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Sample records for nondemented elderly subjects

  1. Relationship between salivary cortisol levels and regional cerebral glucose metabolism in nondemented elderly subjects

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    Kwak, Young Bin; Cho, Sang Soo; Lee, Sung Ha; Chey, Jean Yung; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2004-07-01

    Cortisol is a primary stress hormone for flight-or-fight response in human. Increased levels of cortisol have been associated with memory and learning impairments. However, little is known about the role of cortisol on brain/cognitive functions in older adults. We compared regional cerebral glucose metabolism between elderly subjects with high and low cortisol levels using FDG PET. Salivary cortisol levels were measured four times during a day, and an average of the four measurements was used as the standard cortisol level for the analyses. From a population of 120 nondemented elderly subjects, 19 (mean age, 70.1{+-}4.9 y: 2 males and 17 females) were identified as the high (> mean + 1 SD of the total population) cortisol subjects (mean cortisol, 0.69{+-}0.09 {mu} g/dL), while 14 (mean age, 67.2{+-}4.5 y: all females) as the low (< mean 1 SD) cortisol (mean cortisol, 0.27{+-}0.03 {mu} g/dL). A voxel-wise comparison of FDG PET images from the high and low cortisol subjects was performed using SPM99. When compared with the low cortisol group, the high cortisol group had significant hypometabolism in the right middle temporal gyrus, left precuneus, right parahippocampal gyrus, right inferior temporal and superior temporal gyri (P < 0.01 uncorrected, k = 100). There was no significant increase of glucose metabolism in the high cortisol group compared with the low cortisol group (P < 0.01 uncorrected, k = 100). The high cortisol elderly subjects had hypometabolism in the parahippocampal and temporal gyri and precuneus, regions involved in memory and other cognitive functions. This may represent the preclinical metabolic correlates of forthcoming cognitive dysfunction associated with stress in the elderly. Longitudinal studies of brain metabolism and cognitive function are warranted.

  2. Metabolic correlates of general cognitive function in nondemented elderly subjects: an FDG PET study

    International Nuclear Information System (INIS)

    Cho, Sang Soo; Kwak, Young Bin; Lee, Eun Ju; Ryu, Chang Hyung; Chey, Jean Yung; Kim, Sang Eun

    2004-01-01

    While many studies examined the neural correlates of individual cognitive functions, few made efforts to identify the neural networks associated with general cognitive function. General cognitive function decline in the elderly population is not infrequent. This study examined the brain areas associated with general cognitive function in the elderly subjects. Community-dwelling 116 elderly subjects without dementing illnesses (age, 71±5 y; 13 males and 103 females) participated. General cognitive ability was assessed with the Dementia Rating Scale (K-DRS), which is composed of five subtests of attention, initiation and perseveration, construction, conceptualization, and memory. The EVLT (Elderly Verbal Learning Test), a nine-word list learning test, was used for general memory assessment. Brain FDG PET scans were acquired in all subjects. Brain regions where metabolic levels are correlated with the total scores of K-DRS and EVLT were examined using SPM99. There was a significant positive correlation (P < 0.01 uncorrected, k=100) between the total score of K-DRS and glucose metabolism in the bilateral posterior cingulate gyri, bilateral inferior frontal gyri, left caudate, left inferior parietal lobule, right precuneus, bilateral unci, right parahippocampal gyrus, and right anterior cingulate gyrus. A significant positive correlation between the total score of EVLT and glucose metabolism was shown in the right precuneus, right posterior cingulate gyrus, left insula, bilateral inferior parietal lobules, left anterior cingulate gyrus, left caudate, right inferior frontal gyrus (P < 0.01 uncorrected, k=100). Our data showed the brain regions that are associated with general cognitive function in the elderly. Those regions may serve as the neural substrated of cognitive dysfunction associated with neurodegenerative and cerebrovascular diseases in elderly subjects

  3. Regional distribution of neuritic plaques in the nondemented elderly and subjects with very mild Alzheimer disease.

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    Haroutunian, V; Perl, D P; Purohit, D P; Marin, D; Khan, K; Lantz, M; Davis, K L; Mohs, R C

    1998-09-01

    Identification of the neuropathological lesions that are most closely associated with the earliest symptoms of Alzheimer disease (AD) is crucial to the understanding of the disease process and the development of treatment strategies to affect its progress. Do the classical neuropathological lesions of AD precede, follow, or occur in synchrony with the earliest signs of cognitive deterioration? We examined the extent of neuritic plaque (NP) formation in 5 neocortical regions and the hippocampus, entorhinal cortex, and amygdala in 66 elderly subjects with no dementia, questionable dementia, or mild dementia as assessed using the Clinical Dementia Rating Scale (CDR). Postmortem study of nursing home residents. Even questionable dementia (CDR, 0.5) was associated with a significant (P = .04) increase in neocortical NP density. The density of NPs increased further with increasing dementia severity in all brain regions examined. However, subjects with questionable dementia or definite but mild dementia did not differ significantly from each other. Density of NPs was nearly maximal in subjects with moderate dementia (CDR = 2.0), suggesting that other neuropathological changes may be responsible for cognitive deficits beyond this level. Dementia severity correlated significantly with the density of NPs in all brain regions examined (r range, 0.47-0.56; P mild or questionable dementia is associated with increased density of neocortical NPs that do not distinguish between clinically questionable vs definite dementia.

  4. Comparison between visual assessment of MTA and hippocampal volumes in an elderly, non-demented population

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    Cavallin, Lena; Axelsson, Rimma [CLINTEC, Div. of Medical Imaging and Technology, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden); Dept. of Radiology, Karolinska Univ. Hospital, Stockholm (Sweden)], e-mail: lena.cavallin@karolinska.se; Bronge, Lena [CLINTEC, Div. of Medical Imaging and Technology, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden); Aleris Diagnostics, Stockholm (Sweden); Zhang, Yi [NVS, Novum, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden); Oeksengaard, Anne-Rita [NVS, Novum, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden); Ulleval Univ. Hospital and Asker and Baerum Hospital, Oslo (Norway); Wahlund, Lars-Olof [NVS, Novum, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden); Swedish Brain Power, Karolinska Univ. Hospital, Stockholm (Sweden); Fratiglioni, Laura [ARC Karolinska Inst. Stockholm (Sweden)

    2012-06-15

    Background: It is important to have a replicable easy method for monitoring atrophy progression in Alzheimer's disease. Volumetric methods for calculating hippocampal volume are time-consuming and commonly used in research. Visual assessments of medial temporal lobe atrophy (vaMTA) is a rapid method for clinical use. This method has not been tested in a large non-demented population in comparison with volumetry measurements. Since hippocampal volume decreases with time even in normal aging there is also a need to study the normal age differences of medial temporal lobe atrophy. Purpose: To compare visual assessment of medial temporal lobe atrophy (vaMTA) with hippocampal volume in a healthy, non-demented elderly population. To describe normal ageing using vaMTA. Material and Methods: Non-demented individuals aged 60, 66, 72, 78, 81, 84, and {>=}87 years old were recruited from the Swedish National study on Ageing and Care in Kungsholmen (SNAC-K), Sweden. Standard magnetic resonance imaging (MRI) scans, vaMTA, and calculations of hippocampal volumes were performed in 544 subjects. Results: Significant correlation (rs = -0.32, P < 0.001, sin; and rs = -0.26, P < 0.001, dx) was found between hippocampal volume measurements and vaMTA. In normal ageing, almost 95% of {<=}66-year-olds had a medial temporal lobe atrophy (MTA) score {<=}1, with possible scores ranging from 0 to 4. Subjects aged 72, 78, and 81 years scored {<=}2, while the two oldest age groups had scores {<=}3. Conclusion: There was a highly significant correlation between volumetric measurements of the hippocampus and MTA scoring. In normal ageing, there is increasing MTA score. For non-demented elderly individuals {<=}70 years, an MTA score of 0-1 may be considered normal, compared with MTA {<=}2 for 70-80-years and MTA 3 for >80-year-old individuals.

  5. Association of depression and loneliness with specific cognitive performance in non-demented elderly males.

    Science.gov (United States)

    Tzang, Ruu-Fen; Yang, Albert C; Yeh, Heng-Liang; Liu, Mu-En; Tsai, Shih-Jen

    2015-01-09

    Loneliness and depression are very common in the aged population. Both have negative impacts on cognition in the elderly. The present study aimed to investigate the effect of loneliness and depression on total as well as specific cognitive domains in cognitively normal male subjects. A total of 189 cognitively normal male subjects were recruited and underwent Cognitive Abilities Screening Instrument (CASI) and Wechsler Digit Span Task tests. Depression was assessed by the Geriatric Depression Scale-Short Form (GDS-SF) and loneliness by UCLA loneliness scales. Partial correlation test was used to explore the correlation between loneliness/depression and total as well as specific cognition function, with the controlled factors of age and education. Both depression and loneliness are negatively correlated with global cognitive function as evaluated with CASI (r=-0.227, p=0.002; r=-0.214, p=0.003, respectively). The domains of Attention, Orientation, Abstraction and judgment, and List-generating fluency of cognitive function were specifically associated with loneliness, and the domain of orientation was associated with depression after controlling the factors age and years of education. Our findings suggest that loneliness and depression may have negative impacts on global and specific domains of cognitive function in non-demented elderly males. Both loneliness and depression should be actively recognized earlier and appropriately treated because they are significant sources of cognitive impairment in the elderly.

  6. Effect of smoking on global cognitive function in nondemented elderly

    DEFF Research Database (Denmark)

    Ott, A; Andersen, K; Dewey, M E

    2004-01-01

    Contrary to early case-control studies that suggested smoking protects against Alzheimer disease (AD), recent prospective studies have shown that elderly who smoke may be at increased risk for dementia....

  7. Apathy in elderly nondemented patients with Parkinson's disease: clinical determinants and relationship to quality of life.

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    Skorvanek, Matej; Rosenberger, Jaroslav; Gdovinova, Zuzana; Nagyova, Iveta; Saeedian, Radka Ghorbani; Groothoff, Johan W; Dijk, Jitse P

    2013-12-01

    To describe the prevalence and clinical determinants of apathy in elderly nondemented patients with Parkinson's disease (PD) and their relationship to quality of life (QoL). A total of 106 nondemented elderly patients with PD were examined using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Starkstein Apathy Scale, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, and 39-item Parkinson's disease quality of life questionnaire. Apathy was present in 54% of the studied population. Factors associated with apathy were higher depression scores and a lower daily levodopa equivalent dose. Longer disease duration, higher motor MDS-UPDRS subscore, and higher depression and anxiety scores, but not apathy, were found to be associated with worse QoL. Although apathy does not seem to be an independent predictor of worse QoL specifically in elderly patients with PD, it remains very relevant, as its presence increases caregiver burden. Both depression and potential dopaminergic treatment underdosing can be properly managed, thus potentially reducing the prevalence and severity of apathy in a proportion of the apathetic patients with PD.

  8. Functional connectivity density mapping of depressive symptoms and loneliness in non-demented elderly male

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    Chen-Chia eLan

    2016-01-01

    Full Text Available Background: Depression and loneliness are prevalent and highly correlated phenomena among the elderly and influence both physical and mental health. Brain functional connectivity changes associated with depressive symptoms and loneliness are not fully understood.Methods: A cross-sectional functional MRI study was conducted among 85 non-demented male elders. Geriatric depression scale-short form and loneliness scale were used to evaluate the severity of depressive symptoms and loneliness, respectively. Whole brain voxel-wise resting-state functional connectivity density (FCD mapping was performed to delineate short-range FCD (SFCD and long-range FCD (LFCD. Regional correlations between depressive symptoms or loneliness and SFCD or LFCD were examined using general linear model, with age incorporated as a covariate and depressive symptoms and loneliness as predictors.Results: Positive correlations between depressive symptoms and LFCD were observed in left rectal gyrus, left superior frontal gyrus, right supraorbital gyrus, and left inferior temporal gyrus. Positive correlations between depressive symptoms and SFCD were observed in left middle frontal gyrus, left superior frontal gyrus, bilateral superior medial frontal gyrus, left inferior temporal gyrus, and left middle occipital region. Positive correlations between SFCD and loneliness were centered over bilateral lingual gyrus.Conclusion: Depressive symptoms are associated with FCD changes over frontal and temporal regions, which may involve the cognitive control, affective regulation, and default mode networks. Loneliness is associated with FCD changes in bilateral lingual gyri that are known to be important in social cognition. Depressive symptoms and loneliness may be associated with different brain regions in non-demented elderly male.

  9. Functional Connectivity Density Mapping of Depressive Symptoms and Loneliness in Non-Demented Elderly Male

    Science.gov (United States)

    Lan, Chen-Chia; Tsai, Shih-Jen; Huang, Chu-Chung; Wang, Ying-Hsiu; Chen, Tong-Ru; Yeh, Heng-Liang; Liu, Mu-En; Lin, Ching-Po; Yang, Albert C.

    2016-01-01

    Background: Depression and loneliness are prevalent and highly correlated phenomena among the elderly and influence both physical and mental health. Brain functional connectivity changes associated with depressive symptoms and loneliness are not fully understood. Methods: A cross-sectional functional MRI study was conducted among 85 non-demented male elders. Geriatric depression scale-short form (GDS) and loneliness scale were used to evaluate the severity of depressive symptoms and loneliness, respectively. Whole brain voxel-wise resting-state functional connectivity density (FCD) mapping was performed to delineate short-range FCD (SFCD) and long-range FCD (LFCD). Regional correlations between depressive symptoms or loneliness and SFCD or LFCD were examined using general linear model (GLM), with age incorporated as a covariate and depressive symptoms and loneliness as predictors. Results: Positive correlations between depressive symptoms and LFCD were observed in left rectal gyrus, left superior frontal gyrus, right supraorbital gyrus, and left inferior temporal gyrus. Positive correlations between depressive symptoms and SFCD were observed in left middle frontal gyrus, left superior frontal gyrus, bilateral superior medial frontal gyrus, left inferior temporal gyrus, and left middle occipital region. Positive correlations between SFCD and loneliness were centered over bilateral lingual gyrus. Conclusion: Depressive symptoms are associated with FCD changes over frontal and temporal regions, which may involve the cognitive control, affective regulation, and default mode networks. Loneliness is associated with FCD changes in bilateral lingual gyri that are known to be important in social cognition. Depressive symptoms and loneliness may be associated with different brain regions in non-demented elderly male. PMID:26793101

  10. Phosphatidylserine containing omega-3 Fatty acids may improve memory abilities in nondemented elderly individuals with memory complaints: results from an open-label extension study.

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    Vakhapova, Veronika; Cohen, Tzafra; Richter, Yael; Herzog, Yael; Kam, Yossi; Korczyn, Amos D

    2014-01-01

    The present study is an open-label extension (OLE) aimed at evaluating the effect of 100 mg/day of phosphatidylserine enriched with docosahexaenoic acid (PS-DHA) on cognitive performance in nondemented elderly individuals with memory complaints. From the participants who completed the core study, 122 continued with a 15-week OLE. Efficacy was assessed using a computerized tool and the Clinical Global Impression of Change (CGI-C) rating scale. A significant improvement in sustained attention and memory recognition was observed in the PS-DHA naïve group, while the PS-DHA continuers maintained their cognitive status. Additionally, a significant improvement in CGI-C was observed in the naïve group. The results demonstrate that consumption of 100 mg/day of PS-DHA might be associated with improving or maintaining cognitive status in elderly subjects with memory complaints.

  11. Cognitive and functional patterns of nondemented subjects with equivocal visual amyloid PET findings

    International Nuclear Information System (INIS)

    Payoux, P.; Delrieu, J.; Gallini, A.; Cantet, C.; Voisin, T.; Gillette-Guyonnet, S.; Vellas, B.; Adel, D.; Salabert, A.S.; Hitzel, A.; Tafani, M.; Verbizier, D. de; Darcourt, J.; Fernandez, P.; Monteil, J.; Carrie, I.; Pontecorvo, M.; Andrieu, S.

    2015-01-01

    Despite good to excellent inter-reader agreement in the evaluation of amyloid load on PET scans in subjects with Alzheimer's disease, some equivocal findings have been reported in the literature. We aimed to describe the clinical characteristics of subjects with equivocal PET images. Nondemented subjects aged 70 years or more were enrolled from the MAPT trial. Cognitive and functional assessments were conducted at baseline, at 6 months, and annually for 3 years. During the follow-up period, 271 subjects had 18 F-AV45 PET scans. Images were visually assessed by three observers and classified as positive, negative or equivocal (if one observer disagreed). After debate, equivocal images were reclassified as positive (EP+) or negative (EP-). Scans were also classified by semiautomated quantitative analysis using mean amyloid uptake of cortical regions. We evaluated agreement among the observers, and between visual and quantitative assessments using kappa coefficients, and compared the clinical characteristics of the subjects according to their PET results. In 158 subjects (58.30 %) the PET scan was negative for amyloid, in 77 (28.41 %) the scan was positive and in 36 (13.28 %) the scan was equivocal. Agreement among the three observers was excellent (kappa 0.80). Subjects with equivocal images were more frequently men (58 % vs. 37 %) and exhibited intermediate scores on cognitive and functional scales between those of subjects with positive and negative scans. Amyloid load differed between the EP- and negative groups and between the EP+ and positive groups after reclassification. Equivocal amyloid PET images could represent a neuroimaging entity with intermediate amyloid load but without a specific neuropsychological pattern. Clinical follow-up to assess cognitive evolution in subjects with equivocal scans is needed. (orig.)

  12. Cognitive and functional patterns of nondemented subjects with equivocal visual amyloid PET findings

    Energy Technology Data Exchange (ETDEWEB)

    Payoux, P. [Purpan University Hospital, Department of Nuclear Medicine, CHU Toulouse, Toulouse (France); Inserm, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); Universite de Toulouse, UPS, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); INSERM U825, CHU Purpan, Toulouse Cedex (France); Delrieu, J. [Purpan University Hospital, Gerontopole, Department of Geriatrics, CHU Toulouse, Toulouse (France); INSERM UMR 1027, Toulouse (France); Gallini, A.; Cantet, C.; Voisin, T.; Gillette-Guyonnet, S.; Vellas, B. [Universite de Toulouse, UPS, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); Purpan University Hospital, Gerontopole, Department of Geriatrics, CHU Toulouse, Toulouse (France); INSERM UMR 1027, Toulouse (France); Adel, D.; Salabert, A.S. [Inserm, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); Hitzel, A. [Purpan University Hospital, Department of Nuclear Medicine, CHU Toulouse, Toulouse (France); Universite de Toulouse, UPS, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); Tafani, M. [Purpan University Hospital, Department of Nuclear Medicine, CHU Toulouse, Toulouse (France); Inserm, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); Universite de Toulouse, UPS, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); Verbizier, D. de [Montpellier University Hospital, Department of Nuclear Medicine, Montpellier (France); Darcourt, J. [Centre Antoine Lacassagne, Nuclear Medicine Department, Nice (France); University of Nice-Sophia Antipolis, Nice (France); Fernandez, P. [Pellegrin University Hospital Bordeaux, Nuclear Medicine Department, Bordeaux (France); University Bordeaux II, CNRS UMR 5287 - INCIA, Victor Segalen, Bordeaux (France); Monteil, J. [University Hospital, Department of Nuclear Medicine, Limoges (France); University of Limoges, Limoges (France); Carrie, I. [Purpan University Hospital, Gerontopole, Department of Geriatrics, CHU Toulouse, Toulouse (France); Pontecorvo, M. [Avid Radiopharmaceuticals, Philadelphia, PA (United States); Andrieu, S. [Universite de Toulouse, UPS, Imagerie Cerebrale et Handicaps Neurologiques, UMR 825, Toulouse (France); Purpan University Hospital, Gerontopole, Department of Geriatrics, CHU Toulouse, Toulouse (France); INSERM UMR 1027, Toulouse (France); CHU Toulouse, Department of Epidemiology and Public Health, Toulouse (France)

    2015-08-15

    Despite good to excellent inter-reader agreement in the evaluation of amyloid load on PET scans in subjects with Alzheimer's disease, some equivocal findings have been reported in the literature. We aimed to describe the clinical characteristics of subjects with equivocal PET images. Nondemented subjects aged 70 years or more were enrolled from the MAPT trial. Cognitive and functional assessments were conducted at baseline, at 6 months, and annually for 3 years. During the follow-up period, 271 subjects had {sup 18}F-AV45 PET scans. Images were visually assessed by three observers and classified as positive, negative or equivocal (if one observer disagreed). After debate, equivocal images were reclassified as positive (EP+) or negative (EP-). Scans were also classified by semiautomated quantitative analysis using mean amyloid uptake of cortical regions. We evaluated agreement among the observers, and between visual and quantitative assessments using kappa coefficients, and compared the clinical characteristics of the subjects according to their PET results. In 158 subjects (58.30 %) the PET scan was negative for amyloid, in 77 (28.41 %) the scan was positive and in 36 (13.28 %) the scan was equivocal. Agreement among the three observers was excellent (kappa 0.80). Subjects with equivocal images were more frequently men (58 % vs. 37 %) and exhibited intermediate scores on cognitive and functional scales between those of subjects with positive and negative scans. Amyloid load differed between the EP- and negative groups and between the EP+ and positive groups after reclassification. Equivocal amyloid PET images could represent a neuroimaging entity with intermediate amyloid load but without a specific neuropsychological pattern. Clinical follow-up to assess cognitive evolution in subjects with equivocal scans is needed. (orig.)

  13. CSF Biomarker and PIB-PET–Derived Beta-Amyloid Signature Predicts Metabolic, Gray Matter, and Cognitive Changes in Nondemented Subjects

    Science.gov (United States)

    Insel, Philip; Jagust, William J.; Shaw, Leslie; Trojanowski J, John Q.; Aisen, Paul; Petersen, Ronald C.; Schuff, Norbert; Weiner, Michael W.

    2012-01-01

    Beta-amyloid (Aβ) is a histopathological hallmark of Alzheimer’s disease dementia, but high levels of Aβ in the brain can also be found in a substantial proportion of nondemented subjects. Here we investigated which 2-year rate of brain and cognitive changes are present in nondemented subjects with high and low Aβ levels, as assessed with cerebrospinal fluid and molecular positron emission tomography (PET)–based biomarkers of Aβ. In subjects with mild cognitive impairment, increased brain Aβ levels were associated with significantly faster cognitive decline, progression of gray matter atrophy within temporal and parietal brain regions, and a trend for a faster decline in parietal Fludeoxyglucose (FDG)-PET metabolism. Changes in gray matter and FDG-PET mediated the association between Aβ and cognitive decline. In contrast, elderly cognitively healthy controls (HC) with high Aβ levels showed only a faster medial temporal lobe and precuneus volume decline compared with HC with low Aβ. In conclusion, the current results suggest not only that both functional and volumetric brain changes are associated with high Aβ years before the onset of dementia but also that HC with substantial Aβ levels show higher Aβ pathology resistance, lack other pathologies that condition neurotoxic effects of Aβ, or accumulated Aβ for a shorter time period. PMID:22038908

  14. Association of Depression and Loneliness with Specific Cognitive Performance in Non-Demented Elderly Males

    OpenAIRE

    Tzang, Ruu-Fen; Yang, Albert C.; Yeh, Heng-Liang; Liu, Mu-En; Tsai, Shih-Jen

    2015-01-01

    Background Loneliness and depression are very common in the aged population. Both have negative impacts on cognition in the elderly. The present study aimed to investigate the effect of loneliness and depression on total as well as specific cognitive domains in cognitively normal male subjects. Material/Methods A total of 189 cognitively normal male subjects were recruited and underwent Cognitive Abilities Screening Instrument (CASI) and Wechsler Digit Span Task tests. Depression was assessed...

  15. The assessment and management of pain in the demented and non-demented elderly patient

    Directory of Open Access Journals (Sweden)

    D C Andrade

    2011-01-01

    Full Text Available Persistent pain is a frequent health problem in the elderly. Its prevalence ranges from 45% to 80%. Chronic diseases, such as depression, cardiovascular disease, cancer and osteoporosis have a higher prevalence in aged individuals and increase the risk of developing chronic pain. The presence of pain is known to be associated with sleep disorders in these patients, as well as functional impairment, decreased sociability and greater use of the health system, with consequent increase in costs. Alzheimer's disease patients seem to have a normal pain discriminative capacity and they may probably have weaker emotional and affective experience of pain when compared to other types of dementia. Many patients have language deficits and thus cannot properly describe its characteristics. In more advanced cases, it becomes even difficult to determine whether pain is present or not. Therefore, the evaluation of these patients should be performed in a systematic way. There are three ways to measure the presence of pain: by direct questioning (self-report, by direct behavioral observation and by interviews with caregivers or informants. In recent years, many pain scales and questionnaires have been published and validated specifically for the elderly population. Some are specific to patients with cognitive decline, allowing pain evaluation to be conducted in a structured and reproducible way. The next step is to determine the type of painful syndrome and discuss the bases of the pharmacological management, the use of multiple medications and the presence of comorbidities demand the use of smaller doses and impose contra-indications against some drug classes. A multiprofessional approach is the rule in the management of these patients.

  16. Clock-drawing test in non-demented slovene elderly people with different levels of education

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    Andreja Avberšek

    2005-04-01

    Full Text Available Background: Early detection of dementia has a number of benefits such as pharmaceutical intervention, improved recognition and treatment of comorbid medical disorders. Brief cognitive tests have an important role in initial screening for dementia. So far, only the Mini Mental State Examination (MMSE has been introduced in Slovenia. The MMSE can be complemented with the Clock-Drawing Test (CDT. A standard procedure of applying and evaluating CDT, as well as normative values for Slovenian population are yet to be defined. Our aim was to apply CDT to normal subjects of different age and educational level. Our hypothesis was that education level has no significant effect on performance on CDT.Methods: 132 normal subjects aged 55 to 79 years were enrolled in the study. None of them met the DSM IV criteria for dementia. Clock drawings were evaluated using the Shulman scale. Analysis of variance (ANOVA was performed to compare different age groups.Results: Statistical analysis showed no significant effect of gender (p = 0.88, F = 0.023 and education (p = 0.55, F = 0.77 on clock drawing. CDT performance significantly deteriorated with age (p = 0.000024, F = 7.34.Conclusions: Since we found no significant effect of education on CDT, the hypothesis was accepted. Deterioration of CDT results with age can only partly be attributed to the process of aging. It is highly probable that in a certain number of participants the process of dementia had already started, yet the clinical criteria were not met at the time. Our group of subjects is going to be used as a control group in the process of validation of CDT.

  17. Backward disequilibrium in elderly subjects

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    Patrick Manckoundia

    2008-12-01

    Full Text Available Patrick Manckoundia1,2, France Mourey1,2, Dominic Pérennou2,3, Pierre Pfitzenmeyer1,21Department of Internal Medicine and Geriatrics, University Hospital, Dijon, France; 2INSERM/ERIT-M 0207 Motricity-Plasticity University of Burgundy, Dijon, France; 3Department of Neurological Rehabilitation, University Hospital, Dijon, FranceAbstract: Backward disequilibrium is observed frequently in daily clinical practice. However, there are no epidemiological data concerning this postural disorder. Defined by a posterior position of the centre of mass with respect to the base of support, backward disequilibrium is abnormal postural behavior, usually characterized by a posterior trunk tilt in standing and sitting positions, which predisposes subjects to backward falls. Many afflictions whether they are somatic (degenerative, ischemic and traumatic brain lesions, psychosomatic (psychomotor disadaptation syndrome, confinement to bed, nonuse situations or psychological (depression can cause backward disequilibrium. A vicious circle of falls, and loss of autonomy can arise and this is the main consequence of backward disequilibrium. Thus, in this paper, we review backward disequilibrium in elderly subjects with regard to the causes, consequences, assessment, and management.Keywords: backward disequilibrium, balance, elderly subject, falls, posture

  18. Blood-Based Biomarker Candidates of Cerebral Amyloid Using PiB PET in Non-Demented Elderly

    Science.gov (United States)

    Westwood, Sarah; Leoni, Emanuela; Hye, Abdul; Lynham, Steven; Khondoker, Mizanur R.; Ashton, Nicholas J.; Kiddle, Steven J.; Baird, Alison L.; Sainz-Fuertes, Ricardo; Leung, Rufina; Graf, John; Hehir, Cristina Tan; Baker, David; Cereda, Cristina; Bazenet, Chantal; Ward, Malcolm; Thambisetty, Madhav; Lovestone, Simon

    2018-01-01

    Increasingly, clinical trials for Alzheimer’s disease (AD) are being conducted earlier in the disease phase and with biomarker confirmation using in vivo amyloid PET imaging or CSF tau and Aβ measures to quantify pathology. However, making such a pre-clinical AD diagnosis is relatively costly and the screening failure rate is likely to be high. Having a blood-based marker that would reduce such costs and accelerate clinical trials through identifying potential participants with likely pre-clinical AD would be a substantial advance. In order to seek such a candidate biomarker, discovery phase proteomic analyses using 2DGE and gel-free LC-MS/MS for high and low molecular weight analytes were conducted on longitudinal plasma samples collected over a 12-year period from non-demented older individuals who exhibited a range of 11C-PiB PET measures of amyloid load. We then sought to extend our discovery findings by investigating whether our candidate biomarkers were also associated with brain amyloid burden in disease, in an independent cohort. Seven plasma proteins, including A2M, Apo-A1, and multiple complement proteins, were identified as pre-clinical biomarkers of amyloid burden and were consistent across three time points (p biomarker signature indicative of AD pathology at a stage long before the onset of clinical disease manifestation. As in previous studies, acute phase reactants and inflammatory markers dominate this signature. PMID:27031486

  19. Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented Chinese elders.

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    Mortimer, James A; Ding, Ding; Borenstein, Amy R; DeCarli, Charles; Guo, Qihao; Wu, Yougui; Zhao, Qianhua; Chu, Shugang

    2012-01-01

    Physical exercise has been shown to increase brain volume and improve cognition in randomized trials of non-demented elderly. Although greater social engagement was found to reduce dementia risk in observational studies, randomized trials of social interventions have not been reported. A representative sample of 120 elderly from Shanghai, China was randomized to four groups (Tai Chi, Walking, Social Interaction, No Intervention) for 40 weeks. Two MRIs were obtained, one before the intervention period, the other after. A neuropsychological battery was administered at baseline, 20 weeks, and 40 weeks. Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests. Time-intervention group interactions for neuropsychological measures were evaluated with repeated-measures mixed models. Compared to the No Intervention group, significant increases in brain volume were seen in the Tai Chi and Social Intervention groups (p Improvements also were observed in several neuropsychological measures in the Tai Chi group, including the Mattis Dementia Rating Scale score (p = 0.004), the Trailmaking Test A (p = 0.002) and B (p = 0.0002), the Auditory Verbal Learning Test (p = 0.009), and verbal fluency for animals (p = 0.01). The Social Interaction group showed improvement on some, but fewer neuropsychological indices. No differences were observed between the Walking and No Intervention groups. The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise (Tai Chi). In addition, intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements.

  20. [Lung cancer in the elderly subject].

    Science.gov (United States)

    Albrand, G; Biron, E; Boucot, I; Couderc, L J; Crestani, B; Dombret, M C; Guenard, H; Grivaux, M; Hervy, M P; Housset, B; Jougon, J; Orvoen-Frija, E; Piette, F; Pignon, T; Pinganaud, G; Puisieux, F; Quoix, E; Sauty, E; Vaylet, F; Wary, B; Weill-Engerer, S; Westeel, V; Wislez, M

    2007-06-01

    In France, the average age for the diagnosis of bronchial carcinoma is 64. It is 76 in the population of over 70. In fact, its incidence increases with age linked intrinsic risk of developing a cancer and with general ageing of the population. Diagnosis tools are the same for elderlies than for younger patients, and positive diagnosis mainly depends on fibreoptic bronchoscopy, complications of which being comparable to those observed in younger patients. The assessment of dissemination has been modified in recent years by the availability of PET scanning which is increasingly becoming the examination of choice for preventing unnecessary surgical intervention, a fortiori in elderly subjects. Cerebral imaging by tomodensitometry and nuclear magnetic resonance should systematically be obtained before proposing chirurgical treatment. An assessment of the general state of health of the elderly subject is an essential step before the therapeutic decision is made. This depends on the concept of geriatric evaluation: Geriatric Multidimensional Assessment, and the Comprehensive Geriatric Assessment which concerns overall competence of the elderly. This is a global approach that allows precise definition and ranking of the patient's problems and their impact on daily life and social environment. Certain geriatric variables (IADL, BADL, MMSE, IMC etc) may be predictive of survival rates after chemotherapy or the incidence of complications following thoracic surgery. The main therapeutic principles for the management of bronchial carcinoma are applicable to the elderly subject; long term survival without relapse after surgical resection is independent of age. Whether the oncological strategy is curative or palliative, the elderly patient with bronchial carcinoma should receive supportive treatments. They should be integrated into a palliative programme if such is the case. In fact, age alone is not a factor that should detract from optimal oncological management. The

  1. The Distribution of Thai Mental State Examination Scores among Non-Demented Elderly in Suburban Bangkok Metropolitan and Associated Factors.

    Science.gov (United States)

    Muangpaisan, Weerasak; Assantachai, Prasert; Sitthichai, Kobkul; Richardson, Kathryn; Brayne, Carol

    2015-09-01

    To obtain the distribution of Thai Mental State Examination (TMSE) scores in the Thai population across different age groups and educational levels in men and women aged 50 years and older and its relationship with demographic factors. The different cutpoints in literate and illiterate participants and item performance in both groups were also determined. Community-dwelling participants aged 50 years and over were invited to join the study. Personal information, general health history, and specific illness questionnaires including the activities of daily living, designed by the Survey in Europe on Nutrition and the Elderly, a ConcertedAction (SENECA), and the Thai Mental State Examination (TMSE) were completed in the face-to-face interview. There were 4,459 participants with no specific reported conditions that could potentially influence cognitive performance. The mean (SD) age was 64.2 (7.9) years and mostparticipants were women (71.7%). The median (interquartile range) of the TMSE was 27 (25-29) and 23 (19-26) in literate and illiterate participants, respectively. The distribution of TMSE scores were reported here determined by age, gender and educational level. Percentage of correct response in each TMSE item was low in recall and calculation performance. TMSE score declined with age in both genders and had greater variation with increasing age. TMSE score also increased with increasing levels of education and better financial status. Gender was not associated with the TMSE score adjusting for age, educational level, and economic status. Age, education, and economic status have an influence on the TMSE performance. Controllingfor these three factors, genders does not contribute to significant differences in TMSE performance. Norms adjustedfor these factors should be considered before employing single cutpoints to identify impairment.

  2. Brain Amyloid Deposition and Longitudinal Cognitive Decline in Nondemented Older Subjects: Results from a Multi-Ethnic Population.

    Directory of Open Access Journals (Sweden)

    Yian Gu

    Full Text Available We aimed to whether the abnormally high amyloid-β (Aβ level in the brain among apparently healthy elders is related with subtle cognitive deficits and/or accelerated cognitive decline.A total of 116 dementia-free participants (mean age 84.5 years of the Washington Heights Inwood Columbia Aging Project completed 18F-Florbetaben PET imaging. Positive or negative cerebral Aβ deposition was assessed visually. Quantitative cerebral Aβ burden was calculated as the standardized uptake value ratio in pre-established regions of interest using cerebellar cortex as the reference region. Cognition was determined using a neuropsychological battery and selected tests scores were combined into four composite scores (memory, language, executive/speed, and visuospatial using exploratory factor analysis. We examined the relationship between cerebral Aβ level and longitudinal cognition change up to 20 years before the PET scan using latent growth curve models, controlling for age, education, ethnicity, and Apolipoprotein E (APOE genotype.Positive reading of Aβ was found in 41 of 116 (35% individuals. Cognitive scores at scan time was not related with Aβ. All cognitive scores declined over time. Aβ positive reading (B = -0.034, p = 0.02 and higher Aβ burden in temporal region (B = -0.080, p = 0.02 were associated with faster decline in executive/speed. Stratified analyses showed that higher Aβ deposition was associated with faster longitudinal declines in mean cognition, language, and executive/speed in African-Americans or in APOE ε4 carriers, and with faster memory decline in APOE ε4 carriers. The associations remained significant after excluding mild cognitive impairment participants.High Aβ deposition in healthy elders was associated with decline in executive/speed in the decade before neuroimaging, and the association was observed primarily in African-Americans and APOE ε4 carriers. Our results suggest that measuring cerebral Aβ may give us

  3. Efficacy of Auditory Training in Elderly Subjects

    Science.gov (United States)

    Morais, Aline Albuquerque; Rocha-Muniz, Caroline Nunes; Schochat, Eliane

    2015-01-01

    Auditory training (AT) has been used for auditory rehabilitation in elderly individuals and is an effective tool for optimizing speech processing in this population. However, it is necessary to distinguish training-related improvements from placebo and test–retest effects. Thus, we investigated the efficacy of short-term AT [acoustically controlled auditory training (ACAT)] in elderly subjects through behavioral measures and P300. Sixteen elderly individuals with auditory processing disorder (APD) received an initial evaluation (evaluation 1 – E1) consisting of behavioral and electrophysiological tests (P300 evoked by tone burst and speech sounds) to evaluate their auditory processing. The individuals were divided into two groups. The Active Control Group (n = 8) underwent placebo training. The Passive Control Group (n = 8) did not receive any intervention. After 12 weeks, the subjects were revaluated (evaluation 2 – E2). Then, all of the subjects underwent ACAT. Following another 12 weeks (eight training sessions), they underwent the final evaluation (evaluation 3 – E3). There was no significant difference between E1 and E2 in the behavioral test [F(9.6) = 0.06, p = 0.92, λ de Wilks = 0.65)] or P300 [F(8.7) = 2.11, p = 0.17, λ de Wilks = 0.29] (discarding the presence of placebo effects and test–retest). A significant improvement was observed between the pre- and post-ACAT conditions (E2 and E3) for all auditory skills according to the behavioral methods [F(4.27) = 0.18, p = 0.94, λ de Wilks = 0.97]. However, the same result was not observed for P300 in any condition. There was no significant difference between P300 stimuli. The ACAT improved the behavioral performance of the elderly for all auditory skills and was an effective method for hearing rehabilitation. PMID:26042031

  4. Cognitive testing in non-demented Turkish immigrants

    DEFF Research Database (Denmark)

    Nielsen, T. Rune; Vogel, Asmus M.; Gade, Anders

    2012-01-01

    Nielsen, T. R. Vogel, A., Gade, A. & Waldemar, G. (2012). Cognitive testing in healthy Turkish immigrants - comparison of the RUDAS and the MMSE. Scandinavian Journal of Psychology 53, 455-460. Methods for culturally and linguistically appropriate cognitive testing of elderly minority populations...... of non-demented community-dwelling Turkish immigrants was recruited from the greater Copenhagen area. All participants completed a structured interview regarding demographic, physical and mental health status, as well as measures of depression and acculturation, and cognitive testing with the RUDAS...... significant variable for RUDAS and MMSE performance than any other variable. However, the impact of schooling was considerably more pronounced on the MMSE and the test was not found to be a valid measure of general cognitive function in subjects with less than five years of schooling. Although not entirely...

  5. Study of Spirituality in Elderly With Subjective Memory Complaints.

    Science.gov (United States)

    Trivedi, Surbhi C; Subramanyam, Alka A; Kamath, Ravindra M; Pinto, Charles

    2016-01-01

    Subjective memory complaints are very common among elderly. They can be due to depression, cognitive decline, or be a part of normal aging process. Spirituality is another important dimension in elderly, and it is believed to help them cope with various adversities. This study was done to find out whether any relation exists between these 2 variables in elderly. A total of 120 elderly individuals, presenting with subjective memory complaints, were divided into 3 groups - controls, elderly with depression, and elderly with mild cognitive impairment (MCI). Spirituality in them was studied by dividing it into the subdomains of self-transcendence, presence of meaning in life, search for meaning in life, and locus of control. Spirituality was the highest in controls, followed by MCI group, and then depression group. Spirituality had a direct negative relationship with severity of depression, while relationship of spirituality with severity of cognitive decline was more complex. Relationship of spirituality with mental health status in elderly patients seemed bidirectional, that is, cause as well as effect relationship. © The Author(s) 2015.

  6. Perioperative exercise training in elderly subjects.

    Science.gov (United States)

    Jack, S; West, M; Grocott, M P W

    2011-09-01

    The association between physical fitness and outcome following major surgery is well described - less fit patients having a higher incidence of perioperative morbidity and mortality. This has led to the idea of physical training (exercise training) as a perioperative intervention with the aim of improving postoperative outcome. Studies have started to explore both preoperative training (prehabilitation) and postoperative training (rehabilitation). We have reviewed the current literature regarding the use of prehabilitation and rehabilitation in relation to major surgery in elderly patients. We have focussed particularly on randomised controlled trials, systematic reviews and meta-analyses. There is currently a paucity of high-quality clinical trials in this area, and the evidence base in elderly patients is particularly limited. The review indicated that prehabilitation can improve objectively measured fitness in the short time available prior to major surgery. Furthermore, for several general surgical procedures, prehabilitation using inspiratory muscle training may reduce the risk of some specific complications (e.g., pulmonary complications and predominately atelectasis), but it is unclear whether this translates into an improvement in overall surgical outcome. There is clear evidence that rehabilitation is of benefit to patients following cancer diagnoses, in terms of physical activity, fatigue and health-related quality of life. However, it is uncertain whether this improved physical function translates into increased survival and delayed disease recurrence. Prehabilitation using continuous or interval training has been shown to improve fitness but the impact on surgical outcomes remains ill defined. Taken together, these findings are encouraging and support the notion that pre- and postoperative exercise training may be of benefit to patients. There is an urgent need for adequately powered randomised control studies addressing appropriate clinical outcomes in

  7. Sensory perception and pleasantness of food flavour in elderly subjects.

    NARCIS (Netherlands)

    Graaf, de C.; Polet, P.; Staveren, van W.A.

    1994-01-01

    This study was designed to determine the perceived intensity and pleasantness of different food flavors. A group of 32 young subjects (mean age: 22, range 20-25) and 23 elderly subjects (mean age: 76, range 72-82) judged the intensity and the pleasantness of five series of food flavors, each with

  8. Age- dependent effect of Alzheimer’s risk variant of CLU on EEG alpha rhythm in non-demented adults

    Directory of Open Access Journals (Sweden)

    Natalya ePonomareva

    2013-12-01

    Full Text Available Polymorphism in the genomic region harboring the CLU gene (rs11136000 has been associated with the risk for Alzheimer’s disease (AD. CLU C allele is assumed to confer risk for AD and the allele T may have a protective effect.We investigated the influence of the AD-associated CLU genotype on a common neurophysiological trait of brain activity (resting-state alpha-rhythm activity in non-demented adults and elucidated whether this influence is modified over the course of aging. We examined quantitative EEG (qEEG in cohort of non-demented individuals (age range 20-80 divided into young (age range 20-50 and old (age range 51-80 cohorts and stratified by CLU polymorphism. To rule out the effect of the ApoE genotype on EEG characteristics, only subjects without the ApoE epsilon4 allele were included in the study.The homozygous presence of the AD risk variant CLU CC in non-demented subjects was associated with an increase of alpha3 absolute power. Moreover, the influence of CLU genotype on alpha3 was found to be higher in the subjects older than 50 years of age. The study also showed age-dependent alterations of alpha topographic distribution that occur independently of the CLU genotype.The increase of upper alpha power has been associated with hippocampal atrophy in patients with mild cognitive impairment (Moretti et al., 2012a. In our study, the CLU CC- dependent increase in upper alpha rhythm, particularly enhanced in elderly non-demented individuals, may imply that the genotype is related to preclinical dysregulation of hippocampal neurophysiology in aging and that this factor may contribute to pathogenesis of AD.

  9. Pharmacokinetics, Safety, and Tolerability of Tedizolid Phosphate in Elderly Subjects.

    Science.gov (United States)

    Flanagan, Shawn D; Minassian, Sonia L; Prokocimer, Philippe

    2018-01-10

    Tedizolid phosphate is approved for the treatment of acute bacterial skin and skin structure infections in adults. We evaluated the pharmacokinetics of tedizolid in elderly subjects to guide dosing recommendations. In an open-label phase 1 study (ClinicalTrials.gov identifier NCT01496677), 14 elderly (≥65 years) and 14 younger control (18-45 years) subjects each received a single oral dose of tedizolid phosphate 200 mg. Blood samples were collected before dose and more than 72 hours after dose. The pharmacokinetic parameters of tedizolid after a single dose were similar in both age groups. Geometric mean ratios (elderly/younger controls) and corresponding 90% confidence intervals were maximum observed plasma concentration (C max ), 1.091 (0.917-1.297); AUC from time 0 extrapolated to infinity (AUC 0-∞ ), 1.132 (0.954-1.343). Tedizolid plasma exposure was similar in elderly and younger control subjects. The findings indicated that after intravenous or oral administration of tedizolid phosphate 200 mg once daily, no dose adjustment was warranted in elderly subjects to achieve therapeutic levels. © 2018, The American College of Clinical Pharmacology.

  10. Hypertension and white matter lesions are independently associated with apathetic behavior in healthy elderly subjects: the Sefuri brain MRI study.

    Science.gov (United States)

    Yao, Hiroshi; Takashima, Yuki; Mori, Takahiro; Uchino, Akira; Hashimoto, Manabu; Yuzuriha, Takefumi; Miwa, Yoshikazu; Sasaguri, Toshiyuki

    2009-07-01

    Apathy is defined as a syndrome of primary loss of motivation not attributable to emotional distress, intellectual impairment or consciousness disturbance. The aim of our study was to investigate the effects of vascular risk factors and silent ischemic brain lesions on apathetic behavior of community-dwelling elderly subjects. Brain MRI and other medical examinations were performed on 222 non-demented community-dwelling elderly subjects (96 men and 126 women, average age 70.1 years). The apathy group was defined as the most apathetic quintile determined by Starkstein's apathy scale. Silent infarction, deep white matter lesions (DWMLs) and periventricular hyperintensities were detected in 12.2, 39.2 and 22.5%, respectively. Linear regression analysis (Pearson) revealed that the scores on the apathy scale correlated slightly but significantly with logarithmically transformed scores of the Modified Stroop Test (r=0.135, P=0.045), but not with the Mini-Mental State Examination. The apathy group tended to have more high blood pressure (141.6/82.6 vs. 136.1/79.6 mm Hg), less prevalent hyperlipidemia (18 vs. 35%) and lower serum albumin. Multivariate analysis (the forward stepwise method of logistic analysis) revealed an independent correlation between the apathy and grade of DWMLs (odds ratio 1.826, 95% confidence interval (CI) 1.129-2.953 per grade) or diastolic blood pressure (DBP) (odds ratio 1.055, 95% CI 1.014-1.098 per mm Hg) after adjusting for possible confounders. The mean apathy scale score in the DBP>or=90 mm Hg group was significantly lower (more apathetic) than that in the DBPanalysis of covariance). This study showed that hypertension and DWMLs are independently associated with apathy in healthy elderly subjects.

  11. Hypertension and white matter lesions are independently associated with apathetic behavior in healthy elderly subjects. The Sefuri brain MRI study

    International Nuclear Information System (INIS)

    Yao, Hiroshi; Takashima, Yuki; Mori, Takahiro; Hashimoto, Manabu; Yuzuriha, Takefumi; Uchino, Akira; Miwa, Yoshikazu; Sasaguri, Toshiyuki

    2009-01-01

    Apathy is defined as a syndrome of primary loss of motivation not attributable to emotional distress, intellectual impairment or consciousness disturbance. The aim of our study was to investigate the effects of vascular risk factors and silent ischemic brain lesions on apathetic behavior of community-dwelling elderly subjects. Brain MRI and other medical examinations were performed on 222 non-demented community-dwelling elderly subjects (96 men and 126 women, average age 70.1 years). The apathy group was defined as the most apathetic quintile determined by Starkstein's apathy scale. Silent infarction, deep white matter lesions (DWMLs) and periventricular hyperintensities were detected in 12.2, 39.2 and 22.5%, respectively. Linear regression analysis (Pearson) revealed that the scores on the apathy scale correlated slightly but significantly with logarithmically transformed scores of the Modified Stroop Test (r=0.135, P=0.045), but not with the Mini-Mental State Examination. The apathy group tended to have more high blood pressure (141.6/82.6 vs. 136.1/79.6 mmHg), less prevalent hyperlipidemia (18 vs. 35%) and lower serum albumin. Multivariate analysis (the forward stepwise method of logistic analysis) revealed an independent correlation between the apathy and grade of DWMLs (odds ratio 1.826, 95% confidence interval (CI) 1.129-2.953 per grade) or diastolic blood pressure (DBP) (odds ratio 1.055, 95% CI 1.0 14-1.098 per mmHg) after adjusting for possible confounders. The mean apathy scale score in the DBP≥90 mmHg group was significantly lower (more apathetic) than that in the DBP<80 group (P=0.011, analysis of covariance). This study showed that hypertension and DWMLs are independently associated with apathy in healthy elderly subjects. (author)

  12. Does subjective sleep affect cognitive function in healthy elderly subjects? The Proof cohort.

    Science.gov (United States)

    Saint Martin, Magali; Sforza, Emilia; Barthélémy, Jean Claude; Thomas-Anterion, Catherine; Roche, Frédéric

    2012-10-01

    Some epidemiological data are available on the association between sleep duration and sleep quality, sleep complaints, and the aging related cognitive impairment in the elderly. In this study we examined a large sample of healthy elderly subjects to assess the relationship between sleep quality, subjective cognitive complaints, and neuropsychological performance. A total of 272 elderly subjects (mean age 74.8 ± 1.1 years) were recruited from a population-based cross-sectional study on aging and cardiovascular morbidity. All subjects filled in self-assessment questionnaires evaluating cognitive function, anxiety, depression, sleep-related parameters, and the Pittsburgh Sleep Quality Index (PSQI). Ambulatory polygraphy and extensive neuropsychological tests were also performed. Based on the total PSQI score, subjects were classified as good sleepers (GS, PSQIsleep did not affect the subjective cognitive function score, subjective cognitive impairment being mainly related to anxiety, depression, and sleep medication intake. No significant differences were seen between GS and PS in any of the objective cognitive function tests except for the Trail Making Test A (TMA-A), processing speed being longer in the PS group (psleep-related breathing disorders nor gender affected cognitive performance. Our results suggest that in healthy elderly subjects, subjective sleep quality and duration did not significantly affect subjective and objective cognitive performances, except the attention level, for that the interference of sleep medication should be considered. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Cerebral blood flow MRI in the nondemented elderly is not predictive of post-operative delirium but is correlated with cognitive performance.

    Science.gov (United States)

    Hshieh, Tammy T; Dai, Weiying; Cavallari, Michele; Guttmann, Charles Rg; Meier, Dominik S; Schmitt, Eva M; Dickerson, Bradford C; Press, Daniel Z; Marcantonio, Edward R; Jones, Richard N; Gou, Yun Ray; Travison, Thomas G; Fong, Tamara G; Ngo, Long; Inouye, Sharon K; Alsop, David C

    2017-04-01

    Three-dimensional Arterial Spin Labeling (ASL) MRI was performed before surgery in a cohort of 146 prospectively enrolled subjects ≥ 70 years old scheduled to undergo elective surgery. We investigated the prospective association between ASL-derived measures of cerebral blood flow (CBF) before surgery with postoperative delirium incidence and severity using whole-brain and globally normalized voxel-wise analysis. We also investigated the cross-sectional association of CBF with patients' baseline performance on specific neuropsychological tests, and with a composite general cognitive performance measure (GCP). Out of 146 subjects, 32 (22%) developed delirium. We found no significant association between global and voxel-wise CBF with delirium incidence or severity. We found the most significant positive associations between CBF of the posterior cingulate and precuneus and the Hopkins Verbal Learning Test - Revised total score, Visual Search and Attention Test (VSAT) score and the GCP composite. VSAT score was also strongly associated with right parietal lobe CBF. ASL can be employed in a large, well-characterized older cohort to examine associations between CBF and age-related cognitive performance. Although ASL CBF measures in regions previously associated with preclinical Alzheimer's Disease were correlated with cognition, they were not found to be indicators of baseline pathology that may increase risk for delirium.

  14. Subjective memory complaints in elders: depression, anxiety, or cognitive decline?

    Science.gov (United States)

    Balash, Y; Mordechovich, M; Shabtai, H; Giladi, N; Gurevich, T; Korczyn, A D

    2013-05-01

    To study the association of subjective memory complaints (SMC) with affective state and cognitive performance in elders. We studied community dwelling elderly persons with normal physical examination. Participants completed questionnaires regarding memory difficulties and lifestyle habits, the Geriatric Depression Scale (GDS) and the Spielberger State-Trait Anxiety Inventory (STAI). Depending on their answers to the question about their memory condition, participants were divided into complainers and non-complainers and to five groups according to their MMSE scores. These data have been compared to objective cognitive performance according to Mindstreams - a computerized neuropsychological battery. A logistic regression was performed to evaluate odds ratios (OR) and 95% confidence intervals (CI) for those factors, which were associated with SMС (dependent variable). Of 636 consecutive subjects (61% females), 507 participants (79.7%) had SMС. Presence of SMC was inversely correlated with MMSE scores, (r = -0.108; P for trend = 0.007). GDS and STAI scores were higher among subjects with SMC (OR = 1.23: CI 95%: 1.1-1.36 and OR = 1.03: CI 95%: 1.01-1.07, respectively). SMC did not correlate with objective cognitive performance measured by Mindstreams. Subjective memory complaints are associated with sub-syndromal depression and anxiety in healthy cognitively normal elders. © 2012 John Wiley & Sons A/S.

  15. Regional Hippocampal Atrophy and Higher Levels of Plasma Amyloid-Beta Are Associated With Subjective Memory Complaints in Nondemented Elderly Subjects

    DEFF Research Database (Denmark)

    Cantero, Jose L; Iglesias, Juan E.; Van Leemput, Koen

    2016-01-01

    volume differences in hippocampal subregions were further correlated with plasma Aβ levels and with objective memory performance. Results: Individuals with SMC exhibited significantly higher Aβ1-42 concentrations and lower volumes of CA1, CA4, dentate gyrus, and molecular layer compared with SMC......(-) participants. Regression analyses further showed significant associations between lower volume of the dentate gyrus and both poorer memory performance and higher plasma Aβ1-42 levels in SMC(+) participants. Conclusions: The presence of SMC, lower volumes of specific hippocampal regions, and higher plasma Aβ1...

  16. Nutritional status and cognitive function in frail elderly subjects

    OpenAIRE

    Faxén Irving, Gerd

    2004-01-01

    Longevity, frailty and chronic disease are often associated with protein energy-malnutrition (PEM). Subjects with dementia are at particular risk for PEM. The overall aims of this thesis were to evaluate relationships between nutrition, cognition and functional capacity and to assess interventional means of developing the nutritional care of elderly. In study I and 11, the nutritional status and the cognitive function were examined in 28 and 80 service flat (SF) residents. F...

  17. Cognitive and imaging markers in non-demented subjects attending a memory clinic: study design and baseline findings of the MEMENTO cohort.

    Science.gov (United States)

    Dufouil, Carole; Dubois, Bruno; Vellas, Bruno; Pasquier, Florence; Blanc, Frédéric; Hugon, Jacques; Hanon, Olivier; Dartigues, Jean-François; Harston, Sandrine; Gabelle, Audrey; Ceccaldi, Mathieu; Beauchet, Olivier; Krolak-Salmon, Pierre; David, Renaud; Rouaud, Olivier; Godefroy, Olivier; Belin, Catherine; Rouch, Isabelle; Auguste, Nicolas; Wallon, David; Benetos, Athanase; Pariente, Jérémie; Paccalin, Marc; Moreaud, Olivier; Hommet, Caroline; Sellal, François; Boutoleau-Bretonniére, Claire; Jalenques, Isabelle; Gentric, Armelle; Vandel, Pierre; Azouani, Chabha; Fillon, Ludovic; Fischer, Clara; Savarieau, Helen; Operto, Gregory; Bertin, Hugo; Chupin, Marie; Bouteloup, Vincent; Habert, Marie-Odile; Mangin, Jean-François; Chêne, Geneviève

    2017-08-29

    The natural history and disease mechanisms of Alzheimer's disease and related disorders (ADRD) are still poorly understood. Very few resources are available to scrutinise patients as early as needed and to use integrative approaches combining standardised, repeated clinical investigations and cutting-edge biomarker measurements. In the nationwide French MEMENTO cohort study, participants were recruited in memory clinics and screened for either isolated subjective cognitive complaints (SCCs) or mild cognitive impairment (MCI; defined as test performance 1.5 SD below age, sex and education-level norms) while not demented (Clinical Dementia Rating [CDR] <1). Baseline data collection included neurological and physical examinations as well as extensive neuropsychological testing. To be included in the MEMENTO cohort, participants had to agree to undergo both brain magnetic resonance imaging (MRI) and blood sampling. Cerebral 18 F-fluorodeoxyglucose positon emission tomography and lumbar puncture were optional. Automated analyses of cerebral MRI included assessments of volumes of whole-brain, hippocampal and white matter lesions. The 2323 participants, recruited from April 2011 to June 2014, were aged 71 years, on average (SD 8.7), and 62% were women. CDR was 0 in 40% of participants, and 30% carried at least one apolipoprotein E ε4 allele. We observed that more than half (52%) of participants had amnestic mild cognitive impairment (17% single-domain aMCI), 32% had non-amnestic mild cognitive impairment (16.9% single-domain naMCI) and 16% had isolated SCCs. Multivariable analyses of neuroimaging markers associations with cognitive categories showed that participants with aMCI had worse levels of imaging biomarkers than the others, whereas participants with naMCI had markers at intermediate levels between SCC and aMCI. The burden of white matter lesions tended to be larger in participants with aMCI. Independently of CDR, all neuroimaging and neuropsychological markers

  18. Comparative Clinical, Physiological, and Inflammatory Characteristics of Elderly Subjects With or Without Asthma and Young Subjects With Asthma.

    Science.gov (United States)

    Boulet, Louis-Philippe; Robitaille, Catherine; Deschesnes, Francine; Villeneuve, Hélène; Boulay, Marie-Ève

    2017-12-01

    Asthma seems to present in the elderly as a specific phenotype that remains to be further described. In this prospective observational study, we aimed to assess the multidimensional aspects of asthma in the elderly. In young (18 to 35 years old) subjects with mild to moderate asthma and elderly subjects (aged ≥60 years) either with or without mild to moderate asthma, we compared asthma control, health care and medication use, lung function, markers of airway and systemic inflammation, and adherence to therapy. Fifty subjects were recruited in each group. Elderly people with asthma showed more marked airway obstruction compared with young people with asthma and elderly people without asthma. They also had poorer asthma control, mainly associated with a lower FEV 1 , compared with young people with asthma, although airway responsiveness, health care use, prescribed doses of inhaled corticosteroids, and adherence to treatment were similar in both groups. Elderly subjects had an increase in some markers of systemic inflammation and bronchial epithelial dysfunction compared with young people with asthma. Blood eosinophils were higher in both asthma groups, particularly in elderly people with asthma. Sputum neutrophils were increased in both groups of elderly subjects and sputum eosinophils were increased in elderly people with asthma compared with the other two groups. Asthma in the elderly presents as a specific phenotype associated with increased airway obstruction and mixed airway inflammation in addition to signs of systemic inflammation. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  19. Subjective Quality of Life of Polish, Polish-Immigrant, and Polish-American Elderly.

    Science.gov (United States)

    Berdes, Celia; Zych, Adam A.

    2000-01-01

    Compares subjective quality of life of elderly Poles living in Poland, and Polish immigrants and Polish-American ethnics living in Chicago as part of a secondary data analysis of a study initially conducted in Poland. Conclusions lend support to the idea that U.S.-born elderly people and elderly immigrants to the United States have a significantly…

  20. [Homeostasis model assessment (HOMA) values in Chilean elderly subjects].

    Science.gov (United States)

    Garmendia, María Luisa; Lera, Lydia; Sánchez, Hugo; Uauy, Ricardo; Albala, Cecilia

    2009-11-01

    The homeostasis assessment model for insulin resistance (HOMA-IR) estimates insulin resistance using basal insulin and glucose values and has a good concordance with values obtained with the euglycemic clamp. However it has a high variability that depends on environmental, genetic and physiologic factors. Therefore it is imperative to establish normal HOMA values in different populations. To report HOMA-IR values in Chilean elderly subjects and to determine the best cutoff point to diagnose insulin resistance. Cross sectional study of 1003 subjects older than 60 years of whom 803 (71% women) did not have diabetes. In 154 subjects, an oral glucose tolerance test was also performed. Insulin resistance (IR) was defined as the HOMA value corresponding to percentile 75 of subjects without over or underweight. The behavior of HOMA-IR in metabolic syndrome was studied and receiver operating curves (ROC) were calculated, using glucose intolerance defined as a blood glucose over 140 mg/dl and hyperinsulinemia, defined as a serum insulin over 60 microU/ml, two hours after the glucose load. Median HOMA-IR values were 1.7. Percentile 75 in subjects without obesity or underweight was 2.57. The area under the ROC curve, when comparing HOMA-IR with glucose intolerance and hyperinsulinemia, was 0.8 (95% confidence values 0.72-0.87), with HOMA-IR values ranging from 2.04 to 2.33. HOMA-IR is a useful method to determine insulin resistance in epidemiological studies. The HOMA-IR cutoff point for insulin resistance defined in thi spopulation was 2.6.

  1. Evaluation of the Pharmacokinetics and Pharmacodynamics of Prasugrel in Japanese Elderly Subjects.

    Science.gov (United States)

    Hasunuma, Tomoko; Fukase, Hiroyuki; Miyazaki, Atsuhiro; Nishikawa, Yasuhiro

    2017-07-01

    An increased incidence in bleeding events has been reported in Western elderly patients receiving prasugrel. Therefore, doses in Japanese elderly subjects need to be carefully determined. We assessed the pharmacokinetic and pharmacodynamic effects of prasugrel at the clinical dose used in Japan in healthy Japanese elderly subjects compared with non-elderly subjects. In an open-label parallel-group study conducted in Japan, two groups (elderly, aged >75 years; non-elderly, aged 45-65 years) received a 20-mg loading dose and a 3.75-mg maintenance dose of prasugrel for 7 days. Plasma concentration of its active metabolite, R-138727, and pharmacokinetic parameters were determined on days 1 and 7 after dosing. Pharmacodynamic response to 20 µM of adenosine diphosphate-induced platelet aggregation was measured by light transmission aggregometry. A total of 47 subjects were enrolled (23 elderly, 24 non-elderly). There was no statistically significant difference in pharmacokinetic parameters between groups: area under the plasma concentration-time curve up to the last quantifiable time and maximum plasma concentration were about 174-175 ng·h/mL and 134-153 ng/mL, respectively, after the loading dose; and about 25-26 ng·h/mL and 25 ng/mL, respectively, after the maintenance dose. Inhibition of platelet aggregation was higher in the elderly subjects than in the non-elderly subjects, with a statistically significant difference from 24 h after the loading dose. No serious adverse events (bleeding or non-bleeding) occurred. Prasugrel (20-mg loading dose; 3.75-mg maintenance dose) produced a slight increase in antiplatelet efficacy in elderly compared with non-elderly subjects, despite no statistically significant difference in the pharmacokinetics.

  2. [The place of laparoscopic nephrectomy in the elderly subject].

    Science.gov (United States)

    Paparel, P; Long, J-A; Neuzillet, Y; Escudier, B; Rioux-Leclercq, N; Correas, J-M; Lang, H; Poissonnier, L; Baumert, H; Mejean, A; Soulié, M; Patard, J-J

    2009-11-01

    The concomitant increase in life expectancy and the incidence of kidney cancers will result in an increase in kidney cancers in subjects over 75 years of age in the coming years. A wait-and-see attitude in cases of voluminous tumors, particularly symptomatic tumors, may well alter the quality of life of these patients through chronic abdominal pain, macroscopic hematuria, or alteration of the general condition due to metastatic progression. Curative or palliative surgical management can be envisioned and should be discussed in the multidisciplinary consensus meeting. Before validating the indication for nephrectomy in the elderly patient, a preoperative geriatric assessment should be made. Moreover, preoperative renal function should be carefully evaluated to measure the risk of terminal renal failure. The reduction in the mean duration of the hospital stay provided by laparoscopic surgery allows patients to return home or to their institution more quickly, an important consideration in the rehabilitation of these patients, who are very sensitive to such changes. Laparoscopic nephrectomy, with evidence in the literature of reduced morbidity and satisfactory oncological results, could therefore be superior to open surgery when indicated and technically feasible. (c) 2009 Elsevier Masson SAS. All rights reserved.

  3. Attention and CERAD test performances in cognitively impaired elderly subjects.

    Science.gov (United States)

    Verhülsdonk, S; Hellen, F; Höft, B; Supprian, T; Lange-Asschenfeldt, C

    2015-06-01

    Attention plays a fundamental role in cognitive performance and is closely interrelated with all major cognitive domains. In this retrospective study, we correlated different measures of attention with standard cognitive parameters in 85 cognitively impaired elderly individuals presenting with cognitive complaints to a memory clinic. Z-scores of all relevant cognitive parameters of a extended Consortium to Establish a Registry for Alzheimer's disease (CERAD-Plus) neuropsychological battery were correlated with tonic and phasic alertness, inhibition, and divided attention, assessed by a computerized test battery of attention. The pooled sample consisted of 36 patients with the diagnosis of mild AD, 30 patients with mild cognitive impairment, and 19 patients with major depressive disorder. Subjects of all diagnostic groups exhibited normal results in all subtests of attention. Reaction times of neither the tonic nor the phasic alertness task were correlated with any parameter of memory and global cognition. However, significant correlations were obtained between reaction times in the alertness tasks and the trail-making tests. Omissions in the divided attention task yielded the strongest correlations with deficits in cognitive performance, particularly in the verbal learning tasks, the Boston naming test, and the trail-making tests. Our data demonstrate the relative independency of the CERAD-Plus on the variability of attention and particularly alertness suggesting its robustness in psychiatric memory clinic settings. Moreover, CERAD-Plus subtests correlated considerably with failure rates in divided attention, suggesting that impairment in divided attention tasks may be early markers of cognitive impairment. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Cardiovascular safety of tamsulosin modified release in the fasted and fed state in elderly healthy subjects

    NARCIS (Netherlands)

    Michel, M. C.; Korstanje, C.; Krauwinkel, W.

    2005-01-01

    Objectives: The effect of food on the cardiovascular safety of tamsulosin modified release (MR) capsules 0.4 mg in elderly subjects was assessed both after single and multiple dosing. Methods: Thirty-six elderly (age greater than or equal to 60 years) male volunteers were recruited and after a

  5. Gender differences of social interactions and their effects on subjective well-being among Japanese elders.

    Science.gov (United States)

    Okabayashi, Hideki; Hougham, Gavin W

    2014-01-01

    Gender differences of social interactions and their effects on subjective well-being among Japanese elders over three years were examined. Repeated measurements of 498 elders over a three-year survey interval were obtained from a baseline mail survey and two- and three-year follow-up surveys. Outcomes were analyzed using Hierarchical Linear Modeling. Male elders were more likely to have a spouse and work at paid jobs, while female elders were likely to have more frequent contacts with their child/children and more interactions with friends. As the elders aged over three years, life satisfaction decreased, while depression did not show any significant overall trend. There were no beneficial effects of social interactions on change in well-being, although social participation, interaction with friends, and conversation with spouse were beneficially related to baseline levels of both depressive tendency and life satisfaction. Among female elders only, the number of children had beneficial effects on life satisfaction. There are modest gender differences of the impact of social interactions on the well-being of Japanese elders, and the number of children seems to be more important as potential sources of support for female rather than male elders. Spousal conversation and non-obligatory social interaction such as unpaid social activities and friendship seem to be important for both male and female elders in Japan. These findings suggest that social relations among Japanese elders may be moving away from more gender dependent patterns seen in the past.

  6. Effect of vibration on postural control and gait of elderly subjects: a systematic review.

    Science.gov (United States)

    Aboutorabi, Atefeh; Arazpour, Mokhtar; Bahramizadeh, Mahmood; Farahmand, Farzam; Fadayevatan, Reza

    2017-09-16

    Gait and balance disorders are common in the elderly populations, and their prevalence increases with age. This systematic review was performed to summarize the current evidence for subthreshold vibration interventions on postural control and gait in elderly. A review of intervention studies including the following words in the title/abstract: insole, foot and ankle appliances, vibration, noise and elderly related to balance and gait. Databases searched included PubMed, ISI Web of Knowledge, Ovid, Scopus, and Google Scholar. Fifteen articles were selected for final evaluation. The procedure was followed using the preferred reporting items for systematic reviews and meta-analysis method. There was reduction in center of pressure velocity and displacement especially with eyes closed using vibration in healthy elderly subjects and this effect was greater in elderly faller and patients with more balance deficiency. Vibration programme training increased speed of walking, cadence, step time and length in stroke subjects. The vibratory insoles significantly improved performance on the Timed Up and Go and Functional Reach tests in older people. Vibration was effective on balance improvement in elderly subject especially elderly with more balance deficiency and it can improve gait parameters in patients with greater baseline variability.

