1
|
Kono S, Hashimoto Y, Ohmatsu K, Tsujii M, Kuribayashi S, Karasawa K. Involved-field radiotherapy in older patients with superficial thoracic esophageal squamous cell carcinoma: long-term outcomes and recurrence patterns. Jpn J Radiol 2024:10.1007/s11604-024-01564-w. [PMID: 38647885 DOI: 10.1007/s11604-024-01564-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/17/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE An optimal radiotherapy field for superficial esophageal carcinoma is yet to be established. We evaluated the long-term outcomes and recurrence patterns of involved-field radiotherapy (IFRT) in older patients with superficial thoracic esophageal squamous cell carcinoma (ESCC). MATERIALS AND METHODS Fifty-four patients (49 men and 5 women; mean age, 77 [range: 66-90] years) who underwent IFRT for superficial thoracic ESCC between January 2003 and January 2019 were retrospectively reviewed. Concurrent chemotherapy was administered at the discretion of the attending physician. The primary endpoint was overall survival. The secondary endpoints were progression-free survival and complete response rate. RESULTS The tumors were localized in the upper, middle, and lower thoracic esophagus in 2, 40, and 12 patients, respectively. All patients underwent IFRT using anteroposterior and anterior-posterior oblique opposed beams (off-cord). The prescribed total doses were 50.4, 59.4-61.2, and 66-70 Gy for 6, 40, and 8 patients, respectively. Concurrent chemotherapy was administered to 33 patients. The median follow-up duration was 57 months. The median overall survival was 115 months. The 5-year overall and progression-free survival rates were 71.7% and 60.1%, respectively. Forty-nine patients had a complete response at one month after IFRT (complete response rate: 90.7%). Twenty patients had recurrence; there were 13 in-field and 7 out-of-field recurrence cases. The radiation-related adverse events were generally mild. Grade 3 late toxicity was observed in one patient. CONCLUSIONS The efficacy of IFRT was suggested to be comparable to that of standard treatments. Therefore, IFRT can be a promising approach for treating superficial ESCC in older adults, especially those with severe comorbidities.
Collapse
Affiliation(s)
- Sawa Kono
- Department of Radiation Oncology, Tokyo Women's Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yaichiro Hashimoto
- Department of Radiation Oncology, Tokyo Women's Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Kenta Ohmatsu
- Department of Radiation Oncology, Tokyo Women's Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Miki Tsujii
- Department of Radiation Oncology, Tokyo Women's Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Shigehiko Kuribayashi
- Department of Radiation Oncology, Tokyo Women's Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kumiko Karasawa
- Department of Radiation Oncology, Tokyo Women's Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| |
Collapse
|
2
|
Balbim GM, Boa Sorte Silva NC, Ten Brinke L, Falck RS, Hortobágyi T, Granacher U, Erickson KI, Hernández-Gamboa R, Liu-Ambrose T. Aerobic exercise training effects on hippocampal volume in healthy older individuals: a meta-analysis of randomized controlled trials. GeroScience 2024; 46:2755-2764. [PMID: 37943486 PMCID: PMC10828456 DOI: 10.1007/s11357-023-00971-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
We conducted a meta-analysis of randomized controlled trials investigating the effects of aerobic exercise training (AET) lasting ≥ 4 weeks on hippocampal volume and cardiorespiratory fitness (CRF) in cognitively unimpaired, healthy older individuals. Random-effects robust variance estimation models were used to test differences between AET and controls, while meta-regressions tested associations between CRF and hippocampal volume changes. We included eight studies (N = 554) delivering fully supervised AET for 3 to 12 months (M = 7.8, SD = 4.5) with an average AET volume of 129.85 min/week (SD = 45.5) at moderate-to-vigorous intensity. There were no significant effects of AET on hippocampal volume (SMD = 0.10, 95% CI - 0.01 to 0.21, p = 0.073), but AET moderately improved CRF (SMD = 0.30, 95% CI 0.12 to 0.48, p = 0.005). Improvement in CRF was not associated with changes in hippocampal volume (bSE = 0.05, SE = 0.51, p = 0.923). From the limited number of studies, AET does not seem to impact hippocampal volume in cognitively unimpaired, healthy older individuals. Notable methodological limitations across investigations might mask the lack of effects.
Collapse
Affiliation(s)
- Guilherme Moraes Balbim
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Nárlon Cássio Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Lisanne Ten Brinke
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Ryan S Falck
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
- Department of Neurology, Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany
| | - Kirk I Erickson
- AdventHealth Research Institute, Neuroscience, Orlando, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Rebeca Hernández-Gamboa
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada.
| |
Collapse
|
3
|
Paulin TK, Malmgren L, McGuigan FE, Akesson KE. Osteosarcopenia: Prevalence and 10-Year Fracture and Mortality Risk - A Longitudinal, Population-Based Study of 75-Year-Old Women. Calcif Tissue Int 2024; 114:315-325. [PMID: 38300303 PMCID: PMC10957698 DOI: 10.1007/s00223-023-01181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/28/2023] [Indexed: 02/02/2024]
Abstract
Osteosarcopenia is the coexistence of low bone mass and sarcopenia. In older women, its prevalence is not well described, and it is unknown if sarcopenia is additive to low bone mass for fracture and mortality risk. The study investigated prevalence of osteosarcopenia and if osteosarcopenia is associated with higher fracture and mortality risk than low bone mass alone in older community-dwelling women. The longitudinal, population-based OPRA Cohort (n = 1044), all aged 75 at inclusion, followed for 10 years. Using WHO and EWGSOP2 definitions for low bone mass (T-score < -1.0 femoral neck) and sarcopenia (knee strength; appendicular lean muscle mass) women were categorized (1) Normal, (2) Low bone mass (LBM), and 3) Osteosarcopenia (probable; confirmed). Risk of hip, major osteoporotic fracture, and mortality were estimated. Osteosarcopeniaconfirmed prevalence increased from age 75 to 80 and 85 from 3.0% (29/970) to 4.9% (32/656) to 9.2% (33/358) but prevalence is potentially 2-4 times higher (11.8%, 13.4%, 20.3%) based on osteosarcopeniaprobable. Having osteosarcopeniaprobable significantly increased 10-year risk of hip fracture (HRadj 2.67 [1.34-5.32]), major osteoporotic fracture (HRadj 2.04 [1.27-3.27]), and mortality (HRadj 1.91 [1.21-3.04]). In contrast, LBM increased osteoporotic fracture risk (HRadj 2.08 [1.46-2.97], but not hip fracture (HRadj 1.62 [0.92-2.85]) or mortality (HRadj 0.94 [0.64-1.38]). Median time-to-hip fracture was 7.6 years (normal), 6.0 years (LBM), and 5.7 years (osteosarcopeniaprobable). Prevalence of confirmed osteosarcopenia is almost 10% at age 85. Probable osteosarcopenia significantly increased risk of hip and major osteoporotic fractures and mortality more so than low bone mass alone.
