show that amyloid deposition is not sufficient to cause Alzheimer disease within some specified period. PMID:19001171

Myo-inositol changes precede amyloid pathology and relate to APOE genotype in Alzheimer disease

PubMed Central

Sundgren, Pia C.; Strandberg, Olof; Zetterberg, Henrik; Minthon, Lennart; Blennow, Kaj; Wahlund, Lars-Olof; Westman, Eric

2016-01-01

Objective: We aimed to test whether in vivo levels of magnetic resonance spectroscopy (MRS) metabolites myo-inositol (mI), N-acetylaspartate (NAA), and choline are abnormal already during preclinical Alzheimer disease (AD), relating these changes to amyloid or tau pathology, and functional connectivity. Methods: In this cross-sectional multicenter study (a subset of the prospective Swedish BioFINDER study), we included 4 groups, representing the different stages of predementia AD: (1) cognitively healthy elderly with normal CSF β-amyloid 42 (Aβ42), (2) cognitively healthy elderly with abnormal CSF Aβ42, (3) patients with subjective cognitive decline and abnormal CSF Aβ42, (4) patients with mild cognitive decline and abnormal CSF Aβ42 (Ntotal = 352). Spectroscopic markers measured in the posterior cingulate/precuneus were considered alongside known disease biomarkers: CSF Aβ42, phosphorylated tau, total tau, [18F]-flutemetamol PET, f-MRI, and the genetic risk factor APOE. Results: Amyloid-positive cognitively healthy participants showed a significant increase in mI/creatine and mI/NAA levels compared to amyloid-negative healthy elderly (p < 0.05). In amyloid-positive healthy elderly, mI/creatine and mI/NAA correlated with cortical retention of [18F] flutemetamol tracer ( = 0.44, p = 0.02 and = 0.51, p = 0.01, respectively). Healthy elderly APOE ε4 carriers with normal CSF Aβ42 levels had significantly higher mI/creatine levels (p < 0.001) than ε4 noncarriers. Finally, elevated mI/creatine was associated with decreased functional connectivity within the default mode network (rpearson = −0.16, p = 0.02), independently of amyloid pathology. Conclusions: mI levels are elevated already at asymptomatic stages of AD. Moreover, mI/creatine concentrations were increased in healthy APOE ε4 carriers with normal CSF Aβ42 levels, suggesting that mI levels may reveal regional brain consequences of APOE ε4 before detectable amyloid pathology. PMID:27164711

Myo-inositol changes precede amyloid pathology and relate to APOE genotype in Alzheimer disease.

PubMed

Voevodskaya, Olga; Sundgren, Pia C; Strandberg, Olof; Zetterberg, Henrik; Minthon, Lennart; Blennow, Kaj; Wahlund, Lars-Olof; Westman, Eric; Hansson, Oskar

2016-05-10

We aimed to test whether in vivo levels of magnetic resonance spectroscopy (MRS) metabolites myo-inositol (mI), N-acetylaspartate (NAA), and choline are abnormal already during preclinical Alzheimer disease (AD), relating these changes to amyloid or tau pathology, and functional connectivity. In this cross-sectional multicenter study (a subset of the prospective Swedish BioFINDER study), we included 4 groups, representing the different stages of predementia AD: (1) cognitively healthy elderly with normal CSF β-amyloid 42 (Aβ42), (2) cognitively healthy elderly with abnormal CSF Aβ42, (3) patients with subjective cognitive decline and abnormal CSF Aβ42, (4) patients with mild cognitive decline and abnormal CSF Aβ42 (Ntotal = 352). Spectroscopic markers measured in the posterior cingulate/precuneus were considered alongside known disease biomarkers: CSF Aβ42, phosphorylated tau, total tau, [(18)F]-flutemetamol PET, f-MRI, and the genetic risk factor APOE. Amyloid-positive cognitively healthy participants showed a significant increase in mI/creatine and mI/NAA levels compared to amyloid-negative healthy elderly (p < 0.05). In amyloid-positive healthy elderly, mI/creatine and mI/NAA correlated with cortical retention of [(18)F] flutemetamol tracer ([Formula: see text] = 0.44, p = 0.02 and [Formula: see text] = 0.51, p = 0.01, respectively). Healthy elderly APOE ε4 carriers with normal CSF Aβ42 levels had significantly higher mI/creatine levels (p < 0.001) than ε4 noncarriers. Finally, elevated mI/creatine was associated with decreased functional connectivity within the default mode network (rpearson = -0.16, p = 0.02), independently of amyloid pathology. mI levels are elevated already at asymptomatic stages of AD. Moreover, mI/creatine concentrations were increased in healthy APOE ε4 carriers with normal CSF Aβ42 levels, suggesting that mI levels may reveal regional brain consequences of APOE ε4 before detectable amyloid pathology. © 2016 American Academy of Neurology.

Differentiating between axonal damage and demyelination in healthy aging by combining diffusion-tensor imaging and diffusion-weighted spectroscopy in the human corpus callosum at 7 T.

PubMed

Branzoli, Francesca; Ercan, Ece; Valabrègue, Romain; Wood, Emily T; Buijs, Mathijs; Webb, Andrew; Ronen, Itamar

2016-11-01

Diffusion-tensor imaging and single voxel diffusion-weighted magnetic resonance spectroscopy were used at 7T to explore in vivo age-related microstructural changes in the corpus callosum. Sixteen healthy elderly (age range 60-71 years) and 13 healthy younger controls (age range 23-32 years) were included in the study. In healthy elderly, we found lower water fractional anisotropy and higher water mean diffusivity and radial diffusivity in the corpus callosum, indicating the onset of demyelination processes with healthy aging. These changes were not associated with a concomitant significant difference in the cytosolic diffusivity of the intra-axonal metabolite N-acetylaspartate (p = 0.12), the latter representing a pure measure of intra-axonal integrity. It was concluded that the possible intra-axonal changes associated with normal aging processes are below the detection level of diffusion-weighted magnetic resonance spectroscopy in our experiment (e.g., smaller than 10%) in the age range investigated. Lower axial diffusivity of total creatine was observed in the elderly group (p = 0.058), possibly linked to a dysfunction in the energy metabolism associated with a deficit in myelin synthesis. Copyright © 2016 Elsevier Inc. All rights reserved.

[The Amsterdam Dementia Screening Test in cognitively healthy and clinical samples. An update of normative data].

PubMed

van Toutert, Meta; Diesfeldt, Han; Hoek, Dirk

2016-10-01

The six tests in the Amsterdam Dementia Screening Test (ADST) examine the cognitive domains of episodic memory (delayed picture recognition, word learning), orientation, category fluency (animals and occupations), constructional ability (figure copying) and executive function (alternating sequences). New normative data were collected in a sample of 102 elderly volunteers (aged 65-94), including subjects with medical or other health conditions, except dementia or frank cognitive impairment (MMSE > 24). Included subjects were independent in complex instrumental activities of daily living.Fluency, not the other tests, needed adjustment for age and education. A deficit score (0-1) was computed for each test. Summation (range 0-6) proved useful in differentiating patients with dementia (N = 741) from normal elderly (N = 102).Positive and negative predictive power across a range of summed deficit scores and base rates are displayed in Bayesian probability tables.In the normal elderly, delayed recall for eight words was tested and adjusted for initial recall. A recognition test mixed the target words with eight distractors. Delayed recognition was adjusted for immediate and delayed recall.The ADST and the normative data in this paper help the clinical neuropsychologist to make decisions concerning the presence or absence of neurocognitive disorder in individual elderly examinees.

Strength training in the elderly: effects on risk factors for age-related diseases.

PubMed

Hurley, B F; Roth, S M

2000-10-01

Strength training (ST) is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density (BMD). In the past couple of decades, many studies have examined the effects of ST on risk factors for age-related diseases or disabilities. Collectively, these studies indicate that ST in the elderly: (i) is an effective intervention against sarcopenia because it produces substantial increases in the strength, mass, power and quality of skeletal muscle; (ii) can increase endurance performance; (iii) normalises blood pressure in those with high normal values; (iv) reduces insulin resistance; (v) decreases both total and intra-abdominal fat; (vi) increases resting metabolic rate in older men; (vii) prevents the loss of BMD with age; (viii) reduces risk factors for falls; and (ix) may reduce pain and improve function in those with osteoarthritis in the knee region. However, contrary to popular belief, ST does not increase maximal oxygen uptake beyond normal variations, improve lipoprotein or lipid profiles, or improve flexibility in the elderly.

Fall detection algorithms for real-world falls harvested from lumbar sensors in the elderly population: a machine learning approach.

PubMed

Bourke, Alan K; Klenk, Jochen; Schwickert, Lars; Aminian, Kamiar; Ihlen, Espen A F; Mellone, Sabato; Helbostad, Jorunn L; Chiari, Lorenzo; Becker, Clemens

2016-08-01

Automatic fall detection will promote independent living and reduce the consequences of falls in the elderly by ensuring people can confidently live safely at home for linger. In laboratory studies inertial sensor technology has been shown capable of distinguishing falls from normal activities. However less than 7% of fall-detection algorithm studies have used fall data recorded from elderly people in real life. The FARSEEING project has compiled a database of real life falls from elderly people, to gain new knowledge about fall events and to develop fall detection algorithms to combat the problems associated with falls. We have extracted 12 different kinematic, temporal and kinetic related features from a data-set of 89 real-world falls and 368 activities of daily living. Using the extracted features we applied machine learning techniques and produced a selection of algorithms based on different feature combinations. The best algorithm employs 10 different features and produced a sensitivity of 0.88 and a specificity of 0.87 in classifying falls correctly. This algorithm can be used distinguish real-world falls from normal activities of daily living in a sensor consisting of a tri-axial accelerometer and tri-axial gyroscope located at L5.

[Frailty in the elderly and nutritional status according to the Mini Nutritional Assessment].

PubMed

Guerrero-García, Nadia Belén; Gómez-Lomelí, Zoila Margarita; Leal-Mora, David; Loreto-Garibay, Oscar

2016-01-01

The aging process involves psychosocial and physiological changes, which modify the nutritional status in the elderly. The objective was to assess the nutritional status of a group of elderly patients using the Mini Nutritional Assessment (MNA) and the Fried frailty index, as well as the relation between both. From June to July, 2013, we carried out a cross-sectional study with consecutive sampling of 146 patients of both sexes, from the Hospital Civil "Fray Antonio Alcalde", in Guadalajara, México. We applied the MNA and the Fried frailty index. The mean age was 81.7 years (±7.65). One hundred and six patients (72.6%) were females, and 40 were males (27.4%). Basic anthropometric data showed that the mean weight was 57.67 kg (±13.7), with a mean of 1.52 (±0.09) meters in size; body mass index was 24.85 (±5.32) kg/m2. The results showed that 14.1% of patients with a normal nutritional status suffered from frailty, while 42.1% had risk of malnutrition and frailty. Frailty in the elderly is still present even if they have a normal nutritional status; when the nutritional status decreases, there is a higher prevalence of frailty in this age group.

Preservation of perceptual integration improves temporal stability of bimanual coordination in the elderly: an evidence of age-related brain plasticity.

PubMed

Blais, Mélody; Martin, Elodie; Albaret, Jean-Michel; Tallet, Jessica

2014-12-15

Despite the apparent age-related decline in perceptual-motor performance, recent studies suggest that the elderly people can improve their reaction time when relevant sensory information are available. However, little is known about which sensory information may improve motor behaviour itself. Using a synchronization task, the present study investigates how visual and/or auditory stimulations could increase accuracy and stability of three bimanual coordination modes produced by elderly and young adults. Neurophysiological activations are recorded with ElectroEncephaloGraphy (EEG) to explore neural mechanisms underlying behavioural effects. Results reveal that the elderly stabilize all coordination modes when auditory or audio-visual stimulations are available, compared to visual stimulation alone. This suggests that auditory stimulations are sufficient to improve temporal stability of rhythmic coordination, even more in the elderly. This behavioural effect is primarily associated with increased attentional and sensorimotor-related neural activations in the elderly but similar perceptual-related activations in elderly and young adults. This suggests that, despite a degradation of attentional and sensorimotor neural processes, perceptual integration of auditory stimulations is preserved in the elderly. These results suggest that perceptual-related brain plasticity is, at least partially, conserved in normal aging. Copyright © 2014 Elsevier B.V. All rights reserved.

[Nutritional status and risk factors for malnutrition in low-income urban elders].

PubMed

Hyun, Hye Sun; Lee, Insook

2014-12-01

The purpose of this study was to evaluate the nutritional status of low-income urban elders by diversified ways, and to analyze the risk factors for malnutrition. The participants in this study were 183 low-income elders registered at a visiting healthcare facility in a public health center. Data were collected using anthropometric measurements, and a questionnaire survey. For data analysis, descriptive statistics, χ²-test, t-test, Fisher's exact test, multiple logistic regression analysis were performed using SPSS 20.0. Regarding the nutritional status of low-income elders as measured by the Mini Nutritional Assessment (MNA), 10.4% of the elders were classified as malnourished; 57.4% as at high risk for malnutrition; and 32.2% as having normal nutrition levels. The main factors affecting malnutrition for low-income elders were loss of appetite (OR=3.34, 95% CI: 1.16~9.56) and difficulties in meal preparation (OR=2.35, 95% CI: 1.13~4.88). In order to effectively improve nutrition in low-income urban elders, it is necessary to develop individual intervention strategies to manage factors that increase the risk of malnutrition and to use systematic approach strategies in local communities in terms of a nutrition support system.

Visuospatial characteristics of an elderly Chinese population: results from the WAIS-R block design test.

PubMed

Yin, Shufei; Zhu, Xinyi; Huang, Xin; Li, Juan

2015-01-01

Visuospatial deficits have long been recognized as a potential predictor of dementia, with visuospatial ability decline having been found to accelerate in later stages of dementia. We, therefore, believe that the visuospatial performance of patients with mild cognitive impairment (MCI) and dementia (Dem) might change with varying visuospatial task difficulties. This study administered the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Block Design Test (BDT) to determine whether visuospatial ability can help discriminate between MCI patients from Dem patients and normal controls (NC). Results showed that the BDT could contribute to the discrimination between MCI and Dem. Specifically, simple BDT task scores could best distinguish MCI from Dem patients, while difficult BDT task scores could contribute to discriminating between MCI and NC. Given the potential clinical value of the BDT in the diagnosis of Dem and MCI, normative data stratified by age and education for the Chinese elderly population are presented for use in research and clinical settings.

Primary postural instability: a cause of recurrent sudden falls in the elderly.

PubMed

Djaldetti, R; Lorberboym, M; Melamed, E

2006-12-01

Elderly patients with recurrent falls are frequently diagnosed with an extrapyramidal syndrome. This study aims to characterise a distinct group of patients with recurrent falls and postural instability as a hallmark of the clinical examination. The study took place in the Movement Disorders Unit, Rabin Medical Center, Petah Tiqva, Israel among 26 patients with recurrent falls who had no clinical evidence of a neurodegenerative disease. Medical records, neurological examination and brain imaging studies were assessed. Falls in these patients were sudden, unprovoked, with no vertigo or loss of consciousness. All had postural instability with minimal or no abnormality on the neurological examination. Brain imaging showed diffuse ischaemic changes in 65%. [(123)I]-FPCIT SPECT with the dopamine transporter ligand, performed in five patients, was normal in all. Recurrent falls might be caused by a neurological syndrome that primarily affects balance control. The importance of identifying this disorder is its distinction from other parkinsonian syndromes causing falls.

The Prefrontal Model Revisited: Double Dissociations Between Young Sleep Deprived and Elderly Subjects on Cognitive Components of Performance

PubMed Central

Tucker, Adrienne M.; Stern, Yaakov; Basner, Robert C.; Rakitin, Brian C.

2011-01-01

Study Objectives: The prefrontal model suggests that total sleep deprivation (TSD) and healthy aging produce parallel cognitive deficits. Here we decompose global performance on two common tasks into component measures of specific cognitive processes to pinpoint the source of impairments in elderly and young TSD participants relative to young controls and to each other. Setting: The delayed letter recognition task (DLR) was performed in 3 studies. The psychomotor vigilance task (PVT) was performed in 1 of the DLR studies and 2 additional studies. Subjects: For DLR, young TSD (n = 20, age = 24.60 ± 0.62 years) and young control (n = 17, age = 24.00 ± 2.42); elderly (n = 26, age = 69.92 ± 1.06). For the PVT, young TSD (n = 18, age = 26.65 ± 4.57) and young control (n = 16, age = 25.19 ± 2.90); elderly (n = 21, age = 71.1 ± 4.92). Measurements and Results: Both elderly and young TSD subjects displayed impaired reaction time (RT), our measure of global performance, on both tasks relative to young controls. After decomposing global performance on the DLR, however, a double dissociation was observed as working memory scanning speed was impaired only in elderly subjects while other components of performance were impaired only by TSD. Similarly, for the PVT a second double dissociation was observed as vigilance impairments were present only in TSD while short-term response preparation effects were altered only in the elderly. Conclusions: The similarity between TSD and the elderly in impaired performance was evident only when examining global RT. In contrast, when specific cognitive components were examined double dissociations were observed between TSD and elderly subjects. This demonstrates the heterogeneity in those cognitive processes impaired in TSD versus the elderly. Citation: Tucker AM; Stern Y; Basner RC; Rakitin BC. The prefrontal model revisited: double dissociations between young sleep deprived and elderly subjects on cognitive components of performance. SLEEP 2011;34(8):1039-1050. PMID:21804666

β-Amyloid Deposition Is Associated with Decreased Right Prefrontal Activation during Task Switching among Cognitively Normal Elderly

PubMed Central

Steffener, Jason; Razlighi, Qolamreza R.; Habeck, Christian; Stern, Yaakov

2016-01-01

The accumulation of β-amyloid (Aβ) peptides, a pathological hallmark of Alzheimer's disease (AD), has been associated with functional alterations, often in an episodic memory system with a particular emphasis on medial temporal lobe function. The topography of Aβ deposition, however, largely overlaps with frontoparietal control (FPC) regions implicated in cognitive control that has been shown to be impaired in early mild AD. To understand the neural mechanism underlying early changes in cognitive control with AD, we examined the impact of Aβ deposition on task-evoked FPC activation using functional magnetic resonance imaging (fMRI) in humans. Forty-three young and 62 cognitively normal older adults underwent an fMRI session during an executive contextual task in which task difficulty varied: single (either letter case or vowel/consonant judgment task) vs dual (switching between letter case and vowel/consonant decisions) task. Older subjects additionally completed 18F-florbetaben positron emission tomography scans and were classified as either amyloid positive (Aβ+) or negative (Aβ−). Consistent with previous reports, age-related increases in brain activity were found in FPC regions commonly identified across groups. For both task conditions, Aβ-related increases in brain activity were found compared with baseline activity. For higher cognitive control load, however, Aβ+ elderly showed reduced task-switching activation in the right inferior frontal cortex. Our findings suggest that with Aβ deposition, brain activation in the cognitive control region reaches a maximum with lower control demand and decreases with higher control demand, which may underlie early impairment in cognitive control with AD progression. SIGNIFICANCE STATEMENT The accumulation of β-amyloid (Aβ) peptides, a pathological hallmark of Alzheimer's disease, spatially overlaps with frontoparietal control (FPC) regions implicated in cognitive control, but the impact of Aβ deposition on FPC regions is largely unknown. Using functional magnetic resonance imaging with a task-switching task, we found Aβ-related increases in FPC regions compared with baseline activity. For higher cognitive control load, however, Aβ-related hypoactivity was found in the right inferior frontal cortex, a region highly implicated in cognitive control. The findings suggest that with Aβ deposition, task-related brain activity may reach a plateau early and undergo downstream pathways of neural dysfunction, which may relate to the early impairment of cognitive control seen in the progression of Aβ pathology. PMID:26865619

Memory Binding Test Predicts Incident Amnestic Mild Cognitive Impairment.

PubMed

Mowrey, Wenzhu B; Lipton, Richard B; Katz, Mindy J; Ramratan, Wendy S; Loewenstein, David A; Zimmerman, Molly E; Buschke, Herman

2016-07-14

The Memory Binding Test (MBT), previously known as Memory Capacity Test, has demonstrated discriminative validity for distinguishing persons with amnestic mild cognitive impairment (aMCI) and dementia from cognitively normal elderly. We aimed to assess the predictive validity of the MBT for incident aMCI. In a longitudinal, community-based study of adults aged 70+, we administered the MBT to 246 cognitively normal elderly adults at baseline and followed them annually. Based on previous work, a subtle reduction in memory binding at baseline was defined by a Total Items in the Paired (TIP) condition score of ≤22 on the MBT. Cox proportional hazards models were used to assess the predictive validity of the MBT for incident aMCI accounting for the effects of covariates. The hazard ratio of incident aMCI was also assessed for different prediction time windows ranging from 4 to 7 years of follow-up, separately. Among 246 controls who were cognitively normal at baseline, 48 developed incident aMCI during follow-up. A baseline MBT reduction was associated with an increased risk for developing incident aMCI (hazard ratio (HR) = 2.44, 95% confidence interval: 1.30-4.56, p = 0.005). When varying the prediction window from 4-7 years, the MBT reduction remained significant for predicting incident aMCI (HR range: 2.33-3.12, p: 0.0007-0.04). Persons with poor performance on the MBT are at significantly greater risk for developing incident aMCI. High hazard ratios up to seven years of follow-up suggest that the MBT is sensitive to early disease.

[Social inequality and participation in aging urban societies].

PubMed

Rüssler, H; Köster, D; Heite, E; Stiel, J

2013-06-01

The social and political participation of elderly people is characterized by social inequality. Participation processes normally consolidate and intensify the exclusion of senior citizens having low incomes and low educational qualifications. In the research and development project "Quality of Life of Elderly People in Living Quarters" being conducted by Dortmund University of Applied Sciences and Arts, one of the questions being examined is whether and to what extent socially disadvantaged elderly people in a social space typical of the Ruhr region (reference area Gelsenkirchen-Schalke) can be included in the shaping of their quarter. This paper is based on the results of a quantitative, written survey (cross-section) on the subjects of quality of life and participation, and on a trend analysis measuring the effects of participation processes initiated on the elderly persons involved. The results of the study show that it is possible to involve socially disadvantaged elderly people in participation processes geared to the specific social space. They also indicate that elderly people from different income groups increase their social capital in the context of enabling structures.

[Depression in the elderly. Clinical aspects].

PubMed

Barbier, D

2001-02-24

DIFFICULT DIAGNOSIS: Depression in the elderly can take on many often misleading aspects. Sadness may be considered legitimate or "normal" for an elderly person. Depression may masquerade as an organic disorder where somatic complaints, pain and anxiety predominate. All these different clinical forms may mislead the clinician. THE MASK OF HYPOCHONDRIA: A tendency to hypochondria, found in more than one-half of all depressed elderly subjects, may be reinforced by bouts of complementary examinations. The patient is convinced of having an unrecognized organic disease. The mask of hypochondria must be considered with special care because it is a major risk factor for attempted and successful suicide. THE MASK OF DELUSIONS: Elderly patients often develop a state of melancolia-like depression with delusions. Delusions may be congruent with the predominant depressed mood, for example a guilt feeling for an act never committed, or inversely, non-congruent with the thymic state (persecution, negation delusin), for example Cotard syndrome where the patient is persuaded that his/her organs are malfunctioning or have disappeared. Despite these impressive mood disorders that often incite prescription of a neuroleptic, these elderly patients respond favorably to antidepressor treatment.

Activities of daily living measured by the Harvard Automated Phone Task track with cognitive decline over time in non-demented elderly.

PubMed

Marshall, Gad A; Aghjayan, Sarah L; Dekhtyar, Maria; Locascio, Joseph J; Jethwani, Kamal; Amariglio, Rebecca E; Johnson, Keith A; Sperling, Reisa A; Rentz, Dorene M

2017-01-01

Impairment in activities of daily living is a major burden to both patients and caregivers. Mild impairment in instrumental activities of daily living is often seen at the stage of mild cognitive impairment. The field of Alzheimer's disease is moving toward earlier diagnosis and intervention and more sensitive and ecologically valid assessments of instrumental or complex activities of daily living are needed. The Harvard Automated Phone Task, a novel performance-based activities of daily living instrument, has the potential to fill this gap. To further validate the Harvard Automated Phone Task by assessing its longitudinal relationship to global cognition and specific cognitive domains in clinically normal elderly and individuals with mild cognitive impairment. In a longitudinal study, the Harvard Automated Phone Task was associated with cognitive measures using mixed effects models. The Harvard Automated Phone Task's ability to discriminate across diagnostic groups at baseline was also assessed. Academic clinical research center. Two hundred and seven participants (45 young normal, 141 clinically normal elderly, and 21 mild cognitive impairment) were recruited from the community and the memory disorders clinics at Brigham and Women's Hospital and Massachusetts General Hospital. Participants performed the three tasks of the Harvard Automated Phone Task, which consist of navigating an interactive voice response system to refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and make a bank account transfer and payment (APT-Bank). The 3 tasks were scored based on time, errors, repetitions, and correct completion of the task. The primary outcome measure used for each of the tasks was total time adjusted for correct completion. The Harvard Automated Phone Task discriminated well between young normal, clinically normal elderly, and mild cognitive impairment participants (APT-Script: p<0.001; APT-PCP: p<0.001; APT-Bank: p=0.04). Worse baseline Harvard Automated Phone Task performance or worsening Harvard Automated Phone Task performance over time tracked with overall worse performance or worsening performance over time in global cognition, processing speed, executive function, and episodic memory. Prior cross-sectional and current longitudinal analyses have demonstrated the utility of the Harvard Automated Phone Task, a new performance-based activities of daily living instrument, in the assessment of early changes in complex activities of daily living in non-demented elderly at risk for Alzheimer's disease. Future studies will focus on cross-validation with other sensitive activities of daily living tests and Alzheimer's disease biomarkers.

Activities of daily living measured by the Harvard Automated Phone Task track with cognitive decline over time in non-demented elderly

PubMed Central

Marshall, Gad A.; Aghjayan, Sarah L.; Dekhtyar, Maria; Locascio, Joseph J.; Jethwani, Kamal; Amariglio, Rebecca E.; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

2017-01-01

Background Impairment in activities of daily living is a major burden to both patients and caregivers. Mild impairment in instrumental activities of daily living is often seen at the stage of mild cognitive impairment. The field of Alzheimer’s disease is moving toward earlier diagnosis and intervention and more sensitive and ecologically valid assessments of instrumental or complex activities of daily living are needed. The Harvard Automated Phone Task, a novel performance-based activities of daily living instrument, has the potential to fill this gap. Objective To further validate the Harvard Automated Phone Task by assessing its longitudinal relationship to global cognition and specific cognitive domains in clinically normal elderly and individuals with mild cognitive impairment. Design In a longitudinal study, the Harvard Automated Phone Task was associated with cognitive measures using mixed effects models. The Harvard Automated Phone Task’s ability to discriminate across diagnostic groups at baseline was also assessed. Setting Academic clinical research center. Participants Two hundred and seven participants (45 young normal, 141 clinically normal elderly, and 21 mild cognitive impairment) were recruited from the community and the memory disorders clinics at Brigham and Women’s Hospital and Massachusetts General Hospital. Measurements Participants performed the three tasks of the Harvard Automated Phone Task, which consist of navigating an interactive voice response system to refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and make a bank account transfer and payment (APT-Bank). The 3 tasks were scored based on time, errors, repetitions, and correct completion of the task. The primary outcome measure used for each of the tasks was total time adjusted for correct completion. Results The Harvard Automated Phone Task discriminated well between young normal, clinically normal elderly, and mild cognitive impairment participants (APT-Script: p<0.001; APT-PCP: p<0.001; APT-Bank: p=0.04). Worse baseline Harvard Automated Phone Task performance or worsening Harvard Automated Phone Task performance over time tracked with overall worse performance or worsening performance over time in global cognition, processing speed, executive function, and episodic memory. Conclusions Prior cross-sectional and current longitudinal analyses have demonstrated the utility of the Harvard Automated Phone Task, a new performance-based activities of daily living instrument, in the assessment of early changes in complex activities of daily living in non-demented elderly at risk for Alzheimer’s disease. Future studies will focus on cross-validation with other sensitive activities of daily living tests and Alzheimer’s disease biomarkers. PMID:29124043

Effects of professional oral health care on elderly: randomized trial.

PubMed

Morino, T; Ookawa, K; Haruta, N; Hagiwara, Y; Seki, M

2014-11-01

To better understand the role of the professional oral health care for elderly in improving geriatric oral health, the effects of short-term professional oral health care (once per week for 1 month) on oral microbiological parameters were assessed. Parallel, open-labelled, randomize-controlled trial was undertaken in a nursing home for elderly in Shizuoka, Japan. Thirty-four dentate elderly over 74 years were randomly assigned from ID number to the intervention (17/34) and control (17/34) groups. The outcomes were changes in oral microbiological parameters (number of bacteria in unstimulated saliva; whole bacteria, Streptococcus, Fusobacterium and Prevotella: opportunistic pathogens detection: and index of oral hygiene evaluation [Dental Plaque Index, DPI]) within the intervention period. Each parameter was evaluated at before and after intervention period. Four elderly were lost from mortality (1), bone fracture (1), refused to participate (1) and multi-antibiotics usage (1). Finally, 30 elderly were analysed (14/intervention and 16/control). At baseline, no difference was found between the control and intervention groups. After the intervention period, the percentage of Streptococcus species increased significantly in the intervention group (Intervention, 86% [12/14]; Control, 50% [8/16]: Fisher's, right-tailed, P < 0.05). Moreover, DPI significantly improved in the intervention group (Intervention, 57% [8/14]; Control, 13% [2/16]: Fisher's, two-tailed, P < 0.05). The improvement in DPI extended for 3 months after intervention. None of side effects were reported. The short-term professional oral health care can improve oral conditions in the elderly. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Altered functional MR imaging language activation in elderly individuals with cerebral leukoaraiosis.

PubMed

Welker, Kirk M; De Jesus, Reordan O; Watson, Robert E; Machulda, Mary M; Jack, Clifford R

2012-10-01

To test the hypothesis that leukoaraiosis alters functional activation during a semantic decision language task. With institutional review board approval and written informed consent, 18 right-handed, cognitively healthy elderly participants with an aggregate leukoaraiosis lesion volume of more than 25 cm(3) and 18 age-matched control participants with less than 5 cm(3) of leukoaraiosis underwent functional MR imaging to allow comparison of activation during semantic decisions with that during visual perceptual decisions. Brain statistical maps were derived from the general linear model. Spatially normalized group t maps were created from individual contrast images. A cluster extent threshold of 215 voxels was used to correct for multiple comparisons. Intergroup random effects analysis was performed. Language laterality indexes were calculated for each participant. In control participants, semantic decisions activated the bilateral visual cortex, left posteroinferior temporal lobe, left posterior cingulate gyrus, left frontal lobe expressive language regions, and left basal ganglia. Visual perceptual decisions activated the right parietal and posterior temporal lobes. Participants with leukoaraiosis showed reduced activation in all regions associated with semantic decisions; however, activation associated with visual perceptual decisions increased in extent. Intergroup analysis showed significant activation decreases in the left anterior occipital lobe (P=.016), right posterior temporal lobe (P=.048), and right basal ganglia (P=.009) in particpants with leukoariosis. Individual participant laterality indexes showed a strong trend (P=.059) toward greater left lateralization in the leukoaraiosis group. Moderate leukoaraiosis is associated with atypical functional activation during semantic decision tasks. Consequently, leukoaraiosis is an important confounding variable in functional MR imaging studies of elderly individuals. © RSNA, 2012.

Use of Robotic Pets in Providing Stimulation for Nursing Home Residents with Dementia.

PubMed

Naganuma, M; Ohkubo, E; Kato, N

2015-01-01

Trial experiments utilized robotic pets to facilitate self-reliance in nursing home residents. A remote-control robot modeled clear and meaningful behaviors to elderly residents. Special attention was paid to its effects on mental and social domains. Employing the robot as a gaze target and center of attention created a cue to initiate a communication channel between residents who normally show no interest in each other. The Sony AIBO robot in this study uses commercially available wireless equipment, and all its components are easily accessible to any medical or welfare institution interested in additional practice of these activities.

Investigation of the Effects of Antibiotic Application on the Intestinal Flora in Elderly Hypertension Patients with Infectious Diseases

PubMed Central

SU, Changhai; LIU, Yang; ZHANG, Haiwen; XIAO, Bin; BA, Te’er

2018-01-01

Background: This study aimed to investigate the effects of antibiotic application on the intestinal flora in elderly hypertension patients with infectious diseases. Methods: A total of 2350 infected patients treated in Ordos Central Hospital (Inner Mongolia, China) from January 2010 to August 2016 were retrospectively analyzed and 790 healthy hypertension patients were selected as the control group. The 2350 patients were assigned into group A and B based on the administration with narrow-spectrum antibiotic or broad-spectrum antibiotic. The feces specimens of patients at the 1st, 5th, 9th and 14th day after antibiotic treatment were collected to analyze the bacteriological data and the cases of intestinal flora imbalance after applying the narrow-spectrum and broad-spectrum antibiotic were compared and the differences in the bacterial colony compositions of intestinal floras from those of the healthy hypertension patients at the same period were analyzed. Results: The ratio of intestinal flora imbalance was 50.4% after applying antibiotic in patients from group A and 78.3% in group B. grade I and II imbalance were predominant in group A and grade III imbalance was the most severe one in group B (P<0.05). Compared with the intestinal flora in healthy elderly hypertension patients, the ratio of the primary composition flora of patients with imbalanced intestinal flora was changed obviously. Conclusion: The application of narrow-spectrum antibiotic and shortening the application time of antibiotic can more effectively protect the normal intestinal flora of elderly hypertension patients.

[Development and application of a multidimensional suicide prevention program for Korean elders by utilizing a community network].

PubMed

Jo, Kae Hwa; Kim, Yeong Kyeong

2008-06-01

The purpose of this study was to develop a multidimensional suicide prevention program for Korean elders by utilizing a community network and to evaluate its effect. A non-equivalent control group pretest-posttest design was used. The subjects were recruited from two different elderly institutions located in D city and K province, Korea. Nineteen subjects in the control group received no intervention and 20 subjects in the experimental group received a multidimensional suicide prevention program. There were more significant decreases in depression, suicide ideation, and increases in life satisfaction in the experimental group compared to the control group. According to the above results, the multidimensional suicide prevention program for Korean elders decreased stressful events like depression, and suicide ideation and increased life satisfaction through the community network. These findings suggest that this program can be used as an efficient intervention for elders in a critical situation.

Temporal Information Processing and its Relation to Executive Functions in Elderly Individuals.

PubMed

Nowak, Kamila; Dacewicz, Anna; Broczek, Katarzyna; Kupisz-Urbanska, Malgorzata; Galkowski, Tadeusz; Szelag, Elzbieta

2016-01-01

Normal aging triggers deterioration in cognitive functions. Evidence has shown that these age-related changes concern also executive functions (EF) as well as temporal information processing (TIP) in a millisecond range. A considerable amount of literature data has indicated that each of these two functions sets a frame for our mental activity and may be considered in terms of embodied cognition due to advanced age. The present study addresses the question whether in elderly subjects the efficiency of TIP is related to individual differences in EF. The study involved 53 normal healthy participants aged from 65 to 78. In these subjects TIP was assessed by sequencing abilities measured with temporal-order threshold (TOT). It is defined as the minimum time gap separating two auditory stimuli presented in rapid succession which is necessary for a subject to report correctly their temporal order, thus the relation 'before-after.' The EF were assessed with regard to the efficiency of the executive planning measured with the Tower of London-Drexel University (TOL DX ) which has become a well-known EF task. Using Spearman's rank correlations we observed two main results. Firstly, the indices of the TOL DX indicated a coherent construct reflecting the effectiveness of executive planning in the elderly. Initiation time seemed dissociated from these coherent indices, which suggested a specific strategy of mental planning in the elderly based on on-line planning rather than on preplanning. Secondly, TOT was significantly correlated with the indices of TOL DX . Although some of these correlations were modified by subject's age, the correlation between TOT and the main index of TOL DX ( 'Total Move Score' ) was rather age resistant. These results suggest that normal aging may be characterized by an overlapping of deteriorated TIP and deteriorated EF.

Serum ionized calcium, intact PTH and novel markers of bone turnover in bedridden elderly patients.

PubMed

Sorva, A; Välimäki, M; Risteli, J; Risteli, L; Elfving, S; Takkunen, H; Tilvis, R

1994-12-01

Chronic immobilization could markedly affect calcium and bone metabolism in elderly people. To investigate this, and to test the theory of 'type II' osteoporosis in bedridden elderly patients with low vitamin D status, 55 such subjects were examined. Serum concentrations of ionized calcium (Ca++), intact parathyrin (PTH) and two novel markers of bone collagen formation (carboxyterminal propeptide of type I procollagen; PICP) and resorption (carboxyterminal crosslinked telopeptide of type I collagen; ICTP) were measured. The effects on these parameters after 40 weeks of supplementation with vitamin D (1000 IU d-1) and/or calcium (1 g d-1) were subsequently prospectively evaluated. Despite low (mean 11.6 nmoll-1) serum 25-hydroxyvitamin D levels (25-OHD), those of 1,25-dihydroxy-vitamin D (1,25-(OH)2D) were mostly normal. Neither correlated with Ca++ or PTH. PTH correlated negatively not only with Ca++ (r = -0.328, P < 0.05) but also with ICTP (r = -0.306, P < 0.05). Mean PICP was normal but ICTP was elevated and tended to correlate positively with Ca++ (r = 0.268, P = 0.06). Vitamin D supplementation did not change PICP or ICTP considerably, despite slightly increased 1,25-(OH)2D and slightly decreased PTH. Ca++ values were normal and remained stable. In conclusion, Ca++ and PTH are poor indicators of vitamin D status in chronically immobilized elderly subjects. Furthermore, the results suggest that the increased bone resorption is not due to 'type II' secondary hyperparathyroidism; rather the resorption is primarily increased. Correction of vitamin D deficiency does not seem to benefit ageing bones unless adequate mechanical loading is provided.

Temporal Information Processing and its Relation to Executive Functions in Elderly Individuals

PubMed Central

Nowak, Kamila; Dacewicz, Anna; Broczek, Katarzyna; Kupisz-Urbanska, Malgorzata; Galkowski, Tadeusz; Szelag, Elzbieta

2016-01-01

Normal aging triggers deterioration in cognitive functions. Evidence has shown that these age-related changes concern also executive functions (EF) as well as temporal information processing (TIP) in a millisecond range. A considerable amount of literature data has indicated that each of these two functions sets a frame for our mental activity and may be considered in terms of embodied cognition due to advanced age. The present study addresses the question whether in elderly subjects the efficiency of TIP is related to individual differences in EF. The study involved 53 normal healthy participants aged from 65 to 78. In these subjects TIP was assessed by sequencing abilities measured with temporal-order threshold (TOT). It is defined as the minimum time gap separating two auditory stimuli presented in rapid succession which is necessary for a subject to report correctly their temporal order, thus the relation ‘before-after.’ The EF were assessed with regard to the efficiency of the executive planning measured with the Tower of London-Drexel University (TOLDX) which has become a well-known EF task. Using Spearman’s rank correlations we observed two main results. Firstly, the indices of the TOLDX indicated a coherent construct reflecting the effectiveness of executive planning in the elderly. Initiation time seemed dissociated from these coherent indices, which suggested a specific strategy of mental planning in the elderly based on on-line planning rather than on preplanning. Secondly, TOT was significantly correlated with the indices of TOLDX. Although some of these correlations were modified by subject’s age, the correlation between TOT and the main index of TOLDX (‘Total Move Score’) was rather age resistant. These results suggest that normal aging may be characterized by an overlapping of deteriorated TIP and deteriorated EF. PMID:27807426

Postural stability in the elderly during sensory perturbations and dual tasking: the influence of refractive blur.

PubMed

Anand, Vijay; Buckley, John G; Scally, Andy; Elliott, David B

2003-07-01

To determine the influence of refractive blur on postural stability during somatosensory and vestibular system perturbation and dual tasking. Fifteen healthy, elderly subjects (mean age, 71 +/- 5 years), who had no history of falls and had normal vision, were recruited. Postural stability during standing was assessed using a force platform, and was determined as the root mean square (RMS) of the center of pressure (COP) signal in the anterior-posterior (A-P) and medial-lateral directions collected over a 30-second period. Data were collected under normal standing conditions and with somatosensory and vestibular system perturbations. Measurements were repeated with an additional physical and/or cognitive task. Postural stability was measured under conditions of binocular refractive blur of 0, 1, 2, 4, and 8 D and with eyes closed. The data were analyzed with a population-averaged linear model. The greatest increases in postural instability were due to disruptions of the somatosensory and vestibular systems. Increasing refractive blur caused increasing postural instability, and its effect was greater when the input from the other sensory systems was disrupted. Performing an additional cognitive and physical task increased A-P RMS COP further. All these detrimental effects on postural stability were cumulative. The findings highlight the multifactorial nature of postural stability and indicate why the elderly, many of whom have poor vision and musculoskeletal and central nervous system degeneration, are at greater risk of falling. The findings also highlight that standing instability in both normal and perturbed conditions was significantly increased with refractive blur. Correcting visual impairment caused by uncorrected refractive error could be a useful intervention strategy to help prevent falls and fall-related injuries in the elderly.

Age- and gender-related difference of vocal fold vibration and glottal configuration in normal speakers: analysis with glottal area waveform.

PubMed

Yamauchi, Akihito; Yokonishi, Hisayuki; Imagawa, Hiroshi; Sakakibara, Ken-Ichi; Nito, Takaharu; Tayama, Niro; Yamasoba, Tatsuya

2014-09-01

Glottal area waveform (GAW) analysis is widely used in the assessment of vocal fold vibration by high-speed digital imaging (HSDI). Because normative GAW data obtained from a large number of subjects have not been reported, we conducted a prospective study to obtain normative results for GAW analysis of HSDI findings and clarify normal variations associated with gender and age. Vocally healthy adults were divided into a young group (aged ≤ 35 years) and an elderly group (aged ≥ 65 years). The configuration and size of the glottal area were assessed at different phases of the glottal cycle, and gender- and age-related differences were evaluated. A total of 26 young subjects (nine men and 17 women; mean age: 27 years) and 20 elderly subjects (eight men and 12 women; mean age: 73 years) were investigated. The glottal area at different points of the glottal cycle showed a negative correlation with frequency. Although the GAW parameters of young women appeared to be different from those of the other subgroups, the differences were not statistically significant. Young women predominantly had a triangular- or vase-shaped glottal configuration at all frequencies, whereas the other subgroups showed various glottal shapes. The present study clarified gender- and age-related differences of GAW parameters obtained with HSDI. Young women were likely to show different glottal configurations and different responses to frequency changes from those of young men, elderly men, and elderly women. Phonosurgeons should pay attention to the normal variations detected in the present study. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Score Distributions of the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in Community-Dwelling Older Adults With Vertebral Fracture.

PubMed

Brown, Zachary M; Gibbs, Jenna C; Adachi, Jonathan D; Ashe, Maureen C; Hill, Keith D; Kendler, David L; Khan, Aliya; Papaioannou, Alexandra; Prasad, Sadhana; Wark, John D; Giangregorio, Lora M

2017-11-28

We sought to evaluate the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in community-dwelling women 65 years and older with vertebral fracture and to describe score distributions and potential ceiling and floor effects. This was a secondary data analysis of baseline data from the Build Better Bones with Exercise randomized controlled trial using the BOOMER. A total of 141 women with osteoporosis and radiographically confirmed vertebral fracture were included. Concurrent validity and internal consistency were assessed in comparison to the Short Physical Performance Battery (SPPB). Normality and ceiling/floor effects of total BOOMER scores and component test items were also assessed. Exploratory analyses of assistive aid use and falls history were performed. Tests for concurrent validity demonstrated moderate correlation between total BOOMER and SPPB scores. The BOOMER component tests showed modest internal consistency. Substantial ceiling effect and nonnormal score distributions were present among overall sample and those not using assistive aids for total BOOMER scores, although scores were normally distributed for those using assistive aids. The static standing with eyes closed test demonstrated the greatest ceiling effects of the component tests, with 92% of participants achieving a maximal score. While the BOOMER compares well with the SPPB in community-dwelling women with vertebral fractures, researchers or clinicians considering using the BOOMER in similar or higher-functioning populations should be aware of the potential for ceiling effects.

Prevalence of obesity and its association with socioeconomic factors in elderly Iranians from Razavi-Khorasan province.

PubMed

Nematy, M; Sakhdari, A; Ahmadi-Moghaddam, P; Aliabadi, M; Kimiagar, M; Ilaty, A A; Azimi-Nezhad, M; Shakeri, M T; Ghayour-Mobarhan, M; Sahebkar, A; Ferns, G A A

2009-11-18

There are few data regarding the prevalence of obesity and its socioeconomic determinants among elderly individuals, particularly in Iran. We wished to determine the prevalence of overweight and obesity in free-living elderly people and the relationship to nutritional and socioeconomic factors in the Razavi-Khorasan province of Iran. Free-living elderly persons (917 males/1045 females), aged > or =60 years, were recruited using cluster sampling. Overweight and obesity were evaluated using body mass index (BMI) and subjects were categorized as thin (BMI <18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (> or =30 kg/m2). The association between the prevalence of overweight or obesity with socioeconomic and demographic factors, including gender, place of residence, literacy, type of living, source of income, use of supplements during the past 3 months, and employment status, was examined using regression analysis. The distribution of BMI values indicated that 13, 46.5, 28.9, and 11.7% of the total population were thin, normal, overweight, and obese, respectively. The prevalence of central obesity was higher among Iranian women than men (63.1 vs. 18.6%, respectively). Regression analysis results indicated that gender (p < 0.001), place of residence (p < 0.001), literacy (p = 0.01), and source of income (p < 0.001) were significantly associated with the incidence of overweight or obesity. This study showed that 40.6% of elderly subjects were overweight or obese. Results reinforce the need to plan strategies for primary prevention of this fast-growing public health problem.

Clinical Pharmacokinetics of Levornidazole in Elderly Subjects and Dosing Regimen Evaluation Using Pharmacokinetic/Pharmacodynamic Analysis.

PubMed

Guo, Beining; He, Gaoli; Wu, Xiaojie; Yu, Jicheng; Cao, Guoying; Li, Yi; Fan, Yaxin; Chen, Yuancheng; Shi, Yaoguo; Zhang, Yingyuan; Zhang, Jing

2017-07-01

Levornidazole, the levo-isomer of ornidazole, is a third-generation nitroimidazole derivative newly developed after metronidazole, tinidazole, and ornidazole. An open-label, parallel-controlled, single-dose study was conducted for the investigation of the pharmacokinetic (PK) profile of levornidazole and its metabolites in healthy elderly Chinese subjects, and for the evaluation of 2 dosing regimens in the elderly. Levornidazole was intravenously administered at 500 mg to healthy elderly (aged 60-80 years) or young subjects (aged 19-45 years). The PK profiles of levornidazole and its metabolites in elderly subjects were evaluated and compared with those in the young group. WinNonlin software was used for simulating the PK profile of levornidazole in the elderly population following the dosing regimens of 500 mg BID and 750 mg once daily for 7 days. Monte Carlo simulation was used for estimating the cumulative fraction of response and probability of target attainment of both dosing regimens against Bacteroides spp. The C max , AUC 0-24, and AUC 0-∞ values of levornidazole in the elderly group were 11.98 μg/mL, 131.36 μg·h/mL, and 173.61 μg·h/mL, respectively. The t 1/2 , CL t , and mean residence time from time 0 to infinity were 12.21 hours, 2.91 L/h, and 16.46 hours. The metabolic ratios of metabolites (M) 1, 2, 4, and 6 were <3.0%, and that of M16 was 17.70%. The urinary excretion values of levornidazole, M1, M2, M4, M6, and M16 over 96 hours were 10.21%, 0.92%, ~0%, 2.69%, 0.54%, and 41.98%. The PK properties of levornidazole and the urinary excretion of all metabolites were not statistically different between the 2 groups. The cumulative fraction of response was >90% against B fragilis and other Bacteroides spp, and the probability of target attainment was >90% when the minimum inhibitory concentration was ≤1 μg/mL, in both groups. No dosing regimen adjustment is suggested when levornidazole is used in elderly patients with normal hepatic functioning and mild renal dysfunction. The findings from the PK/PD analysis imply that both regimens may achieve satisfactory clinical and microbiological efficacy against anaerobic infections in elderly patients. Chinese Clinical Trial Registry (http://www.chictr.org.cn) identifier: ChiCTR-OPC-16007938. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

Changing Children's Attitudes toward the Elderly: The Longitudinal Effects of an Intergenerational Partners Program.

ERIC Educational Resources Information Center

Aday, Ronald H.; And Others

1996-01-01

Evaluated effects of a nine-month project that paired fourth graders with elderly volunteers for a number of shared interdisciplinary activities. The Children's Perception of Aging and Elderly inventory posttest scores indicated the experimental group had significantly more positive attitudes toward the elderly than the control group. Results held…

Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study.

PubMed

Yang, Zhi-Qi; Zhao, Qi; Jiang, Ping; Zheng, Song-Bai; Xu, Biao

2017-12-28

Hypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China's elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai's communities. A secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai. Of the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants' median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m 2 ). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities. The prevalence of hypertension was high in China's elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.

Social networks: a profile of the elderly who self-neglect.

PubMed

Burnett, Jason; Regev, Tziona; Pickens, Sabrina; Prati, Laura Lane; Aung, Koko; Moore, Jenny; Dyer, Carmel Bitondo

2006-01-01

Self-neglect is an independent risk factor for early mortality in older people and has been linked to depression and the occurrence of mental and physical decline. Sound social networks have been shown to slow the process of decline in the elderly, and currently little is known about the social networks associated with elder self-neglect. The aim of this study was to explore the social networks associated with elder self-neglect compared with a matched-control group. Ninety-one Adult Protective Services-validated cases of elder self-neglect were compared on formal and informal social network factors with 91controls matched for age, race, gender, and socio-economic status. Elders in the self-neglect group were significantly less likely to (1) Live with a spouse, (2) Live with others, (3) Have weekly contact with children or siblings, (4) Visit with neighbors and friends and (5) Participate in religious activities. Less adequate social resources related to family, friends, and religious affiliations are significantly associated with elder self-neglect.

Investigation effect of oral chamomilla on sleep quality in elderly people in Isfahan: A randomized control trial.

PubMed

Abdullahzadeh, Mehrdad; Matourypour, Pegah; Naji, Sayed Ali

2017-01-01

Elderly people often suffer from sleep disorders. Chamomile due to the many health benefits such as sedation may be effective in improving sleep quality in elderly people. This study aimed to determine the effect of Matricaria chamomilla extract on sleep quality in elderly people admitted to nursing homes of Isfahan in 2014. The present study is a quasi-experimental clinical trial. The study population was 77 cases of elderly hospitalized in nursing homes. Participants were selected through random continuous sampling and divided into intervention and control groups. The intervention group received 400 mg oral capsules of chamomile twice daily, after lunch and after dinner for 4 weeks. The control group did not receive the intervention. Sleep quality in older adults before and after intervention were compared using the Pittsburgh Sleep Quality Index questionnaire. Data were analyzed using descriptive statistics and paired t - and independent t -tests, one-way analysis of variance and liner regression analysis, using SPSS software version 17. Before intervention, the mean score of sleep quality both experimental and control groups showed no significant difference ( P > 0.05). After intervention, the mean score of sleep quality was a significant difference between experimental and control groups ( P < 0.001). Oral administration of chamomile extract has sedative properties in sleep quality of hospitalized elderly patients in nursing homes. Therefore, it can be used in similar cases and nursing care.