  7. Comparison of Center of Force Trajectory during Sit-to-stand Movements Performed by Elderly and Old-old Elderly Subjects

    OpenAIRE

    Kim, Min-hee; Yoo, Won-gyu

    2014-01-01

    [Purpose] This study compared the center of force (COF) trajectory during sit-to-stand (STS) movements performed by elderly and old-old elderly subjects. [Subjects] We recruited 9 elderly and 10 old-old elderly subjects with no knee joint pain or lower limb orthopedic problems. [Methods] The CONFORMat system was used to measure the length of the COF trajectory as the subjects performed the STS task. [Results] The total length of the COF trajectory during the STS movement was significantly gre...

  8. Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea.

    Science.gov (United States)

    Imai, Hissei; Chen, Wen-ling; Fukutomi, Eriko; Okumiya, Kiyohito; Wada, Taizo; Sakamoto, Ryota; Fujisawa, Michiko; Ishimoto, Yasuko; Kimura, Yumi; Chang, Chia-Ming; Matsubayashi, Kozo

    2015-01-01

    The objective of this study is to investigate the cross-cultural relationship between depressive state and subjective economic status, as well as subjective quality of life (QOL) and activities of daily living (ADL) among elderly people in communities in Japan, Taiwan, and Korea. We studied 595 subjects aged 65 years or older in three Asian communities (261 subjects in T town in Japan, 164 in D town in Taiwan, and 170 in H town in Korea). The Geriatric Depression Scale-15, a self-rating questionnaire assessing ADL, subjective QOL, social situations, and past and current medical status, was used. Depression of the elderly was associated with dependence in basic ADL, subjective QOL, and subjective sense of low economic status. After adjusting for the effects of age, sex, and basic ADL, subjective sense of low economic status was closely associated with depression in community-living elderly people in all three communities in Asia. In conclusion, absolute and objective economic status is an important contributing factor to depressive state or psychosocial deterioration, however, we should pay more attention to the roles of perception of low economic status in determining depressive state in community-dwelling elderly people. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Religiosity and Subjective Well-Being amongst Institutionalized Elderly in Pakistan.

    Science.gov (United States)

    Gull, Fouzia; Dawood, Saima

    2013-01-01

    In Pakistan, the issue of institutionalized elderly is a neglected area and little is known about their subjective conditions. The present study was conducted in 2012 which examined the relationship between religiosity and subjective well being amongst institutionalized elderly people. Data was collected from 100 adults above the age of 60 years in Lahore,Pakistan, through purposive sampling strategy. Religiosity was measured through Religiosity Index, while Trait Well Being Inventory was used to assess subjective well being. Pearson product moment correlation coefficient and regression analysis were used for the analysis of the data, which revealed that religiosity has a significant positive relationship with life satisfaction. However, no association was found between religiosity and mood level. Moreover, regression analysis indicated that religiosity positively predicted life satisfaction among elderly. The current research would create awareness and urge the policy makers to look into this social issue and provide better long term care to the residents of old homes.

  10. The relations among relatedness needs, subjective well-being, and depression of Korean elderly.

    Science.gov (United States)

    Seo, SuGyun; Jeon, JeeHye; Chong, YoungSook; An, JeongShin

    2015-01-01

    The first part of the study examined what the relatedness needs Korean elderly have in close relationships (spouse, children, friends) are. The most salient needs were "love and care" for spouse and "contact and often meeting" for children and friends. The second part of the study assessed the relations among the difference between expectation and satisfaction of relatedness needs, subjective well-being, and depression of Korean elderly. Regression analyses showed that the difference between expectation and satisfaction of relatedness needs for spouse and children significantly predicted subjective well-being and depression. Finally, gender differences are discussed in terms of the patriarchal culture of Korean society.

  11. Ethical Issues Related to Research Involving Elderly Subjects

    Science.gov (United States)

    Reich, Warren T.

    1978-01-01

    Drawing on ethical principles and general ethical rules governing aspects of human research, this article identifies and analyzes ethical problems distinctive to biomedical and behavioral research with aged subjects. Policy recommendations governing research in the aged are offered along with an agenda for an extensive research project in this…

  12. Subjective memory complaints in an elderly population with poor sleep quality.

    Science.gov (United States)

    Kang, Suk-Hoon; Yoon, In-Young; Lee, Sang Don; Kim, Tae; Lee, Chung Suk; Han, Ji Won; Kim, Ki Woong; Kim, Chan-Hyung

    2017-05-01

    The association between sleep disturbances and cognitive decline in the elderly has been putative and controversial. We evaluated the relation between subjective sleep quality and cognitive function in the Korean elderly. Among 459 community-dwelling subjects, 352 subjects without depression or neurologic disorders (mean age 68.2 ± 6.1) were analyzed in this study. All the participants completed the Korean version of the consortium to establish a registry for Alzheimer's disease neuropsychological battery (CERAD-KN) as an objective cognitive measure and subjective memory complaints questionnaire (SMCQ). Based on the Pittsburgh sleep quality index, two types of sleepers were defined: 'good sleepers' and 'poor sleepers'. There were 192 good sleepers (92 men) and 160 poor sleepers (51 men). Poor sleepers reported more depressive symptoms and more use of sleep medication, and showed higher SMCQ scores than good sleepers, but there was no difference in any assessments of CERAD-KN. In the regression analysis, depressive symptoms and subjective sleep quality were associated with subjective memory complaints (β = 0.312, p sleep quality was associated with subjective memory complaints, but not with objective cognitive measures. As subjective memory complaints might develop into cognitive disorders, poor sleep quality in the elderly needs to be adequately controlled.

  13. Sex differences in subjective and actigraphic sleep measures: A population-based study of elderly persons

    NARCIS (Netherlands)

    Berg, J.F. van den; Miedema, H.M.E.; Tulen, J.H.M.; Hofman, A.; Neven, A.K.; Tiemeier, H.

    2009-01-01

    Study Objectives: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. Design: Cross-sectional study. Setting: The study was embedded in the Rotterdam Study, a population-based study. Participants: Nine hundred fifty-six

  14. Improved automated perimetry performance in elderly subjects after listening to Mozart

    Directory of Open Access Journals (Sweden)

    Junia Cabral Marques

    2009-01-01

    Full Text Available PURPOSE: To evaluate the performance of automated perimetry of elderly subjects naïve to AP after listening to a Mozart sonata. INTRODUCTION: Automated perimetry (AP is a psychophysical test used to assess visual fields in patients with neurological disorders and glaucoma. In a previous study, Fiorelli et al. showed that young subjects who listened to a Mozart sonata prior to undergoing AP performed better in terms of reliability than those who did not listen to the sonata. METHODS: Fifty-two AP-naïve, normal subjects underwent Automated perimetry (SITA 24-2. The study group (25 subjects underwent AP after listening to Mozart's Sonata for Two Pianos in D Major, and the control group (27 subjects underwent Automated perimetry without prior exposure to the music. RESULTS: The study group had significantly lower false negative rates and a lower visual field reliability score than the controls (P=0.04 and P=0.04, respectively. The test time was shorter for the study group (P=0.03. DISCUSSION: This study shows that elderly subjects, when exposed to the Mozart sonata immediately before AP testing, have lower false negative rates and lower visual field reliability scores when compared with an age- and gender-matched control group. Our results differ from those of Fiorelli et al. who found lower false positive rates and less fixation loss in addition to lower false negative rates. CONCLUSION: Listening to a Mozart sonata seems to improve automated perimetry reliability in elderly subjects.

  15. Improved automated perimetry performance in elderly subjects after listening to Mozart.

    Science.gov (United States)

    Marques, Junia Cabral; Vanessa, Adriana Chaves Oliveira; Fiorelli, Macedo Batista; Kasahara, Niro

    2009-01-01

    To evaluate the performance of automated perimetry of elderly subjects naïve to AP after listening to a Mozart sonata. Automated perimetry (AP) is a psychophysical test used to assess visual fields in patients with neurological disorders and glaucoma. In a previous study, Fiorelli et al. showed that young subjects who listened to a Mozart sonata prior to undergoing AP performed better in terms of reliability than those who did not listen to the sonata. Fifty-two AP-naïve, normal subjects underwent Automated perimetry (SITA 24-2). The study group (25 subjects) underwent AP after listening to Mozart's Sonata for Two Pianos in D Major, and the control group (27 subjects) underwent Automated perimetry without prior exposure to the music. The study group had significantly lower false negative rates and a lower visual field reliability score than the controls (P=0.04 and P=0.04, respectively). The test time was shorter for the study group (P=0.03). This study shows that elderly subjects, when exposed to the Mozart sonata immediately before AP testing, have lower false negative rates and lower visual field reliability scores when compared with an age- and gender-matched control group. Our results differ from those of Fiorelli et al. who found lower false positive rates and less fixation loss in addition to lower false negative rates. Listening to a Mozart sonata seems to improve automated perimetry reliability in elderly subjects.

  16. [Evaluation of mental and communication functions in mapuche and non mapuche elderly subjects in rural communities in Southern Chile].

    Science.gov (United States)

    Mella, Rebeca; Alvear, María; Carrillo, Berta; Caire, Victor

    2003-11-01

    The main predictors of functional impairment in the elderly are alterations in mental or communication functions. To study mental and communication functions in rural elderly subjects of Mapuche and non Mapuche origin. Elderly subjects coming from a rural Mapuche community and a non Mapuche community were studied. Subjects were interviewed at their homes. The communication and mental function assessments of the Functional Autonomy Measurement System were applied. Fifty one Mapuche and 49 non Mapuche subjects with a mean age of 71 +/- 7 and 74 +/- 8 years respectively, were studied. Fifty four percent were female and 31% were illiterate. Twenty six percent had impairment in mental functions. The item with the highest difficulty was memory. The visual function was the most severely impaired among communication items. Mapuche elderly subjects had significantly higher degrees of impairment in mental and communication functions. There is a higher degree of mental and communication impairment among rural Mapuche elderly subjects than in their non Mapuche counterparts.

  17. [Sleep characteristics of elderly and very long-lived subjects].

    Science.gov (United States)

    Stramba-Badiale, M; Ceretti, A; Forni, G

    1979-09-01

    Through the method of the "questionnaire" quantitative and qualitative aspects of the sleep of a group of 24 eldery people and of 24 very old people have been studied. Regarding the sleep of the eldery person the attention is recalled to two data: the presence of dreams of "erotic" contents in 50% of the subjects and the lack of a substancial difference between the agregate duration of sleep of the adult compared to that of the eldery person. About the sleep of the very old person the A.A. underlines the tendency to sleep more in old age: in this research, one hour more than the eldery. The very old people in the total of examined cases are people that, during life, have always gone to bed "early" in the evening. It is suggestive that only two out of 24 very old people have declared to have "anguishing" dreams.

  18. Religiosity and Subjective Well-Being amongst Institutionalized Elderly in Pakistan

    OpenAIRE

    Gull, Fouzia; Dawood, Saima

    2013-01-01

    Background: In Pakistan, the issue of institutionalized elderly is a neg¬lected area and little is known about their subjective conditions. The present study was con-ducted in 2012 which examined the relationship between religiosity and subjective well being amongst institutionalized el¬derly people. Methods: Data was collected from 100 adults above the age of 60 years in Lahore, Pakistan, through purposive sampling strategy. Religiosity was measured through Religiosity Index, while Trait Wel...

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

    Science.gov (United States)

    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.

  20. Food and nutrient intake of Irish community-dwelling elderly subjects: who is at nutritional risk?

    Science.gov (United States)

    Power, S E; Jeffery, I B; Ross, R P; Stanton, C; O'Toole, P W; O'Connor, E M; Fitzgerald, G F

    2014-01-01

    To assess the dietary intakes of Irish community-dwelling elderly individuals, participating in the ELDERMET project. Cross-sectional study. Cork city and county region of southern Ireland. Two hundred and eight (94 males, 114 females) community-dwelling subjects aged 64-93 yrs. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Anthropometric data were recorded. Nutritional status was assessed using the Mini Nutritional Assessment (MNA). A high rate of overweight/obesity was observed in this population group. Consumption of energy-dense, low-nutrient foods was excessive among this population group. Older elderly subjects (≥75 yrs) consumed significantly (Pdiet than males. A considerable proportion of subjects, particularly males, had inadequate intakes of calcium, magnesium, vitamin D, folate, zinc and vitamin C. The data indicate that the diet of Irish community-dwelling elderly individuals is sub-optimal with respect to nutrient intake, and excessive in terms of fat intake, with implications for the health status of this population group. Reductions in dietary fat and increased low fat dairy food intakes are recommended for the prevention of diet-related disease in older persons. In addition, strategies to improve a number of sub-optimal micronutrient intakes need to be developed and implemented, particularly among elderly males.

  1. Spatio-Temporal Parameters\\' Changes in Gait of Male Elderly Subjects

    Directory of Open Access Journals (Sweden)

    Heydar Sadeghi

    2010-03-01

    Full Text Available Objectives: The purpose of this study was to compare spatio-temporal gait parameters between elderly and young male subjects. Methods & Materials: 57 able-bodied elderly (72±5.5 years and 57 healthy young (25±8.5 years subjects participated in this study. A four segment model consist of trunk, hip, shank, and foot with 10 reflective markers were used to define lower limbs. Kinematic data collected using four high speed video based cameras at a sampling frequency of 90 Hz.The t-testfor independent samples (α≤0.05 applied for statistical analysis. Results: Significant differences showed longer stance phase (2%, longer push-of time (4%, slower cadence (13%, slower speed (28% and shorter step length (15% for elderly in comparison with young subjects, though no significant differences were seen in double supporttime between two groups. Conclusion: Due to results, spatio-temporal changes are mainly attributed to the age-related decreases in muscular flexibility, joints>ranges of motion and neuromuscular control in elderly people.

  2. Anodal Transcranial Direct Current Stimulation Promotes Frontal Compensatory Mechanisms in Healthy Elderly Subjects

    Directory of Open Access Journals (Sweden)

    Jesús Cespón

    2017-12-01

    Full Text Available Recent studies have demonstrated that transcranial direct current stimulation (tDCS is potentially useful to improve working memory. In the present study, young and elderly subjects performed a working memory task (n-back task during an electroencephalogram recording before and after receiving anodal, cathodal, and sham tDCS over the left dorsolateral prefrontal cortex (DLPFC. We investigated modulations of behavioral performance and electrophysiological correlates of working memory processes (frontal and parietal P300 event-related potentials. A strong tendency to modulated working memory performance was observed after the application of tDCS. In detail, young, but not elderly, subjects benefited from additional practice in the absence of real tDCS, as indicated by their more accurate responses after sham tDCS. The cathodal tDCS had no effect in any group of participants. Importantly, anodal tDCS improved accuracy in elderly. Moreover, increased accuracy after anodal tDCS was correlated with a larger frontal P300 amplitude. These findings suggest that, in elderly subjects, improved working memory after anodal tDCS applied over the left DLPFC may be related to the promotion of frontal compensatory mechanisms, which are related to attentional processes.

  3. The role and principles of radiotherapy in prostate cancer in the elderly subject

    International Nuclear Information System (INIS)

    Richaud, P.; Salomon, L.; Mongiat-Artus, P.; Gaschignard, N.; Beuzeboc, P.; Peyromaure, M.; Bastide, C.; Cornud, F.; Molinie, V.; Rozet, F.; Staerman, F.; Soulie, M.

    2009-01-01

    The aging of the population has resulted in an increase in the number of elderly patients with prostate cancer. Among the curative treatment options in the elderly subject, external radiotherapy is the most frequently chosen option. Combined treatment including radiotherapy and hormone therapy should be preferred to hormonal therapy alone, including in elderly patients, whenever life expectancy surpasses 4-5 years. The indications for this radiotherapy should be defined in an attempt to prevent excessive or insufficient treatment, to adapt the treatment modalities to the patient's age by assessing its potential toxicity, and to discuss the possible alternatives. In cases of localized prostate cancer in men who are aging well, a standard treatment should be proposed, preferring radiotherapy possibly associated with hormone therapy in cases with negative prognostic factors. Patients with a reversible health problems can also receive standard treatment, notably in cases with aggressive prognostic factors. (authors)

  4. The value of structural MRI measurements of cerebral atrophy in predicting the rate of cognitive decline in the non-demented elderly: a GEE analysis based on data from the Vienna transdanube aging study

    International Nuclear Information System (INIS)

    Roesel, M.

    2011-01-01

    The main objective of this study was the assessment of various structural measurements of cerebral atrophy at baseline and the evaluation of their potential value in predicting future cognitive decline in a longitudinal study design. Data were drawn from the Vienna Transdanube Aging (VITA) study. Magnetic resonance images of 532 subjects aged 75-76 years at baseline were analyzed to assess 8 different cerebral atrophy markers. A population averaged model with the corresponding analytical technique of generalized estimating equations (GEE) were applied to the birth-cohort to assess associations between the MRI-based atrophy markers and 6 cognitive test scores at baseline and two follow-up investigations. Cognitive tests were comprised of the Mini Mental State Examination (MMSE), Boston Naming Test (BNT), Fuld Object Memory Evaluation (FOME), Verbal Fluency (VF) and the Trail Making Tests A and B (TMTA, TMTB). Vascular risk factors and several other covariates that were available in the VITA database were included as additional predictors in the longitudinal data analysis. Severity of right hippocampal head atrophy predicted the rate of cognitive decline in all 6 test scores. (MMSE: β =-0.507; p = 0.002, BNT: β = -1.090; p = 0.004, FOME: β = -0.291; p = 0.003, VF: β = 0.718; p = 0.025, TMTA: Exp(β) = 0.123; p [de

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

    Science.gov (United States)

    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 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

  6. Leisure participation and subjective well-being: Exploring gender differences among elderly in Shanghai, China.

    Science.gov (United States)

    Zhang, Wei; Feng, Qiushi; Lacanienta, Joy; Zhen, Zhihong

    To explore the association between leisure participation and subjective well-being and the role gender in this issue among elderly Chinese in Shanghai, China. Principal components analysis and logistic regressions are used to analyze the cross-sectional data of the 2013 Shanghai Elderly Life and Opinion Survey that contains 2884 respondents (60+ with a mean age of 72.6) recruited from a multistage cluster sampling design. Subjective well-being is measured by happiness and life satisfaction, and leisure participation is examined by the type and diversity of leisure activities. Principal components analysis identifies four major types of leisure activity that elderly Chinese are actively engaged in-detachment-recovery, aesthetic, social, and performing-arts activities. Among them, social activities and performing-arts activities have the most relevance to subjective well-being. Females are more likely to engage in social and performing-arts activities whereas males are more likely to engage in detachment-recovery and aesthetic activities. Performing-arts activities promote subjective well-being only for females. Social activities are beneficial for both gender groups, but more so for males than for females. While increased levels of leisure diversity are linearly related to increased odds of subjective well-being for females, moderate level of leisure diversity is found to be the most important for males. Leisure participation is positively related to subjective well-being among elderly Chinese, and thus could play a critical role in promoting healthy aging. The major gender differences as observed suggest the need to further explore gender-specific barriers in leisure participation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Way K. W. Lau

    2017-05-01

    Full Text Available 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.

  8. Happiness, subjective and objective oral health status, and oral health behaviors among Korean elders.

    Science.gov (United States)

    Yoon, Hyun-Seo; Kim, Hae-Young; Patton, Lauren L; Chun, Jin-Ho; Bae, Kwang-Hak; Lee, Mi-Ok

    2013-10-01

    This study aims to comprehensively assess the association of subjective and objective oral health status and oral health behaviors with happiness, under consideration of demographic, socioeconomic, and general health-related factors. This study also aims to test whether subjective oral health outcomes are better predictors of happiness compared with objective oral health outcomes. The data were collected from 479 community-dwelling elders aged 65 years or over selected by a cluster sampling method. A questionnaire and an oral examination were implemented. A multiple regression method was conducted to assess associations with happiness index (HI). The mean age of the elders was 74.6 years. Mean (standard deviation, SD) HI, EuroQol-visual analog scale (EQ-VAS) and 14-item oral health impact profile (OHIP-14) index were 5.7 (SD 2.3), 59.8 (SD 21.1), and 16.3 (SD 13.1). In the final model, a significant association with HI of the OHIP-14 index (P = 0.091) among all the participants and significant associations of oral symptoms (P = 0.038), wearing a removable denture (P = 0.039), and of the oral health behavior of daily toothbrushing (P = 0.007) among poorer oral health QoL group were confirmed under consideration of other related factors. While correlations of HI to subjective measures of health, EQ-VAS and OHIP-14 score were moderate to weak, those to objective measures of health were only weak or insignificant. Oral impacts which might persistently affect one's daily life need to be considered in designing and delivering public services aimed to promote people's happiness. With oral health impacts and behaviors accounting for 10% of happiness among elders, public and community services for the elderly that support oral health and daily toothbrushing for the dentate are critical for the well-being of our elders. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Modified stepping exercise improves physical performances and quality of life in healthy elderly subjects.

    Science.gov (United States)

    Janyacharoen, Taweesak; Sirijariyawat, Kungsadal; Nithiatthawanon, Teerawat; Pamorn, Puttawat; Sawanyawisuth, Kittisak

    2017-10-01

    Stepping exercise, an aerobic exercise, has been shown to be beneficial to elderly people if performed continuously for at least 12 weeks. This study aimed to evaluate the effects of engaging in modified stepping exercise on stairs with shorter height than the standard stepping platform for a shorter duration (8 weeks) on both physical fitness and quality of life (QoL) in healthy elderly subjects by using a randomized controlled trial. The study was conducted at the Elderly Club, Muang District, Khon Kaen, Thailand. The study examined healthy elderly subjects aged 60-80 who had not engaged in regularly exercise in the past two months and no contraindication for exercise. Eligible subjects were randomly assigned to either the stepping exercise group (SG) or control group (CG). The SG performed stepping exercise together in groups three times a week for eight weeks, while the CG received general health education. Stepping exercise was performed for one hour on a one-step platform that was 18 centimeters in height. Physical performance was measured at the baseline and the end of the study. This included a six-minute walk distance test (6MWT), a five times sit to stand test (FTSST), a timed up and go test (TUGT), a functional reach test (FRT) and a QoL assessment. In total, 42 subjects were enrolled, half of which were randomly assigned to the SG and the other half assigned to the CG. The median age of both groups was equal at 69 years. Other baseline characteristics were comparable. None of the outcomes differed between the two groups baseline. However they showed statistically significant differences at the end of study, with the exception of FTSST. After 8 weeks, the SG performed significantly better on the 6MWT (468 vs. 426 m; P=0.01), TUGT (5.96 vs. 8.52 sec; Pelderly subjects. Physical functions and QoL significantly improved after the short duration of eight weeks.

  10. [Sense of coherence and subjective overload, anxiety and depression in caregivers of elderly relatives].

    Science.gov (United States)

    López-Martínez, Catalina; Frías-Osuna, Antonio; Del-Pino-Casado, Rafael

    2017-11-23

    To analyze the relationship between the sense of coherence and subjective overload, anxiety and depression in caregivers of dependent elderly relatives. Cross-sectional study in an area of the province of Jaén (Andalusia, Spain) with a probabilistic sample of 132 caregivers of dependent elderly. sense of coherence (Life Orientation Questionnaire), subjective burden (Caregiver Strain Index), anxiety and depression (Goldberg Scale), objective burden (Dedication to Care Scale), sex and kinship. Main analyses: bivariate analysis using the Pearson correlation coefficient and multivariate analysis using multiple linear regression. Most of the caregivers studied were women (86.4%), daughter or son of the care recipient (74.2%) and shared home with the latter (69.7%). When controlling for objective burden, sex and kinship, we found that the sense of coherence was inversely related to subjective burden (β = -0.46; p <0.001), anxiety (β = -0.57; p = 0.001) and depression (β = -0.66; p <0.001). The sense of coherence might be an important protective factor of subjective burden, anxiety and depression in caregivers of dependent elderly relatives. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. ABCB1 genotypes and haplotypes in patients with dementia and age-matched non-demented control patients

    Directory of Open Access Journals (Sweden)

    Frankfort Suzanne V

    2006-09-01

    Full Text Available Abstract Amyloid β is an in vitro substrate for P-glycoprotein (P-gp, an efflux pump at the blood brain barrier (BBB. The Multi Drug Resistance (ABCB1 gene, encoding for P-gp, is highly polymorphic and this may result in a changed function of P-gp and may possibly interfere with the pathogenesis of Alzheimer's disease. This study investigates to what extent ABCB1 Single Nucleotide Polymorphisms (SNPs; C1236T in exon 12, G2677T/A in exon 21 and C3435T in exon 26 and inferred haplotypes exist in an elderly population and if these SNPs and haplotypes differ between patients with dementia and age-matched non-demented control patients. ABCB1 genotype, allele and haplotype frequencies were neither significantly different between patients with dementia and age-matched controls, nor between subgroups of different types of dementia nor age-matched controls. This study shows ABCB1 genotype frequencies to be comparable with described younger populations. To our knowledge this is the first study on ABCB1 genotypes in dementia. ABCB1 genotypes are presently not useful as a biomarker for dementia, as they were not significantly different between demented patients and age-matched control subjects.

  12. Correlation between two physical activity programs in the gait of sedentary elderly subjects

    Directory of Open Access Journals (Sweden)

    Mariana Varkala Lanuez

    2010-09-01

    Full Text Available Objectives: To assess the effect of exercise on gait using two different programs: a group of aerobic exercises (Group A, n = 18 and a group of flexibility and balance exercises (Group B, n = 19. Methods: A casualized controlled study, in which each sample controlled itself, was undertaken. The sample comprised 37 male and female subjects, aged from 60 to 90 years, from the outpatient clinic of the Geriatrics Unit of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo; the patients were sedentary and had not exercised regularly during the past six months. Results: Improvement of gait was seen mainly in the group that did specific exercises. Conclusion: The results of this study underline the importance of physical exercises in sedentary elderly subjects, but show the need for programming the exercises towards specific goals, which can optimize the results of this tool of health promotion for the elderly.

  13. Sitting movement in elderly subjects with and without Parkinson's disease: a biomechanical study.

    Science.gov (United States)

    Dionisio, Valdeci Carlos; de Biagi Curtarelli, Mônica; Sande de Souza, Luciane Aparecida Pascucci

    2013-08-01

    The aim of the present study was to compare kinetic, kinematic, and electromyographic variables during the sitting movement between healthy elderly and in those with Parkinson's disease (PD) with moderate involvement. We hypothesized that subjects with PD would show difficulty in selecting the muscles for the task and that this could be related to the co-activation pattern and would be reflected in the behavior of some biomechanical variables. Fifteen subjects participated in this study, seven healthy subjects (NN group) and eight with Parkinson's disease. Electromyography (EMG) activity of the tibialis anterior (TA), soleus (SO), vastus medialis oblique (VMO), biceps femoris (BF), and erector spinae (ES) were recorded, and biomechanical variables were calculated, during four phases of the sitting movement. Compared to healthy subjects, the subjects with PD showed more flexion at the ankle, knee, and hip joints in the initial position and lower joint velocity. However, the EMG activity and hip, knee, and ankle joint torques were not different during all phases of movement. The sitting movement in PD subjects with moderate involvement generates EMG activity and joint torques similar to healthy elderly subjects. Only a reduced movement velocity was found in PD patients during the sitting task. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Plasma antioxidants and brain glucose metabolism in elderly subjects with cognitive complaints

    Energy Technology Data Exchange (ETDEWEB)

    Picco, Agnese; Ferrara, Michela; Arnaldi, Dario; Brugnolo, Andrea; Nobili, Flavio [University of Genoa and IRCCS San Martino-IST, Clinical Neurology, Department of Neuroscience (DINOGMI), Largo P. Daneo, 3, 16132, Genoa (Italy); Polidori, M.C. [University of Cologne, Institute of Geriatrics, Cologne (Germany); Cecchetti, Roberta; Baglioni, Mauro; Bastiani, Patrizia; Mecocci, Patrizia [University of Perugia, Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, Perugia (Italy); Morbelli, Silvia; Bossert, Irene [University of Genoa and IRCCS San Martino-IST, Nuclear Medicine, Department of Health Science (DISSAL), Genoa (Italy); Fiorucci, Giuliana; Dottorini, Massimo Eugenio [Nuclear Medicine, S. M. della Misericordia Hospital, Perugia (Italy)

    2014-04-15

    The role of oxidative stress is increasingly recognized in cognitive disorders of the elderly, notably Alzheimer's disease (AD). In these subjects brain{sup 18}F-FDG PET is regarded as a reliable biomarker of neurodegeneration. We hypothesized that oxidative stress could play a role in impairing brain glucose utilization in elderly subjects with increasing severity of cognitive disturbance. The study group comprised 85 subjects with cognitive disturbance of increasing degrees of severity including 23 subjects with subjective cognitive impairment (SCI), 28 patients with mild cognitive impairment and 34 patients with mild AD. In all subjects brain FDG PET was performed and plasma activities of extracellular superoxide dismutase (eSOD), catalase and glutathione peroxidase were measured. Voxel-based analysis (SPM8) was used to compare FDG PET between groups and to evaluate correlations between plasma antioxidants and glucose metabolism in the whole group of subjects, correcting for age and Mini-Mental State Examination score. Brain glucose metabolism progressively decreased in the bilateral posterior temporoparietal and cingulate cortices across the three groups, from SCI to mild AD. eSOD activity was positively correlated with glucose metabolism in a large area of the left temporal lobe including the superior, middle and inferior temporal gyri and the fusiform gyrus. These results suggest a role of oxidative stress in the impairment of glucose utilization in the left temporal lobe structures in elderly patients with cognitive abnormalities, including AD and conditions predisposing to AD. Further studies exploring the oxidative stress-energy metabolism axis are considered worthwhile in larger groups of these patients in order to identify pivotal pathophysiological mechanisms and innovative therapeutic opportunities. (orig.)

  15. Local dynamic stability and variability of gait are associated with fall history in elderly subjects.

    Science.gov (United States)

    Toebes, Marcel J P; Hoozemans, Marco J M; Furrer, Regula; Dekker, Joost; van Dieën, Jaap H

    2012-07-01

    Gait parameters that can be measured with simple instrumentation may hold promise for identifying individuals at risk of falling. Increased variability of gait is associated with increased risk of falling, but research on additional parameters indicates that local dynamic stability (LDS) of gait may also be a predictor of fall risk. The objective of the present study was to assess the association between gait variability, LDS of gait and fall history in a large sample of elderly subjects. Subjects were recruited and tested at a large national fair. One hundred and thirty four elderly, aged 50-75, who were able to walk without aids on a treadmill, agreed to participate. After subjects walked on a treadmill, LDS (higher values indicate more instability) and variability parameters were calculated from accelerometer signals (trunk worn). Fall history was obtained by self-report of falls in the past 12 months. Gait variability and short-term LDS were, individually and combined, positively associated with fall history. In conclusion, both increased gait variability and increased short-term LDS are possible risk factors for falling in the elderly. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. The effect of Lactobacillus helveticus fermented milk on sleep and health perception in elderly subjects.

    Science.gov (United States)

    Yamamura, S; Morishima, H; Kumano-go, T; Suganuma, N; Matsumoto, H; Adachi, H; Sigedo, Y; Mikami, A; Kai, T; Masuyama, A; Takano, T; Sugita, Y; Takeda, M

    2009-01-01

    To study the effect of Lactobacillus helveticus fermented milk on sleep and health perception in elderly healthy subjects. The study included 29 healthy elderly subjects aged 60-81 years. Prospective, randomized, double-blind and placebo-controlled, with a crossover design. The study included two intervention periods of 3 weeks each, separated by a 3-week washout period. Subjects took 100 g of fermented milk drink or a placebo drink (artificially acidified milk) daily in the first supplementary period and the other drink in the second supplementary period. For each period, we measured sleep quality by means of actigraphy and a sleep questionnaire, and assessed the quality of life (QOL) by SF-36 health survey. There was a significant improvement in sleep efficiency (P=0.03) and number of wakening episodes (P=0.007) in actigraph data after intake of fermented milk, whereas no significant changes were observed for the placebo. Fermented milk did not improve the SF-36 scores significantly from the baseline period. In the GH domain (general health perception) of the SF-36, however, there was marginal improvement as compared to the baseline period. Although the difference between fermented milk and placebo was not statistically significant for any of the sleep or QOL parameters, fermented milk produced slightly greater mean values for many parameters. This short-term (3-week) intervention study indicates that Lactobacillus helveticus fermented milk may have a more favorable effect on improving sleep in healthy elderly people as compared with placebo.

  17. [Relationship between subjective well-being and the functionality of elderly outpatients].

    Science.gov (United States)

    Sposito, Giovana; Diogo, Maria J D'Elboux; Cintra, Fernanda Ap; Neri, Anita L; Guariento, Maria E; De Sousa, Maria L R

    2010-01-01

    The aim of this study was to investigate the relationship between subjective well-being, functional independence and lower-limb performance (muscle strength, gait velocity and balance) among elderly people undergoing outpatient follow-up, stratified by sex and age groups. We evaluated 125 elderly people, aged 60 years and over, who received care at a geriatric outpatient clinic. The instruments used were: 1) Functional Independence Measure (FIM) to evaluate functional dependence; 2) Short Physical Performance Battery (SPPB) to measure physical performance; and 3) Subjective Well-Being (SWB) with questions about health and satisfaction with life. A convenience sample was used, with predominance of females (who had greater functional impairment). The Spearman correlation coefficients for subjective well-being and the performance tests varied from -0.16 to 0.31 for men and -0.09 to 0.29 for women, therefore there were no differences between the sexes. However, the older participants had a higher level of satisfaction than the younger participants. Perceived health was also more satisfactory among the older participants, however comparative perceived health was better among the elderly participants with moderate to good physical performance. The results suggest that older individuals have greater satisfaction with life and better perceived health. Moreover, good physical performance was an important variable for better perceived health when compared to other people.

  18. Relationships between neighborhood attributes and subjective well-being among the Chinese elderly: Data from Shanghai.

    Science.gov (United States)

    Gao, Junling; Weaver, Scott R; Fu, Hua; Jia, Yingnan; Li, Jiang

    2017-11-20

    It has been hypothesized that subjective well-being (SWB) is determined by a combination of individual characteristics, social environment, and physical environment. However, few studies have simultaneously examined the relationships of the social and physical attributes of a neighborhood with SWB. Accordingly, the present study aimed to examine these relationships among Chinese elders. A total of 2,719 elders aged 60 years or older were recruited from 47 neighborhoods in the Xinhua subdistrict of Shanghai by two-stage stratified random sampling and interviewed between July and September 2014. The social and physical attributes of each neighborhood were assessed using validated and psychometrically tested measures. The Chinese version of the international Personal Wellbeing Index was used to assess SWB. Control variables included sex, age, marital status, education level, years living in the neighborhood, self-rated health, chronic conditions, and leisure-time physical activity. Multilevel linear regression analysis was conducted to explore whether social and physical attributes were associated with SWB. The average level of SWB was 74.2 ± 15.7% of the scale maximum. After controlling for individual covariates, individual-level social cohesion and social interaction were positively correlated with SWB, and both individual-level and neighborhood-level aesthetic quality was positively correlated with SWB. In conclusion, both social and physical attributes of neighborhoods were associated with SWB among Chinese elderly. These findings suggest that creating aesthetic and cohesive neighborhoods may encourage Chinese elders to participate in social activities and promote their SWB.

  19. Atrophy of the Posterior Subiculum Is Associated with Memory Impairment, Tau- and Aβ Pathology in Non-demented Individuals

    Directory of Open Access Journals (Sweden)

    Olof Lindberg

    2017-09-01

    Full Text Available Alzheimer’s disease (AD is associated with atrophy of the cornu ammonis (CA 1 and the subiculum subfield of the hippocampus (HC, and with deficits in episodic memory and spatial orientation. These deficits are mainly associated with the functionality of the posterior HC. We therefore hypothesized that key AD pathologies, i.e., β-amyloid and tau pathology would be particularly associated with the volume of the posterior subiculum in non-demented individuals. In our study we included 302 cognitively normal elderly participants (CN, 183 patients with subjective cognitive decline (SCD and 171 patients with amnestic mild cognitive impairment (MCI, all of whom underwent 3T magnetic resonance images (MRI. The subicular subfield was segmented using Freesurfer 5.3 and divided into 10 volumetric segments moving from the most posterior (segment 1 to the most anterior part along the axis of the hippocampal head and body (segment 10. Cerebrospinal fluid (CSF Aβ42 and phosphorylated tau (P-tau were quantified using ELISA and were used as biomarkers for β-amyloid and tau pathology, respectively. In the total sample, tau-pathology and Aβ-pathology and (measured by elevated P-tau and low Aβ42 levels in CSF and mild memory dysfunction were mostly associated with the volume changes of the posterior subiculum. Both SCD and MCI patients with elevated P-tau or low Aβ42 levels displayed predominantly posterior subicular atrophy in comparisons to control subjects with normal CSF biomarker levels. Finally, there was no main effect of Aβ42 or P-tau when comparing SCD with abnormal P-tau or Aβ42 with SCD with normal levels of these CSF-biomarkers. However, in the left subiculum there was a significant interaction revealing atrophy in the left posterior but not the anterior subiculum in participants with low Aβ42 levels. The same pattern was observed on the contralateral side in participants with elevated P-tau levels. In conclusion, AD pathologies and mild

  20. Effect of 3 months vitamin E supplementation on indices of the cellular and humoral immune response in elderly subjects

    NARCIS (Netherlands)

    Waart, de F.; Portengen, L.; Doekes, G.; Verwaal, C.J.; Kok, F.J.

    1997-01-01

    It has been suggested that decreased immune responsiveness in the elderly may be counteracted by the antioxidant vitamin E. In a 3-month double-blind placebo-controlled intervention trial among elderly subjects aged 65 years and over we studied the effects of a daily dose of 100 mg

  1. Calcium excretion, apparent calcium absorption and calcium balance in young and elderly subjects: Influence of protein intake

    NARCIS (Netherlands)

    Pannemans, D.L.E.; Schaafsma, G.; Westerterp, K.R.

    1997-01-01

    The present study was conducted to investigate the effect of dietary protein on urinary Ca excretion, apparent Ca absorption and Ca balance in young and elderly subjects. Young adults (n 29) and elderly persons (n 26) consumed diets containing 12% (diet A) and 21% (diet B) of total energy as protein

  2. Socioeconomic status, frailty, and subjective well-being: A moderated mediation analysis in elderly Chinese.

    Science.gov (United States)

    Yang, Fang; Pang, Joyce S

    2016-11-01

    The study examined the mechanisms underlying the link between socioeconomic status and subjective well-being and explored the role of social activities using a representative sample of older adults ( N = 2773) in Shanghai, China. Results show that frailty mediated the relationship between socioeconomic status and subjective well-being, and social activities moderated the model, such that the mediation effect of frailty was significant only when social activities were lower. Moreover, the moderated mediation model was significant only for women, not for men. Findings highlight the importance of addressing frailty of older adults and promoting social activities (especially for elderly women) in future interventions.

  3. Evaluation of dyspnoea in a sample of elderly subjects recruited from general practice

    DEFF Research Database (Denmark)

    Pedersen, F; Mehlsen, J; Raymond, I

    2007-01-01

    The objectives of this study were to investigate the cause of dyspnoea in a sample of elderly individuals and to assess the diagnostic yield of a three-step examination algorithm for the evaluation of dyspnoea paired with a cost analysis. A total of 152 subjects were examined. A predefined....... Of 129 subjects with dyspnoea, 68 (53%) had signs of lung disease, 27 (21%) had heart disease, a total of 43 (33%) were obese, 20 (16%) were obese without other causes of dyspnoea and five (4%) had general physical deconditioning. Twelve per cent had none of the above-mentioned potential causes...

  4. Association between Serum IGF-I levels and Postoperative Delirium in Elderly Subjects Undergoing Elective Knee Arthroplasty

    Science.gov (United States)

    Yen, Timothy E.; Allen, John C.; Rivelli, Sarah K.; Patterson, Stephanie C.; Metcalf, Meredith R.; Flink, Benjamin J.; Mirrakhimov, Aibek E.; Lagoo, Sandhya A.; Vail, Thomas P.; Young, Christopher C.; Moon, Richard E.; Trzepacz, Paula T.; Kwatra, Madan M.

    2016-01-01

    Evidence is mixed for an association between serum insulin-like growth factor-I (IGF-I) levels and postoperative delirium (POD). The current study assessed preoperative serum IGF-I levels as a predictor of incident delirium in non-demented elderly elective knee arthroplasty patients. Preoperative serum levels of total IGF-I were measured using a commercially available Human IGF-I ELISA kit. POD incidence and severity were determined using DSM-IV criteria and the Delirium Rating Scale-Revised-98 (DRS-R98), respectively. Median IGF-I levels in delirious (62.6 ng/ml) and non-delirious groups (65.9 ng/ml) were not significantly different (p = 0.141). The ratio (95% CI) of geometric means, D/ND, was 0.86 (0.70, 1.06). The Hodges-Lehmann median difference estimate was 7.23 ng/mL with 95% confidence interval (−2.32, 19.9). In multivariate logistic regression analysis IGF-I level was not a significant predictor of incident POD after correcting for medical comorbidities. IGF-I levels did not correlate with DRS-R98 scores for delirium severity. In conclusion, we report no evidence of association between serum IGF-I levels and incidence of POD, although the sample size was inadequate for a conclusive study. Further efforts to investigate IGF-I as a delirium risk factor in elderly should address comorbidities and confounders that influence IGF-I levels. PMID:26846868

  5. The effects of oral amino acid intake on ambulatory capacity in elderly subjects.

    Science.gov (United States)

    Scognamiglio, Roldano; Avogaro, Angelo; Negut, Christian; Piccolotto, Roberto; de Kreutzenberg, Saula Vigili; Tiengo, Antonio

    2004-12-01

    The combination of high prevalence of inactivity in the older population, and high risk of ill-health and disability associated with inactivity, suggests that interventions that are successful in increasing levels of activity may have a great impact on population health in later life. With advancing age, the risk of developing serious nutritional deficiencies also increases. This study was designed to assess the effects of dietary amino acid supplementation on effort tolerance in healthy elderly subjects with reduced physical activity. Forty-four subjects (age > 65 years) with sedentary life-style and lower health-related quality of life were studied. Subjects, in an open-label fashion, received an oral amino acid mixture (AAM, 12 g/day) containing essential and non-essential amino acids for a 3-month period. Ambulatory dysfunction resulting in sedentary life-style was assessed by a 6-min walk test. A walking impairment questionnaire (WIQ) was used to evaluate self-perceived ambulatory dysfunction. Maximal isometric muscular strength of the right hand was measured during isometric exercise by a handgrip dynamometer. The 6-min walk distance increased from 214.5 +/- 32 to 262.8 +/- 34.8 m (p oral amino acid supplement, as used in this pilot study, improves ambulatory capacity and maximal isometric muscle strength in elderly subjects without affecting the main metabolic parameters. Amino acid supplementation may thus represent useful non-pharmacological intervention to maintain physical fitness in these subjects.

  6. Subjective memory complaints and cognitive performance in a sample of healthy elderly

    Directory of Open Access Journals (Sweden)

    Paulo Caramelli

    Full Text Available Abstract Memory loss is a major complaint among the elderly population. However, the clinical significance of this symptom is variable and also controversial in the scientific literature. Objective: To compare the cognitive performance of two groups of healthy elderly, one group with and the other without, subjective memory complaints (SMC. Methods: Sixty cognitively intact elderly individuals (39 females and 21 males, aged 69.9±6.3 years and with educational level of 8.5±5.5 years, were included in the study. Participants were submitted to the Mini-Mental State Examination and to the Cornell depression scale in order to rule out global cognitive impairment and depression, respectively. Moreover, they answered the MAC-Q, a questionnaire devised to evaluate subjective impression of memory function. Subsequently, they were submitted to the digit span forward and backward, the Brief Cognitive Screening Battery, and to the Frontal Assessment Battery. Results: Twenty-seven individuals had MAC-Q scores <25 and thus were classified as not having SMC, while 33 had MAC-Q scores ³25 and were considered to have SMC. No differences for age, gender, education and MMSE scores were found between the two groups. The comparison between the performance of the groups of complainers and non-complainers on the different cognitive tests yielded no significant difference, although there was a trend toward non-complainers performing better on incidental memory. Conclusions: The presence of SMC was not associated to objective memory impairment or to other cognitive deficits in this group of elderly individuals.

  7. MORPHOMETRIC ANALYSIS OF VASCULAR PATHOLOGY IN THE ORBITOFRONTAL CORTEX OF ELDERLY SUBJECTS WITH MAJOR DEPRESSION

    Science.gov (United States)

    Miguel-Hidalgo, Jose Javier; Jiang, Wei; Konick, Lisa; Overholser, James C.; Jurjus, George J.; Stockmeier, Craig A.; Steffens, David; Krishnan, K. Ranga R.; Rajkowska, Grazyna

    2012-01-01

    Objective Late-life depression has been associated with risk for cerebrovascular pathology, as demonstrated in neuroimaging studies of older depressed patients, as well as mood disorder following cerebrovascular accidents. However, more research is needed on neuroanatomical changes in late-life depression, where there has been no clearly documented link to brain injury. Such studies should examine morphological changes in medium and small sized vessels that supply the cortical gray and white matter. Methods The present study used a non-specific histological Nissl staining and a more vessel-specific immunolabeling with endothelial marker von Willebrand Factor (vWF) to estimate density and size of blood vessel segments in the orbitofrontal cortex of 16 elderly subjects with major depressive disorder (MDD) and 9 non-psychiatric comparison subjects. Results The density of Nissl-stained vessel segments and of segments with perivascular spaces was higher in subjects with MDD than in comparison subjects in gray (GM) and white matter (WM). In GM, the density of vWF-immunoreactive segments with cross-sectional areas greater than 800 μm2 was higher in MDD. In WM, only the density of vWF-immunoreactive segments with patent perivascular spaces and diameters larger than 60 μm was higher in subjects with MDD. Also in the WM, only subjects with late-onset MDD presented a significantly higher density of vWF-positive segments than comparison subjects. Conclusions In elderly subjects with MDD, there appear to be morphological changes that increase visibility of medium-sized vessel segments with some labeling techniques, and this increased visibility may be related to increased patency of perivascular spaces around arterioles. PMID:23208772

  8. Fractal time series analysis of postural stability in elderly and control subjects

    Directory of Open Access Journals (Sweden)

    Doussot Michel

    2007-05-01

    Full Text Available Abstract Background The study of balance using stabilogram analysis is of particular interest in the study of falls. Although simple statistical parameters derived from the stabilogram have been shown to predict risk of falls, such measures offer little insight into the underlying control mechanisms responsible for degradation in balance. In contrast, fractal and non-linear time-series analysis of stabilograms, such as estimations of the Hurst exponent (H, may provide information related to the underlying motor control strategies governing postural stability. In order to be adapted for a home-based follow-up of balance, such methods need to be robust, regardless of the experimental protocol, while producing time-series that are as short as possible. The present study compares two methods of calculating H: Detrended Fluctuation Analysis (DFA and Stabilogram Diffusion Analysis (SDA for elderly and control subjects, as well as evaluating the effect of recording duration. Methods Centre of pressure signals were obtained from 90 young adult subjects and 10 elderly subjects. Data were sampled at 100 Hz for 30 s, including stepping onto and off the force plate. Estimations of H were made using sliding windows of 10, 5, and 2.5 s durations, with windows slid forward in 1-s increments. Multivariate analysis of variance was used to test for the effect of time, age and estimation method on the Hurst exponent, while the intra-class correlation coefficient (ICC was used as a measure of reliability. Results Both SDA and DFA methods were able to identify differences in postural stability between control and elderly subjects for time series as short as 5 s, with ICC values as high as 0.75 for DFA. Conclusion Both methods would be well-suited to non-invasive longitudinal assessment of balance. In addition, reliable estimations of H were obtained from time series as short as 5 s.

  9. ADMA/SDMA in Elderly Subjects with Asymptomatic Carotid Atherosclerosis: Values and Site-Specific Association

    Directory of Open Access Journals (Sweden)

    Graziano Riccioni

    2014-04-01

    Full Text Available Asymmetric dimethylarginine (ADMA is an endogenous nitric oxide synthase (NOS inhibitor known as a mediator of endothelial dysfunction and atherosclerosis. Circulating ADMA levels are correlated with cardiovascular risk factors such as hypercholesterolemia, arterial hypertension, diabetes mellitus, hyperhomocysteinemia, age and smoking. We assessed the relationship between ADMA values and site-specific association of asymptomatic carotid atherosclerosis (intima-media thickness (CIMT and plaque in elderly subjects. One hundred and eighty subjects underwent a complete history and physical examination, determination of serum chemistries and ADMA levels, and carotid ultrasound investigation (CUI. All subjects had no acute or chronic symptoms of carotid atherosclerosis. Statistical analyses showed that high plasma levels of ADMA/SDMA were positively correlated to carotid atherosclerosis (CIMT and plaque (p < 0.001, with significant site-specific association. Total cholesterol, low density lipoprotein cholesterol, triglycerides and C-reactive protein plasma concentrations were significantly associated with asymptomatic carotid atherosclerosis (p < 0.001. High serum concentrations of ADMA and SDMA were associated with carotid atherosclerotic lesions as measured by CIMT ad plaque and may represent a new marker of asymptomatic carotid atherosclerosis in elderly subjects.

  10. ADMA/SDMA in Elderly Subjects with Asymptomatic Carotid Atherosclerosis: Values and Site-Specific Association

    Science.gov (United States)

    Riccioni, Graziano; Scotti, Luca; D’Orazio, Nicolantonio; Gallina, Sabina; Speziale, Giuseppe; Speranza, Lorenza; Bucciarelli, Tonino

    2014-01-01

    Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide synthase (NOS) inhibitor known as a mediator of endothelial dysfunction and atherosclerosis. Circulating ADMA levels are correlated with cardiovascular risk factors such as hypercholesterolemia, arterial hypertension, diabetes mellitus, hyperhomocysteinemia, age and smoking. We assessed the relationship between ADMA values and site-specific association of asymptomatic carotid atherosclerosis (intima-media thickness (CIMT) and plaque) in elderly subjects. One hundred and eighty subjects underwent a complete history and physical examination, determination of serum chemistries and ADMA levels, and carotid ultrasound investigation (CUI). All subjects had no acute or chronic symptoms of carotid atherosclerosis. Statistical analyses showed that high plasma levels of ADMA/SDMA were positively correlated to carotid atherosclerosis (CIMT and plaque) (p < 0.001), with significant site-specific association. Total cholesterol, low density lipoprotein cholesterol, triglycerides and C-reactive protein plasma concentrations were significantly associated with asymptomatic carotid atherosclerosis (p < 0.001). High serum concentrations of ADMA and SDMA were associated with carotid atherosclerotic lesions as measured by CIMT ad plaque and may represent a new marker of asymptomatic carotid atherosclerosis in elderly subjects. PMID:24739810

  11. Maintenance of exercise training benefits is associated with adequate milk and dairy products intake in elderly hypertensive subjects following detraining.

    Science.gov (United States)

    Moraes, Wilson Max Almeida Monteiro de; Santos, Neucilane Silveira Dos; Aguiar, Larissa Pereira; Sousa, Luís Gustavo Oliveira de

    2017-01-01

    To investigate whether maintenance of exercise training benefits is associated with adequate milk and dairy products intake in hypertensive elderly subjects after detraining. Twenty-eight elderly hypertensive patients with optimal clinical treatment underwent 16 weeks of multicomponent exercise training program followed by 6 weeks of detraining, and were classified according to milk and dairy products intake as low milk (exercise training, there was a significant reduction (pexercise training benefits related to pressure levels, lower extremity strength and aerobic capacity, is associated with adequate milk and dairy products intake in hypertensive elderly subjects following 6 weeks of detraining.

  12. Utilization of arm span instead of height in body mass index calculation in elderly subjects

    Directory of Open Access Journals (Sweden)

    Yilmaz O

    2016-03-01

    Full Text Available Ozlem Yilmaz, Fatih Tufan, Gulistan Bahat, Mehmet Akif Karan Department of Geriatrics, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, TurkeyWe read with interest the article by Falsarella et al.1 The authors investigated the relationship between body composition and frailty in community-dwelling elderly individuals aged 65 years or older. The findings of this study have considerable importance in terms of evolving preventive, diagnostic, and treatment measures for frailty in the elderly population. We would like to make a comment on this well-designed study. For calculating body mass index (BMI, using arm span instead of height would be more accurate.2 Conditions such as kyphosis and asymptomatic vertebral fractures are commonly seen in elderly individuals (especially in frail ones, and calculation of BMI using height may result in overestimation of BMI in these circumstances. In this way, subjects with low BMI may be considered to have normal BMI, and this may result in underestimation of malnutrition, which is an important contributor to frailty phenotype.View original paper by Falsarella and colleagues.

  13. [Care of elderly subject with iron deficiency anaemia: evaluation of geriatric practice].

    Science.gov (United States)

    Berrut, Gilles; Dibon, Christelle; Hanon, Olivier; Gavazzi, Gaëtan; Chassagne, Philippe; de Decker, Laure

    2014-06-01

    The anemia with iron deficiency is frequent in the elder subjects. Few studies have reported the practice of the geriatric medicine about anemia. A national survey asked geriatric medical practitioners of hospital geriatric ward from June till September, 2013. Questionnaires were sent, filled over the phone. On 568 sent questionnaires, 312 (55%) were filled. The frequency of the anemia is considered of 46 ± 21%. The definition of the anemia in an elderly person is on average 10.7 ± 0.8 g/dL, taking into account the situation of the patient. The wanted biological examinations are the haemoglobin and the ferritinaemia, but many people suggest measuring also folates and vitamin B12 given strong prevalence of comorbidity. Prevalence of iron deficiency anemia estimated between 20 and 80% because of high prevalence of mixed cause which modified the answer. The major causes were reported as of digestive, gynecological and post-operative origins. The treatment is proposed from 9 g/dL. The oral iron and the transfusions are the most quoted. The possibility of injectable iron is reported only by 17%, of the geriatricians. The answers of the geriatricians show strong coherences in the management of the iron deficiency anemia. Guidelines should be adapted for elderly people for exercice capacity, mainly on high frequency of mixed cases.

  14. Body composition changes over 9 years in healthy elderly subjects and impact of physical activity.

    Science.gov (United States)

    Genton, Laurence; Karsegard, Véronique L; Chevalley, Thierry; Kossovsky, Michel P; Darmon, Patrice; Pichard, Claude

    2011-08-01

    Age-related changes of body composition affect health status. This study aims at clarifying body composition changes in healthy elderly subjects, and evaluating the impact of physical activity on these changes. In 1999, 213 subjects ≥ 65 years recruited through advertisements underwent assessment of health state, energy expenditure by physical activity, body composition by bioimpedance analysis and body cell mass by total body potassium. In 2008, 112 of them repeated these assessments with additional determination of Barthel index, Mini Mental State Examination and Geriatric Depression Score. Lean tissues decreased in both genders (p physical activity limited lean tissue loss in men but not in women. Loss of lean tissues occurs exponentially with aging. Further research should confirm these changes in subjects over 80 years. Increasing physical activity limits fat-free mass loss in men but not women. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  15. Vitamin D deficiency and nutritional status in elderly hospitalized subjects in Iceland.

    Science.gov (United States)

    Ramel, Alfons; Jonsson, Palmi V; Bjornsson, Sigurbjorn; Thorsdottir, Inga

    2009-07-01

    Poor nutrition and limited sunlight exposure (season) can be related to reduced serum 25-hydroxyvitamin D (25(OH)D) concentrations. Thus, elderly people in the Nordic countries might be at high risk for vitamin D deficiency. The aims of the study were to describe the prevalence of vitamin D deficiency in elderly hospitalized patients in Reykjavik, Iceland, and to investigate the effects of nutritional status and season on serum 25(OH)D. Cross-sectional study. Nutritional status was assessed and fasting blood was drawn and analysed for serum 25(OH)D and other clinical routine measurements. Departments of Geriatrics, Landspitali-University Hospital, Reykjavik, Iceland. Sixty hospitalized patients (mean age 83.0 (SD 7.9) years) were randomly assigned. Of the patients, 12.3% suffered from vitamin D deficiency (serum 25(OH)D nutritional status on serum 25(OH)D. Anthropometric variables correlated significantly with serum 25(OH)D, but on stepwise linear regression modelling for the prediction of serum 25(OH)D, BMI remained the only predictor variable (B = -1.454, 95% CI -2.535, -0.373, P = 0.009). BMI was significantly negatively associated with serum 25(OH)D in hospitalized elderly patients. Neither nutritional status nor season significantly affected serum 25(OH)D in our patient group. Higher levels of serum 25(OH)D in elderly subjects with lower BMI are most likely explained by volume of distribution rather than by mobilization of vitamin D from its storage in adipose tissue due to age and disease-related catabolism.

  16. Religiosity and Subjective Well-Being amongst Institutionalized Elderly in Pakistan

    Directory of Open Access Journals (Sweden)

    Fouzia Gull

    2013-06-01

    Full Text Available Background: In Pakistan, the issue of institutionalized elderly is a neg¬lected area and little is known about their subjective conditions. The present study was con-ducted in 2012 which examined the relationship between religiosity and subjective well being amongst institutionalized el¬derly people. Methods: Data was collected from 100 adults above the age of 60 years in Lahore, Pakistan, through purposive sampling strategy. Religiosity was measured through Religiosity Index, while Trait Well Being Inventory was used to assess subjective well being. Results: Pearson product moment correlation coefficient and regression analysis were used for the analysis of the data, which revealed that reli¬giosity has a significant positive relationship with life satisfaction. How¬ever, no association was found between religiosity and mood level. More¬over, regression analysis indicated that religiosity positively predicted life satisfaction among elderly. Conclusion: The current research would create awareness and urge the policy makers to look into this social issue and provide better long term care to the residents of old homes.

  17. A one-year longitudinal study of subjective well-being in elderly home care recipients

    DEFF Research Database (Denmark)

    Larsen, Lars; Povlsen, Thomas Kaalby; Mortensen, Steen Lee

    , it was earlier in life, despite age-related stressors. However, when these stressors cause loss of independence and a permanent need for help, it could be a different matter. Objectives: This study attempted to answer the following questions: How large a proportion of home care recipients had well-being levels......A one-year longitudinal study of subjective well-being in elderly home care recipients Larsen, L, Povlsen, T.K., Mortensen, S.L. & Christoffersen, M. Background: Old age is not a risk factor per se when it comes to low well-being. In most old people well-being is as high as, or higher than...... indicating stress and risk of depression? Did the overall level of subjective well-being change during a one-year period? How did subjective well-being in elderly home care recipients compare to the national Danish average? Sample: 759 home care recipients 65 years or older in The Municipality of Aarhus...

  18. Effect of vitamin and trace-element supplementation on cognitive function in elderly subjects.

    Science.gov (United States)

    Chandra, R K

    2001-09-01

    To determine whether supplementation with vitamins and trace elements in modest amounts influences cognitive function in apparently healthy, elderly subjects. The study was designed as a randomized, double-blind, placebo-controlled trial. Ninety-six, apparently healthy, independent men and women older than 65 y of age were recruited and randomized to receive a supplement of trace elements and vitamins or a placebo daily for 12 mo. Blood-nutrient levels were estimated at baseline and at the end of the study. The major outcome measure assessed was cognitive function consisting of immediate and long-term memory, abstract thinking, problem-solving ability, and attention. Eighty-six subjects completed the 1-y trial. The supplemented group showed a significant improvement in all cognitive tests (P 0.1). Those whose blood-nutrient levels were below the reference standard showed lower responses on cognitive tests. There was no significant correlation between individual nutrient levels and performance on various cognitive function tests. Cognitive functions improved after oral supplementation with modest amounts of vitamins and trace elements. This has considerable clinical and public health significance. We recommend that such a supplement be provided to all elderly subjects because it should significantly improve cognition and thus quality of life and the ability to perform activities of daily living. Such a nutritional approach may delay the onset of Alzheimer's disease.

  19. Muscle activation patterns related to diabetic neuropathy in elderly subjects: A Functional Reach Test study.

    Science.gov (United States)

    Maranesi, E; Di Nardo, F; Rabini, R A; Ghetti, G G; Burattini, L; Mercante, O; Fioretti, S

    2016-02-01

    This study was designed to assess, in healthy elderly, non-neuropathic and neuropathic diabetic subjects, the activation patterns of the main muscles involved in the Functional Reach Test, a well-recognized method to identify elderly subjects at risk of balance impairments. Surface electromyographic analysis of Sternocleidomastoideus, Rectus Abdominis, Erectores Spinae at L4 level, Rectus Femoris, Hamstrings, Tibialis Anterior and Soleus was performed in 10 healthy, 10 diabetic non-neuropathic and 10 diabetic neuropathic subjects. Results showed that in every group the first motor is Tibialis Anterior, that is recruited before the start of the test. An earlier activation of Tibialis Anterior (Pmovement timing and to compensate for the delay in the recruitment of the motor units. This anticipation might be involved in the altered postural control with increased balance impairment detected in diabetic neuropathic patients, and thereby it might also be proposed as an index of neuropathy, evidenced in a simple and non-invasive manner. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Variability of insulin-stimulated myocardial glucose uptake in healthy elderly subjects

    DEFF Research Database (Denmark)

    Kofoed, Klaus F; Hove, Jens D; Freiberg, Jacob

    2002-01-01

    , bicycle exercise test, electrocardiogram and echocardiography were studied [ P(coronary artery disease) ...The aim of this study was to assess regional and global variability of insulin-stimulated myocardial glucose uptake in healthy elderly subjects and to evaluate potentially responsible factors. Twenty men with a mean age of 64 years, no history of cardiovascular disease, and normal blood pressure...... glucose uptake is homogeneous throughout the left ventricle, but has moderate inter-individual variability. Inter-individual variability of insulin-stimulated myocardial glucose uptake is primarily explained by variability in coronary vascular reactivity and tissue insulin sensitivity....

  1. Screening for frailty in community-dwelling elderly subjects: Predictive validity of the modified SEGA instrument.

    Science.gov (United States)

    Oubaya, N; Dramé, M; Novella, J-L; Quignard, E; Cunin, C; Jolly, D; Mahmoudi, R

    2017-11-01

    To study the capacity of the SEGAm instrument to predict loss of independence among elderly community-dwelling subjects. The study was performed in four French departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5 or 6 in the AGGIR autonomy evaluation scale were included. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument at baseline. Subjects had follow-up visits at home at 6 and 12 months. During follow-up, vital status and level of independence were recorded. Logistic regression was used to study predictive validity of the SEGAm instrument. Among the 116 subjects with complete follow-up, 84 (72.4%) were classed as not very frail at baseline, 23 (19.8%) as frail, and 9 (7.8%) as very frail; 63 (54.3%) suffered loss of at least one ADL or IADL at 12 months. By multivariable analysis, frailty status at baseline was significantly associated with loss of independence during the 12 months of follow-up (OR=4.52, 95% CI=1.40-14.68; p=0.01). We previously validated the SEGAm instrument in terms of feasibility, acceptability, internal structure validity, reliability, and discriminant validity. This instrument appears to be a suitable tool for screening frailty among community-dwelling elderly subjects, and could be used as a basis to plan early targeted interventions for subjects at risk of adverse outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Wavelet coherence analysis of spontaneous oscillations in cerebral tissue oxyhemoglobin concentrations and arterial blood pressure in elderly subjects.

    Science.gov (United States)

    Cui, Ruofei; Zhang, Ming; Li, Zengyong; Xin, Qing; Lu, Liqian; Zhou, Weiei; Han, Qingyu; Gao, Yuanjin

    2014-05-01

    This study aims to assess the relationship between spontaneous oscillations in changes in cerebral tissue oxyhemoglobin concentrations (Delta [HbO2]) and arterial blood pressure (ABP) signals in healthy elderly subjects during the resting state using wavelet coherence analysis. Continuous recordings of near-infrared spectroscopy (NIRS) and ABP signals were obtained from simultaneous measurements in 33 healthy elderly subjects (age: 70.7±7.9 years) and 27 young subjects (age: 25.2±3.7 years) during the resting state. The coherence between Delta [HbO2] and ABP oscillations in six frequency intervals (I, 0.4-2 Hz; II, 0.15-0.4 Hz; III, 0.05-0.15 Hz; IV, 0.02-0.05 Hz, V, 0.005-0.0095 Hz and VI, 0.005-0.0095 Hz) was analyzed using wavelet coherence analysis. In elderly subjects, the Delta [HbO2] and ABP oscillations were significantly wavelet coherent in interval I, and wavelet phase coherent in intervals I, II and IV. The wavelet coherence in interval I was significantly higher (p=0.040), in elderly subjects than in young subjects whereas that in interval V significantly lower (p=0.015). In addition, the wavelet phase coherence in interval IV was significantly higher in elderly subjects than in young subjects (p=0.028). The difference in the wavelet coherence of the elderly subjects and the young subjects indicates an altered cerebral autoregulation caused by aging. This study provides new insight into the dynamics of Delta [HbO2] and ABP oscillations and may be useful in identifying the risk for dynamic cerebral autoregulation processes. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition.

    Science.gov (United States)

    Bergamin, Marco; Ermolao, Andrea; Tolomio, Silvia; Berton, Linda; Sergi, Giuseppe; Zaccaria, Marco

    2013-01-01

    The aim of this study was to assess the effectiveness of a 24-week exercise protocol carried out in geothermal spring water to improve overall physical function and muscle mass in a group of healthy elderly subjects. A further aim was to compare this water-based protocol with a land-based protocol and a control group. For this purpose, 59 subjects were recruited and randomly allocated to three groups: aquatic group (AG), land group (LG), and control group (CG). AG and LG followed a 6-month, twice-weekly, multimodality exercise intervention. AG underwent the protocol in hot-spring water (36°C) while LG did it in a land-based environment. After the intervention, knee-extension strength was maintained in AG and LG. The 8-foot up-and-go test showed a reduction in both exercise groups (AG -19.3%, P decrease in AG. The back-scratch test revealed an improvement only in AG (25.8%; P decreased by 9.2% (P flexibility. Aquatic exercise appeared a better activity to improve dynamic balance. Thermal swimming pools and the use of rating of perceived exertion as a method of exercise monitoring should be considered potentially useful tools to enhance physical performance and body composition in healthy elderly.

  4. Is there a relationship between objective and subjective assessment of balance in elderly patients with instability?

    Science.gov (United States)

    Rossi-Izquierdo, Marcos; Santos-Pérez, Sofía; Del-Río-Valeiras, María; Lirola-Delgado, Antonio; Faraldo-García, Ana; Vaamonde-Sánchez-Andrade, Isabel; Gayoso-Diz, Pilar; Soto-Varela, Andrés

    2015-09-01

    To assess whether a subjective questionnaire that measures the disability caused by balance disorders in daily life activities is correlated to objective assessment of balance in elderly patients with age-related instability. We included 37 subjects aged 65 years or more who presented balance disorders induced solely by age. Balance assessment was through the sensory organisation test and limits of stability of computerised dynamic posturography, the SwayStar system and the modified timed up and go test. The patients also completed the dizziness handicap inventory (DHI) questionnaire. The SwayStar balance control index (BCI) was most significantly correlated to the DHI score and the score of its different scales. When we divided the patients into subgroups according to DHI score, we only found statistically significant differences in the BCI and number of falls. In our population of elderly patients with instability, there is practically no correlation between the DHI and the static balance assessment. However, there is greater correlation with the BCI, which could show that dynamic balance is perceived as more disabling for these patients. In this case, when designing a rehabilitation protocol we should focus more on dynamic activities such as gait.

  5. Skin movement errors in measurement of sagittal lumbar and hip angles in young and elderly subjects.

    Science.gov (United States)

    Kuo, Yi-Liang; Tully, Elizabeth A; Galea, Mary P

    2008-02-01

    Errors in measurement of sagittal lumbar and hip angles due to skin movement on the pelvis and/or lateral thigh were measured in young (n = 21, age = 18.6 +/- 2.1 years) and older (n = 23, age = 70.9 +/- 6.4 years) age groups. Skin reference markers were attached over specific landmarks of healthy young and elderly subjects, who were videotaped in three static positions of hip flexion using the 2D PEAK Motus video analysis system. Sagittal lumbar and hip angles were calculated from skin reference markers and manually palpated landmarks. The elderly subjects demonstrated greater errors in lumbar angle due to skin movement on the pelvis only in the maximal hip flexion position. The traditional model (ASIS-PSIS-GT-LFE) underestimated sagittal hip angle and the revised model (ASIS-PSIS-2/3Th-1/4Th) provided more accurate measurement of sagittal hip angle throughout the full available range of hip flexion. Skin movement on the pelvis had a small counterbalancing effect on the larger errors from lateral thigh markers (GT-LFE), thereby decreasing hip angle error.

  6. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes.

    Science.gov (United States)

    Abate, Michele; Schiavone, Cosima; Salini, Vincenzo

    2010-12-07

    The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively), who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p shoulder symptomatic pathologies.

  7. Effect of exercise training in patients with chronic obstructive pulmonary disease compared with healthy elderly subjects.