Collapse
Affiliation(s)
- Tine Kolenda Paulin
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden.
- Department of Geriatrics, Skåne University Hospital, Malmö, Sweden.
| | - Linnea Malmgren
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
- Department of Geriatrics, Skåne University Hospital, Malmö, Sweden
| | - Fiona E McGuigan
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
| | - Kristina E Akesson
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
- Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
4
|
Battini V, Barbieri MA, Carnovale C, Spina E, Clementi E, Sessa M. Comparing major and mild cognitive impairment risks in older type-2 diabetic patients: a Danish register-based study on dipeptidyl peptidase-4 inhibitors vs. glucagon-like peptide-1 analogues. J Neurol 2024:10.1007/s00415-024-12300-9. [PMID: 38517522 DOI: 10.1007/s00415-024-12300-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION The prevalence of major and mild cognitive impairment (CI) in type-2 diabetes older patients is 15-25% and 30-60%, respectively, thus affecting quality of life and health outcomes. There is, therefore, the need of head-to-head studies aiming at identifying the optimal treatment for individuals with type-2 diabetes at increased risk of mild and major CI. This study focuses on the risk of developing mild and major CI in Danish patients treated with dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 analogues (GLP-1a) using administrative and healthcare registers. METHODS An active comparator design with a 3-year follow-up period was used. The main outcome was the hospital admission with a diagnosis of mild CI or major CI. Multivariate Cox Regression analysis was performed using the high-dimensional propensity score to obtain adjusted Hazard Ratio (HR) estimates. Inverse probability of treatment weighting (IPTW) and marginal structured model were used to calculate risk differences while accounting for the variations of confounders throughout the follow-up period. RESULTS Our results show a significant higher risk of major CI between DPP-4i and GLP-1a in unadjusted [HR (95% CI) = 3.13 (2.45-4.00), p < 0.001] and adjusted analyses [HR (95% CI) = 1.58 (1.22-2.06), p = 0.001]. No statistically significant differences were observed for mild CI. IPTW resulted stable throughout the follow-up period. Marginal structure modeling (β (95% CI) = 0.022 (0.020-0.024), p < 0.001) resulted in a higher risk of major CI for DPP-4i when compared to GLP-1a. DISCUSSION DPP-4i was associated with an increased risk of developing major CI when compared to GLP-1a among older individuals with type-2 diabetes.
Collapse
Affiliation(s)
- Vera Battini
- Department of Drug Design and Pharmacology, University of Copenhagen, Jagtvej 160, 2100, Copenhagen, Denmark
- Pharmacovigilance and Clinical Research, International Centre for Pesticides and Health Risk Prevention, Department of Biomedical and Clinical Sciences (DIBIC), ASST Fatebenefratelli-Sacco University Hospital, Università Degli Studi Di Milano, Milan, Italy
| | - Maria Antonietta Barbieri
- Department of Drug Design and Pharmacology, University of Copenhagen, Jagtvej 160, 2100, Copenhagen, Denmark
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | - Carla Carnovale
- Pharmacovigilance and Clinical Research, International Centre for Pesticides and Health Risk Prevention, Department of Biomedical and Clinical Sciences (DIBIC), ASST Fatebenefratelli-Sacco University Hospital, Università Degli Studi Di Milano, Milan, Italy
| | - Edoardo Spina
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | - Emilio Clementi
- Pharmacovigilance and Clinical Research, International Centre for Pesticides and Health Risk Prevention, Department of Biomedical and Clinical Sciences (DIBIC), ASST Fatebenefratelli-Sacco University Hospital, Università Degli Studi Di Milano, Milan, Italy
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, LC, Italy
| | - Maurizio Sessa
- Department of Drug Design and Pharmacology, University of Copenhagen, Jagtvej 160, 2100, Copenhagen, Denmark.
| |
Collapse
|
5
|
Yıldırım Ayaz E, Dincer B, Mete E, Kaygusuz Benli R, Cinbaz G, Karacan E, Cankül A, Mesci B. Evaluating the impact of aerobic and resistance green exercises on the fitness, aerobic and intrinsic capacity of older individuals. Arch Gerontol Geriatr 2024; 118:105281. [PMID: 38056100 DOI: 10.1016/j.archger.2023.105281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Our study determined the impact of 12-week aerobic exercise (AE) and aerobic + resistance exercises (AE + RE) within the green exercise concept, on senior fitness, aerobic capacity, and intrinsic capacity (IC). METHODS The study was a multicenter, randomized controlled study conducted at two senior living facilities with individuals aged 65 and above whose cardiorespiratory and musculoskeletal conditions are suitable for moderate exercise and who have normal cognition levels. Block randomization was applied to 96 participants in a ratio of 1:1:1 to be assigned to AE, AE + RE, and control (C) groups. Intervention groups received exercise sessions led by physiotherapists within the senior living facilitiy gardens, with a frequency of once a week for 50 min, for 12 weeks. Also, they were prescribed additional exercise sessions on two additional days of the week. At the commencement of the study and 12th week, shuttle walking test, senior fitness test (SFT), intrinsic capacity assessment (with Timed Up and Go test, Mini Mental State Examination, Geriatric Depression Scale-15, Mini Nutritional Assessment, handgrip strength test) was conducted of all participants. The primary outcome was the Z score of IC, secondary outcomes were VO2max and SFT subparameters. The study was registered in the Protocol Registry and Results System (Clinicaltrials.gov PRS) with the registration number NCT05958745. RESULTS 90 participants successfully completed the study, with 30 individuals in each of the AE, AE + RE, and C groups. By the end of the 12th week, the arm curl score was significantly higher in the AE + RE compared to the C (mean difference: 3.96, 95 % CI= 2.47 to 5.46, p = 0.01). There were significant differences in chair stand, two-minute step, 8-foot up-and-go, chair sit and reach, and back scratch tests in both AE and AE + RE compared to C. AE and AE + RE exhibited significantly higher shuttle test distances and VO2max values compared to the C (p < 0.0001). AE + RE achieved a significantly higher total IC score than the C (mean difference: 0.59, %95 CI= -0.07 to 1.26, p = 0.025). CONCLUSION In this study within the green exercise concept, both AE and AE + RE led to similar improvements in strength, flexibility, mobility, endurance, and aerobic capacity. Notably, AE + RE demonstrated an additional benefit by increasing the total IC, while AE alone did not exhibit the same effect.