Interference Control In Elderly Bilinguals: Appearances Can Be Misleading.

PubMed

Ansaldo, Ana Inés; Ghazi-Saidi, Ladan; Adrover-Roig, Daniel

2015-01-01

Bilingualism has been associated with successful aging. In particular, research on the cognitive advantages of bilingualism suggests that it can enhance control over interference and help delay the onset of dementia signs. However, the evidence on the so-called cognitive advantage is not unanimous; furthermore, little is known about the neural basis of this supposed cognitive advantage in bilingual as opposed to monolingual elderly populations. In this study, elderly bilingual and monolingual participants performed a visuospatial interference control task during functional magnetic resonance imaging (fMRI) scanning. Response times and accuracy rates were calculated for congruent and incongruent conditions of the Simon task, and the neurofunctional correlates of performance on the Simon task were examined. The results showed equivalent performance on the Simon task across groups but different underlying neural substrates in the two groups. With incongruent trials, monolinguals activated the right middle frontal gyrus, whereas bilinguals relied upon the left inferior parietal lobule. These results show that elderly bilinguals and monolinguals have equivalent interference control abilities, but relay on different neural substrates. Thus, while monolinguals show a classical PASA (posterior-anterior shift in aging) effect, recruiting frontal areas, bilinguals activate visuospatial processing alone and thus do not show this posterior-anterior shift. Moreover, a modulation of frontal activity with task-dynamic control of interference, observed in the elderly bilingual group alone, suggests that elderly bilinguals deal with interference control without recruiting a circuit that is particularly vulnerable to aging.

Efficacy and safety of rotigotine in elderly patients with Parkinson's disease in comparison with the non-elderly: a post hoc analysis of randomized, double-blind, placebo-controlled trials.

PubMed

Nomoto, Masahiro; Iwaki, Hirotaka; Kondo, Hiroyuki; Sakurai, Masaya

2018-02-01

Rotigotine-a non-ergot dopamine agonist-has two advantages; it can stimulate all dopamine receptors (D1-D5) like innate dopamine, and its transdermal administration provides continuous dopaminergic stimulation. The age of the patient impacts the effect and adverse events of anti-parkinsonian treatment. We conducted a post hoc analysis on three randomized, double-blind, placebo-controlled trials performed in Japan to clarify the difference of anti-parkinsonian treatment in elderly and non-elderly patients. Data from two combination therapy trials (with levodopa) in advanced stage Parkinson's disease patients and one monotherapy trial in early stage patients were pooled and grouped by age (non-elderly aged < 70, elderly aged 70 +). In each age group, efficacy of rotigotine was compared to placebo. In the combination therapy, total Unified Parkinson's Disease Rating Scale Part III scores and some subtotal scores, including those for tremor, akinesia and gait disturbance, significantly improved in both elderly and non-elderly patients. Regarding safety, the incidence of total adverse event tended to be lower in elderly patients than non-elderly patients, although it was not significant. No difference was observed in maintenance dosage of rotigotine between the two groups. In conclusion, the improvement in motor symptoms and frequency of adverse events were shown to be similar in elderly and non-elderly patients with rotigotine-levodopa combination therapy. Further, there was no major difference in maintenance dosage of rotigotine between the age groups. These results suggest good tolerability of rotigotine among elderly patients.

Tocopherol in Elder Self-Neglect

NASA Technical Reports Server (NTRS)

Aung, K.; Burnett, J.; Dyer, C.; Smith, S. M.

2009-01-01

Although elder self-neglect is the most common form of elder mistreatment, its pathophysiology is not well understood. Alpha-tocopherol is a lipid soluble antioxidant required for the preservation of cell membranes. Since the association between tocopherol and cognitive impairment in older adults has been described, we explored the possibility of its role in elder self-neglect. OBJECTIVE: (1) To determine whether serum tocopherol levels are associated with elder self-neglect, and (2) to assess the association of serum tocopherol levels and cognitive function in elder self-neglect. METHODS: Serum tocopherol levels were measured in a cohort of 67 self-neglecting elders and 67 matched controls, recruited for the Consortium for Research in Elder Self-neglect of Texas. Pearson s correlation tests were performed to assess bivariate associations between serum tocopherol levels and cognitive function. RESULTS: Mean serum alpha-tocopherol levels were 10.8 +/- 4.7 ug/mL in self-neglect group and 13.0 +/- 4.9 ug/mL in control group (p = 0.006, unpaired student s t-test). None of the participants from either group had alpha-tocopherol level lower than the reference range. Mean serum gamma-tocopherol levels were 2.0 +/- 1.0 ug/mL in self-neglect group and 2.0 +/- 1.1 in control group (p=0.83). Proportion of the elders with gamma-tocopherol level lower than the reference range were 4.5% (3/66) in self-neglect group and 10.4% (7/67) in control group (p=0.32, Fisher s Exact Test). Among the self-neglecting elders, no association was found between serum alpha-tocopherol levels and the Mini-Mental State Examination (MMSE) or the Wolf-Klein Clock Drawing Test (CDT) scores (r =-0.42, p=0.75 for MMSE; r=0.08, p=0.54 for CDT). No association was found between serum gamma-tocopherol levels and the MMSE or the CDT (r=-0.12, p=0.35 for MMSE; r=0.05, p=0.68 for CDT). CONCLUSION: In our sample, neither alpha-tocopherol nor gamma-tocopherol appears to have a role in pathophysiology of elder self-neglect. Nevertheless, significantly lower serum alpha-tocopherol levels in the self neglect group merits further research.

Increased walking variability in elderly persons with congestive heart failure

NASA Technical Reports Server (NTRS)

Hausdorff, J. M.; Forman, D. E.; Ladin, Z.; Goldberger, A. L.; Rigney, D. R.; Wei, J. Y.

1994-01-01

OBJECTIVES: To determine the effects of congestive heart failure on a person's ability to walk at a steady pace while ambulating at a self-determined rate. SETTING: Beth Israel Hospital, Boston, a primary and tertiary teaching hospital, and a social activity center for elderly adults living in the community. PARTICIPANTS: Eleven elderly subjects (aged 70-93 years) with well compensated congestive heart failure (NY Heart Association class I or II), seven elderly subjects (aged 70-79 years) without congestive heart failure, and 10 healthy young adult subjects (aged 20-30 years). MEASUREMENTS: Subjects walked for 8 minutes on level ground at their own selected walking rate. Footswitches were used to measure the time between steps. Step rate (steps/minute) and step rate variability were calculated for the entire walking period, for 30 seconds during the first minute of the walk, for 30 seconds during the last minute of the walk, and for the 30-second period when each subject's step rate variability was minimal. Group means and 5% and 95% confidence intervals were computed. MAIN RESULTS: All measures of walking variability were significantly increased in the elderly subjects with congestive heart failure, intermediate in the elderly controls, and lowest in the young subjects. There was no overlap between the three groups using the minimal 30-second variability (elderly CHF vs elderly controls: P < 0.001, elderly controls vs young: P < 0.001), and no overlap between elderly subjects with and without congestive heart failure when using the overall variability. For all four measures, there was no overlap in any of the confidence intervals, and all group means were significantly different (P < 0.05).

Hypothyroidism in the elderly: diagnosis and management

PubMed Central

Bensenor, Isabela M; Olmos, Rodrigo D; Lotufo, Paulo A

2012-01-01

Thyroid disorders are highly prevalent, occurring most frequently in aging women. Thyroid-associated symptoms are very similar to symptoms of the aging process; thus, improved methods for diagnosing overt and subclinical hypothyroidism in elderly people are crucial. Thyrotropin measurement is considered to be the main test for detecting hypothyroidism. Combined evaluations of thyroid stimulating hormone (TSH) and free-thyroxine can detect overt hypothyroidism (high TSH with low free-thyroxine levels) and subclinical hypothyroidism (high TSH with normal free-thyroxine levels). It is difficult to confirm the diagnosis of thyroid diseases based only on symptoms, but presence of symptoms could be an indicator of who should be evaluated for thyroid function. The most important reasons to treat overt hypothyroidism are to relieve symptoms and avoid progression to myxedema. Overt hypothyroidism is classically treated using L-thyroxine; elderly patients require a low initial dose that is increased every 4 to 6 weeks until normalization of TSH levels. After stabilization, TSH levels are monitored yearly. There is no doubt about the indication for treatment of overt hypothyroidism, but indications for treatment of subclinical disease are controversial. Although treatment of subclinical hypothyroidism may result in lipid profile improvement, there is no evidence that this improvement is associated with decreased cardiovascular or all-cause mortality in elderly patients. In patients with a high risk of progression from subclinical to overt disease, close monitoring of thyroid function could be the best option. PMID:22573936

Relationship between body mass index and depressive symptoms: the "fat and jolly" hypothesis for the middle-aged and elderly in China.

PubMed

Zhang, Lin; Liu, Kun; Li, Hong; Li, Dan; Chen, Zhuo; Zhang, Li-Li; Guo, Lei-Lei

2016-11-29

Obesity has been identified as a worldwide epidemic. In China, the highest prevalence of obesity is observed in adults aged ≥45 years old. This study aimed to describe the association between BMI and depressive symptoms among a large representative sample of middle-aged and elderly in China. A longitudinal sample of the middle-aged and elderly (6,224 males and 6,883 females) who were interviewed in the 2011 China Health and Retirement Longitudinal Study was used. A multivariate logistic regression analysis was used to examine the effects of socio-demographic characteristics, lifestyle, activity status, health status, physical exercise and body weight on depressive symptoms. Approximately 6.94% of the males were underweight, 25.48% were overweight and 8.16% were obese. A higher prevalence of obesity was found among women, with 6.89% being underweight, 31.98% overweight and 14.28% obese. The underweight subjects were more likely to be depressed (odds ratio; OR = 1.30 and 1.19) compared with the normal weight people, respectively, whereas overweight and obese men and women were less likely to be depressed (overweight: OR = 0.76 and 0.80; obesity: OR = 0.64 and 0.65, respectively) than people of normal weight. Our data are consistent with the "fat and jolly" hypothesis being valid in both middle-aged and elderly men and women.

Hypothyroidism and hyperthyroidism in the elderly.

PubMed

Mintzer, M J

1992-04-01

Thyroid disease in the elderly can be easily overlooked. Symptoms too often are explained away as normal processes of aging. Development of unstable illness, especially cardiac disease, is a frequent mode of presentation. One symptom or one clinical feature of thyroid disease in the elderly may be overwhelming in its presentation, as in apathetic hyperthyroidism, thyroid myopathy, depression and dementia. Physical examination of the thyroid gland can be helpful but in a high percentage of older patients the gland is normal to palpation. The treatment of hypothyroidism is straightforward. Only myxedema coma requires large doses of levothyroxine parenterally; all other forms of hypothyroidism are treated with oral levothyroxine. The dose is started very low and increased gradually over months. The euthyroid state is achieved gradually and safely. Hyperthyroidism can be treated by several modalities. In the unstable elderly patient, antithyroid medication can quickly produce a euthyroid state. When the patient is stable, further decisions can be made regarding definitive therapy. Radioactive iodine therapy is well-tolerated and effective. On occasion, a second course of therapy is needed to suppress hyperthyroidism. Close follow-up of all patients ever having received this therapy is needed to identify the development of hypothyroidism. Surgical thyroid ablation may be necessary in patients who fail to respond to radioactive iodine therapy. Abnormalities associated with unresolved thyromegaly, dysphagia, or tracheal compression may require surgical intervention. If suspicion exists that the gland is cancerous, surgical intervention is warranted.

Specific algorithm method of scoring the Clock Drawing Test applied in cognitively normal elderly

PubMed Central

Mendes-Santos, Liana Chaves; Mograbi, Daniel; Spenciere, Bárbara; Charchat-Fichman, Helenice

2015-01-01

The Clock Drawing Test (CDT) is an inexpensive, fast and easily administered measure of cognitive function, especially in the elderly. This instrument is a popular clinical tool widely used in screening for cognitive disorders and dementia. The CDT can be applied in different ways and scoring procedures also vary. Objective The aims of this study were to analyze the performance of elderly on the CDT and evaluate inter-rater reliability of the CDT scored by using a specific algorithm method adapted from Sunderland et al. (1989). Methods We analyzed the CDT of 100 cognitively normal elderly aged 60 years or older. The CDT ("free-drawn") and Mini-Mental State Examination (MMSE) were administered to all participants. Six independent examiners scored the CDT of 30 participants to evaluate inter-rater reliability. Results and Conclusion A score of 5 on the proposed algorithm ("Numbers in reverse order or concentrated"), equivalent to 5 points on the original Sunderland scale, was the most frequent (53.5%). The CDT specific algorithm method used had high inter-rater reliability (p<0.01), and mean score ranged from 5.06 to 5.96. The high frequency of an overall score of 5 points may suggest the need to create more nuanced evaluation criteria, which are sensitive to differences in levels of impairment in visuoconstructive and executive abilities during aging. PMID:29213954

Marked reduction in the number of platelet-tritiated imipramine binding sites in geriatric depression

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nemeroff, C.B.; Knight, D.L.; Krishnan, R.R.

The number (Bmax) and affinity (Kd) of platelet-tritiated imipramine binding sites was determined in young and middle-aged controls 50 years of age and younger (n = 25), elderly normal controls over 60 years of age (n = 18), patients who fulfilled DSM-III criteria for major depression who were under 50 years of age (n = 29), patients who fulfilled DSM-III criteria for major depression who were 60 years of age and older (n = 19), and patients who fulfilled both DSM-III criteria for primary degenerative dementia and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disordersmore » Association criteria for probable Alzheimer's disease (n = 13). Both groups of depressed patients (under 50 and over 60 years of age) exhibited significant reductions (decreases 42%) in the number of platelet-tritiated imipramine binding sites with no change in affinity, when compared with their age-matched controls. There was little overlap in Bmax values between the elderly depressed patients and their controls. The patients with probable Alzheimer's disease showed no alteration in platelet-tritiated imipramine binding. There was no statistically significant relationship between postdexamethasone plasma cortisol concentrations and tritiated imipramine binding. These results indicate that platelet-tritiated imipramine binding may have potential utility as a diagnostic adjunct in geriatric depression, and moreover that the reduction in the number of platelet-tritiated imipramine binding sites is not due to hypercortisolemia.« less

Brain morphological and microstructural features in cryptogenic late-onset temporal lobe epilepsy: a structural and diffusion MRI study.

PubMed

Sone, Daichi; Sato, Noriko; Kimura, Yukio; Watanabe, Yutaka; Okazaki, Mitsutoshi; Matsuda, Hiroshi

2018-06-01

Although epilepsy in the elderly has attracted attention recently, there are few systematic studies of neuroimaging in such patients. In this study, we used structural MRI and diffusion tensor imaging (DTI) to investigate the morphological and microstructural features of the brain in late-onset temporal lobe epilepsy (TLE). We recruited patients with TLE and an age of onset > 50 years (late-TLE group) and age- and sex-matched healthy volunteers (control group). 3-Tesla MRI scans, including 3D T1-weighted images and 15-direction DTI, showed normal findings on visual assessment in both groups. We used Statistical Parametric Mapping 12 (SPM12) for gray and white matter structural normalization and comparison and used Tract-Based Spatial Statistics (TBSS) for fractional anisotropy and mean diffusivity comparisons of DTI. In both methods, p < 0.05 (family-wise error) was considered statistically significant. In total, 30 patients with late-onset TLE (mean ± SD age, 66.8 ± 8.4; mean ± SD age of onset, 63.0 ± 7.6 years) and 40 healthy controls (mean ± SD age, 66.6 ± 8.5 years) were enrolled. The late-onset TLE group showed significant gray matter volume increases in the bilateral amygdala and anterior hippocampus and significantly reduced mean diffusivity in the left temporofrontal lobe, internal capsule, and brainstem. No significant changes were evident in white matter volume or fractional anisotropy. Our findings may reflect some characteristics or mechanisms of cryptogenic TLE in the elderly, such as inflammatory processes.

fMRI responses to words repeated in a congruous semantic context are abnormal in mild Alzheimer’s disease

PubMed Central

Olichney, John M.; Taylor, Jason R.; Chan, Shiaohui; Yang, Jin-Chen; Stringfellow, Andrew; Hillert, Dieter G.; Simmons, Amanda L.; Salmon, David P.; Iragui-Madoz, Vicente; Kutas, Marta

2010-01-01

Background We adapted an event-related brain potential word repetition paradigm, sensitive to early Alzheimer’s disease (AD), for functional MRI (fMRI). We hypothesized that AD would be associated with reduced differential response to new/old congruous words. Methods Fifteen mild AD patients (mean age = 72.9) and 15 normal elderly underwent 1.5T fMRI during a semantic category decision task. Results We found robust between-groups differences in BOLD response to congruous words. In controls, the New > Old contrast demonstrated larger responses in much of the left-hemisphere (including putative P600 generators: parahippocampal, cingulate, fusiform, perirhinal, middle temporal (MTG) and inferior frontal gyri (IFG)); the Old > New contrast showed modest activation, mainly in right parietal and prefrontal cortex. By contrast, there were relatively few regions of significant New > Old responses in AD patients, mainly in the right-hemisphere, and their Old > New contrast did not demonstrate a right-hemisphere predominance. Across subjects, the spatial extent of New > Old responses in left medial temporal lobe (MTL) correlated with subsequent recall and recognition (r’s ≥ 0.60). In controls, the magnitude of New - Old response in left MTL, fusiform, IFG, MTG, superior temporal and cingulate gyrus correlated with subsequent cued recall and/or recognition (0.51 ≤ r’s ≤ 0.78). Conclusions A distributed network of mostly left-hemisphere structures, which are putative P600 generators, appears important for successful verbal encoding (with New > Old responses to congruous words in normal elderly). This network appears dysfunctional in mild AD patients, as reflected in decreased word repetition effects particularly in left association cortex, paralimbic and MTL structures. PMID:20433856

The effect of music therapy on depression and physiological parameters in elderly people living in a Turkish nursing home: a randomized-controlled trial.

PubMed

Gök Ugur, Hacer; Yaman Aktaş, Yeşim; Orak, Oya Sevcan; Saglambilen, Okan; Aydin Avci, İlknur

2017-12-01

This study was carried out in an effort to determine the effect of music therapy on depression and physiological parameters in elderly people who were living in a nursing home. The study was a randomized controlled trial. The study sample consisted of 64 elderly people who complied with the criteria of inclusion for the study. The data were collected using the 'Elderly Information Form' and 'Geriatric Depression Scale'. The music group listened to music three days in a week during 8 weeks. The depression levels were assessed at baseline (week 0) and follow-up in the eight week. It was found that the difference between post-test depression scores of the two groups was found to be statistically significant (t = -2.86, p <.01). The mean scores of post-test systolic blood pressure in the music group were found to be significantly lower than those of the control group (t = -3.11, p < .05). It was concluded that music therapy decreased the depression level and systolic blood pressure in elderly people. The study results implies that music therapy can be an effective practice for public health and home care nurses attempting to reduce depression and control physiological parameters of elderly people.

Vitamin D and muscle function in the elderly: the elixir of youth?

PubMed

Girgis, Christian M

2014-11-01

Circumstantial evidence suggests that vitamin D deficiency may contribute to age-related changes in skeletal muscle. This review discusses recent clinical trials examining effects of vitamin D on muscle function in the elderly, and poses the important question: can vitamin D reverse muscle ageing? Observational studies report an association between vitamin D and muscle atrophy/weakness in elderly subjects. Interventional studies suggest that frail, elderly subjects may benefit from vitamin D supplementation by displaying reduced falls, improved muscle function and increased muscle fibre size. However, meta-analyses do not report convincing effects of vitamin D in the elderly. This may be because of multiple factors including lack of standardized endpoints for muscle function, variable study design and different doses of vitamin D supplementation amongst these studies. The evidence base is therefore inconsistent. Vitamin D deficiency may exacerbate ageing of skeletal muscle. However, current evidence that vitamin D supplementation reverses age-related muscle dysfunction is equivocal and does not justify stringent vitamin D targets in the elderly. Until these issues are clarified, the safest option is to aim for conservative vitamin D targets that are sufficient for normal calcium homeostasis.

Health status of elderly based on daily activities living, cholesterol and uric acid profile in Medan city

NASA Astrophysics Data System (ADS)

Amelia, R.; Harahap, J.; Wahyuni, A. S.; Pratama, A.

2018-03-01

Health problems in the elderly come from declining body cells, so the function and body endurance decreased along with increased risk factors for diseases. This study aimed to determine the elderly health status in Public Health Center of Tuntungan Medan. Health status includes measurement of daily activities living (DAL),and health parameter include blood pressure, blood sugar level (BSL), cholesterol level and uric acid level. The study design was descriptive with cross-sectional approach. The study population was the entire elderly population residing in the service area of public health center of Tuntungan Medan (55 subjects). The elderly who had a reasonable level of independence were 47 subjects (85.5%), the majority of elderly were in the category of hypertension stage I (20 subjects; 36.4%) with a mean systolic blood pressure level was 143mmHg. Most of them have BSL that exceeded the standard limit (42 subjects; 76.4%) with BSL mean value was 177mg/dL.Uric acid levels were in the high category (34 subjects; 61.98%) with a mean value of 7.0mm/dL, and most of them have normal cholesterol (43 subjects; 78.2%).

Sexual function and practice in elderly men of lower socioeconomic status.

PubMed

Cogen, R; Steinman, W

1990-08-01

Normal aging plus certain prevalent diseases are believed to render many elderly men impotent. Recent studies have suggested that educated middle-class and upper-class elderly men continue sexual activity, despite erectile dysfunction, by employing alternative practices such as mutual masturbation and oral sex. Few elderly men of lower socioeconomic background have been included in these studies, however. Using physician-administered interviews, 87 men attending an urban Veterans Administration geriatric clinic were studied to determine (1) the prevalence of erectile dysfunction, and (2) the sexual practices and attitudes of this group. Of the 87 men, 28% reported complete loss of erectile function, while 31% had frequent difficulties achieving vaginal intromission. Unlike economically advantaged groups, only 29% used mutual masturbation and 16% used oral sex. Attitudes toward these practices were negative. With one exception, men unable to perform coitus ceased all heterosexual activities.

Sustained choroid plexus function in human elderly and Alzheimer's disease patients.

PubMed

Spector, Reynold; Johanson, Conrad E

2013-09-24

We and other investigators have postulated deterioration of essential choroid plexus (CP) functions in some elderly and especially Alzheimer's disease patients based on apparent anatomical, histological and pathological changes in CP. We have termed this putative phenomenon CP failure. By focusing on four essential energy-requiring CP functions, specifically ascorbic acid (AA) and folate transport from blood into CSF, transthyretin synthesis and secretion into CSF, and electrolyte/acid-base balance in CSF, we were able to evaluate the hypothesis of CP failure by reviewing definitive human data. In both healthy elderly and Alzheimer's disease patients, the CP functions normally to transport AA and folates actively from blood into CSF, synthesize and secrete transthyretin into CSF, and maintain CSF acid-base balance and ion concentrations. These human CSF compositional data provide no support for the notion of CP failure in elderly humans and Alzheimer's disease patients.

MANAGEMENT OF ANOREXIA IN ELDERLY AS REMARKED BY MEDIEVAL PERSIAN PHYSICIANS.

PubMed

Nimrouzi, Majid; Zarshenas, Mohammad M

2015-01-01

Normal ageing is often accompanied by loss of appetite and decrease in food intake. Weight loss of senescence is called anorexia of ageing. As an outstanding scientist and physician of Traditional Persian Medicine, Avicenna has introduced an unconventional approach to seniors. He also believed that the elderly should consider special schemes in order to maintain their health. These schemes include consideration of nutrition, mental states, sleep, bathing, and physical activities, and even choosing some appropriate hobbies. The elderly should consume foods and fruits with laxative and stool-softening properties to prevent constipation. They would also do better to decrease the amount of food eaten at meals, but at the same time increasing the number of meals to compensate for low food intake. Moreover, they should maintain their vital force and avoid any activities that tax the body. Furthermore, considering the principles of hifz-al-sehah can help secure long and healthy lives for the elderly.

[Development and Effects of a Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus].

PubMed

Kang, Hye Yeon; Gu, Mee Ock

2015-08-01

This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus. A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0. For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group. The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.

The comparison respond of braking torque control between PID and SMC controller for electric powered wheelchair descending on slope condition

NASA Astrophysics Data System (ADS)

Asyraf, S. M.; Heerwan, P. M.; Izhar, I. M.

2018-04-01

During descending on a slope, the speed of Electric Powered Wheelchair (EPW) tends to changed rapidly. Normally, most EPW is provided with mechanical braking system which transfers human pulling force of the lever creating friction at the tire. However, the task is difficult for the users are elderly or paralyses. However, even for normal user with good strength, in fear condition they tend to give sudden braking which leads to tire locking up and skidding, eventually EPW unstable. These problems will cause accident and injuries to the users if speed does not properly control. In this paper, the automated braking torque control method was proposed in EPW as alternative to solve this problem and increase the mobility and stability especially during descending on slope in other to help the user of the EPW as their daily transportation. In this research, Proportional-Integral-Derivative and Sliding Mode Control controller are compared to determine the best response for torque braking control. The rapid change of speed can be controlled by the braking torque using proposed controllers based on the desired constant speed set by the control designer. Moreover, the sudden braking that caused tire to lock up and skid can be avoided. Furthermore, result from SMC shows this controller have good time respond to maintain the speed based on desired value when descending at slope condition by controlling the braking torque compared to the PID controller.

Potential contribution of the neurodegenerative disorders risk loci to cognitive performance in an elderly male gout population

PubMed Central

Han, Lin; Jia, Zhaotong; Cao, Chunwei; Liu, Zhen; Liu, Fuqiang; Wang, Lin; Ren, Wei; Sun, Mingxia; Wang, Baoping; Li, Changgui; Chen, Li

2017-01-01

Abstract Cognitive impairment has been described in elderly subjects with high normal concentrations of serum uric acid. However, it remains unclear if gout confers an increased poorer cognition than those in individuals with asymptomatic hyperuricemia. The present study aimed at evaluating cognitive function in patients suffering from gout in an elderly male population, and further investigating the genetic contributions to the risk of cognitive function. This study examined the cognitive function as assessed by Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in 205 male gout patients and 204 controls. The genetic basis of these cognitive measures was evaluated by genome-wide association study (GWAS) data in 102 male gout patients. Furthermore, 7 loci associated with cognition in GWAS were studied for correlation with gout in 1179 male gout patients and 1848 healthy male controls. Compared with controls, gout patients had significantly lower MoCA scores [22.78 ± 3.01 vs 23.42 ± 2.95, P = .023, adjusted by age, body mass index (BMI), education, and emotional disorder]. GWAS revealed 7 single-nucleotide polymorphisms (SNPs) associations with MoCA test at a level of conventional genome-wide significance (P < 9.6 × 10–8). The most significant association was observed between rs12895072 and rs12434554 within the KTN1 gene (Padjusted = 4.2 × 10−9, Padjusted = 4.7 × 10–9) at 14q22. The next best signal was in RELN gene (rs155333, Padjusted = 1.3 × 10–8) at 7q22, while the other variants at rs17458357 (Padjusted = 3.98 × 10–8), rs2572683 (Padjusted = 8.9 × 10–8), rs12555895 (Padjusted = 2.6 × 10–8), and rs3764030 (Padjusted = 9.4 × 10–8) were also statistically significant. The 7 SNPs were not associated with gout in further analysis (all P > .05). Elderly male subjects with gout exhibit accelerated decline in cognition performance. Several neurodegenerative disorders risk loci were identified for genetic contributors to cognitive performance in our Chinese elderly male gout population. Larger prospective studies of the cognitive performance and genetic analysis in gout subjects are recommended. PMID:28953682

[Normalizing effect of the pineal gland peptides on the daily melatonin rhythm in old monkeys and elderly people].

PubMed

Korkushko, O V; Lapin, B A; Goncharova, N D; Khavinson, V Kh; Shatilo, V B; Vengerin, A A; Antoniuk-Shcheglova, I A; Magdich, L V

2007-01-01

In the course of aging both monkeys and people reveal decreased night and average daily level of melatonin in the blood plasma and reduced hormone circadian rhythm amplitude, which evidence the disorder of the pineal gland melatonin releasing function. Peptide preparations of the pineal gland (Epithalamin--a complex of peptides isolated from the pineal gland and Epitalon--synthetic tetrapeptide) recover night release of endogenous melatonin and lead to the normalization of the hormone circadian rhythm in the blood plasma. In elderly people Epithalamin and Epitalon modulate pineal gland functional state: people with pineal gland functional insufficiency report an increase of night melatonin level. The preparations of the pineal gland, effectively increasing melatonin concentration and having no side effects, can be used in clinical geriatric practice.

Characteristics of depression in community-dwelling elderly people as indicated by the tree-drawing test.

PubMed

Murayama, Norio; Endo, Tadashi; Inaki, Koichiro; Sasaki, Shinsai; Fukase, Yuko; Ota, Kazumi; Iseki, Eizo; Tagaya, Hirokuni

2016-07-01

The tree-drawing test (TDT) is a typical projective method, but previous studies have paid little attention to it for elderly people. We investigated the characteristics of depression in community-dwelling elderly people as indicated by the TDT. This study was a complete enumeration survey of elderly people conducted through home visits. The contents of the survey included gender, age, presence or absence of housemates, frequency of going out, the 15-item Geriatric Depression Scale, and TDT. The subjects were divided into three groups (normal, depressed tendency, and depressed) according to the total 15-item Geriatric Depression Scale score. In TDT, no significant difference was observed in drooping crown, shadow of the whole tree, or shadow near the base, which have been regarded as indices of depression in younger people. However, the values concerning the size of the tree, such as the height and width of the whole tree, height and width of the crown, and number of occupied areas (of the paper), were significantly lower in the depressed group than in the other groups. In addition, the width of the trunk was significantly smaller in the depressed group than in the normal group. Subjects were classified as being in a 'depressed state' if they used 40 or fewer areas for drawing (i.e. occupied areas) and a 'non-depressed state' if they used 41 or more areas. This enabled depression to be detected (sensitivity: 71.4%; specificity: 79.9%). The size of the tree in TDT is suggested to reflect characteristics of depression in elderly people, such as introversion, reserve, antisocial attitude, a feeling of inferiority, weakness of ego, and lack of vigour. Furthermore, the numbers of occupied areas were found to be relatively useful in detecting depression in elderly people. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Effects of donepezil on verbal memory after semantic processing in healthy older adults.

PubMed

FitzGerald, David B; Crucian, Gregory P; Mielke, Jeannine B; Shenal, Brian V; Burks, David; Womack, Kyle B; Ghacibeh, Georges; Drago, Valeria; Foster, Paul S; Valenstein, Edward; Heilman, Kenneth M

2008-06-01

To learn if acetylcholinesterase inhibitors alter verbal recall by improving semantic encoding in a double-blind randomized placebo-controlled trial. Cholinergic supplementation has been shown to improve delayed recall in adults with Alzheimer disease. With functional magnetic resonance imaging, elderly adults, when compared with younger participants, have reduced cortical activation with semantic processing. There have been no studies investigating the effects of cholinergic supplementation on semantic encoding in healthy elderly adults. Twenty elderly participants (mean age 71.5, SD+/-5.2) were recruited. All underwent memory testing before and after receiving donepezil (5 mg, n=11 or 10 mg, n=1) or placebo (n=8) for 6 weeks. Memory was tested using a Levels of Processing task, where a series of words are presented serially. Subjects were either asked to count consonants in a word (superficially process) or decide if the word was "pleasant" or "unpleasant" (semantically process). After 6 weeks of donepezil or placebo treatment, immediate and delayed recall of superficially and semantically processed words was compared with baseline performance. Immediate and delayed recall of superficially processed words did not show significant changes in either treatment group. With semantic processing, both immediate and delayed recall performance improved in the donepezil group. Our results suggest that when using semantic encoding, older normal subjects may be aided by anticholinesterase treatment. However, this treatment does not improve recall of superficially encoded words.

The effects of Nordic and general walking on depression disorder patients’ depression, sleep, and body composition

PubMed Central

Park, Seong Doo; Yu, Seong Hun

2015-01-01

[Purpose] This study examined Nordic walking as an exercise intervention for the elderly with depression. [Subjects] Twenty-four patients who were diagnosed with depression were randomly selected and divided into two groups, an experimental group which performed Nordic walking, and a control group, which performed normal walking. [Methods] Both groups practiced their respective walking exercise for 50 minutes per day, three times a week for eight weeks. To compare the effects of the intervention, psychological factors using the Beck depression inventory and sleep quality was assessed using the Korean version Pittsburgh sleep quality index. Skeletal muscle mass, fat free mass, body mass index, body fat percentage, and basal metabolism were estimated three times by a body composition analyzer, before the intervention, four weeks after the intervention, and eight weeks after the intervention. [Results] There was a significant difference in depression with a main effect of time in both groups. There was also a significant difference in sleep in over time and interaction. The differences over time between the two groups were significant for depression, sleep, and skeletal muscle mass. [Conclusion] The results suggests that Nordic walking has a positive effect on depression and sleeping disorders of the elderly, suggesting that Nordic walking based exercise programs should be developed for the elderly who suffer from depression or a sleeping disorder. PMID:26357429

VLDL from Metabolic Syndrome Individuals Enhanced Lipid Accumulation in Atria with Association of Susceptibility to Atrial Fibrillation.

PubMed

Lee, Hsiang-Chun; Lin, Hsin-Ting; Ke, Liang-Yin; Wei, Chi; Hsiao, Yi-Lin; Chu, Chih-Sheng; Lai, Wen-Ter; Shin, Shyi-Jang; Chen, Chu-Huang; Sheu, Sheng-Hsiung; Wu, Bin-Nan

2016-01-20

Metabolic syndrome (MetS) represents a cluster of metabolic derangements. Dyslipidemia is an important factor in MetS and is related to atrial fibrillation (AF). We hypothesized that very low density lipoproteins (VLDL) in MetS (MetS-VLDL) may induce atrial dilatation and vulnerability to AF. VLDL was therefore separated from normal (normal-VLDL) and MetS individuals. Wild type C57BL/6 male mice were divided into control, normal-VLDL (nVLDL), and MetS-VLDL (msVLDL) groups. VLDL (15 µg/g) and equivalent volumes of saline were injected via tail vein three times a week for six consecutive weeks. Cardiac chamber size and function were measured by echocardiography. MetS-VLDL significantly caused left atrial dilation (control, n = 10, 1.64 ± 0.23 mm; nVLDL, n = 7, 1.84 ± 0.13 mm; msVLDL, n = 10, 2.18 ± 0.24 mm; p < 0.0001) at week 6, associated with decreased ejection fraction (control, n = 10, 62.5% ± 7.7%, vs. msVLDL, n = 10, 52.9% ± 9.6%; p < 0.05). Isoproterenol-challenge experiment resulted in AF in young msVLDL mice. Unprovoked AF occurred only in elderly msVLDL mice. Immunohistochemistry showed excess lipid accumulation and apoptosis in msVLDL mice atria. These findings suggest a pivotal role of VLDL in AF pathogenesis for MetS individuals.

SENIORLAB: a prospective observational study investigating laboratory parameters and their reference intervals in the elderly.

PubMed

Risch, Martin; Nydegger, Urs; Risch, Lorenz

2017-01-01

In clinical practice, laboratory results are often important for making diagnostic, therapeutic, and prognostic decisions. Interpreting individual results relies on accurate reference intervals and decision limits. Despite the considerable amount of resources in clinical medicine spent on elderly patients, accurate reference intervals for the elderly are rarely available. The SENIORLAB study set out to determine reference intervals in the elderly by investigating a large variety of laboratory parameters in clinical chemistry, hematology, and immunology. The SENIORLAB study is an observational, prospective cohort study. Subjectively healthy residents of Switzerland aged 60 years and older were included for baseline examination (n = 1467), where anthropometric measurements were taken, medical history was reviewed, and a fasting blood sample was drawn under optimal preanalytical conditions. More than 110 laboratory parameters were measured, and a biobank was set up. The study participants are followed up every 3 to 5 years for quality of life, morbidity, and mortality. The primary aim is to evaluate different laboratory parameters at age-related reference intervals. The secondary aims of this study include the following: identify associations between different parameters, identify diagnostic characteristics to diagnose different circumstances, identify the prevalence of occult disease in subjectively healthy individuals, and identify the prognostic factors for the investigated outcomes, including mortality. To obtain better grounds to justify clinical decisions, specific reference intervals for laboratory parameters of the elderly are needed. Reference intervals are obtained from healthy individuals. A major obstacle when obtaining reference intervals in the elderly is the definition of health in seniors because individuals without any medical condition and any medication are rare in older adulthood. Reference intervals obtained from such individuals cannot be considered representative for seniors in a status of age-specific normal health. In addition to the established methods for determining reference intervals, this longitudinal study utilizes a unique approach, in that survival and long-term well-being are taken as indicators of health in seniors. This approach is expected to provide robust and representative reference intervals that are obtained from an adequate reference population and not a collective of highly selected individuals. The present study was registered under International Standard Randomized Controlled Trial Number registry: ISRCTN53778569.

A qualitative investigation of the impact of asthma and self-management strategies among older adults.

PubMed

O'Conor, Rachel; Martynenko, Melissa; Gagnon, Monica; Hauser, Diane; Young, Edwin; Lurio, Joseph; Wisnivesky, Juan P; Wolf, Michael S; Federman, Alex D

2017-01-02

 We sought feedback from elderly patients living with asthma to understand their experience with assuming self-management roles for their asthma in order to inform the design and implementation of a primary care-based strategy that could best support their asthma control. We held six focus groups with a total of 31 English- and Spanish-speaking older adults with a current diagnosis of asthma. Focus groups addressed the effect of asthma on patients' lives and self-management strategies. Transcripts were analyzed using constant comparative techniques. Asthma exerted a consistent effect on patients' physical and psychological well-being. Common barriers to self-care included misuse of controller medications and uncertainty whether shortness of breath, fatigue, and cough were due to their asthma or some other chronic illness. Patients developed coping strategies to continue with daily activities even when experiencing symptoms, but did not recognize attainable asthma quality of life. Asthma had a distinct impact on elderly adults' quality of life; due to their longstanding history with this condition, many patients had accepted these symptoms as a "new normal." Developing strategies to reorient patients' perceptions of the possibilities for managing their illness will be critical to the success of asthma self-management support programs specific to older adults.

Reviving the protein quality control system: therapeutic target for cardiac disease in the elderly.

PubMed

Meijering, Roelien A M; Henning, Robert H; Brundel, Bianca J J M

2015-04-01

It has been firmly established that ageing constitutes a principal risk factor for cardiac disease. Currently, the underlying mechanisms of ageing that contribute to the initiation or acceleration of cardiac disease are essentially unresolved. Prevailing theories of ageing center on the loss of cellular protein homeostasis, by either design (genetically) or "wear and tear" (environmentally). Either or both ways, the normal protein homeostasis in the cell is affected, resulting in aberrant and misfolded proteins. Should such misfolded proteins escape the protein quality control (PQC) system, they become proteotoxic and accelerate the loss of cellular integrity. Impairment of PQC plays a prominent role in the pathophysiology of ageing-related neurodegenerative disorders such as Parkinson's, Huntington׳s, and Alzheimer׳s disease. The concept of an impaired PQC driving ageing-related diseases has recently been expanded to cardiac diseases, including atrial fibrillation, cardiac hypertrophy, and cardiomyopathy. In this review, we provide a brief overview of the PQC system in relation to ageing and discuss the emerging concept of the loss of PQC in cardiomyocytes as a trigger for cardiac disease. Finally, we discuss the potential of boosting the PQC system as an innovative therapeutic target to treat cardiac disease in the elderly. Copyright © 2015 Elsevier Inc. All rights reserved.

Communication between the elderly person and the family health team: is there integrality?

PubMed

de Almeida, Rita Tereza; Ciosak, Suely Itsuko

2013-01-01

to verify the forms of communication used in four Primary Health Units with Family Health Program teams in Porto Feliz, São Paulo, and how they impact in the care and control of the health of elderly people. this qualitative study sought to capture the communication between elderly people and healthcare professionals. Interviews were conducted with 20 elderly people of both sexes. from the discourses and observations, assertive communication and blocked communication emerged as the central analysis themes, the verbal and nonverbal elements of which, unveiled subjectivity of the communication process, of the local culture and of the psychosocial factors positively and negatively contributing to the healthcare for elderly people. The nursing teams of the Family Health Strategy showed forms of communication that favored the adherence of the elderly people to the care and control of their health. Negatives aspects did not have completely prejudicial consequences, however, should be avoided, in order to facilitate integral care to elderly people. it is worth reinforcing the need for improvement of the nursing team and other healthcare professionals regarding health communication as an innovative technology, bringing credibility to the health promotion and prevention programs with elderly users.

Influence of a removable prosthesis on oral health-related quality of life and mastication in elders with Parkinson disease.

PubMed

Ribeiro, Giselle R; Campos, Camila H; Rodrigues Garcia, Renata Cunha Matheus

2017-11-01

Parkinson disease (PD) symptoms, such as muscle rigidity, tremors in the lips and tongue, and involuntary mandibular movements, may cause oral health-related problems, mastication difficulties, and denture discomfort because of the difficulty in controlling a prosthesis with the oral musculature. The purpose of this observational clinical study was to evaluate the influence of oral rehabilitation with a removable prosthesis on oral health-related quality of life (OHRQoL) and masticatory efficiency (ME) in elders with PD. Thirty-four elders with PD (n=17, mean age 69.4 ±4.7 years) or without PD (n=17, mean age 70.7 ±4.7 years) were recruited. All participants first underwent OHRQoL and ME evaluations. Two months after the insertion of new removable prostheses, the participants were reassessed. The OHRQoL was measured with the Oral Health Impact Profile (OHIP-49). ME was evaluated by determining the percentage weight of the comminuted silicone-based artificial material that passed through a 2.8 mm sieve. For each group, data were compared between baseline and after insertion of new removable prostheses by paired t test or Wilcoxon sign test/signed-rank test. Group differences were assessed at each time point by t test (α=.05). After the insertion of removable prostheses, elders with PD showed improved OHRQoL and ME. Controls also showed improvements on both measures after insertion of removable prostheses. At baseline, elders with PD had lower OHRQoL and ME compared with the controls (P<.05). After removable prosthesis insertion, the elders with PD continued to show lower ME values than the controls, but their OHRQoL was similar. Oral rehabilitation with new removable dental prostheses improved the OHRQoL and ME in elders with and without PD, although ME did not reach control levels in elders with PD. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Intention tremor, parkinsonism, and generalized brain atrophy in male carriers of fragile X.

PubMed

Hagerman, R J; Leehey, M; Heinrichs, W; Tassone, F; Wilson, R; Hills, J; Grigsby, J; Gage, B; Hagerman, P J

2001-07-10

The authors report five elderly men with the fragile X premutation who had a progressive action tremor associated with executive function deficits and generalized brain atrophy. These individuals had elevated fragile X mental retardation 1 gene (FMR1) messenger RNA and normal or borderline levels of FMR1 protein. The authors propose that elevations of FMR1 messenger RNA may be causative for a neurodegenerative syndrome in a subgroup of elderly men with the FMR1 premutation.

A ZigBee-Based Location-Aware Fall Detection System for Improving Elderly Telecare

PubMed Central

Huang, Chih-Ning; Chan, Chia-Tai

2014-01-01

Falls are the primary cause of accidents among the elderly and frequently cause fatal and non-fatal injuries associated with a large amount of medical costs. Fall detection using wearable wireless sensor nodes has the potential of improving elderly telecare. This investigation proposes a ZigBee-based location-aware fall detection system for elderly telecare that provides an unobstructed communication between the elderly and caregivers when falls happen. The system is based on ZigBee-based sensor networks, and the sensor node consists of a motherboard with a tri-axial accelerometer and a ZigBee module. A wireless sensor node worn on the waist continuously detects fall events and starts an indoor positioning engine as soon as a fall happens. In the fall detection scheme, this study proposes a three-phase threshold-based fall detection algorithm to detect critical and normal falls. The fall alarm can be canceled by pressing and holding the emergency fall button only when a normal fall is detected. On the other hand, there are three phases in the indoor positioning engine: path loss survey phase, Received Signal Strength Indicator (RSSI) collection phase and location calculation phase. Finally, the location of the faller will be calculated by a k-nearest neighbor algorithm with weighted RSSI. The experimental results demonstrate that the fall detection algorithm achieves 95.63% sensitivity, 73.5% specificity, 88.62% accuracy and 88.6% precision. Furthermore, the average error distance for indoor positioning is 1.15 ± 0.54 m. The proposed system successfully delivers critical information to remote telecare providers who can then immediately help a fallen person. PMID:24743841

Body composition changes were related to nutrient intakes in elderly men but elderly women had a higher prevalence of sarcopenic obesity in a population of Korean adults.

PubMed

Oh, Chorong; Jho, Sunkug; No, Jae-Kyung; Kim, Hak-Seon

2015-01-01

In this study, we examined the relationship between sarcopenic obesity (SO) and nutrition status, according to sex in Korean adults who were 60 years or older. Body composition was categorized as SO, sarcopenic nonobesity, nonsarcopenic obesity, and nonsarcopenic nonobesity. Obesity was defined by body mass index. Sarcopenia was defined as an appendicular skeletal muscle mass divided by weight (Wt) of less than 1 SD below the sex-specific mean for young adults. Subjects included 1433 subjects (658 men and 775 women) who were 60 years or older and who participated in the fifth Korea National Health and Nutritional Examination Survey 2010. Sarcopenic obesity was more prevalent in women (31.3%) than in men (19.6%). Individuals with SO had significantly higher fasting insulin, homeostasis model assessment of insulin resistance (male: 3.2 ± 1.4, female: 3.4 ± 2.1), and triglycerides (male: 167.3 ± 90.6 mg/dL, female: 160.7 ± 85.0 mg/dL). High-density lipoprotein was under the normal criteria (50 mg/dL) in women. Intake of nutrients associated with muscle loss (protein, vitamin D, calcium, and vitamin C) was significantly different among the male but not the female groups. Although protein intake was normal, calcium and vitamin D intakes were insufficient in all groups. In conclusion, body composition changes were related to nutrient intakes in elderly (60 years or older) men but not elderly women. Women had a higher prevalence of SO than did men, suggesting that early nutritional intervention in elderly women may help them address age-associated body composition changes. Copyright © 2015 Elsevier Inc. All rights reserved.

Out of sight, out of mind: Categorization learning and normal aging.

PubMed

Schenk, Sabrina; Minda, John P; Lech, Robert K; Suchan, Boris

2016-10-01

The present combined EEG and eye tracking study examined the process of categorization learning at different age ranges and aimed to investigate to which degree categorization learning is mediated by visual attention and perceptual strategies. Seventeen young subjects and ten elderly subjects had to perform a visual categorization task with two abstract categories. Each category consisted of prototypical stimuli and an exception. The categorization of prototypical stimuli was learned very early during the experiment, while the learning of exceptions was delayed. The categorization of exceptions was accompanied by higher P150, P250 and P300 amplitudes. In contrast to younger subjects, elderly subjects had problems in the categorization of exceptions, but showed an intact categorization performance for prototypical stimuli. Moreover, elderly subjects showed higher fixation rates for important stimulus features and higher P150 amplitudes, which were positively correlated with the categorization performances. These results indicate that elderly subjects compensate for cognitive decline through enhanced perceptual and attentional processing of individual stimulus features. Additionally, a computational approach has been applied and showed a transition away from purely abstraction-based learning to an exemplar-based learning in the middle block for both groups. However, the calculated models provide a better fit for younger subjects than for elderly subjects. The current study demonstrates that human categorization learning is based on early abstraction-based processing followed by an exemplar-memorization stage. This strategy combination facilitates the learning of real world categories with a nuanced category structure. In addition, the present study suggests that categorization learning is affected by normal aging and modulated by perceptual processing and visual attention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Contribution of four lifelong factors of cognitive reserve on late cognition in normal aging and Parkinson's disease.

PubMed

Rouillard, Maud; Audiffren, Michel; Albinet, Cédric; Ali Bahri, Mohamed; Garraux, Gaëtan; Collette, Fabienne

2017-03-01

Cognitive reserve (CR) was proposed to explain how individual differences in brain function help to cope with the effects of normal aging and neurodegenerative diseases. Education, professional solicitations, and engagement in leisure and physical activities across the lifetime are considered as major determinants of this reserve. Using multiple linear regression analyses, we tested separately in healthy elderly and Parkinson's disease (PD) populations to what extent cognitive performance in several domains was explained by (a) any of these four environmental lifespan variables; (b) demographic and clinical variables (age, gender, depression score, and, for the PD group, duration of disease and dopaminergic drugs). We also tested for an interaction, if any, between these lifespan variables and brain pathology indexed by global atrophy measured from high-resolution anatomical magnetic resonance imaging. Age was negatively associated with cognitive performance in the PD group. In healthy elderly participants, we observed significant positive associations between cognitive performance and (a) education, (b) leisure activities, and (c) professional solicitation (decisional latitude). Furthermore, participants with greater brain atrophy benefited more from CR. In PD patients, education and professional solicitations contributed to cognitive performance but to a lesser extent than in controls. CR factors modulated the relationship between cognition and brain atrophy only in patients with a slight or moderate brain atrophy. Education is the CR factor that contributed the most to late cognitive functioning in both groups, closely followed by leisure activity in normal aging and professional solicitations in PD. Our results also provide evidence suggesting that the effects of CR does not express similarly in normal aging and PD. From a broader perspective, these results seem to indicate that CR factors the most consistently practiced across lifespan (education and professional solicitation) are those that are the more strongly associated to late cognitive efficiency.

Pharmaceutical care of elderly patients with poorly controlled type 2 diabetes mellitus: a randomized controlled trial.

PubMed

Chen, Jyun-Hong; Ou, Huang-Tz; Lin, Tzu-Chieh; Lai, Edward Chia-Cheng; Kao, Yea-Huei Yang

2016-02-01

Care of the elderly with diabetes is more complicated than that for other age groups. The elderly and/or those with multiple comorbidities are often excluded from randomized controlled trials of treatments for diabetes. The heterogeneity of health status of the elderly also increases the difficulty in diabetes care; therefore, diabetes care for the elderly should be individualized. Motivated patients educated about diabetes benefit the most from collaborating with a multidisciplinary patient-care team. A pharmacist is an important team member by serving as an educator, coach, healthcare manager, and pharmaceutical care provider. To evaluate the effects of pharmaceutical care on glycemic control of ambulatory elderly patients with type 2 diabetes. A 421-bed district hospital in Nantou City, Taiwan. We conducted a randomized controlled clinical trial involving 100 patients with type 2 diabetes with poor glycemic control (HbA1c levels of ≥9.0 %) aged ≥65 years over 6 months. Participants were randomly assigned to a standard-care (control, n = 50) or pharmaceutical-care (intervention, n = 50) group. Pharmaceutical care was provided by a certified diabetes-educator pharmacist who identified and resolved drug-related problems and established a procedure for consultations pertaining to medication. The Mann–Whitney test was used to evaluate nonparametric quantitative data. Statistical significance was defined as P < 0.05. The change in the mean HbA1c level from the baseline to the next level within 6 months after recruiting. Nonparametric data (Mann–Whitney test) showed that the mean HbA1c level significantly decreased (0.83 %) after 6 months for the intervention group compared with an increase of 0.43 % for the control group (P ≤ 0.001). Medical expenses between groups did not significantly differ (−624.06 vs. −418.7, P = 0.767). There was no significant difference in hospitalization rates between groups. The pharmacist intervention program provided pharmaceutical services that improved long-term, safe control of blood sugar levels for ambulatory elderly patients with diabetes and did not increase medical expenses.