    Science.gov (United States)

    Mador, M Jeffery; Krauza, Matthew; Shaffer, Mary

    2012-01-01

    Exercise training in patients with chronic obstructive pulmonary disease (COPD) can be challenging because whole-body exercise often elicits disabling symptoms of dyspnea before the exercising muscles reach their critical limits. The extent that this factor limits training has not been totally defined. The purpose of this study was to compare the response to training of patients with moderate to severe COPD with that achieved by healthy elderly subjects who were exercising using an identical program. Eight healthy subjects and 20 patients with COPD (forced expiratory volume in 1 second 42 ± 13% predicted) exercised 3 times a week for 8 weeks. Outcome measures included 6-minute walk distance, maximal exercise capacity (Wmax) during an incremental cycle ergometer test, and submaximal constant workload (60%-70% of subject Wmax) exercise time. Six-minute walk distance and Wmax increased after training to a significantly greater extent in the healthy controls compared with the patients with COPD; 65 ± 24 versus 32 ± 50 m, P = .03; and 25.1±13.9 versus 11.5±13.1 watts, P = .025, respectively. However, these differences disappeared when data were expressed as percent improvement, 12.1 ± 5.3% versus 10.0 ± 15.8%, and 25.6 ± 13.5% versus 23.1 ± 33.3%. Improvement in submaximal constant workload exercise time after training was similar in healthy controls 21.6 ± 6.1 versus patients with COPD 18.8 ± 11.2 minutes. Patients with COPD can show similar relative improvements in exercise capacity compared with healthy elderly subjects. The difference in absolute values reflects, at least in part, the greater baseline exercise capacity.

  8. Cost-effectiveness of nutritional intervention in elderly subjects after hip fracture. A randomized controlled trial.

    Science.gov (United States)

    Wyers, C E; Reijven, P L M; Evers, S M A A; Willems, P C; Heyligers, I C; Verburg, A D; van Helden, S; Dagnelie, P C

    2013-01-01

    Hip fracture patients can benefit from nutritional supplementation during their recovery. Up to now, cost-effectiveness evaluation of nutritional intervention in these patients has not been performed. Costs of nutritional intervention are relatively low as compared with medical costs. Cost-effectiveness evaluation shows that nutritional intervention is likely to be cost-effective. Previous research on the effect of nutritional intervention on clinical outcome in hip fracture patients yielded contradictory results. Cost-effectiveness of nutritional intervention in these patients remains unknown. The aim of this study was to evaluate cost-effectiveness of nutritional intervention in elderly subjects after hip fracture from a societal perspective. Open-label, multi-centre randomized controlled trial investigating cost-effectiveness of intensive nutritional intervention comprising regular dietetic counseling and oral nutritional supplementation for 3 months postoperatively. Patients allocated to the control group received care as usual. Costs, weight and quality of life were measured at baseline and at 3 and 6 months postoperatively. Incremental cost-effectiveness ratios (ICERs) were calculated for weight at 3 months and quality adjusted life years (QALYs) at 6 months postoperatively. Of 152 patients enrolled, 73 were randomized to the intervention group and 79 to the control group. Mean costs of the nutritional intervention was 613 Euro. Total costs and subcategories of costs were not significantly different between both groups. Based on bootstrapping of ICERs, the nutritional intervention was likely to be cost-effective for weight as outcome over the 3-month intervention period, regardless of nutritional status at baseline. With QALYs as outcome, the probability for the nutritional intervention being cost-effective was relatively low, except in subjects aged below 75 years. Intensive nutritional intervention in elderly hip fracture patients is likely to be cost

  9. Friendship among Elderly People: The relationships among functions of friendship, degree of satisfaction with friendship and subjective well-being

    OpenAIRE

    山岡, もも; 松永, しのぶ; YAMAOKA, Momo; MATSUNAGA, Shinobu; 全国療育相談センター; 昭和女子大学心理学科

    2013-01-01

    This study investigates characteristics of friendship among elderly people, particularly the relationships between the functions of friendship, the degree of satisfaction with friendship, and subjective well-being. Written questionnaires completed by 241 elderly people aged between 60 and 88(92 men, mean age 72.03 years; 149 women, mean age 72.11 years)were analyzed. Among men, the duration of friendship was longer than among women. The most common initial acquaintance among men were co-worke...

  10. Caring for frail elders with musculoskeletal conditions and family caregivers' subjective well-being: The role of multidimensional caregiver burden.

    Science.gov (United States)

    Lu, Nan; Liu, Jinyu; Lou, Vivian W Q

    2015-01-01

    The present study examined the unique set of correlates of each dimension of the burden experienced by family caregivers of frail elders with musculoskeletal (MSK) conditions in China, and the role of caregiver burden in between caregiver stressors and subjective well-being. The data was derived from a community sample of 494 elder-caregiver dyads from six urban districts of Shanghai (China). The elders were aged 75 or above, needed assistance in activities of daily living (ADL) and had MSK conditions. The family caregivers were these elders' primary caregivers and at the age of 18 or older. Path analysis was used to examine the proposed model. Care recipients' functional health, cognitive status and behavioral problems affected the multiple dimensions of caregiver burden differently. These three stressors also indirectly affected caregivers' subjective well-being through physical, social and developmental burden. The findings highlighted the mediator role of caregiver burden in between caregiver stressors and subjective well-being, which supported burden-as-mediator theory in understanding family caregiving for frail elders with musculoskeletal conditions in a Chinese context. The focus of intervention should be varied according to the levels of the primary stressors. Policy and intervention implications with regard to the ways of helping Chinese families care for their frail elders with MSK conditions were discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Changes in gait and balance parameters in elderly subjects attending an 8-week supervised Pilates programme.

    Science.gov (United States)

    Newell, D; Shead, V; Sloane, L

    2012-10-01

    Falls in the elderly have important clinical and economic costs and interventions that may reduce the risk of such problems are potentially important. Although evidence exists for a range of exercise interventions, few have looked at a Pilates-based intervention in a supervised community-based setting and none have specifically measured gait parameters as an outcome. This observational study investigated gait parameters including inter-stride variability (ISV) and postural sway in a group (n = 9) of elderly (age range, 60-76) subjects attending a weekly Pilates class over eight weeks. The results suggest that significant improvement in walking speed (0.14 m/s (95% CI: 0.06-0.21)), step cycle (0.07 m (95% CI: 0.01-0.14)) and length (0.10 m (95% CI: 0.05-0.15)) and a composite ambulation index (6.5% (95% CI: 1.85-11.26)) were seen post the intervention, while coefficients of variation decreased around 15%. In addition both anterior-posterior sway decreased along with a improvement in a fall risk index (FRI). Inter-stride variability on the other hand did not change. The results of this study suggest that a short Pilates program may have the potential to improve gait and sway parameters, including those associated with fall risk. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Determination of body composition in elderly subjects suffering of diabetes mellitus and arteriosclerosis

    International Nuclear Information System (INIS)

    Worum, I.; Fueloep, T. Jr.; Ujhelyi, L.; Csongor, J.

    1986-01-01

    The authors determined the body composition of 23 diabetic and 36 arteriosclerotic subjects by multiple-isotope method. Their hormonal status was also assessed at the same time. They determined the body composition of well compensated, orally treated diabetic elderly and it was found that the intracellular volumes are unchanged comparing to healthy elderly controls, the total body fat is slightly increased, while the intracellular volumes (except extracellular volume ECV, in the case of females) are diminished significantly, mainly, in the case of males. In the case of decompensated diabetes treated originally with insulin, they found a general dehydration affecting mainly the intracellular compartments, but also in a less extent the extracellular ones. After one week of treatment with insulin and perfusions the body composition became normalized. The hormonal changes were not significant. In the case of arteriosclerosis they made a distinction after the dominating signs and symptoms between central peripheral arteriosclerosis. It seems after their results that except a diminution of plasma volume (PV), more marked in central arteriosclerosis, no changes could be observed comparing to health age-matched controls. In conclusion they can say that diabetes in its decompensated form causes a general perturbation of body composition in the sense of dehydration necessitating a well-managed rehydration

  13. Sleep-disordered breathing in elderly people and subjective sleep-wake disturbance.

    Science.gov (United States)

    Mant, A; Eyland, E A; Hewitt, H; Fox, M; Goode, E; LeCount, A; Pond, D; Saunders, N A

    1992-07-01

    Sleep-disordered breathing and subjective reports of sleep-wake disturbances are both common in elderly people but previous studies investigating the relationship between the two have produced uncertain results. We hypothesized that there is no relationship between sleep-disordered breathing and subjective reports of sleep-wake disturbance. Ninety-three random-sampled retirement-village residents, mean age 77.6 years, were monitored overnight with a portable microprocessor-based system. The respiratory disturbance index (RDI) was used as a measure of sleep-disordered breathing. Subjects were interviewed regarding sleep-wake patterns and snoring history and the Mini Mental State Examination, Geriatric Depression Scale and Nelson Adult Reading Test were administered. The sleep-wake responses were entered into a principal components analysis. Two components, reflecting night-time and daytime disturbance, accounted for 34% of the variance. Multiple regression analyses were performed using RDI as a continuous dependent variable, and three predictor variables, night-time, and daytime disturbance and history of snoring. Together, these variables accounted for only 2% of the variance. We conclude there is no relationship between mild and moderate sleep-disordered breathing and subjective sleep-wake disturbance in this population.

  14. Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects

    Directory of Open Access Journals (Sweden)

    Michael Ewers

    2014-01-01

    Full Text Available Brain changes reminiscent of Alzheimer disease (AD have been previously reported in a substantial portion of elderly cognitive healthy (HC subjects. The major aim was to evaluate the accuracy of MRI assessed regional gray matter (GM volume, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET, and neuropsychological test scores to identify those HC subjects who subsequently convert to mild cognitive impairment (MCI or AD dementia. We obtained in 54 healthy control (HC subjects a priori defined region of interest (ROI values of medial temporal and parietal FDG-PET and medial temporal GM volume. In logistic regression analyses, these ROI values were tested together with neuropsychological test scores (free recall, trail making test B (TMT-B as predictors of HC conversion during a clinical follow-up between 3 and 4 years. In voxel-based analyses, FDG-PET and MRI GM maps were compared between HC converters and HC non-converters. Out of the 54 HC subjects, 11 subjects converted to MCI or AD dementia. Lower FDG-PET ROI values were associated with higher likelihood of conversion (p = 0.004, with the area under the curve (AUC yielding 82.0% (95% CI = (95.5%, 68.5%. The GM volume ROI was not a significant predictor (p = 0.07. TMT-B but not the free recall tests were a significant predictor (AUC = 71% (95% CI = 50.4%, 91.7%. For the combination of FDG-PET and TMT-B, the AUC was 93.4% (sensitivity = 82%, specificity = 93%. Voxel-based group comparison showed reduced FDG-PET metabolism within the temporo-parietal and prefrontal cortex in HC converters. In conclusion, medial temporal and-parietal FDG-PET and executive function show a clinically acceptable accuracy for predicting clinical progression in elderly HC subjects.

  15. A pilot study on the evaluation of postural strategies in young and elderly subjects using a tridimensional electromagnetic system.

    Science.gov (United States)

    Carneiro, José Ailton Oliveira; Santos-Pontelli, Taiza Elaine Grespan; Colafêmina, José Fernando; Carneiro, Antonio Adilton Oliveira; Ferriolli, Eduardo

    2013-01-01

    One resorts to various postural strategies while attempting to maintain balance. To assess the postural strategies adopted by young and elderly subjects in varying sensory conditions by using a system of tridimensional electromagnetic sensors positioned on the projection of the first thoracic vertebra and on the sacral region. Postural oscillation values for young and elderly subjects were also reported. This observational cross-sectional study enrolled 25 young and 16 elderly individuals. A Polhemus™ device equipped with two sensors was used to assess postural oscillation parameters (maximum displacement, mean velocity, and trajectory). Data acquisition was carried out with subjects standing while undergoing a 90-second test in four sensory conditions: eyes opened, eyes closed, on a stable surface, and on an unstable surface. Sensors 1 and 2 presented significant cross-correlations in all sensory conditions for both groups (r > 0.99; p < 0.001). No statistically significant differences were seen when the cross-correlations for both groups were compared. This study presented an important tool to analyze postural oscillation and assess the postural strategies of young and elderly subjects in different sensory conditions. Young and elderly individuals presented strong correlations between sensors (ankle strategy), but no statistically significant differences were seen between groups.

  16. Personality, Emotional Qualities of Leisure, and Subjective Well-Being in the Elderly.

    Science.gov (United States)

    Kahlbaugh, Patricia; Huffman, Loreen

    2017-07-01

    In this study, we examined personality traits of older adults and their emotional experiences associated with engaging in specific leisure activities. Older individuals (17 males, 32 females), ages ranging from 65 to 97 years (mean age 74), completed measures of Big Five personality traits, positive and negative affect, subjective well-being (SWB), independent functioning, and an emotion-activity inventory. As expected, Extraversion, Agreeableness, Conscientiousness, and Openness to experience were related to positive affect, while Neuroticism was related to negative affect. Openness and Agreeableness were related to positive emotions experienced in social and cognitive domains, and Agreeableness was related to greater SWB, greater positive affect, and more positively experienced activities. Neuroticism was related to lower SWB and fewer positively experienced activities. These findings suggest that assessing the fit between personality and emotions experienced during activities should be considered when creating programs tailored to elderly individuals, with the goal of encouraging more active and rewarding lives.

  17. Gravitational artefact in frequency spectra of movement acceleration: implications for actigraphy in young and elderly subjects.

    Science.gov (United States)

    Van Someren, E J; Lazeron, R H; Vonk, B F; Mirmiran, M; Swaab, D F

    1996-03-01

    Actigraphy, the long-term assessment of wrist movements by means of a small solid-state recorder, is widely used in a variety of human research fields, among which sheep, circadian rhythms and aging. Actigraphs assess movement with the use of accelerometers, which sense accelerations resulting from muscle force as well as accelerations due to changes in the position of the sensor in the gravitational field. In the present paper a method is described to minimise gravitational artefact in movement assessment by calculating the instantaneous acceleration vector from 3 perpendicular acceleration signals. It is shown that the power spectra of single axis acceleration signals are dominated by low-frequency components (+/- 0.25 Hz) due to gravitational artefact. Spectra of the instantaneous acceleration vector indicate that 'true' movement accelerations resulting from muscle force are present in a much wider range: from 0.25 to 11 Hz. Wrist accelerations in elderly subjects were found to be of lower amplitude and frequency as compared to young subjects. It is furthermore shown that a bandpass filter of 0.25 to 2 or 3 Hz, as has been used in commercially available actigraphs, is far from optional, and may even result in a positive bias for movement detection in the elderly. This bias may underly contradictory findings in actigraphic studies on human aging. When a bandpass filter of 0.5-11 Hz is applied to a single-axis acceleration signal, the influence of gravitational artefact and bias are minimized, and the age-related decline in activity is properly detected.

  18. Achilles tendinopathy in elderly subjects with type II diabetes: the role of sport activities.

    Science.gov (United States)

    Abate, Michele; Salini, Vincenzo; Schiavone, Cosima

    2016-04-01

    Exercise is an important therapeutic tool in the management of diabetes in older people. Aim of this study was to assess the relationship among type II diabetes, sport, overweight, and symptomatic Achilles tendinopathy in elderly subjects. Thirty-eight patients suffering from Achilles tendinopathy and thirty-eight controls were enrolled. The prevalence of diabetes and sport practice as well as BMI and Glycated Hemoglobin (HbA1c) values were registered. An ultrasound evaluation of Achilles tendon was performed. Patients showed an increased prevalence of diabetes (42 vs. 13.1 %, p = 0.004), and practice of sport (60.5 vs. 28.9 %, p = 0.0001), and higher BMI values (26.8 ± 3 vs. 24.8 ± 2.3, p = 0.001). Sonographic abnormalities, being diagnostic criteria, were present in all the patients with Achilles tendinopathy, but signs of degeneration were also found in 36.8 % of asymptomatic controls. Symptomatic subjects with diabetes, compared to those without, showed a higher prevalence of severe degeneration (75 vs. 36.3 %, p = 0.01). HbA1c values were significantly lower in sport practitioners, both diabetics and non-diabetics. Moreover, patients practicing sport showed a trend towards lower BMI values, compared to the sedentary counterpart. Sport practice in elderly diabetics provides relevant metabolic advantages, reducing HbA1c and BMI. However, some sport activities (e.g., speed walking, jogging or tennis) can expose to the risk of Achilles tendinopathy. So, sport practice should be encouraged, but practitioners should follow individual training programs and be submitted to periodic sonographic controls.

  19. Variability of insulin-stimulated myocardial glucose uptake in healthy elderly subjects

    Energy Technology Data Exchange (ETDEWEB)

    Kofoed, Klaus F.; Hove, Jens D.; Freiberg, Jacob; Hoest, Ulla; Kelbaek, Henning [Cardiovascular PET Research Unit, Section 9201, Medical Department B, The Heart Center, Rigshospitalet, University of Copenhagen, Juliane Mariesvej 24, 2100 Copenhagen (Denmark); Holm, Soeren [The Cyclotron and PET Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University of Copenhagen (Denmark)

    2002-12-01

    The aim of this study was to assess regional and global variability of insulin-stimulated myocardial glucose uptake in healthy elderly subjects and to evaluate potentially responsible factors. Twenty men with a mean age of 64 years, no history of cardiovascular disease, and normal blood pressure, bicycle exercise test, electrocardiogram and echocardiography were studied [P(coronary artery disease) <5%]. Whole-body insulin sensitivity and insulin-stimulated myocardial glucose uptake were measured during hyperinsulinaemic euglycaemic glucose clamp with fluorine-18 fluorodeoxyglucose, and myocardial rest and hyperaemic blood flow during dipyridamole infusion were measured with nitrogen-13 ammonia and positron emission tomography in 16 left ventricular myocardial segments. Intra-individual and inter-individual variability of insulin-stimulated myocardial glucose uptake [relative dispersion = (standard deviation/mean)] was 13% and 29% respectively. Although inter-individual variability of glucose uptake and blood flow at rest was of the same magnitude, no correlation was found between these measures. Regional and global insulin-stimulated myocardial glucose uptake correlated linearly with whole-body insulin sensitivity (r=0.51, P<0.05 and r=0.56, P<0.01). The strongest independent association by multivariate linear regression analysis was found between myocardial glucose uptake and hyperaemic blood flow (r=0.63, P<0.005). We conclude that in healthy elderly subjects, insulin-stimulated myocardial glucose uptake is homogeneous throughout the left ventricle, but has moderate inter-individual variability. Inter-individual variability of insulin-stimulated myocardial glucose uptake is primarily explained by variability in coronary vascular reactivity and tissue insulin sensitivity. (orig.)

  20. Hippocampal shape is predictive for the development of dementia in a normal, elderly population

    DEFF Research Database (Denmark)

    Achterberg, Hakim C.; van der Lijn, Fedde; den Heijer, Tom

    2014-01-01

    assessed whether hippocampal shape provides additional predictive value independent of hippocampal volume. Five hundred eleven brain MRI scans from elderly nondemented participants of a prospective population-based imaging study were used. During the 10-year follow-up period, 52 of these subjects developed...... dementia. For training and evaluation independent of age and gender, a subset of 50 cases and 150 matched controls was selected. The hippocampus was segmented using an automated method. From the segmentation, the volume was determined and a statistical shape model was constructed. We trained a classifier...

  1. Mental status testing in the elderly nursing home population.

    Science.gov (United States)

    Nadler, J D; Relkin, N R; Cohen, M S; Hodder, R A; Reingold, J; Plum, F

    1995-07-01

    The clinical utility of selected brief cognitive screening instruments in detecting dementia in an elderly nursing home population was examined. One hundred twenty nursing home residents (mean age 87.9) were administered the Mini-Mental State Exam (MMSE) and the Modified Mini-Mental State Exam (3MS). The majority of the subjects (75%) were also administered the Dementia Rating Scale (DRS). Both clinically diagnosed demented (n = 57) and non-demented (n = 63) subjects participated in the study. Dementia was diagnosed in accordance with DSM-III-R criteria by physicians specializing in geriatric medicine. Using standard cutoffs for impairment, the 3MS, MMSE, and DRS achieved high sensitivity (82% to 100%) but low specificity (33% to 52%) in the detection of dementia among nursing home residents. Positive predictive values ranged from 52% to 61%, and negative predictive values from 77% to 100%. Higher age, lower education, and history of depression were significantly associated with misclassification of non-demented elderly subjects. Receiver Operating Characteristic (ROC) curve analyses revealed optimal classification of dementia with cutoff values of 74 for the 3MS, 22 for the MMSE, and 110 for the DRS. The results suggest that the 3MS, MMSE, and DRS do not differ significantly with respect to classification accuracy of dementia in a nursing home population. Elderly individuals of advanced age (i.e., the oldest-old) with lower education and a history of depression appear at particular risk for dementia misclassification with these instruments. Revised cutoff values for impairment should be employed when these instruments are applied to elderly residents of nursing homes and the oldest-old.

  2. Impact of ambulatory physiotherapy on motor abilities of elderly subjects with Alzheimer's disease.

    Science.gov (United States)

    Manckoundia, Patrick; Taroux, Michaël; Kubicki, Alexandre; Mourey, France

    2014-01-01

    We investigated the impact of ambulatory physiotherapy (AP) on motor abilities in elderly subjects with Alzheimer's disease (AD). Subjects with mild to moderate AD were included and divided into "physiotherapy group" (PG) and "no physiotherapy group" (NPG) according to whether or not they received AP between inclusion (T0) and the second time of assessment, between 15 and 36 months after inclusion (T1). The follow-up duration, Mini-Mental State Examination, Tinetti and mini motor test (MMT) scores, Timed Up & Go test (TUG), gait speed (GS), one-leg balance (OLB), history of falls within the last 6 months (HF), ability to rise from the floor (RFF) and the use of a walking aid (UWA) were recorded at T0, and after at least 15 months of follow up (T1). A total of 50 subjects were included in the NPG and 20 in the PG. At baseline, these groups were not significantly different for all the parameters recorded. The anova showed a progression of cognitive disorders in the two groups between T0 and T1 (P Geriatrics Society.

  3. Neutrophils are immune cells preferentially targeted by retinoic acid in elderly subjects

    Directory of Open Access Journals (Sweden)

    Minet-Quinard Régine

    2010-08-01

    Full Text Available Abstract Background The immune system gradually deteriorates with age and nutritional status is a major factor in immunosenescence. Of the many nutritional factors implicated in age-related immune dysfunction, vitamin A may be a good candidate, since vitamin A concentrations classically decrease during aging whereas it may possess important immunomodulatory properties via its active metabolites, the retinoic acids. This prompted us to investigate the immune response induced by retinoids in adults and elderly healthy subjects. Before and after oral supplementation with 13cis retinoic acid (0.5 mg/kg/day during 28 days, whole blood cells were phenotyped, and functions of peripheral blood mononuclear cells (PBMC and polymorphonuclear cells (PMN were investigated by flow cytometry and ELISA tests. Results In both young adults (n = 20, 25 ± 4 years and older subjects (n = 20, 65 ± 4 years, retinoic acid supplementation had no effect on the distribution of leukocyte subpopulations or on the functions of PBMC (Il-2 and sIl-2R production, membrane expression of CD25. Concerning PMN, retinoic acid induced an increase in both spontaneous migration and cell surface expression of CD11b in the two different age populations, whereas bactericidal activity and phagocytosis remained unchanged. Conclusions We demonstrated that retinoic acid induces the same intensity of immune response between adult and older subjects, and more specifically affects PMN functions, i.e. adhesion and migration, than PBMC functions.

  4. The surface electromyographic evaluation of the Functional Reach in elderly subjects.

    Science.gov (United States)

    Maranesi, E; Fioretti, S; Ghetti, G G; Rabini, R A; Burattini, L; Mercante, O; Di Nardo, F

    2016-02-01

    This study proposes a comprehensive assessment of myoelectric activity of the main muscles involved in the Functional Reach (FR) test, in 24 elderly subjects. A specific protocol for the surface electromyography (sEMG) signal acquisition during FR-test was developed. Results show that anterior muscles activate following a caudo-cranial order. Tibialis Anterior (TA) is the first to be activated (-18.0±16.3% of the FR-period), together with Rectus Femoris (-10.4±17.9%). Then, Rectus Abdominis (19.7±24.7%) and Sternocleidomastoideus (19.9±15.6%) activate after the FR-start. Hamstrings, Soleus, and L4-level Erectores Spinae (posterior muscles) activate after the FR-start in this order (11.4±16.8%, 17.7±16.6%, and 35.2±29.0%, respectively) and remain active until the movement end. The analysis of the kinematic strategies adopted by subjects revealed an association between TA-activation patterns and two kinematic strategies (hip/mixed strategy), quantified by an increase (pelderly subjects, providing an early contribution in building a reference frame for balance assessment in clinical context. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Butyryl-cholinesterase is related to muscle mass and strength. A new biomarker to identify elderly subjects at risk of sarcopenia.

    Science.gov (United States)

    Cacciatore, Francesco; Della-Morte, David; Basile, Claudia; Curcio, Francesco; Liguori, Ilaria; Roselli, Mario; Gargiulo, Gaetano; Galizia, Gianluigi; Bonaduce, Domenico; Abete, Pasquale

    2015-01-01

    To determine the relationship between Butyryl-cholinesterase (α-glycoprotein synthesized in the liver, b-CHE) and muscle mass and strength. Muscle mass by bioimpedentiometer and muscle strength by grip strength were evaluated in 337 elderly subjects (mean age: 76.2 ± 6.7 years) admitted to comprehensive geriatric assessment. b-CHE levels were lower in sarcopenic than in nonsarcopenic elderly subjects (p strength and muscular mass both in men and women (r = 0.45 and r = 0.33, p strength in elderly subjects. Thus, b-CHE may be considered to be a fair biomarker for identifying elderly subjects at risk of sarcopenia.

  6. Association between environmental noise and subjective symptoms related to cardiovascular diseases among elderly individuals in Japan.

    Directory of Open Access Journals (Sweden)

    Kenichi Azuma

    Full Text Available Noise in housing environments may increase the risk of cardiovascular diseases (CVDs; however, the most significant sources of noise among elderly individuals remain poorly understood. A nationwide cross-sectional study comprised of 6,181 elderly people (age ≥ 65 years was conducted using a web-based self-reported questionnaire in 2014. Questions pertaining to CVD-related subjective symptoms within the past year addressed symptoms of chest pain, disturbances in pulse, acute impaired tongue movement, limb paralysis, and foot pain or numbness during walking. Questions concerning noise included awakening during the night due to noise, automobile, neighborhood, construction, railway, and aircraft noise. The multivariable analyses revealed that all symptoms were significantly associated with awakening during the night due to noise. Automobile, construction, railway, and aircraft noise were significantly associated with more CVD-related symptoms at nighttime than at daytime. Our results suggest that noise at nighttime is an important risk factor for CVDs. Although several different sources of environmental noise, including automobile, neighborhood, construction, railway, and aircraft noise were found to be significantly associated with CVD-related symptoms, the strongest association was observed for construction noise, followed by neighborhood and automobile noise. The adjusted odds ratios (95% confidence intervals for construction noise at nighttime were 1.12 (1.06-1.19 with disturbances in pulse, 1.21 (1.08-1.35 in acute impaired tongue movement, 1.25 (1.15-1.36 in limb paralysis, and 1.19 (1.12-1.28 in foot pain or numbness during walking. The associations with railway and aircraft noise were found to be weaker than those with automobile, neighborhood, and construction noise. Our study suggests that CVD-related symptoms may exhibit a greater association with construction, neighborhood, and automobile noise than with railway and aircraft noise.

  7. Effect of different types of exercise on sleep quality of elderly subjects.

    Science.gov (United States)

    Bonardi, José M T; Lima, Leandra G; Campos, Giulliard O; Bertani, Rodrigo F; Moriguti, Júlio C; Ferriolli, Eduardo; Lima, Nereida K C

    2016-09-01

    There are still many gaps in research concerning the effect of different physical training modalities on sleep quality in the elderly population. Thus, the objective of the present study was to compare the quality of sleep of hypertensive elderly subjects submitted to two types of training (ie, aerobic exercise alone or combined aerobic and resistance training). Participants aged 60-75 years were randomized to three groups: aerobic group (AG), combined aerobic and resistance group (ARG), and control untrained group (CG). Training lasted ten consecutive weeks with 30 uninterrupted sessions. The actigraph (Actiwatch Minimitter Company, INC - Sunriver, OR, USA) was placed on the non-dominant wrist and activities were monitored continuously while being recorded at one minute intervals. The participants kept the device for a period of 96 hours before the first and last training sessions. There was a reduction in sleep fragmentation index of 18.9 for AG and 13 for ARG (p sleep efficacy was improved in the exercise groups, with a 5.6% increase for AG (p = 0.02) and a 6.1% increase for ARG (p = 0.01). After training, percentage of minutes motionless was increased by 8.2% for AG and by 6.9% for ARG (p sleep quality. A reduction in total activity score during sleep was observed for AG and ARG (p exercise performed for ten weeks similarly improved sleep quality, thus reducing the fragmentation index, the percentage of minutes in motion and total activity score, and increasing sleep efficacy. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

    Directory of Open Access Journals (Sweden)

    Salini Vincenzo

    2010-12-01

    Full Text Available Abstract Background The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. Methods The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively, who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Results Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p vs 3.2 ± 0.4 mm, p vs 20.3%, p vs 7.8%, p Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8% vs 2 (3.1%, p vs 5 (7.8%, p = ns, but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% vs 10.9%, p vs 10.9%, p In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found. Conclusions Our results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics. Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.

  9. The nutritional, glutathione and oxidant status of elderly subjects admitted to a university hospital

    OpenAIRE

    Adel A Alhamdan; Abdulaziz A Alsaif

    2011-01-01

    Background/Aim: Malnutrition in elderly patients is common in hospitals, and many of the age associated chronic diseases have a common factor, which is oxidative stress. The aim of the study was to evaluate the nutritional status, glutathione, and oxidant status of elderly patients. Patients and Methods: The mini-nutritional assessment (MNA) was used to determine the nutritional status of elderly patients. Glutathione concentration in the whole blood, plasma albumin, and thiobarbituric acid-r...

  10. Study on changes of serum leptin, IGF-I and IL-2 levels in elderly subjects with osteoporosis

    International Nuclear Information System (INIS)

    Sun Zihan; Luo Nanping; Niu Aijun; Qi Falian

    2006-01-01

    Objective: To investigate the changes of serum leptin, IGF-I and IL-2 levels in elderly subjects with osteoporosis. Methods: Serum leptin, IGF-I, IL-2 levels (with RIA), total cholesterol contents (with biochemical method) and bone mineral density (BMD) were examined in 65 aged patients with osteoporosis. Results: The serum leptin levels in subjects with osteoporosis were significantly higher than controls (P<0.01). The serum IGF-I and IL-2 levels in subjects with osteoporosis were significantly lower than those in controls (P<0.05, P<0.01). The BMD was positively correlated with the IGF-I levels and negatively correlated with leptin level. Conclusion: Derangement of leptin and IGF-I, IL-2 metabolism is one of the major causes of decreased bone mass and bone formation elderly subjects with osteoporosis. Measurement of serum levels of these parameters is of diagnostic help. (authors)

  11. Water- versus land-based exercise in elderly subjects: effects on physical performance and body composition

    Directory of Open Access Journals (Sweden)

    Bergamin M

    2013-08-01

    Full Text Available Marco Bergamin,1 Andrea Ermolao,1 Silvia Tolomio,1 Linda Berton,2 Giuseppe Sergi,2 Marco Zaccaria1 1Sports Medicine Division, 2Geriatrics Division, University of Padova, Padua, Italy Abstract: The aim of this study was to assess the effectiveness of a 24-week exercise protocol carried out in geothermal spring water to improve overall physical function and muscle mass in a group of healthy elderly subjects. A further aim was to compare this water-based protocol with a land-based protocol and a control group. For this purpose, 59 subjects were recruited and randomly allocated to three groups: aquatic group (AG, land group (LG, and control group (CG. AG and LG followed a 6-month, twice-weekly, multimodality exercise intervention. AG underwent the protocol in hot-spring water (36°C while LG did it in a land-based environment. After the intervention, knee-extension strength was maintained in AG and LG. The 8-foot up-and-go test showed a reduction in both exercise groups (AG −19.3%, P < 0.05; LG −12.6%, P < 0.05, with a significantly greater decrease in AG. The back-scratch test revealed an improvement only in AG (25.8%; P < 0.05, while the sit-and-reach test improved in all groups. Finally, AG reduced fat mass by 4% (P < 0.05, and dominant forearm fat decreased by 9.2% (P < 0.05. In addition, calf muscle density increased by 1.8% (P < 0.05. In summary, both water- and land-based activities were beneficial in maintaining strength and in improving lower-body flexibility. Aquatic exercise appeared a better activity to improve dynamic balance. Thermal swimming pools and the use of rating of perceived exertion as a method of exercise monitoring should be considered potentially useful tools to enhance physical performance and body composition in healthy elderly. Keywords: aging, multimodality exercise, performance, muscle mass

  12. Age-Associated Decline in Dendritic Cell Function and the Impact of Mediterranean Diet Intervention in Elderly Subjects

    Directory of Open Access Journals (Sweden)

    Sarah J. Clements

    2017-12-01

    Full Text Available IntroductionAging is accompanied by increased susceptibility to infection and age-associated chronic diseases. It is also associated with reduced vaccine responses, which is often attributed to immunosenescence and the functional decline of the immune system. Immunosenescence is characterized by a chronic, low-grade, inflammatory state termed inflammaging. Habitants of Mediterranean (MED regions maintain good health into old age; often attributed to MED diets.HypothesisAdoption of a MED-diet by elderly subjects, in Norfolk (UK, may improve immune responses of these individuals and in particular, dendritic cell (DC function.Experimental approachA total of 120 elderly subjects (65–79 years old recruited onto the Nu-AGE study, a multicenter European dietary study specifically addressing the needs of the elderly, across five countries, and were randomized to the control or MED-diet groups, for one year. Blood samples were taken pre- and post-intervention for DC analysis and were compared with each other, and to samples obtained from 45 young (18–40 years old subjects. MED-diet compliance was assessed using high performance liquid chromatography-with tandem mass spectrometry analysis of urine samples. Immune cell and DC subset numbers and concentrations of secreted proteins were determined by flow cytometric analysis.ResultsAs expected, reduced myeloid DC numbers were observed in blood samples from elderly subjects compared with young. The elevated secretion of the adipokine, resistin, after ex vivo stimulation of peripheral blood mononuclear cells from elderly subjects, was significantly reduced after MED-diet intervention.ConclusionThis study provides further evidence of numerical and functional effects of aging on DCs. The MED-diet showed potential to impact on the aging immune cells investigated and could provide an economical approach to address problems associated with our aging population.

  13. Activation during the Trail Making Test measured with functional near-infrared spectroscopy in healthy elderly subjects.

    Science.gov (United States)

    Hagen, Katja; Ehlis, Ann-Christine; Haeussinger, Florian B; Heinzel, Sebastian; Dresler, Thomas; Mueller, Laura D; Herrmann, Martin J; Fallgatter, Andreas J; Metzger, Florian G

    2014-01-15

    Cognitive decline is very common in age and particularly in subjects with neurodegenerative conditions. Besides memory and language, executive functions are very often affected in elderly and patients with Alzheimer's disease or Parkinson's disease. However, the neural alterations associated with these executive deficits are still not fully understood. Therefore, we measured cortical activation using functional near-infrared spectroscopy (fNIRS) in 16 healthy elderly subjects (50-75 years) performing the Trail Making Test (TMT), a widely used neuropsychological instrument measuring executive function. In line with previous studies focusing on younger subjects, the results showed frontal activation during the TMT A and the TMT B in the dorsolateral prefrontal cortex, the frontopolar area and also Broca's area. Furthermore, significant activation in the left motor, somatosensory cortices and somatosensory association cortices was demonstrated. Additionally, after a median split the differences between younger (58 years) subjects were analyzed with the older subjects showing a less focused prefrontal activation. Altogether, fNIRS was found to be suitable to detect cortical activation in elderly subjects during performance of the TMT as well as aging-related differences in prefrontal activation topography. These neural correlates of executive functions should be further investigated as a potential prodromal neural marker of executive deficits and neurodegenerative processes. © 2013.

  14. Effects of socks which improved foot sensation on velocity and stride length of elderly subjects crossing obstacles.

    Science.gov (United States)

    Yoo, Won-Gyu

    2015-08-01

    [Purpose] We developed socks which improve foot sensation and investigated their effect on the velocity and stride length of elderly women crossing obstacles. [Subjects] Ten community-dwelling, elderly women who could walk independently were recruited. [Methods] We measured velocity and stride length using the GAITRite system while the participants crossed obstacles under three conditions: barefoot, wearing ordinary socks, and wearing the socks which improve foot sensation. [Results] Velocity and stride length in bare feet and when wearing the sense-improving socks increased significantly compared to their values when wearing standard socks. Velocity and stride length did not differ between the bare foot and improved sock conditions. [Conclusion] Wearing socks helps protect the foot, but can decrease foot sensory input. Therefore, the socks which improve foot sensation were useful for preventing falls and protecting the feet of the elderly women while they crossed obstacles.

  15. Modafinil-Induced Changes in Functional Connectivity in the Cortex and Cerebellum of Healthy Elderly Subjects.

    Science.gov (United States)

    Punzi, Miriam; Gili, Tommaso; Petrosini, Laura; Caltagirone, Carlo; Spalletta, Gianfranco; Sensi, Stefano L

    2017-01-01

    In the past few years, cognitive enhancing drugs (CEDs) have gained growing interest and the focus of investigations aimed at exploring their use to potentiate the cognitive performances of healthy individuals. Most of this exploratory CED-related research has been performed on young adults. However, CEDs may also help to maintain optimal brain functioning or compensate for subtle and or subclinical deficits associated with brain aging or early-stage dementia. In this study, we assessed effects on resting state brain activity in a group of healthy elderly subjects undergoing acute administration of modafinil, a wakefulness-promoting agent. To that aim, participants ( n = 24) were investigated with resting state functional Magnetic Resonance Imaging (rs-fMRI) before and after the administration of a single dose (100 mg) of modafinil. Effects were compared to age and size-matched placebo group. Rs-fMRI effects were assessed, employing a graph-based approach and Eigenvector Centrality (EC) analysis, by taking in account topological changes occurring in functional brain networks. The main finding of the study is that modafinil promotes enhanced centrality, a measure of the importance of nodes within functional networks, of the bilateral primary visual (V1) cortex. EC analysis also revealed that modafinil-treated subjects show increased functional connectivity between the V1 and specific cerebellar (Crus I, Crus II, VIIIa lobule) and frontal (right inferior frontal sulcus and left middle frontal gyrus) regions. Present findings provide functional data supporting the hypothesis that modafinil can modulate the cortico-cerebellar connectivity of the aging brain.

  16. Validation of the Subjective Vitality Scale and study of the vitality of elderly people according to their physical activity

    Directory of Open Access Journals (Sweden)

    Nuno Couto

    2017-08-01

    Full Text Available The main aim of the study was to validate the Portuguese version of the Subjective Vitality Scale - SVS for the Portuguese elderly population through of confirmatory factorial analysis. The existence of differences in the perception of subjective vitality among sufficiently active and insufficiently active older adults was also analyzed. A total of 309 Portuguese elderly (242 females, 67 males aged 60-90 years (M = 68.59, SD = 6.60 participated in this study. Of the total sample, 256 are sufficiently active, while 53 are insufficiently active. The results show that the model was adjusted to data in a satisfactory way (χ² = 28.95; df = 9; CFI = .97; TLI = .94; SRMR = .04; RMSEA = .08; RMSEA 90% CI = .05 - .12, and show a concurrent validity with the Portuguese version of the Satisfaction with Life Scale. The data obtained allow us concluding that the Portuguese version of the Subjective Vitality Scale can be used as a measure of subjective vitality in the Portuguese elderly population. It was also verified that the subjective perception of vitality is greater among individuals sufficiently active compared with their peers that do not reach the amount of practice of recommended physical activity.

  17. Yoghurt containing galacto-oligosaccharides, prunes and linseed reduces the severity of mild constipation in elderly subjects.

    Science.gov (United States)

    Sairanen, U; Piirainen, L; Nevala, R; Korpela, R

    2007-12-01

    Constipation is a common problem in the elderly. Dietary fibre is recommended for its treatment. The aim was to examine whether yoghurt containing galacto-oligosaccharides (GOS), prunes and linseed relieve constipation in elderly subjects. A randomized, double-blinded, cross-over study. Free-living subjects. A group of 43 elderly subjects with self-reported constipation (mean age 76 years, range 61-92 years, 32 females, 11 males). The study consisted of a 2-week baseline period and 2, 3-week dietary interventions, with a 2-week wash-out period between the interventions. During the interventions, the subjects ingested, in random order, 260 g/day of either control yoghurt or test yoghurt containing GOS (12 g/day), prunes (12 g/day) and linseed (6 g/day). The use of laxatives was controlled and only allowed after 2 days without defecation. Defecation frequency was 5.7 times/week during the baseline period. During the test yoghurt period, defecation frequency was higher (8.0 vs 7.1 times/week, P=0.011), defecation was easier (on the scale 0-3, 1.3 vs 1.5, P=0.010), and there was a tendency towards softer stools (on the scale 0-3, 2.1 vs 2.2, P=0.059) compared with the control yoghurt period. The subjects felt that the test yoghurt relieved constipation more effectively than the control yoghurt (P=0.005). The sum of gastrointestinal symptoms did not differ between the interventions. The use of laxatives remained constant throughout the study. Daily intake of yoghurt containing GOS, prunes and linseed reduced the severity of constipation in elderly subjects with mild constipation. Valio Ltd, R&D.

  18. The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment.

    Science.gov (United States)

    Guercio, Brendan J; Donovan, Nancy J; Munro, Catherine E; Aghjayan, Sarah L; Wigman, Sarah E; Locascio, Joseph J; Amariglio, Rebecca E; Rentz, Dorene M; Johnson, Keith A; Sperling, Reisa A; Marshall, Gad A

    2015-01-01

    Apathy is a common neuropsychiatric symptom in Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI). Detecting apathy accurately may facilitate earlier diagnosis of AD. The Apathy Evaluation Scale (AES) is a promising tool for measurement of apathy in prodromal and possibly preclinical AD. To compare the three AES sub-scales - subject-reported (AES-S), informant-reported (AES-I), and clinician-reported (AES-C) - over time in individuals at risk for AD due to MCI and advanced age (cognitively normal [CN] elderly). Mixed effects longitudinal models were used to assess predictors of score for each AES sub-scale. Cox proportional hazards models were used to assess which AES sub-scales predict progression from MCI to AD dementia. Fifty-seven MCI and 18 CN subjects (ages 53-86) were followed for 1.4 ± 1.2 years and 0.7 ± 0.7 years, respectively. Across the three mixed effects longitudinal models, the common findings were associations between greater apathy and greater years in study, a baseline diagnosis of MCI (compared to CN), and male gender. CN elderly self-reported greater apathy compared to that reported by informants and clinicians, while individuals with MCI under-reported their apathy compared to informants and clinicians. Of the three sub-scales, the AES-C best predicted transition from MCI to AD dementia. In a sample of CN elderly and elderly with MCI, apathy increased over time, particularly in men and those with MCI. AES-S scores may be more sensitive than AES-I and AES-C scores in CN elderly, but less reliable if subjects have MCI. Moreover, the AES-C sub-scale predicted progression from MCI to AD dementia.

  19. Oxidative stress is associated with an increased antioxidant defense in elderly subjects: a multilevel approach.

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    Gemma Flores-Mateo

    Full Text Available BACKGROUND: Studies of associations between plasma GSH-Px activity and cardiovascular risk factors have been done in humans, and contradictory results have been reported. The aim of our study was to assess the association between the scavenger antioxidant enzyme glutathione peroxidase (GSH-Px activity in plasma and the presence of novel and classical cardiovascular risk factors in elderly patients. METHODS: We performed a cross-sectional study with baseline data from a subsample of the PREDIMED (PREvención con DIeta MEDiterránea study in Spain. Participants were 1,060 asymptomatic subjects at high risk for cardiovascular disease (CVD, aged 55 to 80, selected from 8 primary health care centers (PHCCs. We assessed classical CVD risk factors, plasma oxidized low-density lipoproteins (ox-LDL, and glutathione peroxidase (GSH-Px using multilevel statistical procedures. RESULTS: Mean GSH-Px value was 612 U/L (SE: 12 U/L, with variation between PHCCs ranging from 549 to 674 U/L (Variance =  013.5; P<0.001. Between-participants variability within a PHCC accounted for 89% of the total variation. Both glucose and oxidized LDL were positively associated with GSH-Px activity after adjustment for possible confounder variables (P = 0.03 and P = 0.01, respectively. CONCLUSION: In a population at high cardiovascular risk, a positive linear association was observed between plasma GSH-Px activity and both glucose and ox-LDL levels. The high GSH-Px activity observed when an oxidative stress situation occurred, such as hyperglycemia and lipid oxidative damage, could be interpreted as a healthy defensive response against oxidative injury in our cardiovascular risk population.

  20. Do Functionally Fit Elderly Community-Dwelling Subjects Have Enough Time to Safely Cross the Road?

    Directory of Open Access Journals (Sweden)

    Darija Rugelj

    2013-02-01

    Full Text Available Elderly people are the most vulnerable group in urban traffic and a large proportion of them are as pedestrians victims of traffic accidents. The majority of these happen while crossing the road. Crossing a busy road at an intersection with traffic lights or without them is a typical dual task condition requiring a motor task i.e. walking and a cognitive task such as monitoring traffic. The purpose of present study was to compare the walking speed and the related spatio-temporal gait variables of fallers and non-fallers in three walking conditions against the speeds required by regulations in Slovenia for safe street crossing. To assess the spatio-temporal characteristics of gait we used a 7m instrumented walkway.The general results showed that the spatio-temporal gait parameters did not differ between the two groups at the self-selected speed. But as soon as a constraint, such as fast walking speed, was imposed on the subjects the differences between the groups became evident. Fallers demonstrated a significantly slower mean gait velocity and shorter stride length while the cadence and the base of support did not differ between the two groups. In dual task conditions the difference between the two groups reached 25 percent. The fallers group gait velocity dropped to 0.99 m/s. The observed walking speed was slower than considered by the guidelines for the design of traffic light equipped road crossing.In conclusion, the results of walking speed under dual task conditions could be a useful parameter for planning of optimal pedestrian crossing in urban areas. These results will serve for the design of a population based study in Ljubljana.

  1. Oxidative Stress Is Associated with an Increased Antioxidant Defense in Elderly Subjects: A Multilevel Approach

    Science.gov (United States)

    Flores-Mateo, Gemma; Elosua, Roberto; Rodriguez-Blanco, Teresa; Basora-Gallisà, Josep; Bulló, Mònica; Salas-Salvadó, Jordi; Martínez-González, Miguel Ángel; Estruch, Ramon; Corella, Dolores; Fitó, Montserrat; Fiol, Miquel; Arós, Fernando; Gómez-Gracia, Enrique; Subirana, Isaac; Lapetra, José; Ruiz-Gutiérrez, Valentina; Sáez, Guillermo T.; Covas, Maria-Isabel

    2014-01-01

    Background Studies of associations between plasma GSH-Px activity and cardiovascular risk factors have been done in humans, and contradictory results have been reported. The aim of our study was to assess the association between the scavenger antioxidant enzyme glutathione peroxidase (GSH-Px) activity in plasma and the presence of novel and classical cardiovascular risk factors in elderly patients. Methods We performed a cross-sectional study with baseline data from a subsample of the PREDIMED (PREvención con DIeta MEDiterránea) study in Spain. Participants were 1,060 asymptomatic subjects at high risk for cardiovascular disease (CVD), aged 55 to 80, selected from 8 primary health care centers (PHCCs). We assessed classical CVD risk factors, plasma oxidized low-density lipoproteins (ox-LDL), and glutathione peroxidase (GSH-Px) using multilevel statistical procedures. Results Mean GSH-Px value was 612 U/L (SE: 12 U/L), with variation between PHCCs ranging from 549 to 674 U/L (Variance = 1013.5; P<0.001). Between-participants variability within a PHCC accounted for 89% of the total variation. Both glucose and oxidized LDL were positively associated with GSH-Px activity after adjustment for possible confounder variables (P = 0.03 and P = 0.01, respectively). Conclusion In a population at high cardiovascular risk, a positive linear association was observed between plasma GSH-Px activity and both glucose and ox-LDL levels. The high GSH-Px activity observed when an oxidative stress situation occurred, such as hyperglycemia and lipid oxidative damage, could be interpreted as a healthy defensive response against oxidative injury in our cardiovascular risk population. PMID:25269026

  2. A series of pharmacokinetic studies of ceftaroline fosamil in select populations: normal subjects, healthy elderly subjects, and subjects with renal impairment or end-stage renal disease requiring hemodialysis.

    Science.gov (United States)

    Riccobene, Todd; Jakate, Abhijeet; Rank, Doug

    2014-07-01

    Ceftaroline fosamil is a parenteral cephalosporin indicated for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. Ceftaroline, the active component of ceftaroline fosamil, exhibits broad-spectrum bactericidal activity against gram-positive organisms, including methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae, as well as common gram-negative pathogens. The objective of the studies presented herein was to establish the pharmacokinetic profile of ceftaroline in healthy subjects and special populations of interest, such as elderly subjects, subjects with renal impairment, or subjects with end-stage renal disease on intermittent hemodialysis. The mean half-life of ceftaroline in healthy subjects was approximately 2.6 hours, and urinary excretion was the primary route of elimination. Ceftaroline Cmax and AUC values increased in proportion to dose increases within the range of 50-1000 mg, demonstrating an approximately linear pharmacokinetic profile following intravenous infusion. The pharmacokinetic parameters of ceftaroline were modestly altered in elderly subjects compared with younger adults, which was attributed to decreased renal function in elderly subjects. Ceftaroline pharmacokinetic parameters varied with different degrees of renal impairment, resulting in recommended dosage adjustments for patients with moderate to severe impairment. Ceftaroline fosamil was generally well tolerated regardless of age or severity of renal impairment. © 2014, The American College of Clinical Pharmacology.

  3. [Elder].

    Science.gov (United States)

    Arroyo, Pedro; Gutiérrez-Robledo, Luis Miguel

    2016-09-01

    The aim of this review is to present scientific evidence on the biological, dietary, cultural and economic advantages of cow´s milk and dairy products intake in adults, with emphasis on the elderly. The role of milk and dairy products as part of the regular diet, as well as their contribution to a healthy diet for the aged population is described. The updated scientific references on the importance of milk and dairy products on the dietary management of the most prevalent diseases of the eldery -among these energy-protein malnutrition, sarcopenia, obesity, sarcopenic obesity, osteoporosis, diabetes and cardiovascular diseases- are presented.

  4. The effectiveness of acupuncture on the sleep quality of elderly with dementia: a within-subjects trial

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    Kwok T

    2013-07-01

    Full Text Available Timothy Kwok,1,2 Ping Chung Leung,3 Yun Kwok Wing,4 Isaac Ip,2 Bel Wong,2 Daniel Wai Hung Ho,2 Wai Ming Wong,3 Florence Ho2 1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; 2Jockey Club Centre for Positive Ageing, Hong Kong; 3Institute of Chinese Medicine, 4Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong Purpose: Elderly with dementia are often afflicted with sleep problems. Recent studies have suggested that acupuncture may be a feasible alternative to traditional sleep medicine for treating sleep disturbance. This study investigated the effectiveness of acupuncture on sleep quality of elderly with dementia. Patients and methods: Nineteen elders with dementia were followed through a control period and an acupuncture treatment period, each lasting 6 weeks. Outcome measures were subjects' sleep quality and cognitive function. Sleep parameters were recorded by wrist actigraphy. Cognitive function was assessed by the Alzheimer's Disease Assessment Scale – Cognitive (ADAS-Cog. Pretests and posttests were conducted immediately before and after the control and treatment periods. Changes in the outcome measures between control and treatment periods were compared. Results: Wilcoxon signed rank tests revealed that the subjects gained significantly more resting time and total sleep time in the treatment period than in the control period (P < 0.05. A nonsignificant trend for improvement in sleep efficiency was observed. Improvement in cognitive function was not statistically significant. A total of 86% of the subjects completed the treatment regime. Conclusion: Results reveal that acupuncture was effective in improving some domains of sleep quality of elderly with dementia, and the subjects showed acceptance towards the intervention. Strengths and limitations of the present study as well as suggestions for further studies were considered. Keywords: acupuncture, sleep disturbance, patients

  5. The Se.Ko.Ph. study: a European multicentre study on falls in elderly subjects living in residential homes

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    Aladar Bruno Ianes

    2017-05-01

    Full Text Available The aim was to investigate risk factors for falls in elderly people living in residential nursing homes. An observational, prospective, multicentre study was conducted between March 2010 and March 2011 investigating falls in elderly residents living in residential nursing homes (4 Italian¸ 4 French and 5 German nursing homes. A number of risk factors were assessed as well as details of the fall (dynamics, reasons, location and time of occurrence. Differences were observed between the countries related to different nursing practices. Fallers comprised 36.5% of all residents and approximately 40% were injured as a consequence. Six logistic regression models were created to assess which fallrelated variables had the most impact, and showed subjects with faecal incontinence had a lower risk of falling, while subjects afflicted with dementia and visual impairment showed an increased risk of falling. Higher Tinetti scores were found to be related to an increased fall risk. Falls in the elderly occur due to complex interactions between demographic, physical, behavioural and environmental risk factors. Differences between countries in fall rates were seen, probably due to different medical practices, use of aids and restraints, and characteristics of the populations (i.e. the Italian residents tended to be more cognitively impaired and more impaired in balance and gait compared to the French and German residents. There was evidence that subjects with a better clinical status fall more frequently, whereas non-fallers had a worse clinical status and therefore tended to be more bedridden.

  6. Clinical significance of increased serum IL-6 and TNF-α levels in elderly subjects with osteoporosis

    International Nuclear Information System (INIS)

    Li Wei; Luo Nanping; Sun Xiaoming; Liu Hengguo; Li Jinhua

    2008-01-01

    Objective: To study the relationship between the serum levels of IL-6, TNF-α and bone r-carboxyglutamic acid protein (BGP) in elderly subjects with osteoporosis. Methods: Serum IL-6, TNF-α and BGP levels were measured with RIA in 40 elderly patients with osteoporosis, 40 elderly subjects with decreased bone density but not to the degree of osteoporosis (i.e. decreased bone mass), 35 aged controls (above 60) and 35 younger controls (below 45). Results: By definition, the bone density in patients with osteoporosis was significantly lower than that in all other groups (P<0.05-0.01) and the bone density in subjects with decreased bone mass only was also significantly lower than that in younger controls (P<0.01). The serum IL-6 and TNF-α levels in patients with osteoporosis were significantly higher than those in all controls (P<0.05-0.01), especially in advanced eases, while the BGP levels were significantly lower. Conclusion: Serum IL-6, TNF-α and BGP levels could be used as indicators of the degree of osteoporosis. (authors)

  7. Toxic encephalopathy after taking dried seeds of Datura stramonium in two elderly subjects.

    Science.gov (United States)

    Suk, Seung-Han; Kwak, Yong-Tae

    2009-09-01

    An altered mentality, or delirium, is a common medical condition of the elderly in emergency medicine or neurology clinics. Among causes of this, toxic etiology due to an anticholinergic agent is not rare. The authors present two elderly women who were brought to an emergency room because of anticholinergic syndrome. The patients displayed agitative behavior, confusion, urinary retention, dry mouth and dilated pupils within 3 h of ingesting the dried seeds of Datura stramonium which has been used as a herbal medicine or as a traditional folk remedy for relieving coughing and asthma in Korea. They were discharged with a complete recovery after receiving conservative therapy for 5 days. Physicians of emergency medicine should be mindful of anticholinergic syndrome due to herbal medicine when the elderly with a history of delirium come to a hospital.

  8. Association between dental prosthesis need, nutritional status and quality of life of elderly subjects

    DEFF Research Database (Denmark)

    Pillai, Rajath; Mathur, Vijay Prakash; Jain, Veena

    2015-01-01

    clinic were recruited in the study. Mini-nutritional assessment (MNA), geriatric oral health assessment (GOHAI) indices, prosthesis need according to WHO criteria, and prosthesis want was recorded along with age, gender, socioeconomic status and posterior occluding pair. RESULTS: Significant associations......To determine the effect of prosthesis need on nutritional status and oral health-related quality of life (OHrQoL) in elderly and to check the disparity between prosthesis need and prosthesis want in the Indian elderly. METHODS: A total of 946 geriatric participants reporting to a geriatric medicine...

  9. Sexual dimorphism of cortisol metabolism is maintained in elderly subjects and is not oestrogen dependent.

    Science.gov (United States)

    Toogood, A A; Taylor, N F; Shalet, S M; Monson, J P

    2000-01-01

    The net interconversion of inactive cortisone to active cortisol by 11beta-hydroxysteroid dehydrogenase type 1 (11betaHSD1) may determine hepatic and adipose tissue exposure to glucocorticoid action. Cortisol metabolism exhibits a sexual dimorphism with an apparently lower activity of 11betaHSD1 in females that, in an animal model, has been attributed to the effects of oestrogen. The aim of this study is to determine whether the sexual dimorphism of cortisol metabolism persists between post-menopausal, oestrogen-deficient women and elderly men. Fifteen healthy men, aged 60.8-82.0 years, and 7 healthy women, aged 62.4-87.5 years, were studied. None of the subjects was receiving steroid medication at the time of the study. All the women were post-menopausal and none was receiving sex steroid replacement therapy. 24-h urine collections were taken from each patient and assayed for steroid metabolites by gas chromatography. Body composition was determined by dual energy X-ray absorptiometry. Blood was drawn, after an overnight fast, for the determination of serum IGF-I and IGFBP1 levels. The ratio of 11-hydroxy cortisol metabolites to 11-oxo cortisol metabolites (Fm/Em) was significantly higher in men than in women, 0.80 (0.55-1.86) vs. 0.67 (0.46-0.98) (P cortisol and cortisone metabolite (Fm/Em) and total fat mass approached significance, r = - 0.39 (P = 0.07). These relationships were not apparent in the women when considered alone. Among the men there were negative relationships between Fm/Em and total fat mass, r = - 0.48, and Fm/Em and trunk fat mass, r = - 0.48 which approached significance (both P = 0.07). Serum IGFBP-1 levels were not significantly different between the two sexes. There was a significant correlation between IGFBP-1 and Fm/Em in the men, r = 0. 84 (P sexual dimorphism in cortisol metabolism is not dependent on oestrogen, although the possibility that oestrogen exerts a permanent modifying effect on 11beta-HSD1 gene expression during the pre

  10. Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.

    Science.gov (United States)

    Martínez-González, Miguel A; García-Arellano, Ana; Toledo, Estefanía; Bes-Rastrollo, Maira; Bulló, Mónica; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Lamuela-Raventós, Rosa Maria; Rekondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, Jose Manuel; Serra-Majem, Lluis; Martínez, J Alfredo; Eguaras, Sonia; Sáez-Tormo, Guillermo; Pintó, Xavier; Estruch, Ramon

    2014-01-01

    Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78-1.34), 1.30 (0.97-1.75) and 1.55 (1.06-2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88-1.59), 1.02 (0.74-1.41) and 1.57 (1.19-2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. Controlled-Trials.com ISRCTN35739639.

  11. Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study

    Science.gov (United States)

    Martínez-González, Miguel A.; García-Arellano, Ana; Toledo, Estefanía; Bes-Rastrollo, Maira; Bulló, Mónica; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Lamuela-Raventós, Rosa Maria; Rekondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, Jose Manuel; Serra-Majem, Lluis; Martínez, J. Alfredo; Eguaras, Sonia; Sáez-Tormo, Guillermo; Pintó, Xavier; Estruch, Ramon

    2014-01-01

    Background Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. Methods We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. Results After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78–1.34), 1.30 (0.97–1.75) and 1.55 (1.06–2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88–1.59), 1.02 (0.74–1.41) and 1.57 (1.19–2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Conclusions Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. Trial

  12. Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.

    Directory of Open Access Journals (Sweden)

    Miguel A Martínez-González

    Full Text Available Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality.We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR, waist circumference (WC, body mass index (BMI and height with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years and 57% were women (60 to 80 years. All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009.After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70 were 1.02 (0.78-1.34, 1.30 (0.97-1.75 and 1.55 (1.06-2.26. When we used WC (cut-off points: 100, 105 and 110 cm, the multivariable adjusted Hazard Ratios (HRs for mortality were 1.18 (0.88-1.59, 1.02 (0.74-1.41 and 1.57 (1.19-2.08. In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial.Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality.Controlled-Trials.com ISRCTN35739639.

  13. Clinical correlates of objective and subjective quality of life among middle-aged and elderly female inpatients with chronic schizophrenia.

    Science.gov (United States)

    Nakagawa, Seishu; Hayashi, Naoki

    2013-10-01

    The aim of this study was to illustrate the relationship between objective and subjective measures of quality of life (QOL) and to identify the factors influencing QOL in a sample of middle-aged and elderly female patients with schizophrenia in Japan. Middle-aged and elderly female inpatients with schizophrenia (n=66; mean age [SD]: 68.0 [8.0]) were assessed using the Quality of Life Scale (QLS), Lancashire Quality of Life Profile (LQLP), Positive and Negative Symptoms Scale (PANSS), and Rehabilitation Evaluation Hall and Baker (REHAB). Correlation analyses among the measures and regression analyses of objective and subjective QOL measures (QLS and LQLP) were conducted. Explanations of results for the two types of QOL measures in terms of psychotic symptomatology and adjustment variables (PANSS and REHAB) are discussed. There was no salient correlation between objective and subjective QOL measures. The regression analyses identified PANSS anergia and REHAB community skills as factors influencing objective QOL, whereas PANSS depression and paranoid/belligerence were factors influencing subjective QOL. Results indicated that objective and subjective QOL domains should be treated separately in clinical practice for this patient population. Some QOL factors identified in the regression analyses can be used as targets to improve QOL. The findings have important clinical implications for the assessment and treatment of this patient population. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

    Directory of Open Access Journals (Sweden)

    Shimada Hiroyuki

    2011-08-01

    Full Text Available Abstract Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff. Results All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points compared with the no risk SRRST group (0 point were 6.15 (p Conclusion These results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.

  15. Spectral analyses of systolic blood pressure and heart rate variability and their association with cognitive performance in elderly hypertensive subjects.

    Science.gov (United States)

    Santos, W B; Matoso, J M D; Maltez, M; Gonçalves, T; Casanova, M; Moreira, I F H; Lourenço, R A; Monteiro, W D; Farinatti, P T V; Soares, P P; Oigman, W; Neves, M F T; Correia, M L G

    2015-08-01

    Systolic hypertension is associated with cognitive decline in the elderly. Altered blood pressure (BP) variability is a possible mechanism of reduced cognitive performance in elderly hypertensives. We hypothesized that altered beat-to-beat systolic BP variability is associated with reduced global cognitive performance in elderly hypertensive subjects. In exploratory analyses, we also studied the correlation between diverse discrete cognitive domains and indices of systolic BP and heart rate variability. Disproving our initial hypothesis, we have shown that hypertension and low education, but not indices of systolic BP and heart rate variability, were independent predictors of lower global cognitive performance. However, exploratory analyses showed that the systolic BP variability in semi-upright position was an independent predictor of matrix reasoning (B = 0.08 ± .03, P-value = 0.005), whereas heart rate variability in semi-upright position was an independent predictor of the executive function score (B = -6.36 ± 2.55, P-value = 0.02). We conclude that myogenic vascular and sympathetic modulation of systolic BP do not contribute to reduced global cognitive performance in treated hypertensive subjects. Nevertheless, our results suggest that both systolic BP and heart rate variability might be associated with modulation of frontal lobe cognitive domains, such as executive function and matrix reasoning.

  16. Psychophysical estimate of plantar vibration sensitivity brings additional information to the detection threshold in young and elderly subjects

    Directory of Open Access Journals (Sweden)

    Yves Jammes

    Full Text Available Objective: Vibration detection threshold of the foot sole was compared to the psychophysical estimate of vibration in a wide range of amplitudes in young (20–34 years old and elderly subjects (53–67 years old. Methods: The vibration detection threshold was determined on the hallux, 5th metatarsal head, and heel at frequencies of 25, 50 and 150 Hz. For vibrations of higher amplitude (reaching 360 μm, the Stevens power function (Ψ = k * Φn allowed to obtain regression equations between the vibration estimate (Ψ and its physical magnitude (Φ, the n coefficient giving the subjective intensity in vibration perception. We searched for age-related changes in the vibration perception by the foot sole. Results: In all participants, higher n values were measured at vibration frequencies of 150 Hz and, compared to the young adults the elderly had lower n values measured at this frequency. Only in the young participants, the vibration detection threshold was lowered at 150 Hz. Conclusion: The psychophysical estimate brings further information than the vibration detection threshold which is less affected by age. Significance: The clinical interest of psychophysical vibration estimate was assessed in a patient with a unilateral alteration of foot sensitivity. Keywords: Vibration sensitivity, Vibration detection threshold, Foot sole, Elderly

  17. Physician practicing preferences for conventional or homeopathic medicines in elderly subjects with musculoskeletal disorders in the EPI3-MSD cohort

    Directory of Open Access Journals (Sweden)

    Danno K

    2014-09-01

    Full Text Available Karine Danno,1 Clementine Joubert,1 Gerard Duru,2 Jean-Marie Vetel31Laboratoires Boiron, Messimy, France; 2Cyklad Group, Lyon, France; 3Centre Hospitalier du Mans, Le Mans, FranceBackground: Musculoskeletal pain is common in elderly persons. Analgesic use is high in the elderly and may involve unacceptable risk in individuals with chronic pain. Our aim was to compare the socio-demographic characteristics of elderly subjects with musculoskeletal disorders (MSD and to assess medication use and clinical evolution of musculoskeletal pain according to physician prescribing preference: homeopathy (Ho group, conventional medicine (CM group, or mixed prescription (MX group.Methods: The EPI3 study was a 1 year observational survey carried out among general practitioners in France between March 2007 and July 2008. This sub-analysis was carried out on elderly subjects aged ≥70 years from the original EPI3 cohort. Socio-demographic data were collected at inclusion using a self-administered patient questionnaire and medical data were recorded for each patient. Quality of life was measured using the Short Form-12 questionnaire. Patients completed a structured telephone interview on their functional status (evaluated with the QuickDash questionnaire, EIFEL scale or Lequesne index within 72 hours of inclusion. This telephone interview was repeated at 1, 3, and 12 months. Drug exposure was also assessed during these interviews.Results: 146 patients (mean age ± standard deviation: 75.8±4.8 years were analyzed (80.1% female, 74.7% MSD of the spine or lower limbs, 64.4% chronic MSD. Patients in the CM and MX groups were 3.7 times or 2.5 times more likely (odds ratio [OR] =3.71, 95% confidence interval [CI]: 1.12-12.30; OR =2.52, 95% CI: 1.05-6.05; respectively to have used non-steroidal anti-inflammatory drugs (NSAIDs than those in the Ho group. In contrast, analgesic use was comparable in the three groups (OR =1.06 [CM versus Ho], 95% CI: 0.09-12.11; OR =0

  18. Quality of life in elderly subjects with pain in the hip or knee

    NARCIS (Netherlands)

    Hopman-Rock, M.; Kraaimaat, F. W.; Bijlsma, J. W.