Collapse
Affiliation(s)
- Elif Yıldırım Ayaz
- University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Internal Medicine Clinic, Selimiye, Tıbbiye Cd, 34668 Üsküdar, İstanbul Turkey.
| | - Berna Dincer
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Internal Medicine Nursing, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Emel Mete
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Reyhan Kaygusuz Benli
- Demiroglu Science University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Yazarlar St. No:17, 34394 Esentepe Şişli, İstanbul, Turkey
| | - Gülser Cinbaz
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Esra Karacan
- Yeditepe University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Kayışdağı, İnönü Mahallesi, Kayışdağı Cd., 34755 Ataşehir, İstanbul, Turkey
| | - Ayşegül Cankül
- Medipol University Hospital, Internal Medicine and Onkology Clinic, TEM Avrupa Otoyolu Göztepe Çıkışı No:1, 34214, Bağcılar, İstanbul, Turkey
| | - Banu Mesci
- Istanbul Medeniyet University Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Internal Medicine Clinic, Eğitim Mah. Fahrettin Kerim Gökay, Caddesi Kadıköy, İstanbul, Turkey
| |
Collapse
|
6
|
Yeverino Gutiérrez ML, González González MDR, González Santiago O. Trends in Parkinson's mortality in Mexico 2000-2020. Gac Sanit 2024; 38:102361. [PMID: 38422946 DOI: 10.1016/j.gaceta.2024.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To describe the recent trends in Parkinson's disease mortality in Mexico during 2000-2020. METHOD The adjusted mortality rate per 100,000 inhabitants was calculated using the direct method and the world standard population. Trend analysis was performed with the Joinpoint software. RESULTS The average mortality rate was 1.26/100,000 inhabitants (SD: 0.09), and males showed higher mortality than females (M/F ratio=1.60). Older individuals ≥70 years old showed higher mortality rates than the rest of the age groups. During the period of study, a significant increase in mortality was observed from 2000 to 2005, while from 2005 to 2020 no significant trend was observed in all the studied groups. CONCLUSIONS In Mexico, males and older individuals showed the highest mortality rates. The socioeconomic regions with high levels of wellness showed the highest mortality rates levels. Parkinson's mortality rate has remained constant since 2005 in Mexico.
Collapse
Affiliation(s)
- Myrna L Yeverino Gutiérrez
- Laboratory of Pharmacology, Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | | | - Omar González Santiago
- Postgraduate Coordination in Pharmacy, Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México.
| |
Collapse
|
7
|
Scalia M, Parrella M, Borzuola R, Macaluso A. Comparison of acute responses in spinal excitability between older and young people after neuromuscular electrical stimulation. Eur J Appl Physiol 2024; 124:353-363. [PMID: 37524980 DOI: 10.1007/s00421-023-05288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/12/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE This study aims at comparing acute responses in spinal excitability, as measured by H-reflex, between older and young individuals, following a single session of NMES superimposed onto voluntary isometric contractions of the ankle plantar-flexor muscles (NMES+), with respect to passive NMES (pNMES) and voluntary isometric contractions only (ISO). METHODS Thirty-two volunteers, 16 older (OLDER) and 16 young (YOUNG), were asked to sustain a constant force at 20% of maximal voluntary isometric contraction (MVIC) of the ankle plantar-flexor muscles in the dominant limb during each of the 3 conditions (NMES+ , pNMES and ISO). Fifteen repetitions of 6 s were performed, with a resting interval of 6 s between repetitions. Before and after each condition, soleus H-reflexes were elicited by percutaneous electrical stimulation of the posterior tibial nerve and H-reflex amplitudes recorded by surface EMG. RESULTS In OLDER, H-reflex amplitude did not change following any experimental condition (ISO: p = 0.203; pNMES: p = 0.542; NMES+: p = 0.431) compared to baseline. On the contrary, in YOUNG, H-reflex amplitudes significantly increased (p < 0.000) and decreased (p = 0.001) following NMES+ and pNMES, respectively, while there was no significant change in reflex responses following ISO (p = 0.772). CONCLUSION The lack of change in H-reflex responses following either NMES+ or pNMES might reflect a reduced ability of older people in modulating spinal excitability after the conditions. Specifically, an age-related alteration in controlling mechanisms at presynaptic level was suggested.