[Establishment and application effect of fall prevention and control information system in elderly community].

PubMed

Zhao, Ting; Pi, Hong-Ying; Ku, Hong-An; Pan, Li; Gong, Zhu-Yun

2018-02-08

To investigate establishing, applying and evaluating the fall prevention and control information system in elderly community. Relying on internet technology and informatization means, the fall comprehensive prevention and control strategy of elderly was guided into online from offline. The fall prevention and control information system which was a collection of risk assessment, remote education and feedback was established. One hundred and twenty-six elderly (over 60 years old) in community were screened in this study and 84 high-risk elders who were involved in the remote continuous comprehensive intervention were screened out. Intervening measures included distributing propaganda album, making mission slides and video used to play with the interpretation remotely. Then fall related situation before and after intervention was analyzed and the effectiveness of system evaluated. After remote intervention, the fall incidence of high-risk group decreased from 21.43% to 4.76%( P <0.01). The body balance and gait stability improved clearly( P <0. 01). The rate of taking proper prevention and control behavior significantly improved( P <0.01). They believed in themselves not to fall down with more confidence when taking complex behaviors( P <0.01). The security of environment at home significantly enhanced( P <0. 01). Fall prevention and control information system in elderly community was innovative and convenient. The system could roundly assess the status related to fall and accurately screen out high-risk group. The system could implement the remote continuous comprehensive intervention so that the incident of fall was decrease. In conclusion, the system is stable and effective, can be further popularization and application as a successful pilot.

Tactile Intervention as a Novel Technique in Improving Body Stability in Healthy Elderly and Elderly with Diabetes

PubMed Central

Alshammari, Faris S.; Daher, Noha; Alzoghbieh, Eman S.; Dehom, Salem O.; Laymon, Michael S.

2014-01-01

Abstract Background: Body sway increases in the elderly because of normal aging and high incidence of disease such as diabetes. Prevalence of sway is greater in the elderly with diabetes because of damage to the central and peripheral nervous systems. Increase in body sway is associated with an elevated risk of falling. Falling is one of the major causes of morbidity and mortality in the elderly. The purpose of this study was to develop a new technique to improve body stability and decrease body sway in the elderly people with or without diabetes. Subjects and Methods: Twenty-two subjects—12 elderly (mean age, 75.5±7.3 years) and 10 age-matched elderly with diabetes (mean age, 72.5±5.3 years)—were recruited for this study. Subjects received tactile feedback as a tingling sensation resulting from electrical stimulation triggered by body sway. Results: The results showed a significant reduction in body sway in the elderly while standing on foam with eyes open (1.0±0.31 vs. 1.9±0.8; P=0.006) and eyes closed (1.8±0.7 vs. 3.3±1.5; P=0.001). In the group with diabetes, there was a significant reduction in body sway while standing on foam with eyes closed (1.4±0.5 vs. 2.3±0.8; P=0.045) but not with eyes open. Conclusions: In this small study, this technique offers a new tool for training people with diabetes and elderly people to improve body stability and balance. PMID:25299792

Cross-cultural application of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): performances of elderly Chinese Singaporeans.

PubMed

Lim, May-Li; Collinson, Simon Lowes; Feng, Lei; Ng, Tze-Pin

2010-01-01

There is a paucity of normative studies outside of North America and on elderly populations with very low education level. In the present study we examined the performance of poorly educated elderly on the Repeatable Battery Assessment of Neuropsychological Status (RBANS) with 352 cognitively normal elderly Chinese persons living in the community in Singapore who were enrolled in the Singapore Longitudinal Ageing Study (SLAS). Those with no formal education performed significantly less well than those with some years of formal education across four of five RBANS indices as well as the Total Scale score. Age- and education-adjusted normative data for the RBANS were established for the sample. The means and standard deviations of each of 12 subtests raw scores, five Index scores and the Total Scale score were calculated and stratified by age and education. Data from the present study should considerably advance the clinical utility of the RBANS in Chinese geriatric evaluations in Singapore, and can serve as a reference source for poorly educated elderly Chinese from around the region and beyond.

Nutritional and oral health status of an elderly population in Nairobi.

PubMed

Ngatia, E M; Gathece, L W; Macigo, F G; Mulli, T K; Mutara, L N; Wagaiyu, E G

2008-08-01

To determine the nutrition and oral health status of elderly persons in Nairobi, Kenya. A cross-sectional study. Households in Dagoretti Division of Nairobi. Two hundred and eighty nine persons (29.8% males and 70.2% females) aged 45 years and above were assessed. The level of malnutrition using the mid upper arm circumference was 18.8% while by body mass index was 11.4%. Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, with more females (48.0%) than males (25.9%) being overweight. The study established that many of the elderly persons suffered from dental problems, especially periodontitis with 89.9% having dental plaque, calculus 85.6%, gingival recession 82.5% and bleeding gums 77.4%. The decayed index missing and filled teeth, was 7.173 with 19.7% caries free, 51.9% reported tooth mobility and edentulousness was common. Under-nutrition, obesity and dental problems are issues of concern among the elderly. There is need to develop policies that will look into the nutrition and dental health of the elderly in order to improve their welfare.

Body mass index is associated with type 2 diabetes mellitus in Chinese elderly.

PubMed

Zhao, Qianping; Laukkanen, Jari A; Li, Qifu; Li, Gang

2017-01-01

There is limited information on the association between metabolic syndrome components including body mass index (BMI) and type 2 diabetes mellitus in elderly Chinese population. Therefore, we investigated whether components of metabolic syndrome are associated with type 2 diabetes mellitus in elderly. A total of 479 hospitalized patients (aged 65-95 years) with recently diagnosed type 2 diabetes mellitus were studied retrospectively in a cross-sectional study and compared with 183 subjects with prediabetes and 62 subjects without glucose metabolism abnormalities. BMI (24.69±3.59 versus 23.92±3.08 and 23.56±3.25 kg/m 2 ), blood pressure, cholesterol, triglyceride, liver enzymes and prevalence of fatty liver were higher in patients with type 2 diabetes mellitus as compared with elderly subjects with prediabetes or normal glucose metabolism separately (all P <0.05). Multivariable regression analysis showed that BMI was associated positively with insulin resistance and inversely with insulin sensitivity in type 2 diabetes mellitus group (all P <0.05). Higher BMI was associated with increased insulin resistance and decreased insulin sensitivity in elderly Asian population with type 2 diabetes mellitus.

The Memory Aid study: protocol for a randomized controlled clinical trial evaluating the effect of computer-based working memory training in elderly patients with mild cognitive impairment (MCI)

PubMed Central

2014-01-01

Background Mild cognitive impairment (MCI) is a condition characterized by memory problems that are more severe than the normal cognitive changes due to aging, but less severe than dementia. Reduced working memory (WM) is regarded as one of the core symptoms of an MCI condition. Recent studies have indicated that WM can be improved through computer-based training. The objective of this study is to evaluate if WM training is effective in improving cognitive function in elderly patients with MCI, and if cognitive training induces structural changes in the white and gray matter of the brain, as assessed by structural MRI. Methods/Designs The proposed study is a blinded, randomized, controlled trail that will include 90 elderly patients diagnosed with MCI at a hospital-based memory clinic. The participants will be randomized to either a training program or a placebo version of the program. The intervention is computerized WM training performed for 45 minutes of 25 sessions over 5 weeks. The placebo version is identical in duration but is non-adaptive in the difficulty level of the tasks. Neuropsychological assessment and structural MRI will be performed before and 1 month after training, and at a 5-month folllow-up. Discussion If computer-based training results in positive changes to memory functions in patients with MCI this may represent a new, cost-effective treatment for MCI. Secondly, evaluation of any training-induced structural changes to gray or white matter will improve the current understanding of the mechanisms behind effective cognitive interventions in patients with MCI. Trial registration ClinicalTrials.gov NCT01991405. November 18, 2013. PMID:24886034

The Memory Aid study: protocol for a randomized controlled clinical trial evaluating the effect of computer-based working memory training in elderly patients with mild cognitive impairment (MCI).

PubMed

Flak, Marianne M; Hernes, Susanne S; Chang, Linda; Ernst, Thomas; Douet, Vanessa; Skranes, Jon; Løhaugen, Gro C C

2014-05-03

Mild cognitive impairment (MCI) is a condition characterized by memory problems that are more severe than the normal cognitive changes due to aging, but less severe than dementia. Reduced working memory (WM) is regarded as one of the core symptoms of an MCI condition. Recent studies have indicated that WM can be improved through computer-based training. The objective of this study is to evaluate if WM training is effective in improving cognitive function in elderly patients with MCI, and if cognitive training induces structural changes in the white and gray matter of the brain, as assessed by structural MRI. The proposed study is a blinded, randomized, controlled trail that will include 90 elderly patients diagnosed with MCI at a hospital-based memory clinic. The participants will be randomized to either a training program or a placebo version of the program. The intervention is computerized WM training performed for 45 minutes of 25 sessions over 5 weeks. The placebo version is identical in duration but is non-adaptive in the difficulty level of the tasks. Neuropsychological assessment and structural MRI will be performed before and 1 month after training, and at a 5-month folllow-up. If computer-based training results in positive changes to memory functions in patients with MCI this may represent a new, cost-effective treatment for MCI. Secondly, evaluation of any training-induced structural changes to gray or white matter will improve the current understanding of the mechanisms behind effective cognitive interventions in patients with MCI. ClinicalTrials.gov NCT01991405. November 18, 2013.

Cough physiology in elderly women with nontuberculous mycobacterial lung infections.

PubMed

Tsai, Hsiu-Wen; Fennelly, Kevin; Wheeler-Hegland, Karen; Adams, Sherry; Condrey, Jillian; Hosford, Jennifer L; Davenport, Paul W

2017-05-01

Elderly white, thin, nonsmoking women appear to be more susceptible to lung infections with Mycobacterium avium complex and other nontuberculous mycobacteria (NTM). It has been postulated that such disease in women is related to suppression of their cough. We hypothesized that patients with pulmonary NTM (pNTM) infections may have altered cough physiology compared with unaffected control subjects. We used capsaicin-induced cough to assess the cough reflex in pNTM subjects. Eight elderly white women with stable chronic pNTM infections and six unaffected age-matched control subjects were recruited. There was no significant difference between groups in capsaicin-elicited cough motor response, airflow pattern, or cough frequency. The urge-to-cough (UTC) score at the lowest capsaicin concentration was significantly lower in pNTM than control subjects ( P < 0.05). There were no significant differences in the UTC score between pNTM and control subjects at >50 μM capsaicin. These results suggest lower UTC sensitivity to the lowest concentration of capsaicin in pNTM than control subjects. In other words, the pNTM subjects do not sense a UTC when the stimulus is relatively small. NEW & NOTEWORTHY This study investigates the cough motor response and cough sensitivity in patients with nontuberculous mycobacteria (NTM) infection. In elderly white female pulmonary NTM subjects, we demonstrated a capacity to produce coughs similar to that of age-matched control subjects but decreased cough sensitivity in response to a low dose of capsaicin compared with control subjects. These findings are important to understand the pathophysiological mechanisms resulting in NTM disease in elderly white women and/or the syndrome developing in elderly white female NTM patients. Copyright © 2017 the American Physiological Society.

A Real-World Observational Study of Time to Treatment Intensification Among Elderly Patients with Inadequately Controlled Type 2 Diabetes Mellitus.

PubMed

Ajmera, Mayank; Raval, Amit; Zhou, Steve; Wei, Wenhui; Bhattacharya, Rituparna; Pan, Chunshen; Sambamoorthi, Usha

2015-12-01

Among elderly patients, the management of type 2 diabetes mellitus (T2DM) is complicated by population heterogeneity and elderly-specific complexities. Few studies have been done to understand treatment intensification among elderly patients failing multiple oral antidiabetic drugs (OADs). To examine the association between time to treatment intensification of T2DM and elderly-specific patient complexities. In this observational, retrospective cohort study, elderly (aged ≥ 65 years) Medicare beneficiaries (n = 16,653) with inadequately controlled T2DM (hemoglobin A1c ≥ 8.0% despite 2 OADs) were included. Based on the consensus statement for diabetes care in elderly patients published by the American Diabetes Association and the American Geriatric Society, elderly-specific patient complexities were defined as the presence or absence of 5 geriatric syndromes: cognitive impairment; depression; falls and fall risk; polypharmacy; and urinary incontinence. Overall, 48.7% of patients received intensified treatment during follow-up, with median time to intensification 18.5 months (95% CI = 17.7-19.3). Median time to treatment intensification was shorter for elderly patients with T2DM with polypharmacy (16.5 months) and falls and fall risk (12.7 months) versus those without polypharmacy (20.4 months) and no fall risk (18.6 months). Elderly patients with urinary incontinence had a longer median time to treatment intensification (18.6 months) versus those without urinary incontinence (14.6 months). The median time to treatment intensification did not significantly differ by the elderly-specific patient complexities that included cognitive impairment and depression. However, after adjusting for demographic, insurance, clinical characteristics, and health care utilization, we found that only polypharmacy was associated with time to treatment intensification (adjusted hazard ratio, 1.10; 95% CI = 1.04-1.15; P = 0.001). Less than half of elderly patients with inadequately controlled T2DM received treatment intensification. Elderly-specific patient complexities were not associated with time to treatment intensification, emphasizing a positive effect of the integrated health care delivery model. Emerging health care delivery models that target integrated care may be crucial in providing appropriate treatment for elderly T2DM patients with complex conditions.

The impact of glucose disorders on cognition and brain volumes in the elderly: the Sydney Memory and Ageing Study.

PubMed

Samaras, Katherine; Lutgers, Helen L; Kochan, Nicole A; Crawford, John D; Campbell, Lesley V; Wen, Wei; Slavin, Melissa J; Baune, Bernard T; Lipnicki, Darren M; Brodaty, Henry; Trollor, Julian N; Sachdev, Perminder S

2014-04-01

Type 2 diabetes predicts accelerated cognitive decline and brain atrophy. We hypothesized that impaired fasting glucose (IFG) and incident glucose disorders have detrimental effects on global cognition and brain volume. We further hypothesized that metabolic and inflammatory derangements accompanying hyperglycaemia contribute to change in brain structure and function. This was a longitudinal study of a community-dwelling elderly cohort with neuropsychological testing (n = 880) and brain volumes by magnetic resonance imaging (n = 312) measured at baseline and 2 years. Primary outcomes were global cognition and total brain volume. Secondary outcomes were cognitive domains (processing speed, memory, language, visuospatial and executive function) and brain volumes (hippocampal, parahippocampal, precuneus and frontal lobe). Participants were categorised as normal, impaired fasting glucose at both assessments (stable IFG), baseline diabetes or incident glucose disorders (incident diabetes or IFG at 2 years). Measures included inflammatory cytokines and oxidative metabolites. Covariates were age, sex, education, non-English speaking background, smoking, blood pressure, lipid-lowering or antihypertensive medications, mood score, apolipoprotein E genotype and baseline cognition or brain volume. Participants with incident glucose disorders had greater decline in global cognition and visuospatial function compared to normal, similar to that observed in baseline diabetes. Homocysteine was independently associated with the observed effect of diabetes on executive function. Apolipoprotein E genotype did not influence the observed effects of diabetes on cognition. Incident glucose disorders and diabetes were also associated with greater 2-year decline in total brain volume, compared to normal (40.0 ± 4.2 vs. 46.7 ± 5.7 mm(3) vs. 18.1 ± 6.2, respectively, p < 0.005). Stable IFG did not show greater decline in global cognition or brain volumes compared to normal. Incident glucose disorders, like diabetes, are associated with accelerated decline in global cognition and brain volumes in non-demented elderly, whereas stable IFG is not. Preventing deterioration in glucose metabolism in the elderly may help preserve brain structure and function.

Intelligence or years of education: which is better correlated with memory function in normal elderly Japanese subjects?

PubMed

Murayama, Norio; Iseki, Eizo; Tagaya, Hirokuni; Ota, Kazumi; Kasanuki, Koji; Fujishiro, Hiroshige; Arai, Heii; Sato, Kiyoshi

2013-03-01

We compared differences in intelligence and memory function between normal elderly Japanese subjects with more years of education and those with fewer years of education. We also investigated clinical and neuropsychological factors that are strongly correlated with memory function. There were 118 normal elderly subjects who underwent the Mini-Mental State Examination, Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III), and Wechsler Memory Scale Revised. Subjects with at least 13 years of education were categorized as the H group, and those with 12 years of education or less were categorized as the L group. Age and Mini-Mental State Examination scores were not significantly different between the two groups. On the WAIS-III, there were significant differences between the two groups in Verbal IQ and Full Scale IQ. On the Wechsler Memory Scale Revised, there were significant differences between the two groups in Visual Memory, General Memory, and Delayed Recall. Correlation coefficients between memory function and the other factors demonstrated significant but weak correlations between years of education and General Memory (R = 0.22) and between years of education and Delayed Recall (R = 0.20). Strong correlations were found between Verbal IQ and Verbal Memory (R = 0.45), between Verbal IQ and General Memory (R = 0.49), between Full Scale IQ and General Memory (R = 0.50) and between Full Scale IQ and Delayed Recall (R = 0.48). In normal elderly Japanese subjects, years of education weakly correlated with memory function while Verbal IQ, Full Scale IQ and Verbal Comprehension on WAIS-III had stronger correlations with memory function. Verbal IQ and Verbal Comprehension on WAIS-III were found to be insusceptible to the cognitive decline characteristic of Alzheimer's disease or amnestic mild cognitive impairment. Therefore, verbal intelligence, as measured by Verbal IQ and Verbal Comprehension, may be the most useful factor for inferring premorbid memory function in Alzheimer's disease or amnestic mild cognitive impairment patients. © 2013 The Authors. Psychogeriatrics © 2013 Japanese Psychogeriatric Society.

The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support.

PubMed

Bulduk, Serap; Usta, Esra; Dinçer, Yeliz

2017-06-01

Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.

The Prevalence of Thyroid Dysfunction in Elderly Cardiology Patients with Mild Excessive Iodine Intake in the Urban Area of São Paulo

PubMed Central

Duarte, Glaucia C.; Tomimori, Eduardo K.; Camargo, Rosalinda Y. A.; Rubio, Ileana G.S.; Wajngarten, Mauricio; Rodrigues, Amanda G.; Knobel, Meyer; Medeiros-Neto, Geraldo

2009-01-01

OBJECTIVES: To evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting. SUBJECTS AND METHODS: A total of 399 consecutive patients (268 women, age range 60–92 years) who were followed at Heart Institute were evaluated for thyroid dysfunction with serum free T4, TSH, anti-Peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound. RESULTS: Hyperthyroidism (overt and subclinical) was present in 29 patients (6.5%), whereas hypothyroidism (overt and subclinical) was found in 32 individuals (8.1%). Cysts were detected in 11 patients (2.8%), single nodules were detected in 102 (25.6%), and multinodular goiters were detected in 34 (8.5%). Hashimoto’s thyroiditis was present in 16.8% patients, most of whom were women (83.6%). The serum TSH increased with age and was significantly higher (p= <0.01) in patients, compared to the normal control group. No significant differences in serum TSH and free T4 values were observed when patients with atrial fibrillation (AF) where compared with those without arrhythmia. The median urinary iodine levels were 210 μg/L (40–856 μg/L), and iodine levels were higher in men than in women (p<0.01). Excessive iodine intake (urinary iodine >300 μg/L) was observed in one-third of patients (30.8%). CONCLUSIONS: Elderly patients have a higher prevalence of both hypo- and hyperthyroidism as well as thyroid nodules when compared with the general population. About one-third of the older patients had elevated urinary secretion of iodine and a higher prevalence of chronic Hashimoto’s thyroiditis. It is recommended that ultrasonographic studies, tests for thyroid function and autoimmunity should be evaluated in elderly patients. PMID:19219319

The effects of physical exercise with music on cognitive function of elderly people: Mihama-Kiho project.

PubMed

Satoh, Masayuki; Ogawa, Jun-ichi; Tokita, Tomoko; Nakaguchi, Noriko; Nakao, Koji; Kida, Hirotaka; Tomimoto, Hidekazu

2014-01-01

Physical exercise has positive effects on cognitive function in elderly people. It is unknown, however, if combinations of non-pharmaceutical interventions can produce more benefits than single ones. This study aimed to identify if physical exercise combined with music improves cognitive function in normal elderly people more than exercise alone. We enrolled 119 subjects (age 65-84 years old). Forty subjects performed physical exercise (once a week for an hour with professional trainers) with musical accompaniment (ExM group), developed by YAMAHA Music Foundation; 40 subjects performed the same exercise without music (Ex group); 39 subjects were the control group (Cont group). Before and after the year-long intervention, each patient was assessed by neuropsychological batteries. MRIs were performed before and after intervention; the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD) was used to assess medial temporal lobe atrophy. Analysis of variance (ANOVA) was significant only in visuospatial function. The multiple comparison (ExM vs. Ex, ExM vs. Cont, Ex vs. Cont) was significant between the ExM and Cont group. Intra-group analyses before and after intervention revealed significant improvement in visuospatial function in the ExM group, and significant improvements in other batteries in all three groups. The VSRAD score significantly worsened in the ExM and Ex groups. Physical exercise combined with music produced more positive effects on cognitive function in elderly people than exercise alone. We attributed this improvement to the multifaceted nature of combining physical exercise with music, which can act simultaneously as both cognitive and physical training. UMIN Clinical Trials Registry (UMIN-CTR) UMIN000012148.

The Effects of Physical Exercise with Music on Cognitive Function of Elderly People: Mihama-Kiho Project

PubMed Central

Satoh, Masayuki; Ogawa, Jun-ichi; Tokita, Tomoko; Nakaguchi, Noriko; Nakao, Koji; Kida, Hirotaka; Tomimoto, Hidekazu

2014-01-01

Background Physical exercise has positive effects on cognitive function in elderly people. It is unknown, however, if combinations of non-pharmaceutical interventions can produce more benefits than single ones. This study aimed to identify if physical exercise combined with music improves cognitive function in normal elderly people more than exercise alone. Methods We enrolled 119 subjects (age 65–84 years old). Forty subjects performed physical exercise (once a week for an hour with professional trainers) with musical accompaniment (ExM group), developed by YAMAHA Music Foundation; 40 subjects performed the same exercise without music (Ex group); 39 subjects were the control group (Cont group). Before and after the year-long intervention, each patient was assessed by neuropsychological batteries. MRIs were performed before and after intervention; the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD) was used to assess medial temporal lobe atrophy. Results Analysis of variance (ANOVA) was significant only in visuospatial function. The multiple comparison (ExM vs. Ex, ExM vs. Cont, Ex vs. Cont) was significant between the ExM and Cont group. Intra-group analyses before and after intervention revealed significant improvement in visuospatial function in the ExM group, and significant improvements in other batteries in all three groups. The VSRAD score significantly worsened in the ExM and Ex groups. Conclusions Physical exercise combined with music produced more positive effects on cognitive function in elderly people than exercise alone. We attributed this improvement to the multifaceted nature of combining physical exercise with music, which can act simultaneously as both cognitive and physical training. Trial Registration UMIN Clinical Trials Registry (UMIN-CTR) UMIN000012148 PMID:24769624

Community-acquired hyperkalemia in elderly patients: risk factors and clinical outcomes.

PubMed

Turgutalp, Kenan; Bardak, Simge; Helvacı, Ilter; İşgüzar, Gizem; Payas, Ezgi; Demir, Serap; Kıykım, Ahmet

2016-10-01

Although the risk and related factors of hyperkalemia developed in the hospital are known in elderly, risk and related factors of community-acquired hyperkalemia (CAH) in this population are not well known. This study was performed to investigate the risk of CAH in elderly and evaluate the related factors and clinical outcomes. Study design, setting and participants, intervention: Patients (aged ≥65 years) with hyperkalemia were screened. Group 1 (young-old); 65-74 years/old, Group 2 (middle-old); 75-84 years/old, Group 3 (oldest-old); ≥85 years/old, and Group 4 (control group); ≥65 years/old (normal serum potassium levels). The relation between CAH and hospital expenses (HE), the number of comorbid diseases (NCD), and all-cause of mortality rates (MR) were evaluated. We also investigated whether drugs, sex, and NCD are risk factors for the development of CAH. There was a positive correlation between serum potassium levels and length of hospital stay, MR, HE, and NCD (p < 0.001). Risk factors for CAH were the use of non-steroidal-anti inflammatory drugs (NSAIDs) (Odds Ratio [OR]: 2.679), spironolactone (OR: 2.530), and angiotensin converting enzyme inhibitors (ACEI) (OR: 2.242), angiotensin receptor blockers (ARB) (OR: 2.679), ≥2 comorbid diseases (OR: 2.221), female gender (OR: 2.112), and renal injury (OR: 5.55). CAH risk was found to be increased 30.03 times when any of ACEI, ARB, NSAIDs, or spironolactone is given to a patient with a renal injury. Use of NSAIDs, ACEI, ARB, spironolactone and increased NCD are all independent risk factors for CAH in the elderly, especially in patients with kidney diseases.

Lack of effect of sodium nitroprusside on insulin-mediated blood flow and glucose disposal in the elderly.

PubMed

Meneilly, G S; Battistini, B; Floras, J S

2000-03-01

Insulin increases skeletal muscle blood flow in healthy young subjects by a nitric oxide (NO)-dependent mechanism. Impairment of this mechanism may contribute to the insulin resistance of normal aging, a state characterized by reduced endothelial production of NO, an attenuated effect of insulin on skeletal muscle blood flow, and resistance to insulin-mediated glucose uptake (IMGU). We tested the hypothesis that the NO donor sodium nitroprusside (SNP) would augment insulin-mediated vasodilation and thus increase IMGU in healthy elderly subjects. Experiments were performed with young (n = 9; age, 25 +/- 1 years; body mass index [BMI], 24 +/- 1 kg/m2) and old (n = 10; age, 78 +/- 2 years; BMI, 25 +/- 1 kg/m2) healthy subjects. Each group underwent two studies in random order. In one study (control), insulin was infused using the euglycemic clamp protocol for 240 minutes at a rate of 40 mU/m2/min (young) and 34 mU/m2/min (old). In the other study (SNP), SNP was coinfused with insulin from 120 to 240 minutes. At regular intervals in each study, blood samples were obtained and calf blood flow was measured using venous occlusion plethysmography. Glucose and insulin values were similar in control and SNP studies in both age groups. In the young, SNP had no effect on blood flow to the calf, but its action in calf resistance vessels augmented insulin-mediated vasodilation, since incremental calf vascular conductance was greater during SNP infusion (control v SNP, 0.027 +/- 0.002 v 0.040 +/- 0.008 mL/100 mL/min/mm Hg, P< .0001). However, SNP had no effect on insulin-mediated glucose disposal. In the elderly, SNP reduced the blood flow to the calf, but this was countered by its effect on calf resistance vessels such that vascular conductance was unaffected (control v SNP, 0.012 +/- 0.003 v 0.011 +/- 0.003 mL/100 mL/min/mm Hg, P = nonsignificant [NS]). Steady-state (180 to 240 minutes) glucose disposal (control v SNP, 7.47 +/- 0.47 v 6.54 +/- 0.56 mg/kg/min, P < .01) rates were significantly lower during SNP infusion. In summary, systemic infusion of SNP did not increase insulin-mediated glucose disposal in either young or old subjects. Thus, the present findings do not support the concept that increasing NO availability will enhance glucose disposal in either age group. However, because the incremental increases in IMGU during SNP infusion paralleled the changes in blood supply to the calf rather than calf vascular conductance, any potential benefits on NO delivery in elderly subjects may have been offset by the direct or reflex effects of systemic hypotension. Other stimuli to NO production that do not cause hypotension must be tested before this therapeutic strategy can be considered as a potential means for enhancing the metabolic actions of insulin in the elderly.

Factors related to falls among community dwelling elderly.

PubMed

Kuhirunyaratn, Piyathida; Prasomrak, Prasert; Jindawong, Bangonsri

2013-09-01

Falls among the elderly can lead to disability, hospitalization and premature death. This study aimed to determine the factors related to falls among community dwelling elderly. This case-control study was conducted at the Samlium Primary Care Unit (SPCU), Khon Kaen, Thailand. Cases were elderly individuals who had fallen within the previous six months and controls were elderly who had not fallen during that same time period. Subjects were taken from elderly persons registered at the SPCU. The sample size was calculated to be 111 cases and 222 controls. Face to face interviews were conducted with subjects between May and June, 2011. The response rate was 100%. On bivariate analysis, the statistically significant factors related to falls were: regular medication use, co-morbidities, mobility, depression, cluttered rooms, slippery floors, unsupported toilets (without a hand rail), sufficient exercise, rapid posture change and wearing slippers. When controlling for others significant factors, multiple logistic regression revealed significant factors were: regular medication use (AOR: 2.22; 95%CI: 1.19 - 4.12), depression (AOR: 1.76, 95% CI: 1.03 - 2.99), sufficient exercise (AOR: 0.34; 95% CI: 0.19 - 0.58) and wearing slippery shoes (AOR: 2.31; 95% CI: 1.24 - 4.29). Interventions need to be considered to modify these significant factors associated with falls and education should be provided to these at risk.

[Clinical evaluation of influence of aspirin on post-operative bleeding after tooth extraction in the elderly].

PubMed

Wang, Wen-ying; Cui, Nian-hui; Wang, En-bo; Zhang, Wei

2013-05-01

To investigate the feasibility of continuation of aspirin before tooth extraction in the elderly. The patients enrolled in this study were the elderly requiring a single non-impacted tooth extraction. 300 elderly outpatients used lidocaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group I, 100 patients with prolong use of aspirin before tooth extraction as observation group I. 300 elderly outpatients used compound articaine local infiltration anesthesia, 200 patients without using aspirin before tooth extraction served as control group II, 100 patients with prolong use of aspirin before tooth extraction as observation group II.Bleedings at 5, 10, 30 min, 24 h after tooth extraction were observed and the relationship between postoperative bleeding and intake of aspirin was analyzed. There was no significant difference at 5, 10, 30 min, 24 h in postoperative bleeding after extraction between control group I and observation group. The incidence of bleeding of observation group II after tooth extraction at 5 min was higher than that of control group II and there was no significant difference at 10, 30 min, 24 h between the two groups. Continuation of aspirin have no influence on postoperative bleeding. Therefore we suggest that there was no indication to discontinue aspirin for the elderly before a single non-impacted tooth extraction.

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control.

PubMed

Bonnet, Cédrick T; Delval, Arnaud; Defebvre, Luc

2014-11-15

Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease. Copyright © 2014 the American Physiological Society.

Time-compressed speech test in the elderly.

PubMed

Arceno, Rayana Silva; Scharlach, Renata Coelho

2017-09-28

The present study aimed to evaluate the performance of elderly people in the time-compressed speech test according to the variables ears and order of display, and analyze the types of errors presented by the volunteers. This is an observational, descriptive, quantitative, analytical and primary cross-sectional study involving 22 elderly with normal hearing or mild sensorineural hearing loss between the ages of 60 and 80. The elderly were submitted to the time-compressed speech test with compression ratio of 60%, through the electromechanical time compression method. A list of 50 disyllables was applied to each ear and the initial side was chosen at random. On what concerns to the performance in the test, the elderly fell short in relation to the adults and there was no statistical difference between the ears. It was found statistical evidence of better performance for the second ear in the test. The most mistaken words were the ones initiated with the phonemes /p/ and /d/. The presence of consonant combination in a word also increased the occurrence of mistakes. The elderly have worse performance in the auditory closure ability when assessed by the time-compressed speech test compared to adults. This result suggests that elderly people have difficulty in recognizing speech when this is pronounced in faster rates. Therefore, strategies must be used to facilitate the communicative process, regardless the presence of hearing loss.

Differences in acoustic and perceptual parameters of the voice between elderly and young women at habitual and high intensity.

PubMed

Mazzetto de Menezes, Keyla S; Master, Suely; Guzman, Marco; Bortnem, Cori; Ramos, Luiz Roberto

2014-01-01

The present study aimed to compare elderly and young female voices in habitual and high intensity. The effect of increased intensity on the acoustic and perceptual parameters was assessed. Sound pressure level, fundamental frequency, jitter, shimmer, and harmonic to noise ratio were obtained at habitual and high intensity voice in a group of 30 elderly women and 30 young women. Perceptual assessment was also performed. Both groups demonstrated an increase in sound pressure level and fundamental frequency from habitual voice to high intensity voice. No differences were found between groups in any acoustic variables on samples recorded with habitual intensity level. No significant differences between groups were found in habitual intensity level for pitch, hoarseness, roughness, and breathiness. Asthenia and instability obtained significant higher values in elderly than young participants, whereas, the elderly demonstrated lower values for perceived tension and loudness than young subjects. Acoustic and perceptual measures do not demonstrate evident differences between elderly and young speakers in habitual intensity level. The parameters analyzed may lack the sensitivity necessary to detect differences in subjects with normal voices. Phonation with high intensity highlights differences between groups, especially in perceptual parameters. Therefore, high intensity should be included to compare elderly and young voice. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Pharmacokinetics of brotizolam in the elderly

PubMed Central

Jochemsen, Roeline; Nandi, K. L.; Corless, D.; Wesselman, J. G. J.; Breimer, D. D.

1983-01-01

1 Disposition of brotizolam in patients aged 71-93 years was compared with that of healthy young subjects aged 21-26 years. 2 The mean elimination half-life of brotizolam was about twice as long in the elderly as in the young subjects: 9.3 (4.0-19.5) h and 4.8 (3.1-6.3) h respectively. Increase in elimination half-life was attributable to a decrease in hepatic clearance, i.e. 40 (20-58) ml/min in the elderly and 109 (77-156) ml/min in the young. Volume of distribution and protein binding were the same with mean values of 0.56 (0.45-0.72) l/kg and 9.0 (6.8-11.9)% in the elderly and 0.63 (0.40-0.77) l/kg and 8.4 (7.5-9.4)% in the young. 3 Absorption rate of brotizolam was relatively slow in the elderly with a mean peak time of 1.7 h compared with 1.1 h in the young. Mean bioavailability was almost 70% for both groups. Normalized for body weight and dose (0.25 mg) mean peak concentrations were 247 (137-395) ng ml-1 kg in the young and 343 (251-446) ng ml-1 kg in the elderly. 4 It is unlikely that substantial drug accumulation will occur if elderly patients ingest 0.25 mg brotizolam nightly. PMID:6661375

PARTICULATE MATTER AND HEART RATE VARIABILITY AMONG ELDERLY RETIREES: THE BALTIMORE 1998 PM STUDY

EPA Science Inventory

This study investigates the reported relationship between ambient fine particle pollution and impaired cardiac autonomic control in the elderly. Heart rate variability (HRV) among 56 elderly (mean age 82) nonsmoking residents of a retirement center in Baltimore County, Maryland,...

Neuropsychological performance in advanced age: influences of demographic factors and Apolipoprotein E: findings from the Cache County Memory Study.

PubMed

Welsh-Bohmer, Katheen A; Ostbye, Truls; Sanders, Linda; Pieper, Carl F; Hayden, Kathleen M; Tschanz, JoAnn T; Norton, Maria C

2009-01-01

The Cache County Study of Memory in Aging (CCMS) is an epidemiological study of Alzheimer's disease (AD), mild cognitive disorders, and aging in a population of exceptionally long-lived individuals (7th to 11th decade). Observation of population members without dementia provides an opportunity for establishing the range of normal neurocognitive performance in a representative sample of the very old. We examined neurocognitive performance of the normal participants undergoing full clinical evaluations (n = 507) and we tested the potential modifying effects of apolipoprotein E (APOE) genotype, a known genetic risk factor for the later development of AD. The results indicate that advanced age and low education are related to lower test scores across nearly all of the neurocognitive measures. Gender and APOE epsilon4 both had negligible and inconsistent influences, affecting only isolated measures of memory and expressive speech (in case of gender). The gender and APOE effects disappeared once age and education were controlled. The study of this exceptionally long-lived population provides useful normative information regarding the broad range of "normal" cognition seen in advanced age. Among elderly without dementia or other cognitive impairment, APOE does not appear to exert any major effects on cognition once other demographic influences are controlled.

Trajectory Classes of Body Mass Index in a Representative Elderly Community Sample

PubMed Central

2013-01-01

Background. It is unclear whether distinct weight-related trajectory classes, differing in course, demographics, and health characteristics, exist in the elderly population. Methods. Data came from the 10-year (1986–1996) Duke Established Populations for Epidemiologic Studies of the Elderly study of 3,861 black (54%) and white (46%) participants aged 65–105 years. Latent-class trajectories of body mass index (BMI: kg/m2) based on self-reported weight and height at baseline, 3, 6, and 10 years later were determined using generalized mixture models. Polytomous logistic regression was used to identify baseline demographic and health characteristics that distinguished the trajectories, and 10-year postbaseline data to confirm the findings. Results. We identified three trajectories: normal weight (BMI ~24, 27.6% of the sample), overweight (BMI ~26, 65.1%), and obese (BMI ~31, 7.3%). Demographic characteristics distinguished the three trajectories: highest odds of blacks, women, and less education in the obese trajectory, lowest in the normal-weight trajectory. Obese and overweight differed adversely from normal-weight trajectories, but not significantly from each other on cognitive impairment, hypertension, and diabetes. Depressive symptomatology was more prevalent in the obese; they were also younger. There was no association with cancer or heart disease. Conclusion. Distinct trajectories and course of BMI were present in this older population. Weight loss increased with increase in BMI class. Although demographic characteristics distinguished all trajectory classes, adverse health characteristics distinguished the overweight and obese classes from the normal-weight class, but not from each other. Problems associated with education and health are present at study entry and should be addressed earlier in life. PMID:23089335

Impaired Sleep Predicts Cognitive Decline in Old People: Findings from the Prospective KORA Age Study.

PubMed

Johar, Hamimatunnisa; Kawan, Rasmila; Emeny, Rebecca Thwing; Ladwig, Karl-Heinz

2016-01-01

To investigate the association between sleep-related characteristics and cognitive change over 3 years of follow up in an aged population. Sleep characteristics and covariates were assessed at baseline in a standardized interview and clinical examination of the population-based KORA Age Study (n = 740, mean age = 75 years). Cognitive score (determined by telephone interview for cognitive status, TICS-m) was recorded at baseline and 3 years later. At baseline, 82.83% (n = 613) of participants had normal cognitive status, 13.51% (n = 100) were classified with mild cognitive impairment (MCI), and 3.64% (n = 27) with probable dementia. The effect of three distinct patterns of poor sleep (difficulties initiating [DIS] or maintaining sleep [DMS], daytime sleepiness [DS] or sleep duration) were considered on a change in cognitive score with adjustments for potential confounders in generalized linear regression models. Cognitive decline was more pronounced in individuals with DMS compared to those with no DMS (β = 1.33, 95% CI = 0.41-2.24, P < 0.001). However, the predictive power of DMS was only significant in individuals with normal cognition and not impaired subjects at baseline. Prolonged sleep duration increased the risk for cognitive decline in cognitively impaired elderly (β = 1.86, 95% CI = 0.15-3.57, P = 0.03). Other sleep characteristics (DIS and DS) were not significantly associated with cognitive decline. DMS and long sleep duration were associated with cognitive decline in normal and cognitively impaired elderly, respectively. The identification of impaired sleep quality may offer intervention strategies to deter cognitive decline in the elderly with normal cognitive function. © 2016 Associated Professional Sleep Societies, LLC.

The largest Lyapunov exponent of gait in young and elderly individuals: A systematic review.

PubMed

Mehdizadeh, Sina

2018-02-01

The largest Lyapunov exponent (LyE) is an accepted method to quantify gait stability in young and old adults. However, a range of LyE values has been reported in the literature for healthy young and elderly adults in normal walking. Therefore, it has been impractical to use the LyE as a clinical measure of gait stability. The aims of this systematic review were to summarize different methodological approaches of quantifying LyE, as well as to classify LyE values of different body segments and joints in young and elderly individuals during normal walking. The Pubmed, Ovid Medline, Scopus and ISI Web of Knowledge databases were searched using keywords related to gait, stability, variability, and LyE. Only English language articles using the Lyapunov exponent to quantify the stability of healthy normal young and old subjects walking on a level surface were considered. 102 papers were included for full-text review and data extraction. Data associated with the walking surface, data recording method, sampling rate, walking speed, body segments and joints, number of strides/steps, variable type, filtering, time-normalizing, state space dimension, time delay, LyE algorithm, and the LyE values were extracted. The disparity in implementation and calculation of the LyE was from, (i) experiment design, (ii) data pre-processing, and (iii) LyE calculation method. For practical implementation of LyE as a measure of gait stability in clinical settings, a standard and universally accepted approach of calculating LyE is required. Therefore, future studies should look for a standard and generalized procedure to apply and calculate LyE. Copyright © 2017 Elsevier B.V. All rights reserved.

Automatic and controlled attentional orienting in the elderly: A dual-process view of the positivity effect.

PubMed

Gronchi, G; Righi, S; Pierguidi, L; Giovannelli, F; Murasecco, I; Viggiano, M P

2018-04-01

The positivity effect in the elderly consists of an attentional preference for positive information as well as avoidance of negative information. Extant theories predict either that the positivity effect depends on controlled attentional processes (socio-emotional selectivity theory), or on an automatic gating selection mechanism (dynamic integration theory). This study examined the role of automatic and controlled attention in the positivity effect. Two dot-probe tasks (with the duration of the stimuli lasting 100 ms and 500 ms, respectively) were employed to compare the attentional bias of 35 elderly people to that of 35 young adults. The stimuli used were expressive faces displaying neutral, disgusted, fearful, and happy expressions. In comparison to young people, the elderly allocated more attention to happy faces at 100 ms and they tended to avoid fearful faces at 500 ms. The findings are not predicted by either theory taken alone, but support the hypothesis that the positivity effect in the elderly is driven by two different processes: an automatic attention bias toward positive stimuli, and a controlled mechanism that diverts attention away from negative stimuli. Copyright © 2018 Elsevier B.V. All rights reserved.

Activity/inactivity circadian rhythm shows high similarities between young obesity-induced rats and old rats.

PubMed

Bravo Santos, R; Delgado, J; Cubero, J; Franco, L; Ruiz-Moyano, S; Mesa, M; Rodríguez, A B; Uguz, C; Barriga, C

2016-03-01

The objective of the present study was to compare differences between elderly rats and young obesity-induced rats in their activity/inactivity circadian rhythm. The investigation was motivated by the differences reported previously for the circadian rhythms of both obese and elderly humans (and other animals), and those of healthy, young or mature individuals. Three groups of rats were formed: a young control group which was fed a standard chow for rodents; a young obesity-induced group which was fed a high-fat diet for four months; and an elderly control group with rats aged 2.5 years that was fed a standard chow for rodents. Activity/inactivity data were registered through actimetry using infrared actimeter systems in each cage to detect activity. Data were logged on a computer and chronobiological analysis were performed. The results showed diurnal activity (sleep time), nocturnal activity (awake time), amplitude, acrophase, and interdaily stability to be similar between the young obesity-induced group and the elderly control group, but different in the young control group. We have concluded that obesity leads to a chronodisruption status in the body similar to the circadian rhythm degradation observed in the elderly.

Age-related differences in muscle control of the lower extremity for support and propulsion during walking

PubMed Central

Toda, Haruki; Nagano, Akinori; Luo, Zhiwei

2016-01-01

[Purpose] This study examined age-related differences in muscle control for support and propulsion during walking in both males and females in order to develop optimal exercise regimens for muscle control. [Subjects and Methods] Twenty elderly people and 20 young people participated in this study. Coordinates of anatomical landmarks and ground reaction force during walking were obtained using a 3D motion analysis system and force plates. Muscle forces during walking were estimated using OpenSim. Muscle modules were obtained by using non-negative matrix factorization analysis. A two-way analysis of covariance was performed to examine the difference between the elderly and the young in muscle weightings using walking speed as a covariate. The similarities in activation timing profiles between the elderly and the young were analyzed by cross-correlation analysis in males and females. [Results] In the elderly, there was a change in the coordination of muscles around the ankle, and muscles of the lower extremity exhibited co-contraction in late stance. Timing and shape of these modules were similar between elderly and young people. [Conclusion] Our results suggested that age-related alteration of muscle control was associated with support and propulsion during walking. PMID:27134360

Ankle brachial index values, leg symptoms, and functional performance among community-dwelling older men and women in the lifestyle interventions and independence for elders study

USDA-ARS?s Scientific Manuscript database

The prevalence and significance of low normal and abnormal ankle brachial index (ABI) values in a community dwelling population of sedentary, older individuals is unknown. We describe the prevalence of categories of definite peripheral artery disease (PAD), borderline ABI, low-normal ABI and no PAD...

High normal fasting blood glucose is associated with dementia in Chinese elders

PubMed Central

Mortimer, J.A.; Borenstein, A.R.; Ding, D.; DeCarli, C.; Zhao, Q.; Copenhaver, C.; Guo, Q.; Chu, S.; Galasko, D.; Salmon, D.P.; Dai, Q.; Wu, Y.; Petersen, R.; Hong, Z.

2010-01-01

Background Diabetes is a risk factor for MCI and dementia. However, the association between high normal fasting blood glucose (FBG) and dementia has not been studied. Methods Polytomous logistic regression was used to assess the association of dementia and MCI with FBG in an age- and sex-matched sample of 32 dementia patients, 27 amnestic MCI (aMCI) patients and 31 normal controls (NC). Analyses were repeated for those with normal FBG. Correlations between FBG and cognitive test scores were obtained. Results Controlling for age, sex, education, body mass index, Hachinski Ischemic Score, MRI stroke, and normalized brain, hippocampal and white matter hyperintensity MRI volumes; higher FBG was associated with dementia vs. aMCI status (OR= 3.13; 95% CI:1.28–7.69). This association remained (OR= 7.75; 95% CI:1.10–55.56) when analyses were restricted to subjects with normal FBG. When dementia patients were compared with NC adjusting for age, sex and education a significant association with FBG also was seen (OR=1.83; 95%CI:1.09–3.08), but the association was lost when vascular covariates were added to the model. FBG was not associated with aMCI status vs. NC. Higher FBG was correlated with poorer performance on the Trailmaking Test Part B (p=0.003). The percentage of dementia patients with high normal FBG (90%) was significantly higher than that of aMCI patients with high normal FBG (32.9%) (χ2=13.9, p<0.001). Conclusions Higher FBG was associated with dementia (vs. aMCI) independent of vascular risk factors and MRI indicators of vascular disease, and remained a significant risk factor when analyses were restricted to subjects with normal FBG. The results of this cross-sectional study suggest that a high normal level of FBG may be a risk factor for dementia. PMID:21044774

Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients.

PubMed

Uchiwa, Hiroki; Kai, Hisashi; Iwamoto, Yoshiko; Anegawa, Takahiro; Kajimoto, Hidemi; Fukuda, Kenji; Imaizumi, Tsutomu; Fukumoto, Yoshihiro

2018-01-01

Morning hypertension is an independent risk for cerebrovascular and cardiovascular events. Although the prevalence of morning hypertension increases with age, treatment of morning hypertension has not been established, particularly in Very-Elderly patients. We compared the safety and efficacy of a losartan/hydrochlorothiazide (HCTZ) combination in controlling morning hypertension between Very-Elderly (≥75 years) and Young/Elderly patients (<75 years). This study was a subanalysis of the Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy study, in which patients with morning hypertension (≥135/85 mmHg) received a 50-mg losartan/12.5-mg HCTZ combination tablet (combination therapy) or 100-mg losartan (high-dose therapy) for 3 months. High adherence rates and few adverse effects were observed in Very-Elderly patients receiving combination (n = 32) and high-dose (n = 34) therapies and in Young/Elderly patients receiving combination (n = 69) and high-dose (n = 66) therapies. Baseline morning systolic BP (SBP) was similar in both age groups receiving either therapy. Morning SBP was reduced by 20.2 and 18.1 mmHg with combination therapy and by 7.1 and 9.1 mmHg with high-dose therapy in the Very-Elderly and Young/Elderly patients, respectively. Morning BP target (<135/85 mmHg) was achieved in 40.6% and 55.1% by combination therapy and in 14.7% and 24.2% by high-dose therapy in the Very-Elderly and Young/Elderly patients, respectively. Neither therapy changed renal function and serum potassium in Very-Elderly patients. In conclusion, the losartan/HCTZ combination was safe and effective in controlling morning hypertension in Very-Elderly as well as Young/Elderly patients. In addition, combination therapy was also superior to high-dose therapy for lowering morning SBP in Very-Elderly patients.

Erectile dysfunction in the elderly: epidemiology, etiology and approaches to treatment.

PubMed

Seftel, Allen D

2003-06-01

Erectile dysfunction is experienced at least some of the time by most men who have reached 45 years of age, and it is projected to affect 322 million men worldwide by 2025. The prevalence of erectile dysfunction is high in men of all ages and increases greatly in the elderly. This paper reviews the epidemiology of erectile dysfunction with an emphasis on the experience of older men, normal age related changes in the structure and function of the penis that may contribute to increased risk with age, how the accumulation of risk factors with age may contribute to the high prevalence of the disease in older men, and established and emerging therapies. The normal aging process and age related risk factor accumulation contribute to the increased prevalence of erectile dysfunction in the elderly. Remarkable progress has been made in the treatment of erectile dysfunction. At present inhibition of phosphodiesterase 5 with oral agents such as sildenafil would appear to be the initial treatment of choice. These drugs have been shown to be safe and effective, and sildenafil has demonstrated efficacy in patients with many of the comorbidities observed in older men with erectile dysfunction. New treatments, in particular transfection with genes for key mediators of erectile function that are known to be down-regulated in elderly men, also hold promise. Further research into the neural, vascular and molecular mechanisms involved in penile erection will lead to the development of even safer, more effective and more convenient therapies for men with erectile dysfunction.

Reliability of Interaural Time Difference-Based Localization Training in Elderly Individuals with Speech-in-Noise Perception Disorder.

PubMed

Delphi, Maryam; Lotfi, M-Yones; Moossavi, Abdollah; Bakhshi, Enayatollah; Banimostafa, Maryam

2017-09-01

Previous studies have shown that interaural-time-difference (ITD) training can improve localization ability. Surprisingly little is, however, known about localization training vis-à-vis speech perception in noise based on interaural time difference in the envelope (ITD ENV). We sought to investigate the reliability of an ITD ENV-based training program in speech-in-noise perception among elderly individuals with normal hearing and speech-in-noise disorder. The present interventional study was performed during 2016. Sixteen elderly men between 55 and 65 years of age with the clinical diagnosis of normal hearing up to 2000 Hz and speech-in-noise perception disorder participated in this study. The training localization program was based on changes in ITD ENV. In order to evaluate the reliability of the training program, we performed speech-in-noise tests before the training program, immediately afterward, and then at 2 months' follow-up. The reliability of the training program was analyzed using the Friedman test and the SPSS software. Significant statistical differences were shown in the mean scores of speech-in-noise perception between the 3 time points (P=0.001). The results also indicated no difference in the mean scores of speech-in-noise perception between the 2 time points of immediately after the training program and 2 months' follow-up (P=0.212). The present study showed the reliability of an ITD ENV-based localization training in elderly individuals with speech-in-noise perception disorder.