    1997-01-01

    This study examines the quality of life (QOL) of community living elderly people aged 55-74 with chronic, episodic or sporadic pain in the hip or knee and of a reference group without pain (total n = 306). Firstly, it was hypothesized that the experienced QOL is lower in people with more chronic

  19. Subjective Values of Quality of Life Dimensions in Elderly People. A SEM Preference Model Approach

    Science.gov (United States)

    Elosua, Paula

    2011-01-01

    This article proposes a Thurstonian model in the framework of Structural Equation Modelling (SEM) to assess preferences among quality of life dimensions for the elderly. Data were gathered by a paired comparison design in a sample comprised of 323 people aged from 65 to 94 years old. Five dimensions of quality of life were evaluated: Health,…

  20. The use of the Mini Nutritional Assessment to assess the Nutritional Status of Elderly Subjects living in The Riyadh Nursing Home

    International Nuclear Information System (INIS)

    Al-Hamadan, Adel Ibn Abd. Al-Wahab; Alorf, Sadaa Bent Muhamed

    2005-01-01

    All elderly residents (total number 74) in the Riyadh nursing home were included in this study. Body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) were measured. The Mini Nutritional Assessment (MAA), specifically designed for elderly subjects was used in the study to determine the nutritional status. 27% and 43% of elderly subjects were found to be malnourished and at risk of being malnourished, respectively. The means the (BMI), (MAC), and (CC) were about 24 Kg/m2, 26 cm and 29.5 cm, respectively. Elderly people, who were classified as malnourished, according to the (MNA), had the lowest (BMI), (MAC). When the score of the (MNA) was based on the diagnosis of the elderly, the results show the elderly subjects with more one main diagnosis had the lowest score. Based on the score of the (MNA) test, more than 1/4 of the subjects were malnourished. Most of the subjects were consuming three whole meals and more than two serving of fruit and vegetables per day. It seems that food intake, in the nursing home, was satisfactory, among the subjects. Despite that the percentage of malnourished subjects reached 27%. The results of the (MNA) test indicated the necessity of performing national nutritional assessment for this vulnerable group of people in other nursing homes and in the community. (author)

  1. Gender-specific impact of personal health parameters on individual brain aging in cognitively unimpaired elderly subjects

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    Katja eFranke

    2014-05-01

    Full Text Available Aging alters brain structure and function. Personal health markers and modifiable lifestyle factors are related to individual brain aging as well as to the risk of developing Alzheimer’s disease (AD. This study uses a novel magnetic resonance imaging (MRI-based biomarker to assess the effects of 17 health markers on individual brain aging in cognitively unimpaired elderly subjects. By employing kernel regression methods, the expression of normal brain-aging patterns forms the basis to estimate the brain age of a given new subject. If the estimated age is higher than the chronological age, a positive brain age gap estimation (BrainAGE score indicates accelerated atrophy and is considered a risk factor for developing AD. Within this cross-sectional, multi-center study 228 cognitively unimpaired elderly subjects (118 males completed an MRI at 1.5T, physiological and blood parameter assessments. The multivariate regression model combining all measured parameters was capable of explaining 39% of BrainAGE variance in males (p < 0.001 and 32% in females (p < 0.01. Furthermore, markers of the metabolic syndrome as well as markers of liver and kidney functions were profoundly related to BrainAGE scores in males (p < 0.05. In females, markers of liver and kidney functions as well as supply of vitamin B12 were significantly related to BrainAGE (p < 0.05. In conclusion, in cognitively unimpaired elderly subjects several clinical markers of poor health were associated with subtle structural changes in the brain that reflect accelerated aging, whereas protective effects on brain aging were observed for markers of good health. Additionally, the relations between individual brain aging and miscellaneous health markers show gender-specific patterns. The BrainAGE approach may thus serve as a clinically relevant biomarker for the detection of subtly abnormal patterns of brain aging probably preceding cognitive decline and development of AD.

  2. Assessment of subjective well-being status of elderly people in old age homes in Kolkata in relation to their perceived physical health and cognitive functioning

    OpenAIRE

    Jharna Bag; Debashish Sanyal; Liza Thankam Daniel; Asima Chakrabarti

    2014-01-01

    Introduction: There is a limited data on the subjective well-being of elderly people living at old age homes in India. It is needed for planning better maintenance of physical health as well as cognitive function for their overall well-being. Materials and Methods: A descriptive survey was conducted. The data were collected from 50 elderly people who were selected by total enumeration sampling from two different old age home in Kolkata. They were assessed using Subjective Well-being Inventory...

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

    Science.gov (United States)

    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.

  4. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

    Science.gov (United States)

    2011-01-01

    Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff. Results All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p elderly, however, these preliminary results require confirmation in further prospective research. PMID:21838891

  5. Prolactin, EGFR, vimentin and α-actin profiles in elderly rat prostate subjected to steroid hormonal imbalance.

    Science.gov (United States)

    Hetzl, Amanda Cia; Montico, Fabio; Kido, Larissa Akemi; Cagnon, Valéria Helena Alves

    2016-06-01

    The aim of this study was to characterize and relate the prolactin (PR), epidermal growth factor receptor (EGFR), α-actin and vimentin immunoreactivity in the prostate of elderly rats subjected to steroid hormonal imbalance. Senile and young rats were divided into the young group (YNG), the senile group (SE), the castrated group (CAS), the estrogen-deficient group (ED), the castrated+estrogen group (CASE), and the estrogen-deficient+androgen group (EDTEST). PR and EGFR increased in the estrogen and androgen ablation groups. In addition, EGFR influenced the immunolocalization by changing it from the prostatic stroma to the epithelium in elderly rats. Hormone ablation in elderly rats, not only related to androgen but also estrogen, led to increased stromal EGFR immunolocalization. The α-actin pattern decreased in the groups with estrogenic imbalance. Moreover, vimentin increased in the senile and estrogen deficient group. To conclude, we can suggest that EGFR contributed towards the proliferative process in the prostate, by means however, of different mechanisms, considering the androgenic and estrogenic pathways. Also, our results indicated that prolactin could be activated not only in an androgen-independent pathway but also in an estrogen independent pathway. Finally, PR and vimentin immunolocalization increase, in the prostatic stroma in the group showing estrogenic ablation, could be one of the factors which contribute to the reactive stroma formation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Equilibrium and muscle flexibility in elderly people subjected to physiotherapeutic intervention

    Directory of Open Access Journals (Sweden)

    Mariane Fernandes Ribeiro

    2016-09-01

    Full Text Available To evaluate the equilibrium and flexibility of elderly people submitted to a training program involving physical therapy exercises. Six elderly people were selected, average age 69.66 years. Wells’s Bench and the Functional Reach Test (FRT plus Timed Up and Go Test (TUG were employed respectively to assess muscle flexibility and balance analysis. Tests were performed before and after the exercise program which consisted of thirty-five 50 min physical therapy group sessions, twice a week, with stretching exercises, gait training, active exercises, postural correction exercises and breathing exercises. Statistical analysis was done with Sigma-Stat® 3.5. Assessments occurred before and after sessions, and the final test was undertaken after 35 sessions. There was a statistically significant increase in the flexibility of the posterior muscle chain. In the TUG test, the group achieved a shorter time after treatment, with statistical significance between tests. There was a statistically significant increase in the average FRT after the sessions. Current study showed better results in the execution of tests evaluated after the program of physiotherapy activities, contributing towards the improvement of muscle flexibility and balance of elderly people.

  7. Chronic obstructive pulmonary disease (COPD) in elderly subjects: impact on functional status and quality of life.

    Science.gov (United States)

    Peruzza, S; Sergi, G; Vianello, A; Pisent, C; Tiozzo, F; Manzan, A; Coin, A; Inelmen, E M; Enzi, G

    2003-06-01

    Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and disability. Many studies have investigated factors influencing quality of life (QoL) in middle-aged COPD sufferers, but little attention has been given to elderly COPD. The aim of the present study was to investigate the impact of COPD on QoL and functional status in the elderly. Sixty COPD patients and 58 healthy controls over 65 years old were administered Pulmonary Function Tests, 6 min Walking Test (6MWD) for exercise tolerance, the Barthel Index and Mini Mental State Examination (MMSE) for functional status, the Geriatric Depression Scale (GDS) for mood, and the Saint George Respiratory Questionnaire (SGRQ) for QoL. FEV1 and PaO2 were reduced in COPD patients. Also the distance walked during 6MWD was significantly shorter for patients than controls (282.5 +/- 89.5 vs. 332.9 +/- 95.2 m; P < 0.01). Moreover, COPD patients had significantly worse outcomes for the Barthel Index, GDS and SGRQ. The logistic regression model demonstrated that a decrease in FEV1 is the factor most strictly related to the deterioration of QoL in COPD patients. Mood was also an independent factor influencing QoL. In conclusion, elderly COPD patients show a substantial impairment in QoL depending on the severity of airway obstruction; symptoms related to the disease may be exaggerated by mood deflection.

  8. Cognitive processing and body balance in elderly subjects with vestibular dysfunction.

    Science.gov (United States)

    Caixeta, Giovanna Cristina dos Santos; Doná, Flávia; Gazzola, Juliana Maria

    2012-04-01

    Abnormal body balance and cognitive dysfunction may develop in elderly patients with chronic vestibular dysfunction. To evaluate the relationship between cognitive processing and body balance in elderly patients with chronic peripheral vestibular disease. Cross-sectional. Seventy-six patients (> 60 years) with chronic peripheral vestibular dysfunction and dizziness for more than three months were enrolled. The tests for investigating body balance were: the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go Test (TUGT) Timed Up and Go Test modified (TUGTm); the Mini Mental State Examination (MMSE), Test Clock (RT,) and Verbal Fluency Test (VF) were applied for assessing cognition. The mean age was 69.03 years (SD=6.21 years); most were female (82.9%). There was a significant negative correlation between the MMSE and the TUGT (ρ=-0.312; p=0.01), MMSE and TUGTm (ρ=-0.306; p=0.01), FV and TUGT (ρ=-0.346; p=0.01), and FV and TUGTm (ρ=-0.536; p=0.01); there was a significant positive correlation between the TR and BBS (ρ=0.343; p=0.01), TR and DGI (ρ=0.298; p=0.01), FV and BBS (ρ=0.299; p=0.01), and FV and DGI (ρ=0.306; p=0.01). Elderly patients with chronic peripheral vestibular disease and worse performance in body balance tests have functional impairment in cognitive skills.

  9. The Role of Life-Space, Social Activity, and Depression on the Subjective Memory Complaints of Community-Dwelling Filipino Elderly: A Structural Equation Model

    Science.gov (United States)

    de Guzman, Allan B.; Lagdaan, Lovely France M.; Lagoy, Marie Lauren V.

    2015-01-01

    Subjective memory complaints are one of the major concerns of the elderly and remain a challenging area in gerontology. There are previous studies that identify different factors affecting subjective memory complaints. However, an extended model that correlates life-space on subjective memory complaints remains a blank spot. The objective of this…

  10. Lipoprotein-Associated Phospholipase A2 Mass Level Is Increased in Elderly Subjects with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    J. Fortunato

    2014-01-01

    Full Text Available Objective. Lipoprotein-associated phospholipase A2 (Lp-PLA2 is extensively expressed by advanced atherosclerotic lesions and may play a role in plaque instability. We selected a group of elderly subjects that underwent transcatheter aortic valve implantation (TAVI or balloon angioplasty (BA and separated them into two groups, diabetic and nondiabetic, to compare the level of Lp-PLA2 mass between them. Methods. 44 patients aged 79.6±5.6 years with symptomatic severe aortic valve stenosis underwent TAVI (n=35 or BA (n=9. 21 subjects had confirmed type 2 diabetes mellitus. Lp-PLA2 mass was measured using an enzyme-linked immunosorbent assay kit (USCN Life Science, China before and 3 days after the procedure. Results. Lp-PLA2 mass was significantly elevated in this population (1296±358 ng/mL before TAVI; 1413±268 ng/mL before BA and further increased after TAVI (1604±437 ng/mL, P<0.01 or BA (1808±303 ng/mL, P<0.01. Lp-PLA2 mass was significantly increased on the diabetic group before these interventions. Conclusion. Lp-PLA2 may be a novel biomarker for the presence of rupture-prone atherosclerotic lesions in elderly patients. Levels of Lp-PLA2 in diabetic patients may accompany the higher amount of small dense LDL particles seen in these subjects.

  11. Physician practicing preferences for conventional or homeopathic medicines in elderly subjects with musculoskeletal disorders in the EPI3-MSD cohort.

    Science.gov (United States)

    Danno, Karine; Joubert, Clementine; Duru, Gerard; Vetel, Jean-Marie

    2014-01-01

    Musculoskeletal pain is common in elderly persons. Analgesic use is high in the elderly and may involve unacceptable risk in individuals with chronic pain. Our aim was to compare the socio-demographic characteristics of elderly subjects with musculoskeletal disorders (MSD) and to assess medication use and clinical evolution of musculoskeletal pain according to physician prescribing preference: homeopathy (Ho) group, conventional medicine (CM) group, or mixed prescription (MX) group. The EPI3 study was a 1 year observational survey carried out among general practitioners in France between March 2007 and July 2008. This sub-analysis was carried out on elderly subjects aged ≥70 years from the original EPI3 cohort. Socio-demographic data were collected at inclusion using a self-administered patient questionnaire and medical data were recorded for each patient. Quality of life was measured using the Short Form-12 questionnaire. Patients completed a structured telephone interview on their functional status (evaluated with the QuickDash questionnaire, EIFEL scale or Lequesne index) within 72 hours of inclusion. This telephone interview was repeated at 1, 3, and 12 months. Drug exposure was also assessed during these interviews. 146 patients (mean age ± standard deviation: 75.8±4.8 years) were analyzed (80.1% female, 74.7% MSD of the spine or lower limbs, 64.4% chronic MSD). Patients in the CM and MX groups were 3.7 times or 2.5 times more likely (odds ratio [OR] =3.71, 95% confidence interval [CI]: 1.12-12.30; OR =2.52, 95% CI: 1.05-6.05; respectively) to have used non-steroidal anti-inflammatory drugs (NSAIDs) than those in the Ho group. In contrast, analgesic use was comparable in the three groups (OR =1.06 [CM versus Ho], 95% CI: 0.09-12.11; OR =0.34 [MX versus Ho], 95% CI: 0.07-1.57). Overall functional score evolution was similar in the three groups over time (P=0.16). NSAID use was significantly higher in elderly MSD patients consulting a conventional practice

  12. Associations of Subjective Sleep Quality and Daytime Sleepiness With Cognitive Impairment in Adults and Elders With Heart Failure.

    Science.gov (United States)

    Byun, Eeeseung; Kim, Jinyoung; Riegel, Barbara

    2017-01-01

    This study examined the association of subjective nighttime sleep quality and daytime sleepiness with cognitive impairment in 105 adults (sleep quality and daytime sleepiness were measured by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Cognitive impairment was assessed using a neuropsychological battery measuring attention, memory, and processing speed. Multivariate logistic regression was used. In adults, daytime sleepiness was associated with cognitive impairment, whereas poor nighttime sleep quality was associated with cognitive impairment in elders. Age may play an important role in how sleep impacts cognition in persons with heart failure. Improving nighttime sleep quality and daytime sleepiness in this population may improve cognition.

  13. Wavelet coherence analysis of prefrontal tissue oxyhaemoglobin signals as measured using near-infrared spectroscopy in elderly subjects with cerebral infarction.

    Science.gov (United States)

    Han, Qingyu; Zhang, Ming; Li, Wenhao; Gao, Yuanjin; Xin, Qing; Wang, Yan; Li, Zengyong

    2014-09-01

    This study aims to assess the prefrontal functional connectivity using wavelet coherence analysis of cerebral tissue oxyhaemoglobin concentration (Delta [HbO2]) signals in elderly subjects with cerebral infarction (CI) during the resting state. Continuous recordings of near-infrared spectroscopy (NIRS) signals were obtained from the left and right prefrontal lobes in 10 subjects with CI (age: 74.4±9.0years) and 18 healthy elderly subjects (age: 69.9±7.3years) during the resting state. The coherence between left and right prefrontal Delta [HbO2] oscillations in four frequency intervals (I, 0.6-2Hz; II, 0.145-0.6Hz; III, 0.052-0.145Hz and IV, 0.021-0.052Hz) was analyzed using wavelet coherence analysis. In healthy elderly subjects, the Delta [HbO2] oscillations were significantly wavelet coherent in intervals I and III (pwavelet phase coherent in intervals from I to IV. In elderly subjects with CI, the left and right Delta [HbO2] oscillations were significantly wavelet coherent and phase coherent in interval I (pwavelet coherence between the healthy elderly and elderly with CI indicates an altered brain functional connectivity in CI patients. This may be useful for assessing the effectiveness of functional recovery following a CI. Copyright © 2014. Published by Elsevier Inc.

  14. Do spotty high intensity regions found in basal ganglia on MRI T2-weighted brain images of elderly subjects indicate gliosis? Comparison of brain MRI T2-weighted images of elderly subjects and necropsy brain

    International Nuclear Information System (INIS)

    Murai, Hiroshi; Hattori, Hideyuki; Matsumoto, Masayuki

    2001-01-01

    Spotty high intensity regions are frequently found on the MRI T2-weighted brain images (T2WI) of elderly people. High intensity regions with a diameter of 3 mm or less have been considered as expanded perivascular space with no pathological implications on radiological diagnosis. However, its morphometrical basis is not clear. We examined the character of the spotty regions using brain MRI of brain screening subjects, and studied morphometrically arteriolosclerosis and perivascular tissue damage using necropsy brains of subjects aged 65 years and over. The size, number and location of the spotty high intensity regions were examined using the brain MRI of 109 T2WI which is used for brain screening at Kanazawa Medical University Hospital. The frontal lobe, temporal lobe, parietal lobe, hippocampus, midbrain and basal ganglia were sampled from 15 subjects aged 65 years and over, and the tissue sections were processed for HE stain, Elastica van Gieson stain and immunostaining with GFAP. We took photographs of brain arterioli and surrounding parenchyma with a digital telescope camera and the degree of arterioscleosis and tissue damage were assessed by measurements with an image analyzer. Spotty high intensity regions on T2WI with a diameter of 3 mm or less were observed in 95.5% subjects aged 65 years and over. 69.4% spotty region was observed in basal ganglia. There was a significant correlation between age and size. In morphometrical examination, at the basal ganglia, the density of GFAP-positive astrocytes in the perivascular tissue had a significant positive correlation with the proportional thickness of the adventitia, which is an index of arteriosclerosis, and a significant negative correlation with the size of the perivascular space. The results suggested that the spotty regions in the brain MRI of elderly people do not represent dilatations of the perivascular space, but is mild brain damage caused by arteriosclerosis. (author)

  15. Oral supplementation with Lactobacillus delbrueckii subsp. bulgaricus 8481 enhances systemic immunity in elderly subjects.

    Science.gov (United States)

    Moro-García, Marco Antonio; Alonso-Arias, Rebeca; Baltadjieva, Maria; Fernández Benítez, Carlos; Fernández Barrial, Manuel Amadeo; Díaz Ruisánchez, Enrique; Alonso Santos, Ricardo; Alvarez Sánchez, Magdalena; Saavedra Miján, Juan; López-Larrea, Carlos

    2013-08-01

    Throughout life, there is an aging of the immune system that causes impairment of its defense capability. Prevention or delay of this deterioration is considered crucial to maintain general health and increase longevity. We evaluated whether dietary supplementation with Lactobacillus delbrueckii subsp. bulgaricus 8481 could enhance the immune response in the elderly. This multi-center, double-blind, and placebo controlled study enrolled 61 elderly volunteers who were randomly assigned to receive either placebo or probiotics. Each capsule of probiotics contained at least 3 × 10(7)  L. delbrueckii subsp. bulgaricus 8481. Individuals in the study were administered three capsules per day for 6 months. Blood samples were obtained at baseline (time 0), end of month 3, and month 6. We characterized cell subpopulations, measured cytokines by flow cytometry, quantified T cell receptor excision circle (TREC) by real-time PCR (RT-PCR), and determined human β-defensin-2 (hBD-2) concentrations and human cytomegalovirus (CMV) titers by enzyme-linked immunosorbent assay (ELISA). Elderly responded to the intake of probiotic with an increase in the percentage of NK cells, an improvement in the parameters defining the immune risk profile (IRP), and an increase in the T cell subsets that are less differentiated. The probiotic group also showed decreased concentrations of the pro-inflammatory cytokine IL-8 but increased antimicrobial peptide hBD-2. These effects disappeared within 6 months of stopping the probiotic intake. Immunomodulation induced by L. delbrueckii subsp. bulgaricus 8481 could favor the maintenance of an adequate immune response, mainly by slowing the aging of the T cell subpopulations and increasing the number of immature T cells which are potential responders to new antigens.

  16. Difficulty of elderly SCI subjects to translate motor recovery--"body function"--into daily living activities.

    Science.gov (United States)

    Jakob, Werner; Wirz, Markus; van Hedel, Hubertus J A; Dietz, Volker

    2009-11-01

    The objective of this retrospective analysis was to determine whether outcome of body functions and activities as well as length of stay of inpatient rehabilitation is related to age in patients with traumatic spinal cord injury (SCI). Data were collected from a European network of 17 SCI rehabilitation centers (EM-SCI); a total of 237 traumatic SCI subjects were included. Assessments were performed at 1, 6, and 12 months after SCI. The measures analyzed were motor score according to the American Spinal Injury Association, Spinal Cord Independence Measure (SCIM), gait speed, and length of stay. Correlation analysis was applied to quantify the association between age and change in the outcome measures. A positive relationship was found between age and neurological recovery in both the first and second 6-month periods of assessment. A negative relationship was found between age and change in SCIM in the second 6-month period after SCI. A negative relationship between age and gait speed was observed in the first half year. Length of stay was not associated with age. It was concluded that age is an important determining factor for functional outcome after SCI and that elderly patients have difficulties in translating an improvement in neurological outcome into functional changes. Therefore, rehabilitation approaches in elderly subjects should focus on functional training.

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

    Science.gov (United States)

    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

  18. 3D gait assessment in young and elderly subjects using foot-worn inertial sensors.

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    Mariani, Benoit; Hoskovec, Constanze; Rochat, Stephane; Büla, Christophe; Penders, Julien; Aminian, Kamiar

    2010-11-16

    This study describes the validation of a new wearable system for assessment of 3D spatial parameters of gait. The new method is based on the detection of temporal parameters, coupled to optimized fusion and de-drifted integration of inertial signals. Composed of two wirelesses inertial modules attached on feet, the system provides stride length, stride velocity, foot clearance, and turning angle parameters at each gait cycle, based on the computation of 3D foot kinematics. Accuracy and precision of the proposed system were compared to an optical motion capture system as reference. Its repeatability across measurements (test-retest reliability) was also evaluated. Measurements were performed in 10 young (mean age 26.1±2.8 years) and 10 elderly volunteers (mean age 71.6±4.6 years) who were asked to perform U-shaped and 8-shaped walking trials, and then a 6-min walking test (6MWT). A total of 974 gait cycles were used to compare gait parameters with the reference system. Mean accuracy±precision was 1.5±6.8cm for stride length, 1.4±5.6cm/s for stride velocity, 1.9±2.0cm for foot clearance, and 1.6±6.1° for turning angle. Difference in gait performance was observed between young and elderly volunteers during the 6MWT particularly in foot clearance. The proposed method allows to analyze various aspects of gait, including turns, gait initiation and termination, or inter-cycle variability. The system is lightweight, easy to wear and use, and suitable for clinical application requiring objective evaluation of gait outside of the lab environment. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Salt and insulin sensitivity after short and prolonged high salt intake in elderly subjects

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    N.K.C. Lima

    2009-08-01

    Full Text Available Salt sensitivity and insulin resistance are correlated with higher cardiovascular risk. There is no information about changes in salt sensitivity (SS and insulin sensitivity (IS after a chronic salt overload in humans. The aim of this study was to evaluate these parameters in the elderly. Seventeen volunteers aged 70.5 ± 5.9 years followed a low-salt diet (LSD for 1 week and a high-salt diet (HSD for 13 weeks. We evaluated SS after one week (HSD1 and after 13 weeks (HSD13, and subjects’ IS and lipids on their usual diet (UD at HSD1, and at HSD13. Blood pressure (BP was measured at each visit and ambulatory blood pressure monitoring (ABPM was performed twice. SS was the same at HSD1 and HSD13. Systolic BP was lower on LSD than on UD (P = 0.01, HSD1 (P < 0.01 and HSD13 (P < 0.01. When systolic and diastolic BP were evaluated by ABPM, they were higher at HSD13 during the 24-h period (P = 0.03 and P < 0.01 and during the wakefulness period (P = 0.02 and P < 0.01 compared to the UD. Total cholesterol was higher (P = 0.04 at HSD13 than at HSD1. Glucose and homeostasis model assessment (HOMA were lower at HSD1 (P = 0.02 and P = 0.01 than at HSD13. Concluding, the extension of HSD did not change the SS in an elderly group. The higher IS found at HSD1 did not persist after a longer HSD. A chronic HSD increased BP as assessed by ABPM.

  20. Framingham coronary heart disease risk score can be predicted from structural brain images in elderly subjects.

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    Jane Maryam Rondina

    2014-12-01

    Full Text Available Recent literature has presented evidence that cardiovascular risk factors (CVRF play an important role on cognitive performance in elderly individuals, both those who are asymptomatic and those who suffer from symptoms of neurodegenerative disorders. Findings from studies applying neuroimaging methods have increasingly reinforced such notion. Studies addressing the impact of CVRF on brain anatomy changes have gained increasing importance, as recent papers have reported gray matter loss predominantly in regions traditionally affected in Alzheimer’s disease (AD and vascular dementia in the presence of a high degree of cardiovascular risk. In the present paper, we explore the association between CVRF and brain changes using pattern recognition techniques applied to structural MRI and the Framingham score (a composite measure of cardiovascular risk largely used in epidemiological studies in a sample of healthy elderly individuals. We aim to answer the following questions: Is it possible to decode (i.e., to learn information regarding cardiovascular risk from structural brain images enabling individual predictions? Among clinical measures comprising the Framingham score, are there particular risk factors that stand as more predictable from patterns of brain changes? Our main findings are threefold: i we verified that structural changes in spatially distributed patterns in the brain enable statistically significant prediction of Framingham scores. This result is still significant when controlling for the presence of the APOE 4 allele (an important genetic risk factor for both AD and cardiovascular disease. ii When considering each risk factor singly, we found different levels of correlation between real and predicted factors; however, single factors were not significantly predictable from brain images when considering APOE4 allele presence as covariate. iii We found important gender differences, and the possible causes of that finding are discussed.

  1. Analysis of the variability of the pharmacokinetics of multiple drugs in young adult and elderly subjects and its implications for acceptable daily exposures and cleaning validation limits.

    Science.gov (United States)

    Streeter, Anthony J; Faria, Ellen C

    2017-06-01

    The elderly constitute a significant, potentially sensitive, subpopulation within the general population, which must be taken into account when performing risk assessments including determining an acceptable daily exposure (ADE) for the purpose of a cleaning validation. Known differences in the pharmacokinetics of drugs between young adults (who are typically the subjects recruited into clinical trials) and the elderly are potential contributors affecting the interindividual uncertainty factor (UF H ) component of the ADE calculation. The UF H values were calculated for 206 drugs for young adult and elderly groups separately and combined (with the elderly assumed to be a sensitive subpopulation) from published studies where the pharmacokinetics of the young adult and elderly groups were directly compared. Based on the analysis presented here, it is recommended to use a default UF H value of 10 for worker populations (which are assumed to be approximately equivalent to the young adult groups) where no supporting pharmacokinetic data exist, while it is recommended to use a default UF H value of 15 for the general population, to take the elderly into consideration when calculating ADE values. The underlying reasons for the large differences between the exposures in the young adult and elderly subjects for the 10 compounds which show the greatest separation are different in almost every case, involving the OCT2 transporter, glucuronidation, hydrolysis, CYP1A2, CYP2A6, CYP2C19, CYP2D6, CYP3A4 or CYP3A5. Therefore, there is no consistent underlying mechanism which appears responsible for the largest differences in pharmacokinetic parameters between young adult and elderly subjects. Copyright © 2017 Elsevier GmbH. All rights reserved.

  2. The Symmetry in the Selected Plantar Pressure Distribution Parameters of the Elderly Subject With Lower Limb Discrepancy (LLD

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    Raghad Memar

    2012-10-01

    Full Text Available Objectives: lower leg discrepancy is a common problem which causes the changes in the plantar pressure distribution pattern during gait. Therefore, the purpose of this study was to study the symmetry in the various plantar pressure distribution parameters in the elderly subject with leg discrepancy. Methods & Materials: Twenty-one elderly from Esfehan with leg discrepancy (1.5 to 3 cm participated in this study. Plantar pressure distribution and other related parameters were measured in the five discrete steps for each limb by “emed 2” platforms. Three successful steps from five were selected and averaged, and the plantar areas were divided into 11 marks. For each mark peak force (BW%, peak pressure (Kpa, contact area, contact time, pressure time integral and force time integral were calculated. Descriptive statistics (mean and SD to report the plantar pressure pattern, dependent sample t- test for comparison pressure data between long and short limb (P≤0.05 and symmetry index (SI% for the symmetrical status in the selected plantar pressure data of the elderly subject with LLD were used. Results: The consequence of dependent t-test showed that regardless of contact area in the forefoot region and 3th, 4th and 5th toes, there were no significant differences between long and short limb. Symmetry index (SI% also revealed that the contact time in the short limbs heel was less than long limb and peak force and peak pressure in the short limb was less in mid foot region and was greater in forefoot region than long limb. Conclusion: Given The Result Of This Study Showed That In The Short Limb, Initial Contact Time And Weight Acceptance Was Reduced, Which Cause The Increase Of The Pressure In The Forefoot And Also Which Causes The Increase Of Stress Fracture Risk In The Metatarsal Region. Therefore, It Is Suggested That LLD Subject Use Orthotic Or Shoes That Can Increase Their Heel Height And Balancing The Contact Time In The Short Limb To Resolve

  3. Learning and error patterns in the Chinese Verbal Learning Test in subjects with mild cognitive impairment and normal elderly.

    Science.gov (United States)

    Chen, Nai-Ching; Lin, Yu-Ing; Chang, Chiung-Chih; Lin, Ker-Neng; Chuang, Yao-Chung; Chen, Ching; Tu, Ming-Chien; Wang, Pei-Ning

    2011-06-01

    The discrimination between normal elderly (NC) and those with mild cognitive impairment (MCI) is of clinical relevance since the conversion from MCI to Alzheimer dementia (AD) is high. This study enrolled 216 amnestic MCI patients and 103 NC from our memory clinics and assessed whether the learning curve, recall and cued scores, as well as error patterns from the Chinese Version Verbal Learning Test (CVVLT) helped to distinguish between these two groups. Our results revealed that subjects with MCI had a lower rate of acquisition and deceleration of learning in the learning curve. The MCI group also showed a lower retention rate and recall scores as compared with the NC group. Further, the error patterns offered discrimination values between the two groups in total number of perseverations, intrusion in the cued recall, as well as prototypic and unrelated errors in recognition. An inverse correlation was seen between memory scores and error patterns. This study suggests that by combining the learning and error patterns from the verbal memory test, patients with MCI can be better differentiated from normal elderly.

  4. Effects of Aerobic Exercise Based upon Heart Rate at Aerobic Threshold in Obese Elderly Subjects with Type 2 Diabetes

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    Gian Pietro Emerenziani

    2015-01-01

    Full Text Available In obese diabetic subjects, a correct life style, including diet and physical activity, is part of a correct intervention protocol. Thus, the aim of this study was to evaluate the effects of aerobic training intervention, based on heart rate at aerobic gas exchange threshold (AerTge, on clinical and physiological parameters in obese elderly subjects with type 2 diabetes (OT2DM. Thirty OT2DM subjects were randomly assigned to an intervention (IG or control group (CG. The IG performed a supervised aerobic exercise training based on heart rate at AerTge whereas CG maintained their usual lifestyle. Anthropometric measures, blood analysis, peak oxygen consumption (V˙O2peak, metabolic equivalent (METpeak, work rate (WRpeak, and WRAerTge were assessed at baseline and after intervention. After training, patients enrolled in the IG had significantly higher (P<0.001 V˙O2peak, METpeak, WRpeak, and WRAerTge and significantly lower (P<0.005 weight, BMI, %FM, and waist circumference than before intervention. Both IG and CG subjects had lower glycated haemoglobin levels after intervention period. No significant differences were found for all the other parameters between pre- and posttraining and between groups. Aerobic exercise prescription based upon HR at AerTge could be a valuable physical intervention tool to improve the fitness level and metabolic equilibrium in OT2DM patients.

  5. Essential Amino Acids and Exercise Tolerance in Elderly Muscle-Depleted Subjects with Chronic Diseases: A Rehabilitation without Rehabilitation?

    Directory of Open Access Journals (Sweden)

    Roberto Aquilani

    2014-01-01

    Full Text Available Exercise intolerance remains problematic in subjects with chronic heart failure (CHF and/or chronic obstructive pulmonary disease (COPD. Recent studies show that supplemented essential amino acids (EAAs may exert beneficial effects on CHF/COPD physical capacity. The results from 3 investigations (2 conducted on CHF and 1 on COPD subjects served as the basis for this paper. The 3 studies consistently showed that elderly CHF and COPD improved exercise intolerance after 1–3 months of EAA supplementation (8 g/d. In CHF exercise capacity increased 18.7% to 23% (watts; bicycle test, and 12% to 22% (meters in 6 min walking test. Moreover, patients reduced their resting plasma lactate levels (by 25% and improved tissue insulin sensitivity by 16% (HOMA index. COPD subjects enjoyed similar benefits as CHF ones. They increased physical autonomy by 78.6% steps/day and decreased resting plasma lactate concentrations by 23%. EAA mechanisms explaining improved exercise intolerance could be increases in muscle aerobic metabolism, mass and function, and improvement of tissue insulin sensitivity (the latter only for the CHF population. These mechanisms could be accounted for by EAA’s intrinsic physiological activity which increases myofibrils and mitochondria genesis in skeletal muscle and myocardium and glucose control. Supplemented EAAs can improve the physical autonomy of subjects with CHF/COPD.

  6. Structural and functional social support in elderly objective and subjective health ratings

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    Sergio Iglesias-Parro

    2015-08-01

    Full Text Available This paper aims to investigate the causes that explain the discrepancies between the effects of social relationships on health and wellness of the elderly people. Several disciplines of health sciences have developed different theories to explain the evidence that confirm the positive effects of social relations. Furthermore, there is acumuative evidence confirming most of the predictions derived from its principles. However, the empirical evidence has not always confirmed these beneficial relationships and sometimes these evidences contradict some of the theoretical predictions. Even, it is not difficult to find reversed effects. In this paper we follow some of the approaches developed from Social Psychology which analyze the different effects of social relationships on the health of older people. Two types of aspects of social relations have served to this purpose. First, the structural aspects (i.e., frequency of intercourse. Second, qualitative-functional aspects of great tradition in estudies of quality of life and wellbeing of older people (i.e. social support. Following the Convoy Model, we measured perceived social support and frecuency of relationships in 168 spaniards, men and women (aged 62 years old and more. We analyze these discrepancies in the light of the underlying mechanisms.

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

    Science.gov (United States)

    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.

  8. Development of a self-administrated quality of life questionnaire for sarcopenia in elderly subjects: the SarQoL.

    Science.gov (United States)

    Beaudart, Charlotte; Biver, Emmanuel; Reginster, Jean-Yves; Rizzoli, René; Rolland, Yves; Bautmans, Ivan; Petermans, Jean; Gillain, Sophie; Buckinx, Fanny; Van Beveren, Julien; Jacquemain, Marc; Italiano, Patrick; Dardenne, Nadia; Bruyere, Olivier

    2015-11-01

    The impact of sarcopenia on quality of life is currently assessed by generic tools. However, these tools may not detect subtle effects of this specific condition on quality of life. The aim of this study was to develop a sarcopenia-specific quality of life questionnaire (SarQoL, Sarcopenia Quality of Life) designed for community-dwelling elderly subjects aged 65 years and older. Participants were recruited in an outpatient clinic in Liège, Belgium. Sarcopenic subjects aged 65 years or older. The study was articulated in the following four stages: (i) Item generation-based on literature review, sarcopenic subjects' opinion, experts' opinion, focus groups; (ii) Item reduction-based on sarcopenic subjects' and experts' preferences; (iii) Questionnaire generation-developed during an expert meeting; (iv) Pretest of the questionnaire-based on sarcopenic subjects' opinion. The final version of the questionnaire consists of 55 items translated into 22 questions rated on a 4-point Likert scale. These items are organised into seven domains of dysfunction: Physical and mental health, Locomotion, Body composition, Functionality, Activities of daily living, Leisure activities and Fears. In view of the pretest, the SarQoL is easy to complete, independently, in ∼10 min. The first version of the SarQoL, a specific quality of life questionnaire for sarcopenic subjects, has been developed and has been shown to be comprehensible by the target population. Investigations are now required to test the psychometric properties (internal consistency, test-retest reliability, divergent and convergent validity, discriminant validity, floor and ceiling effects) of this questionnaire. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society.

  9. Evaluation of vocal fold vibration with an assessment form for high-speed digital imaging: comparative study between healthy young and elderly subjects.

    Science.gov (United States)

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

    2012-11-01

    We conducted a prospective study with a subjective assessment form for high-speed digital imaging (HSDI) to elucidate the features of vocal fold vibrations in vocally healthy subjects and to clarify gender- and age-related differences. Healthy adult volunteers participated in this study. They were divided into young (aged 35 and younger) and elderly (aged 65 and older) groups, and the scores of an assessment form for HSDI characteristics elaborated at our institution were statistically analyzed. Twenty-six young subjects (males: 9, females: 17; mean age: 27 years) and 20 elderly subjects (males: 8, females: 12; mean age: 72 years) were assigned to our study. Posterior gap and posterior-to-anterior longitudinal phase difference were characteristic to young females, whereas in young males, mucosal wave, anterior-to-posterior longitudinal phase difference, and supraglottic hyperactivity were frequent. In elderly males, axis shift, asymmetry, supraglottic hyperactivity, increased mucosal wave, lateral phase difference, and anterior-to-posterior longitudinal phase difference were frequent; and in elderly females, high incidence of lateral phase difference, atrophic change, anterior gap, and asymmetry were observed. The results show that the behaviors of vocal fold vibrations were diverse even in healthy subjects with no vocal complaints or history of laryngeal diseases, and hence, the diversity of vocal fold vibrations in normal subjects must be taken into account in evaluating vocal fold vibrations. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  10. Diffusion tensor imaging differentiates vascular parkinsonism from parkinsonian syndromes of degenerative origin in elderly subjects

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    Deverdun, Jérémy [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier (France); I2FH, Institut d’Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier (France); Menjot de Champfleur, Sophie [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Clinique du Parc, Castelnau-le-Lez (France); Cabello-Aguilar, Simon [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); I2FH, Institut d’Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier (France); Maury, Florence [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Molino, François [Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier (France); Institut de Génomique Fonctionnelle, UMR 5203 - INSERM U661 - Université Montpellier II - Université, Montpellier I (France); Charif, Mahmoud [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Leboucq, Nicolas [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Ayrignac, Xavier; Labauge, Pierre [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); and others

    2014-11-15

    Background and Purpose: The etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients. Materials and Methods: Thirty-five patients were prospectively included (multiple-system atrophy, n = 5; Parkinson's disease, n = 15; progressive supranuclear palsy, n = 9; vascular parkinsonism, n = 6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach. Results: Statistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p = 0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p = 0.01). Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups. Conclusion: Clinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data.

  11. Diffusion tensor imaging differentiates vascular parkinsonism from parkinsonian syndromes of degenerative origin in elderly subjects

    International Nuclear Information System (INIS)

    Deverdun, Jérémy; Menjot de Champfleur, Sophie; Cabello-Aguilar, Simon; Maury, Florence; Molino, François; Charif, Mahmoud; Leboucq, Nicolas; Ayrignac, Xavier; Labauge, Pierre

    2014-01-01

    Background and Purpose: The etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients. Materials and Methods: Thirty-five patients were prospectively included (multiple-system atrophy, n = 5; Parkinson's disease, n = 15; progressive supranuclear palsy, n = 9; vascular parkinsonism, n = 6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach. Results: Statistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p = 0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p = 0.01). Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups. Conclusion: Clinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data

  12. Reduction of pharmaceutical expenditure by a drug appropriateness intervention in polymedicated elderly subjects in Catalonia (Spain).

    Science.gov (United States)

    Campins, Lluís; Serra-Prat, Mateu; Palomera, Elisabet; Bolibar, Ignasi; Martínez, Miquel Àngel; Gallo, Pedro

    2017-11-18

    To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START). The control group followed the routine standard of care. A time horizon of one year was considered and cost elements included human resources and drug expenditure. 490 patients (245 in each group) were analysed. Both groups experienced a decrease in drug expenditure 12 months after the study started, but this decrease was significantly higher in the intervention group than in the control group (-14.3% vs.-7.7%; p=0.041). Total annual drug expenditure decreased 233.75 €/patient (95% confidence interval [95%CI]: 169.83-297.67) in the intervention group and 169.40 €/patient (95%CI: 103.37-235.43) in the control group over a one-year period, indicating that 64.30 € would be the drug expenditure savings per patient a year attributable to the study intervention. The estimated return per Euro invested in the programme would be 2.38 € per patient a year on average. The study intervention is a cost-effective alternative to standard care that could generate a positive return of investment. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. 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

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    Mulki Shaila

    2013-01-01

    Full Text Available Background: 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. Materials and 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. Results: 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. Conclusion: S ignificant 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.

  14. Safety and immunogenicity of a high dosage trivalent influenza vaccine among elderly subjects

    NARCIS (Netherlands)

    Couch, Robert B.; Winokur, Patricia; Brady, Rebecca; Belshe, Robert; Chen, Wilbur H.; Cate, Thomas R.; Sigurdardottir, Bryndis; Hoeper, Amy; Graham, Irene L.; Edelman, Robert; He, Fenhua; Nino, Diane; Capellan, Jose; Ruben, Frederick L.

    2007-01-01

    To improve immune responses to influenza vaccine, a trivalent inactivated vaccine containing 60 mu g of the HA of each component (A/H3N2, A/H1N1, B) was compared to a licensed vaccine containing 15 mu g of the HA of each. More local and systemic reactions were reported by subjects given the high

  15. Assessment of subjective well-being status of elderly people in old age homes in Kolkata in relation to their perceived physical health and cognitive functioning

    Directory of Open Access Journals (Sweden)

    Jharna Bag

    2014-01-01

    Full Text Available Introduction: There is a limited data on the subjective well-being of elderly people living at old age homes in India. It is needed for planning better maintenance of physical health as well as cognitive function for their overall well-being. Materials and Methods: A descriptive survey was conducted. The data were collected from 50 elderly people who were selected by total enumeration sampling from two different old age home in Kolkata. They were assessed using Subjective Well-being Inventory and a self developed checklist for perceived physical health problems. Cognitive function was assessed by using Mini Mental State Examination. Results: More than half (52% of the elderly people have reported high subjective well-being status. Regression analysis showed that perceived physical health problem (P < 0.001 and having children (P = 0.010 were statistically significant predictors of subjective well-being. Conclusion: In order to improve the quality of life of elderly people health workers should give more emphasis on psychosocial aspects of this population. Improved psychosocial aspects can increase perceived physical health hence subjective well-being.

  16. Ultra-long pharmacokinetic properties of insulin degludec are comparable in elderly subjects and younger adults with type 1 diabetes mellitus.

    Science.gov (United States)

    Korsatko, S; Deller, S; Mader, J K; Glettler, K; Koehler, G; Treiber, G; Urschitz, M; Wolf, M; Hastrup, H; Søndergaard, F; Haahr, H; Pieber, T R

    2014-01-01

    Management of diabetes in elderly subjects is complex and careful management of glucose levels is of particular importance in this population because of an increased risk of diabetes-related complications and hypoglycaemia. The aim of this study was to evaluate the pharmacokinetic and pharmacodynamic properties of insulin degludec (IDeg), a basal insulin with an ultra-long duration of action, in elderly subjects with type 1 diabetes compared with younger adults. This trial was a randomised, double-blind, two-period, crossover trial conducted in a single centre and included both inpatient and outpatient periods. Subjects were men and women aged 18-35 years inclusive (younger adult group) or ≥65 years (elderly group) with type 1 diabetes who received IDeg (0.4 U/kg) via subcutaneous injection in the thigh once-daily for six days. Following 6-day dosing, a 26-hour euglycaemic glucose clamp procedure was conducted to evaluate the steady-state pharmacodynamic effects of IDeg. Blood samples were taken for pharmacokinetic analysis up to 120 h post-dose. Pharmacokinetic endpoints included the total exposure of IDeg, ie the area under the IDeg serum concentration curve during one dosing interval at steady state (AUC(IDeg,τ,SS)) (τ = 0-24 h, equal to one dosing interval) and the maximum IDeg serum concentration at steady state (C(max,IDeg,SS)). Pharmacodynamic endpoints included the total glucose-lowering effect of IDeg, ie the area under the glucose infusion rate (GIR) curve at steady state (AUC(GIR,τ,SS)), and the maximum GIR at steady state (GIR(max,IDeg,SS)). Total exposure (AUC(IDeg,τ,SS)) and maximum concentration (C(max,IDeg,SS)) of IDeg were comparable between elderly subjects and younger adults. Estimated mean age group ratios (elderly/younger adult) for AUC(IDeg,τ,SS) and C(max,IDeg,SS) and corresponding two-sided 95 % confidence intervals (CIs) were 1.04 (95 % CI 0.73-1.47) and 1.02 (95 % CI 0.74-1.39), respectively. Mean AUC(IDeg,0-12h

  17. VALIDATION OF THE SUBJECTIVE GLOBAL ASSESSMENT AND MALNUTRITION INFLAMMATION SCORE TRANSLATED TO PORTUGUESE FOR ELDERLY PATIENTS ON HEMODIALYSIS.

    Directory of Open Access Journals (Sweden)

    Renata Fetter

    2012-06-01

    Full Text Available We aimed to validate the translation of the 7 point subjective global assessment (7 p-SGA and malnutrition inflammation score (MIS from English to Portuguese to be applied for elderly patients on hemodialysis (HD. For the translation, the back-translation method was used. First, two independent bilinguals renal dietitians (Portuguese native speakers worked independently to translate the 7 p-SGA and MIS to Portuguese. After that, the final version was back translated to English by a bilingual English teacher (Portuguese native speaker. In order to investigate the conceptual and semantic equivalence of the translated version, a renal dietitian (English native speaker compared each item of the original English version of the 7 p-SGA and MIS to the back translated English version by rating the similarity between both questionnaires from 1 to 100 (being 100 the highest degree of similarity. The degree of similarity was 96.8 ±7.8 for 7p-SGA and 99.6 ±1.4 for MIS, indicating that the Portuguese versions had equivalent meaning to the original English version. We then performed the validation of the Portuguese version by assessing the concurrent concordance of both nutritional composite indices with objective methods (BMI, body fat %, phase angle, handgrip strength and albumin in 64 elderly patients on HD (male 72%; 70±3 years old. The 7p-SGA was rated as well nourished (score 7-6; n= 30; mildly to moderately malnourished (5-3; n= 34 and severely malnourished (2-1; no patient. The MIS was rated as normal nutrition (score: 0–5; n= 12; mild malnutrition (6–10; n= 38, and moderate-to-severe malnutrition (≥11; n= 14. Among the objective methods, only body fat % differed (P<0.05 between well-nourished and malnourished patients for the 7p-SGA, and for MIS, the same was observed only for body fat % and phase angle. In conclusion, these preliminary results suggest that for elderly patients on HD, the scores proposed by the 7p-SGA and MIS for

  18. Reliability of the Handgrip Strength Test in Elderly Subjects With Parkinson Disease.

    Science.gov (United States)

    Villafañe, Jorge H; Valdes, Kristin; Buraschi, Riccardo; Martinelli, Marco; Bissolotti, Luciano; Negrini, Stefano

    2016-03-01

    The handgrip strength test is widely used by clinicians; however, little has been investigated about its reliability when used in subjects with Parkinson disease (PD). The purpose of this study was to investigate the test-retest reliability of the handgrip strength test for subjects with PD. The PD group consisted of 15 patients, and the control group consisted of 15 healthy subjects. Each patient performed 3 pain-free maximal isometric contractions on each hand on 2 occasions, 1 week apart. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95% limits of agreement (LOA) were calculated. The 2-way analysis of variance (ANOVA) was conducted to determine the differences between sides and groups. Test-retest reliability of measurements of grip strength was excellent for dominant (ICC = 0.97; P = .001) and non-dominant (ICC = 0.98; P = .001) hand of participant with PD and (ICC = 0.99; P = .001) and (ICC = 0.99; P = .001) respectively, of healthy group. The Jamar hand dynamometer had fair to excellent test-retest reliability to test grip strength in participants with PD.

  19. Screening for frailty in elderly subjects living at home: validation of the Modified Short Emergency Geriatric Assessment (SEGAm) instrument.

    Science.gov (United States)

    Oubaya, N; Mahmoudi, R; Jolly, D; Zulfiqar, A A; Quignard, E; Cunin, C; Nazeyrollas, P; Novella, J L; Dramé, M

    2014-01-01

    To validate the modified version of the Short Emergency Geriatric Assessment (SEGAm) frailty instrument in elderly people living at home. Longitudinal, prospective, multicentre study. Four departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse) in two French Regions (Champagne-Ardenne and Lorraine). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5, or 6 in the AGGIR autonomy evaluation scale. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument. Psychometric validation was used to study feasibility and acceptability, internal structure validity, reliability, and discriminant validity of the SEGAm instrument. Between July 1st 2012 and March 31st 2013, 167 patients were included in the study. Averaged age was 77±7 years, the majority were women (70.7%). Feasibility and acceptability of the SEGAm instrument were excellent: we observed no refusal to participate, no drop-out during administration, no missing items, no ceiling or floor effects, and the administration time was short (5.0±3.5 min). By factor analysis, the instrument proved to be unidimensional. It showed good internal consistency (Cronbach's alpha coefficient: 0.68) and good test-retest (intra-class correlation: 0.88) at 7 days interval. Discriminant validity showed a significant difference, mainly for nutritional status, fall risk, dependency, mood and depression risk, and comorbidities. Based on these psychometric properties, the SEGAm appears to be an easy-to-use instrument that is particularly suitable for use in the community to identify frail elderly people who could benefit from early targeted interventions.

  20. Evaluation of dyspnoea in a sample of elderly subjects recruited from general practice

    DEFF Research Database (Denmark)

    Pedersen, F; Mehlsen, J; Raymond, I

    2007-01-01

    . Of 129 subjects with dyspnoea, 68 (53%) had signs of lung disease, 27 (21%) had heart disease, a total of 43 (33%) were obese, 20 (16%) were obese without other causes of dyspnoea and five (4%) had general physical deconditioning. Twelve per cent had none of the above-mentioned potential causes...... in most cases, the most frequent being lung disease followed by heart disease and obesity. These data shed light on the diagnostic yield that can be expected from a relatively simple diagnostic approach, including the most frequent recommended initial screening tests. As expected, the incremental nature...

  1. Estimation of macular pigment optical density in the elderly: test-retest variability and effect of optical blur in pseudophakic subjects

    NARCIS (Netherlands)

    Gallaher, Kevin T.; Mura, Marco; Todd, Wm Andrew; Harris, Tarsha L.; Kenyon, Emily; Harris, Tamara; Johnson, Karen C.; Satterfield, Suzanne; Kritchevsky, Stephen B.; Iannaccone, Alessandro

    2007-01-01

    The reproducibility of macular pigment optical density (MPOD) estimates in the elderly was assessed in 40 subjects (age: 79.1+/-3.5). Test-retest variability was good (Pearson's r coefficient: 0.734), with an average coefficient of variation (CV) of 18.4% and an intraclass correlation coefficient

  2. Resting Brain Perfusion and Selected Vascular Risk Factors in Healthy Elderly Subjects

    DEFF Research Database (Denmark)

    Henriksen, Otto M.; Jensen, Lars T; Krabbe, Katja

    2014-01-01

    with circulating homocysteine, but not with asymmetric dimethylarginine, dyslipidemia or the carotid intima-media thickness. The relative regional brain perfusion was associated with circulating homocysteine, with a relative parietal hypoperfusion and a frontal hyperperfusion. No effect on regional brain perfusion...... was observed for any of the other risk factors. A multiple regression model including homocysteine, caffeine, hematocrit and end-tidal PCO2, explained nearly half of the observed variability. CONCLUSION: Both intrinsic and extrinsic factors influenced global cerebral perfusion variation between subjects....... Further, the results suggest that the inverse relation between homocysteine and brain perfusion is owing to other mechanisms, than reflected by asymmetric dimethylarginine, and that homocysteine may be a marker of cerebral perfusion in aging brains....

  3. Subjectivity

    Directory of Open Access Journals (Sweden)

    Jesús Vega Encabo

    2015-11-01

    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  4. Interrelationship among the health-related and subjective quality of life, daily life activities, instrumental activities of daily living of community-dwelling elderly females in orthopedic outpatients.

    Science.gov (United States)

    Takemasa, Seiichi; Nakagoshi, Ryoma; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Naruse, Susumu; Nanba, Yoshihumi

    2017-05-01

    [Purpose] This study aimed to examine the health-related and subjective quality of life of community-dwelling elderly females in orthopedic outpatients, and also examined how such quality of life correlate with their daily life activities and instrumental activities of daily living. [Subjects and Methods] Subjects were 27 community-dwelling elderly females in orthopedic outpatients (mean age: 76.3 ± 7.4 years). Their health-related quality of life and subjective quality of life, life-space assessment, frenchay activities index were researched. [Results] For the relationships between the total subjective quality of life scores and health-related quality of life scores, significant positive correlations were observed for body pain, general health, vitality, social functions and mental health. The correlations were not statistically significant between the subjective quality of life scores and the life-space assessment and frenchay activities index scores. The correlations were statistically significant between some health-related quality of life scores and the life-space assessment and frenchay activities index scores. [Conclusion] The results suggest that supporting community-dwelling elderly females in orthopedic outpatients to improve their sense of physical and mental well-being, and prevent and reduce their depression and physical pain, is required in order to improve their QOL.

  5. Correlation between depressive symptoms and subjective mastication ability and ability to pronunciation among Korean elderly

    Directory of Open Access Journals (Sweden)

    Min Sun Park

    2016-07-01

    Full Text Available OBJECTIVES The present study examines the relationship between depressive symptoms and subjective chewing and pronunciation ability in Korean seniors. Our goal is to provide the data required to develop appropriate oral health interventions programs for seniors. METHODS The Center for Epidemiologic Studies-Depression Scale (CES-D is widely used depressive symptoms assessment. A Korean version was used for the 2009 Community Health Survey, which was consulted to extract the present study’s participants comprising 50,694 Korean seniors (males, 20,582; females, 30,112 aged ≥65 years. Those with a CES-D score ≥16 were rated ‘depressed.’ SAS version 9.3 was used for the data analysis. RESULTS Prevalence of depressive symptoms increased as the participants socioeconomic status decreased, number of health issues increased, health behavior worsened, and chewing and pronunciation discomfort increased. Males with chewing difficulties were found to have 1.45 times (95% confidence interval [CI], 1.29 to 1.63 greater risk of depressive symptoms than those without, while males with pronunciation discomfort were found to have 1.97 times greater risk of depressive symptoms than those without (95% CI, 1.76 to 2.20. Females with chewing difficulty were found to have 1.50 times (95% CI, 1.39 to 1.61 greater risk of depressive symptoms than those without, and females with pronunciation discomfort were found to have 1.55 times greater risk of depressive symptoms than those without (95% CI, 1.44 to 1.67. CONCLUSIONS Intervention programs designed to help with oral health management and alleviate depressive symptoms in seniors are urgently needed. As the prevalence of depressive symptoms may vary geographically, research examining potential variance at city, district, and town levels would be beneficial.

  6. Identification of changes in kinematics and electromyographic parameters during dual-task gait: a comparative study between young and elderly female subjects

    Directory of Open Access Journals (Sweden)

    Camilla Zamfolini Hallal

    Full Text Available Abstract Introduction : Falls during gait are one of the leading causes of death and injuries in elderly adults. Objective : This study aimed to compare the performance of young (YG and elderly (EG adults during dual-task gait (using a traffic light simulator according to kinematics and electromyographic parameters. Materials and methods : 17 young and 18 elderly physically fit female subjects participated in this study. The volunteers walked on a treadmill under two different conditions: normal gait (M1 and dual-task gait (M2. We recorded EMG signals from the rectus femoris (RF, vastus medialis (VM, vastus lateralis (VL, biceps femoris (BF, tibialis anterior (TA, gastrocnemius lateralis (GL and soleus (SO. The following kinematic data were obtained: step length, step time and self-selected velocity. Data analysis was performed using Wilcoxon's, Mann-Whitney, T-student tests and T-student for independent samples. The level of significance was set at p < 0.05. Results : For both groups, there was greater muscle activation of the RF, VM, VL, BF and SO during M2 than during M1. The YG showed lower muscle activation of the RF, VM, BF and SO during M2 when compared to EG. The EG had smaller step length than the YG. The step length values detected during M1 were higher than the ones collected during M2. During M2, the YG showed higher step time compared to the EG. Elderly subjects walked at a lower self-selected velocity than young subjects. Conclusions : Our findings suggest that dual-task gait modify the neuromuscular behavior in elderly subjects, increasing the risk of falls.

  7. Evaluation of Lower Limb Motor Function Using Wireless Motion Sensors—A Comparison of Normal Elderly Subjects and those Requiring Support Level 1

    Science.gov (United States)

    Miyoshi, Hiroaki; Numata, Takayuki; Kuwae, Yutaka; Sekine, Masaki; Tsuji, Miwa; Okabe, Ichiro; Hara, Keita; Fujimoto, Toshiro; Tamura, Toshiyo

    This study quantitatively compared lower limb motility of normal subjects and those requiring support level 1 (support_1). We developed a wireless inertia sensor with an embedded tri-axial accelerometer and angular velocity sensor. Six normal elderly subjects and ten elderly subjects who were classified as support_1 by the Japanese care insurance system participated in the study. We attached the wireless motion sensors to the center of the lower back and both thighs in the subjects. Subjects were then asked to walk 10 m and perform a stepping exercise. For the evaluation, the cadence, pitch angle, and pitch angular velocity of the thigh auto-correlation function and root mean square (RMS) on the lower back were calculated. The autocorrelation coefficient function for the support_1 subjects was smaller than in the normal subjects, while the RMS was larger in support_1. These differences indicated that the gait and balance abilities of the support_1 subjects were poorer than those of the normal subjects. This suggests that our wireless motion sensor is useful for assessing the motility of the lower limbs while walking and climbing steps.

  8. Bright light in elderly subjects with nonseasonal major depressive disorder: a double blind randomised clinical trial using early morning bright blue light comparing dim red light treatment

    Directory of Open Access Journals (Sweden)

    van Someren Eus JW

    2008-07-01

    Full Text Available Abstract Background Depression frequently occurs in the elderly. Its cause is largely unknown, but several studies point to disturbances of biological rhythmicity. In both normal aging, and depression, the functioning of the suprachiasmatic nucleus (SCN is impaired, as evidenced by an increased prevalence of day-night rhythm perturbations, such as sleeping disorders. Moreover, the inhibitory SCN neurons on the hypothalamus-pituitary adrenocortical axis (HPA-axis have decreased activity and HPA-activity is enhanced, when compared to non-depressed elderly. Using bright light therapy (BLT the SCN can be stimulated. In addition, the beneficial effects of BLT on seasonal depression are well accepted. BLT is a potentially safe, nonexpensive and well accepted treatment option. But the current literature on BLT for depression is inconclusive. Methods/Design This study aims to show whether BLT can reduce non-seasonal major depression in elderly patients. Randomized double blind placebo controlled trial in 126 subjects of 60 years and older with a diagnosis of major depressive disorder (MDD, DSM-IV/SCID-I. Subjects are recruited through referrals of psychiatric outpatient clinics and from case finding from databases of general practitioners and old-people homes in the Amsterdam region. After inclusion subjects are randomly allocated to the active (bright blue light vs. placebo (dim red light condition using two Philips Bright Light Energy boxes type HF 3304 per subject, from which the light bulbs have been covered with bright blue- or dim red light- permitting filters. Patients will be stratified by use of antidepressants. Prior to treatment a one-week period without light treatment will be used. At three time points several endocrinological, psychophysiological, psychometrically, neuropsychological measures are performed: just before the start of light therapy, after completion of three weeks therapy period, and three weeks thereafter. Discussion If BLT

  9. Endogenous Estradiol Is Associated with Verbal Memory in Nondemented Older Men

    Science.gov (United States)

    Zimmerman, Molly E.; Lipton, Richard B.; Santoro, Nanette; McConnell, Daniel S.; Derby, Carol A.; Katz, Mindy J.; Baigi, Khosrow; Saunders-Pullman, Rachel

    2011-01-01

    This study examined the relationship between endogenous hormones and cognitive function in nondemented, ethnically-diverse community-dwelling older men enrolled in the Einstein Aging Study (EAS). All eligible participants (185 men, mean age = 81 years) received neuropsychological assessment (Free and Cued Selective Reminding Test (FCSRT), Logical…

  10. Proficiency in positive vs. negative emotion identification and subjective well-being among long-term married elderly couples

    Science.gov (United States)

    Petrican, Raluca; Moscovitch, Morris; Grady, Cheryl

    2014-01-01

    Evidence is accruing that positive emotions play a crucial role in shaping a healthy interpersonal climate. Inspired by this research, the current investigation sought to shed light on the link between proficiency in identifying positive vs. negative emotions and a close partner's well-being. To this end, we conducted two studies with neurologically intact elderly married couples (Study 1) and an age-matched clinical sample, comprising married couples in which one spouse had been diagnosed with Parkinson's Disease (Study 2), which tends to hinder emotional expressivity. To assess proficiency in identifying emotions from whole body postures, we had participants in both studies complete a pointlight walker task, featuring four actors (two male, two female) expressing one positive (i.e., happiness) and three negative (i.e., sadness, anger, fear) basic emotions. Participants also filled out measures of subjective well-being. Among Study 1's neurologically intact spouses, greater expertise in identifying positive (but not negative) emotions was linked to greater partner life satisfaction (but not hedonic balance). Spouses of PD patients exhibited increased proficiency in identifying positive emotions relative to controls, possibly reflective of compensatory mechanisms. Complementarily, relative to controls, spouses of PD patients exhibited reduced proficiency in identifying negative emotions and a tendency to underestimate their intensity. Importantly, all of these effects attenuated with longer years from PD onset. Finally, there was evidence that it was increased partner expertise in identifying negative (rather than positive) emotional states that predicted greater life satisfaction levels among the PD patients and their spouses. Our results thus suggest that positive vs. negative emotions may play distinct roles in close relationship dynamics as a function of neurological status and disability trajectory. PMID:24803910

  11. Proficiency in Positive versus Negative Emotion Identification and Subjective Well-being among Long-term Married Elderly Couples

    Directory of Open Access Journals (Sweden)

    Raluca ePetrican

    2014-04-01

    Full Text Available Evidence is accruing that positive emotions play a crucial role in shaping a healthy interpersonal climate. Inspired by this research, the current investigation sought to shed light on the link between proficiency in identifying positive versus negative emotions and a close partner’s well-being. To this end, we conducted two studies with neurologically intact elderly married couples (Study 1 and an age-matched clinical sample, comprising married couples in which one spouse had been diagnosed with Parkinson’s Disease (Study 2, which tends to hinder emotional expressivity. To assess proficiency in identifying emotions from whole body postures, we had participants in both studies complete a pointlight walker task, featuring four actors (two male, two female expressing one positive (i.e., happiness and three negative (i.e., sadness, anger, fear basic emotions. Participants also filled out measures of subjective well-being. Among Study 1’s neurologically intact spouses, greater expertise in identifying positive (but not negative emotions was linked to greater partner life satisfaction (but not hedonic balance. Spouses of PD patients exhibited increased proficiency in identifying positive emotions relative to controls, possibly reflective of compensatory mechanisms. Complementarily, relative to controls, spouses of PD patients exhibited reduced proficiency in identifying negative emotions and a tendency to underestimate their intensity. Importantly, all of these effects attenuated with longer years from PD onset. Finally, there was evidence that it was increased partner expertise in identifying negative (rather than positive emotional states that predicted greater life satisfaction levels among the PD patients and their spouses. Our results thus suggest that positive versus negative emotions may play distinct roles in close relationship dynamics as a function of neurological status and disability trajectory.

  12. Homocysteine and brain atrophy on MRI of non-demented elderly

    NARCIS (Netherlands)

    den Heijer, T; Vermeer, SE; Clarke, R; Oudkerk, M; Koudstaal, PJ; Hofman, A; Breteler, MMB

    Patients with Alzheimer's disease have higher plasma homocysteine levels than controls, but it is uncertain whether higher plasma homocysteine levels are involved in the early pathogenesis of the disease. Hippocampal, amygdalar and global brain atrophy on brain MRI have been proposed as early

  13. Polyphenol-rich foods in the Mediterranean diet are associated with better cognitive function in elderly subjects at high cardiovascular risk

    OpenAIRE

    Valls-Pedret, Cinta; Lamuela Raventós, Rosa Ma.; Medina Remón, Alexander; Quintana, Melibea; Corella Piquer, Dolores; Pintó Sala, Xavier; Martínez-González, Miguel Ángel, 1957-; Estruch Riba, Ramon; Ros Rahola, Emilio

    2012-01-01

    Brain oxidative processes play a major role in age-related cognitive decline, thus consumption of antioxidant-rich foods might help preserve cognition. Our aim was to assess whether consumption of antioxidant-rich foods in the Mediterranean diet relates to cognitive function in the elderly. In asymptomatic subjects at high cardiovascular risk (n = 447; 52% women; age 55-80 y) enrolled in the PREDIMED study, a primary prevention dietary-intervention trial, we assessed food intake and cardiovas...

  14. Whole-body vibration improves the anti-inflammatory status in elderly subjects through toll-like receptor 2 and 4 signaling pathways.

    Science.gov (United States)

    Rodriguez-Miguelez, Paula; Fernandez-Gonzalo, Rodrigo; Collado, Pilar S; Almar, Mar; Martinez-Florez, Susana; de Paz, José A; González-Gallego, Javier; Cuevas, María J

    2015-09-01

    Regular physical exercise has anti-inflammatory effects in elderly subjects. Yet, the inflammatory responses after whole body vibration (WBV) training, a popular exercise paradigm for the elderly, remain to be elucidated. This study assessed the effects of WBV training on the inflammatory response associated with toll-like receptors (TLRs) signaling pathways. Twenty-eight subjects were randomized to a training group (TG) or a control group (CG). TG followed an 8-week WBV training program. Blood samples were obtained before and after the training period in both groups. Peripheral blood mononuclear cells were isolated, and mRNA and protein levels of makers involved in the TLR2/TLR4 myeloid differentiation primary response gen 88 (MyD88) and TIR domain-containing adaptor inducing interferon (TRIF)-dependent pathways were analyzed. Plasma TNFα and C-reactive protein levels were also assessed. The WBV program reduced protein expression of TLR2, TLR4, MyD88, p65, TRIF and heat shock protein (HSP) 60, while HSP70 content increased. IL-10 mRNA level and protein concentration were upregulated, and TNFα protein content decreased, after WBV training. Plasma concentration of C-reactive protein and TNFα decreased in the TG. The current data suggest WBV may improve the anti-inflammatory status of elderly subjects through an attenuation of MyD88- and TRIF-dependent TLRs signaling pathways. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. A Comparison of Pharmacokinetic and Pharmacodynamic Properties Between Faster-Acting Insulin Aspart and Insulin Aspart in Elderly Subjects with Type 1 Diabetes Mellitus.

    Science.gov (United States)

    Heise, Tim; Hövelmann, Ulrike; Zijlstra, Eric; Stender-Petersen, Kirstine; Jacobsen, Jacob Bonde; Haahr, Hanne

    2017-01-01

    Due to population aging, an increasing number of elderly patients with diabetes use insulin. It is therefore important to investigate the characteristics of new insulins in this population. Faster-acting insulin aspart (faster aspart) is insulin aspart (IAsp) in a new formulation with faster absorption. This study investigated the pharmacological properties of faster aspart in elderly subjects with type 1 diabetes mellitus (T1DM). In a randomised, double-blind, two-period crossover trial, 30 elderly (≥65 years) and 37 younger adults (18-35 years) with T1DM received single subcutaneous faster aspart or IAsp dosing (0.2 U/kg) and underwent an euglycaemic clamp (target 5.5 mmol/L) for up to 12 h. The pharmacokinetic and pharmacodynamic time profiles were left-shifted for faster aspart versus IAsp. In each age group, onset of appearance occurred approximately twice as fast (~3 min earlier) and early exposure (area under the concentration-time curve [AUC] for serum IAsp from time zero to 30 min [AUC IAsp,0-30 min ]) was greater (by 86% in elderly and 67% in younger adults) for faster aspart than for IAsp. Likewise, onset of action occurred 10 min faster in the elderly and 9 min faster in younger adults, and early glucose-lowering effect (AUC for the glucose infusion rate [GIR] from time zero to 30 min [AUC GIR,0-30 min ]) was greater (by 109%) for faster aspart than for IAsp in both age groups. Total exposure (AUC IAsp,0-t ) and the maximum concentration (C max ) for faster aspart were greater (by 30 and 28%, respectively) in elderly than in younger adults. No age group differences were seen for the total (AUC GIR,0-t ) or maximum (GIR max ) glucose-lowering effect. This study demonstrated that the ultra-fast pharmacological properties of faster aspart are similar in elderly subjects and younger adults with T1DM. ClinicalTrials.gov Identifier: NCT02003677.

  16. Association between memory complaints and incident Alzheimer's disease in elderly people with normal baseline cognition.

    NARCIS (Netherlands)

    Geerlings, M.I.; Jonker, C.; Bouter, L.M.; Adèr, H.J.; Schmand, B.

    1999-01-01

    In the community-based Amsterdam Study of the Elderly, a sample of 3,778 nondemented persons, 65-84 yrs old, was divided into 2 cognitive categories: normal, and borderline and impaired. At baseline, the presence or absence of memory complaints was assessed with a single question. At follow-up,

  17. A pilot study of a new method of cognitive stimulation using abacus arithmetic in healthy and cognitively impaired elderly subjects.