Collapse
Affiliation(s)
- Martina Scalia
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
| | - Martina Parrella
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Riccardo Borzuola
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| |
Collapse
|
8
|
Madashetty S, Palaniswamy HP, Rajashekhar B. The Impact of Age-Related Hearing Loss on Working Memory among Older Individuals: An Event-Related Potential Study. Dement Geriatr Cogn Dis Extra 2024; 14:1-13. [PMID: 38601851 PMCID: PMC11003732 DOI: 10.1159/000538109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/31/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Age-related hearing loss (ARHL) may affect working memory (WM), which impacts problem-solving, decision-making, language comprehension, and learning. Limited research exists on how ARHL affects WM using N-back tasks, but studying this is crucial for understanding neural markers and associated cognitive processes. Our study explores the impact of ARHL on WM using behavioral and electrophysiological measures and how it correlates with speech-in-noise scores in older individuals with ARHL. Method The study involved two groups, each with 20 participants aged 60-80. Group 1 had individuals with mild to moderate sensorineural hearing loss, while Group 2 had age- and education-matched controls with normal or near-normal hearing. Participants underwent audiological assessments and completed cognitive tests, including simple reaction time and N-back tests. During the performance of cognitive tasks, a simultaneous electroencephalography was recorded. Data analysis included behavioral and event-related potentials, source estimation, and functional connectivity analysis. Results The study revealed significantly poor accuracy, longer reaction time, and smaller P300 amplitude among individuals with ARHL, even after controlling for general slowing. Individuals with ARHL experience compromised neural activity, particularly in the temporal and parietal regions, which are vital for cognition and WM. Furthermore, individuals with ARHL exhibited poor communication between the superior temporal gyrus and insulae regions among the brain regions mediating WM during the 1-back task. Also, the study found a strong correlation between hearing measures and WM outcomes. Conclusion The study findings suggest that individuals with ARHL have impaired WM compared to those with normal hearing. This indicates a potential link between ARHL and cognitive decline, which could significantly affect daily life and quality of life. The widely used WM test with simultaneous EEG recording and source estimation analysis would further validate the usefulness of the study in assessing WM in this population.
Collapse
Affiliation(s)
- Sankalpa Madashetty
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Hari Prakash Palaniswamy
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Bellur Rajashekhar
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
9
|
Lv L, Wu XD, Yan HJ, Zhao SY, Zhang XD, Zhu KL. The disparity in hesitancy toward COVID-19 vaccination between older individuals in nursing homes and those in the community in Taizhou, China. BMC Geriatr 2023; 23:828. [PMID: 38066433 PMCID: PMC10709861 DOI: 10.1186/s12877-023-04518-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Older individuals are priority coronavirus disease 2019 (COVID-19) vaccine recipients. Our aim was to investigate the prevalence of and factors influencing vaccine hesitancy in older individuals living in nursing homes and communities. METHODS A self-administered COVID-19 vaccine hesitancy survey was conducted from September 2021 to December 2021 among people aged ≥ 60 years in eight nursing homes (382 participants) and the community (112 participants) in Taizhou, China. The response rate was 72.1% (382/530) for older adults in nursing homes and 68.7% (112/163) for older adults in the community. RESULTS We found that 58.1% of the older individuals in nursing homes and 36.6% of those in the community were hesitant to receive the COVID-19 vaccine and that there was a statistically significant difference (P < 0.001). Multiple logistic regression results indicated that the main factors influencing hesitation among the older individuals in nursing homes were being male (Odds Ratio (OR) = 1.67, 95% Confidence Interval (CI): 1.01-2.76); their cognitive level, including having a high perceived risk of COVID-19 infection (OR = 3.06, 95% CI: 1.73-5.43) or the perception of low vaccine safety (OR = 3.08, 95% CI: 1.545- 6.145); anxiety (OR = 3.43, 95% CI: 1.96-5.99); and no previous influenza vaccination (OR = 1.82, 95% CI: 1.13-2.93); whereas those for older individuals in the community were comorbid chronic diseases (OR = 3.13, 95% CI: 1.11- 8.78) and community workers not recommending the vaccine (OR = 8.223, 95% CI: 1.77-38.27). CONCLUSION The proportion of older individuals in nursing homes who were hesitant to receive the COVID-19 vaccine was significantly higher than for older individuals in the community. Targeted measures should be implemented to reduce vaccine hesitancy and improve vaccination rates in response to the special environment of nursing homes and the characteristics of this population.
Collapse
Affiliation(s)
- Li Lv
- The Affiliated People's Hospital of Ningbo University, Ningbo, 315040, Zhejiang Province, China
| | - Xu-Dong Wu
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Huan-Jun Yan
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Shuang-Ying Zhao
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Xiao-Dong Zhang
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China
| | - Ke-Lei Zhu
- Hepatopancreatobiliary Surgery, People's Hospital Affiliated to Ningbo University, Ningbo University, 251 Baizhang East Road, Ningbo, 315040, Zhejiang Province, China.
| |
Collapse
|
10
|
Yang J, Mo Z, Zhang Y, Ji R, Tao C, Fan Y. The effects of walking aids on shoulder joint kinematics in older persons: an initial study. BMC Geriatr 2023; 23:743. [PMID: 37964210 PMCID: PMC10648336 DOI: 10.1186/s12877-023-04439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Many older persons with degenerative physical functions use walking aids to improve their ambulation ability. The aim of this study was to investigate the effects of walking aids with different configurations on shoulder joint motion in older persons. METHODS The 3D motion capture system VICON was applied to collect data on gait parameters and shoulder motion characteristics of 6 older persons walking either independently or with the assistance of a footed walking frame and a wheeled walking frame. The different effects of walking aids on gait parameters and the shoulder joint motion of older individuals were quantitatively analyzed. RESULTS The gait parameters of the older individuals changed significantly when they used walking frames to assist walking. Compared to independent walking, the range of motion of the shoulder joint was reduced by 79.92% in flexion when walking with a wheeled walking frame. Meanwhile, the range of motion in flexion, extension, and external rotation increased by 76.04%, 85.55%, and 110.99%, respectively, when walking with a footed walking frame. CONCLUSION The motion characteristics of shoulder joints in older persons were significantly affected by using different walking aids. These changes in shoulder joint motion characteristics will lead to potential diseases related to the shoulder musculoskeletal system. These findings are beneficial to determine a walking aid for older people.
Collapse
Affiliation(s)
- Jiemeng Yang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China
- Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Centre for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Zhongjun Mo
- Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Centre for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Yanyu Zhang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China
| | - Run Ji
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China
- Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Centre for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Chunjing Tao
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China.