[A comparison of the effects of intravenous fluid warming and skin surface warming on peri-operative body temperature and acid base balance of elderly patients with abdominal surgery].

PubMed

Park, Hyosun; Yoon, Haesang

2007-12-01

The purpose of this study was to compare the effects of intravenous fluid warming and skin surface warming on peri-operative body temperature and acid base balance of abdominal surgical patients under general anesthesia. Data collection was performed from January 4th, to May 31, 2004. The intravenous fluid warming(IFW) group (30 elderly patients) was warmed through an IV line by an Animec set to 37 degrees C. The skin surface warming (SSW) group (30 elderly patients) was warmed by a circulating-water blanket set to 38 degrees C under the back and a 60W heating lamp 40 cm above the chest. The warming continued from induction of general anesthesia to two hours after completion of surgery. Collected data was analyzed using Repeated Measures ANOVA, and Bonferroni methods. SSW was more effective than IFW in preventing hypothermia(p= .043), preventing a decrease of HCO(3)(-)(p= .000) and preventing base excess (p= .000) respectively. However, there was no difference in pH between the SSW and IFW (p= .401) groups. We conclude that skin surface warming is more effective in preventing hypothermia, and HCO(3)(-) and base excess during general anesthesia, and returning to normal body temperature after surgery than intravenous fluid warming; however, skin surface warming wasn't able to sustain a normal body temperature in elderly patients undergoing abdominal surgery under general anesthesia.

The influence of neck pain on sensorimotor function in the elderly.

PubMed

Uthaikhup, Sureeporn; Jull, Gwendolen; Sungkarat, Somporn; Treleaven, Julia

2012-01-01

Greater disturbances in sensorimotor control have been demonstrated in younger to middle aged groups. However, it is unknown whether or not the impairments documented in these populations can be extrapolated to elders with neck pain. The aim of this study was to investigate the influence of neck pain on sensorimotor function in elders. Twenty elders with neck pain (12 women and 8 men) and 20 healthy elder controls (14 women and 6 men) aged 65 years and over were recruited from the general community. Tests for sensorimotor function included; cervical joint position sense (JPS); computerised rod-and-frame test (RFT); smooth pursuit neck torsion test (SPNT); standing balance (under conditions of eyes open, eyes closed on firm and soft surfaces in comfortable stance); step test and ten-meter walk test with and without head movement. Elders with neck pain had greater deficits in the majority of sensorimotor function tests after controlling for effects of age and comorbidities. Significant differences were found in the SPNT (p<0.01), error in the RFT (frame angled at 10° and 15° anticlockwise) (p<0.05), standing balance (amplitude of sway) - eyes open on a firm surface in the medio-lateral (ML) direction (p=0.03), and total number of steps on the step test, both left and right sides (p<0.01). Elders with neck pain have greater sensorimotor disturbances than elders without neck pain, supporting a contribution of altered afferent information originating from the cervical spine to such disturbances. The findings may inform falls prevention and management programs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Lewy Body Disease

MedlinePlus

Lewy body disease is one of the most common causes of dementia in the elderly. Dementia is the loss of mental ... to affect normal activities and relationships. Lewy body disease happens when abnormal structures, called Lewy bodies, build ...

The Impacts of Cellular Senescence in Elderly Pneumonia and in Age-Related Lung Diseases That Increase the Risk of Respiratory Infections.

PubMed

Yanagi, Shigehisa; Tsubouchi, Hironobu; Miura, Ayako; Matsuo, Ayako; Matsumoto, Nobuhiro; Nakazato, Masamitsu

2017-02-25

Pneumonia generates considerable negative impacts on the elderly. Despite the widespread uses of vaccines and appropriate antibiotics, the morbidity and mortality of elderly pneumonia are significantly higher compared to the counterparts of young populations. The definitive mechanisms of high vulnerability in the elderly against pathogen threats are unclear. Age-associated, chronic low-grade inflammation augments the susceptibility and severity of pneumonia in the elderly. Cellular senescence, one of the hallmarks of aging, has its own characteristics, cell growth arrest and senescence-associated secretory phenotype (SASP). These properties are beneficial if the sequence of senescence-clearance-regeneration is transient in manner. However, persisting senescent cell accumulation and excessive SASP might induce sustained low-grade inflammation and disruption of normal tissue microenvironments in aged tissue. Emerging evidence indicates that cellular senescence is a key component in the pathogenesis of chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF), which are known to be age-related and increase the risk of pneumonia. In addition to their structural collapses, COPD and IPF might increase the vulnerability to pathogen insults through SASP. Here, we discuss the current advances in understanding of the impacts of cellular senescence in elderly pneumonia and in these chronic lung disorders that heighten the risk of respiratory infections.

[Factors related to sarcopenia in community-dwelling elderly subjects in Japan].

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

2013-01-01

This study aimed at determining the factors associated with sarcopenia, defined as low muscle mass and strength and low physical performance, in community-dwelling elderly subjects in Japan. The subjects included 1,074 elderly, community-dwelling Japanese people aged 65 years or older. We measured appendicular muscle mass (AMM) by bioelectrical impedance analysis, grip strength, and usual walking speed. A low muscle mass was defined by the AMM index (AMI, weight [kg]/height [m(2)] as >2 standard deviations below the mean AMI for normal young subjects. The lowest quartile for grip strength and usual walking speed were classified as low muscle strength and low physical performance, respectively. "Sarcopenia" was characterized by a low muscle mass, combined with either a low muscle strength or low physical performance. Subjects without low muscle mass or strength and low physical performance were classified as "normal." Subjects were classified as being "intermediate" if they were neither "sarcopenic" nor "normal." Items in the questionnaire included residential status, past medical history, admission during the past year, smoking and drinking habits, leisure-time physical activity, health status, depression, masticatory ability, and dietary variety score. Sarcopenia was identified in 13.7% of men and 15.5% of women. Among men, a large proportion of subjects with sarcopenia had poor masticatory ability and a low dietary variety score compared with normal or intermediate subjects. Among women, a large proportion of the subjects with sarcopenia lived alone, had poor exercise habits, considered themselves to be unhealthy, and had poor masticatory ability compared with normal or intermediate subjects. A multiple logistic regression analysis showed that age and dietary variety in men and age and masticatory ability in women were associated with sarcopenia. The present study carried out in Japan showed that sarcopenia, assessed by muscle mass, muscle strength, and physical performance, was associated with age, dietary variety score (in men), and masticatory ability (in women).

Clodronate reduces the incidence of fractures in community-dwelling elderly women unselected for osteoporosis: results of a double-blind, placebo-controlled randomized study.

PubMed

McCloskey, Eugene V; Beneton, Monique; Charlesworth, Diane; Kayan, Karthik; deTakats, Dominic; Dey, Abhijit; Orgee, Jane; Ashford, Robert; Forster, Martin; Cliffe, Jennifer; Kersh, Linda; Brazier, John; Nichol, Jon; Aropuu, Sakari; Jalava, Tarja; Kanis, John A

2007-01-01

A 3-year prospective, randomized, placebo-controlled trial of oral clodronate 800 mg showed that the incidence of clinical fractures was decreased by 20% in 5596 elderly women unselected for osteoporosis. The effect occurred in the absence of systematic calcium and vitamin D supplementation and was observed across a wide range of BMDs. To date, most studies with bisphosphonates have reported on their use in individuals selected to be at high risk for fracture usually by the presence of low BMD or a prior fragility fracture, usually of the spine. We wished to determine the effect of the bisphosphonate, clodronate, on the rate of fractures in women > or =75 years of age living in the community. Women > or =75 years of age living in the general community in South Yorkshire and North Derbyshire, identified from general practice registers, were recruited by letter of invitation to a randomized, double-blind, controlled trial of 800 mg oral clodronate (Bonefos) or matching placebo daily over 3 years. The main outcomes were the incidences of hip and any clinical fracture. Of the 5579 elderly women included in the intention-to-treat analysis of efficacy, 114 had a new hip fracture during the 3-year treatment phase: 56 (2.0%) women in the clodronate group and 58 (2.1%) women in the placebo group (hazard ration [HR], 1.02; 95% CI, 0.71-1.47). Clodronate did, however, decrease the incidence of any clinical fracture by 20% (264 women [9.5%] versus 337 [12.1%] in the placebo group; HR, 0.80; 95% CI, 0.68-0.94). The incidence of osteoporosis-associated nonhip fractures was also significantly decreased by 29% (5.2% versus 7.4%; HR, 0.71; 95% CI, 0.57-0.87). The ability of clodronate to reduce the risk of osteoporotic fracture was independent of baseline BMD, but the number needed-to-treat was lower in the presence of osteoporosis. Oral daily clodronate can prevent fractures without significant adverse effects in elderly women living in the general community. The effect on hip fracture risk is not significant, but an effect similar to that at other nonvertebral sites cannot be excluded. This study suggests that antiresorptive therapies can reduce fracture incidence in high-risk individuals even in the presence of a normal or osteopenic BMD.

Communication, Control, and Computer Access for Disabled and Elderly Individuals. ResourceBook 2: Switches and Environmental Controls. Rehab/Education Technology ResourceBook Series.

ERIC Educational Resources Information Center

Brandenburg, Sara A., Ed.; Vanderheiden, Gregg C., Ed.

One of a series of three resource guides concerned with communication, control, and computer access for disabled and elderly individuals, the directory focuses on switches and environmental controls. The book's three chapters each cover products with the same primary function. Cross reference indexes allow access to listings of products by…

Impact of Patient Education on Influenza Vaccine Uptake among Community-Dwelling Elderly: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Leung, Ka Chun; Mui, Carlo; Chiu, Wing Yan; Ng, Yuk Yiu; Chen, Matthew H. Y.; Ho, Pui Hung; Kwok, Chun Pong; Lam, Suki S. M.; Wong, Chun Yip; Wong, Kit Yee; Pang, Herbert H.

2017-01-01

This randomized controlled trial aimed to test the effectiveness of brief face-to-face patient education in increasing influenza vaccination rate among elderly in the community. Recruitment and intervention were conducted at two general outpatient clinics in Hong Kong. 529 eligible patients were randomly assigned to intervention or control group…

75 FR 57490 - Notice of Submission of Proposed Information Collection to OMB Section 202 Supportive Housing for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

... Proposed Information Collection to OMB Section 202 Supportive Housing for the Elderly Application... Elderly and addition of predevelopment grant funding for architectural and engineering work, site control... Proposal: Section 202 Supportive Housing for the Elderly Application Submission Requirements. OMB Approval...

Interrupted Time Series Analysis: A Research Technique for Evaluating Social Programs for the Elderly

ERIC Educational Resources Information Center

Calsyn, Robert J.; And Others

1977-01-01

After arguing that treatment programs for the elderly need to be evaluated with better research designs, the authors illustrate how interrupted time series analysis can be used to evaluate programs for the elderly when random assignment to experimental and control groups is not possible. (Author)

Experienced stress produces inhibitory deficits in old adults' Flanker task performance: First evidence for lifetime stress effects beyond memory.

PubMed

Marshall, Amanda C; Cooper, Nicholas R; Geeraert, Nicolas

2016-01-01

Studies regarding aged individuals' performance on the Flanker task differ with respect to reporting impaired or intact executive control. Past work has explained this discrepancy by hypothesising that elderly individuals use increased top-down control mechanisms advantageous to Flanker performance. This study investigated this mechanism, focussing on cumulative experienced stress as a factor that may impact on its execution, thereby leading to impaired performance. Thirty elderly and thirty young participants completed a version of the Flanker task paired with electroencephalographic recordings of the alpha frequency, whose increased synchronisation indexes inhibitory processes. Among high stress elderly individuals, findings revealed a general slowing of reaction times for congruent and incongruent stimuli, which correlated with alpha desynchronisation for both stimulus categories. Results found high performing (low stress) elderly revealed neither a behavioural nor electrophysiological difference compared to young participants. Therefore, rather than impacting on top-down compensatory mechanisms, findings indicate that stress may affect elderly participants' inhibitory control in attentional and sensorimotor domains. Copyright © 2015 Elsevier B.V. All rights reserved.

Watching elderly and disabled person's physical condition by remotely controlled monorail robot

NASA Astrophysics Data System (ADS)

Nagasaka, Yasunori; Matsumoto, Yoshinori; Fukaya, Yasutoshi; Takahashi, Tomoichi; Takeshita, Toru

2001-10-01

We are developing a nursing system using robots and cameras. The cameras are mounted on a remote controlled monorail robot which moves inside a room and watches the elderly. It is necessary to pay attention to the elderly at home or nursing homes all time. This requires staffs to pay attention to them at every time. The purpose of our system is to help those staffs. This study intends to improve such situation. A host computer controls a monorail robot to go in front of the elderly using the images taken by cameras on the ceiling. A CCD camera is mounted on the monorail robot to take pictures of their facial expression or movements. The robot sends the images to a host computer that checks them whether something unusual happens or not. We propose a simple calibration method for positioning the monorail robots to track the moves of the elderly for keeping their faces at center of camera view. We built a small experiment system, and evaluated our camera calibration method and image processing algorithm.

Optimization of impedance spectroscopy techniques for measuring cutaneous micropore formation after microneedle treatment in an elderly population.

PubMed

Kelchen, Megan N; Holdren, Grant O; Farley, Matthew J; Zimmerman, M Bridget; Fairley, Janet A; Brogden, Nicole K

2014-12-01

The objective of this study was to optimize a reproducible impedance spectroscopy method in elderly subjects as a means to evaluate the effects of microneedles on aging skin. Human volunteers were treated with microneedles at six sites on the upper arm. Repeated impedance measurements were taken pre- and post-microneedle insertion. Two electrode types were evaluated (dry vs. gel), using either light or direct pressure to maintain contact between the electrode and skin surface. Transepidermal water loss (TEWL) was measured as a complementary technique. Five control subjects and nine elderly subjects completed the study. Microneedle insertion produced a significant decrease in impedance from baseline in all subjects (p < 0.05, regardless of electrode type or pressure application), confirming micropore formation. This was supported by a complementary significant increase in TEWL (p < 0.05). The gel*direct condition produced the lowest variability between measurements, as demonstrated by a coefficient of variation of 3.8% and 3.5% (control and elderly subjects, respectively). This was lower than variation between TEWL measurements at the same sites: 19.8% and 21.6% (control and elderly subjects, respectively). Impedance spectroscopy reproducibly measures micropore formation in elderly subjects, which will be essential for future studies describing microneedle-assisted transdermal delivery in aging populations.

An Elderly Care System Based on Multiple Information Fusion

PubMed Central

Lu, Dongwei

2018-01-01

With the development of social economy in the 21st century, and the rising of medical level, the aging of population have become a global trend. However lots of elderly people are in “empty nest” state. In order to solve the problem of high risk of daily life in this group, this paper proposed a method to integrate the information of video images, sound, infrared, pulse, and other information into the elderly care system. The whole system consists of four major components, that is, the main control board, the information acquisition boards, the server, and the client. The control board receives, processes and analyzes the data collected by the information acquisition boards, and uploads necessary information to the server, which are to be saved to the database. When something unexpected occurs to the elderly, the system will notify the relatives through the GPRS (general packet radio service) module. The system also provides an interface for the relatives to inquire the living status of the elderly through an app. The system can monitor the living status for the elderly with the characteristics of quick response, high accuracy, and low cost and can be widely applied to the elderly care at home. PMID:29599947

An Elderly Care System Based on Multiple Information Fusion.

PubMed

He, Zhiwei; Lu, Dongwei; Yang, Yuxiang; Gao, Mingyu

2018-01-01

With the development of social economy in the 21st century, and the rising of medical level, the aging of population have become a global trend. However lots of elderly people are in "empty nest" state. In order to solve the problem of high risk of daily life in this group, this paper proposed a method to integrate the information of video images, sound, infrared, pulse, and other information into the elderly care system. The whole system consists of four major components, that is, the main control board, the information acquisition boards, the server, and the client. The control board receives, processes and analyzes the data collected by the information acquisition boards, and uploads necessary information to the server, which are to be saved to the database. When something unexpected occurs to the elderly, the system will notify the relatives through the GPRS (general packet radio service) module. The system also provides an interface for the relatives to inquire the living status of the elderly through an app. The system can monitor the living status for the elderly with the characteristics of quick response, high accuracy, and low cost and can be widely applied to the elderly care at home.

History of cigarette smoking in cognitively-normal elders is associated with elevated cerebrospinal fluid biomarkers of oxidative stress.

PubMed

Durazzo, Timothy C; Mattsson, Niklas; Weiner, Michael W; Korecka, Magdalena; Trojanowski, John Q; Shaw, Leslie M

2014-09-01

Cigarette smoking in adults is associated with abnormalities in brain neurobiology. Smoking-induced central nervous system oxidative stress (OxS) is a potential mechanism associated with these abnormalities. The goal of this study was to compare cognitively-normal elders on cerebrospinal fluid (CSF) levels of F2-isoprostane biomarkers of OxS. Elders with a lifetime history of smoking (smokers; n=50; 75±5 years of age; 34±28 pack-years; approximately 12% were actively smoking at the time of study) were compared to never-smokers (n=61; 76±6 years of age) on CSF iPF2α-III and 8,12, iso-iPF2α-VI F2-isoprostanes levels. F2-isoprostanes levels were quantitated with HPLC-atmospheric pressure chemical ionization-tandem mass spectrometry. Associations between F2-isoprostanes levels, hippocampal volumes, and cigarette exposure measures were also evaluated. Smokers showed higher iPF2α-III level than never-smokers. An age×smoking status interaction was observed for 8,12, iso-iPF2α-VI, where smokers demonstrate a significantly greater concentration with increasing age than never-smokers. In smokers only, higher 8,12, iso-iPF2α-VI concentration was associated with smaller hippocampal volume, and greater iPF2α-III level was related to greater pack years. This is the first study to demonstrate that a history of cigarette smoking in cognitively-normal elders was associated with significantly elevated CSF F2-isoprostane levels and greater age-related increases in F2-isoprostanes, and that higher F2-isoprostane levels in smokers were related to smaller hippocampal volume. These findings provide additional novel evidence that a history of chronic smoking during adulthood is associated with adverse effects on the human brain that are potentially enduring even with extended smoking cessation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Importance of Applying Condiments in a Commonly Consumed Food System for Understanding the Association Between Familiarity and Sensory Drivers of Liking: A Study Focused on Doenjang.

PubMed

Roh, Soo Hyun; Lee, Soh Min; Kim, Sang Sook; Kim, Kwang-Ok

2018-02-01

Doenjang, a Korean traditional fermented soybean paste, is one of the most essential condiments in Korean cuisine. Condiments are rarely consumed as it is, and are generally applied to other foods. The objective of this study was to understand how sensory drivers of liking of Doenjang would be affected according to food forms in which it is evaluated: the original paste form compared with a normally consumed soup form, and to understand the association of familiarity of evaluated food form. Descriptive analysis and consumer acceptability test was performed in 2 consumption forms: the original paste form and the Doenjang soup from. For consumer liking test, elderly consumers who have more experience to traditional Deonjang were compared to the young in their response to Doenjang paste and soup. The descriptive analysis results showed that the characteristic sensory features of the Deonjang samples were little affected based on the food system in which it was evaluated. However, when the paste was applied in soup, the intensities of the characteristic sensory features were reduced. Acceptability and familiarity of traditional type Doenjang samples for the young and for the elderly consumers were very similar in paste, but it differed when the samples were evaluated in soup. Thus, expectation difference between the young and the elderly was better revealed in soup, a more common food form consumed in practice. The results of this study indicate the importance of understanding sensory drivers of liking for a condiment such as Doenjang in their commonly consumed forms. Compared to the original condiment form, expectation difference between the young and the elderly were better revealed in Deonjang soup, a food form normally consumed in practice. Thus, the results of this study reinforced the importance of investigating sensory drivers of liking for a condiment in a food form that is normally consumed in practice for accurate understanding on consumer preference. © 2018 Institute of Food Technologists®.

Soy isoflavones improve spatial delayed matching-to-place performance and reduce cholinergic neuron loss in elderly male rats.

PubMed

Lee, Yoon-Bok; Lee, Hyong Joo; Won, Moo Ho; Hwang, In Koo; Kang, Tae-Cheon; Lee, Jae-Yong; Nam, Sang-Yoon; Kim, Kang-Sung; Kim, Eugene; Cheon, Sang-Hee; Sohn, Heon-Soo

2004-07-01

To investigate the protective activity of soy isoflavones on neurons, the effects of isoflavones on cholinergic enzyme activity, immunoreactivities of cholinergic enzyme, and delayed matching-to-place (DMP) performance were measured in normal elderly rats. Male Sprague-Dawley rats (n = 48; 10 mo old) were assigned to 3 groups: CD (control diet), ISO 0.3 (0.3 g/kg soy isoflavones diet), and ISO 1.2 (1.2 g/kg soy isoflavones diet). After 16 wk of consuming these diets, choline acetyltransferase (ChAT) activity in the ISO 0.3 group was greater in cortex and basal forebrain (BF; P < 0.05) than in controls. In BF, ChAT activity was also significantly greater in the ISO 1.2 group than in control rats. Acetylcholine esterase (AChE) activity in the ISO 0.3 group was significantly inhibited in cortex, BF, and hippocampus and in the ISO 1.2 group in cortex and hippocampus. Choline acetyltransferase immunoreactivity (ChAT-IR) in the ISO 1.2 group was significantly greater than in controls in the medial septum area. ChAT-IR in the ISO 0.3 and ISO 1.2 groups was significantly higher than in the CD group in the hippocampus CA1 area. Spatial DMP performance by the ISO 0.3 group showed significantly shorter swimming time than by the CD group. These findings show that soy isoflavones can influence the brain cholinergic system and reduce age-related neuron loss and cognition decline in male rats.

Chromosome aberrations in peripheral blood lymphocytes of individuals living in high background radiation areas of Ramsar, Iran.

PubMed

Zakeri, F; Rajabpour, M R; Haeri, S A; Kanda, R; Hayata, I; Nakamura, S; Sugahara, T; Ahmadpour, M J

2011-11-01

In order to investigate the biological effects of exposure to low-dose radiation and to assess the dose-effect relationship in residents of high background radiation areas (HBRAs) of Ramsar, cytogenetic investigation of unstable-type aberrations was performed in 15 healthy elderly women in a HBRA of Ramsar, Talesh mahalle, and in 10 elderly women living in a nearby control area with normal background radiation. In total, 77,714 cells were analyzed; 48,819 cells in HBRA residents and 28,895 cells in controls. On average, 3,108 cells per subject were analyzed (range 1,475-5,007 cells). Significant differences were found in the frequency of dicentric plus centric rings in 100 cells (0.207 ± 0.103 vs. 0.047 ± 0.027, p < 0.0005), total chromosome-type aberrations per 100 cells (0.86 ± 0.44 vs. 0.23 ± 0.17, p < 0.0005), and chromatid-type aberrations per 100 cells (3.31 ± 2.01 vs. 1.66 ± 0.63, p = 0.01) by the Mann-Whitney U test between HBRA and the control, respectively. Using chromosomal aberrations as the main endpoint to assess the dose-effect relationship in residents of HBRAs in Ramsar, no positive correlation was found between the frequency of dicentric plus centric ring aberrations and the cumulative dose of the inhabitants estimated by direct individual dosimetry; however, obvious trends of increase with age appeared in the control group. Based on these results, individuals residing in HBRAs of Ramsar have an increased frequency of detectable abnormalities in unstable aberrations.

Femoral head-neck junction deformity is related to osteoarthritis of the hip.

PubMed

Barros, Hilton José Melo; Camanho, Gilberto Luis; Bernabé, Antônio Carlos; Rodrigues, Marcelo Bordalo; Leme, Luiz Eugênio Garcez

2010-07-01

Primary or idiopathic osteoarthritis (OA) of the hip has increasingly been attributed to the presence of presumably minor femoral or acetabular deformities that are not routinely identified. The alpha angle reflects one such deformity of the femoral neck and reflects a risk for femoroacetabular impingement, which in turn reportedly is associated with OA. If impingement is in fact associated with OA, then one might expect the mean alpha angle to be greater in patients with presumed idiopathic hip OA. We therefore compared the alpha angle among a group of elderly patients with idiopathic OA with that in a control group of elderly individuals without OA. We measured the alpha angles in 50 individuals (72 hips) with a mean age of 70 years (range, 60-84 years) with apparently idiopathic OA and compared their angles with those from a control group of 56 individuals without OA. The alpha angle was measured by means of radiographs of their hips using the Dunn view at 45 degrees flexion. The patients with OA had a greater percentage with abnormal alpha angles than did the normal subjects: 82% versus 30%, respectively. The mean alpha angle in the group with OA was larger than in the control subjects: 66.4 masculine (range, 28 degrees -108 degrees ) versus 48.1 masculine (range, 34 degrees -68 degrees ). Hips with presumably idiopathic OA had more abnormalities at the femoral head-neck junction than did the control hips without OA and may relate to the risk of OA developing. Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Mastication and oral health-related quality of life in removable denture wearers with Alzheimer disease.

PubMed

Campos, Camila H; Ribeiro, Giselle R; Rodrigues Garcia, Renata C M

2018-05-01

Alzheimer disease (AD) can affect masticatory function, affecting oral health-related quality of life (OHRQoL). Whether oral rehabilitation with conventional removable prostheses can restore masticatory function and improve OHRQoL in these individuals is unknown. The purpose of this clinical study was to evaluate the influence of oral rehabilitation with removable prostheses on masticatory efficiency and OHRQoL in elders with and without AD. Thirty-two elders with mild AD (n=16, mean age=76.7 ±6.3 years) or without AD (n=16, mean age=75.2 ±4.4 years) were recruited. All participants first underwent masticatory efficiency and OHRQoL evaluations, and 2 months after insertion of new removable prostheses, the variables were reassessed. Masticatory efficiency was determined using the sieving method, and OHRQoL was measured by applying the Geriatric Oral Health Assessment Index (GOHAI). The data from the baseline and after insertion of the new removable prostheses were compared by paired t test. Group differences at each time point were assessed by t test (α=.05). After insertion of the new removable prostheses, masticatory efficiency and OHRQoL improved in both the elders with AD and the control. At baseline, elders with AD had lower masticatory efficiency and higher OHRQoL than controls (P<.05). After removable prosthesis insertion, elders with AD continued to show lower masticatory efficiency values than controls, but their OHRQoL was similar. Oral rehabilitation with new removable prostheses improved the masticatory efficiency and OHRQoL of elders with and without AD, although masticatory efficiency did not reach control levels in elders with AD. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Calibrating and adjusting expectations in life: A grounded theory on how elderly persons with somatic health problems maintain control and balance in life and optimize well-being

PubMed Central

Helvik, Anne-Sofie; Iversen, Valentina Cabral; Steiring, Randi; Hallberg, Lillemor R-M

2011-01-01

Aim This study aims at exploring the main concern for elderly individuals with somatic health problems and what they do to manage this. Method In total, 14 individuals (mean=74.2 years; range=68–86 years) of both gender including hospitalized and outpatient persons participated in the study. Open interviews were conducted and analyzed according to grounded theory, an inductive theory-generating method. Results The main concern for the elderly individuals with somatic health problems was identified as their striving to maintain control and balance in life. The analysis ended up in a substantive theory explaining how elderly individuals with somatic disease were calibrating and adjusting their expectations in life in order to adapt to their reduced energy level, health problems, and aging. By adjusting the expectations to their actual abilities, the elderly can maintain a sense of that they still have the control over their lives and create stability. The ongoing adjustment process is facilitated by different strategies and result despite lower expectations in subjective well-being. The facilitating strategies are utilizing the network of important others, enjoying cultural heritage, being occupied with interests, having a mission to fulfill, improving the situation by limiting boundaries and, finally, creating meaning in everyday life. Conclusion The main concern of the elderly with somatic health problems was to maintain control and balance in life. The emerging theory explains how elderly people with somatic health problems calibrate their expectations of life in order to adjust to reduced energy, health problems, and aging. This process is facilitated by different strategies and result despite lower expectation in subjective well-being. PMID:21468299

Aging worsens the effects of sleep deprivation on postural control.

PubMed

Robillard, Rébecca; Prince, François; Filipini, Daniel; Carrier, Julie

2011-01-01

Falls increase with age and cause significant injuries in the elderly. This study aimed to determine whether age modulates the interactions between sleep deprivation and postural control and to evaluate how attention influences these interactions in the elderly. Fifteen young (24±2.7 y.o.) and 15 older adults (64±3.2 y.o.) stood still on a force plate after a night of sleep and after total sleep deprivation. Center of pressure range and velocity were measured with eyes open and with eyes closed while participants performed an interference task, a control task, and no cognitive task. Sleep deprivation increased the antero-posterior range of center of pressure in both age groups and center of pressure speed in older participants only. In elderly participants, the destabilizing effects of sleep deprivation were more pronounced with eyes closed. The interference task did not alter postural control beyond the destabilization induced by sleep loss in older subjects. It was concluded that sleep loss has greater destabilizing effects on postural control in older than in younger participants, and may therefore increase the risk of falls in the elderly.

Aging Worsens the Effects of Sleep Deprivation on Postural Control

PubMed Central

Robillard, Rébecca; Prince, François; Filipini, Daniel; Carrier, Julie

2011-01-01

Falls increase with age and cause significant injuries in the elderly. This study aimed to determine whether age modulates the interactions between sleep deprivation and postural control and to evaluate how attention influences these interactions in the elderly. Fifteen young (24±2.7 y.o.) and 15 older adults (64±3.2 y.o.) stood still on a force plate after a night of sleep and after total sleep deprivation. Center of pressure range and velocity were measured with eyes open and with eyes closed while participants performed an interference task, a control task, and no cognitive task. Sleep deprivation increased the antero-posterior range of center of pressure in both age groups and center of pressure speed in older participants only. In elderly participants, the destabilizing effects of sleep deprivation were more pronounced with eyes closed. The interference task did not alter postural control beyond the destabilization induced by sleep loss in older subjects. It was concluded that sleep loss has greater destabilizing effects on postural control in older than in younger participants, and may therefore increase the risk of falls in the elderly. PMID:22163330

LGBQ-Specific Elderly Housing as a "Sparkling Sanctuary": Boundary Work on LGBQ Identity and Community in Relationship to Potential LGBQ-Specific Elderly Housing in Sweden.

PubMed

Rosenberg, Lena; Kottorp, Anders; Johansson, Karin

2017-09-08

This study explored how boundaries in relationship to community and identity were created and negotiated among lesbian, gay, bisexual, and queer (LGBQ) people within the framework of picturing LGBQ-specific elderly housing as a housing alternative in older age, by applying focus group methodology. "An island as a sparkling sanctuary" was identified as a metaphor for how symbolic resources defining the LGBQ community can be manifested in LGBQ-specific qualities of elderly housing. The boundary work underlying this manifestation included elaborations on the dilemma between exclusiveness and normality. The findings illustrate further how symbolic resources and collective identities were developed through dialectic interplay between internal and external definitions. Further, the findings show how boundary work generated shared feelings of similarity and group membership. The associated symbolic and social resources not only served to deal with difficult situations but also to manifest LGBQ identity and sense of community as a "gold medal."

Study on Walking Training System using High-Performance Shoes constructed with Rubber Elements

NASA Astrophysics Data System (ADS)

Hayakawa, Y.; Kawanaka, S.; Kanezaki, K.; Doi, S.

2016-09-01

The number of accidental falls has been increasing among the elderly as society has aged. The main factor is a deteriorating center of balance due to declining physical performance. Another major factor is that the elderly tend to have bowlegged walking and their center of gravity position of the body tend to swing from side to side during walking. To find ways to counteract falls among the elderly, we developed walking training system to treat the gap in the center of balance. We also designed High-Performance Shoes that showed the status of a person's balance while walking. We also produced walk assistance from the insole in which insole stiffness corresponded to human sole distribution could be changed to correct the person's walking status. We constructed our High- Performances Shoes to detect pressure distribution during walking. Comparing normal sole distribution patterns and corrected ones, we confirmed that our assistance system helped change the user's posture, thereby reducing falls among the elderly.

Undisturbed upright stance control in the elderly: Part 2. Postural-control impairments of elderly fallers.

PubMed

Berger, L; Chuzel, M; Buisson, G; Rougier, P

2005-09-01

A common way of predicting falling risks in elderly people can be to study center of pressure (CP) trajectories during undisturbed upright stance maintenance. By estimating the difference between CP and center of gravity (CG) motions (CP - CGv), one can estimate the neuromuscular activity. The results of this study, which included 34 sedentary elderly persons aged over 75 years (21 fallers and 13 nonfallers), demonstrated significantly increased CGh and CP - CGv motions in both axes for the fallers. In addition, the fallers presented larger CGh motions in the mediolateral axis, suggesting an enlarged loading-unloading mechanism, which could have reflected the adoption of a step-initiating strategy. As highlighted by fractional Brownian motion modeling, the distance covered by the CP - CGv motions before the successive control mechanisms switched was enhanced for the fallers in both axes, therefore increasing the risk that the CG would be outside of the base of support.

An attenuation of the 'normal' category effect in patients with Alzheimer's disease: a review and bootstrap analysis.

PubMed

Moreno-Martínez, F Javier; Laws, Keith R

2007-03-01

There is a consensus that Alzheimer's disease (AD) impairs semantic information, with one of the first markers being anomia i.e. an impaired ability to name items. Doubts remain, however, about whether this naming impairment differentially affects items from the living and nonliving knowledge domains. Most studies have reported an impairment for naming living things (e.g. animals or plants), a minority have found an impairment for nonliving things (e.g. tools or vehicles), and some have found no category-specific effect. A survey of the literature reveals that this lack of agreement may reflect a failure to control for intrinsic variables (such as familiarity) and the problems associated with ceiling effects in the control data. Investigating picture naming in 32 AD patients and 34 elderly controls, we used bootstrap techniques to deal with the abnormal distributions in both groups. Our analyses revealed the previously reported impairment for naming living things in AD patients and that this persisted even when intrinsic variables were covaried; however, covarying control performance eliminated the significant category effect. Indeed, the within-group comparison of living and nonliving naming revealed a larger effect size for controls than patients. We conclude that the category effect in Alzheimer's disease is no larger than is expected in the healthy brain and may even represent a small diminution of the normal profile.

Body composition influenced by progressive elastic band resistance exercise of sarcopenic obesity elderly women: a pilot randomized controlled trial.

PubMed

Huang, Shih-Wei; Ku, Jan-Wen; Lin, Li-Fong; Liao, Chun-De; Chou, Lin-Chuan; Liou, Tsan-Hon

2017-08-01

Sarcopenia involves age-related decreases in muscle strength and muscle mass, leading to frailty and disability in elderly people. When combined with obesity, it is defined as sarcopenic obesity (SO), which can result in more functional limitations and metabolic disorders than either disorder alone. The aim of this study was to investigate body composition changes after elastic band resistance training in elderly women with SO. Randomized single-blinded (assessor blinded) controlled pilot trial. Academic medical center. Thirty-five elderly (>60 years old) women with SO. This pilot randomized controlled trial focused on elderly women with SO. The study group underwent progressive elastic band resistance training for 12 weeks (3 times per week). The control group received only a 40-minute lesson about the exercise concept. Dual-energy X-ray absorptiometry was performed before and after intervention to evaluate body composition. Mann-Whitney U and Wilcoxon signed rank tests were used to analyze the differences within and between these groups. In total, 35 elderly women with SO were enrolled and divided into study (N.=18) and control groups (N.=17). No difference was observed in age, biochemical parameters, or Body Mass Index between both groups. After the intervention, the fat proportion of body composition in the right upper extremity (P=0.03), left upper extremity (P=0.04), total fat (P=0.035), and fat percentage (P=0.012) had decreased, and bone mineral density (BMD) (P=0.026), T-score (P=0.028), and Z-score (P=0.021) had increased in the study group. Besides, statistical difference was observed in outcome measurements of right upper extremity (P=0.013), total fat (P=0.023), and fat percentage (P=0.012) between the groups. Our study demonstrated that progressive elastic band resistance exercise can reduce fat mass and increase BMD in elderly women with SO, and that this exercise program is feasible for this demographic. Additional studies with larger sample sizes and longer intervention periods should be conducted. Twelve weeks of progressive elastic band resistance exercise program is safe and effective for SO elder women.

[Male sexuality in the elderly].

PubMed

Rinnab, L; Schrader, A J; Schrader, M; Zengerling, F

2012-10-01

Male sexuality in the elderly is an important issue with a growing relevance. In contrast to the assumption of an asexual state when becoming older, recent representative surveys show that the majority of men maintain sexual desires and fantasies into old age. Sexual activity primarily depends on the availability of a partner and on maintaining intimacy and sexuality in the face of changes in the sexual response cycle and increasing comorbidity. This review aims to clarify the normal aging process, the sexual behavior of aging males and the prevalence of sexual dysfunction.

A cross-sectional study of the effect of health literacy on diabetes prevention and control among elderly individuals with prediabetes in rural China

PubMed Central

Qin, Lulu; Xu, Huilan

2016-01-01

Objectives This study was designed to examine the effect of health literacy on diabetes prevention and control and risk factors for low diabetes health literacy among elderly individuals with prediabetes in rural areas in China. Design setting and participates A cross-sectional survey was conducted among elderly individuals in rural communities in Yiyang City in China. Multi-staged cluster random sampling was used to select 42 areas and 434 individuals with prediabetes who were interviewed using a questionnaire on diabetes health literacy in China. Main outcome measures Participants were asked for general information (age, gender, marital status, history of hyperglycaemia, family history of diabetes mellitus, presence of other diseases and level of education). Binary logistic regression analysis was used to identify risk factors for poor health literacy concerning diabetes prevention and control among elderly subjects with prediabetes. Results The median health literacy score for diabetes prevention and prediabetes control was 10.0 (IQR 7.0–13.0). The level of diabetes health literacy among men was lower than among women (OR 2.831, 95% CI 1.818 to 4.408), and lower among respondents with 1–6 years of education than among those with 6 years or more of education (OR 14.274, 95% CI 5.927 to 34.375). Those with less than 1 year of education had the lowest literacy (OR 31.148, 95% CI 11.661 to 83.204). The level of diabetes health literacy among elderly individuals with prediabetes but no history of hyperglycaemia was lower than among those with a history of hyperglycaemia (OR 2.676, 95% CI 1.101 to 6.504). Conclusions Health literacy concerning diabetes prevention and control among elderly individuals with prediabetes was very low in rural China. Appropriate health education for elderly individuals with low educational levels should be incorporated into diabetes prevention efforts. Trial registration number ChiCTR-IOR-15007033; Results. PMID:27235299

Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial.

PubMed

Chan, Aileen Wk; Yu, Doris Sf; Choi, K C

2017-01-01

To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly. "Hidden elderly" is a term used to describe older adults who are socially isolated and refuse social participation. This pilot randomized controlled trial recruited 48 older adults aged 60 or above who did not engage in any social activity. They were randomized into tai chi qigong (n=24) and standard care control (n=24) groups. The former group underwent a three-month program of two 60-minute sessions each week, with the socially active volunteers paired up with them during practice. Standard care included regular home visits by social workers. Primary outcomes were assessed by means of the Lubben social network and De Jong Gieveld loneliness scales, and by a revised social support questionnaire. Secondary outcomes were covered by a mental health inventory and the Rosenberg self-esteem scale, and quality of life by using the 12-Item Short Form Health Survey. Data was collected at baseline, and at three and six months thereafter. The generalized estimating equations model revealed general improvement in outcomes among participants on the tai chi qigong program. In particular, participants reported a significantly greater improvement on the loneliness scale ( B =-1.32, 95% confidence interval [CI] -2.54 to -0.11, P =0.033) and the satisfaction component of the social support questionnaire ( B =3.43, 95% CI 0.10-6.76, P =0.044) than the control group. The pilot study confirmed that tai chi qigong with elderly neighborhood volunteers is a safe and feasible social intervention for hidden elderly. Its potential benefits in improving social and psychological health suggest the need for a full-scale randomized controlled trial to reveal its empirical effects.

A case control study on factors that influence depression among the elderly in Kuala Lumpur Hospital and Universiti Kebangsaan Malaysia Hospital.

PubMed

Salimah, O; Rahmah, M A; Rosdinom, R; Azhar, S Shamsul

2008-12-01

Depressive illness is common among the aged population. A case control study was conducted, focusing on risk factors influencing depression among the elderly. This study involved 130 elderly patients diagnosed to have depressive illness from the psychiatric clinics of Kuala Lumpur Hospital (HKL) and Universiti Kebangsaan Malaysia Hospital (HUKM). Another group of 130 elderly patients with no history of depressive illness were recruited from the medical specialist clinics. The majority of cases were female (75.4%), aged 60-74 years (92.3%) and from Chinese ethnic group (59.2%). Non-Malay elderly has three times risk (AOR 2.537, 95% CI 1.439-4.471) of suffering the depressive illness compared to the Malay elderly, the elderly with chronic health problems are more likely to be depressed compared to those who do not suffer from any chronic illness (p trend <0.001). Other risk factors identified were family history of depression with four times risk (AOR 4.225, 95% CI 2.017-8.848) and lower social support with eight times risk (AOR 7.949, 95% CI 2.588-24.417). Social support is not only important in encouraging the elderly to practice healthy life style but proven to influence the risk of getting depression among them. Hence, it is very crucial that the elderly is given total attention, respect and love from all parties to ensure prosperity and meaningfulness in life.

Role of inflammatory markers in Elderly Type 2 Diabetic Patients with Mild Cognitive Impairment.

PubMed

Hosny, Salwa S; Bahaaeldin, Ahmed M; Khater, Mohamed S; Bekhet, Meram M; Hebah, Hayam A; Hasanin, Ghada A

2018-04-22

Type 2 diabetes (T2DM) is a risk factor for Alzheimer's disease and mild cognitive impairment. The etiology of cognitive impairment in people with T2DM is uncertain but, chronic hyperglycemia, cerebral micro vascular disease, severe hypoglycemia, and increased prevalence of macro vascular disease are implicated. to determine the serum levels of soluble vascular adhesion molecule (sVCAM-1) and highly sensitive C-reactive protein (hs-CRP) in elderly type 2 diabetics with mild cognitive impairment (MCI). Our study was conducted on 90 elderly subjects (aged 60 years old or more). They were divided into Group І, 30 patients with T2DM and mild cognitive impairment, group ІІ, 30 patients with T2DM without cognitive impairment and group III, 30 healthy subjects as a control group. They were subjected to history taking, full clinical examination, anthropometric measurement, the Addenbrooke's Cognitive Examination III (ACE---III 2012), Fasting plasma glucose, 2 hours plasma glucose, HbA1c, lipid profile, protein/creatinine ratio, serum sVCAM-1 and hs-CRP. Serum levels of sVCAM-1 in diabetic elderly patients with MCI were significantly higher (946.7 ± 162.01 ng/ml) than diabetic elderly patients without cognitive impairment (479.06 ± 65.27 ng/ml) and control (263.7 ± 72.05 ng/ml) with (P=0.002). Serum levels of Hs-CRP in diabetic elderly patients with MCI were significantly higher than as diabetic elderly patients without cognitive impairment and control with (P=0.005). Elderly diabetic patients with mild cognitive impairment, have higher levels of soluble adhesion molecules and markers of low-grade systemic inflammation than other groups. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cortical Thickness and Depressive Symptoms in Cognitively Normal Individuals: The Mayo Clinic Study of Aging.

PubMed

Pink, Anna; Przybelski, Scott A; Krell-Roesch, Janina; Stokin, Gorazd B; Roberts, Rosebud O; Mielke, Michelle M; Knopman, David S; Jack, Clifford R; Petersen, Ronald C; Geda, Yonas E

2017-01-01

Altered cortical thickness has been observed in aging and various neurodegenerative disorders. Furthermore, reduced hippocampal volume has been reported in late-life depression. Even mild depressive symptoms are common in the elderly. However, little is known about the structural MRI measures of depressive symptoms in normal cognitive aging. Thus we sought to examine the association between depressive symptoms with cortical thickness and hippocampal volume as measured by brain MRI among community-dwelling participants. We conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging, involving cognitively normal participants (N = 1,507) aged≥70 years. We observed that depressive symptoms were associated with lower global cortical thickness and lower thickness in specific prefrontal and temporal cortical regions, labeled by FreeSurfer software, version 5.3. As expected, the strength of correlation was very small, given that participants were community-dwelling with only mild depressive symptoms. We did not observe associations between hippocampal volume and depressive symptoms. These findings may provide insight into the structural correlates of mild depressive symptoms in elderly participants.

Brain tissue volumes in the general elderly population. The Rotterdam Scan Study.

PubMed

Ikram, M Arfan; Vrooman, Henri A; Vernooij, Meike W; van der Lijn, Fedde; Hofman, Albert; van der Lugt, Aad; Niessen, Wiro J; Breteler, Monique M B

2008-06-01

We investigated how volumes of cerebrospinal fluid (CSF), grey matter (GM) and white matter (WM) varied with age, sex, small vessel disease and cardiovascular risk factors in the Rotterdam Scan Study. Participants (n=490; 60-90 years) were non-demented and 51.0% had hypertension, 4.9% had diabetes mellitus, 17.8% were current smoker and 54.0% were former smoker. We segmented brain MR-images into GM, normal WM, white matter lesion (WML) and CSF. Brain infarcts were rated visually. Volumes were expressed as percentage of intra-cranial volume. With increasing age, volumes of total brain, normal WM and total WM decreased; that of GM remained unchanged; and that of WML increased, in both men and women. Excluding persons with infarcts did not alter these results. Persons with larger load of small vessel disease had smaller brain volume, especially normal WM volume. Diastolic blood pressure, diabetes mellitus and current smoking were also related to smaller brain volume. In the elderly, higher age, small vessel disease and cardiovascular risk factors are associated with smaller brain volume, especially WM volume.

Real-Life/Real-Time Elderly Fall Detection with a Triaxial Accelerometer

PubMed Central

2018-01-01

The consequences of a fall on an elderly person can be reduced if the accident is attended by medical personnel within the first hour. Independent elderly people often stay alone for long periods of time, being in more risk if they suffer a fall. The literature offers several approaches for detecting falls with embedded devices or smartphones using a triaxial accelerometer. Most of these approaches have not been tested with the target population or cannot be feasibly implemented in real-life conditions. In this work, we propose a fall detection methodology based on a non-linear classification feature and a Kalman filter with a periodicity detector to reduce the false positive rate. This methodology requires a sampling rate of only 25 Hz; it does not require large computations or memory and it is robust among devices. We tested our approach with the SisFall dataset achieving 99.4% of accuracy. We then validated it with a new round of simulated activities with young adults and an elderly person. Finally, we give the devices to three elderly persons for full-day validations. They continued with their normal life and the devices behaved as expected. PMID:29621156

Real-Life/Real-Time Elderly Fall Detection with a Triaxial Accelerometer.

PubMed

Sucerquia, Angela; López, José David; Vargas-Bonilla, Jesús Francisco

2018-04-05

The consequences of a fall on an elderly person can be reduced if the accident is attended by medical personnel within the first hour. Independent elderly people often stay alone for long periods of time, being in more risk if they suffer a fall. The literature offers several approaches for detecting falls with embedded devices or smartphones using a triaxial accelerometer. Most of these approaches have not been tested with the target population or cannot be feasibly implemented in real-life conditions. In this work, we propose a fall detection methodology based on a non-linear classification feature and a Kalman filter with a periodicity detector to reduce the false positive rate. This methodology requires a sampling rate of only 25 Hz; it does not require large computations or memory and it is robust among devices. We tested our approach with the SisFall dataset achieving 99.4% of accuracy. We then validated it with a new round of simulated activities with young adults and an elderly person. Finally, we give the devices to three elderly persons for full-day validations. They continued with their normal life and the devices behaved as expected.

Effect of a creative-bonding intervention on Taiwanese nursing students' self-transcendence and attitudes toward elders.

PubMed

Chen, Shiue; Walsh, Sandra M

2009-04-01

Nursing students worldwide have little interest in caring for a growing elder population. The purpose of this study, based on self-transcendence theory, was to test the effectiveness of a creative-bonding intervention (CBI) to promote self-transcendence and positive attitudes towards elders in Taiwanese nursing students. A quasi-experimental design was used to compare a CBI group (n = 100) with a friendly visit (FV) control group (n = 94). ANCOVA results indicated that after the intervention, the CBI group had significantly more positive attitudes towards elders than the FV group. Nursing school faculty may want to promote art-making activities between students and elders to foster students' interest in elder care.

Predictors of in-hospital mortality in a cohort of elderly Egyptian patients with acute upper gastrointestinal bleeding.

PubMed

Elsebaey, Mohamed A; Elashry, Heba; Elbedewy, Tamer A; Elhadidy, Ahmed A; Esheba, Noha E; Ezat, Sherif; Negm, Manal Saad; Abo-Amer, Yousry Esam-Eldin; Abgeegy, Mohamed El; Elsergany, Heba Fadl; Mansour, Loai; Abd-Elsalam, Sherief

2018-04-01

Acute upper gastrointestinal bleeding (UGIB) affects large number of elderly with high rates of morbidity and mortality. Early identification and management of the factors predicting in-hospital mortality might decrease mortality. This study was conducted to identify the causes of acute UGIB and the predictors of in-hospital mortality in elderly Egyptian patients.286 elderly patients with acute UGIB were divided into: bleeding variceal group (161 patients) and bleeding nonvariceal group (125 patients). Patients' monitoring was done during hospitalization to identify the risk factors that might predict in-hospital mortality in elderly.Variceal bleeding was the most common cause of acute UGIB in elderly Egyptian patients. In-hospital mortality rate was 8.74%. Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding were the predictors of in-hospital mortality.Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding should be considered when triaging those patients for immediate resuscitation, close observation, and early treatment.

Mini-trampoline exercise related to mechanisms of dynamic stability improves the ability to regain balance in elderly.

PubMed

Aragão, Fernando Amâncio; Karamanidis, Kiros; Vaz, Marco Aurélio; Arampatzis, Adamantios

2011-06-01

Falls have been described by several studies as the major cause of hip and femur fractures among the elderly. Therefore, interventions to reduce fall risks, improve dynamic stability and the falling recovery strategies in the elderly population are highly relevant. This study aimed at investigating the effects of a 14-week mini-trampoline exercise intervention regarding the mechanisms of dynamic stability on elderly balance ability during sudden forward falls. Twenty-two elderly subjects participated on mini-trampoline training and 12 subjects were taken as controls. The subjects of the experimental group were evaluated before and after the 14-week trampoline training (exercised group), whereas control subjects were evaluated twice in the forward fall task with a three-month interval. The applied exercise intervention increased the plantarflexors muscle strength (∼10%) as well as the ability to regain balance during the forward falls (∼35%). The 14-week mini-trampoline training intervention increased elderly abilities to recover balance during forward falls; the improvement was attributed to the higher rate of hip moment generation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Criterion validity of a Wechsler-III Scale Short Form in a sample of brazilian elderly.

PubMed

Banhato, Eliane Ferreira Carvalho; Leite, Isabel Cristina Gonçalves; Guedes, Danielle Viveiros; Chaoubah, Alfredo

2010-01-01

Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly.