    Science.gov (United States)

    Matías-Guiu, J A; Pérez-Martínez, D A; Matías-Guiu, J

    2016-06-01

    This study explores the applicability of a cognitive stimulation method based on abacus arithmetic in elderly people with and without cognitive impairment. This observational and prospective pilot study was performed in 2 hospitals. The study assessed the applicability of a programme of arithmetic training developed for use in the elderly population. The primary endpoint was an evaluation of the stimulation programme, in terms of usability, satisfaction, and participation, in healthy elderly controls and elderly patients with mild cognitive impairment or Alzheimer disease. Secondary endpoints were family satisfaction, caregiver burden, and the behaviour and cognition of patients. Usability, satisfaction, and degree of participation were high. The Mini-Mental State Examination showed significant changes (23.1±4.8 before the intervention vs 24.9±4.2 afterwards, P=.002); there were no changes on the Trail Making Test parts A and B, Yesavage Geriatric Depression scale, and Zarit caregiver burden scale. The study suggests that cognitive stimulation with abacus arithmetic may be used in elderly people with and without cognitive impairment. Further studies will be needed to evaluate the efficacy of this kind of programmes. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  18. A randomized, double-blind, placebo-controlled trial of a traditional herbal formula, Yukmijihwang-tang in elderly subjects with xerostomia.

    Science.gov (United States)

    Han, Gajin; Ko, Seok-Jae; Kim, Juyeon; Oh, Ja-Young; Park, Jae-Woo; Kim, Jinsung

    2016-04-22

    Yukmijihwang-tang (YMJ) is a typical herbal formula to treat Yin-deficiency (YD) syndrome by enriching the fluid-humor of the body. YMJ has been used to treat dry mouth symptoms for hundreds of years in traditional East Asian medicine. Xerostomia, a subjective oral dryness, is common in the elderly and results in impaired quality of life. Many conventional treatments for xerostomia provide only temporary symptom relief, and have side effects. The aim of this study is to investigate the efficacy and safety of YMJ for the treatment of xerostomia in the elderly. This study was designed as a randomized, placebo-controlled, double-blinded, two center trial. Ninety-six subjects aged 60-80 years who had experienced xerostomia for at least 3 months and presented with score>40 on the visual analog scale (VAS) for subjective oral dryness were recruited and randomly allocated to YMJ and placebo groups. YMJ or placebo was administered to each group for 8 weeks (3g of YMJ or placebo, three times per day). The primary outcome was change of VAS for xerostomia from 0 to 8 weeks. VAS for xerostomia was decreased by 22.04±22.76 in the YMJ group and 23.58±23.04 in the placebo group. YMJ had no effect on xerostomia. However, participants with BMIs lower than 29.37kg/m(2) showed improvement of xerostomia after 8 weeks of treatment with YMJ compared to placebo. In addition, YMJ improved oral moisture, which is associated with subjective oral dryness in the YMJ group, and the relationship between VAS for xerostomia and YD was significant. A trend was observed in which YMJ improved oral moisture status and subjective oral dryness in elderly subjects with lower BMI and greater tendency toward YD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Performance on Specific Cognitive Domains and Cause of Death: A Prospective Population-Based Study in Non-Demented Older Adults (NEDICES).

    Science.gov (United States)

    Benito-León, Julián; Contador, Israel; Mitchell, Alex J; Domingo-Santos, Ángela; Bermejo-Pareja, Félix

    2016-01-01

    Evidence regarding the relationship between performance on specific cognitive domains and cause of death is scarce. We assessed whether specific cognitive domains predicted mortality and the presence of any association with specific causes of death in a population-dwelling sample of non-demented older adults. In this population-based, prospective study (NEDICES), 2,390 non-demented subjects ≥65 years completed a brief neuropsychological battery. Cox's proportional hazards models, adjusted by sociodemographic and comorbidity factors, global cognitive performance, educational level, and premorbid intelligence were used to assess the risk of death. Participants were followed for a median of 9.2 years (range 0.01-10.7), after which the death certificates of those who died were examined. 880 (36.8%) of 2,390 participants died over a median follow-up of 5.5 years (range 0.01-10.5). Using adjusted Cox regression models, we found that hazard ratios for mortality in participants within the lowest tertiles (worse performance) were 1.31 (speed of cognitive processing, p = 0.03); 1.22 (semantic fluency, p = 0.04), 1.32 (delayed free recall, p = 0.003), and 1.23 (delayed logical memory, p = 0.03). Poor performance on delayed recall and speed of cognitive processing tests were associated with dementia and cerebrovascular disease mortality, respectively. Further, poor performance on semantic fluency was associated with decreased cancer mortality. In this study of community dwelling non-demented older adults, worse neuropsychological performance was associated with increased risk of mortality. Performance on specific cognitive domains were related to different causes of death. Of particular note there appears to be an inverse association between poor semantic fluency and cancer mortality.

  20. Efficacy of an influenza hemagglutinin-diphtheria toxoid conjugate vaccine in elderly nursing home subjects during an influenza outbreak.

    Science.gov (United States)

    Gravenstein, S; Drinka, P; Duthie, E H; Miller, B A; Brown, C S; Hensley, M; Circo, R; Langer, E; Ershler, W B

    1994-03-01

    To compare the efficacy of an influenza hemagglutinin-diphtheria toxoid conjugate vaccine with the commercially available influenza hemagglutinin-subunit vaccine in preventing influenza in older adults living in a nursing home. A prospective, randomized, double-blind vaccine trial with 5 months of follow-up after vaccination. Fourteen Wisconsin nursing homes. Nursing home residents at least 65 years old who were able to give informed consent and were free of malignancy and not receiving immunosuppressive therapy. Participants received, by intramuscular injection, 0.5 mL of a trivalent influenza vaccine containing 15 micrograms each of A/Leningrad/360/86 (H3N2), A/Taiwan/1/86 (H1N1), and B/Ann Arbor/1/86 (HA) or 0.5 mL of an influenza vaccine containing the same antigens conjugated to diphtheria toxoid (HA-D). Blood was obtained pre- and 1 month post-vaccination to assess for any vaccine-induced antibody titer change. Clinical surveillance for respiratory illness was performed twice weekly for 5 months. A record was kept of all signs and symptoms of new respiratory illness, and a viral culture and acute and convalescent sera were obtained. 204 participants received HA and 204 received HA-D. Both groups had similar baseline antibody levels to all influenza antigens. HA-D recipients seroconverted more frequently based on serum neutralizing activity (P < 0.05), had a greater increase in geometric mean titer (GMT), and sustained the increase in antibody titer longer than HA recipients. Vaccine hemagglutinin recall was greater in a subset of HA-D recipients as measured by lymphocyte proliferative assays (P < 0.05). During an outbreak of influenza A (H3N2 A/Shanghai/11/87-like and A/Victoria/7/87-like), fewer HA-D (29/195) than HA (43/204) recipients had laboratory-confirmed infection (P = 0.053), and, of these, fewer HA-D-treated subjects had lower respiratory tract involvement (5/29 HA-D and 17/43 HA) (P = 0.022). HA-D was more immunogenic in institutionalized elderly

  1. Examination of the Philadelphia Geriatric Morale Scale as a Subjective Quality-of-Life Measure in Elderly Hong Kong Chinese

    Science.gov (United States)

    Wong, Eric; Woo, Jean; Hui, Elsie; Ho, Suzanne C.

    2004-01-01

    Purpose: We examine the psychometric properties of the Philadelphia Geriatric Morale Scale (PGMS) in an elderly Chinese population in Hong Kong. Design and Methods: The study consisted of two cohorts: (a) 759 participants aged 70 years and older living in the community who were recruited as part of a territory-wide health survey and interviewed in…

  2. Normal values of pulmonary capillary wedge pressure and the blood pressure response to the Valsalva manoeuvre in healthy elderly subjects.

    NARCIS (Netherlands)

    Remmen, J.J.; Aengevaeren, W.R.M.; Verheugt, F.W.A.; Jansen, R.W.M.M.

    2005-01-01

    The blood pressure response to the Valsalva manoeuvre is related to pulmonary capillary wedge pressure (PCWP) and can be used to diagnose heart failure. However, this has never been studied specifically in the elderly, in whom the prevalence of heart failure is highest. Furthermore, normal values of

  3. Review of Effects of Physical Activity on Strength, Balance, Mobility and ADL Performance in Elderly Subjects with Dementia

    NARCIS (Netherlands)

    Blankevoort, Christiaan G.; van Heuvelen, Marieke J. G.; Boersma, Froukje; Luning, Helga; de Jong, Jeltsje; Scherder, Erik J. A.

    2010-01-01

    Background/Aims: Elderly individuals with dementia are vulnerable for a decline in physical functioning and basic activities of daily living (BADL) which can lead to a decline in autonomy and participation. This study reviews the effect of physical activity on physical functioning and BADL in

  4. When does poor subjective financial position hurt the elderly? Testing the interaction with educational attainment using a national representative longitudinal survey.

    Science.gov (United States)

    Pu, Christy; Huang, Nicole; Tang, Gao-Jun; Chou, Yiing-Jenq

    2011-03-17

    Several studies have demonstrated that perceived financial status has a significant impact on health status among the elderly. However, little is known about whether such a subjective perception interacts with objective socioeconomic status (SES) measures such as education that affect the individual's health. This research used data from the Survey of Health and Living Status of the Middle Age and Elderly in Taiwan (SHLS) conducted by the Bureau of Health Promotion, Department of Health in Taiwan. Waves 1996, 1999 and 2003 were used. The sample consisted of 2,387 elderly persons. The interactive effects of self-rated satisfaction with financial position and educational attainment were estimated. Self-rated health (SRH), depressive symptom (measured by CES-D) and mortality were used to measure health outcomes. Significant interaction effect was found for depressive symptoms. Among those who were dissatisfied with their financial position, those who were illiterate had an odds ratio (OR) of 8.3 (95% CI 4.9 to 14.0) for having depressive symptoms compared with those who were very satisfied with their financial position. The corresponding OR for those with college or above was only 2.7 (95% CI 1.0 to 7.3). No significant interaction effect was found for SRH and mortality. Although poor financial satisfaction was found to be related to poorer health, the strongest association for this effect was observed among those with low educational attainment, and this is especially true for depressive symptoms. Subjective financial status among the elderly should be explored in conjunction with traditional measures of SES.

  5. Effect of Angiotensin-Converting Enzyme Inhibitors on Physical Function in Elderly Subjects: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zhou, Ling-shan; Xu, Ling-jie; Wang, Xue-qing; Huang, Yi-huan; Xiao, Qian

    2015-09-01

    Sarcopenia has been accepted as a new geriatric syndrome, which will become a common and important public health challenge. And angiotensin-converting enzyme inhibitors (ACEIs) have been shown to improve exercise capacity in elderly without heart failure. To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEIs) on physical function in elderly. The Cochrane Library, PubMed, EMBASE and Web of Science were searched. All researches included were randomized controlled trials (RCTs) which compared any kind of ACEIs with placebo or other anti-hypertensives in elderly, and provided empirical data of grip strength and 6-min walk distance change from baseline. Risk of bias was systematically assessed by using the Cochrane risk of bias tool. Data of grip strength and 6-min walk distance change from baseline were collected and mean differences (MDs) were calculated along with 95% CI (confidence interval) by using a random effects model. In 3 RCTs including 337 elderly participants, ACEIs (n = 178) did not significantly improved 6-min walk distance (13.45, 95% CI: -16.71 to 43.61; P = 0.38) versus placebo or other antihypertensives (n = 159). In 3 RCTs including 499 elderly participants, grip strength was not significantly different (-0.67, 95% CI: -1.53 to 0.19; P = 0.12) between ACEIs (n = 260) and placebo or other antihypertensives (n = 239). There exists only 4 RCTs and the number of participants is limited. Pooling of data were from different trials including different participant characteristics. And intervention is not strictly consistent. This study shows that ACEIs can not significantly improve walk distance or the age-related decline of muscle strength for older participants in clinical trials.

  6. [Prevention of decline in subjectively perceived physical function of the elderly by regular participation in a community-based exercise group].

    Science.gov (United States)

    Gotou, Tomomi; Niu, Kaijun; Nagatomi, Ryoichi

    2010-01-01

    The objective of this study was to evaluate the effect of a community-based group exercise program on physical functioning among elderly people. This prospective observational study enrolled 494 persons aged 70-84 years who volunteered for the study and completed a baseline measurement in 2006 and were re-evaluated 1 year later in 2007. The exercise regimen consisted of resistance training and recreational exercise for 1.5 hours conducted twice a month. Physical functioning was evaluated by a self-administered questionnaire consisting of the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) and Motor Fitness Scale (MFS). Decline in physical functioning was defined as a reduction in either TMIG-IC or MFS scores of more than 2 points deviation from the median change of each score. TMIG-IC and MFS results were obtained from 494 and 392 eligible subjects, respectively. After 1 year, 68 subjects (TMIG-IC) and 88 subjects (MFS) reported a decline in physical functioning. After adjustment for confounding factors, the odds ratio of reduced physical functioning, as assessed by the TMIG-IC among the subjects who did not participate in the exercise group and those who did, were 1.00 (control) and 0.15 (95% confidence interval, 0.01-0.75). Similar results were obtained when assessed on the MFS. These results suggest that participation in a community-based exercise group of elderly people was effective in maintaining self-reported physical function.

  7. Elder inmates

    Directory of Open Access Journals (Sweden)

    Kostić Miomira

    2014-01-01

    Full Text Available The criminological literature underscores that criminal offences committed by senior citizens are directly related to their age and entering a new stage of life. In elder offenders, we may observe a distinctive pattern in the development of their criminal activities, the structure of crime, gender-specific criminal offences, their previous criminal records and their social status. The former criminological studies on the elderly population have most frequently focused on examining the senior citizens' fear of crime and their victimization within the family; the studies on criminal offences committed by the elderly seem to be rather scarce. The prior research into the criminal activity of elder offenders has largely addressed the needs and difficulties encountered by elderly inmates, particularly in case they were sentenced to long-term imprisonment and subject to strict parole rules. Some researchers have also extended criticism on the lack of special correctional facilities specifically designed for elder inmates. In general, crime rate drops with aging. In developed countries, there is a constant increase of elder population as opposed to the marked decrease of younger population. Yet, the percentage of convicted offenders among the persons over the age of 55 is still significantly lesser as compared to the percentage of younger convicts. Namely, different issues pertaining to 'elder people behind bars' have eventually become the subject matter of interest of criminologists and penologists, public administration authorities and international organizations advocating the observance of human rights. The incarcerated men and women face many physical and psychological problems which are generally encountered by all people at large but usually at a later age, when they are at least 10 years older than the inmates. Violence, anxiety and distress caused by the immediate prison environment, separation from their friends and families, and the awareness

  8. HEART RATE, MOOD STATES, AND RATING OF PERCEIVED EXERTION AMONG ELDERLY SUBJECTS DURING 3.5 HOURS OF RECREATIONAL ALPINE SKIING

    Directory of Open Access Journals (Sweden)

    Sabine Krautgasser

    2012-12-01

    immediate positive psychological effects on the elderly subjects. Furthermore, recreational alpine skiing has a positive effect on MS ratings reflecting wellbeing, while generating age-appropriate moderate RPE values in elderly alpine skiers.

  9. Association between Toxoplasma gondii seropositivity and memory function in nondemented older adults.

    Science.gov (United States)

    Wyman, Cynthia P; Gale, Shawn D; Hedges-Muncy, Ariana; Erickson, Lance D; Wilson, Eric; Hedges, Dawson W

    2017-05-01

    Toxoplasma gondii (T. gondii) seropositivity may be associated with decreased memory in older adults. To further investigate the association between T. gondii seropositivity and memory in nondemented older adults, we obtained serum samples from 114 nondemented older adults evaluated by the Alzheimer's Disease and Research Center at Washington University in St. Louis, Missouri, USA. We determined T. gondii seropositivity and anti-T. gondii IgG antibody titer and examined associations with memory function while controlling for socioeconomic status, education level, age, and apolipoprotein E4 status. There were few associations between T. gondii seropositivity or anti-T. gondii IgG antibodies and memory, although there was some support suggesting an interaction between anti-T. gondii and sex. In the seropositive-only sample, there was an inverse relationship between anti-T. gondii titer and performance on the selective reminding test. Overall, we found little evidence of an association between impaired memory function and T. gondii seropositivity and anti-T. gondii IgG antibodies in this sample of nondemented older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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

  11. Morphological changes of lumbar vertebral bodies and intervertebral discs associated with decrease in bone mineral density of the spine: a cross-sectional study in elderly subjects.

    Science.gov (United States)

    Kwok, Anthony W L; Wang, Yi-Xiang J; Griffith, James F; Deng, Min; Leung, Jason C S; Ahuja, Anil T; Leung, Ping Chung

    2012-11-01

    Cross-sectional study. To investigate changes in the morphology of the lumbar vertebrae and intervertebral discs associated with osteoporosis of the spine in elderly subjects. Osteoporosis is a common condition that primarily affects the elderly with significant impact on quality of life. How exactly osteopenia and osteoporosis influence vertebral and intervertebral disc morphology remains unknown and needs exploration. A total of 395 community-dwelling ambulatory adults from 67 to 89 years of age were studied. The lumbar bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry. T2-weighted sagittal images of the lumbar spine were obtained using a 1.5-T magnet. For each subject, the anterior height (Ha), middle height (Hm), posterior height (Hp), and anterior-posterior (AP) dimension of the 5 lumbar vertebrae (L1-L5) and 6 intervertebral discs (T12-L1 to L5-S1) were measured. To minimize the age effect, volume of these vertebrae and discs was measured in subgroups of 47 men (mean age = 74 yr, range: 73-75 yr) and 67 women (mean age = 72 yr, range: 71-73 yr). Continuous variables were examined by analysis of covariance after adjustment of height and age. There was no significant age difference between the groups of normal BMD, osteopenia, and osteoporosis. For the vertebral bodies, lower BMD was associated with a decrease of Ha, Hm, and Hp but not AP in both sexes, leading to an increased biconcavity index. For the discs, lower BMD was associated with a decrease of Ha and Hp, as well as AP, and an increase in Hm in both men and women. The disc biconvexity index was increased. Lower BMD is associated with an overall decrease in both vertebral volume and disc volume. Lower BMD is associated with a decreasing trend in both lumbar vertebral and disc volumes in elderly subjects but an increase in the Hm of the intervertebral discs.

  12. No effects of slow oscillatory transcranial direct current stimulation (tDCS) on sleep-dependent memory consolidation in healthy elderly subjects.

    Science.gov (United States)

    Eggert, Torsten; Dorn, Hans; Sauter, Cornelia; Nitsche, Michael A; Bajbouj, Malek; Danker-Hopfe, Heidi

    2013-11-01

    Studies in young healthy volunteers provided evidence of a beneficial impact of an anodal time-varied transcranial direct current stimulation (tDCS) during early slow wave rich sleep on declarative memory but not on procedural memory. The present study investigated whether sleep-dependent memory consolidation can also be affected by slow oscillating tDCS in a population of elderly subjects. 26 subjects (69.1 years ± 7.7 years) received bi-frontal anodal stimulation (max. current density: 0.331 mA/cm(2)) during early NREM sleep in a double-blind placebo-controlled randomized crossover study. Stimulation effects on offline consolidation were tested by using a declarative and a procedural memory task. Furthermore, sleep stages were scored, EEG power was analyzed and spindle densities were assessed. Independently from stimulation condition, performance in both memory tasks significantly decreased overnight. Stimulation revealed no significant effect on sleep-dependent memory consolidation. Verum tDCS was accompanied by significantly more time awake and significantly less NREM stage 3 sleep during five 1-min stimulation free intervals. The results of the present study are in line with other studies showing that offline consolidation during sleep varies with age and is less pronounced in the elderly than in young or middle-aged subjects. Contrary to an almost identical positive study in young adults, slow oscillatory tDCS applied to the elderly failed to show a beneficial effect on memory consolidation in the present study. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Regional Fluid-Attenuated Inversion Recovery (FLAIR at 7 Tesla correlates with Amyloid beta in Hippocampus and Brainstem of cognitively normal elderly subjects.

    Directory of Open Access Journals (Sweden)

    Simon J Schreiner

    2014-09-01

    Full Text Available 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 compound-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: 14 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

  14. Chronic kidney disease and subclinical lacunar infarction are independently associated with frontal lobe dysfunction in community-dwelling elderly subjects. The sefuri brain MRI study

    International Nuclear Information System (INIS)

    Yao, Hiroshi; Takashima, Yuki; Hashimoto, Manabu; Yuzuriha, Takefumi; Miwa, Yoshikazu; Sasaguri, Toshiyuki; Yahara, Koji; Uchino, Akira

    2011-01-01

    Although recent studies have found that chronic kidney disease (CKD) is an independent risk factor for cognitive impairment in population-based cohorts, the mechanisms of cognitive impairment in subjects with CKD are unclear. We examined 503 elderly subjects (mean age: 72.4 years), who were living independently at home without apparent dementia, using MRI. The subject was judged as having frontal lobe dysfunction if the scores on the modified Stroop test were higher than the fifth quintile for each given decade. Serum creatinine values, measured by the enzymatic method, were used for the Japanese equation of estimated glomerular filtration rate (eGFR). Subjects in the frontal lobe dysfunction group tended to have higher blood pressure, lower eGFR and more lacunar infarcts, and were less educated. When possible confounders were entered into the multivariate logistic regression model, the independent predictors of frontal lobe dysfunction were eGFR (odds ratio 0.854; 95% confidence interval (CI) 0.743-0.983 per 10 ml min -1 per 1.73 m 2 ) and the number of lacunar infarction (odds ratio 1.460; 95% CI 1.127-1.892). The mean of the logarithmically transformed Stroop test scores in the eGFR -1 per 1.73 m 2 group was 1.376 (95% CI 1.301-1.451), which was significantly higher than that (1.250) for the eGFR 60-89 ml min -1 per 1.73 m 2 group (95% CI 1.215-1.285) (P=0.009) and tended to be higher than that (1.264) for the eGFR ≥90 ml min -1 per 1.73 m 2 group (95% CI 1.188-1.340) (analysis of covariance, adjusted for age). The present study showed that CKD and subclinical lacunar infarction independently contributed to frontal lobe dysfunction in healthy elderly subjects. (author)

  15. The Effect of the Dried-Bonito Broth on Blood Pressure, 8-Hydroxydeoxyguanosine (8-OHdG), an Oxidative Stress Marker, and Emotional States in Elderly Subjects.

    Science.gov (United States)

    Umeki, Youko; Hayabuchi, Hitomi; Hisano, Manami; Kuroda, Motonaka; Honda, Masashi; Ando, Bunei; Ohta, Masanori; Ikeda, Masaharu

    2008-11-01

    Dried-bonito broth (DBB, katsuo-bushi dashi) is commonly used in Japanese cuisine, and is also used as a traditional remedy for recovery from fatigue and improvement of blood circulation. To clarify the effect of DBB on blood pressure, oxidative stress and emotional states, a randomized crossover human trial was performed. Twenty-seven elderly Japanese subjects ingested DBB or water for one month. Measurement of blood pressure and urinary 8-hydroxydeoxyguanosine (8-OHdG) and evaluation of emotional states were performed before and after the ingestion periods. The changes in systolic blood pressure (SBP) during DBB ingestion was significantly lower than that during water ingestion (p = 0.037). Urinary 8-OHdG significantly decreased during DBB ingestion (p = 0.0002). Evaluation of emotional states indicated that composure significantly improved during DBB ingestion (p = 0.034). These results suggest that the daily ingestion of DBB lower SBP, reduce urinary 8-OHdG and might improve emotional states in elderly subjects.

  16. Satisfaction with dietary life affects oral health-related quality of life and subjective well-being in very elderly people.

    Science.gov (United States)

    Iinuma, Toshimitsu; Arai, Yasumichi; Takayama, Midori; Takayama, Michiyo; Abe, Yukiko; Osawa, Yusuke; Fukumoto, Motoko; Fukui, Yusuke; Shioda, Yohei; Hirose, Nobuyoshi; Komiyama, Kazuo; Gionhaku, Nobuhito

    2017-01-01

    Age-related deterioration in physical and oral health reduces healthy life expectancy and is thus an important problem for very elderly people. We investigated the effects of satisfaction with dietary life (SDL) in everyday life on oral health-related quality of life (OHRQoL) and subjective well-being and examined associations between these factors. We evaluated 426 elders aged 85 years or older. All participants completed a questionnaire that inquired about age, gender, drinking status, body mass index, cognitive function, disability, and comorbidities, among other covariates. Oral, physical, and mental health conditions were also examined. Associations of questionnaire results for SDL with items on subjective well-being (Philadelphia Geriatric Center Morale Scale [PGC] and World Health Organization-5 [WHO-5]) and OHRQoL (Geriatric Oral Health Assessment Index [GOHAI]) were confirmed with multiple logistic regression analysis. In a multivariate model adjusted for various confounders, participants with self-reported "enjoyable" SDL had significantly lower risks for having the lowest scores on the GOHAI, PGC, and WHO-5 (odds ratio [OR] = 0.460, 95% confidence interval [CI] = 0.277-0.762; OR = 0.589, 95% CI = 0.348-0.996; and OR = 0.452, 95% CI = 0.263-0.775, respectively). These associations remained after further adjustment for number of teeth.

  17. Subjective control and health among Mexican-origin elders in Mexico and the United States: structural considerations in comparative research.

    Science.gov (United States)

    Angel, Ronald J; Angel, Jacqueline L; Hill, Terrence D

    2009-05-01

    This study examines the joint impact of psychological and structural factors on Mexican and Mexican American elders' sense of personal control over important aspects of their lives and health in Mexico and the United States. We employ the Mexican Health and Aging Study (MHAS) and the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) to explore patterns of association among structural factors, personal characteristics, indicators of material and physical vulnerability, and expressed locus of control. The results suggest that an older individual's sense of personal control over important aspects of his or her life, including health, reflects real material and social resources in addition to individual predispositions. In Mexico, only the most privileged segment of the population has health insurance, and coverage increases one's sense of personal control. In the United States, on the other hand, Medicare guarantees basic coverage to the vast majority of Mexican Americans over 65, reducing its impact on one's sense of control. Psychological characteristics affect older individuals' sense of personal control over aspects of their health, but the effects are mediated by the economic and health services context in which they are expressed.

  18. Modality dependent changes in event-related potentials correlate with specific cognitive functions in nondemented patients with Parkinson's disease.

    Science.gov (United States)

    Bodis-Wollner, I; Borod, J C; Cicero, B; Haywood, C S; Raskin, S; Mylin, L; Sliwinski, M; Falk, A; Yahr, M D

    1995-01-01

    The relationship between event-related potentials (ERPs) and cognitive functioning was studied in patients with Parkinson's Disease (PD) but without dementia. Auditory and visual stimuli were used; 30 subjects participated in the auditory study and 20 in the visual study. Patient groups did not differ with respect to gender, age, education, illness duration, and level of cognitive functioning. Visual stimuli were 2.3 cpd sinusoidal grating patterns randomly presented in an oddball paradigm (oblique vs. vertical spatial orientation). Auditory stimuli were tones presented at 70 dB SPL at a rate of 1.1/second, also using the oddball paradigm (1.5K vs. 1K tones). All patients were given neuropsychological tests to measure verbal fluency, memory, visual spatial perception, and abstract reasoning. P300 and N200 abnormalities correlated with a number of these measures, such that longer ERP latencies were related to lower scores on tests of cognitive functioning. Patterns of results suggest that auditory and visual ERPs correlate with different subsets of neuropsychological functions in nondemented PD patients and that N200 may provide a new metric for clinical use.

  19. Anthropometric, functional capacity, and oxidative stress changes in Brazilian community-living elderly subjects. A longitudinal study.

    Science.gov (United States)

    Moreira, Priscila Lucelia; Correa, Camila Renata; Corrente, José Eduardo; Martin, Luis Cuadrado; Boas, Paulo Jose Fortes Villas; Ferreira, Ana Lucia Anjos

    2016-01-01

    To examine the changes and relationships among anthropometric, functional and plasma oxidative stress markers in elderly. longitudinal study. measurements in 2008 and 2010. 103 community-dwelling men and women aged 67-92. Anthropometric parameters [waist, hip, arm and calf circumferences; waist-hip ratio, triceps skinfold thickness and others], basic (ADL) and instrumental activities of daily living (IADL)] and plasma oxidative stress markers (α-tocopherol, β-carotene and malondialdehyde) were assessed in 2008 and 2010. ADL, IADL, body weight, skinfold thickness and circumferences of calf and arm decreased and waist and waist-hip ratio increased from 2008 to 2010. α-Tocopherol decreased and malondialdehyde plasma levels increased during the study period. In multiple logistic regression analyses, increased age (OR=1.12; IC: 1.02-1.23; p=0.02), female gender (OR=8.43; IC: 1.23-57.58; p=0.03), hypertension (OR=0.22; IC: 0.06-0.79; p=0.02), arthritis/arthrosis (OR=0.09; IC: 0.009-0.87; p=0.04) and depression (OR=0.20; IC: 0.04-1.03; p=0.05) were independent risk factors for functional decline. Fat reduction, muscle loss, central obesity increase, functional decline and worsening of plasma oxidative stress were observed during 2-year follow-up. Some of the risk factors that were identified could be modified to help prevent functional decline in elderly. The factors deserving attention include hypertension, arthritis/arthrosis and depression. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Relationship Between Self-reported Apathy and Executive Dysfunction in Nondemented Patients With Parkinson Disease

    Science.gov (United States)

    Zgaljardic, Dennis J.; Borod, Joan C.; Foldi, Nancy S.; Rocco, Mary; Mattis, Paul J.; Gordon, Mark F.; Feigin, Andrew S.; Eidelberg, David

    2015-01-01

    Objective The prevalence of apathy was assessed across select cognitive and psychiatric variables in 32 nondemented patients with Parkinson disease (PD) and 29 demographically matched healthy control participants. Background Apathy is common in PD, although differentiating apathy from motor, cognitive, and/or other neuropsychiatric symptoms can be challenging. Previous studies have reported a positive relationship between apathy and cognitive impairment, particularly executive dysfunction. Method Patients were categorized according to apathy symptom severity. Stringent criteria were used to exclude patients with dementia. Results Approximately 44% of patients endorsed significant levels of apathy. Those patients performed worse than patients with nonsignificant levels of apathy on select measures of verbal fluency and on a measure of verbal and nonverbal conceptualization. Further, they reported a greater number of symptoms related to depression and behavioral disturbance than did those patients with nonsignificant levels of apathy. Apathy was significantly related to self-report of depression and executive dysfunction. Performance on cognitive tasks assessing verbal fluency, working memory, and verbal abstraction and also on a self-report measure of executive dysfunction was shown to significantly predict increasing levels of apathy. Conclusions Our findings suggest that apathy in nondemented patients with PD seems to be strongly associated with executive dysfunction. PMID:17846518

  1. Subjective well-being amongst community-dwelling elders: what determines satisfaction with life? Findings from the Dublin Healthy Aging Study.

    Science.gov (United States)

    Ní Mhaoláin, Aine M; Gallagher, Damien; O Connell, Henry; Chin, A V; Bruce, Irene; Hamilton, Fiona; Teehee, Erin; Coen, Robert; Coakley, Davis; Cunningham, Conal; Walsh, J B; Lawlor, Brian A

    2012-02-01

    Life satisfaction is a subjective expression of well-being and successful aging. Subjective well-being is a major determinant of health outcomes in older people. The aim of this study was to determine which factors predicted well-being in older people living in the community as measured by their satisfaction with life. The relationship between life satisfaction, as measured by the Life Satisfaction Index (LSI-A) and physical, cognitive and demographic variables was examined in 466 older people living in the community using a stepwise regression model. Depression, loneliness, neuroticism, extraversion, recent participation in physical activity, age and self-reported exhaustion, were the independent predictors of life satisfaction in our elderly cohort. Subjective well-being, as measured by the Life Satisfaction Scale, is predicted by depression, loneliness, personality traits, recent participation in physical activity and self-reported exhaustion. The mental and emotional status of older individuals, as well as their engagement in physical activity, are as important as physical functionality when it comes to life satisfaction as a measure of well-being and successful aging. These areas represent key targets for intervention.

  2. Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee

    NARCIS (Netherlands)

    Hopman-Rock, M.; Odding, E.; Hofman, A.; Kraaimaat, F.W.; Bijlsma, J.W.J.

    1996-01-01

    Objective. To determine physical and psychosocial disability in subjects aged 55 to 74 years living in the community, in relation to pain in the hip and/or knee, and to explore the relationships between pain, physical and psychosocial disability, and selected background variables. Methods. A

  3. Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee

    NARCIS (Netherlands)

    Hopman-Rock, M.; Odding, E.; Hofman, A.; Kraaimaat, F. W.; Bijlsma, J. W.

    1996-01-01

    To determine physical and psychosocial disability in subjects aged 55 to 74 years living in the community, in relation to pain in the hip and/or knee, and to explore the relationships between pain, physical and psychosocial disability, and selected background variables. A subsample from a community

  4. Ambulatory cardiac arrhythmias in relation to mild hypokalaemia and prognosis in community dwelling middle-aged and elderly subjects

    DEFF Research Database (Denmark)

    Mattsson, Nick; Sadjadieh, Golnaz; Kumarathurai, Preman

    2016-01-01

    AIMS: Severe hypokalaemia can aggravate arrhythmia tendency and prognosis, but less is known about risk of mild hypokalaemia, which is a frequent finding. We examined the associations between mild hypokalaemia and ambulatory cardiac arrhythmias and their prognosis. METHODS AND RESULTS: Subjects f...

  5. Changes in cognitive function and brain glucose metabolism in elderly women with subjective memory impairment: a 24-month prospective pilot study.

    Science.gov (United States)

    Jeong, H S; Park, J S; Song, I U; Chung, Y A; Rhie, S J

    2017-01-01

    Subjective memory impairment (SMI) may precede mild cognitive impairment (MCI) stage and would offer an earlier therapeutic opportunity than MCI would. However, it is not clear whether complaints of forgetfulness are truly reflective of objective memory dysfunction or of impairments in other cognitive domains. The aim of this current longitudinal study was to investigate changes in various cognitive functions and in regional cerebral metabolic rate of glucose (rCMRglc) among elderly women with SMI. Clinical evaluation, comprehensive neuropsychological test, and 18 F-fluoro-2-deoxyglucose positron emission tomography scans were conducted on 24 women with SMI at the baseline and 24-month follow-up. Changes in the cognitive domain scores and rCMRglc were assessed, and the relationships between them were analyzed. All participants stayed in SMI all the way till the follow-up, not converted to MCI or dementia. A significant reduction in executive function was found (mean difference in z-score: -0.21, P = 0.02) without changes in other cognitive domains. Declines in rCMRglc were detected in the left superior temporal gyrus, right posterior cingulate gyrus, left parahippocampal gyrus, right lingual gyrus, and right angular gyrus. The change in executive function had a positive correlation with the percent change of rCMRglc in the right posterior cingulate gyrus (β = 0.43, P = 0.02). Our findings suggest that elderly women with SMI symptoms should be carefully monitored for declines in executive function and related brain glucose metabolism over time. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial.

    Science.gov (United States)

    Kamegaya, Tadahiko; Araki, Yumi; Kigure, Hanami; Yamaguchi, Haruyasu

    2014-03-01

    Japan is one of the most rapidly ageing societies in the world. A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals, but the effectiveness of these services is currently insufficient. Our study explored the efficacy of a comprehensive intervention programme consisting of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects. We administered a 12-week intervention programme consisting of physical and leisure activities aimed at enhancing participants' motivation to participate and support one another by providing a pleasant atmosphere, empathetic communication, praise, and errorless support. This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi. All participants underwent the Five-Cog test, which evaluated the cognitive domains of attention, memory, visuospatial function, language, and reasoning. Executive function was evaluated by the Wechsler Digit Symbol Substitution Test and Yamaguchi Kanji-Symbol Substitution Test. Subjective health status, level of social support, functional capacity, subjective quality of life, and depressive symptoms were assessed with a questionnaire. Grip strength test, timed up-and-go test, 5-m maximum walking times test, and functional reach test were performed to evaluate physical function. Fifty-two participants were randomly allocated to intervention (n = 26) and control (n = 26) groups. Twenty-six participants, aged between 65-87 years, received intervention once a week at a community centre. The programme was conducted by health-care professionals, with the help of senior citizen volunteers. The intervention group (n = 19) showed significant improvement on the analogy task of the Five-Cog test (F(1,38) = 4.242, P = 0.046) and improved quality of life (F(1,38) = 4.773, P = 0.035) as compared to the control group (n = 24). A community-based 12-week

  7. Iron, folacin, vitamin B12 and zinc status and immune response in elderly subjects in the Washington D.C. metropolitan area

    International Nuclear Information System (INIS)

    Henry-Christian, J.R.

    1986-01-01

    The iron, folacin, vitamin B 12 , and zinc status of a group of economically and socially disadvantaged elderly persons in the Washington Metropolitan Area was evaluated. Factors related to deficiencies of these nutrients, the relationships between the status of these nutrients and cell-mediated immunity, and the relationships of iron, folacin and vitamin B 12 status to hemoglobin levels in the subjects were also examined. It was also determined whether there were any interactions among iron, folacin, vitamin B 12 and zinc status in their relationships to cell-mediated immunity. Socio-demographic and nutritional data on the subjects were obtained using a questionnaire. Dietary data were obtained using a dietary record. A fasting blood sample was drawn and the levels of ferritin, folate and vitamin B 12 , and the erythrocyte levels of folate were determined by radioassay. Plasma and hair zinc levels were determined by atomic absorption spectrophotometry. Cell-mediated immune response was determined by transformation of peripheral blood lymphocytes after stimulation by mitogens, and by allogenic lymphocytes in the mixed lymphocyte reaction

  8. β-Amyloid binding in elderly subjects with declining or stable episodic memory function measured with PET and [{sup 11}C]AZD2184

    Energy Technology Data Exchange (ETDEWEB)

    Mattsson, Patrik [Karolinska Institutet, Centre for Psychiatry Research, Department of Clinical Neuroscience, Stockholm (Sweden); Karolinska University Hospital, Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatry Research, Stockholm (Sweden); Forsberg, Anton; Halldin, Christer [Karolinska Institutet, Centre for Psychiatry Research, Department of Clinical Neuroscience, Stockholm (Sweden); Persson, Jonas; Nilsson, Lars-Goeran [Karolinska Institute and Stockholm University, Aging Research Center (ARC), Stockholm (Sweden); Nyberg, Lars [Umeaa University, Department of Radiation Sciences (Diagnostic Radiology), Umeaa (Sweden); Farde, Lars [Karolinska Institutet, Centre for Psychiatry Research, Department of Clinical Neuroscience, Stockholm (Sweden); AstraZeneca Translational Science Center at Karolinska Institutet, Stockholm (Sweden)

    2015-09-15

    Cognitive decline has been suggested as an early marker for later onset of Alzheimer's disease. We therefore explored the relationship between decline in episodic memory and β-amyloid using positron emission tomography (PET) and [{sup 11}C]AZD2184, a radioligand with potential to detect low levels of amyloid deposits. Healthy elderly subjects with declining (n = 10) or stable (n = 10) episodic memory over 15 years were recruited from the population-based Betula study and examined with PET. Brain radioactivity was measured after intravenous administration of [{sup 11}C]AZD2184. The binding potential BP{sub ND} was calculated using linear graphical analysis with the cerebellum as reference region. The binding of [{sup 11}C]AZD2184 in total grey matter was generally low in the declining group, whereas some binding could be observed in the stable group. Mean BP{sub ND} was significantly higher in the stable group compared to the declining group (p = 0.019). An observation was that the three subjects with the highest BP{sub ND} were ApoE ε4 allele carriers. We conclude that cognitive decline in the general population does not seem to stand by itself as an early predictor for amyloid deposits. (orig.)

  9. β-Amyloid binding in elderly subjects with declining or stable episodic memory function measured with PET and [11C]AZD2184

    International Nuclear Information System (INIS)

    Mattsson, Patrik; Forsberg, Anton; Halldin, Christer; Persson, Jonas; Nilsson, Lars-Goeran; Nyberg, Lars; Farde, Lars

    2015-01-01

    Cognitive decline has been suggested as an early marker for later onset of Alzheimer's disease. We therefore explored the relationship between decline in episodic memory and β-amyloid using positron emission tomography (PET) and [ 11 C]AZD2184, a radioligand with potential to detect low levels of amyloid deposits. Healthy elderly subjects with declining (n = 10) or stable (n = 10) episodic memory over 15 years were recruited from the population-based Betula study and examined with PET. Brain radioactivity was measured after intravenous administration of [ 11 C]AZD2184. The binding potential BP ND was calculated using linear graphical analysis with the cerebellum as reference region. The binding of [ 11 C]AZD2184 in total grey matter was generally low in the declining group, whereas some binding could be observed in the stable group. Mean BP ND was significantly higher in the stable group compared to the declining group (p = 0.019). An observation was that the three subjects with the highest BP ND were ApoE ε4 allele carriers. We conclude that cognitive decline in the general population does not seem to stand by itself as an early predictor for amyloid deposits. (orig.)

  10. Subjective worsening of memory predicts dementia after three years

    Directory of Open Access Journals (Sweden)

    Anne Brækhus

    2009-10-01

    Full Text Available  ABSTRACTStudy Objective:  Design:  Setting:  Paricipants:  Measurements:  Results:  Conclusions:  Key words:  aged, 75 years and over; subjective memory impairment; prospective study; dementiaElderly persons expressing a worsening of memory function are at increased risk ofdeveloping dementia.When adjusting for potential confounding by depressive symptoms, two of the GMSquestions scored at baseline, 'Is it more difficult to remember things than it used to be?' and 'Do youwrite reminders to yourself more often now than before?', were significant predictors of dementiawithin three years, OR = 3.3, 95% CI = 1.2–8.6 and OR = 2.8, 95% CI = 1.0–7.6, respectively.Dementia (DSM-III and DSM-III-R criteria.285 non-demented persons aged 75 years and above at start of study, 77.5% women.Persons living at home.Prospective study of a random sample of older people with follow-ups after three, six, nineand twelve years.To assess whether complaining of memory impairment, as measured by the subjectivepart of the Geriatric Mental State examination (GMS, the Canberra community version, predictslater development of dementia.

  11. The effects of long-term daily folic acid and vitamin B12 supplementation on genome-wide DNA methylation in elderly subjects.

    Science.gov (United States)

    Kok, Dieuwertje E G; Dhonukshe-Rutten, Rosalie A M; Lute, Carolien; Heil, Sandra G; Uitterlinden, André G; van der Velde, Nathalie; van Meurs, Joyce B J; van Schoor, Natasja M; Hooiveld, Guido J E J; de Groot, Lisette C P G M; Kampman, Ellen; Steegenga, Wilma T

    2015-01-01

    Folate and its synthetic form folic acid function as donor of one-carbon units and have been, together with other B-vitamins, implicated in programming of epigenetic processes such as DNA methylation during early development. To what extent regulation of DNA methylation can be altered via B-vitamins later in life, and how this relates to health and disease, is not exactly known. The aim of this study was to identify effects of long-term supplementation with folic acid and vitamin B12 on genome-wide DNA methylation in elderly subjects. This project was part of a randomized, placebo-controlled trial on effects of supplemental intake of folic acid and vitamin B12 on bone fracture incidence (B-vitamins for the PRevention Of Osteoporotic Fractures (B-PROOF) study). Participants with mildly elevated homocysteine levels, aged 65-75 years, were randomly assigned to take 400 μg folic acid and 500 μg vitamin B12 per day or a placebo during an intervention period of 2 years. DNA was isolated from buffy coats, collected before and after intervention, and genome-wide DNA methylation was determined in 87 participants (n = 44 folic acid/vitamin B12, n = 43 placebo) using the Infinium HumanMethylation450 BeadChip. After intervention with folic acid and vitamin B12, 162 (versus 14 in the placebo group) of the 431,312 positions were differentially methylated as compared to baseline. Comparisons of the DNA methylation changes in the participants receiving folic acid and vitamin B12 versus placebo revealed one single differentially methylated position (cg19380919) with a borderline statistical significance. However, based on the analyses of differentially methylated regions (DMRs) consisting of multiple positions, we identified 6 regions that differed statistically significantly between the intervention and placebo group. Pronounced changes were found for regions in the DIRAS3, ARMC8, and NODAL genes, implicated in carcinogenesis and early embryonic development

  12. Domain-specific cognitive impairment in non-demented Parkinson's disease psychosis.

    Science.gov (United States)

    Hinkle, Jared T; Perepezko, Kate; Bakker, Catherine C; Dawson, Ted M; Johnson, Vanessa; Mari, Zoltan; Marvel, Cherie L; Mills, Kelly A; Pantelyat, Alexander; Pletnikova, Olga; Rosenthal, Liana S; Shepard, Melissa D; Stevens, Daniel A; Troncoso, Juan C; Wang, Jiangxia; Pontone, Gregory M

    2018-01-01

    In Parkinson's disease (PD), psychosis is associated with cognitive impairment that may be more profound in particular cognitive domains. Our goal was to determine whether psychosis in non-demented PD participants is associated with domain-specific cognitive impairment on the Mini-Mental State Exam (MMSE). The Morris K. Udall Parkinson's Disease Research Center of Excellence Longitudinal Study at Johns Hopkins is a prospective study that was initiated in 1998. Clinical assessments are conducted at two-year intervals at the Johns Hopkins Hospital. We analyzed data from 137 enrolled participants with idiopathic PD. Psychosis diagnoses were established by psychiatrist interview per DSM-IV criteria. An incident dementia diagnosis resulted in exclusion from analysis for that evaluation and any future evaluations in that participant. We used logistic regression with generalized estimated equations (GEE) to model the time-varying relationship between MMSE subscale scores and psychosis, adjusting for potential confounding variables identified through univariable analysis. Thirty-one unique psychosis cases were recorded among non-demented participants. Fifty total evaluations with psychosis present were analyzed. In multivariable regressions, psychosis was associated with lower scores on the orientation (relative odds ratio, rOR: 0.73; 95% CI: 0.58-0.93; p = 0.011), language (rOR: 0.64; 95% CI: 0.48-0.86; p = 0.003), and intersecting pentagon (rOR: 0.43; 95% CI: 0.20-0.92 p = 0.030) subscales of the MMSE. In PD, executive dysfunction, disorientation, and impaired language comprehension may be associated with psychosis. Our findings suggest that the corresponding MMSE subscales may be useful in identifying participants with a higher likelihood of developing psychosis. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Are non-demented patients with Parkinson's disease able to decide about their own treatment?

    Science.gov (United States)

    Eygelshoven, Sandra; van den Hout, Anja; Tucha, Lara; Fuermaier, Anselm B M; Bangma, Dorien F; Thome, Johannes; Lobbestael, Jill; Tucha, Oliver; Koerts, Janneke

    2017-05-01

    Patients with Parkinson's disease (PD) are often confronted with difficult medical decisions, which might be hampered by cognitive impairment or chronic stress. Little is known, however, about the capacity to make medical decisions and the influence of cognition and stress on this ability. This study determined whether non-demented Parkinson's disease patients are able to make medical decisions and whether this capacity is influenced by cognition and stress. Forty-six Parkinson's disease patients and 94 healthy controls were assessed with the MacArthur Competence Assessment Tool for Treatment during which participants were presented with deep brain stimulation as a treatment option for a fictional Parkinson's disease patient. Furthermore, all participants were examined with a stress questionnaire and a neuropsychological test battery. Parkinson's disease patients performed better on the total scale and 'Understanding' subscale of the MacArthur Competence Assessment Tool for Treatment than healthy controls. Lower performance on the Concept Shifting Test in the Parkinson's disease group and lower performance on Letter Digit Substitution Test in the healthy control group predicted lower medical decision-making capacity. No association was found between stress and medical decision-making. Non-demented Parkinson's disease patients show no impairments in medical decision-making compared to healthy controls. In fact, Parkinson's disease patients have a better understanding of their disease and the benefits and risks of treatment options than healthy controls. Psychomotor speed and attention were negatively associated with medical decision-making in both groups. This implies that when these cognitive functions decline, the capacity to make medical decisions also declines. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Relationship between number of metabolic syndrome components and dietary factors in middle-aged and elderly Japanese subjects.

    Science.gov (United States)

    Otsuka, Rei; Imai, Tomoko; Kato, Yuki; Ando, Fujiko; Shimokata, Hiroshi

    2010-06-01

    Metabolic syndrome (MetS) represents a cluster of risk factors for atherosclerosis and is considered a risk factor for cardiovascular disease. The role of diet in the etiology of MetS is poorly understood, especially among Asian subjects. This cross-sectional study assessed the relationship between diet and the number of MetS components among Japanese men (n=609) and women (n=631). Mean (s.d.) age and body mass index were 57.1 (12.1) years and 22.8 (2.8) kg m(-2) for men and 55.5 (12.0) years and 22.0 (3.0) kg m(-2) for women, respectively. Diet was assessed by a 3-day dietary record that included photographs: 16 nutrients, 11 food groups, and energy % of protein and dietary fat were selected as a dietary index. The definition of MetS was based on modified National Cholesterol Education Program, Adult Treatment Panel III criteria, and the number of clustering MetS components was calculated by adding the presence of each five MetS components. A total of 61 men (10.0%) and 46 women (7.3%) were determined to have MetS. After adjusting for age, energy intake, alcohol intake, smoking status and physical activity, a lower intake of vitamin B6 and dietary fiber in men, and lower intake of calcium, milk and dairy products and higher intake of cereal in women were related to the number of MetS components. These results suggest that some dietary factors were related to the number of MetS components among community-dwelling Japanese men and women.

  15. Asymmetry in auditory and spatial attention span in normal elderly genetically at risk for Alzheimer's disease.

    Science.gov (United States)

    Jacobson, Mark W; Delis, Dean C; Bondi, Mark W; Salmon, David P

    2005-02-01

    Some studies of elderly individuals with the ApoE-e4 genotype noted subtle deficits on tests of attention such as the WAIS-R Digit Span subtest, but these findings have not been consistently reported. One possible explanation for the inconsistent results could be the presence of subgroups of e4+ individuals with asymmetric cognitive profiles (i.e., significant discrepancies between verbal and visuospatial skills). Comparing genotype groups with individual, modality-specific tests might obscure subtle differences between verbal and visuospatial attention in these asymmetric subgroups. In this study, we administered the WAIS-R Digit Span and WMS-R Visual Memory Span subtests to 21 nondemented elderly e4+ individuals and 21 elderly e4- individuals matched on age, education, and overall cognitive ability. We hypothesized that a) the e4+ group would show a higher incidence of asymmetric cognitive profiles when comparing Digit Span/Visual Memory Span performance relative to the e4- group; and (b) an analysis of individual test performance would fail to reveal differences between the two subject groups. Although the groups' performances were comparable on the individual attention span tests, the e4+ group showed a significantly larger discrepancy between digit span and spatial span scores compared to the e4- group. These findings suggest that contrast measures of modality-specific attentional skills may be more sensitive to subtle group differences in at-risk groups, even when the groups do not differ on individual comparisons of standardized test means. The increased discrepancy between verbal and visuospatial attention may reflect the presence of "subgroups" within the ApoE-e4 group that are qualitatively similar to asymmetric subgroups commonly associated with the earliest stages of AD.

  16. Association between dietary phylloquinone intake and peripheral metabolic risk markers related to insulin resistance and diabetes in elderly subjects at high cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Juanola-Falgarona Martí

    2013-01-01

    Full Text Available Abstract Background Vitamin K has been related to glucose metabolism, insulin sensitivity and diabetes. Because inflammation underlies all these metabolic conditions, it is plausible that the potential role of vitamin K in glucose metabolism occurs through the modulation of cytokines and related molecules. The purpose of the study was to assess the associations between dietary intake of vitamin K and peripheral adipokines and other metabolic risk markers related to insulin resistance and type 2 diabetes mellitus. Methods Cross-sectional and longitudinal assessments of these associations in 510 elderly participants recruited in the PREDIMED centers of Reus and Barcelona (Spain. We determined 1-year changes in dietary phylloquinone intake estimated by food frequency questionnaires, serum inflammatory cytokines and other metabolic risk markers. Results In the cross-sectional analysis at baseline no significant associations were found between dietary phylloquinone intake and the rest of metabolic risk markers evaluated, with exception of a negative association with plasminogen activator inhibitor-1. After 1-year of follow-up, subjects in the upper tertile of changes in dietary phylloquinone intake showed a greater reduction in ghrelin (−15.0%, glucose-dependent insulinotropic peptide (−12.9%, glucagon-like peptide-1 (−17.6%, IL-6 (−27.9%, leptin (−10.3%, TNF (−26.9% and visfatin (−24.9% plasma concentrations than those in the lowest tertile (all p Conclusion These results show that dietary phylloquinone intake is associated with an improvement of cytokines and other markers related to insulin resistance and diabetes, thus extending the potential protection by dietary phylloquinone on chronic inflammatory diseases. Trial registration http://www.controlled-trials.com as ISRCTN35739639

  17. Apathy and striatal dopamine defects in non-demented patients with Parkinson's disease.

    Science.gov (United States)

    Chung, Su Jin; Lee, Jae Jung; Ham, Jee Hyun; Lee, Phil Hyu; Sohn, Young H

    2016-02-01

    Apathy is a common, disabling symptom in Parkinson's disease (PD). The mechanisms underlying apathy in PD are still unclear, although they may be related to dysfunction in the meso-cortico-limbic circuit, including the ventral striatum. Thus, we performed this study to investigate whether dopamine depletion in the ventral striatum contributes to apathy in PD. We conducted a survey of the degree of apathy (using the Korean version of the Apathy Evaluation Scale, AES-S) in 108 non-demented patients with PD who underwent dopamine transporter (DAT) positron emission tomography scans as an initial diagnostic work-up. Patients with AES-S scores of 37 or higher were defined as having apathetic PD. The Beck Depression Inventory (BDI) was administered to assess the severity of depression. Patients with BDI scores of 15 or higher were regarded as having depression. Apathetic patients (n = 34) tended to exhibit higher BDI scores than non-apathetic patients (n = 74); however, other clinical variables were comparable between the two groups. DAT activity in the striatal sub-regions was also similar between the two groups. Selecting only non-depressed patients, including 20 apathetic and 47 non-apathetic patients, did not alter the results. This study demonstrated that the pattern of striatal dopamine depletion does not contribute to the degree of apathy in early PD. Apathy in PD may be associated with extra-striatal lesions that accompany PD rather than striatal dopaminergic deficits. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Advantages and disadvantages of using the PRISMA7 to determine the elderly subjects for whom the SMAF is useful for assessing functional status in Bobo-Dioulasso (Burkina Faso).

    Science.gov (United States)

    Berthé, A; Somda, M A S; Berthé-Sanou, L; Konaté, B; Hien, H; Bayala, E; Tou, F; Drabo, M; Badini-Kinda, F; Macq, J

    2017-02-01

    One of the difficulties faced by African actors working with the elderly is the lack of appropriate tools for the identification and/or diagnosis of functional disabilities among older people in this limited-resource (material, human, and financial) setting. This study sought to assess the advantages and disadvantages of the combined use of two tools, PRISMA7 (for identifying older individuals at risk of functional disabilities and loss of autonomy) and SMAF (to evaluate the functional status of the elderly) in Bobo-Dioulasso (Burkina Faso). PRISMA7 and SMAF were administered to a representative sample of elderly people who lived at home. Data analysis was performed with Stata. The results show that the combination of PRISMA7 and SMAF made it possible to avoid unncessary administration of the SMAF to all subjects, reducing the number of questionnaires to photocopy by 48 % and the working time by 45 %. The prevalence of moderate to severe functional disabilities was 32 % according to the SMAF alone and 25 % when PRISMA7 was administered first and determined whether the SMAF would be used. The 7 % rate of loss to follow-up shows a need for monitoring or help, generally in instrumental activities. In a limited-resource setting, this combination is a good strategy for identifying and evaluating functional disabilities in the elderly. This strategy allows the development of work plans tailored to individual functional needs.

  19. SORL1 rs1699102 polymorphism modulates age-related cognitive decline and gray matter volume reduction in non-demented individuals.

    Science.gov (United States)

    Li, He; Lv, Chenlong; Yang, Caishui; Wei, Dongfeng; Chen, Kewei; Li, Shaowu; Zhang, Zhanjun

    2017-01-01

    SORL1 rs1699102 is associated with the risk of late-onset Alzheimer's disease. However, the effects of this single nucleotide polymorphism on cognition and brain structure during normal aging are unclear. This study aimed to examine the effects of the rs1699102 polymorphism on age-related cognitive decline and cortical gray matter reduction in the Chinese Han population. A total of 780 non-demented adults completed a battery of neuropsychological tests. High-resolution T1-weighted structural magnetic resonance imaging data from 89 of these subjects were also collected using a Siemens Trio 3.0 Tesla scanner. The T allele carriers displayed an accelerated age-related change in episodic memory and processing speed tests relative to the CC genotype. A similar pattern was observed in the age-related gray matter volume (GMV) reduction of the right middle temporal pole. The GMV in this region was significantly positively correlated with the episodic memory scores. The SORL1 gene rs1699102 polymorphism has been found to be associated with age-related cognitive decline and GMV reduction of the right middle temporal pole in older adults. These findings elucidate how the SORL1 variants shape the neural system to modulate age-related cognitive decline and support the hypothesis that SORL1 may represent a candidate gene for late-onset Alzheimer's disease. © 2016 EAN.

  20. Bright light in elderly subjects with nonseasonal major depressive disorder: a double blind randomised clinical trial using early morning bright blue light comparing dim red light treatment

    NARCIS (Netherlands)

    Lieverse, R.; Nielen, M.M.J.; Veltman, D.J.; Uitdehaag, B.M.J.; van Someren, E.J.W.; Smit, J.H.; Hoogendijk, W.J.G.

    2008-01-01

    Background: Depression frequently occurs in the elderly. Its cause is largely unknown, but several studies point to disturbances of biological rhythmicity. In both normal aging, and depression, the functioning of the suprachiasmatic nucleus (SCN) is impaired, as evidenced by an increased prevalence

  1. Training-induced changes in muscle CSA,muscle strength, EMG and rate of force development in elderly subjects after long-term unilateral disuse

    DEFF Research Database (Denmark)

    Suetta, Charlotte; Aagaard, Per; Rosted, Anne

    2004-01-01

    The ability to develop muscle force rapidly may be a very important factor to prevent a fall and to perform other tasks of daily life. However, information is still lacking on the range of training-induced neuromuscular adaptations in elderly humans recovering from a period of disuse. Therefore, ...

  2. Usual gait speed assessment in middle-aged and elderly Brazilian subjects Velocidade usual da marcha em brasileiros de meia idade e idosos

    Directory of Open Access Journals (Sweden)

    Rômulo D. Novaes

    2011-04-01

    Full Text Available OBJECTIVES: To evaluate the usual gait speed of asymptomatic adult and elderly Brazilians with a 10-meter walk test and to compare the results with foreign reference values. METHODS: Seventy-nine asymptomatic volunteers >40 years old of both genders were assessed. After anamnesis, anthropometry and the application of a habitual physical activity questionnaire, the volunteers were submitted to a 10-meter walk test at usual speed by means of which gait speed, the number of steps and length of stride were calculated. RESULTS: Except for age, all study variables were significantly lower in women. Subjects >70 years old presented a significantly lower gait speed than subjects between 40 and 49 years old and between 50 and 59 in both men (1.09±0.18 m/s, 1.35±0.11 m/s and 1.34±0.22 m/s, respectively and women (1.02±0,10 m/s, 1.27±0.20 m/s and 1.27±0,15 m/s, respectively. Gait speed showed moderate correlations with age (r=-0.41, pOBJETIVOS: Avaliar a velocidade usual da marcha (VM por meio de teste de caminhada de 10 m (TC10m em adultos e idosos assintomáticos brasileiros e compará-la com os valores de referência estrangeiros. MÉTODOS: Setenta e nove voluntários assintomáticos com idade >40 anos, de ambos os gêneros, foram avaliados. Após anamnese, antropometria e questionário de atividade física habitual, os voluntários foram submetidos ao TC10m em velocidade usual. Por meio do tempo de teste, a VM, o número e comprimento dos passos e das passadas foram calculados. RESULTADOS: Com exceção da idade, todas as variáveis estudadas foram significativamente inferiores para as mulheres. Os indivíduos com idade >70 anos apresentaram VM significativamente inferior aos indivíduos entre 40 e 49 anos e entre 50 e 59 anos nos homens (1,09±0,18 m/s, 1,35±0,11 m/s e 1,34±0,22 m/s, respectivamente e nas mulheres (1,02±0,10 m/s, 1,27±0,20 m/s e 1,27±0,15 m/s, respectivamente. A VM apresentou correlações moderadas com a idade (r=-0,41, p

  3. Vascular and amyloid pathologies are independent predictors of cognitive decline in normal elderly.

    Science.gov (United States)

    Vemuri, Prashanthi; Lesnick, Timothy G; Przybelski, Scott A; Knopman, David S; Preboske, Greg M; Kantarci, Kejal; Raman, Mekala R; Machulda, Mary M; Mielke, Michelle M; Lowe, Val J; Senjem, Matthew L; Gunter, Jeffrey L; Rocca, Walter A; Roberts, Rosebud O; Petersen, Ronald C; Jack, Clifford R

    2015-03-01

    Our primary objective was to investigate a biomarker driven model for the interrelationships between vascular disease pathology, amyloid pathology, and longitudinal cognitive decline in cognitively normal elderly subjects between 70 and 90 years of age. Our secondary objective was to investigate the beneficial effect of cognitive reserve on these interrelationships. We used brain amyloid-β load measured using Pittsburgh compound B positron emission tomography as a marker for amyloid pathology. White matter hyperintensities and brain infarcts were measured using fluid-attenuated inversion recovery magnetic resonance imaging as a marker for vascular pathology. We studied 393 cognitively normal elderly participants in the population-based Mayo Clinic Study of Aging who had a baseline 3 T fluid-attenuated inversion recovery magnetic resonance imaging assessment, Pittsburgh compound B positron emission tomography scan, baseline cognitive assessment, lifestyle measures, and at least one additional clinical follow-up. We classified subjects as being on the amyloid pathway if they had a global cortical amyloid-β load of ≥1.5 standard uptake value ratio and those on the vascular pathway if they had a brain infarct and/or white matter hyperintensities load ≥1.11% of total intracranial volume (which corresponds to the top 25% of white matter hyperintensities in an independent non-demented sample). We used a global cognitive z-score as a measure of cognition. We found no evidence that the presence or absence of vascular pathology influenced the presence or absence of amyloid pathology and vice versa, suggesting that the two processes seem to be independent. Baseline cognitive performance was lower in older individuals, in males, those with lower education/occupation, and those on the amyloid pathway. The rate of cognitive decline was higher in older individuals (P pathologies. In those subjects with both vascular and amyloid pathologies, the effect of both pathologies on

  4. Interferência mútua entre atividade visual e atividade motora em jovens e idosos Mutual interference between a visual and a motor task in young and elderly subjects

    Directory of Open Access Journals (Sweden)

    Patrícia Pereira dos Santos Teixeira

    2008-01-01

    Full Text Available Como o envelhecimento provoca dificuldade na capacidade de dividir a atenção, este estudo visou verificar, em jovens e idosos: (1 a eventual interferência entre uma tarefa visual e uma motora; (2 se essa interferência (caso exista ocorre de forma diferente no desempenho de jovens e idosos; (3 se as tarefas propostas têm correlação com testes validados, de seqüência alfanumérica (TMT e de levantar e caminhar cronometrado (TLCC. A tarefa visual consistiu na verbalização do reconhecimento de duas figuras iguais ou diferentes apresentadas rapidamente. A tarefa motora consistiu na alternância de passos do chão a uma plataforma fixa de 10 cm de altura. As tarefas foram avaliadas isoladas (tarefa-simples e associadas (tarefa-dupla em dois grupos: 10 jovens (23±2,8 anos e 10 idosos (68,8±8,6 anos. Na tarefa visual, os jovens fizeram menos erros que os idosos (pSince aging brings about difficulty in dividing attention, this study aimed at verifying, in youth and aged: (1 the possible interference between a visual and a motor task; (2 whether such interference varies between young and elderly subjects; (3 whether there is correlation between the proposed tasks and the trail making test (TMT and the timed up-and-go test (TUGT. The visual task measured the ability to state whether two quickly presented figures were same or different. The motor task consisted on alternating steps from the ground to a 10 cm-high platform. Tasks were assessed both as single-task (isolated and dual-task (simultaneous in two groups: 10 young people (aged 23±2.8 and 10 elderly (aged 68.8±8.6. In the visual task, young volunteers presented less errors than the elderly (p<0.001; in both groups no increase in the number of errors was detected at dual-task when compared to the single-task. At the motor task the elderly presented lower speed in dual-task as compared to the single-task (p=0.009. TMT correlated positively to the number of alternations of step (p<0

  5. Sintomas de estresse e estratégias de coping em idosos saudáveis Síntomas de estrés y estrategias de coping en ancianos saludables Stress symptoms and coping strategies in healthy elderly subjects

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    Juliana Nery de Souza Talarico

    2009-12-01

    enfocado en la emoción están asociados a niveles semejantes de estrés.Elderly subjects may present stress symptoms due to physical, psychological and social changes during aging process. The aim of this study was to identify stress symptoms in elderly subjects and the coping strategies they used, verifying the relationship between these variables. The Stress Symptoms List (SSL and the Jalowiec Coping Scale were administered to 41 healthy elderly subjects. Elderly subjects presented stress symptoms with a mean score of 42.8. Although problem-focused coping was predominantly observed, no significant difference was observed between mean SSL scores among elderly subjects who used problem-focused or emotion-focused coping. Although elderly subjects mainly elected problem-focused coping, stress intensity was independent of the coping style, showing that both problem- and emotion-focused coping are associated with similar stress levels.

  6. Low episodic memory performance in cognitively normal elderly subjects is associated with increased posterior cingulate gray matter N-acetylaspartate: a 1H MRSI study at 7 Tesla.

    Science.gov (United States)

    Schreiner, Simon J; Kirchner, Thomas; Wyss, Michael; Van Bergen, Jiri M G; Quevenco, Frances C; Steininger, Stefanie C; Griffith, Erica Y; Meier, Irene; Michels, Lars; Gietl, Anton F; Leh, Sandra E; Brickman, Adam M; Hock, Christoph; Nitsch, Roger M; Pruessmann, Klaas P; Henning, Anke; Unschuld, Paul G

    2016-12-01

    Low episodic memory performance characterizes elderly subjects at increased risk for Alzheimer's disease (AD) and may reflect neuronal dysfunction within the posterior cingulate cortex and precuneus (PCP) region. To investigate a potential association between cerebral neurometabolism and low episodic memory in the absence of cognitive impairment, tissue-specific magnetic resonance spectroscopic imaging at ultrahigh field strength of 7 Tesla was used to investigate the PCP region in a healthy elderly study population (n = 30, age 70 ± 5.7 years, Mini-Mental State Examination 29.4 ± 4.1). The Verbal Learning and Memory Test (VLMT) was administered as part of a neuropsychological battery for assessment of episodic memory performance. Significant differences between PCP gray and white matter could be observed for glutamate-glutamine (p = 0.001), choline (p = 0.01), and myo-inositol (p = 0.02). Low Verbal Learning and Memory Test performance was associated with high N-acetylaspartate in PCP gray matter (p = 0.01) but not in PCP white matter. Our data suggest that subtle decreases in episodic memory performance in the elderly may be associated with increased levels of N-acetylaspartate as a reflection of increased mitochondrial energy capacity in PCP gray matter. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. EFFECTS OF TAI CHI EXERCIE ON ATTENTION IN HEALTHY ELDERLY SUBJECTS AS MEASURED BY NEAR-INFRARED SPECTROSCOPY DURING THE STROOP TASK

    OpenAIRE

    Wang, Wenchao; Qiu, Chen; Ota, Toyosaku; Sawada, Masayuki; Kishimoto, Naoko; Kishimoto, Toshifumi

    2013-01-01

    Background: To our knowledge,there is no study that has examined the effect of Tai Chi exercise(Tai Chi) on attention function using functional brain imaging methodologies. Recent developments in near-infrared spectroscopy(NIRS) have enabled non-invasive clarification of brain functions by measurement of hemoglobin concentrations as cerebral blood volume. So, in the present study, we examined the effects of Tai Chi in the healthy elderly as measured by NIRS during the Stroop task. Methods: Tw...

  8. Subsyndromal delirium compared with delirium, dementia, and subjects without delirium or dementia in elderly general hospital admissions and nursing home residents

    OpenAIRE

    Sepulveda, Esteban; Leonard, Maeve; Franco, Jose G.; Adamis, Dimitrios; McCarthy, Geraldine; Dunne, Colum; Trzepacz, Paula T.; Gaviria, Ana M.; de Pablo, Joan; Vilella, Elisabet; Meagher, David J.

    2016-01-01

    Introduction Subsyndromal delirium (SSD) complicates diagnosis of delirium and dementia, although there is little research comparing their symptom profiles. Methods Cross-sectional study of 400 elderly patients' admission to a general hospital or nursing home diagnosed with delirium, SSD, dementia, or no-delirium/no-dementia (NDND). Symptom profiles were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). Results Twenty percent patients had delirium, 19.3% had SSD, 29.8% had dement...