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, and with the School of Engineering Medicine, Beihang University, Beijing, 100191, China.
| |
Collapse
|
11
|
Zhang H, Wei X, Pan J, Chen X, Sun X. Anemia and frailty in the aging population: implications of dietary fiber intake (findings of the US NHANES from 2007-2018). BMC Geriatr 2023; 23:634. [PMID: 37805459 PMCID: PMC10560428 DOI: 10.1186/s12877-023-04352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 09/25/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Frailty has long been seen as an indicator of reduced physical functions in the elderly, which may be caused by a variety of chronic illnesses or cancerous tumors. Dietary fiber was connected with anemia and frailty, whereas it was uncertain if dietary fiber consumption modifies the impact of anemia on frailty in elderly adults. METHODS We performed a secondary analysis using older adults aged 60 years and over from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 cycles. Dietary fiber intake was estimated using two 24-h dietary recalls. Participants were dichotomized as frail or non-frail based on a modified Fried physical frailty phenotype from previous NHANES studies. The weighted logistic regression was used to estimate the odds ratio (OR) and confidence interval (CI) for the associations between hemoglobin levels and frailty at high- and low-dietary fiber intake levels. RESULTS A total of 9644 older adults were included in this study, and the weighted sample was 56,403,031, of whom 3,569,186 (6.3%) were deemed to be frail, and the remainder were deemed to be non-frail. Among the low dietary fiber intake group, higher hemoglobin was significantly associated with a lower risk of frailty (OR = 0.79, 95% CI: 0.71-0.87), and anemia was associated with an almost threefold elevated risk of frailty (OR = 3.24, 95% CI:1.98-5.29) in the fully adjusted model. However, this phenomenon was not observed in groups with high dietary fiber intake. In addition, L-shaped dose response relationship was found in the high dietary fiber intake group (P overall association < 0.001; P non-linear association = 0.076). Whereas the dose response relationship was not significant in the high dietary fiber intake group (P overall association 0.752; P non-linear association = 0.734). CONCLUSIONS Frailty was positively associated with the severity of anemia in older adults with low, but not high, dietary fiber intake. Adequate fiber intake may be an innovative dietary strategy to reduce frailty in older adults.
Collapse
Affiliation(s)
- HuanRui Zhang
- Department of Geriatric, The First Hospital of China Medical University, NO.155 Nanjing North Street, Heping Ward, Shenyang, 110001, China
| | - Xuejiao Wei
- Department of Health Services and Policy Research, Queen's University, Kingston, ON, Canada
| | - Jiani Pan
- Department of Geriatric, The First Hospital of China Medical University, NO.155 Nanjing North Street, Heping Ward, Shenyang, 110001, China
| | - XiTao Chen
- Department of Thoracic Surgery, The First Hospital of China Medical University, NO.155 Nanjing North Street, Heping Ward, Shenyang, 110001, China.
| | - XiaoDi Sun
- Department of Geriatric, The First Hospital of China Medical University, NO.155 Nanjing North Street, Heping Ward, Shenyang, 110001, China.
| |
Collapse
|
12
|
Yoshiko A, Hirono T, Takeda R, Chosa N, Beppu M, Watanabe K. Applicability of the seated step test for assessing thigh muscle sarcopenia in older individuals. Exp Gerontol 2023; 181:112283. [PMID: 37660763 DOI: 10.1016/j.exger.2023.112283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023]
Abstract
Assessment of lower limb muscle mass and related functions in older individuals is important because of their essential role in maintaining locomotion and activities of daily living. Therefore, a simple and reliable method for assessing these parameters should be established. The seated step test is easy and safe and can be used to assess lower limb agility; however, its relationship to skeletal muscle mass and function remains unknown. The present study aimed to investigate the relationships between the seated step test and lower limb muscle mass and function. For the analysis, we included 85 participants aged 73.1 ± 6.0 years. The participants performed an alternate up-down leg step test for 10 s while seated in a chair. Lower limb muscle mass was measured using bioimpedance analysis. Skeletal muscle mass index (SMI) was calculated using the following equation: lower limb muscle mass (kg) / height2 (m2). As the muscle functional parameters, we measured the isometric knee extension peak torque (KEPT), knee flexion peak torque (KFPT), and rate of torque development (RTD) for isometric knee extension in all participants. The seated step test score had a significant relationship with KEPT, KFPT, and SMI, but not with RTD. In the single regression analysis, the seated step test significantly predicted KEPT, KFPT, and SMI. These results suggest that up-down seated step test can be a reliable method to estimate lower limb muscle size and function in older individuals.
Collapse
Affiliation(s)
- Akito Yoshiko
- Faculty of Liberal Arts and Sciences, Chukyo University, Aichi, Japan.
| | - Tetsuya Hirono
- School of Health and Sport Sciences, Chukyo University, Aichi, Japan
| | - Ryosuke Takeda
- School of Health and Sport Sciences, Chukyo University, Aichi, Japan
| | - Naoki Chosa
- Department of Orthopaedic Surgery, University of Miyazaki, Miyazaki, Japan
| | | | - Kohei Watanabe
- School of Health and Sport Sciences, Chukyo University, Aichi, Japan
| |
Collapse
|
13
|
Liu H, Hu T. Correlation between air pollution and cognitive impairment among older individuals: empirical evidence from China. BMC Geriatr 2023; 23:366. [PMID: 37710153 PMCID: PMC10503026 DOI: 10.1186/s12877-023-03932-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 03/25/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Little information is available regarding the impact of air pollution on cognitive impairment in older individuals in developing countries. This study empirically tested the impacts of the air quality index (AQI), air pollution intensity (quantified by the number of days of extreme air pollution in a year), and different pollutants on the cognitive abilities of older Chinese individuals. METHODS A panel of 28,395 participants spanning 122 cities in 2015 and 2018 was used, based on 3-year follow-up survey data from the China Health and Retirement Longitudinal Study (CHARLS) database. Data from the two phases of the CHARLS microsurvey were combined with relevant statistical data on air pollution in each region in the current year. These two surveys were used to investigate changes in basic health and macro-environmental indicators in older individuals in China, and a mean difference test was conducted. We then reduced the sample selection error by controlling for environmental migration and used two-way fixed and instrumental variable methods for endogenous treatment to avoid the estimation error caused by missing variables. RESULTS Air pollution had a significantly negative effect on the cognitive abilities of older individuals (odds ratio [OR]: 1.4633; 95% confidence interval [95% CI]: 1.20899-1.77116). Different pollution intensities(only AQI value is greater than 200 or more) had apparent effects on cognitive impairment, with an OR of approximately 1.0. Sulfur dioxide had significantly negative effects on cognitive ability, with OR of 1.3802 (95% CI: 1.25779-1.51451). Furthermore, air pollution impact analysis showed heterogeneous results in terms of age, sex, education, and regional economic development level. In addition, social adaptability (calculated using social participation, learning, adaptability, and social support) not only had a significant positive effect on the cognitive abilities of older individuals, but also regulated the cognitive decline caused by air pollution. CONCLUSIONS Air pollution affects cognitive impairment in older individuals, especially in those with lower education levels, and living in economically underdeveloped areas. This effect is synchronous and has a peak at an AQI of > 200.