Criterion validity of a Wechsler-III Scale Short Form in a sample of brazilian elderly

PubMed Central

Banhato, Eliane Ferreira Carvalho; Leite, Isabel Cristina Gonçalves; Guedes, Danielle Viveiros; Chaoubah, Alfredo

2010-01-01

Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. Objectives To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. Methods 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. Results More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. Conclusions The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly. PMID:29213688

Cortical Modulation of Motor Control Biofeedback among the Elderly with High Fall Risk during a Posture Perturbation Task with Augmented Reality

PubMed Central

Chang, Chun-Ju; Yang, Tsui-Fen; Yang, Sai-Wei; Chern, Jen-Suh

2016-01-01

The cerebral cortex provides sensorimotor integration and coordination during motor control of daily functional activities. Power spectrum density based on electroencephalography (EEG) has been employed as an approach that allows an investigation of the spatial–temporal characteristics of neuromuscular modulation; however, the biofeedback mechanism associated with cortical activation during motor control remains unclear among elderly individuals. Thirty one community-dwelling elderly participants were divided into low fall-risk potential (LF) and high fall-risk potential (HF) groups based upon the results obtained from a receiver operating characteristic analysis of the ellipse area of the center of pressure. Electroencephalography (EEG) was performed while the participants stood on a 6-degree-of-freedom Stewart platform, which generated continuous perturbations and done either with or without the virtual reality scene. The present study showed that when there was visual stimulation and poor somatosensory coordination, a higher level of cortical response was activated in order to keep postural balance. The elderly participants in the LF group demonstrated a significant and strong correlation between postural-related cortical regions; however, the elderly individuals in the HF group did not show such a relationship. Moreover, we were able to clarify the roles of various brainwave bands functioning in motor control. Specifically, the gamma and beta bands in the parietal–occipital region facilitate the high-level cortical modulation and sensorimotor integration, whereas the theta band in the frontal–central region is responsible for mediating error detection during perceptual motor tasks. Finally, the alpha band is associated with processing visual challenges in the occipital lobe.With a variety of motor control demands, increment in brainwave band coordination is required to maintain postural stability. These investigations shed light on the cortical modulation of motor control among elderly participants with varying fall-risk potentials. The results suggest that, although elderly adults may be without neurological deficits, inefficient central modulation during challenging postural conditions could be an internal factor that contributes to the risk of fall. Furthermore, training that helps to improve coordinated sensorimotor integration may be a useful approach to reduce the risk of fall among elderly populations or when patients suffer from neurological deficits. PMID:27199732

Age Related Decline in Postural Control Mechanisms.

ERIC Educational Resources Information Center

Stelmach, George E.; And Others

1989-01-01

Studied voluntary and reflexive mechanisms of postural control of young (N=8) and elderly (N=8) adults through measurement of reflexive reactions to large-fast and small-slow ankle rotation postural disturbances. Found reflexive mechanisms relatively intact for both groups although elderly appeared more disadvantaged when posture was under the…

42 CFR 460.74 - Infection control.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Infection control. 460.74 Section 460.74 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE...

Ethical Issues Relative to Autonomy and Personal Control in Independent and Cognitively Impaired Elders.

ERIC Educational Resources Information Center

Rice, Virginia Hill; And Others

1997-01-01

Discusses ethical issues surrounding health care for independent elders, those in long-term care, and those with cognitive impairments, as well as death, dying, euthanasia, and assisted suicide. Suggests that nurses should focus on older adults' choice, autonomy, and personal control. (SK)

Physical therapy in the postoperative of proximal femur fracture in elderly. Literature review

PubMed Central

Carneiro, Mariana Barquet; Alves, Débora Pinheiro Lédio; Mercadante, Marcelo Tomanik

2013-01-01

The proximal femoral fracture in the elderly is a serious public health problem. Surgical treatment of this fracture is used to reduce morbidity, together with postoperative physical therapy. The objective was to conduct a systematic review of physical therapy protocols in postoperative for fractures of the proximal femur in elderly. We selected randomized controlled trials in elderly in the past 10 years, in Portuguese and English. There were 14 articles in the literature. Physical therapy has an important role in functional recovery of the elderly. Level of Evidence I, Systematic Review RCTs (Study results were homogenous). PMID:24453665

Effect of Oral Health Care Program on Oral Health Status of Elderly People Living in Nursing Homes: a Quasi-experimental Study.

PubMed

Ildarabadi, Es-Hagh; Armat, Mohammad Reza; Motamedosanaye, Vahideh; Ghanei, Farzaneh

2017-12-01

Oral health of elderly people plays a major role in their overall health and quality of life, and is an integral part of personal care. The aim of this study was to evaluate the effect of implementing the oral health care program (OHCP) on oral health status of elderly people resident in nursing homes. This quasi-experimental study was carried out using a pretest-posttest design on 101 elderly people (46 in the intervention group and 55 in the control group) resident in two randomly selected nursing homes in Mashhad, Iran. In the intervention group, the OHCP was carried out by caregivers for 8 weeks. The control group received routine care. Using the oral health assessment tool, the oral health status of elderly people was assessed in both groups at three times; onset of the study, 4th, and 8th week after the start of the study. The oral health status of the elderly people in both groups was not statistically significantly different at baseline, but it changed significantly at the 4 th , and 8 th weeks (p<.001). The implementation of the OHCP for elderly people resident in nursing homes may improve their oral health status after 4 weeks. It is recommended that OHCP be included in care plans of all nursing homes to improve the elderly people's oral health status.

Elder American Indian women's knowledge of pelvic floor disorders and barriers to seeking care.

PubMed

Dunivan, Gena C; Komesu, Yuko M; Cichowski, Sara B; Lowery, Christine; Anger, Jennifer T; Rogers, Rebecca G

2015-01-01

The objectives of this study are to evaluate urinary incontinence and pelvic organ prolapse knowledge among elder southwestern American Indian women and to assess barriers to care for pelvic floor disorders through community-engaged research. Our group was invited to provide an educational talk on urinary incontinence and pelvic organ prolapse at an annual meeting of American Indian elders. Female attendees aged 55 years or older anonymously completed demographic information and 2 validated questionnaires, the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and Barriers to Incontinence Care Seeking Questionnaire (BICS-Q). Questionnaire results were compared with historical controls from the original PIKQ and BICS-Q validation study. One hundred forty-four women completed the questionnaires. The mean age was 77.7 ± 9.1 years. The mean (SD) for PIKQ of urinary incontinence score was 6.6 (3.0) (similar to historic gynecology controls 6.8 [3.3], P = 0.49), and the mean (SD) for PIKQ on pelvic organ prolapse score was 5.4 (2.9) (better than historic gynecology controls 3.6 [3.2], P < 0.01). Barriers to care seeking reported by the elder women were highest on the BICS-Q subscales of "cost" and "inconvenience." Urinary incontinence knowledge is similar to historic gynecology controls, and pelvic organ prolapse knowledge is higher than historic gynecology controls among elder southwestern American Indian women. American Indian elder women report high levels of barriers to care. The greatest barriers to care seeking for this population were related to cost and inconvenience, reflecting the importance of assessing socioeconomic status when investigating barriers to care. Addressing these barriers may enhance care-seeking southwestern American Indian women.

The impacts of sarcopenia and obesity on physical performance in the elderly.

PubMed

Chang, Ching-I; Huang, Kuo-Chin; Chan, Ding-Cheng; Wu, Chih-Hsing; Lin, Cheng-Chieh; Hsiung, Chao A; Hsu, Chih-Cheng; Chen, Ching-Yu

2015-01-01

The current definition of sarcopenic obesity in the elderly does not seem to take the ageing difference of body composition into sufficient consideration. The study accordingly attempted to better define sarcopenia/obesity based on various references, and the impacts of sarcopenia/obesity on elderly physical performance were also examined. 2629 elderly subjects (age ≧65) and 998 young adults were recruited for Sarcopenia and Translational Ageing Research in Taiwan (START). For each eligible subject, body composition was measured by bio-impedance analysis and physical performance, including upper and lower extremity function, was examined. The thresholds of sarcopenic obesity were defined as a value at two standard deviations from the gender-specific means of the young population or at the adopted value of our elderly population. Compared to the young adults, the elderly subjects reported a lower appendicular skeletal muscle index (ASMI, kg/m(2)) and a significantly higher fat percentage (%). From three different criteria, thresholds of obesity or sarcopenia were 31.41%, 30.16%, 30.64% (fat percentage) or 6.76kg/m(2), 7.36kg/m(2), 7.09kg/m(2) (ASMI) for men and 39.17%, 41.43%, 43.25% or 5.28kg/m(2), 5.74kg/m(2), 5.70kg/m(2) for women. The elderly subjects were classified into four groups. With covariates adjusted, the "sarcopenia only," "obesity only," and "sarcopenic obesity" elderly subjects were worse than their normal counterparts in physical performance (all p<0.05 except for the handgrip strength compared in groups 1 and 3). Sarcopenic obesity seems to exert a synergistic impact on elderly physical performance. Body composition should be an essential part in geriatric assessment and elderly care. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Gated Auditory Speech Perception in Elderly Hearing Aid Users and Elderly Normal-Hearing Individuals: Effects of Hearing Impairment and Cognitive Capacity

PubMed Central

Lidestam, Björn; Hällgren, Mathias; Rönnberg, Jerker

2014-01-01

This study compared elderly hearing aid (EHA) users and elderly normal-hearing (ENH) individuals on identification of auditory speech stimuli (consonants, words, and final word in sentences) that were different when considering their linguistic properties. We measured the accuracy with which the target speech stimuli were identified, as well as the isolation points (IPs: the shortest duration, from onset, required to correctly identify the speech target). The relationships between working memory capacity, the IPs, and speech accuracy were also measured. Twenty-four EHA users (with mild to moderate hearing impairment) and 24 ENH individuals participated in the present study. Despite the use of their regular hearing aids, the EHA users had delayed IPs and were less accurate in identifying consonants and words compared with the ENH individuals. The EHA users also had delayed IPs for final word identification in sentences with lower predictability; however, no significant between-group difference in accuracy was observed. Finally, there were no significant between-group differences in terms of IPs or accuracy for final word identification in highly predictable sentences. Our results also showed that, among EHA users, greater working memory capacity was associated with earlier IPs and improved accuracy in consonant and word identification. Together, our findings demonstrate that the gated speech perception ability of EHA users was not at the level of ENH individuals, in terms of IPs and accuracy. In addition, gated speech perception was more cognitively demanding for EHA users than for ENH individuals in the absence of semantic context. PMID:25085610

[Relationship between cognitive function and physical activities: a longitudinal study among community-dwelling elderly].

PubMed

Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki

2012-01-01

The purpose of this study was to evaluate whether physical activities reduce the risk of cognitive decline in community-dwelling elderly. We investigated correlations between cognitive functions at baseline and physical activities, correlations between cognitive functions at baseline and cognitive decline over 4 years, as well as correlations between physical activity at baseline and cognitive decline over 4 years. At baseline, 2,431 community-dwelling elderly completed the cognitive screening by telephone (TICS-J), and answered the questionnaires about physical activities. Of these, 1,040 subjects again completed the TICS-J over 4 years. Physical activities contained moving ability, walking frequency, walking speed, the exercise frequency. At baseline, 870 elderly (age 75.87±4.96 (mean±SD) years, duration of education 11.05±2.41) showed normal cognitive functions and 170 (79.19±6.22, 9.61±2.23) showed cognitive impairment. The total TICS-J score was significantly higher in cognitive normal subjects compared with that of cognitive impaired subjects (36.02±1.89, 30.19±2.25, respectively, p<0.001). Logistic regression analyses showed that moving ability significantly reduced the risk of cognitive impairment in an unadjusted model, and walking speed also reduced the risk of cognitive impairment at baseline even in an adjusted model. Cognitive function at baseline might be a predictor of cognitive function over 4 years. The longitudinal study revealed that walking speed and exercise frequency significantly correlate with maintenance of cognitive function over 4 years. This study provides that physical activities, especially walking speed have significant correlation with cognitive function.

Vibration perception threshold in relation to postural control and fall risk assessment in elderly.

PubMed

de Mettelinge, Tine Roman; Calders, Patrick; Palmans, Tanneke; Vanden Bossche, Luc; Van Den Noortgate, Nele; Cambier, Dirk

2013-09-01

This study investigates (i) the potential discriminative role of a clinical measure of peripheral neuropathy (PN) in assessing postural performance and fall risk and (ii) whether the integration of a simple screening vibration perception threshold (VPT) for PN in any physical (fall risk) assessment among elderly should be recommended, even if they do not suffer from DM. One hundred and ninety-five elderly were entered in a four-group model: DM with PN (D+; n = 75), DM without PN (D-; n = 28), non-diabetic elderly with idiopathic PN (C+; n = 31) and non-diabetic elderly without PN (C-; n = 61). Posturographic sway parameters were captured during different static balance conditions (AMTI AccuGait, Watertown, MA). VPT, fall data, Mini-Mental State Examination and Clock Drawing Test were registered. Two-factor repeated-measures ANOVA was used to compare between groups and across balance conditions. The groups with PN demonstrated a strikingly comparable, though bigger sway, and a higher prospective fall incidence than their peers without PN. The indication of PN, irrespective of its cause, interferes with postural control and fall incidence. The integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. Implications for Rehabilitation The indication of peripheral neuropathy (PN), irrespective of its cause, interferes with postural control and fall incidence. Therefore, the integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. It might be useful to integrate somatosensory stimulation in rehabilitation programs designed for fall prevention.

The Relationship of Health Locus of Control, Perceived Health Status and Activity Levels of Non-Institutionalized Elderly Clients.

ERIC Educational Resources Information Center

Speake, Dianne L.

Individuals of all ages need to maintain an active lifestyle to promote health. The physiological changes associated with aging, however, make the elderly especially vulnerable to disuse atrophy associated with inactivity. Exercise programs for the elderly are being established in increasing numbers, but high dropout rates from these programs…

Organization of Functional Postural Responses Following Perturbations in Multiple Directions in Elderly Fallers Standing Quietly

ERIC Educational Resources Information Center

Matjacic, Zlatko; Sok, David; Jakovljevic, Miroljub; Cikajlo, Imre

2013-01-01

The objective of the study was to assess functional postural responses by analyzing the center-of-pressure trajectories resulting from perturbations delivered in multiple directions to elderly fallers. Ten elderly individuals were standing quietly on two force platforms while an apparatus delivered controlled perturbations at the level of pelvis…

[Evaluation of a medication self-management education program for elders with hypertension living in the community].

PubMed

Lee, Jong Kyung

2013-04-01

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension. The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program. There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure. The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

The role of perioperative oral nutritional supplementation in elderly patients after hip surgery.

PubMed

Liu, Ming; Yang, Jing; Yu, Xi; Huang, Xiao; Vaidya, Sushan; Huang, Fuguo; Xiang, Zhou

2015-01-01

The effect of perioperative oral nutritional supplementation (ONS) on elderly patients after hip surgery remains controversial. This study intended to ascertain whether perioperative ONS is beneficial for the rehabilitation of elderly patients after hip surgery. We searched databases including PubMed, Embase, and the Cochrane Central Register of Controlled Trials for articles published up to May 2014. Randomized controlled trials of ONS for elderly patients after hip surgery were included. The combined trials showed that ONS had a positive effect on the serum total protein (P<0.00001) and led to a significantly decreased number of complications (P=0.0005). Furthermore, data from the infection subgroups showed significant decreases in wound infection (P=0.02), respiratory infection (P=0.04), and urinary tract infection (P=0.03). Clinical observation suggests that the intervention may improve the level of serum albumin, although the data did not reach statistical significance (P=0.48). Regarding mortality, there was no significant statistical difference between the intervention group and the control (P=0.93). Based on the evidence available, this meta-analysis is consistent with the hypothesis that perioperative ONS can help elderly patients recover after hip surgery and reduce complications.

Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg, Russia.

PubMed

Bakhtiyarova, S; Lesnyak, O; Kyznesova, N; Blankenstein, M A; Lips, P

2006-01-01

Vitamin D deficiency leads to secondary hyperparathyroidism and osteomalacia, and both conditions are associated with fractures, the most severe being hip fracture. The serum 25-hydroxyvitamin D level depends on latitude and season. Yekaterinburg is situated at a high latitude and the duration of winter is about 5 months. In this study, the serum 25(OH)D and PTH concentrations, and the prevalence of hypovitaminosis D in elderly people, inhabitants of Yekaterinburg, were investigated. The study was performed on 63 people with hip fracture (mean age, 68.8 years) and 97 independently living elderly people (mean age, 70.2 years). Serum 25(OH)D (mean+/-SD) in the hip fracture group was 22.4+/-11.4 nmol/L, significantly lower than in control group, which was 28.1+/-10.1 nmol/L. The percentage of patients with severe hypovitaminosis D (<25 nmol/L) in the hip fracture group was 65%, compared to 47% in the control group (p<0.05). The prevalence of hypovitaminosis D among hip fracture patients, as well as among independently living elderly people in Yekaterinburg, was high. Supplementation of vitamin D in elderly people with and without fracture might prevent secondary hyperparathyroidism, osteomalacia and fractures.

Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai.

PubMed

Samnieng, P; Ueno, M; Shinada, K; Zaitsu, T; Wright, F A C; Kawaguchi, Y

2012-03-01

This study was to analyze the association of hyposalivation with oral function, nutritional status and oral health in community-dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8, SD 5.9 years). Oral function (tasting, speaking, swallowing and chewing) and Mini Nutritional Assessment (MNA) were evaluated. Oral examination investigated teeth and periodontal status. Both unstimulated and stimulated whole saliva were collected for 5 minutes. Among all subjects, 14.4 % were classified within the hyposalivation. Hyposalivation was associated with gender, systemic disease, medication, and smoking. Subjects within the hyposalivation group had a higher number of decayed teeth and a higher prevalence of periodontitis than the normal salivation group (p < 0.05). The hyposalivation group also had a lower number of teeth present and a lower mean MNA score than the normal salivation group (p < 0.05). Logistic regression analysis showed that hyposalivation in both dentate and edentulous subjects was significantly associated with tasting, speaking, swallowing and chewing. This study suggested that hyposalivation is a risk factor not only for dental caries and periodontal disease but also for taste disturbances, speaking problems, swallowing problems, poor chewing ability and malnutrition. Monitoring salivary flow is an important measure in the care of older people.

Working memory activation of neural networks in the elderly as a function of information processing phase and task complexity.

PubMed

Charroud, Céline; Steffener, Jason; Le Bars, Emmanuelle; Deverdun, Jérémy; Bonafe, Alain; Abdennour, Meriem; Portet, Florence; Molino, François; Stern, Yaakov; Ritchie, Karen; Menjot de Champfleur, Nicolas; Akbaraly, Tasnime N

2015-11-01

Changes in working memory are sensitive indicators of both normal and pathological brain aging and associated disability. The present study aims to further understanding of working memory in normal aging using a large cohort of healthy elderly in order to examine three separate phases of information processing in relation to changes in task load activation. Using covariance analysis, increasing and decreasing neural activation was observed on fMRI in response to a delayed item recognition task in 337 cognitively healthy elderly persons as part of the CRESCENDO (Cognitive REServe and Clinical ENDOphenotypes) study. During three phases of the task (stimulation, retention, probe), increased activation was observed with increasing task load in bilateral regions of the prefrontal cortex, parietal lobule, cingulate gyrus, insula and in deep gray matter nuclei, suggesting an involvement of central executive and salience networks. Decreased activation associated with increasing task load was observed during the stimulation phase, in bilateral temporal cortex, parietal lobule, cingulate gyrus and prefrontal cortex. This spatial distribution of decreased activation is suggestive of the default mode network. These findings support the hypothesis of an increased activation in salience and central executive networks and a decreased activation in default mode network concomitant to increasing task load. Copyright © 2015 Elsevier Inc. All rights reserved.

Effect of duration and inter-stimulus interval on auditory temporal order discrimination in young normal-hearing and elderly hearing-impaired listeners

NASA Astrophysics Data System (ADS)

Narendran, Mini M.; Humes, Larry E.

2003-04-01

Increasing the rate of presentation can have a deleterious effect on auditory processing, especially among the elderly. Rate can be manipulated by changing the duration of individual components of a sequence of sounds, by changing the inter-stimulus interval (ISI) between components, or both. Consequently, when age-related deficits in performance appear to be attributable to rate of stimulus presentation, it is often the case that alternative explanations in terms of the effects of stimulus duration or ISI are also possible. In this study, the independent effects of duration and ISI on the discrimination of temporal order for four-tone sequences were investigated in a group of young normal-hearing and elderly hearing-impaired listeners. It was found that discrimination performance was driven by the rate of presentation, rather than stimulus duration or ISI alone, for both groups of listeners. The performance of the two groups of listeners differed significantly for the fastest presentation rates, but was similar for the slower rates. Slowing the rate of presentation seemed to improve performance, regardless of whether this was done by increasing stimulus duration or increasing ISI, and this was observed for both groups of listeners. [Work supported, in part, by NIA.

Aided speech recognition in single-talker competition by elderly hearing-impaired listeners

NASA Astrophysics Data System (ADS)

Coughlin, Maureen; Humes, Larry

2004-05-01

This study examined the speech-identification performance in one-talker interference conditions that increased in complexity while audibility was ensured over a wide bandwidth (200-4000 Hz). Factorial combinations of three independent variables were used to vary the amount of informational masking. These variables were: (1) competition playback direction (forward or reverse); (2) gender match between target and competition talkers (same or different); and (3) target talker uncertainty (one of three possible talkers from trial to trial). Four groups of listeners, two elderly hearing-impaired groups differing in age (65-74 and 75-84 years) and two young normal-hearing groups, were tested. One of the groups of young normal-hearing listeners was tested under acoustically equivalent test conditions and one was tested under perceptually equivalent test conditions. The effect of each independent variable on speech-identification performance and informational masking was generally consistent with expectations. Group differences in the observed informational masking were most pronounced for the oldest group of hearing-impaired listeners. The eight measures of speech-identification performance were found to be strongly correlated with one another, and individual differences in speech understanding performance among the elderly were found to be associated with age and level of education. [Work supported, in part, by NIA.

[Dietary approach to improving the nutritional status in institutionalized elderly hemodialysis patients with a poor dietary intake: a single-arm pilot study].

PubMed

Yamashita, Makiko; Komatsu, Rieko; Maruyama, Yuko; Takaki, Tomoyuki; Ichinose, Hiroshi; Sasaki, Osamu; Sawase, Kenji; Harada, Takashi; Funakoshi, Satoshi

2018-01-01

The hemodialysis (HD) diet, which is a high-calorie and high-fat regimen, may inadvertently lead to an inadequate dietary intake, resulting in undernutrition among elderly HD patients. Therefore, an attempt was made to improve the dietary intake by implementing a modified diet regimen in eligible elderly HD patients. Elderly HD patients who had ingested < 50% of the meals provided and were diagnosed with undernutrition among all elderly patients institutionalized at the special elderly nursing home annexed to Nagasaki Kidney Hospital between June and November 2012. Of the elderly HD patients in the nursing home (n = 27), the study included a total of 7 consecutive patients (male/female, 1/6; mean age, 84.1±6.4 years old; duration of HD, 4.3±3.8 years; geriatric nutritional index [GNRI], 83.5±8.3; normalized protein catabolic ratio [nPCR], 0.78±0.14). The modified diet regimen, which involved reducing food portion sizes and incorporating a liquid diet, led to a significant increase in their dietary intake from 48.1% at baseline to 97.1% of the meals provided 3 months after the start of the modified HD diet regimen. Their GNRI also significantly increased from 83.5±8.3 to 86.1±10.2, and their serum albumin levels significantly increased from 3.2±0.2 g/dL to 3.4±0.4 g/dL, suggesting improvements in their nutritional status. The attempted dietary approach for elderly HD patients was shown to potentially increase their dietary intake and improve their nutritional status without affecting the efficiency of HD being implemented.

Age-related influence of vision and proprioception on Ia presynaptic inhibition in soleus muscle during upright stance

PubMed Central

Baudry, Stéphane; Duchateau, Jacques

2012-01-01

This study investigated the modulation of Ia afferent input in young and elderly adults during quiet upright stance in normal and modified visual and proprioceptive conditions. The surface EMG of leg muscles, recruitment curve of the soleus (SOL) Hoffmann (H) reflex and presynaptic inhibition of Ia afferents from SOL, assessed with the D1 inhibition and single motor unit methods, were recorded when young and elderly adults stood with eyes open or closed on two surfaces (rigid vs. foam) placed over a force platform. The results showed that elderly adults had a longer path length for the centre of pressure and larger antero-posterior body sway across balance conditions (P < 0.05). Muscle EMG activities were greater in elderly compared with young adults (P < 0.05), whereas the Hmax expressed as a percentage of the Hmax was lower (P = 0.048) in elderly (38 ± 16%) than young adults (58 ± 16%). The conditioned H reflex/test H reflex ratio (D1 inhibition method) increased with eye closure and when standing on foam (P < 0.05), with greater increases for elderly adults (P = 0.019). These changes were accompanied by a reduced peak motor unit discharge probability when standing on rigid and foam surfaces (P ≤ 0.001), with a greater effect for elderly adults (P = 0.026). Based on these latter results, the increased conditioned H reflex/test H reflex ratio in similar sensory conditions is likely to reflect occlusion at the level of presynaptic inhibitory interneurones. Together, these findings indicate that elderly adults exhibit greater modulation of Ia presynaptic inhibition than young adults with variation in the sensory conditions during upright standing. PMID:22946095

Older Latinos' Attitudes toward and Comfort with End-of-Life Planning

ERIC Educational Resources Information Center

Heyman, Janna C.; Gutheil, Irene A.

2010-01-01

The purpose of this study was to determine which of two educational interventions delivered in Spanish would influence Latino elders' attitudes toward and comfort with end-of-life planning in comparison with a control group receiving only standard information routinely provided. Using a posttest-only control group design, elders receiving home…

Increased collagenase and dipeptidyl peptidase I activity in leucocytes from healthy elderly people

PubMed Central

Llorente, L; Richaud-Patin, Y; Díaz-Borjón, A; Jakez-Ocampo, J; Alvarado-De La Barrera, C

1999-01-01

The incidence of infectious diseases increases with ageing. The enzymatic activity of leucocytes may have a relevant role in the morbidity and mortality due to infections in the elderly. In this study we have compared the activity of enzymes involved in the inflammatory response in leucocytes from young and elderly women. A total of 35 healthy females was studied, 20 volunteers aged 78–98 years (mean 89.1 years) and 15 young controls aged 19–34 years (mean 26 years). All of them were in good clinical condition, without any acute or chronic disease. Intracellular enzyme activity was analysed by flow cytometry in leucocytes from young and elderly women. The enzyme substrates employed were for oxidative burst, l-aminopeptidase, collagenase, cathepsin B, C, D and, G and dipeptidyl peptidase I. The intracellular enzyme activity assessed by flow cytometry in leucocytes from young and elderly women was similar, as far as oxidative burst, l-aminopeptidase, cathepsin B, C, D and G are concerned. An increased collagenase activity was detected in granulocytes from elders. The mean fluorescence channels for this enzyme corresponded to 86 ± 23 and 60 ± 15 in cells from elders and controls, respectively (P = 0.01224). An increased dipeptidyl peptidase I activity was detected in lymphocytes from elderly women. The corresponding values for this enzyme in elders and the young were 65.9 ± 43.3 and 17.3 ± 5, respectively (P = 0.0036). The proper functional activity of intracellular enzymes involved in inflammatory responses is likely to be determinant for successful ageing. PMID:10361229

Elder mistreatment and physical health among older adults: the South Carolina Elder Mistreatment Study.

PubMed

Cisler, Josh M; Amstadter, Ananda B; Begle, Angela M; Hernandez, Melba; Acierno, Ron

2010-08-01

Exposure to potentially traumatic events (PTEs), including interpersonal violence, is associated with poorer physical health in young adults. This relation has not been well-investigated among older adults in specific populations. The present study was designed to investigate whether exposure to PTEs and elder mistreatment are associated with physical health status among older adults residing in South Carolina. Older adults aged 60 and above (N = 902) participated in a structured interview assessing elder mistreatment history, PTEs, demographics, and social dependency variables. Results demonstrated that PTEs were associated with poor self-rated health independently and when controlling for other significant predictors. A recent history of emotional mistreatment was associated with poor self-rated health independently, but not when controlling for other significant predictors.

Dementia

MedlinePlus

... elderly people, it is not part of normal aging. Many different diseases can cause dementia, including Alzheimer's disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve symptoms or slow down ...

Anthropometric measures change and quality of life in elderly people: a longitudinal population-based study in Southern Brazil.

PubMed

Tessari, Ana Aparecida; Giehl, Maruí Weber Corseuil; Schneider, Ione Jayce Ceola; González-Chica, David Alejandro

2016-12-01

To analyze the effects of anthropometric measures change on quality of life (QoL) in elderly, using measured anthropometric data on body mass index (BMI) and waist circumference (WC). Population-based cohort study investigating a sample of elderly (≥60) assessed in 2009 (n = 1705) and followed up in 2013 (n = 1197). QoL was evaluated in 2013 using the CASP-19. Variables evaluated as exposure including BMI and WC in 2009 (both standardized), categories of anthropometric measures change from 2009 to 2013 (excess weight = BMI ≥ 25.0 kg/m 2 ; large WC = top quartile), and the absolute BMI and WC change in same period. Multivariate linear regressions adjusted for possible confounding factors and mediators were used. Both BMI and WC at baseline were associated with lower QoL scores, even after adjustment for confounding variables (β BMI  = -0.9; 95 % CI -1.5; -0.3 and β WC  = -1.0; 95 % CI -1.7; -0.4). Additionally, QoL scores were lower among elderly with excess weight (β = -1.4; 95 % CI -2.9; 0.0) or large WC (β = -3.3; 95 % CI -5.2; -1.4) in both waves than among those whose BMI and WC were always normal, but changes in anthropometric measures did not affect QoL. The presence of chronic diseases was a partial mediator of these associations, especially for effects of BMI change. Anthropometric measures change treated as a continuous variable was not associated with QoL. Having excess weight and large WC in both waves was associated with lower QoL scores in elderly, but changing the anthropometric measures did not affect this outcome. Maintaining weight and WC within normal limits during aging can help to preserve QoL.

Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan.

PubMed

Huang, C-L; Chang, H-W; Chang, J-B; Chen, J-H; Lin, J-D; Wu, C-Z; Pei, D; Hung, Y-J; Lee, C-H; Chen, Y-L; Hsieh, C-H

2016-08-01

Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardiovascular disease (CVD). But the role of normoglycemia on the development of T2D and CVD in elderly population remains unclear. To determine an optimal cut-off for fasting plasma glucose (FPG) to predict MetS and subsequent risk of T2D and CVD in an elderly Taiwanese population with normal FPG levels. Two stages included cross-sectional (Stage 1) and prospective (Stage 2) cohort study. In Stage 1 18 287 subjects aged  ≥60 years were enrolled; of these, 5039 without T2D and CVD advanced to Stage 2 and a mean follow-up of 3.8 years. MetS components were analysed, and in Stage 1, FPG cut-offs for MetS risk were calculated using receiver operating characteristic (ROC) curve analyses. In Stage 2, subjects without T2D and CVD in Stage 1 were classified into high-FPG and low-FPG groups based on cut-offs, and sex specific differences in incidence for T2D and CVD were calculated. ROC curve analysis gave an optimal FPG cut-off for MetS of 93 mg/dl and 92 mg/dl for males and females, respectively. The high-FPG group had a 1.599- and 1.353-fold higher chance of developing T2D compared with the low-FPG group for males and females, respectively (95% CI: 1.606-2.721 and 1.000-1.831, P  =  0.015 and 0.05). The high-FPG group had a 1.24-fold higher chance of developing CVD for females (95% CI: 1.015-1.515, P  =  0.035); however, there was no difference for males. Our results suggest that FPG within the normal range was associated with MetS, and elderly subjects with high normal levels have a higher incidence of developing T2D for both sexes, and CVD for females, over the short-term. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparison of clock drawing with Mini Mental State Examination as a screening test in elderly acute hospital admissions.

PubMed Central

Death, J.; Douglas, A.; Kenny, R. A.

1993-01-01

Clock drawing is a quick, easy to remember test that is well received by patients. It is a good screening test for Alzheimer's disease in the outpatient setting. We evaluated its usefulness compared with the standard Mini Mental State Examination (MMSE) in elderly acute medical and surgical hospital admissions. Within 48 hours of admission, 117 patients over 70 years old were administered the MMSE and asked to draw a clock. Using the MMSE as the standard, clock drawing had a sensitivity of 77% and a specificity of 87%. Patients with discrepant scores were then further evaluated. The findings suggest that normal clock drawing ability reasonably excludes cognitive impairment or other causes of an abnormal MMSE in elderly acute medical and surgical hospital admissions, where cognitive impairment is common and frequently missed. PMID:8255833

Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

PubMed

Kim, Jong-Pill; Yang, Jinhyang

The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

Integrated care for frail elderly compared to usual care: a study protocol of a quasi-experiment on the effects on the frail elderly, their caregivers, health professionals and health care costs.

PubMed

Fabbricotti, Isabelle Natalina; Janse, Benjamin; Looman, Wilhelmina Mijntje; de Kuijper, Ruben; van Wijngaarden, Jeroen David Hendrikus; Reiffers, Auktje

2013-04-12

Frail elderly persons living at home are at risk for mental, psychological, and physical deterioration. These problems often remain undetected. If care is given, it lacks the quality and continuity required for their multiple and changing problems. The aim of this project is to improve the quality and efficacy of care given to frail elderly living independently by implementing and evaluating a preventive integrated care model for the frail elderly. The design is quasi-experimental. Effects will be measured by conducting a before and after study with control group. The experimental group will consist of 220 elderly of 8 GPs (General Practitioners) who will provide care according to the integrated model (The Walcheren Integrated Care Model). The control group will consist of 220 elderly of 6 GPs who will give care as usual. The study will include an evaluation of process and outcome measures for the frail elderly, their caregivers and health professionals as well as a cost-effectiveness analysis. A concurrent mixed methods design will be used. The study population will consist of elderly 75 years or older who live independently and score a 4 or higher on the Groningen Frailty Indicator, their caregivers and health professionals. Data will be collected prospectively at three points in time: T0, T1 (3 months after inclusion), and T2 (12 months after inclusion). Similarities between the two groups and changes over time will be assessed with t-tests and chi-square tests. For each measure regression analyses will be performed with the T2-score as the dependent variable and the T0-score, the research group and demographic variables as independent variables. A potential obstacle for this study will be the willingness of the elderly and their caregivers to participate. To increase willingness, the request to participate will be sent via the elders' own GP. Interviewers will be from their local region and gifts will be given. A successful implementation of the integrated model is also necessary. The involved parties are members of a steering group and have contractually committed themselves to the project. Current Controlled Trials ISRCTN05748494.

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia.

PubMed

Ahmad Sharoni, Siti Khuzaimah; Abdul Rahman, Hejar; Minhat, Halimatus Sakdiah; Shariff-Ghazali, Sazlina; Azman Ong, Mohd Hanafi

2018-01-01

Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. Australian New Zealand Clinical Trial Registry ACTRN12616000210471.

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia

PubMed Central

Abdul Rahman, Hejar; Minhat, Halimatus Sakdiah; Shariff-Ghazali, Sazlina; Azman Ong, Mohd Hanafi

2018-01-01

Background Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. Methods A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. Results 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). Conclusion The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12616000210471 PMID:29534070

Effects of 18-month low-magnitude high-frequency vibration on fall rate and fracture risks in 710 community elderly--a cluster-randomized controlled trial.

PubMed

Leung, K S; Li, C Y; Tse, Y K; Choy, T K; Leung, P C; Hung, V W Y; Chan, S Y; Leung, A H C; Cheung, W H

2014-06-01

This study is a prospective cluster-randomized controlled clinical trial involving 710 elderly subjects to investigate the long-term effects of low-magnitude high-frequency vibration (LMHFV) on fall and fracture rates, muscle performance, and bone quality. The results confirmed that LMHFV is effective in reducing fall incidence and enhancing muscle performance in the elderly. Falls are direct causes of fragility fracture in the elderly. LMHFV has been shown to improve muscle function and bone quality. This study is to investigate the efficacy of LMHFV in preventing fall and fractures among the elderly in the community. A cluster-randomized controlled trial was conducted with 710 postmenopausal females over 60 years. A total of 364 participants received daily 20 min LMHFV (35 Hz, 0.3 g), 5 days/week for 18 months; 346 participants served as control. Fall or fracture rate was taken as the primary outcome. Also, quadriceps muscle strength, balancing abilities, bone mineral density (BMD), and quality of life (QoL) assessments were done at 0, 9, and 18 months. With an average of 66.0% compliance in the vibration group, 18.6% of 334 vibration group subjects reported fall or fracture incidences compared with 28.7% of 327 in the control (adjusted HR = 0.56, p = 0.001). The fracture rate of vibration and control groups were 1.1 and 2.3 % respectively (p = 0.171). Significant improvements were found in reaction time, movement velocity, and maximum excursion of balancing ability assessment, and also the quadriceps muscle strength (p < 0.001). No significant differences were found in the overall change of BMD. Minimal adverse effects were documented. LMHFV is effective in fall prevention with improved muscle strength and balancing ability in the elderly. We recommend its use in the community as an effective fall prevention program and to decrease related injuries.

An Evaluation of Deficits in Semantic Cuing, Proactive and Retroactive Interference as Early Features of Alzheimer’s disease

PubMed Central

Crocco, Elizabeth; Curiel, Rosie E.; Acevedo, Amarilis; Czaja, Sara J.; Loewenstein, David A.

2015-01-01

OBJECTIVE To determine the degree to which susceptibility to different types of semantic interference may reflect the earliest manifestations of early Alzheimer disease (AD) beyond the effects of global memory impairment. METHODS Normal elderly (NE) subjects (n= 47), subjects with amnestic mild cognitive impairment (aMCI: n=34) and 40 subjects with probable AD were evaluated using a unique cued recall paradigm that allowed for an evaluation of both proactive and retroactive interference effects while controlling for global memory impairment (LASSI-L procedure). RESULTS Controlling for overall memory impairment, aMCI subjects had much greater proactive and retroactive interference effects than NE subjects. LASSI-L indices of learning using cued recall evidenced high levels of sensitivity and specificity with an overall correct classification rate of 90%. These provided better discrimination than traditional neuropsychological measures of memory function. CONCLUSION The LASSI-L paradigm is unique and unlike other assessments of memory in that items presented for cued recall are explicitly presented, and semantic interference and cuing effects can be assessed while controlling for initial level of memory impairment. This represents a powerful procedure allowing the participant to serve as his or her own control. The high levels of discrimination between subjects with aMCI and normal cognition that exceeded traditional neuropsychological measures makes the LASSI-L worthy of further research in the detection of early AD. PMID:23768680

Brain levels of high-energy phosphate metabolites and executive function in geriatric depression.

PubMed

Harper, David G; Joe, Elizabeth B; Jensen, J Eric; Ravichandran, Caitlin; Forester, Brent P

2016-11-01

Depression in late life has been associated with difficulties in cognitive processing, particularly in the domains of executive function, processing speed and memory, and increases the risk of developing dementia suggesting a neurodegenerative phenotype. Mitochondrial dysfunction is frequently an early event in neurodegenerative illnesses and may be operative in patients with late life depression. Phosphorus magnetic resonance spectroscopy (31P MRS) allows for the quantification of bioenergetic molecules produced by mitochondria. Ten patients with late life depression and eight normal elderly controls were studied with Stroop color and interference tests, which are widely used measures of processing speed and executive function, respectively, followed by (31P) MRS 3-dimensional chemical-shift imaging measuring levels of adenosine triphosphate, phosphocreatine, inorganic phosphate, and pH over the whole brain. In all subjects, gray matter phosphocreatine was positively associated with Stroop interference. Levels of white matter adenosine triphosphate were associated with Stroop interference in subjects with late life depression but not normal elderly. There was also a complementary association between white matter inorganic phosphate and Stroop interference in late life depression patients. These findings suggest two independent sources of executive function dependence on bioenergetic state in the aging brain. The dependence of executive function performance in subjects with late life depression on ATP in white matter may be associated with mitochondrial impairment and is consistent with predictions of the vascular depression hypothesis. Further research with wider neuropsychological testing targeting bioenergetic markers could help clarify the scope of these effects. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Undisturbed upright stance control in the elderly: Part 1. Age-related changes in undisturbed upright stance control.

PubMed

Berger, L; Chuzel, M; Buisson, G; Rougier, P

2005-09-01

The authors investigated age-related changes in postural control in 33 healthy young adults (18-31 years), 29 seniors (62-75 years), and 22 elderly people (75-96 years). A force platform recorded the results. The horizontal motions of the center of gravity (CGh) and their difference in the plane of support CP - CGv were deduced from the complex center of pressure (CP) trajectories. With fractional Brownian modeling, one can establish that the aging process seems to induce a transition phase in which seniors take more time to initiate the corrective process in the mediolateral (ML) axis than do younger people. The elderly develop a new strategy characterized by the mobilization of higher neuromuscular energy to maintain equilibrium. In the ML axis, the larger displacements could be caused mainly by a hip strategy that could facilitate step initiation. In the anteroposterior (AP) axis, seniors and elderly individuals maintain a relative ability to stabilize their CG into the base of support compared with younger people.

Active video gaming to improve balance in the elderly.

PubMed

Lamoth, Claudine J C; Caljouw, Simone R; Postema, Klaas

2011-01-01

The combination of active video gaming and exercise (exergaming) is suggested to improve elderly people's balance, thereby decreasing fall risk. Exergaming has been shown to increase motivation during exercise therapy, due to the enjoyable and challenging nature, which could support long-term adherence for exercising balance. However, scarce evidence is available of the direct effects of exergaming on postural control. Therefore, the aim of the study was to assess the effect of a six-week videogame-based exercise program aimed at improving balance in elderly people. Task performance and postural control were examined using an interrupted time series design. Results of multilevel analyses showed that performance on the dot task improved within the first two weeks of training. Postural control improved during the intervention. After the intervention period task performance and balance were better than before the intervention. Results of this study show that healthy elderly can benefit from a videogame-based exercise program to improve balance and that all subjects were highly motivated to exercise balance because they found gaming challenging and enjoyable.

Bipedal hopping timed to a metronome to detect impairments in anticipatory motor control in people with mild multiple sclerosis.

PubMed

Kirkland, Megan C; Chen, Alice; Downer, Matthew B; Holloway, Brett J; Wallack, Elizabeth M; Lockyer, Evan J; Buckle, Natasha C M; Abbott, Courtney L; Ploughman, Michelle

2018-06-01

People with mild multiple sclerosis (MS) often report subtle deficits in balance and cognition but display no measurable impairment on clinical assessments. We examined whether hopping to a metronome beat had the potential to detect anticipatory motor control deficits among people with mild MS (Expanded Disability Status Scale ≤ 3.5). Participants with MS (n = 13), matched controls (n = 9), and elderly subjects (n = 13) completed tests of cognition (Montreal Cognitive Assessment (MoCA)) and motor performance (Timed 25 Foot Walk Test (T25FWT)). Participants performed two bipedal hopping tasks: at 40 beats/min (bpm) and 60-bpm in random order. Hop characteristics (length, symmetry, variability) and delay from the metronome beat were extracted from an instrumented walkway and compared between groups. The MS group became more delayed from the metronome beat over time whereas elderly subjects tended to hop closer to the beat (F = 4.52, p = 0.02). Delay of the first hop during 60-bpm predicted cognition in people with MS (R = 0.55, β = 4.64 (SD 4.63), F = 4.85, p = 0.05) but not among control (R = 0.07, p = 0.86) or elderly subjects (R = 0.17, p = 0.57). In terms of hopping characteristics, at 60-bpm, people with MS and matched controls were significantly different from the elderly group. However, at 40-bpm, the MS group was no longer significantly different from the elderly group, even though matched controls and elderly still differed significantly. This new timed hopping test may be able to detect both physical ability, and feed-forward anticipatory control impairments in people with mild MS. Hopping at a frequency of 40-bpm seemed more challenging. Several aspects of anticipatory motor control can be measured: including reaction time to the first metronome cue and the ability to adapt and anticipate the beat over time. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes.

PubMed

Edington, J; Barnes, R; Bryan, F; Dupree, E; Frost, G; Hickson, M; Lancaster, J; Mongia, S; Smith, J; Torrance, A; West, R; Pang, F; Coles, S J

2004-04-01

Malnutrition is common in sick elderly people on admission to hospital and in the community. We conducted a randomised controlled trial to determine if nutritional supplementation after discharge from hospital improved nutritional status and functional outcomes, or reduced health-care costs. Elderly malnourished subjects were randomised to 8 weeks of supplementation or no supplementation post discharge, and followed up for 24 weeks. Weight, body mass index, anthropometrics, handgrip strength, quality of life and requirements for health-care professionals' services and social services were measured throughout the study. Nutritional status improved significantly from baseline to week 24 in the intervention group (P<0.05), but not in the control group. There was no significant difference in nutritional status between groups at week 24. Handgrip strength improved significantly in the intervention group during supplementation, and was significantly different from that of the control group at week 8, but decreased thereafter. There was no significant difference in quality of life or health economic outcomes between groups at week 24. In already malnourished elderly subjects, it may be too late to expect to improve function or quality of life or to reduce health-care costs simply by providing nutritional supplements after hospitalisation. Prevention is key. All elderly patients should be nutritionally assessed as part of their routine care, and appropriate intervention initiated early.

We Remember… Elders' Memories and Perceptions of Sleeping Sickness Control Interventions in West Nile, Uganda.

PubMed

Kovacic, Vanja; Tirados, Inaki; Esterhuizen, Johan; Mangwiro, Clement T N; Lehane, Michael J; Torr, Stephen J; Smith, Helen

2016-06-01

The traditional role of African elders and their connection with the community make them important stakeholders in community-based disease control programmes. We explored elders' memories related to interventions against sleeping sickness to assess whether or not past interventions created any trauma which might hamper future control operations. Using a qualitative research framework, we conducted and analysed twenty-four in-depth interviews with Lugbara elders from north-western Uganda. Participants were selected from the villages inside and outside known historical sleeping sickness foci. Elders' memories ranged from examinations of lymph nodes conducted in colonial times to more recent active screening and treatment campaigns. Some negative memories dating from the 1990s were associated with diagnostic procedures, treatment duration and treatment side effects, and were combined with memories of negative impacts related to sleeping sickness epidemics particularly in HAT foci. More positive observations from the recent treatment campaigns were reported, especially improvements in treatment. Sleeping sickness interventions in our research area did not create any permanent traumatic memories, but memories remained flexible and open to change. This study however identified that details related to medical procedures can remain captured in a community's collective memory for decades. We recommend more emphasis on communication between disease control programme planners and communities using detailed and transparent information distribution, which is not one directional but rather a dialogue between both parties.

Neurological soft signs in persons with amnestic mild cognitive impairment and the relationships to neuropsychological functions.

PubMed

Li, Hui-Jie; Wang, Peng-Yun; Jiang, Yang; Chan, Raymond C K; Wang, Hua-Li; Li, Juan

2012-06-07

Neurological abnormalities have been reported in people with amnestic mild cognitive impairment (aMCI). The current study aimed to examine the prevalence of neurological soft signs (NSS) in this clinical group and to examine the relationship of NSS to other neuropsychological performances. Twenty-nine people with aMCI and 28 cognitively healthy elderly people were recruited for the present study. The NSS subscales (motor coordination, sensory integration, and disinhibition) of the Cambridge Neurological Inventory and a set of neuropsychological tests were administered to all the participants. People with aMCI exhibited significantly more motor coordination signs, disinhibition signs, and total NSS than normal controls. Correlation analysis showed that the motor coordination subscale score and total score of NSS were significantly inversely correlated with the combined Z-score of neuropsychological tests in aMCI group. These preliminary findings suggested that people with aMCI demonstrated a higher prevalence of NSS compared to healthy elderly people. Moreover, NSS was found to be inversely correlated with the neuropsychological performances in persons with aMCI. When taken together, these findings suggested that NSS may play a potential important role and serve as a tool to assist in the early detection of aMCI.

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

PubMed Central

Estebsari, Fatemeh; Dastoorpoor, Maryam; Mostafaei, Davoud; Khanjani, Narges; Khalifehkandi, Zahra Rahimi; Foroushani, Abbas Rahimi; Aghababaeian, Hamidreza; Taghdisi, Mohammad Hossein

2018-01-01

Background Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. Methods This parallel randomized controlled trial was conducted in 2014–2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ2 tests, multiple linear and logistic regression, and structural equation modeling (SEM). Results The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (P<0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P<0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P<0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P<0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=−0.406, β=−0.340, SE=0.03, P<0.05), and through social support, self-efficacy, and health promoting behaviors. Conclusion Educational interventions can be effective in preventing elder abuse. PMID:29713151

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial.

PubMed

Estebsari, Fatemeh; Dastoorpoor, Maryam; Mostafaei, Davoud; Khanjani, Narges; Khalifehkandi, Zahra Rahimi; Foroushani, Abbas Rahimi; Aghababaeian, Hamidreza; Taghdisi, Mohammad Hossein

2018-01-01

Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ 2 tests, multiple linear and logistic regression, and structural equation modeling (SEM). The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher ( P <0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P <0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P <0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P <0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, P <0.05), and through social support, self-efficacy, and health promoting behaviors. Educational interventions can be effective in preventing elder abuse.

Adverse respiratory effects of outdoor air pollution in the elderly.

PubMed

Bentayeb, M; Simoni, M; Baiz, N; Norback, D; Baldacci, S; Maio, S; Viegi, G; Annesi-Maesano, I

2012-09-01

Compared to the rest of the population, the elderly are potentially highly susceptible to the effects of outdoor air pollution due to normal and pathological ageing. The purpose of the present review was to gather data on the effects on respiratory health of outdoor air pollution in the elderly, on whom data are scarce. These show statistically significant short-term and chronic adverse effects of various outdoor air pollutants on cardiopulmonary morbidity and mortality in the elderly. When exposed to air pollution, the elderly experience more hospital admissions for asthma and chronic obstructive pulmonary disease (COPD) and higher COPD mortality than others. Previous studies also indicate that research on the health effects of air pollution in the elderly has been affected by methodological problems in terms of exposure and health effect assessments. Few pollutants have been considered, and exposure assessment has been based mostly on background air pollution and more rarely on objective measurements and modelling. Significant progress needs to be made through the development of 'hybrid' models utilising the strengths of information on exposure in various environments to several air pollutants, coupled with daily activity exposure patterns. Investigations of chronic effects of air pollution and of multi-pollutant mixtures are needed to better understand the role of air pollution in the elderly. Lastly, smoking, occupation, comorbidities, treatment and the neighbourhood context should be considered as confounders or modifiers of such a role. In this context, the underlying biological, physiological and toxicological mechanisms need to be explored to better understand the phenomenon through a multidisciplinary approach.

PTSD in the elderly: the interaction between trauma and aging.