  9. Elderly Suicide

    Science.gov (United States)

    Elderly Suicide Fact Sheet Based on 2012 Data (2014) Overview • The elderly (ages 65 and older) made up 13. ... population; they accounted for 16.37% of all suicides in the US. • The rate of suicides for ...

  10. Medical Complications Predict Cognitive Decline in Nondemented Hip Fracture Patients-Results of a Prospective Observational Study.

    Science.gov (United States)

    Hack, Juliana; Eschbach, Daphne; Aigner, Rene; Oberkircher, Ludwig; Ruchholtz, Steffen; Bliemel, Christopher; Buecking, Benjamin

    2018-03-01

    The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.

  11. [Subjective hardship and training by female staff working in direct contact with the elderly in nursing homes: a cross-sectional study].

    Science.gov (United States)

    Pélissier, Carole; Fontana, Luc; Fort, Emmanuel; Charbotel, Barbara

    2015-12-01

    To describe training given and training desired and to assess the relation between training and perceived hard working conditions as experienced by female staff working in direct contact with the elderly in nursing homes. A transverse descriptive study was conducted with the involvement of 78 occupational physicians, and included staff in 105 nursing homes in the Rhône-Alpes Region of France. Data on training received during the previous 5 years and on training needs were collected from staff by self-administered questionnaire. 1,446 nursing assistants, 667 housekeepers and 348 nurses were included. The most frequent form of training during the previous 5 years was in handling. Staff most frequently desired training in palliative care and psychological approaches to residents. Part-time workers had less frequently had training during the previous 5 years. Staff with daytime hours significantly more often had training in the reception of and activities for the elderly and in hygiene than did night-staff. Almost half of respondents reported very hard working conditions related to physical handling of residents or to the physical deterioration of elderly persons. More than two-thirds reported very hard working conditions related to death. In all occupational categories, respondents who had had training in palliative care less often reported experiencing very hard working conditions related to death. Better adaptation of the training offer to the needs expressed by employees could improve the experience of working conditions in nursing homes. A longitudinal study could assess the impact of training in palliative care on reported hard working conditions related to death.

  12. Vivências de idosos submetidos à prostatectomia por câncer: subsídios para o cuidado de enfermagem = Experiences of elderly people subjected to prostatectomy for cancer: subsidies for the care of nursing

    Directory of Open Access Journals (Sweden)

    Stumm, Eniva Miladi Fernandes et al.

    2010-01-01

    Full Text Available O câncer de próstata é o mais incidente na terceira idade. A pesquisa busca apreender vivências de idosos submetidos à prostatectomia por câncer e mecanismos de enfrentamento utilizados para lidar com a situação. É qualitativa, descritiva, com 14 idosos residentes no município de Três Passos – RS. Os instrumentos de coleta de dados foram as observações em diário de campo e a entrevista semiestruturada. Da análise do conteúdo imerso nas falas dos idosos, emergiu uma categoria analítica – o idoso vivenciando e enfrentando o processo de adoecimento por câncer de próstata, subdividida em quatro temas: o conhecimento do diagnóstico de câncer; a aceitação das modalidades de tratamento propostas; a vivência de complicações cirúrgicas e da radioterapia; as estratégias utilizadas pelos idosos para lidar com o câncer. Os resultados desta pesquisa podem contribuir com profissionais, pesquisadores, estudantes da área da saúde, no sentido de refletir e de qualificar a assistência ao idoso com câncer de próstata. Prostate cancer is most incident in the third age. The research searches to learn through the experience of people subjected to prostatectomy due to cancer and mechanisms to deal with the situation. Descriptive is qualitatively, with 14 elderly resident in the city of Três Passos/RS. The data collection instruments were field journaling observation and semi structured interview. Through the analysis of the content immersed in the interview of the elderly emerged an analytical category: The elderly experiencing and addressing the process of getting sick by prostate cancer, subdivided into four themes: knowledge of cancer diagnosis; the acceptance of the proposed treatment modalities; surgical experience complications and radiotherapy. The strategies used by elderly for dealing with cancer. The results of this research can contribute with professionals, researchers, healthcare students in order to reflect and

  13. Lower-but-normal serum TSH level is associated with the development or progression of cognitive impairment in elderly: Korean Longitudinal Study on Health and Aging (KLoSHA).

    Science.gov (United States)

    Moon, Jae Hoon; Park, Young Joo; Kim, Tae Hui; Han, Ji Won; Choi, Sung Hee; Lim, Soo; Park, Do Joon; Kim, Ki Woong; Jang, Hak Chul

    2014-02-01

    The association between subclinical hyperthyroidism and the risk of dementia has been validated in several studies. However, the effect of thyroid function within reference range on the risk of cognitive dysfunction including mild cognitive impairment (MCI) and dementia is still unclear. Our aim was to investigate the association between thyroid function and the risk of MCI and dementia in euthyroid elderly subjects. We conducted a population-based prospective study as a part of the Korean Longitudinal Study on Health and Aging. A total of 313 participants who were euthyroid and nondemented at baseline and completed cognitive function tests at a 5-year follow-up evaluation (mean age 72.5 ± 6.9 y) were analyzed in the present study. Baseline thyroid function was compared according to the development of MCI or dementia during the study period. Binary logistic regression analysis was performed to investigate the independent association between thyroid function and cognitive impairment. At baseline evaluation, 237 subjects were cognitively normal, and 76 subjects had MCI. Diagnoses of cognitive function in 259 subjects remained unchanged or improved during the study period (nonprogression group), whereas 54 subjects showed progression of cognitive impairment to MCI or dementia (progression group). In the progression group, baseline serum TSH levels were lower than those in nonprogression group. Baseline serum free T₄ levels were not significantly different between these two groups. The association between lower baseline serum TSH levels and the development of MCI or dementia was maintained after adjustment for conventional baseline risk factors. Lower serum TSH level within the reference range was independently associated with the risk of cognitive impairment including MCI and dementia in elderly subjects.

  14. Poor trail making test performance is directly associated with altered dual task prioritization in the elderly--baseline results from the TREND study.

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    Markus A Hobert

    Full Text Available BACKGROUND: Deterioration of executive functions in the elderly has been associated with impairments in walking performance. This may be caused by limited cognitive flexibility and working memory, but could also be caused by altered prioritization of simultaneously performed tasks. To disentangle these options we investigated the associations between Trail Making Test performance--which specifically measures cognitive flexibility and working memory--and dual task costs, a measure of prioritization. METHODOLOGY AND PRINCIPAL FINDINGS: Out of the TREND study (Tuebinger evaluation of Risk factors for Early detection of Neurodegenerative Disorders, 686 neurodegeneratively healthy, non-demented elderly aged 50 to 80 years were classified according to their Trail Making Test performance (delta TMT; TMT-B minus TMT-A. The subjects performed 20 m walks with habitual and maximum speed. Dual tasking performance was tested with walking at maximum speed, in combination with checking boxes on a clipboard, and subtracting serial 7 s at maximum speeds. As expected, the poor TMT group performed worse when subtracting serial 7 s under single and dual task conditions, and they walked more slowly when simultaneously subtracting serial 7 s, compared to the good TMT performers. In the walking when subtracting serial 7 s condition but not in the other 3 conditions, dual task costs were higher in the poor TMT performers (median 20%; range -6 to 58% compared to the good performers (17%; -16 to 43%; p<0.001. To the contrary, the proportion of the poor TMT performance group that made calculation errors under the dual tasking situation was lower than under the single task situation, but higher in the good TMT performance group (poor performers, -1.6%; good performers, +3%; p = 0.035. CONCLUSION: Under most challenging conditions, the elderly with poor TMT performance prioritize the cognitive task at the expense of walking velocity. This indicates that poor cognitive

  15. Inverse relationship between body mass index and mortality in older nursing home residents: a meta-analysis of 19,538 elderly subjects

    DEFF Research Database (Denmark)

    Veronese, Nicola; Cereda, E; Solmi, M

    2015-01-01

    Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS sea......Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic Pub...... by random-effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow-up were meta-analysed. Compared with normal weight, all-cause mortality HRs were 1.41 (95% CI = 1.26-1.58) for underweight, 0...... and obese than in normal-weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting....

  16. Subjective and psychological well-being of students of a University of the Third Age: Benefits of continuing education for psychological adjustment in the elderly

    Science.gov (United States)

    Ordonez, Tiago Nascimento; Lima-Silva, Thaís Bento; Cachioni, Meire

    2011-01-01

    Objectives The present study sought to characterize the degree of general satisfaction with life and degree of satisfaction on four domains: health, physical capacity, mental capacity and social involvement, and to determine the characteristics of self-reports of individuals enrolled on the program in relation to their psychological well-being focusing on the dimensions: autonomy, personal growth, control, positive relationships with others, purpose, personal acceptance and generativity, and to analyse the effect of time studying on level of well-being. Method A total of 140 elderly students of a University for the Third Age took part in the study. The Global Satisfaction With Life Scale and the Self Development Scale (with six psychological well-being subscales) were applied. Continuous variables for the two groups were compared using the Mann-Whitney test. Spearman’s correlation coefficient was used to analyze the relationship among numeric variables. Internal consistency of the instrument scales was analysed by calculating Cronbach’s alpha coefficient. Results Results showed that students who had attended the University of the Third Age for six months or longer had a higher level of satisfaction with life and greater psychological adjustment compared with new entrants to the same institution. Conclusion The study results confirmed the positive effects of continuing education on the well-being of elderly and its contribution to successful aging. PMID:29213747

  17. Benefits in cognitive function, blood pressure, and insulin resistance through cocoa flavanol consumption in elderly subjects with mild cognitive impairment: the Cocoa, Cognition, and Aging (CoCoA) study.

    Science.gov (United States)

    Desideri, Giovambattista; Kwik-Uribe, Catherine; Grassi, Davide; Necozione, Stefano; Ghiadoni, Lorenzo; Mastroiacovo, Daniela; Raffaele, Angelo; Ferri, Livia; Bocale, Raffaella; Lechiara, Maria Carmela; Marini, Carmine; Ferri, Claudio

    2012-09-01

    Flavanol consumption is favorably associated with cognitive function. We tested the hypothesis that dietary flavanols might improve cognitive function in subjects with mild cognitive impairment. We conducted a double-blind, parallel arm study in 90 elderly individuals with mild cognitive impairment randomized to consume once daily for 8 weeks a drink containing ≈990 mg (high flavanols), ≈520 mg (intermediate flavanols), or ≈45 mg (low flavanols) of cocoa flavanols per day. Cognitive function was assessed by Mini Mental State Examination, Trail Making Test A and B, and verbal fluency test. At the end of the follow-up period, Mini Mental State Examination was similar in the 3 treatment groups (P=0.13). The time required to complete Trail Making Test A and Trail Making Test B was significantly (Ptest score was significantly (Pelderly subjects with mild cognitive impairment. This effect appears mediated in part by an improvement in insulin sensitivity.

  18. Aspectos clínicos e funcionais do equilíbrio corporal em idosos com vertigem posicional paroxística benigna Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Daniela Patricia Vaz

    2013-04-01

    Full Text Available Vertigem Posicional Paroxística Benigna (VPPB pode alterar o equilíbrio corporal em pacientes idosos. OBJETIVO: Observar os efeitos da manobra de Epley em idosos com VPPB, avaliando os aspectos clínicos e funcionais do equilíbrio corporal. Forma de estudo: clínico e prospectivo. MÉTODO: Após o diagnóstico da doença (teste de DixHallpike, os testes Time Up and Go (TUGT, Clinical test of Sensory Interaction and Balance (CTSIB e o teste de membros inferiores (MMI foram realizados antes e após a manobra de reposicionamento de Epley modificada. RESULTADOS: O gênero feminino foi o mais prevalente e a média etária foi de 70,10 anos (DP = 7,00. Todos os pacientes apresentaram ductolitíase de canal posterior. Os seguintes sintomas melhoraram após a manobra: a instabilidade postural (p = 0,006, náusea e vômito (p = 0,021 e zumbido (p = 0,003. Em relação ao TUGT e o escore do teste de MMII, observou-se diminuição significante do tempo pós-manobra de Epley (p Benign paroxysmal positional vertigo (BPPV may compromise the balance of elderly subjects. OBJECTIVE: To observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance. METHOD: This is a prospective clinical study. Patients diagnosed with BPPV (Dix-Hallpike test were submitted to the Timed Up & Go (TUG test, the Clinical Test of Sensory Interaction and Balance (CTSIB, and lower limb testing before and after they were repositioned using the modified Epley maneuver. RESULTS: Most subjects were females, and the group's mean age was 70.10 years (SD = 7.00. All patients had canalithiasis of the posterior canal. The following symptoms improved after the maneuver: postural instability (p = 0.006, nausea and vomiting (p = 0.021, and tinnitus (p = 0.003. Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver (p < 0.001. Patients performed better on the CTSIB after the Epley

  19. Bone quantitative ultrasound measurements in relation to the metabolic syndrome and type 2 diabetes mellitus in a cohort of elderly subjects at high risk of cardiovascular disease from the PREDIMED study.

    Science.gov (United States)

    Bulló, M; Garcia-Aloy, M; Basora, J; Covas, M I; Salas-Salvado, J

    2011-12-01

    The aim of this study is to determine whether metabolic syndrome, its individual components, or the presence of type 2 diabetes mellitus are associated with a better bone status estimated by quantitative ultrasound at the calcaneus. Cross-sectional study. Outpatient clinics. 251 elderly subjects at high cardiovascular risk from the PREDIMED study were included. MetS was defined according to the ATPIII diagnosis criteria. Calcaneus quantitative ultrasound (QUS) assessment was performed using the Sahara system. Subjects with MetS showed significantly lower 24-hour urinary deoxypyridinoline/creatinine (u-DPD/creatinine) levels and higher broadband ultrasound attenuation, and a tendency to higher bone mineral density (BMD) and quantitative ultrasound index (QUI) than their counterparts. Individuals with type 2 diabetes mellitus (T2DM) showed a significantly higher bone broadband ultrasound attenuation (BUA) and QUI than their non-diabetic counterparts, despite they shown a higher prevalence of osteoporotic fractures. Multiple linear regression analyses showed that quantitative ultrasound parameters were positively associated with the metabolic syndrome and T2DM. Of the bone biochemical markers, only u-DPD/creatinine was related to MetS, abdominal obesity, hypertriglyceridemia component of the MetS, and the number of features that define the MetS. This is the first study showing a positive association between MetS or T2DM with better bone status and lower bone resorption markers measured by quantitative ultrasound. Our results suggest that metabolic abnormalities have a positive effect on healthy bone in elderly subjects at high risk of cardiovascular disease.

  20. Engaged lifestyle and cognitive function in middle and old-aged, non-demented persons: a reciprocal association?

    Science.gov (United States)

    Bosma, Hans; van Boxtel, Martin P J; Ponds, R W H M; Jelicic, Marko; Houx, Peter; Metsemakers, Job; Jolles, Jelle

    2002-12-01

    Some studies have shown that cognitive function is positively affected by an engaged and active lifestyle. However, a recent study found evidence for an opposite causal direction, i.e., persons with good cognitive function more often start to engage in leisure-time activities. Here, we longitudinally examine the causal direction of the association between an engaged lifestyle and cognitive function in middle and old-aged Dutch men and women. The participants in the prospective cohort study "Maastricht Aging Study" (MAAS) were recruited from a register of 15 family practices in the South of the Netherlands. There were 830 non-demented men and women, aged 49 to 81 in 1993-1995 (baseline phase). They were re-examined three years later (follow-up phase). During both phases, all persons reported on their participation in mental, social, and physical activities. Six separate neuropsychological tests, including the Mini-Mental State Examination, were used to define cognitive function at baseline and follow-up. All three activities measured were negatively related to cognitive decline between both phases. Effects were moderate, but consistent. Persons participating in all three activities were particularly protected against longitudinal decline. Furthermore, persons with the best baseline cognitive performance were more likely to increase their number of activities during follow-up compared with persons with the poorest scores. In summary, an engaged lifestyle and cognitive function mutually influence each other in middle and old aged, non-demented persons. This reciprocal association is characterized by simultaneous positive effects of leisure-time activities and good cognitive function on cognitive function and leisure-time activities, respectively. This reciprocal association may create a self-reinforcing, beneficial or adverse life-course in middle and old age.

  1. A follow up study of non-demented patients with primary visual cortical hypometabolism: prodromal dementia with Lewy bodies.

    Science.gov (United States)

    Fujishiro, Hiroshige; Iseki, Eizo; Kasanuki, Koji; Chiba, Yuhei; Ota, Kazumi; Murayama, Norio; Sato, Kiyoshi

    2013-11-15

    We previously reported non-demented patients with glucose hypometabolism in the primary visual cortex (PVC), which is the preferentially affected region in patients with dementia with Lewy bodies (DLB). It remains unknown, however, whether these patients represent a prodromal DLB state. Eleven non-demented patients who attended our memory clinic for more than three years (mean follow-up period: 44 ± 5 months) were examined. All the patients had glucose hypometabolism in the PVC on [(18)F]-fluoro-d-glucose (FDG) positron emission tomography (PET) scans at baseline. Four patients, including one with a clinical history of occipital bleeding, exhibited no core or suggestive features of DLB. Seven patients reported recurrent nocturnal dream-enactment behavior, which is consistent with probable rapid eye movement (REM) sleep behavior disorder (RBD). The condition of the patient with occipital bleeding was stable, which is consistent with an underlying non-neurodegenerative disorder. Of the remaining 10 patients, 5 had stable cognitive conditions (non-converters) and 5 exhibited progression to dementia (converters). The clinical diagnoses of 4 patients with probable RBD were changed to probable DLB. Despite no differences in psychological profiles at baseline between non-converters and converters, the initial pattern of cortical metabolism differed: converters had lower glucose hypometabolism in the parietal and the lateral occipital cortex compared to non-converters. The metabolic reduction in the PVC is present in patients with prodromal DLB. Moreover, the spatial profiles of reduced glucose metabolism at baseline could help to define the distinct prognostic subgroup that has a greater risk of conversion to DLB. © 2013 Elsevier B.V. All rights reserved.

  2. Relationship Between Subjectively Evaluated Health and Fear of Death Among Elderly in Three Cultural Contexts: Effects of Internal and External Resources

    Czech Academy of Sciences Publication Activity Database

    Hofer, J.; Busch, H.; Poláčková Šolcová, Iva; Tavel, P.

    Roč. 84, č. 4 ( 2017 ), s. 343-365 ISSN 0091-4150 R&D Projects: GA ČR GA17-02634S Institutional support: RVO:68081740 Keywords : fear of death * subjective health * social support * optimism * old age * culture Subject RIV: AN - Psychology OBOR OECD: Cognitive sciences Impact factor: 0.662, year: 2016

  3. Relationship Between Subjectively Evaluated Health and Fear of Death Among Elderly in Three Cultural Contexts: Effects of Internal and External Resources

    Czech Academy of Sciences Publication Activity Database

    Hofer, J.; Busch, H.; Poláčková Šolcová, Iva; Tavel, P.

    2017-01-01

    Roč. 84, č. 4 (2017), s. 343-365 ISSN 0091-4150 R&D Projects: GA ČR GA17-02634S Institutional support: RVO:68081740 Keywords : fear of death * subjective health * social support * optimism * old age * culture Subject RIV: AN - Psychology OBOR OECD: Cognitive sciences Impact factor: 0.662, year: 2016

  4. Qualidade de vida em idosos com distintos níveis de atividade física Quality of life in elderly subjects with different levels of physical activity

    Directory of Open Access Journals (Sweden)

    José Jean de Oliveira Toscano

    2009-06-01

    Full Text Available O estilo de vida saudável tem sido associado ao hábito de práticas de atividades físicas e, consequentemente, a melhores padrões de saúde e qualidade de vida. O principal objetivo deste estudo foi comparar a qualidade de vida em idosos com distintos níveis de atividade física. O tipo de estudo foi o transversal de base populacional e a amostra composta por 238 idosas, com media de idade de 69,2 (± 6,6 anos, escolhidas aleatoriamente em 23 grupos de convivência do município de Aracaju-SE. O nível de atividade física foi avaliado pelo IPAQ (International Physical Activity Questionnaire na sua versão longa e a qualidade de vida, por meio do SF-36 (The medical outcomes study 36-item short-form healthy survey. A análise estatística utilizou ferramentas da estatística descritiva e, para a comparação entre as variáveis, o teste de associação de Kruskal-Wallis com significância de p Healthy lifestyle has been associated with practice of physical activity and consequently with better health and quality of life standards. The aim of this study was to associate the levels of physical activity with the quality of life of the elderly. The study was transversal and a randomized sample was formed with 238 female elderly subjects (69.2 ±6.69 years drafted from 23 elderly groups of Aracaju. The level of physical activity was evaluated by IPAQ (International Physical Activity Questionnaire - long form and quality of life by SF-36 (The medical outcomes study 36-item short-form healthy survey. Statistical analysis used descriptive statistics instruments and for analysis between variables Kruskal-Wallis test was used (p <0.05. Significant association was identified in this study between the level of physical activity and health-related quality of life. Elderly women with high physical activity level presented better results in the eight health domains investigated.

  5. Processamento cognitivo e equilíbrio corporal em idosos com disfunção vestibular Cognitive processing and body balance in elderly subjects with vestibular dysfunction

    Directory of Open Access Journals (Sweden)

    Giovanna Cristina dos Santos Caixeta

    2012-04-01

    Full Text Available Idosos com disfunção vestibular crônica podem apresentar alteração do equilíbrio corporal e disfunção cognitiva. OBJETIVO: Avaliar a relação entre o processamento cognitivo e o equilíbrio corporal de idosos com vestibulopatia periférica crônica. Forma de Estudo: Transversal. MATERIAL E MÉTODO: O estudo incluiu 76 pacientes (> 60 anos, com disfunção vestibular periférica crônica, com queixa de tontura há mais de três meses. Os testes utilizados para investigar o equilíbrio corporal foram: Berg Balance Scale (BBS, Dynamic Gait Index (DGI, Timed Up and Go Test (TUGT e Timed Up Go Test modificado (TUGTm e para a avaliação cognitiva utilizou-se Mini Exame do Estado Mental (MEEM, Teste do Relógio (TR e Teste de Fluência Verbal (FV. RESULTADOS: A média etária dos pacientes foi de 69,03 anos (DP=6,21 anos, sendo a maioria feminina (82,9%. Observou-se correlação negativa significante entre o MEEM e TUGT (ρ=-0,312; p=0,01, MEEM e TUGTm (ρ=-0,306; p=0,01, FV e TUGT (ρ=-0,346; p=0,01 e FV e TUGTm (ρ=-0,536; p=0,01; e correlação positiva significante entre TR e BBS (ρ=0,343; p=0,01, TR e DGI (ρ=0,298; p=0,01, FV e BBS (ρ=0,299; p=0,01, e FV e DGI (ρ=0,306; p=0,01. CONCLUSÃO: Idosos com vestibulopatia periférica crônica com pior desempenho no equilíbrio corporal funcional apresentam prejuízo nas habilidades cognitivas.Abnormal body balance and cognitive dysfunction may develop in elderly patients with chronic vestibular dysfunction. AIM: To evaluate the relationship between cognitive processing and body balance in elderly patients with chronic peripheral vestibular disease. Type of Study: Cross-sectional. METHODS: Seventy-six patients (> 60 years with chronic peripheral vestibular dysfunction and dizziness for more than three months were enrolled. The tests for investigating body balance were: the Berg Balance Scale (BBS, Dynamic Gait Index (DGI, Timed Up and Go Test (TUGT Timed Up and Go Test modified (TUGTm; the

  6. Effect of cysteine-rich whey protein (immunocal®) supplementation in combination with resistance training on muscle strength and lean body mass in non-frail elderly subjects: a randomized, double-blind controlled study.

    Science.gov (United States)

    Karelis, A D; Messier, V; Suppère, C; Briand, P; Rabasa-Lhoret, R

    2015-05-01

    The purpose of the present study was to examine the effect of a cysteine-rich whey protein (Immunocal®) supplementation in combination with resistance training on muscle strength and lean body mass (LBM) in elderly individuals. We hypothesized that the cysteine-rich whey protein (Immunocal®) group would experience a greater increase in muscle strength and lean body mass versus the control group (casein). Randomized double-blind controlled intervention study. Institut de Recherches Cliniques de Montréal in Montreal, Canada. Ninety-nine non-frail elderly subjects were recruited. Participants were randomly assigned into two groups. The experimental group received a cysteine-rich whey protein isolate (Immunocal®) (20 g/day) and the control group received casein (20 g/day) during a 135-day period. In addition, both groups performed the same resistance training program (3 times per week). Body composition (DXA) and muscle strength (leg press) were measured. Of the 99 recruited participants, 84 completed the 135-day study period. Of these, 67 subjects (33 in the casein group and 34 in the Immunocal® group) complied and used at least 80 % of the study product and completed at least 80 % of their training sessions. Results in this selected group show an increase in all three muscle strength variables (absolute, normalized by BW and by LBM) by 31.0 %, 30.9 % and 30.0 %, respectively in the casein group as well as 39.3 %, 39.9 % and 43.3 %, respectively in the Immunocal® group after the intervention (p cysteine-rich whey protein (Immunocal®) versus casein.

  7. Not quite PIB-positive, not quite PIB-negative: slight PIB elevations in elderly normal control subjects are biologically relevant.

    Science.gov (United States)

    Mormino, Elizabeth C; Brandel, Michael G; Madison, Cindee M; Rabinovici, Gil D; Marks, Shawn; Baker, Suzanne L; Jagust, William J

    2012-01-16

    Researchers employing Pittsburgh Compound B positron emission tomography (PIB-PET) imaging have consistently indentified old normal control (oNC) subjects with elevated tracer uptake, suggesting the presence of beta-amyloid deposition in these individuals. However, a consensus regarding the level at which PIB reveals a biologically meaningful signal does not exist (ie. an appropriate cutoff value for PIB positivity remains unclear). In this exploratory study, we sought to investigate the range of PIB distribution volume ratio (DVR) values present in our oNC cohort (N=75, age range=58-97). oNC subjects were classified based on global PIB index values (average DVR across prefrontal, parietal, lateral temporal and cingulate cortices) by employing two approaches: (1) an iterative outlier approach that revealed a cutoff value of 1.16 (IO-cutoff) and (2) an approach using data from a sample of young normal control subjects (N=11, age range=20-30) that yielded a cutoff value of 1.08 (yNC-cutoff). oNC subjects falling above the IO-cutoff had values similar to AD subjects ("PIB+", 15%). Subjects falling between the 2 cutoffs were considered to have ambiguous PIB status ("Ambig", 20%) and the remaining oNC were considered "PIB-" (65%). Additional measures capturing focal DVR magnitude and extent of elevated DVR values were consistent with the classification scheme using PIB index values, and revealed evidence for elevated DVR values in a subset of PIB- oNC subjects. Furthermore, there were a greater proportion of ambiguously elevated values compared to low values, and these elevated values were present in regions known to show amyloid deposition. The analyses presented in this study, in conjunction with recently published pathological data, suggest a biological relevance of slight PIB elevations in aging. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. [Alcoholism in the elderly.].

    Science.gov (United States)

    Vermette, G

    1981-01-01

    The author discusses the problem of alcoholism in the elderly. In the first part he describes the general situation of old people and the problems they most frequently encounter. He puts forward the hypothesis that the specific problems related to old age are a determining factor in the on-set or aggravation of an alcool abuse problem. In the second part he presents a brief survey of the literature on the subject and mentions the difficulties relative to a request for help by an elderly person grappling with an alcool abuse problem. Finally, he examines the nature of the treatment to be provide to such a person.

  9. Tremor in the elderly

    DEFF Research Database (Denmark)

    Deuschl, Günther; Petersen, Inge; Lorenz, Delia

    2015-01-01

    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...... and Movement Disorder Society....

  10. Effects of therapeutic lifestyle change diets high and low in dietary fish-derived fatty acids on lipoprotein metabolism in middle-aged and elderly subjects

    Science.gov (United States)

    The effects of Therapeutic Lifestyle Change (TLC) diets, low and high in dietary fish on apolipoprotein metabolism were examined. Subjects were provided with a Western diet for 6-weeks followed by 24-weeks of either of two TLC diets (10/group). Apolipoprotein kinetics were determined in the fed stat...

  11. Plasma clearance of noradrenaline does not change with age in normal subjects

    DEFF Research Database (Denmark)

    Hilsted, J; Christensen, N J; Larsen, S

    1985-01-01

    Noradrenaline kinetics (plasma concentrations, plasma clearance and appearance rates) were investigated in seven elderly healthy subjects and in six young healthy subjects. Forearm venous plasma noradrenaline concentrations were higher in the elderly subjects compared with the young subjects. Pla...

  12. Relação do bem-estar subjetivo, estratégias de enfrentamento e apoio social em idosos Relationships of subjective well-being, coping strategies and perceived social support in the elderly

    Directory of Open Access Journals (Sweden)

    Miriam Teresa Domínguez Guedea

    2006-01-01

    Full Text Available Foram analisadas as relações das estratégias de enfrentamento, apoio social e variáveis sócio-demográficas com o bem-estar subjetivo de uma amostra de idosos. O bem-estar foi definido pela satisfação com a vida, os afetos positivos e afetos negativos. Participaram 123 idosos (média = 67,1; desvio padrão = 6,1, residentes em João Pessoa, Brasil. Análises de regressão hierárquica revelaram que (a a satisfação com a vida é maior em mulheres, nas pessoas que recebem pensão, as pessoas que estão satisfeitas com o apoio recebido, as pessoas que dão apoio aos outros e nas pessoas que enfrentam os problemas de forma direta e uma re-avaliação positiva; (b os afetos positivos aumentam com a satisfação do apoio recebido e com o enfrentamento direto e re-avaliativo e a diminuição do enfrentamento de esquiva e (c os afetos negativos diminuem ao dar apoio e aumentam com o enfrentamento de esquiva. Os resultados mostram as diferenças dos componentes cognitivo e afetivo do bem-estar e apontam a necessidade de investigar a autonomia funcional do idoso.Subjective well-being was studied in a sample of the elderly by analyzing the relationship among coping strategies, social support, and social-demographic variables. Well-being was defined by life satisfaction and positive and negative affect. There were 123 elderly participants (mean=67.1; standard deviation=6.1 who were residents in João Pessoa, Brazil. Hierarchical regression analyses revealed that (a life satisfaction is higher in: women, people who receive pensions, people who are satisfied with the support they receive, people who give support to others, and people who cope with problems directly and by re-appraising the situation in a positive way; (b positive affect increases with the satisfaction of the support received, with direct and re-appraisal coping, and with the decrease of coping by avoidance, and (c negative affect decreases with giving support and increases with

  13. Lower subjective quality of life and the development of social anxiety symptoms after the discharge of elderly patients with remitted schizophrenia: a 5-year longitudinal study.

    Science.gov (United States)

    Kumazaki, Hirokazu; Kobayashi, Hiroyuki; Niimura, Hidehito; Kobayashi, Yasushi; Ito, Shinya; Nemoto, Takahiro; Sakuma, Kei; Kashima, Haruo; Mizuno, Masafumi

    2012-10-01

    Remitted schizophrenic patients living in the community often encounter difficulties in their daily lives, possibly leading to the development of social anxiety symptoms. Although several studies have reported the significance of social anxiety as a comorbidity in patients with schizophrenia, few longitudinal data are available on the development of social anxiety symptoms in patients with remitted schizophrenia, especially in association with the process of "deinstitutionalization." The aims of this study were to assess the social anxiety symptoms in remitted outpatients with schizophrenia and to examine whether the development of social anxiety symptoms was associated with psychotic symptoms, social functioning, or subjective quality of life. Fifty-six people with schizophrenia who were discharged through a deinstitutionalization project were enrolled in this longitudinal study and prospectively assessed with regard to their symptoms, social functioning, and subjective quality of life. The severity of social anxiety symptoms was measured using the Liebowitz Social Anxiety Scale (LSAS). Global/Social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the World Health Organization-Quality of Life 26 (WHO-QOL26). Thirty-six patients completed the reassessment at the end of the 5-year follow-up period. The mean LSAS total score worsened over time, whereas other symptoms improved from the baseline. The mean WHO-QOL26 score in the worsened LSAS group was significantly lower than that in the stable LSAS group. At baseline, WHO-QOL26 scores were associated with an increase in the severity of social anxiety symptoms. In community-dwelling patients with remitted schizophrenia, a lower subjective quality of life might lead to the development of social anxiety symptoms, both concurrently and prospectively. To achieve a complete functional recovery, additional interventions for social

  14. Neuropathological findings in entorhinal cortex of subjects aged 50 years or older and their correlation with dementia in a sample from Southern Brazil

    Directory of Open Access Journals (Sweden)

    Edson Rodrigues Neto

    Full Text Available ABSTRACT Introduction: The aims of this study were to survey neurodegenerative changes detected by abnormal protein deposits in the Entorhinal Cortex (EC of subjects aged 50 years or older and to correlate these findings with suspected dementia, as detected by the IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly . Methods: Fourteen brains were submitted to the immunohistochemistry technique for different proteins (beta-amyloid, tau, -synuclein and phospho-TDP-43 and data obtained compared with IQCODE scores. Results: Fifty-seven percent of the individuals exhibited IQCODE results compatible with dementia, being classified into the demented group (DG: 87.5% of patients had neuropathological findings corresponding to Alzheimer's-like brain pathology (ALBP. Of the patients in the non-demented group (NDG, 16.7% met neuropathological criteria for ALBP. All individuals in the DG showed deposits of more than one kind of protein in the EC. The most common association was hyperphosphorylated tau and beta-amyloid protein (87.5%. Discussion: Most individuals with dementia had neuropathological findings of ALBP, as did one individual with no signs of dementia, characterizing a preclinical stage. The results of this study suggest that deposits of a single type of anomalous protein are normal findings in an aging brain, while more than one kind of protein or the combined presence of anomalous protein deposits indicate the presence of dementia.

  15. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study--a randomized controlled trial.

    Science.gov (United States)

    Mastroiacovo, Daniela; Kwik-Uribe, Catherine; Grassi, Davide; Necozione, Stefano; Raffaele, Angelo; Pistacchio, Luana; Righetti, Roberta; Bocale, Raffaella; Lechiara, Maria Carmela; Marini, Carmine; Ferri, Claudio; Desideri, Giovambattista

    2015-03-01

    Recent evidence has indicated that flavanol consumption may have many health benefits in humans, including improved cognitive activities. The aim was to evaluate the effect of flavanol consumption on cognitive performance in cognitively intact elderly subjects. This was a double-blind, controlled, parallel-arm study conducted in 90 elderly individuals without clinical evidence of cognitive dysfunction who were randomly assigned to consume daily for 8 wk a drink containing 993 mg [high flavanol (HF)], 520 mg [intermediate flavanol (IF)], or 48 mg [low flavanol (LF)] cocoa flavanols (CFs). Cognitive function was assessed at baseline and after 8 wk by using the Mini-Mental State Examination (MMSE), the Trail Making Test (TMT) A and B, and the Verbal Fluency Test (VFT). The changes in MMSE score in response to the 3 different treatments were not different. In contrast, there was a positive impact of the intervention on specific aspects of cognitive function. Mean changes (±SEs) in the time required to complete the TMT A and B after consumption of the HF (-8.6 ± 0.4 and -16.5 ± 0.8 s, respectively) and IF (-6.7 ± 0.5 and -14.2 ± 0.5 s, respectively) drinks significantly (P consumption of the LF drinks (-0.8 ± 1.6 and -1.1 ± 0.7 s, respectively). Similarly, VFT scores significantly improved among all treatment groups, but the magnitude of improvement in the VFT score was significantly (P consumption can reduce some measures of age-related cognitive dysfunction, possibly through an improvement in insulin sensitivity. These data suggest that the habitual intake of flavanols can support healthy cognitive function with age. © 2015 American Society for Nutrition.

  16. O impacto da voz na qualidade da vida da mulher idosa Vocal impact on quality of life of elderly female subjects

    Directory of Open Access Journals (Sweden)

    Henrique Olival Costa

    2005-04-01

    Full Text Available Embora várias investigações venham enfocando a fisiologia e anatomia da voz e laringe do idoso, pouco tem sido produzido com a preocupação de saber o impacto das condições vocais na qualidade de vida desta porção da população. OBJETIVO: Verificar o impacto da voz na qualidade da vida da mulher idosa, usando os questionários Short-form Health Survey - SF36 e Voice Index Handicap (VHI. DESENHO DO ESTUDO: Estudo de coorte prospectivo com corte transversal. MÉTODO E MATERIAL: Cinqüenta mulheres idosas participaram desta pesquisa, com idades entre 60 e 87 anos e idade média de 70.8 anos, recrutadas aleatoriamente. As participantes do estudo foram submetidas aos dois questionários: O SF36 e O VHI. Foram comparadas as respostas de ambos os questionários pelo teste de Kruskall-Wallis, verificando se havia diferença significante entre as variáveis. O teste de Spearman foi usado para avaliar se havia correlação entre os resultados das variáveis de VHI com os resultados obtidos no parâmetro de SF36 de qualidade de vida. RESULTADOS: Nós obtivemos valores considerados estatisticamente significantes nas correlações entre domínio físico de VHI e funcionamento físico, dor física e papel físico na vida do SF-36. CONCLUSÃO: Houve uma correlação estatisticamente significante e positiva entre os resultados obtidos nos parâmetros funcionamento físico, vitalidade, saúde geral, saúde mental, dor corporal e papel físico na vida do SF36. Houve uma correlação estatisticamente significante e negativa entre os resultados totais obtidos no SF36 e o VHI.Although there are several investigations focusing the physiology and anatomy of voice and the senior's larynx, little has been produced to support the knowledge of the impact of vocal conditions on quality of life of this portion of the population. AIM: To verify the impact of voice on quality of the life of elderly women, using the questionnaires Short-Form Health Survey - SF36 and

  17. Robots in Elderly Care

    Directory of Open Access Journals (Sweden)

    Alessandro Vercelli

    2018-03-01

    Full Text Available Low birth rate and the long life expectancy represent an explosive mixture, resulting in the rapid aging of population. The costs of healthcare in the grey society are increasing dramatically, and soon there will be not enough resources and people for care. This context requires conceptually new elderly care solutions progressively reducing the percentages of the human-based care. Research on robot-based solutions for elderly care and active ageing aims to answer these needs. From a general perspective, robotics has the power to completely reshape the landscape of healthcare both in its structure and its operation. In fact, the long-term sustainability of healthcare systems could be addressed by automation powered by digital health technologies, such as artificial intelligence, 3D-printing or robotics. The latter could take over monotonous work from healthcare workers, which would allow them to focus more on patients and to have lesser workload. Robots might be used in elder care with several different aims. (i Robots may act as caregivers, i.e. assist the elderly, (ii they can provide remainders and instructions for activities of daily life and safety, and/or assist their carers in daily tasks; (iii they can help monitor their behaviour and health; and (iv provide companionship, including entertainment and hobbies, reminiscence and social contact. The use of Robots with human subjects/patients raise several sensitive questions. First of all, robots may represent information hubs, and can collect an incredible amount of data about the subjects and their environment. In fact, they record habits such as sleeping, exercising, third persons entering in the house, appointments. Communications may be continuously recorded. Moreover, by connecting with medical devices, they can store medical data. On one hand, this represents a very powerful tool to collect information about the single subject (precision medicine, about disease (thus eventually finding

  18. Poor trail making test performance is directly associated with altered dual task prioritization in the elderly--baseline results from the TREND study.

    Science.gov (United States)

    Hobert, Markus A; Niebler, Raphael; Meyer, Sinja I; Brockmann, Kathrin; Becker, Clemens; Huber, Heiko; Gaenslen, Alexandra; Godau, Jana; Eschweiler, Gerhard W; Berg, Daniela; Maetzler, Walter

    2011-01-01

    Deterioration of executive functions in the elderly has been associated with impairments in walking performance. This may be caused by limited cognitive flexibility and working memory, but could also be caused by altered prioritization of simultaneously performed tasks. To disentangle these options we investigated the associations between Trail Making Test performance--which specifically measures cognitive flexibility and working memory--and dual task costs, a measure of prioritization. Out of the TREND study (Tuebinger evaluation of Risk factors for Early detection of Neurodegenerative Disorders), 686 neurodegeneratively healthy, non-demented elderly aged 50 to 80 years were classified according to their Trail Making Test performance (delta TMT; TMT-B minus TMT-A). The subjects performed 20 m walks with habitual and maximum speed. Dual tasking performance was tested with walking at maximum speed, in combination with checking boxes on a clipboard, and subtracting serial 7 s at maximum speeds. As expected, the poor TMT group performed worse when subtracting serial 7 s under single and dual task conditions, and they walked more slowly when simultaneously subtracting serial 7 s, compared to the good TMT performers. In the walking when subtracting serial 7 s condition but not in the other 3 conditions, dual task costs were higher in the poor TMT performers (median 20%; range -6 to 58%) compared to the good performers (17%; -16 to 43%; pelderly with poor TMT performance prioritize the cognitive task at the expense of walking velocity. This indicates that poor cognitive flexibility and working memory are directly associated with altered prioritization.

  19. Relações entre o bem-estar subjetivo e a funcionalidade em idosos em seguimento ambulatorial Relationship between subjective well-being and the functionality of elderly outpatients

    Directory of Open Access Journals (Sweden)

    Giovana Sposito

    2010-02-01

    Full Text Available OBJETIVO: Este estudo teve como objetivo verificar a relação entre o bem-estar subjetivo, independência funcional e desempenho de membros inferiores (força muscular, velocidade de marcha e equilíbrio de idosos em seguimento ambulatorial, em relação ao sexo e a grupos etários. MÉTODOS: Foram avaliados 125 idosos de ambos os sexos com idade mínima de 60 anos, atendidos em um ambulatório de geriatria. Os instrumentos utilizados foram: 1 Medida da Independência Funcional (MIF para avaliar a dependência funcional; 2 Short Physical Performance Battery (SPPB para medir o desempenho físico; 3 Bem-Estar Subjetivo (BES: questões sobre a saúde e satisfação com a vida. RESULTADOS: A amostra utilizada foi de conveniência, com predomínio do sexo feminino, que apresentou maior comprometimento funcional. As correlações do bem-estar subjetivo com o teste de desempenho não demonstraram diferenças entre os sexos, contudo os idosos mais velhos apresentaram maior nível de satisfação que os idosos mais jovens. A saúde percebida também foi mais satisfatória entre os idosos mais velhos. Entretanto, a saúde percebida comparada mostrou melhores resultados nos idosos com moderado a bom desempenho físico. CONCLUSÃO: Os resultados sugerem que indivíduos mais velhos apresentam maior satisfação com a vida e melhor saúde percebida. Além disso, o bom desempenho físico foi uma variável de relevância para melhor saúde percebida quando comparada a outras pessoas.OBJECTIVE: The aim of this study was to investigate the relationship between subjective well-being, functional independence and lower-limb performance (muscle strength, gait velocity and balance among elderly people undergoing outpatient follow-up, stratified by sex and age groups. METHODS: We evaluated 125 elderly people, aged 60 years and over, who received care at a geriatric outpatient clinic. The instruments used were: 1 Functional Independence Measure (FIM to evaluate

  20. Psychomotor Retardation in untreated depressed elderly

    Directory of Open Access Journals (Sweden)

    Lieve Lia Beheydt

    2015-01-01

    Full Text Available Background: Psychomotor retardation (PR is one of the core features in depression according to 17 DSM V1, but also aging in itself causes cognitive and psychomotor slowing. This is the first study 18 investigating psychomotor retardation in relation to cognitive functioning and to the concomitant 19 effect of depression and aging in a geriatric population ruling out contending effects of psychotropic 20 medication. Methods: A group of 28 non-demented depressed elderly is compared to a matched 21 control group of 20 healthy elderly. All participants underwent a test battery containing clinical 22 depression measures, cognitive measures of processing speed, executive function and memory, 23 clinical ratings of psychomotor retardation and objective computerized fine motor skill-tests. 24 Statistical analysis consisted of a General Linear Method (GLM multivariate analysis of variance to 25 compare the clinical, cognitive and psychomotor outcomes of the two groups. Results: Patients 26 performed worse on all clinical, cognitive and psychomotor retardation measures. Both groups 27 showed an effect of cognitive load on fine motor function but the influence was significantly larger 28 for patients than for healthy elderly except for the initiation time. Limitations: due to the restrictive 29 inclusion criteria, only a relatively limited sample size could be obtained. Conclusion: With a 30 medication free sample, an additive effect of depression and aging on cognition and PR in geriatric 31 patients was found,. As this effect was independent of demand of effort (by varying the cognitive 32 load, it was apparently not a motivational slowing effect of depression.

  1. Temporal Lobe and Frontal-Subcortical Dissociations in Non-Demented Parkinson's Disease with Verbal Memory Impairment.

    Science.gov (United States)

    Tanner, Jared J; Mareci, Thomas H; Okun, Michael S; Bowers, Dawn; Libon, David J; Price, Catherine C

    2015-01-01

    The current investigation examined verbal memory in idiopathic non-dementia Parkinson's disease and the significance of the left entorhinal cortex and left entorhinal-retrosplenial region connections (via temporal cingulum) on memory impairment in Parkinson's disease. Forty non-demented Parkinson's disease patients and forty non-Parkinson's disease controls completed two verbal memory tests--a wordlist measure (Philadelphia repeatable Verbal Memory Test) and a story measure (Logical Memory). All participants received T1-weighted and diffusion magnetic resonance imaging (3T; Siemens) sequences. Left entorhinal volume and left entorhinal-retrosplenial connectivity (temporal cingulum edge weight) were the primary imaging variables of interest with frontal lobe thickness and subcortical structure volumes as dissociating variables. Individuals with Parkinson's disease showed worse verbal memory, smaller entorhinal volumes, but did not differ in entorhinal-retrosplenial connectivity. For Parkinson's disease entorhinal-retrosplenial edge weight had the strongest associations with verbal memory. A subset of Parkinson's disease patients (23%) had deficits (z-scores frontal-subcortical gray or frontal white matter regions. These findings argue for additional investigation into medial temporal lobe gray and white matter connectivity for understanding memory in Parkinson's disease.

  2. The duration of stage transition during pharyngeal swallowing among young-elderly, and mid-elderly individuals

    OpenAIRE

    Byeon, Haewon; Koh, Hyeung Woo

    2016-01-01

    [Purpose] Understanding the normal movements of the pharyngeal stage is important in the assessment of dysphagia. This study classified an elderly population into young-elderly and mid-elderly individuals and investigated the difference in stage transition duration between the two groups to provide basic material for assessment of dysphagia in old age. [Subjects and Methods] The subjects of the study were 12 middle-aged individuals (40?49 years), young-elderly individuals (65?74 years), and 9...

  3. Inquérito sobre hipertensão arterial e décifit cognitivo em idosos de um serviço de geriatria A survey on hypertension and cognitive deficit in elderly subjects in a geriatric unit

    Directory of Open Access Journals (Sweden)

    Luciana Tricai Cavalini

    2003-04-01

    association between hypertension and cognitive deficit. The identification of individuals with cognitive impairment was carried out using the Mini Mental State Examination, applied to all patients attending the service from August 1998 to January 1999. Patient interviews and medical record reviews made exposure classification possible (hypertensive/non-hypertensive. RESULTS: Ninety-nine subjects with cognitive impairment were identified among the 307 participants, representing a prevalence rate of 32,2% (95% CI = 27,0% - 37,4%. A strong inverse association between hypertension and cognitive deficit was estimated for the group aged 80 or more, whose diagnosis had been registered for at least five years (OR = 0,13; 95% CI = 0,03 - 0,54. This association was not found among those aged 65 - 79. CONCLUSIONS: The inverse association between hypertension and cognitive deficit in the most elderly strengthens the hypothesis of other authors that a certain blood pressure rate is needed to maintain cognitive function in this age group. Further studies on the subject in our country are suggested.

  4. Prevalence and predictors of “subjective cognitive complaints” in the Sydney Memory and Ageing Study.

    Science.gov (United States)

    Slavin, Melissa J; Brodaty, Henry; Kochan, Nicole A; Crawford, John D; Trollor, Julian N; Draper, Brian; Sachdev, Perminder S

    2010-08-01

    To document the prevalence of self- and informant report of cognitive problems, usually referred to as "subjective cognitive complaints" (SCCs), in a community-dwelling sample of older adults and to examine the relationship between SCCs and objective impairment, mood, and personality measures. Eight hundred twenty-seven nondemented community-dwelling adults aged 70-90 years. Participants were asked 24 SCC questions, including the Memory Complaint Questionnaire (MAC-Q), and completed neuropsychological testing in the domains of memory, language, executive function, visuospatial skills, and psychomotor speed. The Geriatric Depression Scale, Goldberg Anxiety Scale, and Neuroticism, Openness, and Conscientiousness from the NEO-Five Factor Inventory were used as measures of participants' psychological status. Informants completed 19 SCC questions, including a modified short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Overall, 95.5% of participants or their informants endorsed at least one SCC. Although participants were more likely to endorse a memory complaint, informants seemed more accurate in endorsing a complaint when cognitive impairment was objectively present. SCC correlated with participants' scores on measures of depression, anxiety, neuroticism, and inversely with measures of openness and conscientiousness. Age, education, and sex had little impact on these effects. Regression analysis showed that psychological factors explained the number of complaints more than cognitive performance. The usefulness of SCCs as a criterion for mild cognitive impairment is questioned because of their high prevalence and their relationship to psychological factors. This may be helpful for clinicians to bear in mind when presented with patients with cognitive complaints.

  5. Evaluating Photographs as a Replacement for the In-Person Physical Examination of the Scored Patient-Generated Subjective Global Assessment in Elderly Hospital Patients.

    Science.gov (United States)

    Miller, Michelle; Thomas, Jolene; Suen, Jenni; Ong, De Sheng; Sharma, Yogesh

    2018-02-08

    Undernourished patients discharged from the hospital require follow-up; however, attendance at return visits is low. Teleconsultations may allow remote follow-up of undernourished patients; however, no valid method to remotely perform physical examination, a critical component of assessing nutritional status, exists. This study aims to compare agreement between photographs taken by trained dietitians and in-person physical examinations conducted by trained dietitians to rate the overall physical examination section of the scored Patient Generated Subjective Global Assessment (PG-SGA). Nested cross-sectional study. Adults aged ≥60 years, admitted to the general medicine unit at Flinders Medical Centre between March 2015 and March 2016, were eligible. All components of the PG-SGA and photographs of muscle and fat sites were collected from 192 participants either in the hospital or at their place of residence after discharge. Validity of photograph-based physical examination was determined by collecting photographic and PG-SGA data from each participant at one encounter by trained dietitians. A dietitian blinded to data collection later assessed de-identified photographs on a computer. Percentage agreement, weighted kappa agreement, sensitivity, and specificity between the photographs and in-person physical examinations were calculated. All data collected were included in the analysis. Overall, the photograph-based physical examination rating achieved a percentage agreement of 75.8% against the in-person assessment, with a weighted kappa agreement of 0.526 (95% CI: 0.416, 0.637; Pphysical examination by trained dietitians achieved a nearly acceptable percentage agreement, moderate weighted kappa, and fair sensitivity-specificity pair. Methodological refinement before field testing with other personnel may improve the agreement and accuracy of photograph-based physical examination. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All

  6. [Dignity of the elderly].

    Science.gov (United States)

    Ribera Casado, José Manuel

    2015-01-01

    A discussion is presented on what is understood by «dignity» when applied to the elderly, highlighting it universal character and contrasting it with the greater risks of suffering «indignities» to which the elderly are exposed. The discussion is divided into 3 sections. In the first, the risk factors in this sense could lead to physiological losses and illnessess, which in in the physical, mental and social sense are associated with ageing. In the second, the question of discrimination of the elderly as a form of aggression due to age, and is so widespread and infrequently studied. Lastly, it is discussed how to interpret the advice of the United Nations on how to promote active ageing as a defence system against indignities. It concludes with the message that neither the limitations that accompany the ageing process, nor the different forms of aggression that the elderly may be subjected to, provide sufficient argument neither for a loss of individual nor collective dignity. This is something which we all must endeavour to achieve and which must be maintained and be respected by individuals and by society at all times. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

  7. Nutrition in the elderly.

    Science.gov (United States)

    Pirlich, M; Lochs, H

    2001-12-01

    Malnutrition is more common in elderly persons than in younger adults. Ageing itself, however, neither leads to malabsorption nor to malnutrition with the exception of a higher frequency of atrophic gastritis in older persons. Malnutrition in elderly people is therefore a consequence of somatic, psychic or social problems. Typical causes are chewing or swallowing disorders, cardiac insufficiency, depression, social deprivation and loneliness. Undernutrition is associated with a worse prognosis and is an independent risk factor for morbidity and mortality. Awareness of this problem is therefore important. For the evaluation of nutritional status, it must be remembered that most normal values are derived from younger adults and may not necessarily be suitable for elderly persons. Suitable tools for evaluating the nutritional status of elderly persons are e.g. the body mass index, weight loss within the last 6 months, the Mini Nutritional Assessment (MNA) or the Subjective Global Assessment (SGA). An improvement in the nutritional status can be achieved by simple methods such as the preparation of an adequate diet, hand feeding, additional sip feeding or enteral nutrition. Copyright 2001 Harcourt Publishers Ltd.

  8. The Metabolic Syndrome Predicts Longitudinal Changes in Clock Drawing Test Performance in Older Nondemented Hypertensive Individuals.

    Science.gov (United States)

    Viscogliosi, Giovanni; Chiriac, Iulia Maria; Andreozzi, Paola; Ettorre, Evaristo

    2016-05-01

    The present study evaluated the metabolic syndrome (MetS) as independent predictor of 1-year longitudinal changes in cognitive function. 104 stroke- and dementia-free older hypertensive subjects were studied. MetS was defined by NCEP ATP-III criteria. Cognitive function was assessed by the Clock Drawing Test (CDT); 1-year changes in cognitive function were expressed as annual changes in CDT performance. Brain magnetic resonance imaging studies (1.5T) were performed. Participants with MetS exhibited greater cognitive decline than those without (-1.78 ± 1.47 versus -0.74 ± 1.44 CDT points, t = 3.348, df = 102, p < 0.001). MetS predicted cognitive decline (β = -0.327, t = -3.059, df = 96, p = 0.003) independently of its components, age, baseline cognition, neuroimaging findings, blood pressure levels, and duration of hypertension. With the exception of systolic blood pressure, none of the individual components of MetS explained 1-year changes in CDT performance. MetS as an entity predicted accelerated 1-year decline in cognitive function, assessed by CDT, in a sample of older hypertensive subjects. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. A randomized clinical trial to evaluate the effects of rasagiline on depressive symptoms in non-demented Parkinson's disease patients.

    Science.gov (United States)

    Barone, P; Santangelo, G; Morgante, L; Onofrj, M; Meco, G; Abbruzzese, G; Bonuccelli, U; Cossu, G; Pezzoli, G; Stanzione, P; Lopiano, L; Antonini, A; Tinazzi, M

    2015-08-01

    Depressed mood is a common psychiatric problem associated with Parkinson's disease (PD), and studies have suggested a benefit of rasagiline treatment. ACCORDO (see the ) was a 12-week, double-blind, placebo-controlled trial to evaluate the effects of rasagiline 1 mg/day on depressive symptoms and cognition in non-demented PD patients with depressive symptoms. The primary efficacy variable was the change from baseline to week 12 in depressive symptoms measured by the Beck Depression Inventory (BDI-IA) total score. Secondary outcomes included change from baseline to week 12 in cognitive function as assessed by a comprehensive neuropsychological battery; Parkinson's disease quality of life questionnaire (PDQ-39) scores; Apathy Scale scores; and Unified Parkinson's Disease Rating Scale (UPDRS) subscores. One hundred and twenty-three patients were randomized. At week 12 there was no significant difference between groups for the reduction in total BDI-IA score (primary efficacy variable). However, analysis at week 4 did show a significant difference in favour of rasagiline (marginal means difference ± SE: rasagiline -5.46 ± 0.73 vs. placebo -3.22 ± 0.67; P = 0.026). There were no significant differences between groups on any cognitive test. Rasagiline significantly improved UPDRS Parts I (P = 0.03) and II (P = 0.003) scores versus placebo at week 12. Post hoc analyses showed the statistical superiority of rasagiline versus placebo in the UPDRS Part I depression item (P = 0.04) and PDQ-39 mobility (P = 0.007) and cognition domains (P = 0.026). Treatment with rasagiline did not have significant effects versus placebo on depressive symptoms or cognition in PD patients with moderate depressive symptoms. Although limited by lack of correction for multiple comparisons, post hoc analyses signalled some improvement in patient-rated cognitive and depression outcomes. © 2015 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European

  10. Demented versus non-demented very old inpatients: the same comorbidities but poorer functional and nutritional status.

    Science.gov (United States)

    Zekry, Dina; Herrmann, François R; Grandjean, Raphael; Meynet, Marie-Pierre; Michel, Jean-Pierre; Gold, Gabriel; Krause, Karl-Heinz

    2008-01-01

    demented patients have been reported to be healthier than other old people of the same age. to assess comorbid conditions, functional and nutritional status in medically ill hospitalised patients with normal cognition or affected by dementia of various causes and severities, or mild cognitive impairment (MCI). a prospective study was carried out, between January and December 2004, in the Rehabilitation and Geriatric Hospital (HOGER). activities of daily living (ADL), instrumental activities of daily living (IADL) and mini nutritional assessment (MNA) scores were assessed as a function of the status of the patient two weeks before admission to hospital. On admission, cognitive status was assessed by a systematic battery of neuropsychological tests, comorbid conditions were assessed with the Charlson comorbidity index (CCI), and body mass index (BMI) and functional independence measure (FIM) were determined. BMI and FIM were also determined on discharge. we studied 349 patients (mean age 85.2 +/- 6.7; 76% women): 161 (46.1%) cognitively normal, 37 (10.6%) with MCI and 151 (43.3%) demented (61 Alzheimer's disease (AD), 62 mixed dementia (MD) and 17 vascular dementia (VaD)). ADL, IADL, FIM and MNA scores on admission decreased with cognitive status, regardless of the type of dementia. Functionality at discharge remained significantly lower in demented patients than in other patients. CCI was high and similar in all three groups (mean 4.6 +/- 2.7). Patients with VaD had poorer health than other demented patients, with a higher average comorbidity score, more frequent hypertension, stroke and hyperlipidaemia. Comorbidity did not increase with severity levels of dementia. in this cohort of very old inpatients, demented patients, non-demented patients and patients with MCI had similar levels of comorbidity, but demented patients had a poorer functional and nutritional status.

  11. Informed Consent, Research, and the Elderly

    Science.gov (United States)

    Berkowitz, Sandra

    1978-01-01

    Informed consent is a legal doctrine designed to protect an individual from unwarranted medical intrusions upon his body. Because the processes of aging may affect the elderly subject's capacity to give competent, knowing, and voluntary consent, the securing of informed consent from the elderly will often require special procedural safeguards.…

  12. Isolated Elderly.

    Science.gov (United States)

    Fischer, Lucy Rose; And Others

    The Minnesota Senior Study, the first statewide survey of the elderly in nearly 20 years, was based on a telephone survey with a statewide sample of 1,500 non-institutionalized Minnesotans age 60 and older. Substantial numbers of Minnesotans age 60-plus were found to have low social contacts. Five percent, or about 33,000 older Minnesotans, fell…

  13. Osteoporosis in Elderly

    Directory of Open Access Journals (Sweden)

    Mehmet Ilkin Naharci

    2012-08-01

    Full Text Available Osteoporosis is a disorder that affects commonly the people above 65 years, impairs the functional status, decreases the life quality, and increases mortality and cost. Lateral screening of vertebra or displaying of proximal femur with DEXA is gold standard method for the evaluation of diagnosis and fracture risk in elderly subjects. Physical examination for the analysis of risk factors of falling and laboratory methods for the diagnosis of secondary osteporosis were used. While increasing muscle strength and balance, exercise programs, calcium and vitamin D supplement are helpful in the prevention of falling. As anti-osteoporotic drugs, aleandronat, risedronat, and strontium ranelat have anti-fracture efficiencies for both hip and vertebra fracture. It is considered that the making of periodically routine health examination is important for early diagnosis and treatment in elderly people. In routine examination of elderly subject, it would be helpful that declaring of actions to be done for the prevention of osteoporosis development, if occured, the stopping of progression, and the prevention of falling as part of health training. [TAF Prev Med Bull 2012; 11(4.000: 471-482

  14. Gait analysis comparing Parkinson's disease with healthy elderly subjects Comparação da doença de Parkinson com idosos saudáveis através da análise da marcha

    Directory of Open Access Journals (Sweden)

    Roberta de Melo Roiz

    2010-02-01

    Full Text Available There is a lack of studies comparing the kinematics data of idiopathic Parkinson's disease (IPD patients with healthy elder (HE subjects, and when there is such research, it is not correlated to clinical measures. OBJECTIVE: To compare the spatio-temporal and kinematic parameters of Parkinsonian gait with the HE subjects group and measure the relation between these parameters and clinical instruments. METHOD: Twelve patients with IPD and fifteen HE subjects were recruited and evaluated for clinical instruments and gait analysis. RESULTS: There were statistically significant differences between HE group and the IPD group, in stride velocity, in stride length (SL, and in the hip joint kinematic data: on initial contact, on maximum extension during terminal contact and on maximum flexion during mid-swing. Regarding the clinical instruments there were significant correlated with in stride velocity and SL. CONCLUSION: Clinical instruments used did not present proper psychometric parameters to measure the IPD patient's gait, while the 3D system characterized it better.Poucos estudos comparam os dados cinemáticos de pacientes com doença de Parkinson idiopática (DPI com indivíduos idosos saudáveis, e quando realizam não correlacionam com medidas clínicas. OBJETIVO: Comparar os parâmetros espaço-temporais e cinemáticos da marcha na DP com os de idosos saudáveis (IS e avaliar a relação entre estes parâmetros com os instrumentos clínicos. MÉTODO: Doze pacientes com DPI e quinze IS foram recrutados e avaliados por instrumentos clínicos e de análise de marcha. RESULTADOS: Houve diferenças estatísticas significantes entre o grupo de IS e o de DPI na velocidade da marcha e no comprimento do passo (CP, nos dados cinemáticos das articulações do quadril: no contato inicial, na máxima extensão no apoio e na máxima flexão na oscilação. No que diz respeito aos instrumentos clínicos houve significativa correlação com a velocidade da

  15. Biochemical reference values in elderly black subjects

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... the resulting estimate of normal range. Clin Chem 1971; 17: 275-284. 13. Wooton IDO, King E]. Normal values for blood constituents: inter-hospital differences. Lancer 1953; I: 70. 14. Chen FWK, Millard PH. The effect of ageing on certain biochemical values. Mod Geriarrics 1972; 2: 92. IS. Forbes GB, Reina ...

  16. The predictive value of self-rated health in the presence of subjective memory complaints on permanent nursing home placement in elderly primary care patients over 4-year follow-up.

    Science.gov (United States)

    Nielsen, Anni B S; Siersma, Volkert; Waldemar, Gunhild; Waldorff, Frans B

    2014-01-01

    self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear. seven-hundred fifty-seven non-nursing home residents ≥65 years from general practices in Central Copenhagen were followed for 4 years (2002-2006). Patients gave information on SRH, cognition (SMC and MMSE), quality of life (EQ-5D) and socio-demographics. Information on comorbidities and permanent NH placement came from registries. The association between SRH (dichotomised into good versus poor) and SMC, and permanent NH placement was assessed using Cox proportional hazard regression adjusted for potential confounders. NH placement totaled 6.5% at 4-year follow-up. Poor SRH increased NH placement [hazard ratio (HR) = 2.07, 95% CI: 1.11-3.87] adjusted for age, SMC, MMSE, sex and comorbidities. SRH was not associated with NH placement if accounting for additional health information; however, SMC was (HR = 2.47, 95% CI: 1.26-4.86). Increased placement was seen for patients with good SRH and SMC (HR = 6.64, 95% CI: 2.31-19.12), but not among patients with poor SRH and SMC (HR = 1.37, 95% CI: 0.59-3.20) when compared with the reference group (good SRH and without SMC). both poor SRH and SMC were associated with permanent NH placement risk among elderly primary care patients. However, when SMC was present a reverse association was found for SRH: good SRH increased NH placement. Since SRH is integrated in widely used psychometric instruments, further research is needed to establish the mechanism and implications of this finding.

  17. Gender differences in the impact of mental disorders and chronic physical conditions on health-related quality of life among non-demented primary care elderly patients.

    Science.gov (United States)

    Baladón, Luisa; Rubio-Valera, Maria; Serrano-Blanco, Antoni; Palao, Diego J; Fernández, Ana

    2016-06-01

    This paper aims to estimate the comorbidity of mental disorders and chronic physical conditions and to describe the impact of these conditions on health-related quality of life (HRQoL) in a sample of older primary care (PC) attendees by gender. Cross-sectional survey, conducted in 77 PC centres in Catalonia (Spain) on 1192 patients over 65 years old. Using face-to-face interviews, we assessed HRQoL (SF-12), mental disorders (SCID and MINI structured clinical interviews), chronic physical conditions (checklist), and disability (Sheehan disability scale). We used multivariate quantile regressions to model which factors were associated with the physical component summary-short form 12 and mental component summary-short form 12. The most frequent comorbidity in both men and women was mood disorder with chronic pain and arthrosis. Mental disorders mainly affected 'mental' QoL, while physical disorders affected 'physical' QoL. Mental disorders had a greater impact on HRQoL than chronic physical conditions, with mood and adjustment disorders being the most disabling conditions. There were some gender differences in the impact of mental and chronic physical conditions on HRQoL. Anxiety disorders and pain had an impact on HRQoL but only in women. Respiratory diseases had an effect on the MCS in women, but only affected the PCS in men. Mood and adjustment disorders had the greatest impact on HRQoL. The impact profile of mental and chronic physical conditions differs between genders. Our results reinforce the need for screening for mental disorders (mainly depression) in older patients in PC.

  18. Ambient Technology to Assist Elderly People in Indoor Risks

    OpenAIRE

    Rami Yared; Bessam Abdulrazak

    2016-01-01

    While elderly people perform their daily indoor activities, they are subjected to several risks. To improve the quality of life of elderly people and promote healthy aging and independent living, elderly people need to be provided with an assistive technology platform to rely on during their activities. We reviewed the literature and identified the major indoor risks addressed by assistive technology that elderly people face during their indoor activities. In this paper, we identify these ris...

  19. Elderly\\'s Leisure Times

    Directory of Open Access Journals (Sweden)

    Ali Zarei

    2007-04-01

    Full Text Available Objectives: Daily hours" by the word means times. Leisure is the concept of comfort, rest, relation and free of any working situations. And technically; it consists of times and opportunity that have reminded after daily job and performance of any types of activity. Sociologists leisure has anew conceptuality in compare to do believe society in which such phenomenon can't be considered as classical unemployment, as was in the past. Methods & Materials: This research is about needs in elderlies' leisure times. This research shows that all leisure programs are sum of nearly all complete practical programs in domination of adult's leisure times. A performed with careful planning and programming and multifactorial rather than expansion of accomplishment's are beneficial is our country. We distributed special research questionnaires as accidental mode among adults, in general parks of qzvin province. We assessed archive information by use of unparametric statistics of expansion. In addition, we used piraloon coefficient of correlation too. Results: According to achieve result of research among elderlies' leisure programs which consist of" film showing", sport and art programs which have allocated extended portion for their own. Elderlies' views about sport were very positive. Exercise of sport has been considered as effective to their heath and their soul and society cultural promotions. Conclusion: All keeping centers of elderlies have t.v, radio and other facilities for showing video-films which consist of sports, also complete installation of sports, arts used as human drives, were very useful in optimizing elderlies' leisure times objectives.