Collapse
Affiliation(s)
- Huan Liu
- School of Society, Soochow University, No. 199, Ren’ai Road, Suzhou Industrial Park, Su Zhou, Jiangsu 215123 China
| | - Tiantian Hu
- Shenzhen Futian District Economic Development Promotion Association, Shenzhen, China
- Qiaocheng Consulting (Shenzhen) Co., Ltd, Shenzhen, China
| |
Collapse
|
14
|
Costenoble A, Knoop V, Debain A, Bautmans I, Van Laere S, Lieten S, Rossi G, Verté D, Gorus E, De Vriendt P. Transitions in robust and prefrail octogenarians after 1 year: the influence of activities of daily living, social participation, and psychological resilience on the frailty state. BMC Geriatr 2023; 23:485. [PMID: 37563561 PMCID: PMC10416541 DOI: 10.1186/s12877-023-04178-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 07/17/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Knowledge opportunities lie ahead as everyday activities, social participation, and psychological resilience might be important predictors for frailty state transitioning in the oldest old. Therefore, this article aims to examine whether changes in basic-, instrumental-, advanced- activities of daily living (b-, i-, a-ADLs), social participation, and psychological resilience predict both a transition from robustness to prefrailty or frailty and vice versa among community-dwelling octogenarians over a follow-up period of one year. METHODS To evaluate worsened and improved frailty transitions after one year in 322 octogenarians (Mage = 83.04 ± 2.78), the variables sex, ADLs (b-ADL-DI, i-ADL-DI, a-ADL-DI as baseline and as difference after 6 months values), the CD-RISC (Connor-Davidson Resilience Scale, as baseline and as difference after 6 months), the social participation variables (total participation score, being a member, total number of memberships, level of social participation, being a board member, volunteering, and formal participation as baseline and as difference after 6 months values), were included in a logistic regression analysis. RESULTS Limitations in a-ADLs at baseline (OR: 1.048, 95% confidence interval, 1.010-1.090) and an increment of limitations in a-ADLs after 6 months (OR: 1.044, 95% confidence interval, 1.007-1.085) were predictors to shift from robust to a worsened frailty state after one year follow-up. Additionally, being a woman (OR: 3.682, 95% confidence interval, 1.379-10.139) and social participation, specifically becoming a board member in 6 months (OR: 4.343, 95% confidence interval, 1.082-16.347), were protectors of robustness and thus related to an improved frailty transition after one year. CONCLUSIONS Encouraging healthy lifestyle behaviors to help the maintenance of ADLs, possibly leading to more social participation, could be promising in the prevention of frailty.
Collapse
Affiliation(s)
- Axelle Costenoble
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
| | - Veerle Knoop
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- SOMT University of Physiotherapy, Amersfoort, The Netherlands
| | - Aziz Debain
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Sven Van Laere
- Interfaculty Center Data Processing and Statistics, VUB, Brussels, Belgium
| | - Siddhartha Lieten
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Gina Rossi
- Personality and Psychopathology Research Group, Faculty of Psychology and Educational Sciences, VUB, Brussels, Belgium
| | - Dominique Verté
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Belgian Ageing Studies Research Group, VUB, Brussels, Belgium
| | - Ellen Gorus
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Gerontology Department, VUB, Brussels, Belgium
- Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Patricia De Vriendt
- Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
- Gerontology Department, VUB, Brussels, Belgium.
- Arteveldehogeschool, Ghent, Belgium.
| |
Collapse
|
15
|
van Eijk E, van der Spek YM, van Deudekom FJA, van den Bos F, Mooijaart SP, Trompet S. Temporal changes in characteristics and external validity of randomized controlled trials in older people from 2012 to 2019. BMC Geriatr 2023; 23:324. [PMID: 37226093 DOI: 10.1186/s12877-023-04018-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/04/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Older individuals are often underrepresented in clinical trials. In 2012 only 7% of RCT's specifically studied older people and their geriatric characteristics were poorly reported. The aim of this review was to investigate temporal changes in characteristics and external validity of randomized controlled trials in older people from 2012 to 2019. METHODS PubMed was searched for randomized clinical trials (RCTs) published in 2019. Firstly, the proportion of RCTs specially designed for older people were determined by the following criteria: a reported mean age of ≥ 70 years or a lower age cutoff of ≥ 55. Secondly, the trials with a majority of older people, defined by a reported mean age of ≥ 60 years, were screened for reporting of geriatric assessments. Both parts were compared with identical reviews performed in 2012. RESULTS From a 10% random sample, 1446 RCTs were included in this systematic review. First, 8% of trials were specifically designed for older people in 2019 compared to 7% in 2012. Secondly, 25% of the trials included a majority of older people in 2019, compared to 22% in 2012. Thirdly, in 52% of these trials in 2019 one or more of the geriatric assessments were reported compared to 34% in 2012. CONCLUSIONS Although in 2019 the proportion of published RCTs specifically designed for older people remains low, more characteristics on geriatric assessments were reported compared to 2012. Continued efforts should be paid to increase both the number and the validity of trials for older people.