PubMed

Lapp, Leann Kimberly; Agbokou, Catherine; Ferreri, Florian

2011-08-01

Because an increasingly large cohort of individuals is approaching their elderly years, there is concern about how the healthcare system will cope with the greater demands placed upon it. One area of concern is the impact of trauma and post traumatic stress disorder (PTSD) in the aged. Although several reviews have highlighted the lack of knowledge and research on the topic, there still remain gaps in the literature. Nevertheless, some recent behavioral, endocrinological and neuroimaging studies may provide new insights into the discussion. The central aims of this paper are to summarize the etiological, epidemiological and clinical aspects of PTSD, trauma, and the elderly, and to integrate this knowledge with (i) what is known about PTSD in adults, and (ii) the behavioral, hormonal and cerebral changes associated with healthy aging. A comprehensive search was performed with ISI Web of Science and PubMed for articles pertinent to the psychology and biology of PTSD, trauma, and the elderly. There exist both significant similarities and differences between adults and elderly with PTSD concerning cognitive and biological profile. Evidence suggests that PTSD in the elderly does not follow a simple clinical trajectory. PTSD in the elderly must be considered within the context of normal aging. Strong claims about an interaction between PTSD and aging are difficult to make due to sample heterogeneity, but it is clear that PTSD in this age group presents unique aspects not seen in younger cohorts. Further research must integrate their studies with the biological, psychological, and social changes already associated with the aging process.

Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men.

PubMed

Pereira, Fernando Borges; Leite, André Ferreira; de Paula, Ana Patrícia

2015-02-01

Analyze the influence of sarcopenia in bone health of elderly men. This cross-sectional study evaluated 198 men aged over 60 years. Body composition was measured by dual energy X-ray absorptiometry. The BMD was measured at the femoral neck, total hip, lumbar spine and 33% radius. The diagnosis of abnormal BMD was defined for men who presented densitometric diagnosis of osteopenia or osteoporosis defined by T-score of femoral neck, total hip and lumbar spine. The pre-sarcopenia and sarcopenia were defined according to the European Working Group on Sarcopenia in Older People. The group diagnosed with normal BMD, compared to the group of abnormal BMD, have significantly higher body weight, body mass index, grip strength, lean mass, fat mass, and relative appendicular skeletal muscle mass (RASM). However, after multiple linear regression analysis, we found that only the RASM, lean mass, and handgrip strength in the dominant hand influenced the variability of the BMD after adjustment for age and weight. Regression analyzes showed a positive association between greater appendicular lean mass and a smaller number of elderly patients with abnormal BMD diagnostic. The regression analyzes showed that elderly men diagnosed with pre-sarcopenia and sarcopenia had more abnormal BMD than non-sarcopenic elderly men. We concluded that pre-sarcopenia and sarcopenia were associated with abnormal BMD. The lean mass, compared to fat mass, has a greater positive influence on the BMD of elderly men. This result suggests the importance of the increase in lean mass for the bone health of elderly men.

Circles of Tobacco Wisdom: learning about traditional and commercial tobacco with Native elders.

PubMed

Nadeau, Melanie; Blake, Norby; Poupart, John; Rhodes, Kristine; Forster, Jean L

2012-11-01

Circles of Tobacco Wisdom (CTW) was an elder-led, community-based project that aimed to enhance tobacco control in the American Indian community. Its goal was to provide elders with the knowledge, opportunities, and support to enable them to assume leadership of a tobacco control movement that was grounded in the ceremonial traditions of tobacco use. The purpose of this study was to test the effects of the pilot intervention on participants. The design of this pilot study intervention was a single group, pre-post comparison, with a pre-post survey, monthly check-ins, and a post-1-year focus group. Twelve elders were included in the pre- and post-analyses. All twelve elders were women who self-identified as American Indian (mean age = 64). The CTW elders participated in monthly talking circles, quarterly learning sessions, and a post-1-year focus group, and took part in other learning, support, and community action opportunities. Data were collected from December 2008 through November 2009 and analyzed throughout the process. American Indian Elders' tobacco-related knowledge, perceptions, beliefs, and behaviors were measured while participating in the CTW project. Knowledge, perceptions, beliefs, and behavior changes were seen with cigarette smoking, secondhand smoke, and ceremonial tobacco use and risk perception. After 6 months, the number of people the elders had talked with about tobacco increased, elders were more likely to have a discussion on tobacco at a community event, and their comfort level talking about commercial and traditional tobacco also increased. A number of themes also were identified in the focus group: feeling more comfortable talking about tobacco issues, learning a lot about traditional and commercial tobacco, and realizing the dangers of smoking. Elders increased their knowledge about commercial and traditional tobacco and changed related attitudes as a result of CTW. Further, American Indian Elders perceived that CTW was effective. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

South Winnipeg Integrated Geriatric Program (SWING): A Rapid Community-Response Program for the Frail Elderly

ERIC Educational Resources Information Center

Montgomery, Patrick R.; Fallis, Wendy M.

2003-01-01

The objective of this study was to compare enhanced access to geriatric assessment and case management to usual home care service provision for the frail elderly. This was a demonstration project, with randomized allocation to control or intervention groups of frail elderly persons who had been referred to the Home Care service in Winnipeg. Of the…

A Multivariate Examination of Explanations for the Occurrence of Elder Abuse

ERIC Educational Resources Information Center

Litwin, Howard; Zoabi, Sameer

2004-01-01

The goal of the study was to determine the relative strength of four major explanations for the rise of elder abuse among a population in transition from traditional to modern culture. The study compared a sample of 120 abused elderly Arab Israelis with a control group of 120 nonabused older adults from the same background. The abuse status…

The effect of using welfare IT convergence contents on physical function, depression, and social participation in the elderly.

PubMed

Kim, DeokJu; Yang, YeongAe

2016-03-01

[Purpose] This study investigates the effects of welfare IT convergence contents on physical function, depression, and social participation among the elderly. It also aims to provide material for future activity mediation for the elderly. [Subjects] Two hundred subjects >65 years were selected from six elderly welfare facilities and related institutions in the Busan and Gyeongbuk areas and were evaluated from 2014 to 2015. [Methods] This study assessed physical function, depression, and social participation; 100 subjects who utilized commercialized welfare IT convergence contents were included in an experimental group and 100 subjects who had no experience thereof were included in a control group. [Results] When comparing differences in physical function between the groups, balance maintenance was better in the experimental group. There were also significant differences in depression and social participation. The experimental group displayed higher physical function, lower depression levels, and higher social participation levels compared to the control group. [Conclusion] Welfare IT convergence contents positively influence occupational performance in the elderly. Future research is necessary to provide information to the elderly through various routes, so that they can understand welfare IT convergence contents and actively utilize them.

Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

PubMed Central

Uthaikhup, Sureeporn; Prasert, Romchat; Paungmali, Aatit; Boontha, Kritsana

2015-01-01

Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold heat pain responses. The pain measures were assessed over the cervical spine and at a remote site, the tibialis anterior muscle. Results Elders with chronic neck pain had lower pressure pain threshold over the articular pillar of C5-C6 and decreased cold pain thresholds over the cervical spine and tibialis anterior muscle when compared with controls (p < 0.05). There were no between group differences in heat pain thresholds and suprathreshold heat pain responses (p > 0.05). Conclusion The presence of pain hypersensitivity in elderly women with chronic neck pain appears to be dependent on types of painful stimuli. This may reflect changes in the peripheral and central nervous system with age. PMID:26039149

Effects of 12-week brisk walking training on exercise blood pressure in elderly patients with essential hypertension: a pilot study.

PubMed

He, L I; Wei, Wang Ren; Can, Zhao

2018-01-24

Essential hypertension (EP) is characterized by blood pressure (BP) elevations, which often lead to target organ damage and cardiovascular illness. The following study investigates whether aerobic exercise programs with different intensities could reduce the magnitude of BP rise. Patients with essential hypertension were recruited from the Baoshan Community Health Service Center. A total of 46 patients were finally selected and randomly assigned into two groups: control group (CON) included patients who did not participate in exercise intervention training; treatment group (TRG) included patients who participated in 12-week brisk walking training (60-min of brisk walking, three times a week for a total of 12 weeks). 3-minute step tests of low and high intensity were conducted pre- and post-intervention. To compare the effects of exercise intervention, 23 subjects with normal blood pressure (NBP) who did not participate in 12-week brisk walking training, were recruited. After 12 weeks of brisk walking, SBP of TRG during resting, low and high-intensity exercise was significantly reduced by 8.3mmHg, 15.6mmHg, and 22.6mmHg, respectively; while HR of TRG's during resting, low and high intensity was significantly reduced by 3.6beats/minute, 8.7beats/minute and 11.3beats/minute, respectively. Meanwhile, after 12 weeks of brisk walking, TRG's steps per day, [Formula: see text]o 2max , moderate physical activity time and physical activity energy expenditure significantly increased by 6000 steps, 2.4 ml/kg/m, 40 minutes and 113 kcal, respectively. At the same time, TRG's body fat rate and sedentary time significantly reduced by 2% and 60 minutes per day. Brisk walking can reduce the magnitude of BP rise during exercise of different intensities and may be reduced the risk of acute cardiovascular incidents in elderly patients with essential hypertension. EP: Essential hypertension; BP: blood pressure; CON: control group; TRG: treatment group; NBP: normal blood pressure; PA: physical activity.

Flow void of cerebrospinal fluid in idiopathic normal pressure hydrocephalus of the elderly: can it predict outcome after shunting?

PubMed

Krauss, J K; Regel, J P; Vach, W; Jüngling, F D; Droste, D W; Wakhloo, A K

1997-01-01

We investigate the predictive value of cerebrospinal fluid (CSF) flow void on outcome after shunting in a prospective series of patients with idiopathic normal pressure hydrocephalus (NPH). The degree and extension of CSF flow void were examined on T2-weighted magnetic resonance imaging scans of 37 elderly patients with idiopathic NPH who underwent subsequent shunting. The degree of flow void was assessed in comparison with the signal of large cerebral arteries. The extension was evaluated via the calculation of sum scores for the occurrence of flow void in different locations of the ventricular system. Those parameters were not considered in the decision to perform shunting. CSF flow void in the aqueduct and the adjacent third and fourth ventricles of the 37 patients with idiopathic NPH was compared with that of 37 age-matched control patients. CSF flow void scores in patients with idiopathic NPH were investigated for correlations between postoperative outcome scores and ventricular width indices. No difference was found between the occurrence of aqueductal CSF flow void in patients with idiopathic NPH and the control group. A significant difference, however, was noted for the extension of the CSF flow void, which was greater in the NPH group. Postoperative improvement was found in 33 of 37 patients with idiopathic NPH at a mean follow-up of 15.6 months. Only small, statistically not significant correlations were found between CSF flow void and postoperative outcome. Flow void sum scores, however, correlated significantly with ventricular width indices. The degree and extension of CSF flow void on T2-weighted magnetic resonance imaging scans have little predictive value for outcome after shunting in patients with idiopathic NPH. The greater extension of the CSF flow void in patients with NPH is most likely related to increased ventricular width. It is not useful to consider CSF flow void findings on conventional magnetic resonance imaging scans in making the decision to offer shunting in patients with idiopathic NPH.

The Use of Cognitive Cues for Anticipatory Strategies in a Dynamic Postural Control Task - Validation of a Novel Approach to Dual-Task Testing.

PubMed

Laessoe, Uffe; Grarup, Bo; Bangshaab, Jette

2016-01-01

Dual-task testing is relevant in the assessment of postural control. A combination of a primary (motor) and a secondary (distracting cognitive) tasks is most often used. It remains a challenge however, to standardize and monitor the cognitive task. In this study a new dual-task testing approach with a facilitating, rather than distracting, cognitive component was evaluated. Thirty-one community-dwelling elderly and fifteen young people were tested with respect to their ability to use anticipatory postural control strategies. The motor task consisted of twenty-five repetitive tasks in which the participants needed to exceed their limit of stability in order to touch one out of eight lights. The participants performed three tests. In two of the tests the color cues of the lights allowed the participants to utilize cognitive strategies to plan their next movement and improve their performance time. The young performed the baseline motor task test in an average of 29 seconds, while the average time for the elderly was 44 seconds. When comparing the performance time with a leading cue to the time with no cue, the young group improved their performance time significantly better than the elderly did: young: 17% (5), elderly: 5% (8); p<0.001. Similar differences were seen with a more complicated leading cue: young: 12% (5), elderly: 4% (9); p<0.01. The reliability of the test showed moderate to substantial agreement (ICC = 0.74), with a small learning effect between two sessions. The dual-task test was sensitive enough to discriminate between elderly and young people. It revealed that the elderly did not utilize cognitive cues for their anticipatory postural control strategies as well as the young were able to. The test procedure was feasible and comprehensible for the participants, and it may be relevant to standardize a similar test for an alternative dual-task approach in the clinical setting.

[Eating habits in the prevention of cardiovascular diseases and associated factors in elderly hypertensive individuals].

PubMed

Gadenz, Sabrina Dalbosco; Benvegnú, Luís Antônio

2013-12-01

Cardiovascular diseases are the leading cause of death and disability in the elderly. In this study, healthy eating habits and associated factors in the prevention of cardiovascular disease in elderly hypertensive individuals were identified. It involved a cross-sectional study gathering primary data in a family health unit in a city in the interior of the state of Rio Grande do Sul and 212 elderly hypertensive individuals participated in the study. A higher prevalence among the lower age bracket of elderly individuals, female, with little schooling and low income was revealed. Healthy eating habits among the elderly hypertensive individuals assessed are below those recommended in the prevention of cardiovascular disease. Social and economic factors, health characteristics and the use of health services influenced the adoption of healthy eating habits. The results of this study suggest that elderly hypertensive individuals find it difficult to adopt healthy eating habits. This contributes further to the definition of strategies for routine prevention and control of cardiovascular diseases in the elderly.

The effect of a family-based intervention with a cognitive-behavioral approach on elder abuse.

PubMed

Khanlary, Zahra; Maarefvand, Masoomeh; Biglarian, Akbar; Heravi-Karimooi, Majideh

2016-01-01

Elder abuse may become a health issue in developing countries, including Iran. The purpose of this investigation was to study the effectiveness of Family-Based Cognitive-Behavioral Social Work (FBCBSW) in reducing elder abuse. In a randomized clinical trial in Iran, 27 elders participated in intervention and control groups. The intervention groups received a five-session FBCBSW intervention and completed the Domestic-Elder-Abuse-Questionnaire (DEAQ), which evaluates elder abuse at baseline and follow-ups. Repeated measures of analysis of variance (ANOVA) and the Wilcoxon test were used to analyze the data. The repeated measures ANOVA revealed that FBCBSW was successful in reducing elder abuse. The Wilcoxon test indicated that emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, and financial abuse significantly decreased over time, but there was no statistically significant difference in physical abuse before and after the intervention. The findings from this study suggest that FBCBSW is a promising approach to reducing elder abuse and warrants further study with larger samples.

[Detection of human papillomavirus (HVP) 16/18 infections of the vaginal uterine cervix in females before and following conisation].

PubMed

Götze, W; Jantschak, J; Kohls, A; Elling, D; Schildhaus, I

1990-01-01

280 women have been tested by FISH to detect an HPV 16/18-infection of the portio uteri. In a group of 133 women treated by conisation (all with a history of abnormal smear and colposcopy) 67 (50%) were positive for HPV 16/18 DNA before the operation. Follow up examinations of 20 cases with positive HPV 16/18 test before conisation, showed 6 and 12 months after operation only in 3 cases a persistence of HPV 16/18 infection. Only 5 (6.4%) of 78 women with a history of conisation and diagnosis CIN III some years ago were positive for HPV 16/18. In another group of 47 elderly women, treated by abrasio and with normal cervical histology, only 5 (10.6%) had a positive result in the HPV 16/18 FISH-test. 2 (10.6%) of 22 women with normal smear and colposcopy (control group) were positive for HPV 16/18.

Balance disorders in the elderly and the benefit of balance exercise.

PubMed

Prasansuk, Suchitra; Siriyananda, Chana; Nakorn, Apinan Na; Atipas, Suvajana; Chongvisal, Samut

2004-10-01

Symptoms of balance disorders including 'unsteadiness', 'dizziness and vertigo' are common in the elderly and commonly found in general practice in medicine. There are many causes of balance disorders and vary from one person to another. Disorder of the internal ear or vestibular end-organ type is one cause. Unsteadiness of somato-sensory or proprioception is common in the elderly so is degenerative disorder of central control in brain. The elderly are prone to many chronic illnesses or disorders which are causes of balance disorder or give rise to more rapid degeneration of the central nervous system i.e. high blood pressure, diabetes mellitus, heart disease, proprioception and joint problems, arthritis and muscular weakness due to lack of good health and exercise. The objectives of this research study were to find the etiologies of balance disorders and how Balance Exercises and the 'National Health Service' can be of benefit in helping to prevent them. 1565 elderly inhabitants (age > or = 60 years) of 20 communities adjacent to Siriraj Hospital were selected for study. Among these, 625 persons had a history of balance disorders. Among those, 256 had symptoms during the week selected for examination. The average age was 66 years old, women outnumbered men with a ratio of 2.4:1. The common underlying causes were hypertension in 32.4%, diabetes mellitus 13.8%, arthritis 8.1%, and heart disease 4.4% respectively. All are still taking one or more types of drug. The subjects were randomly divided into two groups for the study purpose of effectiveness of balance exercise. Group 1 did not perform the head balance exercise and Group 2 performed the head balance exercise. Audiometric testing showed impaired hearing in 90% of the subjects. The majority slowed hearing loss in high frequencies. Testing of middle ear function found 75% of Group 1 to have normal middle ear function 77% of Group 2. Brainstem Electrical Response Audiometry (BERA) showed normal response latencies of in 96% of group 1 and 94% of Group 2. Poor morphology of waveform was found in 12% of Group 1 and 16% of Group 2. Doppler sonography for intra-cranial blood flow measurement showed abnormal flow of the ICA in 17.6% of group 1 and 20.16% of group 2. Basilar arterial abnormal flow was found in 77.6% of Group 1 and 80.6% of Group 2 respectively. The flow of ICA was improved after 8 weeks in both groups. The measurement of balance by Posturography showed 86.7% abnormality in Group 1 and 83.5% abnormality in Group 2 (and the majority due to inner ear problems but many cases had a mixture of joints and CNS problems too). Results of the self-evaluation (by questionaires) showed the elderly to have symptoms of light headedness in 51% and loss of balance in 29%, Vertigo with rotation occurred in 23.6%. 49% of the symptoms were intermittent, 56.4% experienced a 'fall". On questioning about the benefit and performance of Head and Neck Exercises, 82.8% found the exercises were easy to perform, 56.4% said the results were very beneficial.

Verbal and Visuospatial Performance in Male Alcoholics: A Test of the Premature-Aging Hypothesis.

ERIC Educational Resources Information Center

Shelton, M. D.; And Others

1984-01-01

Compared the levels and patterns of performance of middle-aged, hospitalized chronic alcoholics (N=36), nonalcoholic peer controls (N=36), and a group of elderly nonalcoholic men (N=24) on a paired-associate learning task. Results showed that both the alcoholics and elderly performed significantly poorer than the middle-aged control subjects. (LLL)

Can the CAMCOG be a good cognitive test for patients with Alzheimer's disease with low levels of education?

PubMed

Aprahamian, Ivan; Martinelli, José Eduardo; Cecato, Juliana; Izbicki, Rafael; Yassuda, Mônica Sanches

2011-02-01

The Cambridge Cognitive Examination (CAMCOG) is a useful test in screening for Alzheimer's disease (AD). However, the interpretation of CAMCOG cut-off scores is problematic and reference values are needed for different educational strata. Given the importance of earlier diagnoses of mild dementia, new cut-off values are required which take into account patients with low levels of education. This study aims to evaluate whether the CAMCOG can be used as an accurate screening test among AD patients and normal controls with different educational levels. Cross-sectional assessment was undertaken of 113 AD and 208 elderly controls with heterogeneous educational levels (group 1: 1-4 years; group 2: 5-8 years; and group 3: ≥ 9 years) from a geriatric clinic. submitted to a thorough diagnostic evaluation for AD including the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX). Controls had no cognitive or mood complaints. Sensitivity (SE) and specificity (SP) for the CAMCOG in each educational group was assessed with receiver-operator-characteristic (ROC) curves. CAMCOG mean values were lower when education was reduced in both diagnostic groups (controls - group 1: 87; group 2: 91; group 3: 96; AD - group 1: 63; group 2: 62; group 3: 77). Cut-off scores for the three education groups were 79, 80 and 90, respectively. SE and SP varied among the groups (group 1: 88.1% and 83.5%; group 2: 84.6% and 96%; group 3: 70.8% and 90%). The CAMCOG can be used as a cognitive test for patients with low educational level with good accuracy. Patients with higher education showed lower scores than previously reported.

Category specific deficits in Alzheimer's disease: fact or artefact?

PubMed

Tippett, Lynette J; Meier, Sandra L; Blackwood, Kirsty; Diaz-Asper, Catherine

2007-10-01

Impairments in semantic memory commonly occur in Alzheimer's Disease (AD) but do these occur along category-specific lines? We administered a confrontation naming task comprising living and nonliving items to 68 individuals with AD and 59 age-matched control participants, in a study designed to address some of the methodological issues affecting investigation of category effects. In Experiment 1, stimuli were matched for familiarity and word frequency and also visual complexity, and the AD group showed a differential deficit in nonliving things. In Experiment 2, however, living and nonliving stimuli were matched for age-of-acquisition, name agreement, word frequency, and naming accuracy of elderly controls and there was no categorical impairment in the AD group. The AD group was subdivided first into mild and moderate AD, and then into normal or impaired overall naming groups and performance was reanalysed, but there was still no significant category deficit in any group. Converging evidence was provided by hierarchical regressions across items, as age-of-acquisition, name agreement and word frequency were significant predictors of naming performance in mild and moderate AD groups, but category was not. In Experiment 3, stimulus items were matched for familiarity and naming accuracy of elderly controls when their performance was off-ceiling, and again no differential effect of category was found. When we reduced slightly how closely matched stimuli were for familiarity we then found a differential impairment in living things in the AD group. When reviewing the changing pattern of results from use of different stimulus sets, we concluded that the main determinant of whether or not a categorical impairment of either sort is found in AD is which stimulus properties are controlled during stimulus selection. We conclude that AD does not generally lead to a selective category loss in semantic knowledge.

The Effects of Highly Challenging Balance Training in Elderly With Parkinson's Disease: A Randomized Controlled Trial.

PubMed

Conradsson, David; Löfgren, Niklas; Nero, Håkan; Hagströmer, Maria; Ståhle, Agneta; Lökk, Johan; Franzén, Erika

2015-10-01

Highly challenging exercises have been suggested to induce neuroplasticity in individuals with Parkinson's disease (PD); however, its effect on clinical outcomes remains largely unknown. To evaluate the short-term effects of the HiBalance program, a highly challenging balance-training regimen that incorporates both dual-tasking and PD-specific balance components, compared with usual care in elderly with mild to moderate PD. Participants with PD (n = 100) were randomized, either to the 10-week HiBalance program (n = 51) or to the control group (n = 49). Participants were evaluated before and after the intervention. The main outcomes were balance performance (Mini-BESTest), gait velocity (during normal and dual-task gait), and concerns about falling (Falls Efficacy Scale-International). Performance of a cognitive task while walking, physical activity level (average steps per day), and activities of daily living were secondary outcomes. A total of 91 participants completed the study. After the intervention, the between group comparison showed significantly improved balance and gait performance in the training group. Moreover, although no significant between group difference was observed regarding gait performance during dual-tasking; the participants in the training group improved their performance of the cognitive task while walking, as compared with the control group. Regarding physical activity levels and activities of daily living, in comparison to the control group, favorable results were found for the training group. No group differences were found for concerns about falling. The HiBalance program significantly benefited balance and gait abilities when compared with usual care and showed promising transfer effects to everyday living. Long-term follow-up assessments will further explore these effects. © The Author(s) 2015.

[Sexual life in elderly patients with cardiovascular disease].

PubMed

Karpuz, Hakan

2017-09-01

Sexual activity is an important component of patient and partner quality of life for men and women with cardiovascular disease, including many elderly patients. Older adults desire sexual intimacy when there is a partner and a health status that allows sexual relationships. Older individuals desire to love and enjoy sexual activity in relation to personal circumstances, and when health status allows them to experience close relations, most often within marriage especially in our country. Normal changes occur in the phases of sexual cycle with aging, male erectile dysfunction and female sexual dysfunction increase with age. Elderly patients are often affected by multiple organic diseases which can interfere with sexual function especially cardiovascular disease. Treating those disorders or modifying lifestyle-related risk factors may help prevent sexual dysfunction in the elderly. Sexuality is important for older adults and physicians should give their patient's opportunity to voice their concerns with sexual function and offer them alternatives for evaluation and treatment. Asking about sexual health remains difficult or embarrassing for many physicians; in addition, many patients find it difficult to raise sexual issues with their doctor.

Lipid-Emulsion Propofol Less Attenuates the Regulation of Body Temperature than Micro-Emulsion Propofol or Sevoflurane in the Elderly

PubMed Central

Jeong, Cheol Won; Ju, Jin; Lee, Dae Wook; Lee, Seong Heon

2012-01-01

Purpose Anesthesia and surgery commonly cause hypothermia, and this caused by a combination of anesthetic-induced impairment of thermoregulatory control, a cold operation room environment and other factors that promote heat loss. All the general anesthetics markedly impair normal autonomic thermoregulatory control. The aim of this study is to evaluate the effect of two different types of propofol versus inhalation anesthetic on the body temperature. Materials and Methods In this randomized controlled study, 36 patients scheduled for elective laparoscopic gastrectomy were allocated into three groups; group S (sevoflurane, n=12), group L (lipid-emulsion propofol, n=12) and group M (micro-emulsion propofol, n=12). Anesthesia was maintained with typical doses of the study drugs and all the groups received continuous remifentanil infusion. The body temperature was continuously monitored after the induction of general anesthesia until the end of surgery. Results The body temperature was decreased in all the groups. The temperature gradient of each group (group S, group L and group M) at 180 minutes from induction of anesthesia was 2.5±0.6℃, 1.6±0.5℃ and 2.3±0.6℃, respectively. The body temperature of group L was significantly higher than that of group S and group M at 30 minutes and 75 minute after induction of anesthesia, respectively. There were no temperature differences between group S and group M. Conclusion The body temperature is maintained at a higher level in elderly patients anesthetized with lipid-emulsion propofol. PMID:22187253

Effects of a progressive muscle relaxation intervention on dementia symptoms, activities of daily living, and immune function in group home residents with dementia in Japan

PubMed Central

Momose, Yumiko

2016-01-01

Aim To evaluate the effects of progressive muscle relaxation on the behavioral and psychological symptoms of dementia, activities of daily living, and immune function of elderly patients with dementia in group homes. Methods The participants were ranked by their group home unit. Odd ranks were assigned to the intervention group and even ranks to the control group. The intervention group participated in progressive muscle relaxation for 15 min each day for 90 days in the group environment; the control group members continued with their normal routine. All the participants’ secretory immunoglobulin A was measured and they were assessed with the Neuropsychiatric Inventory‐Nursing Home version, Nishimura Mental State Scale for the Elderly, and Nishimura Activities of Daily Living Scale. Results The intervention group comprised 18 participants from six units and the control group comprised 19 participants from five units. After the intervention, the Neuropsychiatric Inventory scores were significantly better in the intervention group, particularly for Agitation and Anxiety. The intervention group also showed significantly lower Apathy and Irritability scores and significant improvement in the Interest, Volition, and Social relationships scores on the Mental State Scale, with improvement in the activities of daily living total. However, there was no difference in the secretory immunoglobulin A level between the groups. Conclusion The results suggest that progressive muscle relaxation improves the behavioral and psychological symptoms of dementia and activities of daily living in group home residents with dementia, but does not affect their immune function. PMID:27696678

Lipid-emulsion propofol less attenuates the regulation of body temperature than micro-emulsion propofol or sevoflurane in the elderly.

PubMed

Jeong, Cheol Won; Ju, Jin; Lee, Dae Wook; Lee, Seong Heon; Yoon, Myung Ha

2012-01-01

Anesthesia and surgery commonly cause hypothermia, and this caused by a combination of anesthetic-induced impairment of thermoregulatory control, a cold operation room environment and other factors that promote heat loss. All the general anesthetics markedly impair normal autonomic thermoregulatory control. The aim of this study is to evaluate the effect of two different types of propofol versus inhalation anesthetic on the body temperature. In this randomized controlled study, 36 patients scheduled for elective laparoscopic gastrectomy were allocated into three groups; group S (sevoflurane, n=12), group L (lipid-emulsion propofol, n=12) and group M (micro-emulsion propofol, n=12). Anesthesia was maintained with typical doses of the study drugs and all the groups received continuous remifentanil infusion. The body temperature was continuously monitored after the induction of general anesthesia until the end of surgery. The body temperature was decreased in all the groups. The temperature gradient of each group (group S, group L and group M) at 180 minutes from induction of anesthesia was 2.5 ± 0.6°C, 1.6 ± 0.5°C and 2.3 ± 0.6°C, respectively. The body temperature of group L was significantly higher than that of group S and group M at 30 minutes and 75 minute after induction of anesthesia, respectively. There were no temperature differences between group S and group M. The body temperature is maintained at a higher level in elderly patients anesthetized with lipid-emulsion propofol.

Skeletal muscle mass and risk of death in an elderly population.

PubMed

Chuang, S-Y; Chang, H-Y; Lee, M-S; Chia-Yu Chen, R; Pan, W-H

2014-07-01

Body mass index (BMI) has a U-shaped relationship with mortality among the elderly, in contrast to the general adult population. Skeletal muscle mass may be more appropriate than BMI for classifying mortality risk among the elderly. We investigated the relationship between skeletal muscle mass and mortality among elderly Chinese persons. A total of 1512 elderly from the Nutrition and Health Survey in Taiwanese Elderly (1999-2000) was enrolled, and the survival status was followed using data from the National Death Registry. The skeletal muscle mass index (SMMI) was calculated by dividing skeletal muscle mass by height in meters squared. The Cox proportional hazard model was used to estimate the association between SMMI and mortality. During the follow-up (average time: 7.9 years), one-third elderly died (n = 506) by any cause and 25% of them was cardiovascular mortality (ICD-9-CM: between 390 and 459). The total mortality and cardiovascular mortality were 4.23 and 1.07 per 100 person-years. Elderly participants with the lowest SMMI had the highest total mortality and cardiovascular mortality among the four quartiles (6.72, 3.76, 3.25 and 3.50 per 100 PY for total mortality; 1.81, 0.76, 0.87, 0.93 for cardiovascular mortality). Those with a low (1st quartile) SMMI had a 2-fold increase in total mortality (1.96; 1.63-2.35) and cardiovascular mortality (2.16; 1.51-3.08) risk compared to those with a normal [2nd, 3rd, or 4th quartile] SMMI. The threshold relationship between SMMI and mortality is contrast to the reverse J-shaped relationship between BMI and total mortality. Therefore, skeletal muscle mass measurement may be considered with a high priority to identify elderly individuals with a high mortality risk. Copyright © 2014. Published by Elsevier B.V.

Neuromuscular Electrical Stimulation for Mobility Support of Elderly

PubMed Central

2015-01-01

The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within “MOBIL” we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in “compliance data storage” as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC) and maximum stimulation induced contraction (MSC) were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period. Therefore the correlation between normalized MVC and normalized MSC was calculated. It is obvious that MVC can increase to strongly variable extent (3 to 65 %), but in few cases also decrease (-4 to 15 %) over the study period. The correlation suggests that an increase of roughly 1 % of normalized MSC can lead to an increase of about 10 % in MVC in the given training conditions. Overall, we can say that we have a stimulator that has turned out to work sufficiently. The most important feature is the integrated compliance recording because this is very useful for interpretation of the study outcome. The electrical stimulation training has shown that even with relatively small induced contraction intensity we still get some increase in the achievable voluntary extension torque. PMID:26913167

Neuromuscular Electrical Stimulation for Mobility Support of Elderly.

PubMed

Mayr, Winfried

2015-08-24

The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in "compliance data storage" as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC) and maximum stimulation induced contraction (MSC) were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period. Therefore the correlation between normalized MVC and normalized MSC was calculated. It is obvious that MVC can increase to strongly variable extent (3 to 65 %), but in few cases also decrease (-4 to 15 %) over the study period. The correlation suggests that an increase of roughly 1 % of normalized MSC can lead to an increase of about 10 % in MVC in the given training conditions. Overall, we can say that we have a stimulator that has turned out to work sufficiently. The most important feature is the integrated compliance recording because this is very useful for interpretation of the study outcome. The electrical stimulation training has shown that even with relatively small induced contraction intensity we still get some increase in the achievable voluntary extension torque.

A cross-sectional study of the effect of health literacy on diabetes prevention and control among elderly individuals with prediabetes in rural China.

PubMed

Qin, Lulu; Xu, Huilan

2016-05-27

This study was designed to examine the effect of health literacy on diabetes prevention and control and risk factors for low diabetes health literacy among elderly individuals with prediabetes in rural areas in China. A cross-sectional survey was conducted among elderly individuals in rural communities in Yiyang City in China. Multi-staged cluster random sampling was used to select 42 areas and 434 individuals with prediabetes who were interviewed using a questionnaire on diabetes health literacy in China. Participants were asked for general information (age, gender, marital status, history of hyperglycaemia, family history of diabetes mellitus, presence of other diseases and level of education). Binary logistic regression analysis was used to identify risk factors for poor health literacy concerning diabetes prevention and control among elderly subjects with prediabetes. The median health literacy score for diabetes prevention and prediabetes control was 10.0 (IQR 7.0-13.0). The level of diabetes health literacy among men was lower than among women (OR 2.831, 95% CI 1.818 to 4.408), and lower among respondents with 1-6 years of education than among those with 6 years or more of education (OR 14.274, 95% CI 5.927 to 34.375). Those with less than 1 year of education had the lowest literacy (OR 31.148, 95% CI 11.661 to 83.204). The level of diabetes health literacy among elderly individuals with prediabetes but no history of hyperglycaemia was lower than among those with a history of hyperglycaemia (OR 2.676, 95% CI 1.101 to 6.504). Health literacy concerning diabetes prevention and control among elderly individuals with prediabetes was very low in rural China. Appropriate health education for elderly individuals with low educational levels should be incorporated into diabetes prevention efforts. ChiCTR-IOR-15007033; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Age and education adjusted normative data and discriminative validity for Rey's Auditory Verbal Learning Test in the elderly Greek population.

PubMed

Messinis, Lambros; Nasios, Grigorios; Mougias, Antonios; Politis, Antonis; Zampakis, Petros; Tsiamaki, Eirini; Malefaki, Sonia; Gourzis, Phillipos; Papathanasopoulos, Panagiotis

2016-01-01

Rey's Auditory Verbal Learning Test (RAVLT) is a widely used neuropsychological test to assess episodic memory. In the present study we sought to establish normative and discriminative validity data for the RAVLT in the elderly population using previously adapted learning lists for the Greek adult population. We administered the test to 258 cognitively healthy elderly participants, aged 60-89 years, and two patient groups (192 with amnestic mild cognitive impairment, aMCI, and 65 with Alzheimer's disease, AD). From the statistical analyses, we found that age and education contributed significantly to most trials of the RAVLT, whereas the influence of gender was not significant. Younger elderly participants with higher education outperformed the older elderly with lower education levels. Moreover, both clinical groups performed significantly worse on most RAVLT trials and composite measures than matched cognitively healthy controls. Furthermore, the AD group performed more poorly than the aMCI group on most RAVLT variables. Receiver operating characteristic (ROC) analysis was used to examine the utility of the RAVLT trials to discriminate cognitively healthy controls from aMCI and AD patients. Area under the curve (AUC), an index of effect size, showed that most of the RAVLT measures (individual and composite) included in this study adequately differentiated between the performance of healthy elders and aMCI/AD patients. We also provide cutoff scores in discriminating cognitively healthy controls from aMCI and AD patients, based on the sensitivity and specificity of the prescribed scores. Moreover, we present age- and education-specific normative data for individual and composite scores for the Greek adapted RAVLT in elderly subjects aged between 60 and 89 years for use in clinical and research settings.

The third/second generation PTH assay ratio as a marker for parathyroid carcinoma: evaluation using an automated platform.

PubMed

Cavalier, Etienne; Betea, Daniela; Schleck, Marie-Louise; Gadisseur, Romy; Vroonen, Laurent; Delanaye, Pierre; Daly, Adrian F; Beckers, Albert

2014-03-01

Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by second-generation PTH assays, the normal 3rd/2nd generation PTH ratio (<1) is inverted in PCa (ie, >1). The objective of the investigation was to study the utility and advantages of automated 3rd/2nd generation PTH ratio measurements using the Liaison XL platform over existing manual techniques. The study was conducted at a tertiary-referral academic center. This was a retrospective laboratory study. Eleven patients with advanced PCa (mean age 56.0 y). The controls were patients with primary-hyperparathyroidism (n = 144; mean age 53.8 y), renal transplantation (n = 41; mean age 50.6 y), hemodialysis (n = 80; mean age 65.2 y), and healthy elderly subjects (n = 40; mean age 72.6 y). The median (interquartile range) 3rd/2nd generation PTH ratio was 1.16 (1.10-1.38) in the PCa group, which was significantly higher than the control groups: hemodialysis: 0.74 (0.71-0.75); renal transplant: 0.77 (0.73-0.79); primary hyperparathyroidism: 0.76 (0.74-0.78); healthy elderly: 0.80 (0.74-0.83). An inverted 3rd/2nd-generation PTH ratio (>1) was seen in 9 of 11 PCa patients (81.8%) and in 7 of 305 controls (2.3%): 3 of 80 hemodialysis (3.8%), and 4 of 144 primary-hyperparathyroidism patients (2.8%). Of four PCa patients who had a normal PTH ratio with the manual method, two had an inverted 3rd/2nd-generation PTH ratio with the automated method. Study of the 3rd/2nd-generation PTH ratio in large patient populations should be feasible using a mainstream automated platform like the Liaison XL. The current study confirms the utility of the inverted 3rd/2nd-generation PTH ratio as a marker of PCa (sensitivity: 81.8%; specificity: 97.3%).

Episodic memory loss is related to hippocampal-mediated beta-amyloid deposition in elderly subjects.

PubMed

Mormino, E C; Kluth, J T; Madison, C M; Rabinovici, G D; Baker, S L; Miller, B L; Koeppe, R A; Mathis, C A; Weiner, M W; Jagust, W J

2009-05-01

Although beta-amyloid (Abeta) plaques are a primary diagnostic criterion for Alzheimer's disease, this pathology is commonly observed in the brains of non-demented older individuals. To explore the importance of this pathology in the absence of dementia, we compared levels of amyloid deposition (via 'Pittsburgh Compound-B' (PIB) positron emission tomography (PET) imaging) to hippocampus volume (HV) and episodic memory (EM) in three groups: (i) normal controls (NC) from the Berkeley Aging Cohort (BAC NC, n = 20); (ii) normal controls (NC) from the Alzheimer's disease neuroimaging initiative (ADNI NC, n = 17); and (iii) PIB+ mild cognitive impairment subjects from the ADNI (ADNI PIB+ MCI, n = 39). Age, gender and education were controlled for in each statistical model, and HV was adjusted for intracranial volume (aHV). In BAC NC, elevated PIB uptake was significantly associated with smaller aHV (P = 0.0016) and worse EM (P = 0.0086). Within ADNI NC, elevated PIB uptake was significantly associated with smaller aHV (P = 0.047) but not EM (P = 0.60); within ADNI PIB+ MCI, elevated PIB uptake was significantly associated with both smaller aHV (P = 0.00070) and worse EM (P = 0.046). To further understand these relationships, a recursive regression procedure was conducted within all ADNI NC and PIB+ MCI subjects (n = 56) to test the hypothesis that HV mediates the relationship between Abeta and EM. Significant correlations were found between PIB index and EM (P = 0.0044), PIB index and aHV (P < 0.0001), as well as between aHV and EM (P < 0.0001). When both aHV and PIB were included in the same model to predict EM, aHV remained significant (P = 0.0015) whereas PIB index was no longer significantly associated with EM (P = 0.50). These results are consistent with a model in which Abeta deposition, hippocampal atrophy, and EM occur sequentially in elderly subjects, with Abeta deposition as the primary event in this cascade. This pattern suggests that declining EM in older individuals may be caused by Abeta-induced hippocampus atrophy.

Effects of concurrent and aerobic exercises on postexercise hypotension in elderly hypertensive men.

PubMed

Ferrari, Rodrigo; Umpierre, Daniel; Vogel, Guilherme; Vieira, Paulo J C; Santos, Lucas P; de Mello, Renato Bandeira; Tanaka, Hirofumi; Fuchs, Sandra C

2017-11-01

Despite the fact that simultaneous performance of resistance and aerobic exercises (i.e., concurrent exercise) has become a standard exercise prescription for the elderly, no information is available on its effects on post-exercise hypotension (PEH) in elderly men with hypertension. To compare the effects of different types of exercise on PEH in elderly men with hypertension. Twenty elderly men with essential hypertension participated in three crossover interventions, in random order, and on separate days: a non-exercise control session at seated rest, aerobic exercise performed for 45min, and 45min of concurrent resistance and aerobic exercise consisted of 4 sets of 8 repetitions at 70% 1RM of resistance exercise followed by aerobic exercise on treadmill. After each session, blood pressure (BP) was measured continuously for 1h in the laboratory and for 24h under ambulatory conditions. During the first hour in laboratory, diastolic BP was lower after aerobic (-5mmHg) and concurrent exercise (-6mmHg) in comparison with Control. Day-time diastolic BP was significantly lower after aerobic exercise (-7mmHg) when compared to the control. No significant differences were found among the three experimental sessions for night-time and 24-hour diastolic BP, as well as day-time, night-time and 24-hour systolic BP. Concurrent exercise produced acute PEH similar to aerobic exercise but such effect did not last as long as aerobic exercise in elderly patients with essential hypertension. Copyright © 2017 Elsevier Inc. All rights reserved.

Training induced adaptations in characteristics of postural reflexes in elderly men.

PubMed

Granacher, U; Gollhofer, A; Strass, D

2006-12-01

The aging neuromuscular system is affected by structural and functional changes which lead to a general slowing down of neuromuscular performance and an increased risk of falling. The impact of heavy resistance (HR) training in the elderly on maximum voluntary contraction (MVC) and rate of force development (RFD) has been investigated in the past. However, the influence of sensorimotor (SENSO) training and HR training on the ability to compensate for gait perturbations has not yet been investigated in the elderly. Therefore, the purpose of the study was to examine the impact of HR and SENSO training in elderly men on unexpected treadmill perturbations. Functional reflex activity was recorded by means of surface EMG in 40 male subjects (>60 years) before and after 13 weeks of HR and SENSO training and in another 20 male subjects (>60 years), which served as a CONTROL-group. SENSO training resulted in a decrease in onset latency, an enhanced reflex activity in the prime mover as well as a decrease in maximal angular velocity of the ankle joint complex during the perturbation impulses. No significant changes were observed in the HR- and in the CONTROL-group. The results clearly indicate that SENSO training has an impact on spinal motor control mechanisms in the elderly. Training induced improvements in perception and procession of afferent information could be a possible reason for the increase in reflex contraction. Due to these adaptive processes, SENSO training could be a well-suited method for fall preventive programs in elderly people.

Testing a novel method for improving wayfinding by means of a P3b Virtual Reality Visual Paradigm in normal aging.

PubMed

de Tommaso, Marina; Ricci, Katia; Delussi, Marianna; Montemurno, Anna; Vecchio, Eleonora; Brunetti, Antonio; Bevilacqua, Vitoantonio

2016-01-01

We propose a virtual reality (VR) model, reproducing a house environment, where color modification of target places, obtainable by home automation in a real ambient, was tested by means of a P3b paradigm. The target place (bathroom door) was designed to be recognized during a virtual wayfinding in a realistic reproduction of a house environment. Different color and luminous conditions, easily obtained in the real ambient from a remote home automation control, were applied to the target and standard places, all the doors being illuminated in white (W), and only target doors colored with a green (G) or red (R) spotlight. Three different Virtual Environments (VE) were depicted, as the bathroom was designed in the aisle (A), living room (L) and bedroom (B). EEG was recorded from 57 scalp electrodes in 10 healthy subjects in the 60-80 year age range (O-old group) and 12 normal cases in the 20-30 year age range (Y-young group). In Young group, all the target stimuli determined a significant increase in P3b amplitude on the parietal, occipital and central electrodes compared to frequent stimuli condition, whatever was the color of the target door, while in elderly group the P3b obtained by the green and red colors was significantly different from the frequent stimulus, on the parietal, occipital, and central derivations, while the White stimulus did not evoke a significantly larger P3b with respect to frequent stimulus. The modulation of P3b amplitude, obtained by color and luminance change of target place, suggests that cortical resources, able to compensate the age-related progressive loss of cognitive performance, need to be facilitated even in normal elderly. The event-related responses obtained by virtual reality may be a reliable method to test the environmental feasibility to age-related cognitive changes.

Poor glycemic control is associated with the risk of subclinical hypothyroidism in patients with type 2 diabetes mellitus.

PubMed

Cho, Jae Ho; Kim, Ho Jin; Lee, Jun Ho; Park, Il Rae; Moon, Jun Sung; Yoon, Ji Sung; Lee, In-Kyu; Won, Kyu Chang; Lee, Hyoung Woo

2016-07-01

Overt hypothyroidism is frequently found in patients with type 2 diabetes mellitus (T2DM), but it remains unknown the relationship between subclinical hypothyroidism (SCH) and T2DM. We attempt to evaluate the difference in prevalence of SCH between patients with T2DM and general population, and the association between SCH and glycemic control status ofdiabetic patients. This was cross-sectional study. Total 8,528 subjects who visited for health check-up were recruited. SCH was defined as an elevated level of serum thyroid stimulating hormone (> 4.0 mIU/L) with a normal level of free thyroxine. T2DM group was categorized into three groups by glycosylated hemoglobin (HbA1c): < 7% (reference), ≥ 7% and < 9%, ≥ 9%. Finally, 7,966 subjects were included. The prevalence of SCH was not different between healthy controls and subjects with T2DM (8.1% vs. 7.4%, p = 0.533; in men, 5.7% vs. 5.1%, p = 0.573; in women, 10.9% vs. 11.7%, p = 0.712), but it was increased with highest HbA1c group more than well controlled group, especially in women. The risk of SCH was increased by group with poorer glycemic control; the odds ratio for HbA1c ≥ 9% compared to < 7% was 2.52 (95% confidence interval [CI], 1.09 to 5.86; p = 0.031), and 4.58 (95% CI, 1.41 to 14.87; p = 0.011) in women, but not significant in men. The prevalence of SCH was similar between T2DM and healthy group. Poor glycemic control in T2DM was obviously associated with the risk of SCH, especially in elderly women. These results suggest SCH as comorbidity may be considered in elderly women with poor glycemic control.

Systems proteomic analysis reveals that clusterin and tissue inhibitor of metalloproteinases 3 increase in leptomeningeal arteries affected by cerebral amyloid angiopathy.

PubMed

Manousopoulou, A; Gatherer, M; Smith, C; Nicoll, J A R; Woelk, C H; Johnson, M; Kalaria, R; Attems, J; Garbis, S D; Carare, R O

2017-10-01

Amyloid beta (Aβ) accumulation in the walls of leptomeningeal arteries as cerebral amyloid angiopathy (CAA) is a major feature of Alzheimer's disease. In this study, we used global quantitative proteomic analysis to examine the hypothesis that the leptomeningeal arteries derived from patients with CAA have a distinct endophenotypic profile compared to those from young and elderly controls. Freshly dissected leptomeningeal arteries from the Newcastle Brain Tissue Resource and Edinburgh Sudden Death Brain Bank from seven elderly (82.9 ± 7.5 years) females with severe capillary and arterial CAA, as well as seven elderly (88.3 ± 8.6 years) and five young (45.4 ± 3.9 years) females without CAA were used in this study. Arteries from four patients with CAA, two young and two elderly controls were individually analysed using quantitative proteomics. Key proteomic findings were then validated using immunohistochemistry. Bioinformatics interpretation of the results showed a significant enrichment of the immune response/classical complement and extracellular matrix remodelling pathways (P < 0.05) in arteries affected by CAA vs. those from young and elderly controls. Clusterin (apolipoprotein J) and tissue inhibitor of metalloproteinases-3 (TIMP3), validated using immunohistochemistry, were shown to co-localize with Aβ and to be up-regulated in leptomeningeal arteries from CAA patients compared to young and elderly controls. Global proteomic profiling of brain leptomeningeal arteries revealed that clusterin and TIMP3 increase in leptomeningeal arteries affected by CAA. We propose that clusterin and TIMP3 could facilitate perivascular clearance and may serve as novel candidate therapeutic targets for CAA. © 2016 The Authors. Neuropathology and Applied Neurobiology published by John Wiley & Sons Ltd on behalf of British Neuropathological Society.

Second-generation antipsychotics and risk of cerebrovascular accidents in the elderly.

PubMed

Percudani, Mauro; Barbui, Corrado; Fortino, Ida; Tansella, Michele; Petrovich, Lorenzo

2005-10-01

Concern has been recently raised for risperidone and olanzapine, possibly associated with cerebrovascular events in placebo-controlled trials conducted in elderly subjects with dementia. We investigated the relationship between exposure to second-generation antipsychotics (SGAs) and occurrence of cerebrovascular accidents in the elderly. From the regional database of hospital admissions of Lombardy, Italy, we extracted all patients aged 65 or older with cerebrovascular-related outcomes for the year 2002. From the regional database of prescriptions reimbursed by the National Health Service, we extracted all patients aged 65 or older who received antipsychotic prescriptions during 2001. The 2 databases were linked anonymously using the individual patient code. The proportions of cerebrovascular accidents were 3.31% (95% confidence interval, 2.95-3.69) in elderly subjects exclusively exposed to SGAs and 2.37% (95% confidence interval, 2.19-2.57) in elderly subjects exclusively exposed to first-generation antipsychotics. After background group differences were controlled for, exposure to SGAs significantly increased the risk of accidents. The analysis of cerebrovascular events in elderly subjects exposed to each individual SGA, in comparison with exposure to haloperidol, showed a significantly increased risk for risperidone only (adjusted odds ratio, 1.43; 95% confidence interval, 1.12-1.93). These data provide preliminary epidemiological evidence that exposure to SGAs, in comparison with exposure to first-generation antipsychotics, significantly increased the risk of cerebrovascular accidents in the elderly.

Analysis of the prognostic value of BMI and the difference in its impact according to age and sex in DLBCL patients.

PubMed

Kanemasa, Yusuke; Shimoyama, Tatsu; Sasaki, Yuki; Tamura, Miho; Sawada, Takeshi; Omuro, Yasushi; Hishima, Tsunekazu; Maeda, Yoshiharu

2018-02-01

Studies that have evaluated the prognostic value of body mass index (BMI) in patients with diffuse large B-cell lymphoma have recently been reported. However, the impact of BMI on survival outcomes remains controversial. We retrospectively analyzed the data of 406 diffuse large B-cell lymphoma patients treated with R-CHOP or R-CHOP-like regimens. The number (%) of patients that were categorized into 1 of 4 groups according to BMI were underweight (<18.5 kg/m 2 ), 58 (14.3%); normal weight (≥18.5 to <25 kg/m 2 ), 262 (64.5%); overweight (≥25 to <30 kg/m 2 ), 75 (18.5%); and obese (≥30.0 kg/m 2 ), 11 (2.7%). While the prognosis of overweight patients was good, being similar to that of normal weight, underweight, and obese patients had a worse prognosis (5-y overall survival [OS] was 57.9%, 74.3%, 73.4%, and 40.9% for underweight, normal weight, overweight, and obese patients, respectively; P = .004). In multivariate analysis, underweight and obesity were independent prognostic factors for OS compared with normal weight (hazard ratios 2.90 and 5.17, respectively). In elderly female patients (≥70 y), patients with a low BMI (<25 kg/m 2 ) had significantly inferior OS than those with a high BMI (≥25 kg/m 2 ) (5-y OS, 61.5% vs 85.7%; P = .039). In contrast, in young female patients (<70 years), patients with a low BMI had significantly better OS than those with a high BMI (5-y OS, 88.6% vs 46.4%; P < .001). In male patients, there were no differences in the effect of BMI on OS between young and elderly patients. In this study, we demonstrated that being underweight and obese were independent prognostic factors compared with being normal weight. In female patients, BMI had a different impact on the prognosis of young and elderly patients, whereas in male patients, there was no difference in the effect of BMI on prognosis according to age. Copyright © 2017 John Wiley & Sons, Ltd.