  20. Killer Immunoglobulin-like Receptors (KIR) haplogroups A and B track with Natural Killer Cells and Cytokine Profile in Aged Subjects: Observations from Octo/Nonagenarians in the Belfast Elderly Longitudinal Free-living Aging STudy (BELFAST)

    Science.gov (United States)

    2013-01-01

    Background Natural Killer Cells (NK) play an important role in detection and elimination of virus-infected, damaged or cancer cells. NK cell function is guided by expression of Killer Immunoglobulin-like Receptors (KIRs) and contributed to by the cytokine milieu. KIR molecules are grouped on NK cells into stimulatory and inhibitory KIR haplotypes A and B, through which NKs sense and tolerate HLA self-antigens or up-regulate the NK-cytotoxic response to cells with altered HLA self-antigens, damaged by viruses or tumours. We have previously described increased numbers of NK and NK-related subsets in association with sIL-2R cytokine serum levels in BELFAST octo/nonagenarians. We hypothesised that changes in KIR A and B haplotype gene frequencies could explain the increased cytokine profiles and NK compartments previously described in Belfast Elderly Longitudinal Free-living Aging STudy (BELFAST) octo/nonagenarians, who show evidence of ageing well. Results In the BELFAST study, 24% of octo/nonagenarians carried the KIR A haplotype and 76% KIR B haplotype with no differences for KIR A haplogroup frequency between male or female subjects (23% v 24%; p=0.88) or for KIR B haplogroup (77% v 76%; p=0.99). Octo/nonagenarian KIR A haplotype carriers showed increased NK numbers and percentage compared to Group B KIR subjects (p=0.003; p=0.016 respectively). There were no KIR A/ B haplogroup-associated changes for related CD57+CD8 (high or low) subsets. Using logistic regression, KIR B carriers were predicted to have higher IL-12 cytokine levels compared to KIR A carriers by about 3% (OR 1.03, confidence limits CI 0.99–1.09; p=0.027) and 14% higher levels for TGF-β (active), a cytokine with an anti-inflammatory role, (OR 1.14, confidence limits CI 0.99–1.09; p=0.002). Conclusion In this observational study, BELFAST octo/nonagenarians carrying KIR A haplotype showed higher NK cell numbers and percentage compared to KIR B carriers. Conversely, KIR B haplotype carriers, with

  1. Incapacidade funcional para atividades básicas e instrumentais da vida diária em idosos Disability relating to basic and instrumental activities of daily living among elderly subjects

    Directory of Open Access Journals (Sweden)

    Giovâni Firpo Del Duca

    2009-10-01

    ndice de Katz y la Escala de Lawton, respectivamente. Se definió como incapacidad funcional para cada dominio la necesidad de ayuda parcial o total para la realización de, como mínimo, una actividad de la vida diaria. Se empleó la regresión de Poisson con varianza robusta en los análisis bruto y ajustado considerándose el muestreo por conglomerados. RESULTADOS: La prevalencia de incapacidad para las actividades básicas fue de 26,8% (IC 95%:23,0;30,8 y la menor proporción de independencia fue para controlar funciones de orinar y/o evacuar. Para las actividades instrumentales, la prevalencia de incapacidad funcional fue de 28,8% (IC 95%:24,5;33,1, sobre todo para realizar traslados utilizando algún medio de transporte. Elevado porcentual de ancianos (21,7% presentó más de una actividad con incapacidad en las actividades instrumentales; ya en las actividades básicas, la mayor parte presentó dependencia para solo una actividad (16,6%. En el análisis ajustado, la incapacidad para las actividades básicas se asoció con color de la piel parda/negra/otras (p=0,01 y con el aumento de la edad (pOBJECTIVE: To assess the prevalence of disability and associated factors in elderly, by focusing on basic and instrumental activities of daily living. METHODS: This was a cross-sectional study on 598 subjects aged 60 years or over who were selected through two-stage cluster sampling in Pelotas, Southern Brazil, between 2007 and 2008. Basic and instrumental activities were evaluated using the Katz Index and the Lawton Scale, respectively. Disability relating to each domain was defined as the need for partial or total assistance to perform at least one activity of daily living. Poisson regression with robust variance was used in the crude and adjusted analyses, taking the cluster sampling into account. RESULTS: The prevalence of disability relating to basic activities was 26.8% (95% CI: 23.0; 30.8. The lowest proportion of independence was in relation to controlling the

  2. Non-demented Parkinson's disease patients with apathy show decreased grey matter volume in key executive and reward-related nodes.

    Science.gov (United States)

    Martinez-Horta, Saul; Sampedro, Frederic; Pagonabarraga, Javier; Fernandez-Bobadilla, Ramón; Marin-Lahoz, Juan; Riba, Jordi; Kulisevsky, Jaime

    2017-10-01

    Apathy is a common but poorly understood neuropsychiatric disturbance in Parkinson's disease (PD). In a recent study using event-related brain potentials we demonstrated impaired reward processing and compromised mesocortico-limbic pathways in PD patients with clinical symptoms of apathy. Here we aimed to further investigate the involvement of reward circuits in apathetic PD patients by assessing potential differences in brain structure. Using structural magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) we quantified grey matter volume (GMV) in a sample of 18 non-demented and non-depressed PD patients with apathy, and 18 matched non-apathetic patients. Both groups were equivalent in terms of sociodemographic characteristics, disease stage, cognitive performance and L-Dopa equivalent daily dose. Apathetic patients showed significant GMV loss in cortical and subcortical brain structures. Various clusters of cortical GMV decrease were found in the parietal, lateral prefrontal cortex, and orbitofrontal cortex (OFC). The second largest cluster of GMV loss was located in the left nucleus accumbens (NAcc), a subcortical structure that is a key node of the human reward circuit. Isolated apathy in our sample is explained by the combined GMV loss in regions involved in executive functions, and cortical and subcortical structures of the mesolimbic reward pathway. The correlations observed between apathy and cognition suggests apathy as a marker of more widespread brain degeneration even in a sample of non-demented PD patients.

  3. Effects of age, stage of disease, and educational level on cognitive dysfunction in non-demented idiopathic Parkinsonism: A preliminary report

    Directory of Open Access Journals (Sweden)

    Saptarshi Adhikari

    2012-01-01

    Full Text Available Background: Parkinsonism is known to be associated with clinically significant impairments on an array of cognitive deficits. The degree of impairment is dependent not only on the course of the disease, but also on other bio-social factors. The objective of the present study was to examine the cognitive dysfunction in non-demented idiopathic Parkinson′s disease (IPD in relation to age, stage of disease, and educational level in a sample in Kolkata, India. Materials and Methods: The sample consisted of 51 (42 males, 9 females right-handed patients suffering from non-demented IPD, of age between 40 and 82 years. Data were collected during on-phase medication by using the Kolkata Cognitive Screening Battery. Data were analyzed using means, standard deviations, and multivariate analyses of variance (MANOVA. Results and Conclusion: The patients with IPD were impaired in comparison to the available normative data in almost all aspects of cognitive functioning and higher order mental processes. With increasing age, the patients showed greater impairment in delayed memory and recognition task. Patients of more severe stage showed greater impairment in MMSE, delayed recall, and information. Those with lower education had more impaired visuoconstructional ability, information, comprehension, similarities, and arithmetic.

  4. Report on the Elderly 1996

    NARCIS (Netherlands)

    J.M. Timmermans; M.M.Y. de Klerk

    2000-01-01

    The Social and Cultural Planning Office has been asked to asked to provide information on a regular basis about a number of different population groups. This third report on the elderly looks at the following subjects: demographic trends and networks education and

  5. Thyroid dysfunction in the elderly

    African Journals Online (AJOL)

    1997-09-09

    thirds of the subjects in this study. The serum TSH concentration is a reliable screening test for thyroid dysfunction in the elderly, but is less useful if used to identify biochemical thyroid disease. An elevated TSH concentration is a ...

  6. Contributions of mild parkinsonian signs to gait performance in the elderly.

    Science.gov (United States)

    Allali, Gilles; Verghese, Joe; Mahoney, Jeannette R

    2014-01-01

    Mild parkinsonian signs (MPS) and gait abnormalities are common in aging, but the association between MPS and objective gait measures is not established in the elderly. This study aims to identify the link between MPS and quantitative gait measures, as well as to determine the pathogenesis of MPS in non-demented community-dwelling older adults without idiopathic Parkinson's disease or other parkinsonian syndromes. Three hundred seventy-four non-demented older adults (mean age, 76.44 ± 6.71 years, 57 % women) participated in this study, where comprehensive neurological and medical assessments were conducted. We defined MPS based on the presence of any one of bradykinesia, rigidity, or rest tremor. Velocity and spatial, temporal, and variability gait parameters were recorded using an instrumented walkway. The associations of MPS and gait parameters as well as the relationship of individual MPS with medical illnesses were assessed with linear regressions controlling for key covariates. Participants with MPS walked slower and with disturbed spatial and variability components of gait compared to those without MPS. Bradykinesia was associated with worse spatial and variability gait parameters. This association was only significant for axial bradykinesia, but not for the presence of bradykinesia in the limbs. Cerebrovascular disease (β = .20, p gait performance in older adults. Cerebrovascular disease, a preventable condition, was specifically associated with bradykinesia.

  7. Gait in elderly with cerebral small vessel disease.

    Science.gov (United States)

    de Laat, Karlijn F; van Norden, Anouk G W; Gons, Rob A R; van Oudheusden, Lucas J B; van Uden, Inge W M; Bloem, Bastiaan R; Zwiers, Marcel P; de Leeuw, Frank-Erik

    2010-08-01

    Gait disorders are common in the elderly and are related to loss of functional independence and death. White matter lesions (WMLs) may be related, but only a minority of individuals with WMLs has gait disorders. Probably other factors are involved, including location and the independent effect of frequently coinciding lacunar infarcts, the other aspect of cerebral small vessel disease. The aim of our study was to investigate the effect of both the severity and location of both WMLs and lacunar infarcts on gait. Four hundred thirty-one independently living, nondemented elderly aged between 50 and 85 years with cerebral small vessel disease were included in this analysis and underwent MRI scanning. The number and location of lacunar infarcts were rated and WML volume was assessed by manual segmentation with automated delineating of different regions. Gait was assessed quantitatively with an electronic walkway as well as the semiquantitatively Tinetti and Timed-Up-and-Go test. WMLs and lacunar infarcts were both independently associated with most gait parameters with stride length as the most sensitive parameter related to WMLs. WMLs in the sublobar (basal ganglia/internal capsule) and limbic areas and lacunar infarcts in the frontal lobe and thalamus were related to a lower velocity. Cerebral small vessel disease is related to gait disturbances. Because small vessel disease may, in part, be preventable, it should be regarded as a potentially important target for postponing gait impairment.

  8. Um estudo piloto na avaliação das estratégias posturais em jovens e idosos usando um sistema eletromagnético tridimensional A pilot study on the evaluation of postural strategies in young and elderly subjects using a tridimensional electromagnetic system

    Directory of Open Access Journals (Sweden)

    José Ailton Oliveira Carneiro

    2013-04-01

    Full Text Available Para manter o equilíbrio postural, algumas estratégias posturais são normalmente usadas. OBJETIVO: Avaliar as estratégias posturais de jovens e idosos em diferentes condições sensoriais usando um sistema de sensores eletromagnéticos tridimensionais posicionados na primeira vértebra torácica e região sacral. Também reportamos valores de oscilação postural dos jovens e idosos. MÉTODO: Estudo transversal observacional. Participaram do estudo 25 jovens e 16 idosas. O equipamento PolhemusTM com dois sensores foi usado para avaliar os parâmetros de oscilação postural (deslocamento máximo, velocidade média e trajetória. A aquisição dos dados foi realizada com os sujeitos em pé, realizando um teste de 90 segundos para as quatro condições sensoriais: olhos abertos e fechados nas superfícies estável e instável. RESULTADOS: Os sensores 1 e 2 apresentaram alta correlação cruzada em todas as condições sensoriais para ambos os grupos (r > 0.99; p One resorts to various postural strategies while attempting to maintain balance. OBJECTIVE: To assess the postural strategies adopted by young and elderly subjects in varying sensory conditions by using a system of tridimensional electromagnetic sensors positioned on the projection of the first thoracic vertebra and on the sacral region. Postural oscillation values for young and elderly subjects were also reported. METHOD: This observational cross-sectional study enrolled 25 young and 16 elderly individuals. A PolhemusTM device equipped with two sensors was used to assess postural oscillation parameters (maximum displacement, mean velocity, and trajectory. Data acquisition was carried out with subjects standing while undergoing a 90-second test in four sensory conditions: eyes opened, eyes closed, on a stable surface, and on an unstable surface. RESULTS: Sensors 1 and 2 presented significant cross-correlations in all sensory conditions for both groups (r > 0.99; p < 0.001. No

  9. Efficacy, safety and tolerability of rasagiline as adjunctive therapy in elderly patients with Parkinson's disease.

    Science.gov (United States)

    Tolosa, E; Stern, M B

    2012-02-01

    Rasagiline, an MAO-B inhibitor, is indicated for the treatment of Parkinson's disease (PD). In this post hoc analysis, the efficacy, safety and tolerability of rasagiline as an adjunct to levodopa were compared with placebo in elderly (≥70 years) and younger (Rasagiline: Efficacy and Safety on the Treatment of 'OFF' and Lasting effect in Adjunct therapy with Rasagiline Given Once daily randomized, double-blind, placebo-controlled trials with the primary efficacy end-point being the reduction from baseline in daily OFF time. Secondary efficacy end-points included scores for Clinical Global Improvement (CGI)-Examiner during ON time, Unified Parkinson's Disease Rating Scale (UPDRS)-ADL during OFF time, UPDRS-Motor during ON time and total daily ON time with and without troublesome dyskinesia. Tolerability was evaluated from adverse events (AEs) in the two age groups. Rasagiline decreased daily OFF time versus placebo (Prasagiline but were not significant. Between-group comparisons (≥70 vs. 0.1), and rasagiline was well tolerated amongst both groups of patients with a comparable incidence of total and dopaminergic AEs (P>0.1). Adjunct rasagiline is efficacious and well tolerated in elderly non-demented patients (≥70 years) with moderate to advanced PD. Confirmation of the efficacy and safety of rasagiline in the elderly patient subgroup is especially relevant because of the increasing number of elderly patients with PD. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

  10. Does self-reported sleep quality predict poor cognitive performance among elderly living in elderly homes?

    Science.gov (United States)

    Amer, Motassem S; Hamza, Sarah A; El Akkad, Rania M; Abdel Galeel, Yamen I I

    2013-01-01

    Sleep complaints are common among elderly, especially institutionalized elderly, as they experience poorer sleep quality and higher use of sedative hypnotics, when compared to community-dwelling elderly. Recent findings suggest that there may be a relationship between poor quality of sleep and cognitive deficits. This study aimed at studying the relation between sleep quality and cognitive performance in older adults living in elderly homes. 100 elderly living in an elderly home in El Mansoura, Egypt, were recruited in this study, 50 cases with subjective poor quality of sleep and 50 controls with subjective good quality of sleep as assessed by Pittsburgh sleep quality index (PSQI). Each participant went through comprehensive geriatric assessment (CGA), including geriatric depression scale (GDS), assessment of cognitive function by mini mental state examination (MMSE). 52% of poor sleepers showed impaired MMSE, while only 24% of good sleepers had impaired MMSE. Both orientation and (attention and calculation) were more affected (P = 0.027 and 0.035, respectively). Linear correlation coefficient between PSQI and different variables revealed significant negative correlation with total MMSE score, attention and calculation. Poor quality of sleep is related to cognitive impairment among elderly living in elderly homes and this problem should be taken in consideration among this group of elders.

  11. platelet counts and mean platelet volume amongst elderly

    African Journals Online (AJOL)

    Dr Ahmed

    Sex and age differences in platelet counts were observed in the elderly subjects ... as a result of progressive reduction in haemopoietic stem cells due to exhaustion of .... apparently thrombocytopenia when count observed do not differ from those usually observed in healthy elderly subjects of the same age and sex group.

  12. Association of Peripheral Interleukin-6 with Global Cognitive Decline in Non-demented Adults: A Meta-Analysis of Prospective Studies

    Directory of Open Access Journals (Sweden)

    Steven Bradburn

    2018-01-01

    Full Text Available Background: Elevated biomarkers of systemic inflammation have been reported in individuals with cognitive decline, however, most of the literature concerns cross-sectional analyses that have produced mixed results. This study investigates the etiology of this association by performing meta-analyses on prospective studies investigating the relationship between baseline interleukin-6 (IL-6, an established marker of peripheral inflammation, with cognitive decline risk in non-demented adults at follow-up.Methods: We reviewed studies reporting peripheral IL-6 with future cognitive decline, up to February 2017 by searching the PubMed, Science Direct, Scopus and Google Scholar databases. Studies which contained odds ratios (ORs for the association between circulating baseline IL-6 and longitudinal cognitive performance in non-demented community dwelling older adults were pooled in random-effects models.Results: The literature search retrieved 5,642 potential articles, of which 7 articles containing 8 independent aging cohorts were eligible for review. Collectively, these studies included 15,828 participants at baseline. Those with high circulating IL-6 were 1.42 times more likely to experience global cognitive decline at follow-up, over a 2–7-year period, compared to those with low IL-6 (OR 1.42, 95% CI 1.18–1.70; p < 0.001. Subgroup and sensitivity analyses suggests that this association is independent of the study sample size, duration of follow-up and cognitive assessments used.Conclusions: These results add further evidence for the association between high peripheral inflammation, as measured by blood IL-6, and global cognitive decline. Measuring circulating IL-6 may be a useful indication for future cognitive health.

  13. Increased gait unsteadiness in community-dwelling elderly fallers

    Science.gov (United States)

    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 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.

  14. Experience of Oral Care among Elderly in Nursing Homes

    OpenAIRE

    Buiyan, Salmah; Sheng, Nongfei

    2014-01-01

    Life expectancy among the elderly has been improving for decades and edentulousness is constantly decreasing among the senior citizens. The steady decrease of tooth loss among the elderly is a challenge to the dental profession due to the increased demand of oral care. This study aims to explore the perspectives regarding oral health and oral care among the elderly living in nursing homes. Ten subjects from two nursing homes in Umeå were interviewed based on a defined interview guide. The int...

  15. Social representations of elderly people care and social network maps

    Directory of Open Access Journals (Sweden)

    Annie Mehes Maldonado Brito

    2017-06-01

    Full Text Available This study aimed to understand the social representations of elderly people self-care, care to other elders and their social network, by relating them to care practices used by social networks. The study included a survey distributed to 102 elderly subjects who were asked about their gender and dependency level, in order to identify the elderly social network and the structural part of the social representation of elderly people care. The results shown by the configuration and network map indicate a difference between gender in the elderly social network configuration, where men and independent elderly felt less loneliness, which may reflect a slight deterioration of dependent elderly’s social network. In social practice, elderly people care is assigned to informal caregivers, family members and women. The social representation of elderly people care mainly included the pragmatic aspects of care, functionality and passivity. There is a need for educational policies related to health and aging that favor not only the elderly, but also people who are close to experience old age, especially those who have become, in social practice, elderly caregivers.

  16. [Polyneuropathy in the elderly].

    Science.gov (United States)

    Löscher, Wolfgang; Iglseder, Bernhard

    2017-06-01

    The peripheral nervous system is subject to changes during the ageing process, e. g. deep tendon reflexes decrease, as does proprioception. Polyneuropathies, on the other hand, need to be distinguished from age-related changes as independent diseases with etiologies similar to those at younger ages. Etiologies includes metabolic disorders, primary inflammatory polyneuropathies, and systemic disorders. Neuropathies associated with diabetes, malignancy, and monoclonal gammopathies appear to be more common in older patients. Using a systematic approach, it is possible to establish a specific diagnosis in the majority of cases. Since polyneuropathies contribute to reduced mobility in the elderly, an assessment of functional skills is mandatory. Polyneuropathy therapy is primarily based on the treatment of underlying conditions and neuropathic pain management. Physiotherapy and rehabilitation target pain relief and maintaining activities of daily living.

  17. Um estudo dos relatos afetivos subjetivos a estímulos do International Affective Picture System em uma amostra geriátrica brasileira Subjective affective ratings to photographic stimuli of the International Affective Picture System in a Brazilian elderly sample

    Directory of Open Access Journals (Sweden)

    Weyler Galvão Porto

    2008-08-01

    Full Text Available INTRODUÇÃO: A literatura científica indica a possibilidade de a percepção da emoção e a formação da memória emocional serem discordantes entre jovens e idosos. A mesma é pobre ao explorar essa possibilidade. Neste estudo, relatamos os resultados obtidos em um experimento-piloto com uma amostra de idosos brasileiros, que classificaram subjetivamente, através da escala Self Assessment Manikin, imagens oriundas do International Affective Picture System. MÉTODO: Quarenta e oito idosos voluntários da Universidade Aberta da Terceira Idade, saudáveis clínica e cognitivamente, avaliaram o caráter alertante e a valência afetiva de 71 imagens do International Affective Picture System, aleatoriamente escolhidas. RESULTADOS: O grau de alerta reportado por idosos diante de um estímulo emocional é tanto maior quanto menor o prazer provocado por essa imagem-estímulo, resultando na existência de uma forte correlação negativa (r = 0,93 entre o grau de alerta e o estímulo desprazeroso. Em uma comparação do acima obtido com outro experimento normativo semelhante feito com jovens brasileiros e americanos, apontou-se para uma possível diferença cultural na forma de relatar subjetivamente um estímulo emocional. CONCLUSÕES: Os resultados obtidos com esta amostra estudada sugerem que pode existir uma diferença nos relatos afetivos entre os jovens e idosos, onde uma normatização do International Affective Picture System para uma amostra maior, representativa da população de idosos, seria útil para responder esta questão.INTRODUCTION: The scientific literature points to a possible bias in the form perception and emotional memory are constructed when elderly and young individuals are compared. However, this possibility is underexplored. This paper presents the results obtained from a pilot study based on an elderly emotional subjective report after evaluation using the International Affective Picture System images and Self Assessment

  18. Influence and interactions of cathepsin D, HLA-DRB1 and APOE on cognitive abilities in an older non-demented population.

    Science.gov (United States)

    Payton, A; van den Boogerd, E; Davidson, Y; Gibbons, L; Ollier, W; Rabbitt, P; Worthington, J; Horan, M; Pendleton, N

    2006-01-01

    Cathepsin D (CTSD), human leukocyte antigen DRB1 (HLA-DRB1) and apolipoprotein E (APOE) have all been associated with cognitive ability in both demented and non-demented individuals. CTSD is a pleiotrophic protein whose functions include the processing of proteins prior to presentation by HLA. Several studies have also reported that a functional exon 2 polymorphism in the CTSD gene interacts with APOEepsilon4 resulting in an increased risk of developing Alzheimer's disease (AD). We have previously reported that the CTSD exon 2 polymorphism regulates fluid intelligence. In this study, we extend this finding to other cognitive domains and investigate interactions with APOE and HLA-DRB1. Using a cohort of 766 non-demented volunteers, we found that the CTSD exon 2 T allele was associated with a decrease in several cognitive domains that comprise processing speed [random letters (RLs) test, P = 0.012; alphabet-coding task (ACT), P = 0.001], spatial recall (SR) (P = 0.016) and an additional test of fluid intelligence (P = 0.010). We also observed that the HLA-DR1 was associated with enhanced cumulative recall ability (P = 0.006), and conversely HLA-DR5 was associated with diminished delayed verbal recall and SR abilities (P = 0.014 and P = 0.003, respectively). When analysed independently, APOEepsilon4 did not influence any cognitive domains. In contrast, CTSD T/APOEepsilon4-positive volunteers scored lower on tests of fluid intelligence (P = 0.015), processing speed (ACT, P = 0.001; RL, P = 0.013) and immediate recall (P = 0.029). Scores were lower for all these tests than when CTSD and APOE were analysed independently. This supports previous findings in AD that have also reported an epistatic interaction. In addition, we found that CTSD T/HLA-DR2-positive volunteers had reduced processing speed (ACT, P = 0.040; RL, P = 0.014) and had significantly lower cumulative and SR abilities (P = 0.003 and P = 0.001, respectively). Biological interaction between these two

  19. [Information and communication technology and health of the elderly].

    Science.gov (United States)

    Sanchez, Stéphane; De Boissieu, Paul; Gueyraud, Cédric; Armingaud, Didier; Guerrier, Marc; Denormandie, Philippe

    2016-01-01

    New technologies offer many advantages, especially in terms of animation in elderly care homes. Consoles and digital tablets used without any medical implication were the subject of a literature review on their impact on the health of the elderly.. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Mitochondrial biogenesis and angiogenesis in skeletal muscle of the elderly

    DEFF Research Database (Denmark)

    Iversen, Ninna; Krustrup, Peter; Rasmussen, Hans N

    2011-01-01

    . To investigate this, lifelong endurance trained elderly (ET; n=8) aged 71.3±3.4years and untrained elderly subjects (UT; n=7) aged 71.3±4years, performed a cycling exercise bout at 75% VO(2max) with vastus lateralis muscle biopsies obtained before (Pre), immediately after exercise (0h) and at 2h of recovery...

  1. [Hypertension in the elderly].

    Science.gov (United States)

    Handschin, Anja; Henny-Fullin, Katja; Buess, Daniel; Leuppi, Jörg; Dieterle, Thomas

    2015-06-01

    Arterial hypertension remains the most important risk factor for cardiovascular and renal diseases. In view of an increasing prevalence with older age and an increasingly aging population, the treatment of elderly patients with arterial hypertension will become increasingly important in daily practice. Arterial hypertension in the elderly differs in many aspects from arterial hypertension in younger patients. For example, isolated systolic hypertension is the predominant form of arterial hypertension in the elderly. In comparison to younger patients, treatment of hypertension in the elderly is less well investigated. However, available data suggest that lowering of blood pressure in the elderly and very elderly reduces the risk of heart failure, stroke, and even mortality. The best evidence for the treatment of hypertension in the elderly exists for diuretics and calcium antagonists. However, the primary choice of antihypertensive therapy should be guided by the presence of existing cardiovascular and/or renal comorbidities.

  2. A COOPERATIVE ASSISTANCE SYSTEM BETWEEN VEHICLES FOR ELDERLY DRIVERS

    Directory of Open Access Journals (Sweden)

    Naohisa HASHIMOTO

    2009-01-01

    Full Text Available This paper proposes a new concept of elderly driver assistance systems, which performs the assistance by cooperative driving between two vehicles, and describes some experiments with elderly drivers. The assistance consists of one vehicle driven by an elderly driver called a guest vehicle and the other driven by a assisting driver called a host vehicle, and the host vehicle assists or escorts the guest vehicle through the inter-vehicle communications. The functions of the systems installed on a single-seat electric vehicle are highly evaluated by subjects of elderly drivers in virtual streets on a test track.

  3. The effects of normal aging on amyloid-β deposition in nondemented adults with Down syndrome as imaged by [11C]PiB

    Science.gov (United States)

    Lao, PJ; Betthauser, TJ; Hillmer, AT; Price, JC; Klunk, WE; Mihaila, I; Higgins, AT; Bulova, PD; Hartley, SL; Hardison, R; Tumuluru, RV; Murali, D; Mathis, CA; Cohen, AD; Barnhart, TE; Devenny, DA; Mailick, MR; Johnson, SC; Handen, BL; Christian, BT

    2015-01-01

    Introduction In Down syndrome (DS), the overproduction of amyloid precursor protein is hypothesized to predispose young adults to early expression of Alzheimer-like neuropathology. Methods PET imaging with [11C]PiB examined the pattern of amyloid-β deposition in 68 nondemented adults with DS (30-53 years) to determine the relationship between deposition and normal aging. Standard uptake value ratio (SUVR) images were created with cerebellum as the reference region. Results Multiple linear regression revealed slight but highly significant (corrected p<0.05) positive correlations between SUVR and age. The striatum showed the strongest correlation, followed by precuneus, parietal cortex, anterior cingulate, frontal cortex, and temporal cortex. Conclusion There is an age-related amyloid-β deposition in the DS population, but as a pattern of elevated cortical retention becomes apparent, the correlation of SUVR with age ceases to be significant. Factors unrelated to aging may drive an increase in deposition during early Alzheimer's disease pathogenesis. PMID:26079411

  4. The predictive value of self-rated health in the presence of subjective memory complaints on permanent nursing home placement in elderly primary care patients over 4-year follow-up

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert Dirk; Waldemar, Gunhild

    2013-01-01

    self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear.......self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear....

  5. Sagittal plane momentum control during walking in elderly fallers.

    Science.gov (United States)

    Fujimoto, Masahiro; Chou, Li-Shan

    2016-03-01

    The purpose of this study was to examine sagittal plane momentum control during walking with the use of center of mass (COM) velocity and acceleration. COM control in the antero-posterior direction during walking of healthy young and elderly adults, and elderly fallers (n=15/group) was examined. Using a single-link-plus-foot inverted pendulum model, boundaries for the region of stability were determined based on the COM position at toe-off and its instantaneous velocity or the peak acceleration prior to toe-off (ROSv or ROSa, respectively). Although no significant difference in forward COM velocity was detected between healthy young and elderly subjects, the peak forward COM acceleration differed significantly, suggesting age-related differences in momentum control during walking. Elderly fallers demonstrated significantly slower forward COM velocities and accelerations and placed their COM significantly more anterior than healthy young and elderly subjects at toe-off, which resulted in their COM position-velocity combination located within the ROSv. Similar results were obtained in the ROSa, where elderly fallers demonstrated a larger stability margin than healthy young and elderly subjects. Significantly slower peak COM accelerations could be indicative of a poor momentum control ability, which was more pronounced in elderly fallers. Examining COM acceleration, in addition to its velocity, would provide a greater understanding of person's momentum control, which would allow us to better reveal underlying mechanisms of gait imbalance or falls. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Pharmacokinetics and drug metabolism in the elderly.

    Science.gov (United States)

    Klotz, Ulrich

    2009-01-01

    Aging involves progressive impairments in the functional reserve of multiple organs, which might also affect drug metabolism and pharmacokinetics. In addition, the elderly population will develop multiple diseases and, consequently, often has to take several drugs. As the hepatic first-pass effect of highly cleared drugs could be reduced (due to decreases in liver mass and perfusion), the bioavailability of some drugs can be increased in the elderly. Significant changes in body composition occur with advancing age. Lipophilic drugs may have an increased volume of distribution (Vd) with a prolonged half-life, and water-soluble drugs tend to have a smaller Vd. In the elderly, hepatic drug clearance of some drugs can be reduced by up to 30% and CYP-mediated phase I reactions are more likely to be impaired than phase II metabolism, which is relatively preserved in the elderly. Concerning the most important CYP3A4 studies with human liver microsomes and clinical studies with the validated probe, midazolam, it is indicated that there are no significant differences in CYP3A4 activity between young and old populations. Finally, renal excretion is decreased (up to 50%) in about two thirds of elderly subjects, but confounding factors such as hypertension and coronary heart disease account also for a decline in kidney function. In conclusion, age-related physiological and pharmacokinetic changes as well as the presence of comorbidity and polypharmacy will complicate drug therapy in the elderly.

  7. Hyponatremia in the elderly: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Filippatos TD

    2017-11-01

    Full Text Available Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece Abstract: Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the “tea and toast” syndrome. The aim of this review is to present certain challenges in the evaluation and treatment of hyponatremia in the elderly population and provide practical solutions. Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants, the syndrome of inappropriate antidiuretic hormone secretion (SIAD or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients. Special attention is needed in the elderly population to exclude endocrinopathies as a cause of hyponatremia before establishing the diagnosis of SIAD, which then requires a stepped diagnostic approach to reveal its underlying cause. The treatment of hyponatremia depends on the type of hyponatremia. Special attention is also needed to correct serum sodium levels at the appropriate rate, especially in chronic hyponatremia, in order to avoid the osmotic demyelination syndrome. In conclusion, both the evaluation and the treatment of hyponatremia pose many challenges in the elderly population. Keywords: sodium, prognosis, hypopituitarism, elderly, pituitary

  8. Screening a heterogeneous elderly South African population for ...

    African Journals Online (AJOL)

    Screening a heterogeneous elderly South African population for cognitive impairment: the utility and performance of the Mini-Mental State Examination, Six Item Screener, Subjective Memory Rating Scale and Deterioration Cognitive Observee.

  9. Dysphagia in the elderly.

    OpenAIRE

    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 hav...

  10. Characteristics of Falls Among Institutionalized Elderly People

    Directory of Open Access Journals (Sweden)

    Ahmad Ali Akbari Kamrani

    2007-01-01

    Full Text Available Objectives: Falls by elderly people area frequent cause of morbidity and mortality, especially in institutionalized elders. to describe the features of falls among institutionalized elderly people. Methods & Materials: characteristics of falls in the preceding six months (March 2006 - September 2006 that occurred among elder lies (aged over 60years with normal physical function and cognitive status, who lived at Kahrizak Institute, along term nursing home in Tehran, were surveyed and analyzed. Results: The mean age of the patients with falls was 76.9 yrs. These numbers of falls had occurred among 29 elders that 48.3% were women and 51.7% were men. 57.6% off alls were simple and elders could standup immediately independently. 42.4% of falls needed to help for standup, 2 elder person (2.6% had sever consequence of fall and had fractures. (Skull fracture, head trauma & hip fracture 30.3% of falls occurred in yard, 28.9% at room, 18.4%inhallway, 14.5% at WC, .3.9%at bathroom, and 3.9% at lunch saloon. Analysis of the time of falls showed: 45.3% of falls occurred at 7bl2 am, 13.2% at the lunch time (12bI4, 17% at 14b19, 11.3%at night (19b4 am, and 13.2% at 4b7 am. Conclusion: falls among elder lies occur mainly outside of room. And occur at the time of maximum activities, for example at morning; also falls have been happened more in subjects older, and occasionally result in sever injury such as head trauma, skull fracture, femur and pelvis fracture and cause more mortality and morbidity. Control of environmental risk factors could be protective factors against falls.

  11. Economic Dependency and Depression in Elderly

    Directory of Open Access Journals (Sweden)

    Charchit P. Mehta

    2016-01-01

    Full Text Available Background: Aging has become greatest challenge globally. In developing countries including India elderly population (persons aged 60 years and above is projected to outpace the rich world resulting in 50-80 percent of them expected to be staying in resource constraint countries. By 2050 of the total population more than 20 percent will be elderly. Depressive illness associated with dementia is one of the important problems in elderly. With increase in longevity there will be sharp rise in old age dependency ratio which can drain the resources in any country due to expenditure on health, social security and education. Aim & Objectives: The present study was carried out to assess the extent of degree of depression in elderly and study the associated factors like economic dependency. Material and Methods: Randomly selected subjects were administered the questionnaire of Geriatric Depression Scale (GDS, in the Geriatric Clinic of a tertiary care hospital, to categorize them based on the scores, into mild, moderate and severe. Some of the factors were studied and analysed to nd out their association with depression like working status, socioeconomic status and economic dependency. Results: Proportion of elderly having depression was 52.4% with females outnumbering males. Depression seems to be more in those elderly who were not working, were from low socioeconomic status and not having pension as 38.6% who had no pension were depressed. Moderate to severe depression was more in economically dependent (20% as compared to those who were independent nancially. Conclusion: Economic dependency seems to be important associated factor responsible for depression in elderly along with other factors like socioeconomic status, pension status etc. Implementation of adequate health services and social security system is needed to prevent the marginalization of elderly.

  12. Imbalances in the elderly

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    Maksim Valeryevich Zamergrad

    2012-01-01

    Full Text Available The paper considers the main causes of imbalance in elderly patients. It gives data on the specific features of the course of the most common vestibular diseases in the elderly, such as benign paroxysmal positional vertigo, Meniere’s disease, stroke, and transient ischemic attack. At the same time the vestibular system-aging mechanisms that are able to induce disequilibrium are considered. Multisensory disequilibrium is discussed as the most common cause of instability in the elderly. Basic treatments for vestibular diseases in the elderly, including drug therapy and vestibular rehabilitation, are analyzed.

  13. Increased walking variability in elderly persons with congestive heart failure

    Science.gov (United States)

    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 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).

  14. Elderly outpatient profile and predictors of falls.

    Science.gov (United States)

    Gomes, Grace Angélica de Oliveira; Cintra, Fernanda Aparecida; Batista, Fernanda Sotelo; Neri, Anita Liberalesso; Guariento, Maria Elena; Sousa, Maria da Luz Rosario de; D'Elboux, Maria José

    2013-01-01

    CONTEXT AND OBJECTIVES Falls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects. DESIGN AND SETTING Cross-sectional descriptive study forming part of the project "Quality of Life of Frail Elderly People", carried out in Campinas, Brazil. METHODS The subjects were 145 elderly individuals (76.3 ± 7.8 years old), of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out. RESULTS Cluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found. CONCLUSIONS The results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  15. Elderly outpatient profile and predictors of falls

    Directory of Open Access Journals (Sweden)

    Grace Angélica de Oliveira Gomes

    Full Text Available CONTEXT AND OBJECTIVESFalls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects.DESIGN AND SETTINGCross-sectional descriptive study forming part of the project “Quality of Life of Frail Elderly People”, carried out in Campinas, Brazil.METHODSThe subjects were 145 elderly individuals (76.3 ± 7.8 years old, of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out.RESULTSCluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found.CONCLUSIONSThe results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  16. Factors Affecting Hypertension among the Malaysian Elderly

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    Sima Ataollahi Eshkoor

    2016-03-01

    Full Text Available Hypertension is a common chronic disease in the elderly. This study aimed to determine the effects of age, ethnicity, gender, education, marital status, nutritional parameters, and blood elements on the risk of high blood pressure in the Malaysian elderly. This research was conducted on a group of 2322 non-institutionalized Malaysian elderly. The hierarchy binary logistic regression analysis was applied to estimate the risk of hypertension in respondents. Approximately, 45.61% of subjects had hypertension. The findings indicated that the female gender (Odds ratio (OR = 1.54, an increase in body weight (OR = 1.61, and an increase in the blood levels of albumin (OR = 1.51, glucose (OR = 1.92, and triglycerides (OR = 1.27 significantly increased the risk of hypertension in subjects (p < 0.05. Conversely, an increase in both dietary carbohydrates (OR = 0.74, and blood cholesterol level (OR = 0.42 significantly reduced the risk of hypertension in samples (p < 0.05. Furthermore, the results showed that ethnicity was a non-relevant factor to increase the risk of hypertension in subjects. It was concluded that female gender, an increase in body weight, and an increase in the blood levels of glucose, triglycerides, and albumin enhanced the risk of high blood pressure in the Malaysian elderly. In addition, an increase in both dietary carbohydrates and blood cholesterol level decreased hypertension in subjects.

  17. Value of FDG-PET scans of non-demented patients in predicting rates of future cognitive and functional decline

    Energy Technology Data Exchange (ETDEWEB)

    Torosyan, Nare; Mason, Kelsey; Dahlbom, Magnus; Silverman, Daniel H.S. [David Geffen School of Medicine at the University of California Los Angeles, Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, Los Angeles, CA (United States); Collaboration: the Alzheimer' sDisease Neuroimaging Initiative

    2017-08-15

    The aim of this study was to examine the value of fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting subsequent rates of functional and cognitive decline among subjects considered cognitively normal (CN) or clinically diagnosed with mild cognitive impairment (MCI). Analyses of 276 subjects, 92 CN subjects and 184 with MCI, who were enrolled in the Alzheimer's Disease Neuroimaging Initiative, were conducted. Functional decline was assessed using scores on the Functional Activities Questionnaire (FAQ) obtained over a period of 36 months, while cognitive decline was determined using the Alzheimer's disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) scores. PET images were analyzed using clinically routine brain quantification software. A dementia prognosis index (DPI), derived from a ratio of uptake values in regions of interest known to be hypometabolic in Alzheimer's disease to regions known to be stable, was generated for each baseline FDG-PET scan. The DPI was correlated with change in scores on the neuropsychological examinations to examine the predictive value of baseline FDG-PET. DPI powerfully predicted rate of functional decline among MCI patients (t = 5.75, p < 1.0E-8) and pooled N + MCI patient groups (t = 7.02, p < 1.0E-11). Rate of cognitive decline on MMSE was also predicted by the DPI among MCI (t = 6.96, p < 1.0E-10) and pooled N + MCI (t = 8.78, p < 5.0E-16). Rate of cognitive decline on ADAS-cog was powerfully predicted by the DPI alone among N (p < 0.001), MCI (t = 6.46, p < 1.0E-9) and for pooled N + MCI (t = 8.85, p = 1.1E-16). These findings suggest that an index, derivable from automated regional analysis of brain PET scans, can be used to help predict rates of functional and cognitive deterioration in the years following baseline PET. (orig.)

  18. Exoskeleton plantarflexion assistance for elderly.

    Science.gov (United States)

    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.

  19. Cognitive performance correlates with the degree of dopaminergic degeneration in the associative part of the striatum in non-demented Parkinson's patients.

    Science.gov (United States)

    Kübler, Dorothee; Schroll, Henning; Buchert, Ralph; Kühn, Andrea A

    2017-09-01

    Parkinson's disease (PD) patients show cognitive deficits that are relevant in terms of prognosis and quality of life. Degeneration of striatal dopaminergic afferents proceeds from dorsal/caudal to anterior/ventral and is discussed to account for some of these symptoms. Treatment with dopamine (DA) has differential effects on cognitive dysfunctions, improving some and worsening others. We hypothesized that cognitive performance during the dopaminergic OFF state correlates with DAT availability in the associative striatum. 16 PD patients underwent motor and cognitive examination ON and OFF DA. Global cognition was measured using the Montréal Cognitive Assessment (MoCA) test and executive functioning using a Stroop test. Nigrostriatal dopaminergic innervation was characterized with [ 123 I]FP-CIT SPECT. A connectivity atlas of the striatum was used to assess DAT availability in functionally defined striatal subregions. Correlations between imaging data and behavioral data OFF medication were calculated. Correlations between DAT availability and MoCA performance in the dopaminergic OFF state was strongest in the associative part of the striatum (r = 0.674, p = 0.004). MoCA test performance did not differ between the ON and the OFF state. There was no correlation of DAT availability with Stroop performance in the OFF state but performance was significantly better during the ON state. Not only motor but also cognitive dysfunctions in PD are associated with striatal dopaminergic depletion. Cognitive decline in non-demented PD patients goes along with nigrostriatal degeneration, most pronounced in the associative subdivision of the striatum. In addition, the present findings suggest that executive dysfunctions are ameliorated by DA whereas global cognition is not improved by dopaminergic medication.

  20. Comparative assessment of different methods for the estimation of gait temporal parameters using a single inertial sensor: application to elderly, post-stroke, Parkinson's disease and Huntington's disease subjects.

    Science.gov (United States)

    Trojaniello, Diana; Ravaschio, Andrea; Hausdorff, Jeffrey M; Cereatti, Andrea

    2015-09-01

    The estimation of gait temporal parameters with inertial measurement units (IMU) is a research topic of interest in clinical gait analysis. Several methods, based on the use of a single IMU mounted at waist level, have been proposed for the estimate of these parameters showing satisfactory performance when applied to the gait of healthy subjects. However, the above mentioned methods were developed and validated on healthy subjects and their applicability in pathological gait conditions was not systematically explored. We tested the three best performing methods found in a previous comparative study on data acquired from 10 older adults, 10 hemiparetic, 10 Parkinson's disease and 10 Huntington's disease subjects. An instrumented gait mat was used as gold standard. When pathological populations were analyzed, missed or extra events were found for all methods and a global decrease of their performance was observed to different extents depending on the specific group analyzed. The results revealed that none of the tested methods outperformed the others in terms of accuracy of the gait parameters determination for all the populations except the Parkinson's disease subjects group for which one of the methods performed better than others. The hemiparetic subjects group was the most critical group to analyze (stride duration errors between 4-5 % and step duration errors between 8-13 % of the actual values across methods). Only one method provides estimates of the stance and swing durations which however should be interpreted with caution in pathological populations (stance duration errors between 6-14 %, swing duration errors between 10-32 % of the actual values across populations). Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Aging and Identity: Meanings of Elderly Women

    Directory of Open Access Journals (Sweden)

    Irani Iracema de Lima Argimon

    2012-06-01

    Full Text Available This paper presents the results of a survey that focus on reflections on the construction of identity in elderly women. Interviews were conducted by semi-structured form with six elderly women and the data were analyzed based on the Comprehensive Review of Phenomenological Base. Not reduce the subject to biological, genetic, social allows us to develop these projects and achievements in this time of life where the experience can lead to a better well-being and quality of life.

  2. [Anemia in the elderly].

    Science.gov (United States)

    Maerevoet, M; Sattar, L; Bron, D; Gulbis, B; Pepersack, T

    2014-09-01

    Anaemia is a problem that affects almost 10% over 65 years and 20% over 85 years. There is no physiological anaemia in the elderly. Any anaemia expresses the existence of a pathological process, regardless of its severity. Anaemia in the elderly is always associated with a poor prognosis that is in terms of mortality, morbidity and risk of fragility. The diagnostic approach to anemia in the elderly is the same as in younger individual. There are many causes of anaemia; anaemia balance is a complex diagnostic process. Most anaemias are due to a deficiency, chronic inflammation or comorbidity. However, in the elderly, the etiology of anaemia is often multifactorial. In a number of cases remain unexplained anaemia. In a number of cases, anemia remain unexplained. Treatment of anaemia is the treatment of the cause, but specific therapeutic aspects to the elderly should be considered, as among other martial substitution or use of erythropoietin (EPO).

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

    OpenAIRE

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

    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...

  4. The Elder Problem

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    John W. Elder

    2017-03-01

    Full Text Available This paper presents an autobiographical and biographical historical account of the genesis, evolution and resolution of the Elder Problem. It begins with John W. Elder and his autobiographical story leading to his groundbreaking work on natural convection at Cambridge in the 1960’s. His seminal work published in the Journal of Fluid Mechanics in 1967 became the basis for the modern benchmark of variable density flow simulators that we know today as “The Elder Problem”. There have been well known and major challenges with the Elder Problem model benchmark—notably the multiple solutions that were ultimately uncovered using different numerical models. Most recently, it has been shown that the multiple solutions are indeed physically realistic bifurcation solutions to the Elder Problem and not numerically spurious artefacts. The quandary of the Elder Problem has now been solved—a major scientific breakthrough for fluid mechanics and for numerical modelling. This paper—records, reflections, reminiscences, stories and anecdotes—is an historical autobiographical and biographical memoir. It is the personal story of the Elder Problem told by some of the key scientists who established and solved the Elder Problem. 2017 marks the 50 year anniversary of the classical work by John W. Elder published in Journal of Fluid Mechanics in 1967. This set the stage for this scientific story over some five decades. This paper is a celebration and commemoration of the life and times of John W. Elder, the problem named in his honour, and some of the key scientists who worked on, and ultimately solved, it.

  5. Interleukin-1 alpha (rs1800587) genetic polymorphism is associated with specific cognitive functions but not depression or loneliness in elderly males without dementia.

    Science.gov (United States)

    Wang, Eileen H; Hong, Chen-Jee; Yeh, Heng-Liang; Liou, Ying-Jay; Yang, Albert C; Liu, Mu-En; Tsai, Shih-Jen

    2013-11-27

    Inflammatory process is considered to be a pathway that results in neurodegeneration, and numerous plasma cytokines have been examined for their association with cognitive function and depression. Interleukin-1 alpha (IL-1A) genetic polymorphism (rs1800587) has been found to be associated with Alzheimer's disease susceptibility. The aim of this study was to investigate the effect of IL-1A rs1800587 genetic effects on cognitive functions, loneliness and depression severity in elderly males without dementia or major depression. 192 non-demented Chinese elderly male were recruited and underwent Cognitive Abilities Screening Instrument (CASI), Wechsler Digit Span Task, Geriatric Depression Scale-short form, and UCLA Loneliness Scale assessment. IL-1A rs1800587 is a C to T transition at position -889. Compared to the C/C carriers, the T allele carriers had significantly overall higher CASI score (p=0.017) after using age and total education years as co-variates. This was especially true in the four distinct domains of long-term memory (pDepression Scale-short form or UCLA Loneliness Scale. Our data supports that the T allele of IL-1A rs1800587 genetic polymorphism is associated with better cognitive function in the elderly. Further research will be needed to better understand the molecular mechanism for IL-1A genetic effects on cognitive function in the elderly. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. A força de preensão manual é boa preditora do desempenho funcional de idosos frágeis: um estudo correlacional múltiplo The hand-grip forecasts the functional performance of fragile elder subjects: a multiple-correlation study

    Directory of Open Access Journals (Sweden)

    Amandio A.R. Geraldes

    2008-02-01

    institutionalized elderly subjects, having a good potential as an epidemiologic exposition variable to forecast functional performance.

  7. [Disability among elderly women in Brazil].

    Science.gov (United States)

    Parahyba, Maria Isabel; Veras, Renato; Melzer, David

    2005-06-01

    To estimate disability rates and explore associations, identifying the most significant socioeconomic markers associated with the prevalence of mobility disability among elderly women. National mobility disability rates were estimated based on information from the 1998 National Household Survey (PNAD), conducted by the Instituto Brasileiro de Geografia e Estatística. The present study analyzes the elderly women population, totaling 16,186 subjects. Logistic regression models were constructed considering 'difficulty walking 100 meters' as the dependent variable. The prevalence of markers of mild, moderate and severe disability was greater among women, and increased with age. In logistic regression analysis, markers most strongly associated with increased prevalence of mobility disability were age, gender, low schooling, and low income. Rural residence was also associated with reduced prevalence. Our results suggest potential risk factors for the development of functional decline in elderly women, given that the associations encountered were consistent with those reported by other studies in the literature.

  8. Measuring continuity of elders' posthospital care.

    Science.gov (United States)

    Bull, M J; Luo, D; Maruyama, G M

    2000-01-01

    Continuity of care is a critical component of quality patient care, yet the paucity of reliable and valid measures of continuity of care make it difficult to ascertain the extent to which continuity has been achieved. The purpose of this article is to describe the development of an instrument to measure continuity of care that incorporates the perspectives of elders hospitalized for a chronic illness and their family caregivers. The instrument was used, and its reliability and validity examined, in a series of studies related to elders' posthospital transition. Elders in the studies ranged in age from 55 to 94 years. The findings supported content and construct validity, internal consistency reliability, and ability to detect changes in the same subjects at different points in time for the care management and services subscales. With further refinement, the continuity of provider and conflicting information subscales might also facilitate assessment of care continuity.

  9. PERCEPTIONS AND EXPERIENCES OF ELDERLY RESIDENTS IN A NURSING HOME

    Directory of Open Access Journals (Sweden)

    Renata Alessandra Evangelista

    2014-12-01

    Full Text Available The objective of this study was to evaluate the perception of the elderly residents of a long-stay nursing home on the process of institutionalization. We interviewed 14 subjects, five women and nine men, aged between 60 and 92 years. Data collection was conducted with a semi-structured sociodemographic interview, which presented the guiding question: “Tell me about how is your life, what do you do and how did you come to live here”. From the analysis, we found topics related to feelings of abandonment, loneliness, anger, ingratitude, living with chronic pain, satisfaction of property in the nursing home, productivity and social relationship. Given the thematic analysis, it was possible to group them into three categories such as: what the elderly feel, what the elderly perceive and what the elderly desire. As a result, we need public policies that addresses to the service provided by institutions regarding elderly expectations.

  10. Ambient Technology to Assist Elderly People in Indoor Risks

    Directory of Open Access Journals (Sweden)

    Rami Yared

    2016-10-01

    Full Text Available While elderly people perform their daily indoor activities, they are subjected to several risks. To improve the quality of life of elderly people and promote healthy aging and independent living, elderly people need to be provided with an assistive technology platform to rely on during their activities. We reviewed the literature and identified the major indoor risks addressed by assistive technology that elderly people face during their indoor activities. In this paper, we identify these risks as: fall, wrong self-medication management, fire, burns, intoxication by gas/smoke, and the risk of inactivity. In addition, we discuss the existing assistive technology systems and classify the risk detection algorithms, techniques and the basic system principles and interventions to enhance safety of elderly people.

  11. Plasma Adiponectin Levels in Elderly Patients with Prediabetes

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    Si Eun Kong

    2015-09-01

    Full Text Available BackgroundThe significance of adiponectin levels in elderly individuals with prediabetes has yet to be determined. Thus, the present study was performed to evaluate the relationships between adiponectin levels and anthropometric variables, body composition parameters, insulin sensitivity, and lipid profiles in elderly prediabetic patients.MethodsThe present study included 120 subjects with prediabetes who were >65 years of age and were selected from among 1,993 subjects enrolled in the Korea Rural Genomic Cohort Study. All subjects underwent a 75 g oral glucose tolerance test and tests for measurement of insulin sensitivity. All diagnoses of prediabetes satisfied the criteria of the American Diabetes Association.ResultsPlasma adiponectin levels were lower in elderly prediabetic subjects than elderly subjects with normal glucose tolerance (P<0.01 as well as in elderly prediabetic patients with metabolic syndrome (MetS than in those without MetS (P<0.02. When the subjects were categorized into two groups according to plasma adiponectin levels, the waist-to-hip ratio and 2-hour insulin levels were significantly lower in individuals with high plasma adiponectin levels than in those with low plasma adiponectin levels. Additionally, the plasma adiponectin levels of elderly prediabetic subject were inversely correlated with body mass index (BMI, waist circumference (WC, waist-to-hip ratio, visceral fat, visceral fat ratio, and 2-hour insulin levels.ConclusionThe present findings demonstrated that the major factors correlated with adiponectin levels in elderly prediabetic subjects were BMI, WC, waist-to-hip ratio, visceral fat, visceral fat ratio, and 2-hour insulin levels.

  12. White matter changes and diabetes predict cognitive decline in the elderly: the LADIS study

    DEFF Research Database (Denmark)

    Verdelho, A; Madureira, S; Moleiro, C

    2010-01-01

    We aimed to study if age-related white matter changes (WMC) and vascular risk factors were predictors of cognitive decline in elderly subjects with WMC living independently.......We aimed to study if age-related white matter changes (WMC) and vascular risk factors were predictors of cognitive decline in elderly subjects with WMC living independently....

  13. Relationship Between Basic Psychological Needs and Mental Vitality in the Elderly

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    Mehdi Arabzadeh

    2017-09-01

    Conclusion The basic psychological needs are considered as an important factor for maintaining subjective vitality in the elderly. Therefore, understanding the basic psychological needs and strengthening these factors can be an effective method for enhancing the subjective vitality of elderly people.

  14. Knee and ankle range of motion during stepping down in elderly compared to young men

    NARCIS (Netherlands)

    Lark, S.D.; Buckley, J.G.; Jones, D.A.; Sargeant, A.J.

    2004-01-01

    A major factor limiting mobility in elderly subjects is their difficulty with descending steps but the physiological and biomechanical basis of this problem is not well understood. To address this question we have compared the kinematics of stepping down in six elderly male subjects and six weight-

  15. [Psychiatry in elderly prisoners].

    Science.gov (United States)

    Fovet, T; Geoffroy, P A; Vaiva, G; Adins, C; Thomas, P; Amad, A

    2016-04-01

    The high prevalence of psychiatric disorders in prison and the aging of inmates should lead to the consideration of gerontopsychiatry in the prison environment. This review aims to emphasize the clinical characteristics and associated comorbidities of elderly prisoners with psychiatric disorders. We examined the international literature in September 2013 and performed the literature search with PubMed electronic database using the following Mesh headings: "prisons", "prisoners", "geriatric psychiatry", "geriatric assessment", "geriatric nursing". Fourteen studies were retained by the literature search strategy and were included in the qualitative analysis. More than one out of two elderly prisoners (>60 year-old) suffer from a psychiatric disorder. Major depressive disorder (MDD) is the first psychiatric disorder diagnosed among elderly prisoners, affecting 30 to 50% of them. Personality disorders are also very common demonstrating a prevalence of about 30%. Psychotic disorders concern 5% of the elderly prisoners and thus largely exceed the prevalence in the general population. Furthermore, stress events are frequent in prison and might precipitate or worsen psychiatric disorders. This review highlights the difficulties and complexities of care plans and management for the elderly in prison. The situation of elderly prisoners with psychiatric disorders is extremely worrying. In addition, both the aging of the population and the lengthening of incarcerations increase the number of elderly prisoners, widely exposed to psychiatric disorders, and thus will probably worsen these issues in the future. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  16. Hypertension in the elderly

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    Giuliano Pinna

    2012-12-01

    Full Text Available IntroductionThere is a high prevalence of hypertension in the elderly, as evidenced by clinical and health behavioral policies. Still, there are uncertainties on the treatment of hypertension, especially treatment of the very elderly. These considerations have largely been ignored in clinical trials due to concern regarding contamination by other pathologies that are difficult to frame and manage.Methods We performed an effective and ample literature review and provided reflections on the Consensus Conference ACCF/AHA 2011 on the principle types of hypertension found in the elderly. We also considered the associated principle pathologies for various treatments and related organs.Discussion Even if the goal of treatment of elevated blood pressure in the elderly is same as in younger population, it is no longer certain that a target systolic blood pressure (SBP <140 mmHg should be persistently reached in the very elderly. It is important to note that for all studies these values have never been reached. In the treatment of isolated systolic hypertension (ISH the preferred target is a SBP >160 mmHg. Treating hypertension in the elderly and very elderly reduces the risk of stroke and heart failure, though the evidence is inconclusive for all-cause mortality.Conclusion Hypertension in the elderly is very common and needs to be treated with criteria that consider the patient's age, comorbidities, lifestyle and adherence. Above all, in the very elderly, therapeutic treatment should be personalized according to the above criteria. Where possible pharmaceutical therapy should be limited at the preference of healthy lifestyle changes (physical activity, diet, etc..

  17. Gender discrimination in the elderly and its impact on the elderly health.

    Science.gov (United States)

    Keskinoglu, Pembe; Ucuncu, Tugba; Yildirim, Idris; Gurbuz, Turgut; Ur, Ismail; Ergor, Gul

    2007-01-01

    The aim of this study was to determine gender discrimination and risk factors in the elderly population and to assess the impact of that discrimination on elderly health. One hundred and sixty-eight elderly individuals who were selected from the records by simple randomized sampling were enrolled in the study. Data were obtained by face-to-face interviews at the residence of the elderly individuals. Chi(2)-Analysis, t-test, Mann-Whitney U-test, and logistic regression were used for data analysis. 81.1% of the elderly were married and 40.5% were middle or high school graduates, and 93.9% of the subjects had at least one living child. It was determined that 51.7% of the females, and 21.3% of the males were exposed to negative gender discrimination. This discrimination was higher among women in all sub-groups. In fact, older women and elderly individuals with only primary school education or less were significantly more exposed to gender discrimination (p=0.008 and p=0.043, respectively). It was found that only economical variables were related to poor health status, without gender discrimination. Despite the fact that the freedom has been obtained in some areas such as participation in household decision-making and dressing, the patriarchal family structure and sexual inequality continue in older age.

  18. The elderly patients' dignity

    DEFF Research Database (Denmark)

    Høy, Bente; Hall, E.O.C.; Wagner, L.

    2007-01-01

    This study shows how care providers in hospital practice perceive the elderly patient's dignity as a core value in health promoting care towards the elderly. Fifteen focus group interviews were conducted with care providers who told about their nursing practice experience. The interviews were...... analysed using a phenomenological hermeneutical approach. The results disclose that when caring for the elderly patient's health potential, care providers saw dignity as the core value of health. Dignity was found to capture three themes: autonomy, identity, and worthiness. These themes reflect...

  19. Elder Abuse and Neglect

    Directory of Open Access Journals (Sweden)

    Muge Gulen

    2013-06-01

    Full Text Available Abuse and neglect are preventable societal problems that influence elderly individuals physically, spiritually and socially. Elder abuse is neglected for many years and is a growing problem all over the world. The aim of this article is to review the evaluation of elderly individuals who are exposed to abuse and neglect with systematic detailed history and physical examination and to describe individual, familial, and social measures that should be taken to prevent these abuses. [Archives Medical Review Journal 2013; 22(3.000: 393-407

  20. The effect of Pilates method on elderly flexibility

    Directory of Open Access Journals (Sweden)

    Adriana Coutinho de Azevedo Guimarães

    Full Text Available Introduction Pilates as physical exercise practice brings countless benefits, such as improvement of motor aptitudes and skills.Objective To look into the effect of the Pilates method on the hip and shoulder girdle flexibility levels in the elderly.Methods Experimental study composed of 30 elderly subjects of the control group and 30 of the Pilates group within a 12 week training time. A form was used to characterize the sample and to assess hip flexibility and shoulder girdle. Descriptive and inferential statistics were used, under a significance level of p < 0.05.Results On hip flexibility, the 30 elderly individuals from the control group remained under normal and inferior classification, not presenting any differences between the variables (p = 0.180 from the pretest to the retest. In the intervention group, 60% of the elderly subjects were assessed as normal. In the retest, such percentage increased to 66.7%. In the pretest, 10% of the elderly subjects were given the superior classification, and in the retest, it increased to 33%, not presenting significance between the variables (p = 0.180. On shoulder flexibility in the intervention group, 63% of the elderly subjects were graded as normal, and 17% as superior. In the shoulder retest the number of elderly individuals decreased to 47% in the normal classification, and increased to 33% in the superior classification, presenting a significant difference (p = 0.001.Conclusion The elderly subjects who did not take part into the Pilates method presented a lower flexibility degree, considering that, the latter reduces in aging. As a preventive way of improving such limitation, the practice of the Pilates method is suggested.

  1. A randomized clinical trial to evaluate the effects of rasagiline on depressive symptoms in non-demented Parkinson’s disease patients

    Science.gov (United States)

    Barone, P; Santangelo, G; Morgante, L; Onofrj, M; Meco, G; Abbruzzese, G; Bonuccelli, U; Cossu, G; Pezzoli, G; Stanzione, P; Lopiano, L; Antonini, A; Tinazzi, M

    2015-01-01

    Background and purpose Depressed mood is a common psychiatric problem associated with Parkinson’s disease (PD), and studies have suggested a benefit of rasagiline treatment. Methods ACCORDO (see the 1) was a 12-week, double-blind, placebo-controlled trial to evaluate the effects of rasagiline 1 mg/day on depressive symptoms and cognition in non-demented PD patients with depressive symptoms. The primary efficacy variable was the change from baseline to week 12 in depressive symptoms measured by the Beck Depression Inventory (BDI-IA) total score. Secondary outcomes included change from baseline to week 12 in cognitive function as assessed by a comprehensive neuropsychological battery; Parkinson’s disease quality of life questionnaire (PDQ-39) scores; Apathy Scale scores; and Unified Parkinson’s Disease Rating Scale (UPDRS) subscores. Results One hundred and twenty-three patients were randomized. At week 12 there was no significant difference between groups for the reduction in total BDI-IA score (primary efficacy variable). However, analysis at week 4 did show a significant difference in favour of rasagiline (marginal means difference ± SE: rasagiline −5.46 ± 0.73 vs. placebo −3.22 ± 0.67; P = 0.026). There were no significant differences between groups on any cognitive test. Rasagiline significantly improved UPDRS Parts I (P = 0.03) and II (P = 0.003) scores versus placebo at week 12. Post hoc analyses showed the statistical superiority of rasagiline versus placebo in the UPDRS Part I depression item (P = 0.04) and PDQ-39 mobility (P = 0.007) and cognition domains (P = 0.026). Conclusions Treatment with rasagiline did not have significant effects versus placebo on depressive symptoms or cognition in PD patients with moderate depressive symptoms. Although limited by lack of correction for multiple comparisons, post hoc analyses signalled some improvement in patient-rated cognitive and depression outcomes. PMID:25962410

  2. National Health Insurance program and life satisfaction of the elderly.

    Science.gov (United States)

    Liao, Pei-An; Chang, Hung-Hao; Sun, Lih-Chyun

    2012-01-01

    To ensure people's fundamental right to adequate medical care, universal health insurance is given a high priority in contemporary public policy. This article investigates the effects of the introduction of Taiwan's National Health Insurance (NHI) on life satisfaction within the elderly segment of the population. A longitudinal data set including 610 males and 430 females aged 65 or above was constructed from the Survey of Health and Living Status of the Elderly in Taiwan. A difference-in-differences-in-differences model was employed and estimated by the random-effect regression method. The effects of NHI on life satisfaction are different by gender. Compared to the change in life satisfaction between the previously uninsured and insured elderly men, the introduction of NHI had a larger effect of 4.330 points on reducing the disparity in life satisfaction between previously uninsured and insured elderly women. Education, living arrangements, lifestyle, social activities, geographic location, and urbanization level are also important determinants for life satisfaction among the elderly. Although NHI is designed to ensure equality for accessing health care, the implementation of NHI has also improved the subjective well-being of the elderly, with a larger improvement for the elderly women. The post-NHI disparity reductions in life satisfaction between the previously uninsured and insured are significantly greater among elderly women. Our analysis of Taiwan's experience should provide a valuable lesson to countries that are in the initial stages of proposing a universal health insurance program.

  3. Association between exercise habits and subcortical gray matter volumes in healthy elderly people: A population-based study in Japan

    Directory of Open Access Journals (Sweden)

    Mikie Yamamoto

    2017-06-01

    Conclusion: Subjects with exercise habits show larger subcortical gray matter volumes than subjects without exercise habits in community-dwelling elderly subjects in Japan. Specifically, the volume of the nucleus accumbens correlates with both exercise habits and cognitive preservation.

  4. Early assessment of dementia: the contribution of different memory components

    NARCIS (Netherlands)

    Spaan, P.E.; Raaijmakers, J.G.; Jonker, C.

    2005-01-01

    A broad memory test battery (reflecting explicit and implicit memory functioning) was administered to a heterogeneous sample of initially nondemented, community-dwelling elderly subjects. To examine the profile of preclinical dementia, subjects were tested twice: At baseline, all subjects were

  5. [Spondylodiscitis in the elderly].

    Science.gov (United States)

    Kerkenaar, Marlies E; van Marum, Rob J; Sprong, Tom; Bootsma, J E M Janet

    2016-01-01

    The incidence of spondylodiscitis is highest among the elderly. Because of the ageing population the incidence of spondylodiscitis is rising. In this article, we illustrate dilemmas which may occur when treating older patients with spondylodiscitis by presenting two cases. The first patient is a 74-year-old man in whom there was uncertainty about the diagnosis on the basis of imaging results. The second patient is an 82-year-old man with dementia in whom longstanding intravenous treatment was too burdensome and treatment with oral antibiotics was started. The diagnosis of spondylodiscitis in elderly can be challenging because of frequent atypical presentation and comorbidity. So far, there is not much known about the prognosis of spondylodiscitis in the elderly, which make decisions about treatment difficult. The prognosis seems worse in elderly with multimorbidity. A comprehensive geriatric assessment can help to guide treatment decisions by estimating the chance of good functional recovery.

  6. Expanding subjectivities

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda; Soldz, Stephen

    2012-01-01

    A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool...... to understanding, especially but not exclusively in observational and interview-based studies. Psychodynamic or psychoanalytic approaches to research add an emphasis on unconscious motivational processes in both researchers and research participants that impact research experience and data. Building upon Anglo......-Saxon and continental traditions, this special issue provides examples of the use of researcher subjectivity, informed by psychoanalytic thinking, in expanding research understanding....

  7. Muscle function and postural balance in lifelong trained male footballers compared with sedentary elderly men and youngsters

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus D.; Andersen, Lars Juel

    2010-01-01

    in UE (Ptraining, providing an enhanced ability to counteract unexpected perturbations in postural balance. The superior RFD and balance in elderly footballers were......The present study investigated whether elderly subjects exposed to lifelong football training have better rapid muscle force characteristics, body composition and postural stability in comparison with untrained elderly. Ten elderly men exposed to lifelong football training (FTE; 69.6 ± 1.4 years...

  8. Nonexercise movement in elderly compared with young people.

    Science.gov (United States)

    Harris, Ann M; Lanningham-Foster, Lorraine M; McCrady, Shelly K; Levine, James A

    2007-04-01

    The association between free-living daily activity and aging is unclear because nonexercise movement and its energetic equivalent, nonexercise activity thermogenesis, have not been exhaustively studied in the elderly. We wanted to address the hypothesis that free-living nonexercise movement is lower in older individuals compared with younger controls matched for lean body mass. Ten lean, healthy, sedentary elderly and 10 young subjects matched for lean body mass underwent measurements of nonexercise movement and body posture over 10 days using sensitive, validated technology. In addition, energy expenditure was assessed using doubly labeled water and indirect calorimetry. Total nonexercise movement (acceleration arbitrary units), standing time, and standing acceleration were significantly lower in the elderly subjects; this was specifically because the elderly walked less distance per day despite having a similar number of walking bouts per day compared with the young individuals. The energetic cost of basal metabolic rate, thermic effect of food, total daily energy expenditure, and nonexercise activity thermogenesis were not different between the elderly and young groups. Thus, the energetic cost of walking in the elderly may be greater than in the young. Lean, healthy elderly individuals may have a biological drive to be less active than the young.

  9. Elderly Labor and Unemployment

    OpenAIRE

    Watanabe, Minoru; Yasuoka, Masaya

    2017-01-01

    Economically developed countries are confronting the aging of society. Especially, their respective shares of elderly people among the total population in Japan are highest in the world. Moreover, the labor participation rates of older people in Japan are higher than in other OECD countries. Several reasons underlie the increased labor participation of older people in Japan. One reason is the subsidy for the labor supply of elderly people. This paper presents an examination of how this subsid...

  10. [Solitude in the elderly].

    Science.gov (United States)

    Delisle, I

    1998-11-01

    Elderly people who are deprived of the warmth of human contact are at the risk of turning inward. For the very old, an atmosphere such as this can become psychologically catastrophic and lead to depressive syndromes such as extreme sadness, a desire to do nothing, sleep problems and even dementia. An in-depth analysis of the environment of the elderly inspires readers to address care objectives and interventions that will minimize and prevent these negative consequences.