Collapse
Affiliation(s)
- Estelle van Eijk
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Yanna M van der Spek
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | | | - Frederiek van den Bos
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Simon P Mooijaart
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
- LUMC Center for Medicine for Older People, Leiden, The Netherlands
| | - Stella Trompet
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands.
- LUMC Center for Medicine for Older People, Leiden, The Netherlands.
| |
Collapse
|
16
|
Spaetgens B, Brouns SHA, Linkens AEMJH, Poeze M, Ten Broeke RHM, Brüggemann RAG, Sipers W, Henry RMA, Hanssen NMJ. Associations between presence of diabetes, mortality and fracture type in individuals with a hip fracture. Diabetes Res Clin Pract 2022; 192:110084. [PMID: 36122868 DOI: 10.1016/j.diabres.2022.110084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022]
Abstract
AIMS An overlooked aspect of diabetes is an increased risk of hip fractures, with associated mortality. We investigated whether fracture type and/or burden of comorbidities explains the increased risk of mortality in diabetes after hip fracture. METHODS For this cohort study, we used a de-identified data set of hip fracture patients registered in a quality-of-care registry (2017/2018) included in Maastricht University Medical Centre. RESULTS Among 594 hip fracture patients, 90 (15.2 %) had diabetes. Median (IQR) age was 82 (71-87) years and 63.8 % were women. Compared to patients without, patients with diabetes had higher median Charlson Comorbidity Index [1 (0-2) vs 0 (0-2), P < 0.001)] and were more likely to sustain intertrochanteric/subtrochanteric fractures [54.4 vs 38.7 %, P = 0.02]. Over a median follow-up of 2.7 (1.6-3.3) years, crude mortality rate was 30.8 % in patients without and 50.0 % in patients with diabetes. This association remained unaltered after adjustment for age, sex, BMI, fracture type or burden of co-morbidities. CONCLUSION Individuals with diabetes display a greatly increased absolute mortality risk after hip fracture. This association was not attenuated after adjustment for fracture type or non-diabetes associated co-morbidity. These findings have important implications for diabetes care in hip fracture patients, and underline the importance of fracture prevention.
Collapse
Affiliation(s)
- Bart Spaetgens
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - Steffie H A Brouns
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Aimée E M J H Linkens
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Martijn Poeze
- Department of Trauma Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - René H M Ten Broeke
- Department of Orthopedic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Renée A G Brüggemann
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Walther Sipers
- Department of Geriatric Medicine, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| | - Ronald M A Henry
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Division of General Internal Medicine, Section Acute Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nordin M J Hanssen
- Amsterdam Diabetes Centre, Department of Internal and Vascular Medicine, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| |
Collapse
|
17
|
Lampl C, Kraus V, Lehner K, Loop B, Chehrenama M, Maczynska Z, Ritter S, Klatt J, Snellman J. Safety and tolerability of erenumab in individuals with episodic or chronic migraine across age groups: a pooled analysis of placebo-controlled trials. J Headache Pain 2022; 23:104. [PMID: 35978286 PMCID: PMC9386939 DOI: 10.1186/s10194-022-01470-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Erenumab, a fully human monoclonal antibody that targets the calcitonin gene-related peptide receptor, has demonstrated efficacy and safety in the prevention of episodic and chronic migraine. There exists an unmet need to establish the safety of erenumab in older individuals, in view of existing multiple comorbidities, polypharmacy, and age-related physiological changes. This pooled analysis of five large migraine-prevention studies examined the safety of erenumab stratified across age groups, particularly in older populations. METHODS Pooled and age-stratified analysis of safety data from the 12-week double-blind treatment phase (DBTP) of five randomized, placebo-controlled Phase 2 and 3 studies of erenumab in participants with episodic or chronic migraine across the age groups < 40 years, 40-49 years, 50-59 years, and ≥ 60 years was completed. The safety of erenumab across age groups was determined by assessing safety endpoints including treatment-emergent adverse events (AEs), serious AEs, and events leading to study drug discontinuation. RESULTS Overall, 3345 participants across five studies were randomized to receive either placebo (n = 1359), erenumab 70 mg (n = 1132) or erenumab 140 mg (n = 854); 3176 (94.9%) completed the DBTP, and 169 (5.1%) discontinued, mainly due to participant decision (110; 3.3%). Overall, 1349 (40.6%), 1122 (33.8%), and 850 (25.6%) participants received at least one dose of placebo, erenumab 70 mg, and erenumab 140 mg, respectively. Incidence of treatment-emergent AEs was similar across all age groups for both doses of erenumab (70 mg or 140 mg) and placebo (< 40 years, 44.0% vs 44.4%; 40-49 years, 42.5% vs 49.2%; 50-59 years, 46.5% vs 41.6%; ≥ 60 years, 43.8% vs 59.4%). Incidence of treatment-emergent serious AEs overall, and stratified by age groups for both doses and placebo was low (< 40 years, 0.9% vs 1.2%; 40-49 years, 1.7% vs 1.9%; and 50-59 years, 1.6% vs 1.1%), with no serious AEs reported in participants aged ≥ 60 years. No deaths were reported. CONCLUSIONS Erenumab (70 mg or 140 mg) exhibited a similar safety profile compared with placebo across age groups in individuals with episodic or chronic migraine, with no increased emergence of events due to age. Erenumab was well tolerated in older participants with multiple comorbidities, polypharmacy, and age-related physiological changes. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifiers: NCT02066415, NCT02456740, NCT02483585, NCT03096834, NCT03333109.