Nutritional deficits in elderly smokers with respiratory symptoms that do not fulfill the criteria for COPD

PubMed Central

Obase, Yasushi; Mouri, Keiji; Shimizu, Hiroki; Ohue, Yoshihiro; Kobashi, Yoshihiro; Kawahara, Kazue; Oka, Mikio

2011-01-01

Background and objective Whereas nutrition deficits are recognized as an expression of systemic inflammation in the elderly with diagnosed chronic obstructive pulmonary disease (COPD), if they occur in symptomatic elderly smokers, unfulfilled COPD criteria are not confirmed. Methods Respiratory function, anthropometry assessment, and diet intake evaluation of 13 COPD patients (COPD group), ten symptomatic elderly smokers (SYSM group), and 27 healthy volunteers (control group) were compared. All were 70 years old or older. Results The SYSM group had lower body weight, body mass index, percentage ideal body weight, body fat percentage, arm muscle circumference, tricep skin fold thickness, serum albumin, prealbumin, and transferrin than the control group and were similar to the COPD group (P < 0.05 each and nonsignificant each). Resting energy expenditure was no different among the groups. Intake of energy, vitamins (A, B1, B2, and C), calcium, iron, fiber, and sodium was also lower in the SYSM group than in the control group (P < 0.05 all) and was similar to the COPD group. Conclusion Elderly smokers who are symptomatic but who do not fulfill the COPD diagnostic criteria have nutritional deficits related to insufficient energy intake that are similar to those seen in COPD patients. PMID:22259244

The role of perioperative oral nutritional supplementation in elderly patients after hip surgery

PubMed Central

Liu, Ming; Yang, Jing; Yu, Xi; Huang, Xiao; Vaidya, Sushan; Huang, Fuguo; Xiang, Zhou

2015-01-01

Background The effect of perioperative oral nutritional supplementation (ONS) on elderly patients after hip surgery remains controversial. This study intended to ascertain whether perioperative ONS is beneficial for the rehabilitation of elderly patients after hip surgery. Materials and methods We searched databases including PubMed, Embase, and the Cochrane Central Register of Controlled Trials for articles published up to May 2014. Randomized controlled trials of ONS for elderly patients after hip surgery were included. Results The combined trials showed that ONS had a positive effect on the serum total protein (P<0.00001) and led to a significantly decreased number of complications (P=0.0005). Furthermore, data from the infection subgroups showed significant decreases in wound infection (P=0.02), respiratory infection (P=0.04), and urinary tract infection (P=0.03). Clinical observation suggests that the intervention may improve the level of serum albumin, although the data did not reach statistical significance (P=0.48). Regarding mortality, there was no significant statistical difference between the intervention group and the control (P=0.93). Conclusion Based on the evidence available, this meta-analysis is consistent with the hypothesis that perioperative ONS can help elderly patients recover after hip surgery and reduce complications. PMID:26005339

Minimizing drug misuse among elders: a proposal.

PubMed Central

Craig, J A; Eves, G B

1987-01-01

This proposal is aimed at reducing the risk of adverse drug interactions that may occur when over-the-counter (OTC) preparations are taken in conjunction with prescription drugs in an unsupervised regimen. Such polymedicating is practiced widely among the elderly. A pilot program would be implemented over 12 months at three drugstores of a major retail chain. A barcode-based computer system would be used to identify potential adverse drug interactions for elderly customers. All volunteers admitted to the study, controls and subjects, would agree to buy all their medications, prescriptions and OTC, at the participating pharmacies. In return, the volunteers would receive discounts of 25 percent on prescription and OTC drugs and 10 percent on vitamins. Study subjects (N = 375) would carry barcoded identification (BID) cards that would activate the computerized program to assess each purchase for compatibility with their other medications; controls (N = 375) would carry "dummy" BID cards that would prompt the computer to approve all drug purchases. A final comparison of the subjects with the controls, as well as with a sample of elderly residents selected randomly from the community, would determine whether such a computerized, commercially based drug use review system could reduce the potential for adverse interactions between OTC and prescription drugs among the elderly. PMID:3101129

Intelligibility of foreign-accented speech: Effects of listening condition, listener age, and listener hearing status

NASA Astrophysics Data System (ADS)

Ferguson, Sarah Hargus

2005-09-01

It is well known that, for listeners with normal hearing, speech produced by non-native speakers of the listener's first language is less intelligible than speech produced by native speakers. Intelligibility is well correlated with listener's ratings of talker comprehensibility and accentedness, which have been shown to be related to several talker factors, including age of second language acquisition and level of similarity between the talker's native and second language phoneme inventories. Relatively few studies have focused on factors extrinsic to the talker. The current project explored the effects of listener and environmental factors on the intelligibility of foreign-accented speech. Specifically, monosyllabic English words previously recorded from two talkers, one a native speaker of American English and the other a native speaker of Spanish, were presented to three groups of listeners (young listeners with normal hearing, elderly listeners with normal hearing, and elderly listeners with hearing impairment; n=20 each) in three different listening conditions (undistorted words in quiet, undistorted words in 12-talker babble, and filtered words in quiet). Data analysis will focus on interactions between talker accent, listener age, listener hearing status, and listening condition. [Project supported by American Speech-Language-Hearing Association AARC Award.

The fragile elderly hip: Mechanisms associated with age-related loss of strength and toughness☆

PubMed Central

Reeve, Jonathan; Loveridge, Nigel

2014-01-01

Every hip fracture begins with a microscopic crack, which enlarges explosively over microseconds. Most hip fractures in the elderly occur on falling from standing height, usually sideways or backwards. The typically moderate level of trauma very rarely causes fracture in younger people. Here, this paradox is traced to the decline of multiple protective mechanisms at many length scales from nanometres to that of the whole femur. With normal ageing, the femoral neck asymmetrically and progressively loses bone tissue precisely where the cortex is already thinnest and is also compressed in a sideways fall. At the microscopic scale of the basic remodelling unit (BMU) that renews bone tissue, increased numbers of actively remodelling BMUs associated with the reduced mechanical loading in a typically inactive old age augments the numbers of mechanical flaws in the structure potentially capable of initiating cracking. Menopause and over-deep osteoclastic resorption are associated with incomplete BMU refilling leading to excessive porosity, cortical thinning and disconnection of trabeculae. In the femoral cortex, replacement of damaged bone or bone containing dead osteocytes is inefficient, impeding the homeostatic mechanisms that match strength to habitual mechanical usage. In consequence the participation of healthy osteocytes in crack-impeding mechanisms is impaired. Observational studies demonstrate that protective crack deflection in the elderly is reduced. At the most microscopic levels attention now centres on the role of tissue ageing, which may alter the relationship between mineral and matrix that optimises the inhibition of crack progression and on the role of osteocyte ageing and death that impedes tissue maintenance and repair. This review examines recent developments in the understanding of why the elderly hip becomes fragile. This growing understanding is suggesting novel testable approaches for reducing risk of hip fracture that might translate into control of the growing worldwide impact of hip fractures on our ageing populations. PMID:24412288

Surgery in elderly patients with intracranial meningioma: neuropsychological functioning during a long term follow-up.

PubMed

Di Cristofori, Andrea; Zarino, Barbara; Bertani, Giulio; Locatelli, Marco; Rampini, Paolo; Carrabba, Giorgio; Caroli, Manuela

2018-05-01

Surgical treatment of elderly patients with meningioma is has proved to be safe, especially when patients are selected using dedicated surgical scores. These scores take into account tumor size, edema, location and patient's co-morbidities. Neuropsychological functioning (NPF) of this kind of patients has been poorly studied in literature and it is not taken into account by these scores. Aim of our study was to describe the long-term outcome in terms of NPF of elderly patients undergoing surgery. Patients older than 70 years of age affected by intracranial meningioma and selected with the Clinical-Radiological Grading Score were included in our study. Neuropsychological testing was performed using a dedicated battery of tests before surgery, 3 and 12 months after surgery. Clinical, neurological and radiological outcomes were studied as well. Forty-one patients with a median age of 74 years were included in this study. Preoperatively only 1/41 patients showed a normal NPF with all tests scoring normally. Four out of 39 patients showed a complete neuropsychological recovery after 3 months; while 10/37 patients had a complete recovery after 12 months. NPF showed a trend of progressive improvement after surgery. Our study is the first experience reported in literature describing a long term follow-up in elderly patients after surgery for intracranial meningioma. In our series, surgery determined an improvement of NPF over time; especially with a low complication rate related to the selection of patients obtained through the CRGS. Further studies need to be performed in order to understand how brain edema, tumor size, volume and tumor location affect NPF in both short and long term.

Usefulness of bedside tissue Doppler echocardiography and B-type natriuretic peptide (BNP) in differentiating congestive heart failure from noncardiac cause of acute dyspnea in elderly patients with a normal left ventricular ejection fraction and permanent, nonvalvular atrial fibrillation: insights from a prospective, monocenter study.

PubMed

Arques, Stephane; Roux, Emmanuel; Sbragia, Pascal; Pieri, Bertrand; Gelisse, Richard; Luccioni, Roger; Ambrosi, Pierre

2007-05-01

The incremental role of bedside tissue Doppler echocardiography and B-type natriuretic peptide (BNP) over the clinical judgment has been recently reported in the emergency diagnosis of congestive heart failure with a normal left ventricular ejection fraction (HFNEF). However, how well does this diagnostic strategy be applicable in the setting of atrial fibrillation is unknown. To investigate the usefulness of bedside tissue Doppler echocardiography and BNP in the emergency diagnosis of HFNEF in elderly patients with permanent, nonvalvular atrial fibrillation. Forty-one consecutive elderly patients with an ejection fraction > or =50% (mean age 84 years; 22 with HFNEF and 19 with noncardiac cause), hospitalized for acute dyspnea at rest, were prospectively enrolled; bedside septal E/Ea and BNP were obtained at admission. By multivariable logistic regression analysis including the clinical judgment of heart failure, E/Ea and BNP, E/Ea (P = 0.014) and BNP (P = 0.018) provided independent diagnostic information. Optimal cutoffs were 13 for E/Ea (area under the ROC curve of 0.846, P < 0.0001; sensitivity 81.8%, specificity 89.5%) and 253 pg/ml for BNP (area under the ROC curve of 0.928, P < 0.0001; sensitivity 86.4%, specificity 89.5%). The concordance between the clinical judgment and BNP concentration at the cutoff of 253 pg/ml correctly classified 24 of 25 patients; E/Ea at the cutoff of 13 correctly classified 14 of the 16 patients with discrepancy. Bedside tissue Doppler echocardiography and BNP provide useful additional diagnostic information over the clinical judgment for the emergency diagnosis of HFNEF in elderly patients with permanent, nonvalvular atrial fibrillation.

Reference values for CSF outflow resistance and intracranial pressure in healthy elderly.

PubMed

Malm, Jan; Jacobsson, Johan; Birgander, Richard; Eklund, Anders

2011-03-08

The intracranial pressure (ICP) and CSF outflow resistance (R(out)) are essential to describe the dynamics of the CSF system. R(out) affects ICP, pulse amplitudes, CSF absorption, and the compliance of the system. The objective of this study was to determine the reference values in healthy elderly subjects. Elderly people (60-82 years), who considered themselves healthy, were recruited through an advertisement in the local newspaper. All were evaluated with a 3-T MRI. Subjects were eligible if they did not have any psychiatric or neurologic disorder or signs of advanced atherosclerotic disease. CSF resting pressure (ICP) and R(out) were determined by a constant pressure infusion method with the patient in the supine position. The study population consisted of 40 subjects (mean age 70 years; 23 women). The median ICP was 11.6 mm Hg (15.8 cmH(2)O) and the reference interval was ICP 7.8-14.3 mm Hg (10.6-19.4 cmH(2)O) (defined as 5th to 95th percentiles). The median R(out) was 8.6 mm Hg/mL/min. The variation in R(out) was large and not normally distributed. The 90th percentile of R(out) was 17.4 mm Hg/mL/min. This study reports reference values for ICP and R(out) and should be used for comparison when investigating disorders with suspected CSF dynamic disturbances in the elderly. ICP was in the same range as that reported in the young and middle-aged. The upper limit of R(out) was higher than previously believed to be the upper limit of normal for this age group.

Pilot study of the Mini Nutritional Assessment on predicting outcomes in older adults with type 2 diabetes.

PubMed

Liu, Gong-Xiang; Chen, Yan; Yang, Ying-Xue; Yang, Kun; Liang, Jin; Wang, Shuang; Gan, Hua-Tian

2017-12-01

To date, few studies have focused on the nutritional status of elderly hospitalized patients with diabetes. Our aims were to explore the prevalence of malnutrition among elderly diabetes patients admitted to the hospital, and to explore the relationships between malnutrition and geriatric syndromes, diabetic complications, and clinical outcomes. A prospective, observational study including diabetes patients aged ≥65 years was carried out in a central hospital in Western China. Nutritional status was assessed using the Mini Nutritional Assessment incorporated into a comprehensive geriatric assessment. Follow up was carried out for ≤2.8 years. Of 302 participants, the prevalence of malnutrition, risk of malnutrition, and normal nutrition was 18.5%, 33.1% and 48.3%, respectively. In multivariate analysis, incontinence (odds ratio [OR] 3.17, 95% confidence interval [CI] 1.08-9.36), diabetic microvascular complications (OR 2.22, 95% CI 1.06-4.61) and activities of daily living (ADL) dependence (OR 11.6, 95% CI 5.10-26.5) were independently associated with malnutrition. Malnourished patients had longer hospital stays (P = 0.003) and higher mortality rates (P < 0.001) than patients either at risk of malnutrition or with a normal nutritional status. Multivariate analysis also showed that malnutrition was independently associated with an increased risk of death (OR 2.86, 95% CI 1.30-6.28). The present study showed a high prevalence of malnutrition among elderly diabetes patients hospitalized for geriatric care. Considering the negative impact of malnutrition on hospital stay and mortality, adequate nutritional care should be emphasized for each elderly patient with diabetes, regardless of body mass index. Geriatr Gerontol Int 2017; 17: 2485-2492. © 2017 Japan Geriatrics Society.

Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

PubMed Central

Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K.

2016-01-01

Introduction The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. Methods This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. Results We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65–101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9–100]) with a negative predictive value of 100 (98.7–100). Conclusion Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls. PMID:27330655

Transcobalamin 776C→G polymorphism is associated with peripheral neuropathy in elderly individuals with high folate intake.

PubMed

Sawaengsri, Hathairat; Bergethon, Peter R; Qiu, Wei Qiao; Scott, Tammy M; Jacques, Paul F; Selhub, Jacob; Paul, Ligi

2016-12-01

The 776C→G polymorphism of the vitamin B-12 transport protein transcobalamin gene (TCN2) (rs1801198; Pro259Arg) is associated with a lower holotranscobalamin concentration in plasma. This effect may reduce the availability of vitamin B-12 to tissues even when vitamin B-12 intake is adequate. Clinical outcomes associated with vitamin B-12 insufficiency could potentially be worsened by high folate intake. We determined the association of the TCN2 776C→G polymorphism and folate intake with peripheral neuropathy in elders with normal plasma concentrations of vitamin B-12. Participants in this cross-sectional study (n = 171) were from a cohort of community-based, home-bound elderly individuals aged ≥60 y who underwent an evaluation by physicians including an assessment for peripheral neuropathy. Participants were administered food-frequency and general health status questionnaires, anthropometric measurements were taken, and a fasting blood sample from each subject was collected. Odds of neuropathy were 3-fold higher for GG genotypes than for CC genotypes (OR: 3.33; 95% CI: 1.15, 9.64). When folate intake was >2 times the Recommended Dietary Allowance (800 μg), GG genotypes had 6.9-fold higher odds of neuropathy than CC genotypes (OR: 6.9; 95% CI: 1.31, 36.36). There was no difference between the genotypes in the odds of peripheral neuropathy when folate intake was ≤800 μg (OR: 1.5; 95% CI: 0.18, 12.33). The TCN2 776C→G polymorphism is associated with increased odds of peripheral neuropathy in the elderly, even with a normal vitamin B-12 status, especially if their folate intake is >2 times the Recommended Dietary Allowance. © 2016 American Society for Nutrition.

Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients.

PubMed

Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K

2016-05-01

The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100]) with a negative predictive value of 100 (98.7-100). Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

Sarcopenia and falls in community-dwelling elderly subjects in Japan: Defining sarcopenia according to criteria of the European Working Group on Sarcopenia in Older People.

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Tamaki, Junko

2014-01-01

This study assessed the association between sarcopenia (using the definition of the European Working Group on Sarcopenia in Older People) and fall in the past year among community-dwelling Japanese elderly. Subjects were 1110 community-dwelling Japanese aged 65 or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. "Sarcopenia" was characterized by low muscle mass and low muscle strength or low physical performance. "Presarcopenia" was characterized only by low muscle mass. Subjects who did not have any of these deficiencies were classified as "normal." We then administered a questionnaire assessing age, sex, household status, chronic illness, lifestyle-related habits, and fall. This study showed the prevalence of fall was 16.9% and 21.3% in men and women, respectively, while that of sarcopenia was 13.4% and 14.9% in men and women, respectively. In men and women, the prevalence of sarcopenia was higher among those who had fallen. A logistic regression analysis using age, body fat, current drinker status, and physical inactivity for men, and age, body fat, smoking, and diabetes for women as covariate variables revealed that sarcopenia was significantly associated with a history of fall. The odds ratio for fall in the sarcopenia group relative to the normal group was 4.42 (95%CI 2.08-9.39) in men and 2.34 (95%CI 1.39-3.94) in women. This study revealed sarcopenia to be associated with falling in elderly Japanese. Sarcopenia prevention interventions may help prevent falls among elderly individuals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Vitamin D Levels Are Inversely Associated with Liver Fat Content and Risk of Non-Alcoholic Fatty Liver Disease in a Chinese Middle-Aged and Elderly Population: The Shanghai Changfeng Study.

PubMed

Wang, Dan; Lin, Huandong; Xia, Mingfeng; Aleteng, Qiqige; Li, Xiaoming; Ma, Hui; Pan, Baishen; Gao, Jian; Gao, Xin

2016-01-01

Vitamin D exerts metabolic activities. We investigated whether the 25-hydroxy vitamin D [25(OH)D] is associated with liver fat content (LFC) and non-alcoholic fatty liver disease (NAFLD) in a middle-aged, elderly Chinese population. A total of 2,960 participants (954 men and 2,006 women) aged over 45 years old were enrolled. Each participant underwent a standard interview, anthropometric measurements and laboratory examinations. Vitamin D deficiency and insufficiency was diagnosed when serum 25(OH) D level was < 50 and 50-75nmol/L. An ultrasound quantitative method was used to assess the LFC. Among the 2,960 participants, 1,982 (67.0%) subjects had vitamin D deficiency, 769 (26.0%) had vitamin D insufficiency, and 209 (7%) had normal vitamin D. Male subjects with vitamin D deficiency and insufficiency had significantly higher LFC than those with normal 25(OH)D (P = 0.034), while the LFC values showed no significant difference among the female subjects with vitamin D sufficiency, insufficiency and deficiency (P = 0.396). Univariate correlation analysis showed that 25(OH)D had a significantly negative association with LFC in men (r = -0.085, P = 0.009), but not in women. After adjusting for age, cigarette smoking, examination season, serum calcium, PTH and all possible confounders that displayed significant associations with LFC in univariate correlation analysis, serum 25(OH)D remained associated with LFC in middle-aged and elderly Chinese men. Serum 25(OH)D level was inversely associated with LFC in middle-aged and elderly Chinese men.

The influence of mechanical vibration on local and central balance control.

PubMed

Ehsani, Hossein; Mohler, Jane; Marlinski, Vladimir; Rashedi, Ehsan; Toosizadeh, Nima

2018-04-11

Fall prevention has an indispensable role in enhancing life expectancy and quality of life among older adults. The first step to prevent falls is to devise reliable methods to identify individuals at high fall risk. The purpose of the current study was to assess alterations in local postural muscle and central sensory balance control mechanisms due to low-frequency externally applied vibration among elders at high fall risk, in comparison with healthy controls, as a potential tool for assessing fall risk. Three groups of participants were recruited: healthy young (n = 10; age = 23 ± 2 years), healthy elders (n = 10; age = 73 ± 3 years), and elders at high fall risk (n = 10; age = 84 ± 9 years). Eyes-open and eyes-closed upright standing balance performance was measured with no vibration, 30 Hz, and 40 Hz vibration of Gastrocnemius muscles. When vibratory stimulation was applied, changes in local-control performance manifested significant differences among the groups (p < 0.01). On average between conditions, we observed 97% and 92% less change among high fall risk participants when compared to healthy young and older adults, respectively. On the other hand, vibration-induced changes in the central-control performance were not significant between groups (p ≥ 0.19). Results suggest that local-control deficits are responsible for balance behavior alterations among elders at high fall risk and healthy individuals. This observation may be attributable to deterioration of short-latency reflexive loop in elders at high fall risk. On the other hand, we could not ascribe the balance alterations to problems related to central nervous system performance or long-latency responses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Medical experimentation in the elderly.

PubMed

Bernstein, J E; Nelson, F K

1975-07-01

Participation in human experimental research constitutes a major problem for the geriatric subject. Because there is a high incidence of noncontagious disease in the elderly, they are the group most useful for the study of new therapeutic agents or procedures. However, normal aging processes, often coupled with disease of the central nervous system, render elderly persons less able to comprehend the nature and risks of such studies. These factors permit easy exploitation of geriatric subjects in medical experimentation, with possible exposure to a significant risk of serious drug reactions and unnecessary hospitalization. Recent federal regulations have given "special protections" to children, prisoners, and the mentally infirm in experimental research, to guard against abuse of their human rights. A basic requirement is that informed consent be carefully obtained and documented. Such "special protections" should now be extended to geriatric subjects so that there will be no further exploitation in the course of valid clinical research.

Adaptation to long-term prostate cancer survival: the perspective of elderly Asian/Pacific Islander wives.

PubMed

Ka'opua, Lana Sue I; Gotay, Carolyn C; Hannum, Meghan; Bunghanoy, Grace

2005-05-01

Increasingly evident is the important role of partners in patients' adaptation to diagnosis, treatment, and recovery. Yet, little is known about partners' adaptation when patients reach the benchmark known as long-term survival. This study describes elderly wives of prostate cancer survivors' perspectives of adaptation to the enduring challenges of prostate cancer survival and considers their experience in the context of ethnicity. Content analysis and grounded theory methods guided data collection and analysis of two waves of in-depth interviews with 26 elderly Asian/Pacific Islanders (Chinese, Filipino, Japanese, Native Hawaiian) living in Hawai'i. Continuous learning was the most common phenomenon as reflected in four types of adaptive work: involvement in husband's health, affirmation of the marital bond, normalization of adversity, and participation in personally meaningful acts. Issues are highlighted for consideration in developing culturally relevant, age-appropriate, and strengths-based interventions.

Physical function mitigates the adverse effects of being thin on mortality in a free-living older Taiwanese cohort.

PubMed

Lee, M-S; Chen, R C-Y; Chang, Y-H; Huang, Y-C; Wahlqvist, M L

2012-01-01

To examine the significance of underweight and physical function as well as their interaction on mortality in the aged. Prospective cohort. The Elderly Nutrition and Health Survey in Taiwan during 1999-2000. Total of 1435 representative free-living elders (739 men and 696 women). Body composition was assessed by various anthropometrics. Physical function score (PF, ranged 0-100) was derived from the SF-36(®). Death by December 31, 2006 was the outcome measure. After 7.9 (median: 7.0) years follow-up, 381 (223 men, 158 women) of 1435 eligible participants had died. Those with the lowest PF (<45) had 3.43 (hazards ratio (HR), 95% confidence interval (CI) = 2.20-5.36) times the all-cause mortality risk of the highest PF (≥58). Interactions for PF and BMI (P =0.02) and for PF and wrist circumference (P =0.09) on death were found after controlling for potential confounders. Jointly, compared to normal-BMI-highest-PF, the greatest HR for death occurred where BMI <18.5 kg/m2 was combined with the lowest-PF after covariate adjustments (HR = 8.67, 95% CI = 3.77-20.0). Similarly, the lowest arm muscle circumference (MAMC)-PF had a HR of 5.22 compared to mid-MAMC-highest-PF. However, percent and absolute body fat, estimated by bioelectrical impedance, was comparable to non-sarcopenic individuals. Thin elderly Taiwanese with sarcopenia, and less skeleton, are at the most risk of death, especially if physical function is limited.

Individualized Gaussian process-based prediction and detection of local and global gray matter abnormalities in elderly subjects.

PubMed

Ziegler, G; Ridgway, G R; Dahnke, R; Gaser, C

2014-08-15

Structural imaging based on MRI is an integral component of the clinical assessment of patients with potential dementia. We here propose an individualized Gaussian process-based inference scheme for clinical decision support in healthy and pathological aging elderly subjects using MRI. The approach aims at quantitative and transparent support for clinicians who aim to detect structural abnormalities in patients at risk of Alzheimer's disease or other types of dementia. Firstly, we introduce a generative model incorporating our knowledge about normative decline of local and global gray matter volume across the brain in elderly. By supposing smooth structural trajectories the models account for the general course of age-related structural decline as well as late-life accelerated loss. Considering healthy subjects' demography and global brain parameters as informative about normal brain aging variability affords individualized predictions in single cases. Using Gaussian process models as a normative reference, we predict new subjects' brain scans and quantify the local gray matter abnormalities in terms of Normative Probability Maps (NPM) and global z-scores. By integrating the observed expectation error and the predictive uncertainty, the local maps and global scores exploit the advantages of Bayesian inference for clinical decisions and provide a valuable extension of diagnostic information about pathological aging. We validate the approach in simulated data and real MRI data. We train the GP framework using 1238 healthy subjects with ages 18-94 years, and predict in 415 independent test subjects diagnosed as healthy controls, Mild Cognitive Impairment and Alzheimer's disease. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Individualized Gaussian process-based prediction and detection of local and global gray matter abnormalities in elderly subjects

PubMed Central

Ziegler, G.; Ridgway, G.R.; Dahnke, R.; Gaser, C.

2014-01-01

Structural imaging based on MRI is an integral component of the clinical assessment of patients with potential dementia. We here propose an individualized Gaussian process-based inference scheme for clinical decision support in healthy and pathological aging elderly subjects using MRI. The approach aims at quantitative and transparent support for clinicians who aim to detect structural abnormalities in patients at risk of Alzheimer's disease or other types of dementia. Firstly, we introduce a generative model incorporating our knowledge about normative decline of local and global gray matter volume across the brain in elderly. By supposing smooth structural trajectories the models account for the general course of age-related structural decline as well as late-life accelerated loss. Considering healthy subjects' demography and global brain parameters as informative about normal brain aging variability affords individualized predictions in single cases. Using Gaussian process models as a normative reference, we predict new subjects' brain scans and quantify the local gray matter abnormalities in terms of Normative Probability Maps (NPM) and global z-scores. By integrating the observed expectation error and the predictive uncertainty, the local maps and global scores exploit the advantages of Bayesian inference for clinical decisions and provide a valuable extension of diagnostic information about pathological aging. We validate the approach in simulated data and real MRI data. We train the GP framework using 1238 healthy subjects with ages 18–94 years, and predict in 415 independent test subjects diagnosed as healthy controls, Mild Cognitive Impairment and Alzheimer's disease. PMID:24742919

Type 2 diabetes mellitus is associated with increased risks of sarcopenia and pre-sarcopenia in Chinese elderly

PubMed Central

Wang, Taotao; Feng, Xiao; Zhou, Jingjing; Gong, Hongyan; Xia, Song; Wei, Qing; Hu, Xu; Tao, Ran; Li, Lei; Qian, Frank; Yu, Li

2016-01-01

Sarcopenia is a condition characterized by progressive and generalized loss of skeletal muscle mass and function. In this study, we used a cross-sectional study with 1090 community-dwelling Chinese citizens aged 60 years and older to evaluate the association of type 2 diabetes mellitus (T2DM) with the risk of sarcopenia and pre-sarcopenia. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) criteria that include both muscle mass and muscle function/physical activity. Pre-sarcopenia was defined as having low skeletal muscle index but with normal muscle/physical activity. The prevalence of sarcopenia and pre-sarcopenia was significantly higher in T2DM patients than in healthy controls (14.8% vs. 11.2%, p = 0.035 for sarcopenia, and 14.4% vs. 8.4%, p = 0.002 for pre-sarcopenia). In multivariate logistic regression analyses adjusting by age, gender, anti-diabetic medication, energy intake, protein intake, physical activity, and visceral fat area, we found that Chinese elderly with T2DM exhibited significantly increased risks of sarcopenia (OR = 1.37, 95% CI = 1.02–2.03) and pre-sarcopenia (OR = 1.73, 95% CI = 1.10–2.83) compared to non-diabetic individuals. This is the first study to evaluate the association of T2DM with the risks of sarcopenia and pre-sarcopenia in China. Among a group of community-dwelling Chinese elderly, T2DM was significantly associated with increased risks of sarcopenia and pre-sarcopenia. PMID:27958337

Type 2 diabetes mellitus is associated with increased risks of sarcopenia and pre-sarcopenia in Chinese elderly.

PubMed

Wang, Taotao; Feng, Xiao; Zhou, Jingjing; Gong, Hongyan; Xia, Song; Wei, Qing; Hu, Xu; Tao, Ran; Li, Lei; Qian, Frank; Yu, Li

2016-12-13

Sarcopenia is a condition characterized by progressive and generalized loss of skeletal muscle mass and function. In this study, we used a cross-sectional study with 1090 community-dwelling Chinese citizens aged 60 years and older to evaluate the association of type 2 diabetes mellitus (T2DM) with the risk of sarcopenia and pre-sarcopenia. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) criteria that include both muscle mass and muscle function/physical activity. Pre-sarcopenia was defined as having low skeletal muscle index but with normal muscle/physical activity. The prevalence of sarcopenia and pre-sarcopenia was significantly higher in T2DM patients than in healthy controls (14.8% vs. 11.2%, p = 0.035 for sarcopenia, and 14.4% vs. 8.4%, p = 0.002 for pre-sarcopenia). In multivariate logistic regression analyses adjusting by age, gender, anti-diabetic medication, energy intake, protein intake, physical activity, and visceral fat area, we found that Chinese elderly with T2DM exhibited significantly increased risks of sarcopenia (OR = 1.37, 95% CI = 1.02-2.03) and pre-sarcopenia (OR = 1.73, 95% CI = 1.10-2.83) compared to non-diabetic individuals. This is the first study to evaluate the association of T2DM with the risks of sarcopenia and pre-sarcopenia in China. Among a group of community-dwelling Chinese elderly, T2DM was significantly associated with increased risks of sarcopenia and pre-sarcopenia.

Automatic determination of white matter hyperintensity properties in relation to the development of Alzheimer's disease

NASA Astrophysics Data System (ADS)

van der Velden, Sandra; Moenninghoff, Christoph; Wanke, Isabel; Jokisch, Martha; Weimar, Christian; Lopes Simoes, Rita; van Cappellen van Walsum, Anne-Marie; Slump, Cornelis

2016-03-01

Alzheimer's disease (AD) is the most common form of dementia seen in the elderly. No curing medicine for AD exists at this moment. In the search for an effective medicine, research is directed towards the prediction of conversion of mild cognitive impairment (MCI) to AD. White matter hyperintensities (WMHs) have been shown to contain information regarding the development of AD, although non-conclusive results are found in literature. These studies often use qualitative measures to describe WMHs, which is time consuming and prone to variability. To investigate the relation between WMHs and the development of AD, algorithms to automatically determine quantitative properties in terms of volume and spatial distribution of WMHs are developed and compared between normal controls and MCI subjects. MCI subjects have a significantly higher total volume of WMHs than normal controls. This difference persists when lesions are classified according to their distance to the ventricular wall. Spatial distribution is also described by defining different brain regions based on a common coordinate system. This reveals that MCI subjects have a larger WMH volume in the upper part of the brain compared to normal controls. In four subjects, the change of WMH properties over time is studied in detail. Although such a small dataset cannot be used to give definitive conclusions, the data suggests that progression of WMHs in subjects with a low lesion load is caused by an increase in the number of lesions and by the progression of juxtacortical lesions. In subjects with a larger lesion load, progression is caused by expansion of pre-existing lesions.

The strategic framework of tuberculosis control and prevention in the elderly: a scoping review towards End TB targets.

PubMed

Li, Jun; Chung, Pui-Hong; Leung, Cyrus L K; Nishikiori, Nobuyuki; Chan, Emily Y Y; Yeoh, Eng-Kiong

2017-06-01

With the rapid pace of population ageing, tuberculosis (TB) in the elderly increasingly becomes a public health challenge. Despite the increasing burden and high risks for TB in the elderly, targeted strategy has not been well understood and evaluated. We undertook a scoping review to identify current TB strategies, research and policy gaps in the elderly and summarized the results within a strategic framework towards End TB targets. Databases of Embase, MEDLINE, Global health and EBM reviews were searched for original studies, review articles, and policy papers published in English between January 1990 and December 2015. Articles examining TB strategy, program, guideline or intervention in the elderly from public health perspective were included.Nineteen articles met the inclusion criteria. Most of them were qualitative studies, issued in high- and middle-income countries and after 2000. To break the chain of TB transmission and reactivation in the elderly, infection control, interventions of avoiding delay in diagnosis and containment are essential for preventing transmission, especially in elderly institutions and aged immigrants; screening of latent TB infection and preventive therapy had effective impacts on reducing the risk of reactivation and should be used less reluctantly in older people; optimizing early case-finding with a high index of suspicion, systematic screening for prioritized high-risk groups, initial empirical and adequate follow-up treatment with close monitoring and evaluation, as well as enhanced programmatic management are fundamental pillars for active TB elimination. Evaluation of TB epidemiology, risk factors, impacts and cost-effectiveness of interventions, adopting accurate and rapid diagnostic tools, shorter and less toxic preventive therapy, are critical issues for developing strategy in the elderly towards End TB targets.TB control strategies in the elderly were comprehensively mapped in a causal link pathway. The framework and principals identified in this study will help to evaluate and improve current program, develop targeted strategy, as well as raise more discussions on the research priority settings and policy transitions. Given the scarceness of policy and evaluated interventions, as well as the unawareness of shifting TB epidemiology and strategy especially in developing countries, the increasing need of a ready TB program for the elderly warrants further research.

Improvement in muscle performance after one-year cessation of low-magnitude high-frequency vibration in community elderly.

PubMed

Cheung, W-H; Li, C-Y; Zhu, T Y; Leung, K-S

2016-03-01

To investigate the effects on muscle performance after one-year cessation of 18-month low-magnitude high-frequency vibration (LMHFV) intervention in the untrained community elderly. This is a case-control study with 59 community elderly women (25 control without any treatment; 34 received 18-month LMHFV but discontinued for 1 year from our previous clinical study). Muscle strength, balancing ability, occurrence of fall/fracture, quality of life (QoL) were assessed 1-year after cessation of intervention. The 30-month results were compared with baseline and 18-month treatment endpoint data between groups. At 30 months (i.e. one year post-intervention), the muscle strengths of dominant and non-dominant legs relative to baseline in treatment group were significantly better than those of control. In balancing ability test, reaction time, movement velocity and maximum excursion of treatment group (relative to baseline) remained significantly better than the control group. The muscle strength, balancing ability and quality of life at 30 months relative to 18 months did not show significant differences between the two groups. The benefits of LMHFV for balancing ability, muscle strength and risk of falling in elderly were retained 1 year after cessation of LMHFV.

[The effects of foot reflexion massage on sleep disturbance, depression disorder, and the physiological index of the elderly].

PubMed

Song, Rye-Hun; Kim, Do-Hwan

2006-02-01

This study was to examine the effects of foot reflexion massage on sleep disturbance, depression disorder, and the physiological index of the elderly in nursing homes. The research design was a non-equivalent control group pretest-posttest quasi-experimental study. The subjects in this study were 50 elderly people who resided in two different nursing homes in the same region. An experimental group and a control group were organized with 25 subjects respectively, and foot reflexion massage was provided for 12 sessions, 30 minutes per session. The selected dependent variables were sleep disturbance, depression disorder, and physiological indices(blood plasma serotonin, serum cortisol), which were all measured before and after foot reflexion massage was offered. Data analysis included chi2-test, t-test, paired t-test, and ANCOVA, using the SPSS program package. 1. The experimental group improved sleep quality more than the control group. 2. The experimental group had less depression disorder than the control group. 3. The experimental group had higher serotonin levels than the control group. It's necessary to give foot reflexion massage as a successful nursing intervention to elderly who undergo a change in sleep, and suffer from a depression disorder due to a deterioration in sleep.

Seizures in the elderly: Impact on mental status, mood and sleep

PubMed Central

Haut, Sheryl R.; Katz, Mindy; Masur, Jonathan; Lipton, Richard B.

2009-01-01

Co-morbidities of epilepsy have not been well explored in the elderly. Herein, we examined mental status, mood, and sleep in elderly patients with epilepsy, compared to age and gender matched community controls without epilepsy from the Einstein Aging Study. Testing included a mental status test, the Blessed Information Memory and Concentration (BIMC) test; Prime-MD Patient Health Questionnaire (PHQ) Depression and Anxiety Modules; and Medical Outcomes Study Sleep Scale. Persons with epilepsy (n=31) had higher mean BIMC scores than controls (n=31, BIMC 6.3 vs.1.2; p<0.0001). Mean PHQ Depression scores were higher for cases than controls indicating more depressive symptoms (4.2 vs. 0.8; p=0.006); six cases (18%) and no controls met screening criteria for depression. Mean PHQ Anxiety scores were also higher for cases than controls (3.7 vs. 0.0; p=0.001). Cases demonstrated poorer sleep scores in the categories of somnolence (p=0.009) and shortness of breath/headache (p=0.021). Thus, co-morbidities of epilepsy in this elderly population included decreased mental status, a higher prevalence of depression and anxiety, and poorer sleep health when compared to age mates without epilepsy. Mental status impairment was not related to anti-epileptic medication or mood disturbance. Further investigation will explore these associations prospectively. PMID:19189862

Association of blood glucose level and hypertension in Elderly Chinese Subjects: a community based study.

PubMed

Yan, Qun; Sun, Dongmei; Li, Xu; Chen, Guoliang; Zheng, Qinghu; Li, Lun; Gu, Chenhong; Feng, Bo

2016-07-13

There is a scarcity of epidemiological researches examining the relationship between blood pressure (BP) and glucose level among older adults. The objective of the current study was to investigate the association of high BP and glucose level in elderly Chinese. A cross-sectional study of a population of 2092 Chinese individuals aged over 65 years was conducted. Multiple logistic analysis was used to explore the association between hypertension and hyperglycemia. Independent risk factors for systolic and diastolic BP were analyzed using stepwise linear regression. Subjects in impaired fasting glucose group (IFG) (n = 144) and diabetes (n = 346), as compared with normal fasting glucose (NFG) (n = 1277), had a significant higher risk for hypertension, with odds ratios (ORs) of 1.81 (95 % CI, 1.39-2.35) (P = 0.000) and 1.40 (95 % CI, 1.09-1.80) (P = 0.009), respectively. Higher fasting plasma glucose (FPG) levels in the normal range were still significantly associated with a higher prevalence of hypertension in both genders, with ORs of 1.24 (95 % CI, 0.85-1.80), R (2) = 0.114, P = 0.023 in men and 1.61 (95 % CI, 1.12-2.30), R (2) = 0.082, P = 0.010 in women, respectively, when compared with lower FPG. Linear regression analysis revealed FPG was an independent factor of systolic and diastolic BP. Our findings suggest that hyperglycemia as well as higher FPG within the normal range is associated with a higher prevalence of hypertension independent of other cardiovascular risk factors in elderly Chinese. Further studies are needed to explore the relationship between hyperglycemia and hypertension in a longitudinal setting.

Cortical Amyloid Beta in Cognitively Normal Elderly Adults is Associated with Decreased Network Efficiency within the Cerebro-Cerebellar System

PubMed Central

Steininger, Stefanie C.; Liu, Xinyang; Gietl, Anton; Wyss, Michael; Schreiner, Simon; Gruber, Esmeralda; Treyer, Valerie; Kälin, Andrea; Leh, Sandra; Buck, Alfred; Nitsch, Roger M.; Prüssmann, Klaas P.; Hock, Christoph; Unschuld, Paul G.

2014-01-01

Background: Deposition of cortical amyloid beta (Aβ) is a correlate of aging and a risk factor for Alzheimer disease (AD). While several higher order cognitive processes involve functional interactions between cortex and cerebellum, this study aims to investigate effects of cortical Aβ deposition on coupling within the cerebro-cerebellar system. Methods: We included 15 healthy elderly subjects with normal cognitive performance as assessed by neuropsychological testing. Cortical Aβ was quantified using (11)carbon-labeled Pittsburgh compound B positron-emission-tomography late frame signals. Volumes of brain structures were assessed by applying an automated parcelation algorithm to three dimensional magnetization-prepared rapid gradient-echo T1-weighted images. Basal functional network activity within the cerebro-cerebellar system was assessed using blood-oxygen-level dependent resting state functional magnetic resonance imaging at the high field strength of 7 T for measuring coupling between cerebellar seeds and cerebral gray matter. A bivariate regression approach was applied for identification of brain regions with significant effects of individual cortical Aβ load on coupling. Results: Consistent with earlier reports, a significant degree of positive and negative coupling could be observed between cerebellar seeds and cerebral voxels. Significant positive effects of cortical Aβ load on cerebro-cerebellar coupling resulted for cerebral brain regions located in inferior temporal lobe, prefrontal cortex, hippocampus, parahippocampal gyrus, and thalamus. Conclusion: Our findings indicate that brain amyloidosis in cognitively normal elderly subjects is associated with decreased network efficiency within the cerebro-cerebellar system. While the identified cerebral regions are consistent with established patterns of increased sensitivity for Aβ-associated neurodegeneration, additional studies are needed to elucidate the relationship between dysfunction of the cerebro-cerebellar system and risk for AD. PMID:24672483

Cortical Amyloid Beta in Cognitively Normal Elderly Adults is Associated with Decreased Network Efficiency within the Cerebro-Cerebellar System.

PubMed

Steininger, Stefanie C; Liu, Xinyang; Gietl, Anton; Wyss, Michael; Schreiner, Simon; Gruber, Esmeralda; Treyer, Valerie; Kälin, Andrea; Leh, Sandra; Buck, Alfred; Nitsch, Roger M; Prüssmann, Klaas P; Hock, Christoph; Unschuld, Paul G

2014-01-01

Deposition of cortical amyloid beta (Aβ) is a correlate of aging and a risk factor for Alzheimer disease (AD). While several higher order cognitive processes involve functional interactions between cortex and cerebellum, this study aims to investigate effects of cortical Aβ deposition on coupling within the cerebro-cerebellar system. We included 15 healthy elderly subjects with normal cognitive performance as assessed by neuropsychological testing. Cortical Aβ was quantified using (11)carbon-labeled Pittsburgh compound B positron-emission-tomography late frame signals. Volumes of brain structures were assessed by applying an automated parcelation algorithm to three dimensional magnetization-prepared rapid gradient-echo T1-weighted images. Basal functional network activity within the cerebro-cerebellar system was assessed using blood-oxygen-level dependent resting state functional magnetic resonance imaging at the high field strength of 7 T for measuring coupling between cerebellar seeds and cerebral gray matter. A bivariate regression approach was applied for identification of brain regions with significant effects of individual cortical Aβ load on coupling. Consistent with earlier reports, a significant degree of positive and negative coupling could be observed between cerebellar seeds and cerebral voxels. Significant positive effects of cortical Aβ load on cerebro-cerebellar coupling resulted for cerebral brain regions located in inferior temporal lobe, prefrontal cortex, hippocampus, parahippocampal gyrus, and thalamus. Our findings indicate that brain amyloidosis in cognitively normal elderly subjects is associated with decreased network efficiency within the cerebro-cerebellar system. While the identified cerebral regions are consistent with established patterns of increased sensitivity for Aβ-associated neurodegeneration, additional studies are needed to elucidate the relationship between dysfunction of the cerebro-cerebellar system and risk for AD.

Improved Prefrontal Activity and Chewing Performance as Function of Wearing Denture in Partially Edentulous Elderly Individuals: Functional Near-Infrared Spectroscopy Study

PubMed Central

Kamiya, Kazunobu; Narita, Noriyuki; Iwaki, Sunao

2016-01-01

The purpose of this study was to elucidate the effects of wearing a denture on prefrontal activity during chewing performance. We specifically examined that activity in 12 elderly edentulous subjects [63.1±6.1 years old (mean ± SD)] and 12 young healthy controls (22.1±2.3 years old) using functional near-infrared spectroscopy (fNIRS) in order to evaluate the quality of prefrontal functionality during chewing performance under the conditions of wearing a denture and tooth loss, and then compared the findings with those of young healthy controls. fNIRS and electromyography were used simultaneously to detect prefrontal and masticatory muscle activities during chewing, while occlusal force and masticatory score were also examined by use of a food intake questionnaire. A significant increase in prefrontal activity was observed during chewing while wearing a denture, which was accompanied by increased masticatory muscle activity, occlusal force, and masticatory score, as compared with the tooth loss condition. Prefrontal activation during chewing while wearing a denture in the elderly subjects was not much different from that in the young controls. In contrast, tooth loss in the elderly group resulted in marked prefrontal deactivation, accompanied by decreased masticatory muscle activity, occlusal force, and masticatory score, as compared with the young controls. We concluded that intrinsic prefrontal activation during chewing with a denture may prevent prefrontal depression induced by tooth loss in elderly edentulous patients. PMID:27362255

The prevention of hip fracture with risedronate and ergocalciferol plus calcium supplementation in elderly women with Alzheimer disease: a randomized controlled trial.

PubMed

Sato, Yoshihiro; Kanoko, Tomohiro; Satoh, Kei; Iwamoto, Jun

A high incidence of fractures, particularly of the hip, represents an important problem in patients with Alzheimer disease (AD), who are prone to falls and have osteoporosis. We previously found that deficiency of 25-hydroxyvitamin D and compensatory hyperparathyroidism cause reduced bone mineral density in female patients with AD. We address the possibility that treatment with risedronate sodium and ergocalciferol plus calcium supplementation may reduce the incidence of nonvertebral fractures in elderly women with AD. A total of 500 elderly women with AD were randomly assigned to daily treatment with 2.5 mg of risedronate sodium or a placebo, combined with 1000 IU of ergocalciferol and 1200 mg of elementary calcium, and followed up for 18 months. At baseline, patients of both groups showed 25-hydroxyvitamin D deficiency with compensatory hyperparathyroidism. During the study period, bone mineral density in the risedronate group increased by 4.1% and decreased by 0.9% in the control group. Vertebral fractures occurred in 29 patients (24 hip fractures) in the control group and 8 patients (5 hip fractures) in the risedronate group. The relative risk in the risedronate group compared with the control group was 0.28 (95% confidence interval, 0.13-0.59). Elderly patients with AD hypovitaminosis D are at increased risk for hip fracture. Treatment with risedronate and ergocalciferol may be safe and effective in reducing the risk of a fracture in elderly patients with AD.

Serum interleukin-6 is related to lower cognitive functioning in elderly patients with major depression.

PubMed

Ali, Nehad Samir; Hashem, Abdel Hamid Hashem; Hassan, Akmal Mostafa; Saleh, Alia Adel; El-Baz, Heba Nabil

2018-05-01

There is an increased evidence of an association between inflammatory mediators, particularly serum IL-6, depression and cognitive impairment in the elderly. This study aims at exploring the relation of peripheral IL-6 to cognitive functions in elderly patients with major depressive disorder (MDD). (1) Assessment of serum IL-6 levels and cognitive functions in elderly patients suffering from major depression and comparing them to healthy age-matched control subjects; (2) correlation between serum IL-6 levels and clinical characteristics of depression and cognitive functions in these patients. The study is an observational, case-control study. It consisted of 80 subjects, 40 with the diagnosis of MDD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) with early onset (first episode before the age of 60) and 40 community-dwelling subjects. They were subjected to the Structured Clinical Interview according to DSM-IV, Montreal Cognitive Assessment, Montgomery Asberg Depression Rating Scale, and serum IL-6 assay using ELISA. In the depression group, subjects had lower scores in cognitive testing, than the control group (p = 0.001). Serum IL-6 was found to have a negative correlation with cognitive testing in these patients even after controlling for the severity of depressive status and Body Mass Index (BMI) (p = 0.025). MDD in elderly subjects is associated with decline in cognitive functions that may be related to peripheral IL-6 levels.

Healthy habits: what kind of guidance the elderly population is receiving from health professionals?

PubMed

Flores, Thaynã Ramos; Nunes, Bruno Pereira; Assunção, Maria Cecília Formoso; Bertoldi, Andréa Dâmaso

2016-03-01

To describe the prevalence of guidance on healthy habits received from health professionals by elderly and its relation to socioeconomic demographic, behavioral and health indicators, and the type of services. Cross sectional population based study including individuals aged 60 years or more in the urban area of Pelotas, Rio Grande do Sul, Brazil. Seven guidance on healthy habits were evaluated: weight control, reduction in salt, sugar and fat intake, physical activity practice, not smoking and not drinking alcohol. Among the 1,451 elderly interviewed, 1,281 (88.3%) consulted in the last year. The orientations more refereed were to fat (61.7%) and salt (61.5%) intake reduction and physical activity (58.2%). Elderly who consulted three times or more and in services financed by the Unified Health System received more guidance. Those elderly from the socioeconomic classes A/B were more likely to receive guidance for weight control (RP = 1.27; 95%CI 1.06 - 1.70) and physical activity (RP = 1.34; 95%CI 1.06 - 1.69). The orientation from health professionals were uncommon and, in some cases, unfocused.

Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly

PubMed Central

Ferreira, Cristiane Batisti; Teixeira, Pâmela dos Santos; Alves dos Santos, Geiane; Dantas Maya, Athila Teles; Americano do Brasil, Paula; Souza, Vinícius Carolino; Córdova, Cláudio; Lima, Ricardo Moreno; Nóbrega, Otávio de Toledo

2018-01-01

With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted. PMID:29593907

Influence of Pause Duration and Nod Response Timing in Dialogue between Human and Communication Robot

NASA Astrophysics Data System (ADS)

Takasugi, Shoji; Yoshida, Shohei; Okitsu, Kengo; Yokoyama, Masanori; Yamamoto, Tomohito; Miyake, Yoshihiro

The purpose of this study is to clarify the influence from timing of utterance and body motion in dialogue between human and robot. We controlled pause duration and nod response timing in robot-side, and analyzed impression of communication in human-side by using Scheffe's Paired Comparison method. The results revealed that the impression of communication significantly modified by changing the pause duration and nod response timing. And, timing pattern of the impression altered diversely in elderly people than in younger, indicating that elderly generation uses various timing control mechanisms. From these results, it was suggested that timing control and impression of communication are mutually influenced, and this mechanism is thought to be useful to realize human-robot communication system for elderly generation.