  11. Vaccines for the elderly.

    Science.gov (United States)

    Weinberger, B; Grubeck-Loebenstein, B

    2012-10-01

    Vaccination is the most efficient strategy to prevent infectious disease. The increased vulnerability to infection of the elderly makes them a particularly important target population for vaccination. However, most vaccines are less immunogenic and efficient in the elderly because of age-related changes in the immune system. Vaccination against influenza, Streptococcus pneumoniae and varicella zoster virus is recommended for the elderly in many countries. Various strategies such as the use of adjuvants and novel administration routes are pursued to improve influenza vaccination for the elderly and recent developments in the field of pneumococcal vaccination led to the licensure of protein-conjugated polysaccharide vaccines containing up to 13 serotypes. As antibody titres are generally lower in the elderly and-particularly for inactivated vaccines-decline fast in the elderly, regular booster immunizations, for example against tetanus, diphtheria and, in endemic areas, tick-borne encephalitis, are essential during adulthood to ensure protection of the elderly. With increasing health and travel opportunities in old age the importance of travel vaccines for persons over the age of 60 is growing. However, little is known about immunogenicity and efficacy of travel vaccines in this age group. Despite major advances in the field of vaccinology over the last decades, there are still possibilities for improvement concerning vaccines for the elderly. Novel approaches, such as viral vectors for antigen delivery, DNA-based vaccines and innovative adjuvants, particularly toll-like receptor agonists, will help to achieve optimal protection against infectious diseases in old age. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  12. Preventive practices in the elderly and vulnerability to HIV

    Directory of Open Access Journals (Sweden)

    Valéria Peixoto Bezerra

    Full Text Available Objective: To know the vulnerability of the elderly to the HIV infection in the context of preventive practices. Method: Exploratory qualitative study, lead from December 2012 to May 2013, with 37 nursing Coexistence Groups in João Pessoa - Paraiba. The Focus Group was elected as the research technique, and the empirical material obtained was subjected to a Content Analysis Technique, thematic modality. Results: The elderly recognize the importance of preventive practices, but they face difficulties in its use when their emotional relationships with their partners do not favor preventive behavior, resulting in vulnerability. The elderly showed the population groups most vulnerable to HIV and do not recognize themselves as such. Conclusion: The complexity of the various contexts experienced by the elderlies of this study indicate the need for more research that allows advances in the understanding of subjectivity imposed in relations that underlie the aging process and the experience of sexuality in this age group.

  13. Elderly vs. younger problem drinker 'treatment' and recovery experiences.

    Science.gov (United States)

    Fitzgerald, J L; Mulford, H A

    1992-09-01

    To address the question of whether or not elderly problem drinkers experience any treatment contact discrimination or recovery rate disadvantages, the programme utilization and recovery rate experiences of a representative sample of older and younger persons arrested for drinking and driving (OWI) in Iowa were compared. Subjects were interviewed by phone or mail shortly after their OWI arrest and then again approximately 12 months later. Younger persons (18-54 years old) were compared with elderly persons (55 and over and 65 and over). The elderly subjects were also dichotomized as early onset (at least one problem drinking indicator occurred prior to age 55) or late onset (all problem drinking indicators occurred at age 55 or later). The elderly were as likely as, or more likely than, their younger counterparts to make a treatment contact, to remain in treatment and to recover.

  14. Insomnia in the elderly: cause, approach, and treatment.

    Science.gov (United States)

    Kamel, Nabil S; Gammack, Julie K

    2006-06-01

    Insomnia is a prevalent problem in late life. Sleep problems in the elderly are often mistakenly considered a normal part of aging. Insomnia, the most common sleep disorder, is a subjective report of insufficient or nonrestorative sleep despite adequate opportunity to sleep. Despite the fact that more than 50% of elderly people have insomnia, it is typically undertreated, and nonpharmacologic interventions are underused by health care practitioners. This article will review the causes of insomnia in the elderly, the approach to patient evaluation, and the nonpharmacologic and pharmacologic treatment of insomnia.

  15. Neurobiology of Elderly Suicide.

    Science.gov (United States)

    Richard-Devantoy, S; Turecki, G; Jollant, F

    2016-07-02

    Suicide in the elderly is an underestimated and complex issue that has mainly been explored in sociological, clinical and psychological perspectives. Suicide in non-elderly adults has been associated with diverse neurobiological alterations that may shed light on future predictive markers and more efficient preventative interventions. The aim of this paper was to review studies specifically investigating the neurobiology of elderly suicidal behaviour. We performed a systematic English and French Medline and EMBASE search until 2013. Contrary to literature about the non-elderly, we found a paucity of studies investigating the biomarkers of suicidal risk in elderly adults. Main findings were found in the neurocognitive domain. Studies generally supported the existence of cognitive deficits, notably decision-making impairment and reduced cognitive inhibition, in patients with a history of suicidal act compared to patients without such history. However, replications are needed to confirm findings. Due to several limitations including the small number of available studies, frequent lack of replication and small sample size, no firm conclusions can be drawn. The authors encourage further investigations in this field as insight in the neurobiology of these complex behaviors may limit clichés about end of life and aging, as well as improve future prevention of suicide in the elderly.

  16. Suicidal Behavior in Elderly

    Directory of Open Access Journals (Sweden)

    Murat Aslan

    2014-09-01

    Full Text Available The size of the elderly population is expected to increase dramatically in the next decades worldwide, also in Turkey. In accordance with these demographic changes, psychiatric disorders in late life, including suicide becomes much important. Elderly suicide is a very serious public health problem. Suicide rates in both males and females generally increase with age. However, the pattern is different in every nation. Suicidal behaviour in old age exists as a spectrum ranging from death wishes to completed suicide. Risk factors for suicide in old age are male sex, lower socioeconomic status, social isolation, having personality traits like hopelessness and dependency on others etc., the presence of psychiatric and physical disorders and previous suicidal behaviour. The most common cause for elderly suicide, as for all suicides, is untreated depression. Thus, elderly depression needs to be recognized and treated. The treatment of depressive disorder and other psychiatric diorders in late life, counselling in crisis situations and prevention of social isolation in elderly people are the major points for the prevention of suicide in old age. In this review article is to investigate the relationship between elderly and suicidal behavior. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000: 294-309

  17. Epilepsy in the Elderly

    Directory of Open Access Journals (Sweden)

    Lu-An Chen

    2012-06-01

    Full Text Available Elderly people are the largest and continuously fastest growing population among patients with epilepsy. Elderly patients with epilepsy are very different from other age groups in many respects and clinicians shouldn’t treat them in the same way as younger adults. Accurate diagnosis of epilepsy in the elderly is much more difficult and atypical manifestations and misdiagnoses are certainly not the exception. Syncope is probably the most important differential diagnosis. High clinical suspicion and proper investigation are the best tools for prompt diagnosis. Etiologies of late-onset epilepsy are mainly symptomatic and cerebrovascular diseases are the most common causes in this age group, followed by degenerative diseases such as Alzheimer’s disease. It is appropriate to consider starting antiepileptic drug (AED treatment at the first-ever seizure in elderly patients who have remote symptomatic causes such as stroke and dementia. According to the high recurrence rate of seizure and the good response to AEDs in elderly patients, the proper choice from various AEDs for seizure control is very important. Decision-making for AED choice depends on many different factors, including pharmacological properties, efficacy, tolerability from side effects, drug interactions, and medical comorbidities. The newer AEDs with lesser adverse effects and fewer drug interactions appear to be reasonable treatment options for elderly patients. However, more evidence from clinical trials in this specific age group is warranted.

  18. Learning mnemonics: a preliminary evaluation of a computer-aided instruction package for the elderly.

    Science.gov (United States)

    Finkel, S I; Yesavage, J A

    1989-01-01

    Sixty-two normal elderly subjects averaging 71 years old were taught a common mnemonic device for recall of lists using a Computer-Aided Instruction (CAI) package. Improvement in list-learning after CAI training was not statistically different from a separate group of 218 elderly subjects who received instruction from a trainer in a normal classroom situation. Improvement in the CAI group was significantly related to higher scores on the Openness to Experience subscale of the NEO-Personality Inventory. CAI devices for memory training in the elderly may find a place in training selected elders on specific areas of memory loss.

  19. [Transient amnesia in the elderly].

    Science.gov (United States)

    Sellal, François

    2006-03-01

    The two main aetiologies of transient amnesia in the elderly are idiopathic transient global amnesia (TGA) and iatrogenic or toxic amnesia. Vascular and epileptic amnesia are less common. According to the literature, transient psychogenic amnesia, which is a frequent cause of amnesia at age 30 to 50, is very rare in the elderly. TGA is the prototypical picture of transient amnesia. It occurs more often after age 50, with no identified cause, even if some authors accept emotional stress or minor head trauma as occasional precipitants. The mechanism of TGA remains a matter of discussion. It may be the consequence of a spreading depression similar to that described in migraine with aura, but other arguments support an ischemic mechanism. Iatrogenic amnesias are mainly caused by benzodiazepines (BZs) or anticholinergics. The former may occur in a non-anxious subject, who is not a usual consumer of BZ and takes a single dose. The latter are more often due to a hypersensitivity to anticholinergic drugs, in particular in patients presenting with a covert, incipient Alzheimer's disease. A vascular origin must be considered when amnesia is accompanied by other neurological symptoms, and when the regression of the amnesic disorder is slow, lasting several days. It results from lesions involving various mechanisms and locations, mainly subcortical. Partial seizures, most often mesio-temporal, more rarely frontal, may be the cause of transient amnesia in the elderly, in the absence of a past history of epilepsy. The red flag supportive of an epileptic origin is the repetition of stereotyped amnesic episodes. EEG demonstration of seizures may be difficult and the response to antiepileptic drugs effective on partial seizures is usually good.

  20. Factors Influencing Depression among Elderly Patients in Geriatric Hospitals

    OpenAIRE

    Jee, Young Ju; Lee, Yun Bok

    2013-01-01

    [Purpose] The purpose of this study was to investigate the prevalence of depression among elderly patients and identify the factors influencing depression in a geriatric hospital in Korea. [Subjects] A self-report questionnaire was administered to the patients in community geriatric hospitals. Participants were 195 elderly patients. [Methods] The instruments utilized in this study were the Geriatric Depression Scale Short Form Korea (GDSSF-K), an activity of daily living scale, a self-esteem ...

  1. Assessing the nutritional status of hospitalized elderly

    Directory of Open Access Journals (Sweden)

    Abd Aziz NAS

    2017-10-01

    Full Text Available Nur Adilah Shuhada Abd Aziz, Nur Islami Mohd Fahmi Teng, Mohd Ramadan Abdul Hamid, Nazrul Hadi Ismail Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia Purpose: The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue.Methods: A literature search was performed on six databases using the terms “malnutrition”, “hospitalised elderly”, “nutritional assessment”, “Mini Nutritional Assessment (MNA”, “Geriatric Nutrition Risk Index (GNRI”, and “Subjective Global Assessment (SGA”.Results: According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients.Conclusion: It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future. Keywords: malnutrition in elderly

  2. Mining Spatiotemporal Patterns of the Elder's Daily Movement

    Science.gov (United States)

    Chen, C. R.; Chen, C. F.; Liu, M. E.; Tsai, S. J.; Son, N. T.; Kinh, L. V.

    2016-06-01

    With rapid developments in wearable device technology, a vast amount of spatiotemporal data, such as people's movement and physical activities, are generated. Information derived from the data reveals important knowledge that can contribute a long-term care and psychological assessment of the elders' living condition especially in long-term care institutions. This study aims to develop a method to investigate the spatial-temporal movement patterns of the elders with their outdoor trajectory information. To achieve the goal, GPS based location data of the elderly subjects from long-term care institutions are collected and analysed with geographic information system (GIS). A GIS statistical model is developed to mine the elderly subjects' spatiotemporal patterns with the location data and represent their daily movement pattern at particular time. The proposed method first finds the meaningful trajectory and extracts the frequent patterns from the time-stamp location data. Then, a density-based clustering method is used to identify the major moving range and the gather/stay hotspot in both spatial and temporal dimensions. The preliminary results indicate that the major moving area of the elderly people encompasses their dorm and has a short moving distance who often stay in the same site. Subjects' outdoor appearance are corresponded to their life routine. The results can be useful for understanding elders' social network construction, risky area identification and medical care monitoring.

  3. Correlation between hypertension and cognitive function in elderly

    Science.gov (United States)

    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.

  4. Assessment of Nutritional Vulnerability of the Elderly using Mini ...

    African Journals Online (AJOL)

    Objective: The vulnerability of the elderly (65years and above) to nutritional risks is the main thrust of this paper. Subjects and methods: Multi-stage random sampling technique was used to select a total of 600 subjects from eight communities in Umuahia North and Ikwuano Local Government Areas of Abia state.

  5. Opportunistic hearing screening in elderly inpatients

    Directory of Open Access Journals (Sweden)

    Krishan Ramdoo

    2014-04-01

    Full Text Available Objective: To determine the prevalence of occult hearing loss in elderly inpatients, to evaluate feasibility of opportunistic hearing screening and to determine subsequent provision of hearing aids. Materials and methods: Subjects (>65 years were recruited from five elderly care wards. Hearing loss was detected by a ward-based hearing screen comprising patient-reported assessment of hearing disability and a whisper test. Subjects failing the whisper test or reporting hearing difficulties were offered formal audiological assessment. Results: Screening was performed on 51 patients aged between 70 and 95 years. Of the patients, 21 (41% reported hearing loss and 16 (31% failed the whisper test. A total of 37 patients (73% were referred for audiological assessment with 17 (33% found to have aidable hearing loss and 11 were fitted with hearing aids (22%. Discussion: This study highlights the high prevalence of occult hearing loss in elderly inpatients. Easy two-step screening can accurately identify patients with undiagnosed deafness resulting in significant proportions receiving hearing aids. Key sentences Approximately 14% of the elderly population use hearing aids despite a reported prevalence of deafness in up to 55%. The use of hearing aids is associated with an improvement in physical, emotional, mental and social well-being. An easy screening test for hearing loss consists of patient-reported hearing loss and a whisper test. Opportunistic screening of elderly inpatients resulted in referral of 73% of screened patients for formal audiology. Of the screened patients, 22% were provided with hearing aids.

  6. SUBJECT INDEX

    Indian Academy of Sciences (India)

    Unknown

    SUBJECT INDEX. Absorption. Effect of NaCl on the spectral and kinetic properties of cresyl violet (CV)-sodium dodecyl sulphate (SDS) complex. 299. Acid catalysts. Temperature-programmed desorption of water and ammonia on sulphated zirconia catalysts for measuring their strong acidity and acidity distribution. 281.

  7. SUBJECT INDEX

    Indian Academy of Sciences (India)

    Unknown

    SUBJECT INDEX. Ab initio calculations. Basis set effects on energy and hardness profiles of the hydrogen fluoride dimer. 549. Activation by calcinations. Highly active and reusable catalyst from Fe-Mg- hydrotalcite anionic clay for Friedel–Crafts type benzyla- tion reactions. 635. Adsorption. Adsorption studies of iron(III) on ...

  8. Subject Index

    Indian Academy of Sciences (India)

    J. Astrophys. Astr. (2006) 27, 469–472. Subject Index. Astrophysical Processes. Spatial Damping of Linear Compressional Magnetoacoustic Waves in Quiescent. Prominences (K. A. P. Singh), 321. Report on the Dynamical Evolution of an Axially Symmetric Quasar Model. (N. J. Papadopoulos & N. D. Caranicolas), 389.

  9. SUBJECT INDEX

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    SUBJECT INDEX. 1D inversion. A direct inversion scheme for deep resistivity sound- ing data using artificial neural networks. 49. 40. Ar-. 39. Ar thermochronology. Tectono-thermal evolution of the India-Asia colli- sion zone based on. 40. Ar-. 39. Ar thermochronology in. Ladakh, India. 737. ANN. Artificial neural network ...

  10. Abuse and maltreatment in the elderly

    Directory of Open Access Journals (Sweden)

    Rosa Martins

    2014-11-01

    Conclusion: We found that the abuse and mistreatment are present in the everyday life of many seniors and are a difficult subject to approach. The evidence, invite us to reflect on the development of intervention strategies, particularly at the levels of emotional abuse, neglect, promotion of health and family functioning in order to contribute to the reduction or extinction of abuse and ill-treatment in the elderly.

  11. Equações de referência para a predição da força de preensão manual em brasileiros de meia idade e idosos Reference equations for predicting of handgrip strength in brazilian middle-aged and elderly subjects

    Directory of Open Access Journals (Sweden)

    Rômulo Dias Novaes

    2009-09-01

    Full Text Available O objetivo deste estudo foi avaliar os valores normais da força de preensão manual do membro superior dominante (FPM-D e não dominante (FPM-ND em sujeitos de meia idade e idosos assintomáticos e elaborar equações de referência para a predição da FPM. Foram investigados 54 voluntários (51,9% homens com idade >50 anos, medindo-se massa corporal, estatura e perimetria do braço direito e esquerdo, e calculando-se o índice de massa corporal. A FPM-D e FPM -ND foram avaliadas por dinamometria mecânica. O índice de atividade física habitual (IAF foi avaliado pelo questionário de Baecke. A FPM-D foi superior à FPM-ND em ambos os sexos e em todas as idades (pThe aim of the present study was to evaluate normal values of dominant (D and non-dominant (ND upper limb handgrip strength (HGS in asymptomatic middle-aged elderly subjects and to establish reference equations for predicting HGS. Fifty-four volunteers (51.9% men aged >50 years old were enrolled. Weight, height, and both arms circumference were measured, being the body mass index calculated. Mechanical dynamometry was used to measure D-HGS and ND-HGS. Self-reported level of regular physical activity was assessed by Baecke questionnaire. D-HGS was higher than ND-HGS for both sexes and in all age groups (p<0.05. Significant correlations were found between HGS and age, height, weight, and arm circumferences. The best reference equations were the following: D-HGSkgf=39.996 - (0.382 x age years+(0.174 x weight kg+(13.628 x sex men=1;women=0 (Adjusted R²=0.677; and ND-HGSkgf=44.968 - (0.420 x age years+(0.110 x weight kg+(9.274 x sex men=1; women=0 (Adjusted R²=0.546. The consistent difference found between dominant and non-dominant HGS requires the use of specific normative data for each hand. Hence easily-obtained attributes such as age, height, weight, arm circumference and sex can predict HGS expected values for asymptomatic elder adults.

  12. Anemia in the elderly.

    Science.gov (United States)

    Pang, Wendy W; Schrier, Stanley L

    2012-05-01

    There have been several large-scale epidemiologic studies, including the National Health and Nutrition Examination Survey III (NHANES III), which have described the prevalence and impact of anemia in the elderly. The information derived has been critically important. However, given the large number of patients surveyed, these reports necessarily relied substantially on the laboratory-based screening evaluations. There are now two recent reports describing the cause of anemia in elderly outpatients, and although the numbers are smaller than the large scale surveys, they constitute comprehensive hematologic evaluations with therapeutic interventions and clinical follow-up. The purpose of this review is to compare these different analyses. There are distinct differences and similarities in the two types of studies, which are derived from patients seen in hematology clinics. Despite comprehensive hematologic evaluation, the puzzling entity of unexplained anemia of the elderly is confirmed and found to account for 30-46% of patients. NHANES III classified iron-deficiency anemia with other nutritional anemias, a classification that might be correct in the developing third world, but in North America and Western Europe, iron deficiency is more often caused by blood loss and the cause must be sought and dealt with. The myelodysplastic syndromes are an important cause of anemia in the elderly, with a prevalence of at least 4%. Large-scale screening studies of anemia in the elderly are of great importance, and when complemented by comprehensive hematologic evaluations, provide a more accurate picture of the clinical situation.

  13. Elder homelessness. A community perspective.

    Science.gov (United States)

    Bissonnette, A; Hijjazi, K H

    1994-09-01

    Elder homelessness is an increasing problem in our society. After presenting demographics of elder homelessness, this article discusses successful Boston-based program models. Nurse-directed community solutions are emphasized.

  14. Engaging Elderly People in Telemedicine Through Gamification.

    Science.gov (United States)

    de Vette, Frederiek; Tabak, Monique; Dekker-van Weering, Marit; Vollenbroek-Hutten, Miriam

    2015-12-18

    Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great connectivity between these taxonomies

  15. Urinary tract infections in the elderly population.

    Science.gov (United States)

    Matthews, S James; Lancaster, Jason W

    2011-10-01

    Urinary tract infections (UTIs) are a common problem in the elderly population. The spectrum of disease varies from a relatively benign cystitis to potentially life-threatening pyelonephritis. This review covers the management of asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter-associated bacteriuria/symptomatic UTIs, and antibiotic prophylaxis for recurrent infections in elderly men and women. Literature was obtained from English-language searches of MEDLINE (1966-April 2011), Cochrane Library, BIOSIS (1993-April 2011), and EMBASE (1970-April 2011). Further publications were identified from citations of resulting articles. Search terms included, but were not limited to, urinary tract infections, asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter associated urinary tract infections, recurrent urinary tract infections, and elderly. The prevalence of UTIs in elderly women depends on the location in which these women are living. For elderly women living in the community, UTIs compromise the second most common infection, whereas in residents of long-term care facilities (LTCFs) and hospitalized subjects, it is the number one cause of infection. The spectrum of patient presentation varies from classic signs and symptoms in the independent elderly population to atypical presentations, including increased lethargy, delirium, blunted fever response, and anorexia. Although there are few guidelines specifically directed toward the management of UTIs in the elderly population, therapy generally mirrors the recommendations for the younger adult age groups. When choosing a treatment regimen, special attention must be given to the severity of illness, living conditions, existing comorbidities, presence of external devices, local antibiotic resistance patterns, and the ability of the patient to comply with therapy. Improved guidelines

  16. Health Blief Model-based intervention to improve nutritional behavior among elderly women

    OpenAIRE

    Iranagh, Jamileh Amirzadeh; Rahman, Hejar Abdul; Motalebi, Seyedeh Ameneh

    2016-01-01

    BACKGROUND/OBJECTIVES Nutrition is a determinant factor of health in elderly people. Independent living in elderly people can be maintained or enhanced by improvement of nutritional behavior. Hence, the present study was conducted to determine the impact of Health Belief Model (HBM)-based intervention on the nutritional behavior of elderly women. SUBJECTS/METHODS Cluster-random sampling was used to assess the sample of this clinical trial study. The participants of this study attended a 12-we...

  17. Malnutrition in elderly: social and economic determinants.

    Science.gov (United States)

    Donini, L M; Scardella, P; Piombo, L; Neri, B; Asprino, R; Proietti, A R; Carcaterra, S; Cava, E; Cataldi, S; Cucinotta, D; Di Bella, G; Barbagallo, M; Morrone, A

    2013-01-01

    Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition. A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated. According to the Mini Nutritional Assessment (MNA), a high prevalence of malnutrition was found out in both genders: 26% of F and 16.3% of M were classified as being malnourished (MNAshop, prepare and cook meals because of a low income, distance from markets or supermarkets as well as impossibility to drive the car or to use public transportation. This study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition.

  18. Cross-sectional associations of cortical β-amyloid with erythrocyte membrane long-chain polyunsaturated fatty acids in older adults with subjective memory complaints.

    Science.gov (United States)

    Hooper, Claudie; De Souto Barreto, Philipe; Payoux, Pierre; Salabert, Anne Sophie; Guyonnet, Sophie; Andrieu, Sandrine; Vellas, Bruno

    2017-08-01

    Omega-3 (n-3) and 6 (n-6) polyunsaturated fatty acids (PUFAs) have been associated with reduced cognitive decline in observational studies. Hence, we examined the cross-sectional associations between cortical β-amyloid (Aβ) and erythrocyte membrane PUFAs in 61 non-demented elderly individuals reporting subjective memory complaints from the Multidomain Alzheimer Preventive Trial placebo arm. Cortical-to-cerebellar standard uptake value ratios were obtained using [ 18 F] florbetapir positron emission tomography. Fatty acids were measured in erythrocyte membranes by gas chromatography. Associations were explored using adjusted multiple linear regression models and were considered significant at p ≤ 0.005 after correction for multiple testing (10 comparisons). We found no significant associations between cortical Aβ and erythrocyte membrane PUFAs. The associations closest to significance after adjustment were those between Aβ and erythrocyte membrane arachidonic acid (without apolipoprotein E status adjustment: B-coefficient, 0.03; CI, 0.01, 0.05; p = 0.02. Including Apolipoprotein E adjustment: B-coefficient, 0.03; CI, 0.00, 0.06; p = 0.04) and Aβ and erythrocyte membrane linoleic acid (without apolipoprotein E status adjustment: B-coefficient, -0.02; CI, -0.04, 0.00; p = 0.02. Including Apolipoprotein E adjustment: B-coefficient, -0.02; CI, -0.04, 0.00; p = 0.09). Furthermore, the association between Aβ and erythrocyte membrane arachidonic acid seemed to be specific to Apolipoprotein E ε4 non-carriers (B-coefficient 0.03, CI: 0.00, 0.06, p = 0.03, n = 36). In contrast, no association was found between Aβ and erythrocyte membrane linoleic acid in Apolipoprotein E ε4 stratified analysis. Investigating the relationships between Aβ and PUFAs longitudinally would provide further evidence as to whether fatty acids, particularly arachidonic acid and linoleic acid, might modulate cognition through Aβ-dependent mechanisms. © 2017 International

  19. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

    Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th......, the administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

  20. [Vaccination in the elderly].

    Science.gov (United States)

    Kwetkat, A; Pletz, M W

    2013-10-01

    The aging immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated course of infections in the elderly with increased morbidity and mortality rates. Furthermore, it can lead to decreased efficacy of vaccination. The administration of more immunogenic vaccines can be beneficial in the elderly. Implementing vaccination recommendations for the elderly by STIKO can reduce burden of infectious diseases by prevention of infection or reduction of severity of infection. The following vaccinations are recommended by STIKO for all persons aged 60 and above: annual influenza vaccination (additionally all nursing home residents independently of age), once only pneumococcal polysaccharide vaccination, completion of tetanus and diphtheria (Td) vaccination as well as regular revaccination. All adults should be vaccinated against pertussis with Tdap vaccine once. Meanwhile, pneumococcal conjugate vaccine is allowed for administration in adults but is not recommended by STIKO yet. A lifelong course of vaccination may help to attenuate the effect of immunosenescence.

  1. Poverty among Elderly in India

    Science.gov (United States)

    Srivastava, Akanksha; Mohanty, Sanjay K.

    2012-01-01

    Using consumption expenditure data of the National Sample Survey 2004-2005, this paper estimates the size of elderly poor and tests the hypotheses that elderly households are not economically better-off compared to non-elderly households in India. Poverty estimates are derived under three scenarios--by applying the official cut-off point of the…

  2. Benzodiazepine poisoning in elderly

    Directory of Open Access Journals (Sweden)

    Perković-Vukčević Nataša

    2016-01-01

    Full Text Available Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender, benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old, middle aged (41-65-year old and elderly (older than 65. Results. During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Conclusion. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

  3. Cholecystectomy for the elderly

    DEFF Research Database (Denmark)

    Nielsen, Liv Bjerre Juul; Harboe, Kirstine Moll; Bardram, Linda

    2014-01-01

    The number of Danish inhabitants older than 65 years is increasing, and cholecystectomy is one of the most common surgical procedures performed for this age group. This study aimed to analyze the role of age as an independent predictor of outcome for elderly cholecystectomy patients.......The number of Danish inhabitants older than 65 years is increasing, and cholecystectomy is one of the most common surgical procedures performed for this age group. This study aimed to analyze the role of age as an independent predictor of outcome for elderly cholecystectomy patients....

  4. Physical activity in elderly

    Directory of Open Access Journals (Sweden)

    Jan Cvecka

    2015-08-01

    Full Text Available Aging is a multifactorial irreversible process associated with significant decline in muscle mass and neuromuscular functions. One of the most efficient methods to counteract age-related changes in muscle mass and function is physical exercise. An alternative effective intervention to improve muscle structure and performance is electrical stimulation. In the present work we present the positive effects of physical activity in elderly and a study where the effects of a 8-week period of functional electrical stimulation and strength training with proprioceptive stimulation in elderly are compared.

  5. Obesity in the elderly

    OpenAIRE

    Penny Montenegro, Eduardo

    2017-01-01

    Older people are not exempt of being overweight or obese; in Peru this occurs respectively in 21.4% and 11.9% of the elderly, less than in people of younger age. Overweight and obesity are associated to noncommunicable chronic diseases, and to increase in morbidity and mortality. There is no trustworthy data on the optimum body-mass index in the elderly, but we use both the body-mass index and measurement of the abdominal circumference. Best efforts should be done to prevent this problem befo...

  6. Struggles in (Elderly) Care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene

    This book provides a critical engagement with the intensified struggles to be found within elderly care provision. Various social and political processes, including the forces of globalisation and the de-gendering of care, have changed how we might understand this national and global political...... of contestation. Dahl approaches these issues from a post-structuralist and radical feminist position, while drawing from feminist sociology, feminist political science, nursing philosophy and feminist history. In particular, Struggles In (Elderly) Care highlights how the predominantly feminist theorization...

  7. Loneliness, Depression and Health Status of the Institutionalized Elderly in Korea and Japan

    OpenAIRE

    Kim, Oksoo; Byeon, Young-Soon; Kim, Jung-Hee; Endo, Emiko; Akahoshi, Makoto; Ogasawara, Hiromi

    2009-01-01

    The purpose of the study was to describe loneliness, depression, and health status in Korean and Japanese institutionalized elderly and explore differences between the countries. Also this study determined predictors of depression in each group. Methods: Elderly subjects, aged 65–98 (n = 184), were recruited from private nursing homes in Korea and Japan. Subjects were interviewed on health status, loneliness, and depression. Results: Korean subjects had higher loneliness scores than Jap...

  8. Dietary Intake of Vitamin D in the Moroccan Elderly

    Directory of Open Access Journals (Sweden)

    El-Houcine Sebbar

    2018-01-01

    Full Text Available Aim: Vitamin D deficiency is common in the elderly. The aim of our work is to evaluate the dietary intake of vitamin D in the Moroccan elderly. Methods: This study included 159 subjects aged over 60 years who performed a vitamin D questionnaire (VDQ, covering the consumption of four foods with high vitamin D content (fish, milk, margarine and yoghurt. Results: The average dietary vitamin D intake was 2.7 μg/day. This observational study in Moroccan elderly indicates a high prevalence of insufficient vitamin D intake, and below the recommended consumption values, particularly in those aged over 70 years. Conclusion: Inadequate vitamin D intake is common among the Moroccan elderly. To fight against this situation, initiatives must be implemented, including improved population education, lifestyle, and vitamin D supplementation, in order to avoid serious adverse health consequences of bone.

  9. Cough physiology in elderly women with nontuberculous mycobacterial lung infections.

    Science.gov (United States)

    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 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.

  10. Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease.

    Science.gov (United States)

    de Laat, Karlijn F; van Norden, Anouk G W; Gons, Rob A R; van Oudheusden, Lucas J B; van Uden, Inge W M; Norris, David G; Zwiers, Marcel P; de Leeuw, Frank-Erik

    2011-02-01

    Although cerebral small vessel disease, including white matter lesions (WML) and lacunar infarcts, is associated with gait disturbances, not all individuals with small vessel disease have these disturbances. Identical-appearing WML on MRI could reflect different degrees of microstructural integrity. Moreover, conventional MRI does not assess the integrity of normal-appearing white matter (NAWM). We therefore investigated the relation between white matter integrity assessed by diffusion tensor imaging in WML, NAWM, several regions of interest, and gait. A total of 484 nondemented elderly persons between 50 and 85 years old with cerebral small vessel disease were included in this analysis and underwent MRI and diffusion tensor imaging scanning. Mean diffusivity and fractional anisotropy within WML, NAWM, and regions of interest were related to quantitative and semiquantitative gait parameters. Mean diffusivity in the WML was inversely related with gait (velocity β=-0.15; P=0.002). For the fractional anisotropy, this relation was less evident. The same was found in the NAWM (velocity β=-0.21; Pgait disturbances.

  11. Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican-Americans.

    Science.gov (United States)

    Reyes-Ortiz, Carlos A; Al Snih, Soham; Markides, Kyriakos S

    2005-01-01

    To estimate the prevalence of and risk factors for falls among community-dwelling elders in Latin America and the Caribbean and among elderly Mexican-Americans in the southwestern United States. Data for the study came from a project called Health, Well-Being, and Aging in Latin America and the Caribbean (Salud, Bienestar y Envejecimiento en América Latina y el Caribe) (the "SABE project") (surveys from seven cities, with a total of 9,765 subjects) and from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (1,483 subjects). The overall prevalence of falls across the seven SABE cities and the H-EPESE ranged from 21.6% in Bridgetown, Barbados, to 34.0% in Santiago, Chile. In multiple logistic regression analyses, female gender, increased age, high depressive symptoms, and having any functional limitations were significant independent risk factors for falls in most of the cities studied as well as among the elderly Mexican-Americans. In several of the cities, significant risk factors also included diabetes, urinary incontinence, and arthritis. The prevalence of falls had a large variation among the countries studied. Some of the risk factors that we identified could be modified so as to help prevent falls in older people in these populations. The factors deserving attention include depressive symptoms, functional limitations, diabetes, and urinary incontinence.

  12. Feasibility, reliability, and validity of a smartphone based application for the assessment of cognitive function in the elderly.

    Directory of Open Access Journals (Sweden)

    Robert M Brouillette

    Full Text Available While considerable knowledge has been gained through the use of established cognitive and motor assessment tools, there is a considerable interest and need for the development of a battery of reliable and validated assessment tools that provide real-time and remote analysis of cognitive and motor function in the elderly. Smartphones appear to be an obvious choice for the development of these "next-generation" assessment tools for geriatric research, although to date no studies have reported on the use of smartphone-based applications for the study of cognition in the elderly. The primary focus of the current study was to assess the feasibility, reliability, and validity of a smartphone-based application for the assessment of cognitive function in the elderly. A total of 57 non-demented elderly individuals were administered a newly developed smartphone application-based Color-Shape Test (CST in order to determine its utility in measuring cognitive processing speed in the elderly. Validity of this novel cognitive task was assessed by correlating performance on the CST with scores on widely accepted assessments of cognitive function. Scores on the CST were significantly correlated with global cognition (Mini-Mental State Exam: r = 0.515, p<0.0001 and multiple measures of processing speed and attention (Digit Span: r = 0.427, p<0.0001; Trail Making Test: r = -0.651, p<0.00001; Digit Symbol Test: r = 0.508, p<0.0001. The CST was not correlated with naming and verbal fluency tasks (Boston Naming Test, Vegetable/Animal Naming or memory tasks (Logical Memory Test. Test re-test reliability was observed to be significant (r = 0.726; p = 0.02. Together, these data are the first to demonstrate the feasibility, reliability, and validity of using a smartphone-based application for the purpose of assessing cognitive function in the elderly. The importance of these findings for the establishment of smartphone-based assessment batteries

  13. Functional correlates of detailed body composition in healthy elderly subjects.

    Science.gov (United States)

    Geisler, Corinna; Schweitzer, Lisa; Müller, Manfred James

    2018-01-01

    Methods of body composition analysis are now widely used to characterize health status, i.e., nutritional status, metabolic rates, and cardiometabolic risk factors. However, the functional correlates of individual body components have not been systematically analyzed. In this study, we have used a two-compartment model, which was assessed by air displacement plethysmography. Detailed body composition was measured by whole body magnetic resonance imaging in a healthy population of 40 Caucasians, aged 65-81 yr (20 men; body mass index range: 18.6-37.2 kg/m 2 ). Physical, metabolic, as well as endocrine functions included pulmonary function, handgrip strength, gait speed, sit-to-stand test, physical activity, blood pressure, body temperature, resting energy expenditure (REE), liver and kidney functions (glomerular filtration rate), insulin sensitivity [homeostasis model assessment (HOMA)], plasma lipids, plasma leptin, testosterone, dehydroepiandrosterone, insulin-like growth factor I levels, thyroid status, vitamins, and inflammation. Individual body compartments were intercorrelated, e.g., skeletal muscle mass (SM) correlated with visceral adipose tissue ( r = 0.53) and kidneys ( r = 0.62). For the functional correlates, SM ( r = 0.58) and liver volume ( r = 0.63) were associated with REE, SM correlated with handgrip strength ( r = 0.57), and kidneys with glomerular filtration rate ( r = 0.57). While visceral adipose tissue correlated with HOMA ( r = 0.59), subcutaneous adipose tissue was related to plasma leptin levels ( r = 0.84). The subcutaneous adipose tissue-to-leptin relationship was moderated by inflammation increasing the explained variance of leptin levels by 4.0%. In linear regression analysis, detailed body composition explained variances in REE (75.0%), HOMA (41.0%), and leptin (78.0%) compared with a body mass index-based model (REE 16.0%, HOMA 31.0%, leptin 45.0%). In addition, detailed body composition explained 39.0% of the variance in kidney function. NEW & NOTEWORTHY BCA should be used to address specific body functions only. In clinical practice, there is need of a clear focus on the specific research question related to physical, metabolic, or endocrine functions.

  14. Macronutrient status of the elderly (60-80 years) from Central India ...

    African Journals Online (AJOL)

    present investigation was undertaken to assess the macronutrient intake of the elderly (60-80 years) from Central India. Four hundred elderly, which included 200 males and 200 females were selected from Nagpur city, Maharashtra, India, through stratified random sampling. All subjects were personally interviewed.

  15. The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people

    NARCIS (Netherlands)

    Wouters-Wesseling, W.; Hooijdonk, van C.; Wagenaar, L.; Bindels, J.G.; Groot, de C.P.G.M.; Staveren, van W.A.

    2003-01-01

    Background & aims: The elderly are at an increased risk of poor nutritional status which is mutually interacting with functional status. We evaluated the effects of a liquid nutrition supplement on anthropometric and functional indices in elderly people. Methods: Subjects (n=68; mean age=82 +/-

  16. Hardiness among Elderly Women.

    Science.gov (United States)

    Wagnild, Gail; Young, Heather

    Hardiness has been defined as a mediator in life stress and, within the health/illness context, has been conceptualized as a personality characteristic. This study used a descriptive exploratory design to examine the concept of hardiness among elderly women. The Stress, Appraisal, and Coping model developed by Lazarus and Folkman (1986) was the…

  17. Vaccines for the elderly.

    Science.gov (United States)

    Del Giudice, Giuseppe; Weinberger, Birgit; Grubeck-Loebenstein, Beatrix

    2015-01-01

    The aging of the human population is posing serious challenges to research and to public health authorities in order to prevent diseases that more frequently affect the elderly, a portion of the population that will increase more and more in the coming years. While some vaccines exist and are used in the elderly to effectively fight against some infections (e.g. influenza, pneumococci, varicella-zoster virus, diphtheria, and tetanus), still a lot of work remains to be done to better adapt these vaccines and to develop new ones for this age group. The prevention of infectious diseases affecting the elderly can be successful only through a holistic approach. This approach will aim at the following: (1) a deeper understanding of the mechanisms leading to the senescence of the immune system, (2) a better and broader use of vaccines recommended for the elderly, (3) the use of vaccines currently considered only for other age groups and (4) actively priming the population when they are immunological competent, before the physiological waning of immune responsiveness may affect the beneficial effects of vaccination. © 2014 S. Karger AG, Basel

  18. Honoring the Elders.

    Science.gov (United States)

    Yazzie, Evangeline Parsons; St. Clair, Robert N.

    The co-directors of the 1998 Annual Symposium for Language Renewal and Revitalization describe how they came up with a focus and presenters for the symposium. They began by discussing their concern over the loss of indigenous languages and cultures, then decided to honor tribal elders by choosing one to represent them all as the symposium's…

  19. Lucas Cranach the Elder

    NARCIS (Netherlands)

    Heydenreich, Gunnar

    2007-01-01

    This study provides the first exhaustive description of the materials, techniques and studio practices of Lucas Cranach the Elder. The author describes the characteristic elements of the painter's production, drawing on results of technical examination, as well as an evaluation of documentary

  20. Elderly health and implementation of the Brazilian National Health Policy for Elderly Persons on the performed actions in basic healthcare

    Directory of Open Access Journals (Sweden)

    SCHMINSKI VIEIRA, Roseli

    2016-06-01

    Full Text Available The Brazilian National Health Policy for Elderly Persons (PNSPI – in Portuguese was formulated by the Ministry of Health through Ordinance No. 2.528/2006 in line with the 1988 Brazilian Constitution. The study investigated whether municipalities from the South region of the State of Santa Catarina had knowledge and applied the PNSPI, on the performed actions in basic healthcare, especially on the Units of Family Healthcare Services based on what the Constitution and the Statute of the Elderly comprise. A deductive method with a qualitative approach and a descriptive research were used. As a result, some difficulties experienced by the research subjects related to two important points of policies and strategies of PNSPI were identified: the lack of a planned policy and of a continuous health education for the elderly; and the lack of a stimulating exercise of social control, whether in the health sector, or in the Municipal Council of Elderly People.

  1. Hypotensive responses to common daily activities in institutionalized elderly. A potential risk for recurrent falls.

    Science.gov (United States)

    Jonsson, P V; Lipsitz, L A; Kelley, M; Koestner, J

    1990-07-01

    Transient hypotension may be one of many factors contributing to the high prevalence of falls among elderly people. To determine the frequency and magnitude of hypotensive responses to common daily activities, and their potential relationship to falls in the elderly, we examined blood pressure (BP) and heart rate during a standardized series of activities in 38 institutionalized recurrent fallers (age, 87 +/- 6 years), 20 institutionalized nonfallers (age, 85 +/- 5 years), and 10 healthy young control subjects (age, 24 +/- 3 years). The coefficient of variation for systolic BP during all activities was higher in elderly subjects (fallers, 14% +/- 5%; nonfallers, 12% +/- 3%) than in young control subjects (8% +/- 1%). In contrast, the coefficient of variation for heart rate during all activities was higher in young subjects than in the elderly subjects. Elderly subjects had marked BP reduction following meals and nitroglycerin, which was significantly greater in fallers than in nonfallers, independent of the cause of the fall. Thus, institutionalized elderly have marked BP variability and hypotensive responses to meals and nitroglycerin. A decline in BP during common preload-reducing stresses may predispose some elderly people to falls.

  2. Gray matter and white matter changes in non-demented amyotrophic lateral sclerosis patients with or without cognitive impairment: A combined voxel-based morphometry and tract-based spatial statistics whole-brain analysis.

    Science.gov (United States)

    Christidi, Foteini; Karavasilis, Efstratios; Riederer, Franz; Zalonis, Ioannis; Ferentinos, Panagiotis; Velonakis, Georgios; Xirou, Sophia; Rentzos, Michalis; Argiropoulos, Georgios; Zouvelou, Vasiliki; Zambelis, Thomas; Athanasakos, Athanasios; Toulas, Panagiotis; Vadikolias, Konstantinos; Efstathopoulos, Efstathios; Kollias, Spyros; Karandreas, Nikolaos; Kelekis, Nikolaos; Evdokimidis, Ioannis

    2018-04-01

    The phenotypic heterogeneity in amyotrophic lateral sclerosis (ALS) implies that patients show structural changes within but also beyond the motor cortex and corticospinal tract and furthermore outside the frontal lobes, even if frank dementia is not detected. The aim of the present study was to investigate both gray matter (GM) and white matter (WM) changes in non-demented amyotrophic lateral sclerosis (ALS) patients with or without cognitive impairment (ALS-motor and ALS-plus, respectively). Nineteen ALS-motor, 31 ALS-plus and 25 healthy controls (HC) underwent 3D-T1-weighted and 30-directional diffusion-weighted imaging on a 3 T MRI scanner. Voxel-based morphometry and tract-based spatial-statistics analysis were performed to examine GM volume (GMV) changes and WM differences in fractional anisotropy (FA), axial and radial diffusivity (AD, RD, respectively). Compared to HC, ALS-motor patients showed decreased GMV in frontal and cerebellar areas and increased GMV in right supplementary motor area, while ALS-plus patients showed diffuse GMV reduction in primary motor cortex bilaterally, frontotemporal areas, cerebellum and basal ganglia. ALS-motor patients had increased GMV in left precuneus compared to ALS-plus patients. We also found decreased FA and increased RD in the corticospinal tract bilaterally, the corpus callosum and extra-motor tracts in ALS-motor patients, and decreased FA and increased AD and RD in motor and several WM tracts in ALS-plus patients, compared to HC. Multimodal neuroimaging confirms motor and extra-motor GM and WM abnormalities in non-demented cognitively-impaired ALS patients (ALS-plus) and identifies early extra-motor brain pathology in ALS patients without cognitive impairment (ALS-motor).

  3. Assessing the nutritional status of hospitalized elderly

    Science.gov (United States)

    Abd Aziz, Nur Adilah Shuhada; Teng, Nur Islami Mohd Fahmi; Abdul Hamid, Mohd Ramadan; Ismail, Nazrul Hadi

    2017-01-01

    Purpose The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue. Methods A literature search was performed on six databases using the terms “malnutrition”, “hospitalised elderly”, “nutritional assessment”, “Mini Nutritional Assessment (MNA)”, “Geriatric Nutrition Risk Index (GNRI)”, and “Subjective Global Assessment (SGA)”. Results According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients. Conclusion It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future. PMID:29042762

  4. Anorexia and eating patterns in the elderly.

    Directory of Open Access Journals (Sweden)

    Lorenzo Maria Donini

    Full Text Available To evaluate the change in eating habits occurring in community-dwelling and institutionalized elderly subjects with senile anorexia.Cross-sectional, observational.Community, nursing homes and rehabilitation or acute care facilities in four Italian regions.A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards.All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables.In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups ("meat, eggs and fish" and "fruit and vegetables" whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety.Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients.

  5. Anorexia and eating patterns in the elderly.

    Science.gov (United States)

    Donini, Lorenzo Maria; Poggiogalle, Eleonora; Piredda, Maria; Pinto, Alessandro; Barbagallo, Mario; Cucinotta, Domenico; Sergi, Giuseppe

    2013-01-01

    To evaluate the change in eating habits occurring in community-dwelling and institutionalized elderly subjects with senile anorexia. Cross-sectional, observational. Community, nursing homes and rehabilitation or acute care facilities in four Italian regions. A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards). All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables). In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups ("meat, eggs and fish" and "fruit and vegetables") whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety. Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients.

  6. Chronic respiratory diseases and quality of life in elderly nursing home residents.

    Science.gov (United States)

    Carreiro-Martins, Pedro; Gomes-Belo, Joana; Papoila, Ana Luísa; Caires, Iolanda; Palmeiro, Teresa; Gaspar-Marques, João; Leiria-Pinto, Paula; Mendes, Ana Sofia; Paulo-Teixeira, João; Botelho, Maria Amália; Neuparth, Nuno

    2016-08-01

    Few studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (elderly nursing home residents. © The Author(s) 2016.

  7. Social and health profiles of rural elderly Malays.

    Science.gov (United States)

    Shahar, S; Earland, J; Abd Rahman, S

    2001-05-01

    To evaluate the social and health functions of rural elderly Malays. A survey was carried out on 350 elderly Malays aged 60 and above using a set of socio and health questionnaires. The majority of elderly people in the study were married (64%), unemployed with no pension (76%), relied on children for their main economic resources (62%) and perceived that they have sufficient money to buy the food they require (61%). Most of the subjects felt healthy, contented and satisfied with their everyday life, were able to do most of the Activities of Daily Living (ADL) tasks and were actively involved in community activities. However, most of the subjects (60%) had either one or two diagnosed chronic diseases. Thus, only 15% of the subjects had not taken any type of medicines during the previous 12 months. Although the majority of the elderly in this study were able to perform all the ADL tasks and perceived their health as good, physical impairments (eg. sight, hearing and chewing difficulties) are prevalent and the use of medicines is widespread. It is expected that in future a greater proportion of rural elderly Malays will live alone and will face economic and health problems because of the lack of sufficient and satisfactory programmes for this age group.

  8. Health status among elderly Hungarians and Americans.

    Science.gov (United States)

    Buss, T F; Beres, C; Hofstetter, C R; Pomidor, A

    1994-07-01

    Selected health status data for elderly populations from similar industrial cities-Youngstown, Ohio, USA, and Debrecen, Hungary-were compared. Because of their impoverished health care system, unregulated heavily industrialized society, and unhealthful life-styles Hungarians were hypothesized to have poorer health status than Americans, even after taking into account demographic mediating factors. The study provides a health status baseline for elderly Hungarians shortly after communism's fall in 1989-1990 and shows how great a gap exists between Hungarian health status and that in the West. Hungarians were in much poorer health as measured by functional status, symptomatology, medical condition, depression, and subjective health status. Distinctions persisted when controlling for gender, age, and education. Poverty-level (and income) did not explain health status differences. The paper concludes that Hungary should pay more attention to health promotion, prevention, and primary care, as well as to reforming patient management in hospitals, nursing homes, and home care programs.

  9. Pharmacological pain management in the elderly patient

    Directory of Open Access Journals (Sweden)

    Gary McCleane

    2008-01-01

    Full Text Available Gary McCleaneRampark Pain Centre, Lurgan, Northern Ireland, United KingdomAbstract: With the increasing number of elderly patients the issue of pain management for older people is of increasing relevance. The alterations with aging of the neurobiology of pain have impacts of pain threshold, tolerance and treatment. In this review the available evidence from animal and human experimentation is discussed to highlight the differences between young and older subjects along with consideration of how these changes have practical effect on drug treatment of pain. Cognitive impairment, physical disability and social isolation can also impact on the accessibility of treatment and have to be considered along with the biological changes with ageing. Conventional pain therapies, while verified in younger adults cannot be automatically applied to the elderly without consideration of all these factors and in no other group of patients is a holistic approach to treatment more important.Keywords: pain, analgesia, pain threshold, pain tolerance

  10. Calcium Intake in the Moroccan Elderly

    Directory of Open Access Journals (Sweden)

    Sebbar El-houcine

    2017-08-01

    Full Text Available Introduction: Calcium intakes of elderly people are often below the recommendations which are 1200 mg/day. The advancing age may be accompanied by a loss of capacity to absorb additional calcium in case of deficiency. The aim of our work is to evaluate the calcium intake in the Moroccan elderly. Methods: The version translated into Arabic dialect Fardellone questionnaire is tested on a sample of 159 subjects aged over 60 years. Results: The study population includes 87 women (55%, 72 men (45%. The mean calcium intake was respectively 3078 mg by week (that means 440 mg/day. The assessment of calcium intake showed a deficiency and the average consumption of calcium per day is significantly lower than the recommended daily amount for this population. The comparison of both gender found a deficit higher among women than among men. Conclusion: Evaluation of the calcium intake is an essential tool for better management of metabolic bone diseases.

  11. The validity and reliability of the Turkish version of Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in patients with mild and moderate Alzheimer's disease and normal subjects.

    Science.gov (United States)

    Mavioglu, H; Gedizlioglu, M; Akyel, S; Aslaner, T; Eser, E

    2006-03-01

    The cognitive subscale of the Alzheimer's Disease Assesment Scale (ADAS-Cog) is the most widely used test in clinical trials dealing with Alzheimer's disease (AD). The aim of this study was to investigate the validity and reliability of the Turkish version of ADAS-Cog. Twenty-nine patients with AD, fulfilling NINCDS-ADRDA criteria of probable AD, who were in stage 3-5 according to the Global Deterioration Scale (GDS), and 27 non-demented control subjects with similar age, gender and educational status were recruited for the study. The Turkish version of ADAS-Cog, Standardized Mini Mental Status Examination (MMSE) and Short Orientation-Memory-Concentration Test (SOMCT) were applied to both of the groups. Inter-rater reliability, internal consistency, test-retest reliability; face validity, differential validity and convergent validity were statistically analyzed. Both MMSE and ADAS-Cog have significantly differentiated patients with AD and control subjects (p ADAS-Cog scores in AD group (r: -0.739). ADAS-Cog was also highly significantly correlated with GDS (r: 0.720) and SOMCT (r: 0.738). For the group with AD, control and whole cohort coefficients of internal consistency, Cronbach's alpha: 0.800, 0.515, 0.873 were found respectively. Inter-rater reliability for total ADAS-Cog score was found as ICC: 0.99 and 0.98 and test-retest reliability was found as ICC: 0.91 and 0.95 for demented and nondemented subjects, respectively. The Turkish version of ADAS-Cog has been found to be highly reliable and valid in differentiating patients with mild and moderate AD from nondemented subjects.

  12. [Home end-of-life care for advanced dementia vs advanced cancer elderly patients: dying elderly at home project].

    Science.gov (United States)

    Hirakawa, Yoshihisa; Masuda, Yuichiro; Kuzuya, Masafumi; Iguchi, Akihisa; Asahi, Takiko; Uemura, Kazumasa

    2006-05-01

    The aim of this study was to assess the frequency of symptoms and end-of-life care received in advanced dementia and advanced cancer elderly patients dying at home during the last two days of their lives and to evaluate the differences observed between the two groups. We used data from the Dying Elderly at Home (DEATH) project, which was a prospective study of home elderly patients dying with end-stage illness. Consecutive deceased subjects aged 65 or older who were seen at 16 study clinics belonging to the Japanese Society of Hospice and Home-care with diagnoses of all illnesses including advanced dementia and advanced cancer and died at home from October 2002 to September 2004 were included in the study. We evaluated 36 deceased subjects with advanced dementia and 116 with advanced cancer. We collected the following information: sociodemographics, ADLs, cognitive impairment, observed symptoms and end-of-life care provided during the last 48 hours of life. Deceased subjects with advanced dementia were less likely to show symptoms of pain, acute confusion, or nausea/vomiting and more likely to display fever or cough than advanced cancer patients. Also, those with advanced dementia were more likely to receive intravenous drip injection or narcotic analgesia and more likely to be given sputum suction, or antibiotics. We observed that the dying process and end-of-life care for advanced dementia elderly patients was different from that for advanced cancer elderly patients.

  13. [Depression in the elderly].

    Science.gov (United States)

    Hattori, Hideyuki

    2008-09-01

    The incidence of depression is higher than that of dementia in the elderly. Unlike depression in other age groups, that in the elderly is characterized by frequent physical complaints, irritation, and delusional tendencies. The treatment of depression in the elderly requires the complex incorporation of psychiatric and gerontological viewpoints. Psychiatrically, difficulty in accepting decreases in psychological and physical functions and solitude is important, as a psychological characteristic, inducing the development of depression. Biochemically, there is an underlying decrease in the function of brain monoaminergic nerve activated, such as by serotonin and noradrenalin. Radiologically, damage to the cerebral white matter and a decrease in the frontal lobe function have been frequently reported. Depression is difficult to differentiate from dementia and is also often complicated by dementia. Since a depressive state often precede Alzheimer's disease, evaluation of cognitive function is also necessary in patients with a depressive state. Although apathy is often observed as a symptom of dementia and tends to be confused with a depressive symptom, caution is necessary because of differences in the treatment method. Gerontologically, depression is one of geriatric syndrome and isa frequently observed in the elderly in the later stage and closely associated with a decrease in activities of daily life. Depression is also closely associated with lifestyle-related diseases, and its incidence is high in the presence of cerebrovascular disease, ischemic heart disease, hypertension, and diabetes mellitus, and conversely, depression is often complicated by lifestyle-related disease. Anxiety and depression are frequently observed in the frail elderly, but few studies on the assessment and appropriate approach for psychological matters. Further studies are necessary. The treatment of depression in the elderly could be classified into 3 stages. In the acute stage, the

  14. [Specific risks of physical activity in the elderly].

    Science.gov (United States)

    Paillard, T

    2015-01-01

    The aim of this paper is to present the specific risks of physical activity in elderly subjects. These risks mainly consist of the loss of physical integrity and the weakening of the capabilities of metabolic regulation. The risk of impairment of physical integrity (e.g. injury) related to regular physical activity is not overall greater in elderly subjects than in young subjects. The choice of a physical activity that is suited to the elderly subject's physical and cognitive abilities largely limits these risks. When physical activity is adapted to suit elderly subjects, the number of accidents in relation to the number of participants is actually very low. In fact, participation in a program of education for prevention related to physical activity reduces the risk of accidents and injuries (and, thus, falls) occurring thereafter. In the case of metabolic risks, isometric muscular contractions carried out under certain conditions (duration: > 6 seconds; intensity: > 50% of maximal voluntary contraction) are inappropriate. Physical activity carried out in extreme thermal atmospheres (0-5° 25-30°) should be avoided. Hydration is very important and liquids should be drunk well before any thirst sensation occurs.

  15. [Relationship between sleep and constipation in the elderly Chileans].

    Science.gov (United States)

    González Cañete, Natalia; Peña D'ardaillon, Francisca; Candia Johns, Priscila; Durán Agüero, Samuel

    2014-09-12

    There is scarce information about constipation in elderly subjects. Among the variety of factors causing constipation, the sleeping hours are a factor usually not taken into account. To determine the association between hours of sleep during the week and weekend, with constipation in older adults. Sleep quality, stool consistency, physical activity (PA) and dietary fiber intake was assessed using various validated surveys in 424 healthy autonomous elderly men and women, living in Santiago, Chile. Half of the participants reported having abnormal stools (constipation and diarrhea). Subjects who had constipation had lower PA and greater difficulty falling asleep than subjects with normal bowel movements. The elderly participants with constipation had a higher amount of sleep during the week and weekend, that subjects with normal bowel movements (9.4 ± 1.6 vs 8.8 ± 1.8 hours, p = 0.013). The constipated subjects slept significantly more than those with normal evacuation (9.7 ± 1.5 vs 9.2 ± 1.8, p = 0.024). No differences in the nutritional status and fiber intake among patients with different consistencies were found. There is an association between sleep and the consistency of the stools in elderly patients. It would be interesting to evaluate whether long-term improvement of these factors could have a positive impact on the other. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. Sleep quality and duration in relation to memory in the elderly: Initial results from the Hellenic Longitudinal Investigation of Aging and Diet.

    Science.gov (United States)

    Tsapanou, A; Gu, Y; O'Shea, D M; Yannakoulia, M; Kosmidis, M; Dardiotis, E; Hadjigeorgiou, G; Sakka, P; Stern, Y; Scarmeas, N

    2017-05-01

    Sleep is crucial for cognition, particularly for memory, given its complex association with neurodegenerative processes. The aim of the present study was to examine the association between sleep quality as well as sleep duration and memory performance in a Greek elderly population. Cross-sectional design in the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a population representative study of Greek elderly (65years or older). Data from 1589 participants free of sleep medication were included. Sleep quality was estimated by using the Sleep Scale from the Medical Outcomes Study. An extensive neuropsychological assessment examining memory was administered to each participant. Linear regression analyses were used to examine whether sleep quality (higher score, poor quality) and/or sleep duration were associated with memory expressed in the form of a z-score. Age, sex, education, and body mass index were included as covariates. The main analyses were conducted first on the total sample, then with the exclusion of demented participants, and finally with the exclusion of both demented and participants with Mild Cognitive Impairment (MCI). We then conducted further analyses on the non-demented, non-MCI group, initially stratified by Apolipoprotein E-ε4 gene. We further examined the role of co-morbidities, as well as the association between sleep duration groups and memory. We also explored any interaction effect between sex and sleep quality/duration on memory. We then examined the associations between components of sleep measures and memory scores. Lastly, we examined the associations between sleep quality/duration and verbal/non-verbal memory separately. In the total sample, we noted significant associations between sleep duration and memory (B=-0.001, p≤0.0001), but not for sleep quality and memory (B=-0.038, p=0.121). After excluding the demented participants, the associations were significant for: sleep quality and memory (B=-0.054, p=0.023), and

  17. Gastric emptying rate in the elderly: implications for drug therapy

    International Nuclear Information System (INIS)

    Evans, M.A.; Triggs, E.J.; Cheung, M.; Broe, G.A.; Creasey, H.

    1981-01-01

    The effect of the aging process on gastric emptying was studied in 11 elderly subjects (mean age, 77) and in 7 young healthy volunteers (mean age, 26). Gastric emptying rates were assessed by a modified sequential scinti-scanning technique after administration of the nonabsorbable chelated radiopharmaceutical 99mTc-DTPA. The rate of emptying, expressed as half-time (T 1/2e) in minutes, was significantly longer (p less than 0.001) in the elderly subjects (mean apparent T 1/2e . 123.23 min) compared to the young healthy volunteers (mean apparent T 1/2e . 49.69 min). Clinical implications of these findings are discussed, particularly with respect to the rate and extent of drug absorption in elderly persons

  18. Differences in trunk accelerometry between frail and non-frail elderly persons in functional tasks.

    Science.gov (United States)

    Galán-Mercant, Alejandro; Cuesta-Vargas, Antonio I

    2014-02-21

    Physical conditions through gait and other functional task are parameters to consider for frailty detection. The aim of the present study is to measure and describe the variability of acceleration, angular velocity and trunk displacement in the ten meter Extended Timed Get-Up-and-Go test in two groups of frail and non-frail elderly people through instrumentation with the iPhone4® smartphone. Secondly, to analyze the differences and performance of the variance between the study groups (frail and non-frail).This is a cross-sectional study of 30 subjects aged over 65 years, 14 frail subjects and 16 non-frail subjects. The highest difference between groups in the Sit-to-Stand and Stand-to-Sit subphases was in the y axis (vertical vector). The minimum acceleration in the Stand-to-Sit phase was -2.69 (-4.17/-0.96) m/s2 frail elderly versus -8.49 (-12.1/-5.23) m/s2 non-frail elderly, p elderly versus -5.93 (-6.87/-4.51) m/s2 non-frail elderly, p movement angular velocity in the frail elderly was specifically 25.60°/s, compared to 112.8°/s for the non-frail elderly, p elderly people. For the Extended Timed Up and Go test, this device allows more sensitive differentiation between population groups than the traditionally used variable, namely time.

  19. Struggles in (Elderly) Care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene

    of contestation. Dahl approaches these issues from a post-structuralist and radical feminist position, while drawing from feminist sociology, feminist political science, nursing philosophy and feminist history. In particular, Struggles In (Elderly) Care highlights how the predominantly feminist theorization......This book provides a critical engagement with the intensified struggles to be found within elderly care provision. Various social and political processes, including the forces of globalisation and the de-gendering of care, have changed how we might understand this national and global political...... of care has been dominated by a sociological bias that could be improved using insights from political science concerning concepts of power and struggle, and the importance of the state and governance....

  20. [Suicide in the Elderly].

    Science.gov (United States)

    Velásquez Suarez, Juliana María

    2013-01-01

    Suicide is a public health problem worldwide, with multiple features and risk factors. It has some common and unique trends in each phase across the lifespan. To review the medical literature related to suicide in the elderly, in order to determine the current status of this problem in the world, and especially in Colombia. Literature review. There is a high volume of articles about suicide in general, even in Colombia, with many papers describing the problem in a comprehensive manner, but there is a need for more studies and publications on the scope of this problem in the elderly. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  1. [Catatonia in the elderly].

    Science.gov (United States)

    Chiba, Yuhei; Odawara, Toshinari

    2013-10-01

    Catatonia is a syndrome characterized by mutism, stupor, immobility, negativism, posturing, stereotypy, and echophenomena. Not only patients with schizophrenia, but also patients with general medical disease, mood disorder, and substance-related disorder exhibit catatonia. In the patients with catatonia, it is recommended to examine whether they have a general medical disease. We present two catatonic elder patients. Case 1 exhibited catatonia with vascular dementia, and was revealed to have anti-phospholipid antibody syndrome. Case 2 exhibited catatonia with dementia with Lewy bodies, and was revealed to have Hashimoto's encephalopathy. The first recommended treatment for catatonia is benzodiazepines. In case of benzodiazepine resistance or malignant catatonia, it should be considered electroconvulsive therapy, but it needs to be carefully implemented for elder patients.

  2. POSITIVE EFFECT OF LEARNING FOREIGN LANGUAGE IN A HEALTHY ELDERLY

    Directory of Open Access Journals (Sweden)

    Ahmad Muhammad Diponegoro

    2015-12-01

    Full Text Available The study of elderly found that almost all cognitive functions decline with age. Results of previous studies have shown that cognitive training related to everyday life (reading aloud and learning vocabularies and wisdom, namely learning intervention or therapy, can improve two cognitive function (executive functions and processing speed in elderly people. This study investigates the positive effects of learning foreign language on cognitive functions of an elderly person. This study provides sufficient evidence of learning foreign language effectiveness in a healthy elderly.  Method used is  one single case subject design. A healthy elderly was asked to read aloud and memorize several Quran chapters and verses and write Arabic verbs proposition and several nouns found it the memorized verses and put it into correct sentences. The written words are concerning daily life activity. Since the Qur’an has best structure of Arab sentence, memorizing it help to understand the Arabic sentences properly. The finding support the previous research that the elderly able to improve their cognitive processes and ability through studying foreign language. Keywords: psycholinguistic, foreign language, cognitive function, reading

  3. Depression in elderly: A review of Indian research

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2015-01-01

    Full Text Available To review the existing literature on depression among elderly arising from India. Search was carried out using PubMed, Google Scholar, Google, and Medknow search engines to identify the relevant studies. Most of the literatures that are available are in terms of prevalence of depression. Community-based studies involving 70 to 7,150 elderly subjects report prevalence rate varying from 8.9% to 62.16%. Clinic-based studies involving 50 to 5,260 participants report prevalence rates ranging from 42.4% to 72%. Studies have reported depression to be more common among females. Other demographic factors that have been associated with depression among elderly include being unmarried, divorced or widowed elderly, residing in rural locality, being illiterate, increasing age, lower socioeconomic status, and unemployment. Depression has also been shown to be associated with various psychosocial factors, lifestyle and dietary factors, and presence of chronic physical illness. There are limited data on various therapeutic interventions. Available data suggest usefulness of pranayam, cognitive behavior therapy, and electroconvulsive therapy. The review of data suggests that prevalence of depression among elderly in India is high. However, there is lack of data on symptom profile and limited data is available on various therapeutic interventions for the management of depression in elderly from India. There is urgent need to conduct large multicentric studies to fill this void in research.

  4. Community approaches to elder abuse.

    Science.gov (United States)

    Dyer, Carmel B; Heisler, Candace J; Hill, Carrie A; Kim, Lucia C

    2005-05-01

    Collaboration of professionals from diverse disciplines is required to address the multiple, complex issues and needs of community-dwelling elders who are abused or neglected. Reporting suspected elder abuse or neglect cases to Adult Protective Service (APS) agencies provides access to services that address the social, medical, and legal needs of elderly persons. A geriatric interdisciplinary team can provide a comprehensive medical, functional, and social assessment. Based on the findings from the assessment and in collaboration with the APS team, the intervention plan can be formulated. Some cases of elder abuse or neglect may require intervention from the criminal justice or the civil justice system for serious legal issues such as sexual assault, financial exploitation, or guardianship. Other resources, such as Area Agencies on Aging, local women's shelters, and The National Center for Elder Abuse, are available to help manage elder abuse and neglect cases in the community.

  5. Elbow Matching Accuracy in Young and Elderly Humans under Unusual Mechanical Constraints.

    Science.gov (United States)

    Talis, Vera L; Levik, Yuri S

    2016-01-01

    Experiment was carried out to study the proprioception accuracy of elderly (61-83 years old) and young (22-36 years old) subjects during contralateral elbow matching in sagittal plane. The subjects performed the task under ordinary condition and under experimental condition (matching forearm attached to the rocking cylindrical platform of low (LS), or high (HS) height, so that the elbow flexion was associated with tilting movement of the support and with backward movement of the upper arm). Control matching of young and elderly subjects does not differ significantly in terms of constant and absolute error. First block of LS and HS induced absolute error increase and matching arm velocity decrease in both groups, but in the second block of matching on rocking supports both arms velocity of elderly subject decreased and absolute error of elderly subjects toward the second block of rocking condition appeared lower than those of young subjects. Aftereffect of the restricted matching could be observed in elderly as a significant increase of matching arm velocity and corresponding constant error increase. It could be concluded that under unusual mechanical constraints elderly subjects tended to use "conservative" strategy followed by significant aftereffect toward the final ordinary support condition.

  6. Elbow matching accuracy in young and elderly humans under unusual mechanical constraints

    Directory of Open Access Journals (Sweden)

    Vera Talis

    2016-11-01

    Full Text Available Experiment was carried out to study the proprioception accuracy of elderly (61-83 years old and young (22-36 years old subjects during contralateral elbow matching in sagittal plane. The subjects performed the task under ordinary condition and under experimental condition (matching forearm attached to the rocking cylindrical platform of low (LS, or high (HS height, so that the elbow flexion was associated with tilting movement of the support and with backward movement of the upper arm. Control matching of young and elderly subjects does not differ significantly in terms of constant and absolute error. First block of LS and HS induced absolute error increase and matching arm velocity decrease in both groups, but in the second block of matching on rocking supports both arms velocity of elderly subject decreased and absolute error of elderly subjects towards the second block of rocking condition appeared lower than those of young subjects. Aftereffect of the restricted matching could be observed in elderly as a significant increase of matching arm velocity and corresponding constant error increase. It could be concluded that under unusual mechanical constraints elderly subjects tended to use conservative strategy followed by significant aftereffect towards the final ordinary support condition.

  7. Struggles in (Elderly) Care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene

    concern. Emerging discourses such as neoliberalism have also reframed elderly care to increase existing tensions at the individual, national, and transnational level. Dahl argues that in order t