The relationship of subepidermal moisture and early stage pressure injury by visual skin assessment.

PubMed

Kim, Chul-Gyu; Park, Seungmi; Ko, Ji Woon; Jo, Sungho

2018-05-08

The purpose of this study was to examine the relationship of subepidermal moisture and early stage pressure injury by visual skin assessment in elderly Korean. Twenty-nine elderly participated at a particular nursing home. Data were collected for 12 weeks by one wound care nurse. Visual skin assessment and subepidermal moisture value were measured at both buttocks, both ischia, both trochanters, sacrum, and coccyx of each subject once a week. Subepidermal moisture value of stage 1 pressure injury was significantly higher than that of no injury and blanching erythema. After adjustment with covariates, odds ratios of blanching erythema to normal skin and stage 1 pressure injury to blanching erythema/normal skin were statistically significant (p < 0.05). Odds ratio of blanching erythema to normal skin was 1.003 (p = .047) by 1-week prior subepidermal moisture value, and that of concurrent subepidermal moisture value was 1.004 (p = .011). Odds ratio of stage 1 pressure injury to normal skin/blanching erythema was 1.003 (p = .005) by 1-week prior subepidermal moisture value, and that for concurrent subepidermal moisture value was 1.007 (p = .030). Subepidermal moisture was associated with concurrent and future (1 week later) skin damage at both trochanters. Subepidermal moisture would be used to predict early skin damage in clinical nursing field for the effective pressure injury prevention. Copyright © 2018. Published by Elsevier Ltd.

The Effects of Delirium Prevention Guidelines on Elderly Stroke Patients.

PubMed

Song, Jihye; Lee, Minkyung; Jung, Dukyoo

2017-07-01

This study aimed to evaluate the effectiveness of the delirium prevention interventions recommended by the Delirium Prevention Guidelines for Elderly Stroke Patients (DPGESP). The DPGESP comprises nine dimensions with 28 interventions, including risk factor assessment, orientation disorder prevention, sleeping pattern maintenance, sensory interventions, constipation, dehydration, hypoxia and infection prevention, pain management, and appropriate nutrition maintenance. This quasi-experimental study used a nonequivalent control group and a pretest-posttest design. The experimental and control groups each included 54 patients, and the participants were elderly patients who were admitted to the stroke unit. The study outcomes were the delirium incidence and severity, stroke impact, and length of hospitalization. Posttest values for delirium incidence, severity, stroke impact, and length of hospitalization were significantly improved in the experimental group. Implementation of the DPGESP had beneficial effects on the delirium incidence and severity, stroke impact, and length of hospitalization among elderly patients admitted to a stroke unit.

Causal inference as an emerging statistical approach in neurology: an example for epilepsy in the elderly.

PubMed

Moura, Lidia Mvr; Westover, M Brandon; Kwasnik, David; Cole, Andrew J; Hsu, John

2017-01-01

The elderly population faces an increasing number of cases of chronic neurological conditions, such as epilepsy and Alzheimer's disease. Because the elderly with epilepsy are commonly excluded from randomized controlled clinical trials, there are few rigorous studies to guide clinical practice. When the elderly are eligible for trials, they either rarely participate or frequently have poor adherence to therapy, thus limiting both generalizability and validity. In contrast, large observational data sets are increasingly available, but are susceptible to bias when using common analytic approaches. Recent developments in causal inference-analytic approaches also introduce the possibility of emulating randomized controlled trials to yield valid estimates. We provide a practical example of the application of the principles of causal inference to a large observational data set of patients with epilepsy. This review also provides a framework for comparative-effectiveness research in chronic neurological conditions.

Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement: A randomized controlled trial.

PubMed

Macpherson, Helen; Ellis, Kathryn A; Sali, Avni; Pipingas, Andrew

2012-03-01

There is potential for multivitamin supplementation to improve cognition in the elderly. This randomized, double-blind, placebo-controlled trial was conducted to investigate the effects of 16 weeks multivitamin supplementation (Swisse Women's 50+ Ultivite ®) on cognition in elderly women. Participants in this study were 56 community dwelling, elderly women, with subjective complaints of memory loss. Cognition was assessed using a computerized battery of memory and attention tasks designed to be sensitive to age-related declines to fluid intelligence, and a measure of verbal recall. Biochemical measures of selected nutrients, homocysteine, markers of inflammation, oxidative stress, and blood safety parameters were also collected. All cognitive and haematological parameters were assessed at baseline and 16 weeks post-treatment. The multivitamin improved speed of response on a measure of spatial working memory, however benefits to other cognitive processes were not observed. Multivitamin supplementation decreased levels of homocysteine and increased levels of vitamin B(6) and B(12), with a trend for vitamin E to increase. There were no hepatotoxic effects of the multivitamin formula indicating this supplement was safe for everyday usage in the elderly. Sixteen weeks ssupplementation with a combined multivitamin, mineral and herbal formula may benefit working memory in elderly women at risk of cognitive decline.

The effects of celery leaf (apium graveolens L.) treatment on blood glucose and insulin levels in elderly pre-diabetics

PubMed Central

Yusni, Yusni; Zufry, Hendra; Meutia, Firdalena; Sucipto, Krishna W.

2018-01-01

Objectives: To analyze the effect of celery leaf extract on blood glucose and plasma insulin levels in elderly pre-diabetics. Methods: This study was conducted between March and November 2014 at the Faculty of Medicine, Syiah Kuala University, Banda Aceh, Indonesia. A quasi-experimental pretest-posttest with a control group was conducted with elderly pre-diabetic volunteers. The subjects included 16 elderly pre-diabetics older than 60 (6 males and 10 females). The subjects were randomly divided into 2 groups: a control group (placebo-treated) and a treatment group (celery-treated). The treatment consisted of celery leaf extract capsules at the dose of 250 mg, 3 times per day (morning, afternoon and evening), 30 minutes before a meal, for 12 days. Data analysis was performed using the t-test (p<0.05). Results: There was a significant decrease in pre-prandial plasma glucose levels (p=0.01) and post-prandial plasma glucose levels (p=0.00), but no significant increase in plasma insulin levels (p=0.15) after celery leaf treatment in elderly pre-diabetics. Conclusion: Celery was effective at reducing blood glucose levels, but there was a lack of association between blood glucose levels and plasma insulin levels in elderly pre-diabetics. PMID:29436564

Integration of RFID and web service for assisted living.

PubMed

Unluturk, Mehmet S; Kurtel, Kaan

2012-08-01

The number of people over 65 years old throughout most stable and prosperous countries in the world is increasing. Availability of their care in their own homes is imperative because of the economic reasons and their choices where to live (World Health Organization, Definition of an older or elderly person. http://www.who.int/healthinfo/survey/ageingdefnolder/en/ ; EQUIP-European Framework for Qualifications in Home Care Services for Older People, http://www.equip-project.com ; Salonen, 2009). "Recent advancement in wireless communications and electronics has enabled the development of low-cost sensor networks. The sensor networks can be utilized in various application areas." (Akyildiz, et al. 2002) These two statements show that there is a great promise in wireless technology and utilizing it in assisted living might be very beneficial to the elderly people. In this paper, we propose software architecture called Location Windows Service (LWS) which integrates the Radio Frequency Identification (RFID) technology and the web service to build an assisted living system for elderly people at home. This architecture monitors the location of elderly people without interfering in their daily activities. Location information messages that are generated as the elderly move from room to room indicate that the elderly person is fit and healthy and going about their normal life. The communication must be timely enough to follow elderly people as they move from room to room without missing a location. Unacknowledged publishing, subscription filtering and short location change messages are also included in this software model to reduce the network traffic in large homes. We propose some defense schemes being applied to the network environment of the assisted living system to prevent any external attacks.

Salivary flow rate and periodontal infection - a study among subjects aged 75 years or older.

PubMed

Syrjälä, A-M H; Raatikainen, L; Komulainen, K; Knuuttila, M; Ruoppi, P; Hartikainen, S; Sulkava, R; Ylöstalo, P

2011-05-01

To analyse the relation of stimulated and unstimulated salivary flow rates to periodontal infection in home-dwelling elderly people aged 75 years or older. This study was based on a subpopulation of 157 (111 women, 46 men) home-dwelling, dentate, non-smoking elderly people (mean age 79.8, SD 3.6 years) from the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly Study). The data were collected by interview and oral clinical examination. Persons with very low (< 0.7 ml min⁻¹) and low stimulated salivary flow rates (0.7- < 1.0 ml min⁻¹) had a decreased likelihood of having teeth with deepened (≥ 4 mm) periodontal pockets, RR: 0.7, CI: 0.5-0.9 and RR: 0.7, CI: 0.5-0.9, respectively, when compared with those with normal stimulated salivary flow. Persons with a very low unstimulated salivary flow rate (< 0.1 ml min⁻¹) had a decreased likelihood of having teeth with deepened (≥ 4 mm) periodontal pockets, RR 0.8, CI: 0.6-1.0, when compared with subjects with low/normal unstimulated salivary flow. In a population of dentate, home-dwelling non-smokers, aged 75 years or older, low stimulated and unstimulated salivary flow rates were weakly associated with a decreased likelihood of having teeth with deep periodontal pockets. © 2010 John Wiley & Sons A/S.

Social Breakdown and Competence. A Model of Normal Aging

ERIC Educational Resources Information Center

Kuypers, J. A.; Bengtson, V. L.

1973-01-01

Presents a model emphasizing the interactions between reorganization of social systems and individual competencies in old age. The model suggests the process by which loss of coping abilities and feelings of worthlessness develop. Implications for effective intervention with the elderly are discussed. (DP)

Dysphagia in the elderly.

PubMed Central

Paterson, W. G.

1996-01-01

OBJECTIVE: To review the problem of dysphagia in the elderly so that primary care physicians are better able to recognize and manage it. QUALITY OF EVIDENCE: Dysphagia, a prevalent problem in the elderly, causes significant morbidity and even mortality. Age-related deterioration of the oropharyngeal phase of swallowing is well documented. Diagnosis and treatment of dysphagia in the elderly is based mainly on clinical experience with large groups of patients. Few controlled clinical trials have been conducted. MAIN FINDINGS: Oropharyngeal dysphagia in the elderly is often due to irreversible neuromuscular disease. These patients benefit from swallowing therapy performed by speech pathologists. Esophageal causes of dysphagia are similar in the elderly and young patients, and the approach to treatment is also similar, although noninvasive forms of therapy play a larger role for elderly patients. CONCLUSIONS: Dysphagia is a common problem that lowers quality of life for the elderly. Primary care physicians must be aware of causes of dysphagia for which specific treatments are available, as well as of the role of nonspecific treatments offered by ancillary health professionals. Images p928-a p930-a PMID:8688695

Dietary intake of antioxidants and fats in the context of coronary heart disease prevention among elderly people.

PubMed

Kolarzyk, Emilia; Skop-Lewandowska, Agata; Jaworska, Jagoda; Ostachowska-Gąsior, Agnieszka; Krzeszowska-Rosiek, Teresa

2018-03-14

Some literature data indicate that the proper intake of exogenic antioxidants from food and the proper intake of fats can offer significant protection against coronary heart disease. The estimation of total antioxidant capacity of food intake on the basis of Dietary Antioxidant Index (DAI), together with an assessment of the contribution of particular food products in DAI, and the evaluation of consumption of all dietary fats and frequency of consumption of products that are a source of fats among elderly people in Krakow, Poland. 143 persons (73 women and 70 men) aged 65-80 were studied. None of them was under specialist medical control, including cardiological control. DAI was investigated on the basis of the Food Frequency Questionnaire (FFQ) which included 145 food items. DAI was measured using the method by Benzi and expressed as FRAP (the ability to reduce Fe³⁺ to Fe²⁺, measured in mMol/l). The daily intake of fats was estimated using the 24-h nutritional recall. The frequency of fats consumption was estimated with the usage of FFQ. For statistical analysis, χ2 test was used. The mean value of DAI of all studied persons was 34.27 + 11.72 mMol/l. The largest percentage of those studied had FRAP values in the range 25-35 mMol/l. The highest contribution in the total DAI value was found in fruit (36.2%), grains and cereal-based products (23.6%), and beverages (24.0%). The consumption of vegetables was on the fourth position (7.1%). The contribution of the remaining food products was low. The consumption of total fats (about 70g/24h) and saturated fatty acids (14% of energetic value) exceeded the recommendations. The participation of mono-and polyunsaturated fatty acids in the diets was not in accordance with recommendations. The most frequently consumed fats were animal fats (sausages, butter) and cakes, but the consumption of vegetable oils, fish, nuts and seeds of oil plants was too low. The majority of elderly people made mistakes in their nutrition. The enrichment in natural antioxidants of the diets of elderly people and the normalization of their fats consumption should become an important element of primary and secondary prophylaxis of cardiovascular diseases.

[Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people].

PubMed

Bae, Jeongyee; Cho, Seong Il

2014-12-01

The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program. Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

An adapted mindfulness-based stress reduction program for elders in a continuing care retirement community: quantitative and qualitative results from a pilot randomized controlled trial.

PubMed

Moss, Aleezé S; Reibel, Diane K; Greeson, Jeffrey M; Thapar, Anjali; Bubb, Rebecca; Salmon, Jacqueline; Newberg, Andrew B

2015-06-01

The purpose of this study was to test the feasibility and effectiveness of an adapted 8-week Mindfulness-Based Stress Reduction (MBSR) program for elders in a continuing care community. This mixed-methods study used both quantitative and qualitative measures. A randomized waitlist control design was used for the quantitative aspect of the study. Thirty-nine elderly were randomized to MBSR (n = 20) or a waitlist control group (n = 19), mean age was 82 years. Both groups completed pre-post measures of health-related quality of life, acceptance and psychological flexibility, facets of mindfulness, self-compassion, and psychological distress. A subset of MBSR participants completed qualitative interviews. MBSR participants showed significantly greater improvement in acceptance and psychological flexibility and in role limitations due to physical health. In the qualitative interviews, MBSR participants reported increased awareness, less judgment, and greater self-compassion. Study results demonstrate the feasibility and potential effectiveness of an adapted MBSR program in promoting mind-body health for elders. © The Author(s) 2014.

Detached mindfulness reduced both depression and anxiety in elderly women with major depressive disorders.

PubMed

Ahmadpanah, Mohammad; Akbari, Tayebe; Akhondi, Amineh; Haghighi, Mohammad; Jahangard, Leila; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Brand, Serge

2017-11-01

We investigated the influence of detached mindfulness (DM) in treating symptoms of depression and anxiety among elderly women. Thirty-four elderly females (mean age: 69.23 years) suffering from moderate major depressive disorders (MDD) and treated with a standard medication (citalopram) at therapeutic doses were randomly assigned either to an intervention condition (DM; group treatment, twice weekly) or to a control condition (with leisure activities, twice weekly). At baseline (BL), four weeks later at study completion (SC), and four weeks after that at follow-up (FU), participants completed ratings for symptoms of depression and anxiety; experts blind to patients' group assignments rated patients' symptoms of depression. Symptoms of depression (self and experts' ratings) and anxiety declined significantly over time in the DM, but not in the control condition. Effects remained stable at FU. The pattern of results suggests that, compared to a control condition, a specific psychotherapeutic intervention such as DM can have a beneficial effect in elderly female patients with MDD. Copyright © 2017 Elsevier B.V. All rights reserved.

Coping in old age with extreme childhood trauma: aging Holocaust survivors and their offspring facing new challenges.

PubMed

Fridman, Ayala; Bakermans-Kranenburg, Marian J; Sagi-Schwartz, Abraham; Van IJzendoorn, Marinus H

2011-03-01

The Holocaust has become an iconic example of immense human-made catastrophes, and survivors are now coping with normal aging processes. Childhood trauma may leave the survivors more vulnerable when they are facing stress related to old age, whereas their offspring might have a challenging role of protecting their own parents from further pain. Here we examine the psychological adaptation of Holocaust survivors and their offspring in light of these new challenges, examining satisfaction with life, mental health, cognitive abilities, dissociative symptoms, and physical health. Careful matching of female Holocaust survivors and comparison subjects living in Israel was employed to form a case-control study design with two generations, including four groups: 32 elderly female Holocaust survivors and 47 daughters, and 33 elderly women in the comparison group, and 32 daughters (total N = 174). Participants completed several measures of mental and physical health, and their cognitive functioning was examined. The current study is a follow-up of a previous study conducted 11 years ago with the same participants. Holocaust survivors showed more dissociative symptomatology (odds = 2.39) and less satisfaction with their life (odds = 2.79) as compared to a matched group. Nonetheless, adult offspring of Holocaust survivors showed no differences in their physical, psychological, and cognitive functioning as compared to matched controls. Holocaust survivors still display posttraumatic stress symptoms almost 70 years after the trauma, whereas no intergenerational transmission of trauma was found among the second generation.

Increased gait unsteadiness in community-dwelling elderly fallers

NASA Technical Reports Server (NTRS)

Hausdorff, J. M.; Edelberg, H. K.; Mitchell, S. L.; Goldberger, A. L.; Wei, J. Y.

1997-01-01

OBJECTIVE: To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers. STUDY DESIGN: Retrospective, case-control study. SETTING: General community. PARTICIPANTS: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group. MAIN OUTCOME MEASURES: Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk. RESULTS: All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p < .0002). In contrast, walking speed of the elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects. CONCLUSIONS: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.

Cardiac remodelling in a baboon model of intrauterine growth restriction mimics accelerated ageing.

PubMed

Kuo, Anderson H; Li, Cun; Li, Jinqi; Huber, Hillary F; Nathanielsz, Peter W; Clarke, Geoffrey D

2017-02-15

Rodent models of intrauterine growth restriction (IUGR) successfully identify mechanisms that can lead to short-term and long-term detrimental cardiomyopathies but differences between rodent and human cardiac physiology and placental-fetal development indicate a need for models in precocial species for translation to human development. We developed a baboon model for IUGR studies using a moderate 30% global calorie restriction of pregnant mothers and used cardiac magnetic resonance imaging to evaluate offspring heart function in early adulthood. Impaired diastolic and systolic cardiac function was observed in IUGR offspring with differences between male and female subjects, compared to their respective controls. Aspects of cardiac impairment found in the IUGR offspring were similar to those found in normal controls in a geriatric cohort. Understanding early cardiac biomarkers of IUGR using non-invasive imaging in this susceptible population, especially taking into account sexual dimorphisms, will aid recognition of the clinical presentation, development of biomarkers suitable for use in humans and management of treatment strategies. Extensive rodent studies have shown that reduced perinatal nutrition programmes chronic cardiovascular disease. To enable translation to humans, we developed baboon offspring cohorts from mothers fed ad libitum (control) or 70% of the control ad libitum diet in pregnancy and lactation, which were growth restricted at birth. We hypothesized that intrauterine growth restriction (IUGR) offspring hearts would show impaired function and a premature ageing phenotype. We studied IUGR baboons (8 male, 8 female, 5.7 years), control offspring (8 male, 8 female, 5.6 years - human equivalent approximately 25 years), and normal elderly (OLD) baboons (6 male, 6 female, mean 15.9 years). Left ventricular (LV) morphology and systolic and diastolic function were evaluated with cardiac MRI and normalized to body surface area. Two-way ANOVA by group and sex (with P < 0.05) indicated ejection fraction, 3D sphericity indices, cardiac index, normalized systolic volume, normalized LV wall thickness, and average filling rate differed by group. Group and sex differences were found for normalized LV wall thickening and normalized myocardial mass, without interactions. Normalized peak LV filling rate and diastolic sphericity index were not correlated in control but strongly correlated in OLD and IUGR baboons. IUGR programming in baboons produces myocardial remodelling, reduces systolic and diastolic function, and results in the emergence of a premature ageing phenotype in the heart. To our knowledge, this is the first demonstration of the specific characteristics of cardiac programming and early life functional decline with ageing in an IUGR non-human primate model. Further studies across the life span will determine progression of cardiac dysfunction. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Clonazepam-associated Bradycardia in a Disabled Elderly Woman with Multiple Complications

PubMed Central

Maruyoshi, Hidetomo; Maruyoshi, Natsue; Hirosue, Motone; Ikeda, Komei; Shimamoto, Masaaki

2017-01-01

We herein report an 87-year-old woman who was taking clonazepam at 1.5 mg/day. She was hospitalized with an old cerebral infarction complicated with symptomatic epilepsy, dementia, dyslipidemia, and chronic cholecystitis. Electrocardiogram revealed severe bradycardia at 31 beats/min. The bradycardia disappeared on day 3 after clonazepam withdrawal, although the serum clonazepam level had been within normal limits. She was diagnosed with clonazepam-associated bradycardia, which was likely related to the potential calcium channel-blocking properties of clonazepam. Because of age-related pharmacokinetic and pharmacodynamic changes, the adverse effects of clonazepam should be considered, especially in disabled elderly individuals with multiple comorbidities. PMID:28794360

Clonazepam-associated Bradycardia in a Disabled Elderly Woman with Multiple Complications.

PubMed

Maruyoshi, Hidetomo; Maruyoshi, Natsue; Hirosue, Motone; Ikeda, Komei; Shimamoto, Masaaki

2017-09-01

We herein report an 87-year-old woman who was taking clonazepam at 1.5 mg/day. She was hospitalized with an old cerebral infarction complicated with symptomatic epilepsy, dementia, dyslipidemia, and chronic cholecystitis. Electrocardiogram revealed severe bradycardia at 31 beats/min. The bradycardia disappeared on day 3 after clonazepam withdrawal, although the serum clonazepam level had been within normal limits. She was diagnosed with clonazepam-associated bradycardia, which was likely related to the potential calcium channel-blocking properties of clonazepam. Because of age-related pharmacokinetic and pharmacodynamic changes, the adverse effects of clonazepam should be considered, especially in disabled elderly individuals with multiple comorbidities.

Oropharyngeal dysphagia.

PubMed

Cook, Ian J

2009-09-01

Although the aging process per se can produce measurable changes in the normal oropharyngeal swallow, these changes alone are rarely sufficient to cause clinically apparent dysphagia. The causes of oropharyngeal dysphagia in the elderly are predominantly neuromyogenic, with the most common cause being stroke. The evaluation of oropharyngeal dysphagia in the elderly involves early exclusion of structural abnormalities, detection of aspiration by videofluoroscopy which might dictate early introduction of nonoral feeding, and exclusion of underlying systemic and neuromyogenic causes that have specific therapies in their own right. Such conditions include Parkinson disease, myositis, myasthenia, and thyrotoxicosis. Management is best delivered by a multidisciplinary team involving physician, speech pathologist, nutritionist and, at times, a surgeon.

Homocysteine and Cognitive Performance in Elders with Self-Neglect

NASA Technical Reports Server (NTRS)

Burnett, J.; Smith, S.M.; Aung, K.; Dyer, C.

2009-01-01

Elevated plasma homocysteine has been associated with altered cognitive performance in older adults. Elders referred to Adult Protective Services (APS) for self-neglect have been reported to have elevated plasma homocysteine levels and to suffer from cognitive impairment. This study assesses the association, if any, between plasma homocysteine and cognitive performance among elders with self-neglect. Methods: Sixty-five community-living adults, 65 years of age and older, reported to Adult Protective Services for self-neglect and 55 matched controls (matched for age, ethnicity, gender and socio-economic status) consented and participated in this study. The research team conducted in-home comprehensive geriatric assessments which included the mini-mental state exam (MMSE), the 15-item geriatric depression scale (GDS), the Wolf-Klein Clock Drawing Tests (CDT) and a comprehensive nutritional biochemistry panel, which included plasma homocysteine. Student s t tests and Pearson correlations were conducted to assess for bivariate associations. Results: Elders with self-neglect had significantly higher plasma homocysteine levels (M=12.68umol/L, sd=4.4) compared to the controls (M=10.40umol/L, sd=3.61;t=3.21, df=127, p=.002). There were no statistically significant associations between cognitive performance and plasma homocysteine in the self-neglect group, however there was a significant correlation between plasma homocysteine and the CDT among the controls (r=-.296, p=.022). Conclusion: Mean plasma homocysteine levels were significantly higher in elders with self-neglect, however, they do not appear to be related to cognitive performance, indicating that cognitive impairment in elder self-neglect involve mechanisms other than hyperhomocysteinemia. These findings warrant further investigation

The Effect of Cognitive Remediation Therapy on Social Skills in Institutionalized Elderly Patients with Schizophrenia.

PubMed

Mohammadi, Fatemeh; Momtaz, Yadollah Abolfathi; Motallebi, Seyedeh Ameneh; Boosepasi, Shahnaz

2017-01-01

There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group. The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Lifestyle intervention using Internet of Things (IoT) for the elderly: A study protocol for a randomized control trial (the BEST-LIFE study).

PubMed

Kato, Sawako; Ando, Masahiko; Kondo, Takaaki; Yoshida, Yasuko; Honda, Hiroyuki; Maruyama, Shoichi

2018-05-01

Modification of lifestyle habits, including diet and physical activity, is essential for the prevention and control of type 2 diabetes mellitus (T2DM) in elderly patients. However, individualized treatment is more critical for the elderly than for general patients. This study aimed to determine lifestyle interventions that resulted in lowering hemoglobin A 1c (HbA 1c ) in Japanese pre- and early diabetic elderly subjects. The BEST-LIFE trial is an ongoing, open-label, 6-month, randomized (1:1) parallel group trial. Subjects with HbA 1c of ≥5.6%-randomly assigned to the intervention or control group -use wearable monitoring devices loaded with Internet of things (IoT) systems that aids them with self-management and obtaining monthly remote health guidance from a public health nurse. The primary outcome is changes in HbA 1c after a 6-month intervention relative to the baseline values. The secondary outcome is the change of behavior modification stages. The background, rationale, and study design of this trial are also presented. One hundred forty-five subjects have already been enrolled in this lifestyle intervention program, which will end in 2019. The BEST-LIFE trial will provide new evidence regarding the effectiveness and safety of our program on lowering HbA 1c in elderly subjects with T2DM. It will also investigate whether information communication technology tools and monitoring devices loaded with IoT can support health care in elderly subjects. The trial registration number is UMIN-CTR: UMIN 000023356.

Relationship between Functional Visual Acuity and Useful Field of View in Elderly Drivers

PubMed Central

Negishi, Kazuno; Masui, Sachiko; Mimura, Masaru; Fujita, Yoshio; Tsubota, Kazuo

2016-01-01

Purpose To investigate the relationship between the functional visual acuity (FVA) and useful field of view (UFOV) in elderly drivers and assess the usefulness of the FVA test to screen driving aptitude in elderly drivers. Methods This study included 45 elderly drivers (31 men, 14 women; mean age, 68.1 years) and 30 younger drivers (26 men, 4 women; mean age, 34.2 years) who drive regularly. All participants underwent measurement of the binocular corrected distant visual acuity (CDVA), binocular corrected distant FVA (CDFVA), and Visual Field with Inhibitory Tasks Elderly Version (VFIT-EV) to measure UFOV. The tear function and cognitive status also were evaluated. Results The CDVA, the CDFVA, cognitive status, and the correct response rate (CAR) of the VFIT-EV were significantly worse in the elderly group than in the control group (P = 0.000 for all parameters). The cognitive status was correlated significantly with the CDVA (r = -0.301, P = 0.009), CDFVA (r = -0.402, P = 0.000), and the CAR of the VFIT-EV (r = 0.348, P = 0.002) in all subjects. The results of the tear function tests were not correlated with the CDVA, CDFVA, or VFIT-EV in any subjects. Stepwise regression analysis for all subjects in the elderly and control groups showed that the CDFVA predicted the CAR most significantly among the clinical factors evaluated. Conclusion The FVA test is a promising method to screen the driving aptitude, including both visual and cognitive functions, in a short time. PMID:26808364

Communication, Control, and Computer Access for Disabled and Elderly Individuals. ResourceBook 1: Communication Aids. Rehab/Education Technology ResourceBook Series.

ERIC Educational Resources Information Center

Brandenburg, Sara A., Ed.; Vanderheiden, Gregg C., Ed.

One of a series of three resource guides concerned with communication, control, and computer access for disabled and elderly individuals, the directory focuses on communication aids. The book's six chapters each cover products with the same primary function. Cross reference indexes allow access to listings of products by function, input/output…

Physical Fitness and Serum Vitamin D and Cognition in Elderly Koreans.

PubMed

Ahn, Jeong-Deok; Kang, Hyunsik

2015-12-01

Poor physical fitness and low serum vitamin D are known to be modifiable risk factors for cognitive declines with normal aging. We investigated the association of physical fitness and serum vitamin D levels with global cognitive function in older adults. In this cross-sectional study, a total of 412 older Korean adults (108 men aged 74.4 ± 6.0 years and 304 women aged 73.1 ± 5.4 years) completed the Korean version of Mini-Mental State Examination (MMSE) to assess global cognitive performance and the senior fitness test to assess strength, flexibility, agility, and endurance domains of physical fitness. Body mass index, percent body fat, serum vitamin D, geriatric depression scale (GDS), level of education, smoking, and history of cardiovascular or cerebrovascular disease were also assessed as covariates. Age, sex, GDS, and body fatness were negatively associated with MMSE-based cognitive performance. Serum vitamin D and physical fitness were positively associated with MMSE-based cognitive performance. Multivariate linear regression showed that agility (partial R(2) = -0.184, p = 0.029) and endurance (partial R(2) = 0.191, p = 0.022) domains of physical fitness along with serum vitamin D (partial R(2) = 0.210, p = 0.012) were significant predictors for global cognitive performance after controlling for covariates (i.e., age, sex, education, GDS, body fatness, and comorbidity index). The current findings of the study suggest that promotion of physical fitness and vitamin D supplementation should be key components of interventions to prevent cognitive decline with normal aging. Key pointsCognitive declines are associated with normal aging as well as modifiable lifestyle risk factors, and there is an increasing need to identify the modifiable risk factors for the onset of cognitive declines and to provide evidence-based strategies for healthy and successful aging.In Korea, little is known about the relationships of physical fitness and serum vitamin D with cognitive function in older adults, and we determined the associations between a) serum vitamin D levels and cognitive function and b) physical fitness and cognitive function among community-dwelling elderly Koreans.The current findings of the study suggest that agility and endurance domains of physical fitness along with serum vitamin D were significant predictors for global cognitive performance after controlling for covariates.

Physical Fitness and Serum Vitamin D and Cognition in Elderly Koreans

PubMed Central

Ahn, Jeong-Deok; Kang, Hyunsik

2015-01-01

Poor physical fitness and low serum vitamin D are known to be modifiable risk factors for cognitive declines with normal aging. We investigated the association of physical fitness and serum vitamin D levels with global cognitive function in older adults. In this cross-sectional study, a total of 412 older Korean adults (108 men aged 74.4 ± 6.0 years and 304 women aged 73.1 ± 5.4 years) completed the Korean version of Mini-Mental State Examination (MMSE) to assess global cognitive performance and the senior fitness test to assess strength, flexibility, agility, and endurance domains of physical fitness. Body mass index, percent body fat, serum vitamin D, geriatric depression scale (GDS), level of education, smoking, and history of cardiovascular or cerebrovascular disease were also assessed as covariates. Age, sex, GDS, and body fatness were negatively associated with MMSE-based cognitive performance. Serum vitamin D and physical fitness were positively associated with MMSE-based cognitive performance. Multivariate linear regression showed that agility (partial R2 = -0.184, p = 0.029) and endurance (partial R2 = 0.191, p = 0.022) domains of physical fitness along with serum vitamin D (partial R2 = 0.210, p = 0.012) were significant predictors for global cognitive performance after controlling for covariates (i.e., age, sex, education, GDS, body fatness, and comorbidity index). The current findings of the study suggest that promotion of physical fitness and vitamin D supplementation should be key components of interventions to prevent cognitive decline with normal aging. Key points Cognitive declines are associated with normal aging as well as modifiable lifestyle risk factors, and there is an increasing need to identify the modifiable risk factors for the onset of cognitive declines and to provide evidence-based strategies for healthy and successful aging. In Korea, little is known about the relationships of physical fitness and serum vitamin D with cognitive function in older adults, and we determined the associations between a) serum vitamin D levels and cognitive function and b) physical fitness and cognitive function among community-dwelling elderly Koreans. The current findings of the study suggest that agility and endurance domains of physical fitness along with serum vitamin D were significant predictors for global cognitive performance after controlling for covariates. PMID:26664270

Elderly persons' experiences of striving to receive care on their own terms in nursing homes.

PubMed

Anderberg, Patrice; Berglund, Anna-Lena

2010-02-01

Elderly persons' participation in and decisions about their own care need more attention. The aim of this study was to gain a deeper understanding of elderly persons' experiences of care and help, and how their lives change in nursing homes. Fifteen elderly persons living in four nursing homes were interviewed about their experiences of needing care and help in their daily life. The interviews were analysed using van Manen's phenomenological approach. Elderly persons' experiences of care and help were described as: a balance between sorrow and relief, a struggle to maintain control and connectedness, managing to live in the present and yet worrying about the future, and an attempt to hide one's vulnerability in order to be accepted and create an inner calm in an exposed situation. In conclusion, important issues were raised concerning elderly persons' perspectives on care and help in daily life in nursing homes.

Does Eating Out Make Elderly People Depressed? Empirical Evidence from National Health and Nutrition Survey in Taiwan.

PubMed

Chang, Hung-Hao; Saeliw, Kannika

2017-06-01

This study investigates the association between eating out and depressive symptoms among elderly people. Potential mediators that may link to elderly eating out and depressive symptoms are also discussed. A unique dataset of 1,184 individuals aged 65 and older was drawn from the National Health and Nutrition Survey in 2008 in Taiwan. A bivariate probit model and an instrumental variable probit model were estimated to account for correlated, unmeasured factors that may be associated with both the decision and frequency of eating out and depressive symptoms in the elderly. An additional analysis is conducted to check whether the nutrient intakes and body weights can been seen as mediators that link the association between eating out and depressive symptoms of the elderly. Elderly people who eat out are 38 percent points more likely to have depressive symptoms than their counterparts who do not eat out, after controlling for socio-demographic characteristics and other factors. A positive association between the frequency of eating out and the likelihood of having depressive symptoms of the elderly is also found. It is evident that one addition meal away from home is associated with an increase of the likelihood of being depressed by 3.8 percentage points. With respect to the mediations, we find that nutrient intakes and body weight are likely to serve as mediators for the positive relationship between eating out and depressive symptoms in the elderly. Our results show that elderly who eat out have a higher chance of having depressive symptoms. To prevent depressive symptoms in the elderly, policy makers should be aware of the relationship among psychological status, physical health and nutritional health when assisting the elderly to better manage their food consumption away from home. Our study have some caveats. First, the interpretation of our results on the causality issue calls for caution in that our analysis relies on a cross-sectional survey. Second, other measures to define elderly depression, such as the Center for Epidemiological Studies-Depression (CES-D) score, can be used to check the robustness of our findings. Finally, the availability of food outlets in the local area and family characteristics are possibly associated with food away from home of the elderly. If data permit, the relationship between eating out and elderly depressive symptoms can be better identified after controlling for variables related to food facilities and family characteristics.

The Effect of Emotional Focused Intervention on Spousal Emotional Abuse and Marital Satisfaction among Elderly Married Couples: A Randomized Controlled Trial.

PubMed

Hazrati, Maryam; Hamid, Tengku Aizan; Ibrahim, Rahimah; Hassan, Siti Aishah; Sharif, Farkhondeh; Bagheri, Zahra

2017-10-01

This study examined the impacts of an Emotional Focused Intervention on emotional abuse behaviors and marital satisfaction among the elderly married couples. This randomized controlled trial study was carried out in Shiraz-Iran, during September 2013-2014. The elderly couples were invited to join an emotional focused intervention, following the advertisement and announcement on bulletin boards in the elderly day clinic centers and all governmental primary health care centers. Then, 57 couples (114 participants) who were eligible for study were assigned in two groups by block randomization (29 in the experimental and 28 in the control group(.The couples in the experimental group received intervention twice a week for four weeks. Each session lasted 90 minutes. The control group didn't receive any intervention and the subjects were put in the waiting list. The outcome measures were evaluated by Multidimensional Measure of Emotional Abuse Questionnaire (MMEAQ) and Marital Satisfaction Questionnaire for Older People (MSQFOP). Repeated measurement ANOVA was used to detect any significant changes between groups in their mean scores of emotional abuse behaviors and marital satisfaction from pre- to post-test, and 3 months after the intervention. Analysis of data was performed using SPSS, version 19, and P≤0.05 was measured as significant. The mean duration of marriage was 39.56±9.64 years. In the experimental group, the abusive behaviors decreased significantly (P<0.001) at times 2 and 3 compared with time 1, and marital satisfaction improved significantly only at time 3 (P<0.001). These differences were not significant in the control group. Emotion-focused couple-based interventions are helpful in reducing the spousal emotional abuse and improving marital satisfaction in among the elderly couples. Trial Registration Number: 2013111715426N1.

Year-long changes in protein metabolism in elderly men and women supplemented with a nutrition cocktail of beta-hydroxy-beta-methylbutyrate (HMB), L-arginine, and L-lysine.

PubMed

Baier, Shawn; Johannsen, Darcy; Abumrad, Naji; Rathmacher, John A; Nissen, Steven; Flakoll, Paul

2009-01-01

A major contributing factor to the loss of mobility in elderly people is the gradual and continuous loss of lean body mass. To determine whether supplementation of an amino acid cocktail daily for 1 year could improve the age-associated changes in protein turnover and lean body mass in elderly people. Elderly (76+/-1.6 years) women (n=39) and men (n=38) were recruited for a double-blinded controlled study. Study participants were randomly assigned to either an isonitrogenous control-supplement (n=37) or a treatment-supplement (HMB/Arg/Lys) consisting of beta-hydroxy-beta-methylbutyrate, L-arginine, and L-lysine (n=40) for the 1-year study. Lean tissue mass was measured using both bioelectrical-impedance analysis (BIA) and dual energy x-ray absorptiometry (DXA). Rates of whole-body protein turnover were estimated using primed/intermittent oral doses of 15N-glycine. In subjects taking the HMB/Arg/Lys supplement, lean tissue increased over the year of study while in the control group, lean tissue did not change. Compared with control, HMB/Arg/Lys increased body cell mass (BIA) by 1.6% (P=.002) and lean mass (DXA) by 1.2% (P=.05). The rates of protein turnover were significantly increased 8% and 12% in the HMB/Arg/Lys-supplemented group while rates of protein turnover decreased 11% and 9% in the control-supplemented subjects (P<.01), at 3 and 12 months, respectively. Consumption of a simple amino acid-related cocktail increased protein turnover and lean tissue in elderly individuals in a year-long study.

Metabolic control in a nationally representative diabetic elderly sample in Costa Rica: patients at community health centers vs. patients at other health care settings

PubMed Central

Brenes-Camacho, Gilbert; Rosero-Bixby, Luis

2008-01-01

Background Costa Rica, like other developing countries, is experiencing an increasing burden of chronic conditions such as diabetes mellitus (DM), especially among its elderly population. This article has two goals: (1) to assess the level of metabolic control among the diabetic population age ≥ 60 years old in Costa Rica, and (2) to test whether diabetic elderly patients of community health centers differ from patients in other health care settings in terms of the level of metabolic control. Methods Data come from the project CRELES, a nationally representative study of people aged 60 and over in Costa Rica. This article analyzes a subsample of 542 participants in CRELES with self-reported diagnosis of diabetes mellitus. Odds ratios of poor levels of metabolic control at different health care settings are computed using logistic regressions. Results Lack of metabolic control among elderly diabetic population in Costa Rica is described as follows: 37% have glycated hemoglobin ≥ 7%; 78% have systolic blood pressure ≥ 130 mmHg; 66% have diastolic blood pressure ≥ 80 mmHg; 48% have triglycerides ≥ 150 mg/dl; 78% have LDL ≥ 100 mg/dl; 70% have HDL ≤ 40 mg/dl. Elevated levels of triglycerides and LDL were higher in patients of community health centers than in patients of other clinical settings. There were no statistical differences in the other metabolic control indicators across health care settings. Conclusion Levels of metabolic control among elderly population with DM in Costa Rica are not that different from those observed in industrialized countries. Elevated levels of triglycerides and LDL at community health centers may indicate problems of dyslipidemia treatment among diabetic patients; these problems are not observed in other health care settings. The Costa Rican health care system should address this problem, given that community health centers constitute a means of democratizing access to primary health care to underserved and poor areas. PMID:18447930

Differential effects of decision latitude and control on the job demands-strain relationship: a cross-sectional survey study among elderly care nursing staff.

PubMed

Schmidt, Klaus-Helmut; Diestel, Stefan

2011-03-01

According to the influential Job Demands-Control (JD-C) model developed by Karasek (1979; Karasek and Theorell, 1990), job strain is expected to result from high job demands and low job control as well as an interaction between both job characteristics. Previous research, however, has found such an interaction only rarely or inconsistently.It has been suggested that the conceptualization of the control variable (formerly referred to as decision latitude) may be particularly responsible for the lack of supportive findings. The present study aimed at clarifying this issue by contrasting a focused measure of control with a traditional measure of decision latitude in their relations to job strain of health care workers. The measure of decision latitude encompassed a wide range of job characteristics including control, task variety, and learning opportunities. A cross-sectional questionnaire survey was conducted with job satisfaction, psychosomatic complaints and emotional exhaustion as criterion measures of job strain. A supra-regional organization for residential elderly care with 11 nursing homes located in a federal state in Germany. Questionnaires were distributed to the whole nursing staff, of which 379 filled in the questionnaire during normal working hours (68% participation rate). In addition to confirmatory factor analyses, descriptive statistics, and bivariate correlations, hierarchical multiple regression analyses were performed for testing the corresponding interaction effects. Findings confirmed the assumption that the focused measure of control and the traditional measure of decision latitude represent distinct, yet correlated factors. Furthermore, findings revealed a significant interaction effect between job demands and control on all outcomes considered. By way of contrast, there was no equivalent interaction effect between job demands and decision latitude. In line with the JD-C model, the adverse influence of increasing demands on job satisfaction, psychosomatic complaints and emotional exhaustion were reduced with increasing job control. Extending the opportunities of health care workers to control work scheduling and the way of performing given tasks can make them less vulnerable against the adverse effects of high job demands. Copyright © 2010 Elsevier Ltd. All rights reserved.

Is right hemisphere decline in the perception of emotion a function of aging?

PubMed

McDowell, C L; Harrison, D W; Demaree, H A

1994-11-01

The hypothesis that the right cerebral hemisphere declines more quickly than the left cerebral hemisphere in the normal aging process was tested using accuracy and intensity measures in a facial recognition test and using response time and response bias measures in a tachistoscopic paradigm. Elderly and younger men and women (N = 60) participated in both experiments. Experiment 1 required facial affect identification and intensity ratings of 50 standardized photographs of 5 affective categories: Happy, Neutral, Sad, Angry, and Fearful. The elderly were significantly less accurate in identifying facial affective valence. This effect was found using negative and neutral expressions. Results for happy expressions, however, were consistent with the younger group. In Experiment 2, age differences in hemispheric asymmetry were evaluated using presentation of affective faces in each visual field. Following prolonged experience with the affective stimuli during Experiment 1, the elderly showed heightened cerebral asymmetry for facial affect processing compared to the younger group. Both groups showed a positive affective bias to neutral stimuli presented to the left hemisphere. Elderly and younger subjects scored significantly higher on Vocabulary and Block Design subtests of the WAIS-R, respectively. Overall, the findings suggest that the elderly have more difficulty processing negative affect, while their ability to process positive affect remains intact. The results lend only partial support to the right hemi-aging hypothesis.

Reduced Dynamic Coupling Between Spontaneous BOLD-CBF Fluctuations in Older Adults: A Dual-Echo pCASL Study.

PubMed

Chiacchiaretta, Piero; Cerritelli, Francesco; Bubbico, Giovanna; Perrucci, Mauro Gianni; Ferretti, Antonio

2018-01-01

Measurement of the dynamic coupling between spontaneous Blood Oxygenation Level Dependent (BOLD) and cerebral blood flow (CBF) fluctuations has been recently proposed as a method to probe resting-state brain physiology. Here we investigated how the dynamic BOLD-CBF coupling during resting-state is affected by aging. Fifteen young subjects and 17 healthy elderlies were studied using a dual-echo pCASL sequence. We found that the dynamic BOLD-CBF coupling was markedly reduced in elderlies, in particular in the left supramarginal gyrus, an area known to be involved in verbal working memory and episodic memory. Moreover, correcting for temporal shift between BOLD and CBF timecourses resulted in an increased correlation of the two signals for both groups, but with a larger increase for elderlies. However, even after temporal shift correction, a significantly decreased correlation was still observed for elderlies in the left supramarginal gyrus, indicating that the age-related dynamic BOLD-CBF uncoupling in this region is more pronounced and can be only partially explained with a simple time-shift between the two signals. Interestingly, these results were observed in a group of elderlies with normal cognitive functions, suggesting that the study of dynamic BOLD-CBF coupling during resting-state is a promising technique, potentially able to provide early biomarkers of functional changes in the aging brain.

Self-esteem in later life: a nursing perspective.

PubMed

Taft, L B

1985-10-01

Self-esteem provides a measure for the quality of life of the elderly in long-term care. This article defines self-esteem in relation to self-concept and identifies the antecedents that affect its development. Elements of labeling theory, activity theory, and social exchange theory are explored to account for a potential decline in self-esteem among the elderly. According to this electric theoretical framework, stigmatization, decreased social interaction, and loss of control over the environment are all negatively correlated with self-esteem. Institutionalization intensifies the effect of these forces. Nursing is in a unique position to promote self-esteem by combating ageism, promoting social interaction, and maximizing the control and participation of elderly residents.

Association of body mass index with amnestic and non-amnestic mild cognitive impairment risk in elderly.

PubMed

Wang, Feng; Zhao, Minghui; Han, Zhaoli; Li, Dai; Zhang, Shishuang; Zhang, Yongqiang; Kong, Xiaodong; Sun, Ning; Zhang, Qiang; Lei, Ping

2017-09-15

Previous studies focused on the relationship between body mass index and cognitive disorder and obtained many conflicting results. This study explored the potential effects of body mass index on the risk of mild cognitive impairment (amnestic and non-amnestic) in the elderly. The study enrolled 240 amnestic mild cognitive impairment patients, 240 non-amnestic mild cognitive impairment patients and 480 normal cognitive function controls. Data on admission and retrospective data at baseline (6 years ago) were collected from their medical records. Cognitive function was evaluated using Mini-Mental State Examination and Montreal Cognitive Assessment. Being underweight, overweight or obese at baseline was associated with an increased risk of amnestic mild cognitive impairment (OR: 2.30, 95%CI: 1.50 ~ 3.52; OR: 1.74, 95%CI: 1.36 ~ 2.20; OR: 1.71, 95%CI: 1.32 ~ 2.22, respectively). Being overweight or obese at baseline was also associated with an increased risk of non-amnestic mild cognitive impairment (OR: 1.51, 95%CI: 1.20 ~ 1.92; OR: 1.52, 95%CI: 1.21 ~ 1.97, respectively). In subjects with normal weights at baseline, an increased or decreased body mass index at follow-up was associated with an elevated risk of amnestic mild cognitive impairment (OR: 1.80, 95%CI: 1.10 ~ 3.05; OR: 3.96, 95%CI: 2.88 ~ 5.49, respectively), but only an increased body mass index was associated with an elevated risk of non-amnestic mild cognitive impairment (OR: 1.71, 95%CI: 1.16 ~ 2.59). Unhealthy body mass index levels at baseline and follow-up might impact the risk of both types of mild cognitive impairment (amnestic and non-amnestic).

Visible Virchow-Robin spaces on magnetic resonance imaging of Alzheimer's disease patients and normal elderly from the Sunnybrook Dementia Study.

PubMed

Ramirez, Joel; Berezuk, Courtney; McNeely, Alicia A; Scott, Christopher J M; Gao, Fuqiang; Black, Sandra E

2015-01-01

Visible Virchow-Robin spaces (VRS) are commonly used markers for small vessel disease in aging and dementia. However, as previous reports were based on subjective visual ratings, the goal of this project was to validate and apply an MRI-based quantitative measure of VRS as a potential neuroimaging biomarker. A modified version of Lesion Explorer was applied to MRIs from Alzheimer's disease patients (AD: n = 203) and normal elderly controls (NC: n = 94). Inter-rater reliability, technique validity, group/gender differences, and correlations with other small vessel disease markers were examined (lacunes and white matter hyperintensities, WMH). Inter-rater reliability and spatial congruence was excellent (ICC = 0.99, SI = 0.96), and VRS volumes were highly correlated with established rating scales (CS: ρ = 0.84, p < 0.001; BG: ρ = 0.75, p < 0.001). Compared to NC, AD had significantly greater volumes of WMH (p < 0.01), lacunes (p < 0.001), and VRS in the white matter (p < 0.01), but not in the basal ganglia (n.s.). Compared to women, demented and non-demented men had greater VRS in the white matter (p < 0.001), but not in the basal ganglia (n.s.). Additionally, VRS were correlated with lacunes and WMH, but only in AD (r = 0.3, p < 0.01). Compared to women, men may be more susceptible to greater volumes of VRS, particularly in the white matter. RESULTS support the hypothesis that VRS in the white matter may be more related to AD-related vascular pathology compared to VRS found in the basal ganglia. Future work using this novel VRS segmentation tool will examine its potential utility as an imaging biomarker of vascular rather than parenchymal amyloid.

Does hearing aid use affect audiovisual integration in mild hearing impairment?

PubMed

Gieseler, Anja; Tahden, Maike A S; Thiel, Christiane M; Colonius, Hans

2018-04-01

There is converging evidence for altered audiovisual integration abilities in hearing-impaired individuals and those with profound hearing loss who are provided with cochlear implants, compared to normal-hearing adults. Still, little is known on the effects of hearing aid use on audiovisual integration in mild hearing loss, although this constitutes one of the most prevalent conditions in the elderly and, yet, often remains untreated in its early stages. This study investigated differences in the strength of audiovisual integration between elderly hearing aid users and those with the same degree of mild hearing loss who were not using hearing aids, the non-users, by measuring their susceptibility to the sound-induced flash illusion. We also explored the corresponding window of integration by varying the stimulus onset asynchronies. To examine general group differences that are not attributable to specific hearing aid settings but rather reflect overall changes associated with habitual hearing aid use, the group of hearing aid users was tested unaided while individually controlling for audibility. We found greater audiovisual integration together with a wider window of integration in hearing aid users compared to their age-matched untreated peers. Signal detection analyses indicate that a change in perceptual sensitivity as well as in bias may underlie the observed effects. Our results and comparisons with other studies in normal-hearing older adults suggest that both mild hearing impairment and hearing aid use seem to affect audiovisual integration, possibly in the sense that hearing aid use may reverse the effects of hearing loss on audiovisual integration. We suggest that these findings may be particularly important for auditory rehabilitation and call for a longitudinal study.