Collapse
Affiliation(s)
- Christian Lampl
- Department of Neurology, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Austria.
| | - Viktoria Kraus
- Department of Neurology, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Austria
| | - Katrina Lehner
- Department of Neurology, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Austria
| | - Brett Loop
- Novartis Pharmaceuticals, Cambridge, MA, USA
| | | | | | - Shannon Ritter
- Novartis Pharmaceutical Corporation, East Hanover, NJ, USA
| | | | | |
Collapse
|
18
|
Poruk KE, Shahrokni A, Brennan MF. Surgical resection for intraductal papillary mucinous neoplasm in the older population. Eur J Surg Oncol 2021; 48:1293-1299. [PMID: 34887167 PMCID: PMC10091239 DOI: 10.1016/j.ejso.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/27/2021] [Accepted: 12/01/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Surgery for intraductal papillary mucinous neoplasm (IPMN) in older adults requires a careful balance of risk and benefit. We sought to analyze patient outcomes in the older individuals after pancreatic resection for IPMN. METHODS Retrospective analysis of a prospectively maintained database was performed for patients 65 years or older undergoing IPMN resection between January 1, 2012 and December 31, 2017. Statistical analysis was performed based on age and Memorial Sloan Kettering Frailty Index (MSKFI) score. RESULTS 148 patients underwent resection of an IPMN, including five patients who required two operations for recurrent disease. Median age at surgery was 74 (range, 65-90 years), and 52% were male. Most patients underwent pancreaticoduodenectomy (53%) or distal pancreatectomy/splenectomy (35%). An associated adenocarcinoma was seen on pathology for 56 patients (37%). Median hospital length of stay was 7 days (range, 4-46 days). Grade 3 or higher post-operative complications on the Clavien-Dindo classification scale were seen in 20%. No patient died within 30-days. Patient outcomes were evaluated by age, split at age ≥75 (considered "elderly"), and separately by MSKFI score. No differences in post-operative morbidity or mortality was seen when stratified by age (65 - 74 vs > 75 years) or by MSKFI frailty score. CONCLUSION Pancreatic resection can be safely performed in selected patients 65 years and older with low morbidity and mortality. More analysis is needed to determine if MSKFI score is a useful predictor of complications in older individuals.
Collapse
Affiliation(s)
- Katherine E Poruk
- Department of Surgery, The Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA.
| | - Armin Shahrokni
- Department of Geriatrics, The Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA.
| | - Murray F Brennan
- Department of Surgery, The Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA
| |
Collapse
|
19
|
Pérez de Isla L, Watts GF, Muñiz-Grijalvo O, Díaz-Díaz JL, Alonso R, Zambón D, Fuentes-Jimenez F, Mauri M, Padró T, Vidal-Pardo JI, Barba MA, Ruiz-Pérez E, Michán A, Mediavilla JD, Hernandez AM, Romero-Jimenez MJ, Badimon L, Mata P. A resilient type of familial hypercholesterolaemia: case-control follow-up of genetically characterized older patients in the SAFEHEART cohort. Eur J Prev Cardiol 2021; 29:795-801. [PMID: 34864959 DOI: 10.1093/eurjpc/zwab185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/08/2021] [Accepted: 10/19/2021] [Indexed: 12/12/2022]
Abstract
AIMS Knowledge of the features of patients with familial hypercholesterolaemia (FH) who are protected from atherosclerotic cardiovascular disease (ASCVD) is important for the clinical and prognostic care of this apparently high-risk condition. Our aim was to investigate the determinant and characteristics of patients with FH who are protected from ASCVD and have normal life expectancy, so-called 'resilient' FH (R-FH). METHODS AND RESULTS Spanish Familial Hypercholesterolaemia cohort study (SAFEHEART) is an open, multicentre, nation-wide, long-term prospective cohort study in genetically defined patients with heterozygous FH in Spain. Patients in the registry who at the time of analysis were at least 65 years or those who would have reached that age had they not died from an ASCVD event were analysed as a case-control study. Resilient FH was defined as the presence of a pathogenic mutation causative of FH in a patient aged ≥65 years without clinical ASCVD. Nine hundred and thirty registrants with FH met the study criteria. A defective low-density lipoprotein (LDL)-receptor mutation, higher plasma level of high-density lipoprotein cholesterol (HDL-C), younger age, female gender, absence of hypertension, and lower plasma lipoprotein (a) [Lp(a)] concentration were independently predictive of R-FH. In a second model, higher levels of HDL-C and lower 10-year score in SAFEHEART-RE were also independently predictive of R-FH. CONCLUSION Resilient FH may be typified as being female and having a defective LDL-receptor mutation, higher levels of plasma HDL-C, lower levels of Lp(a), and an absence of hypertension. The implications of this type of FH for clinical practice guidelines and the value for service design and optional care of FH remains to be established. TRIAL REGISTRATION ClinicalTrials.gov number NCT02693548.
Collapse
Affiliation(s)
- Leopoldo Pérez de Isla
- Cardiology Department, Hospital Clínico San Carlos, IDISSC, Facultad de Medicina, Universidad Complutense, C/Profesor Martín Lagos s/n, 28040 Madrid, Spain.,Fundación Hipercolesterolemia Familiar, C/General Alvarez de Castro 14, 28010 Madrid, Spain
| | - Gerald F Watts
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia.,Department of Cardiology, Royal Perth Hospital, Lipid Disorders Clinic, Cardiometabolic Services, Perth, Western Australia, Australia
| | | | | | - Rodrigo Alonso
- Fundación Hipercolesterolemia Familiar, C/General Alvarez de Castro 14, 28010 Madrid, Spain.,Center for Advanced Metabolic Medicine and Nutrition, Santiago, Chile
| | - Daniel Zambón
- Department of Endocrinology, Hospital Clinic, Barcelona, Spain
| | | | - Marta Mauri
- Internal Medicine Department, Hospital de Terrassa, Barcelona, Spain
| | - Teresa Padró
- ICCC Cardiovascular, Institut de Recerca del Hospital Santa Creu i Sant Pau, IIB Santa Pau, Barcelona, Spain
| | - José I Vidal-Pardo
- Department of Endocrinology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Miguel A Barba
- Internal Medicine Department, Complejo Hospitalario Universitario, Albacete, Spain
| | - Enrique Ruiz-Pérez
- Department of Endocrinology, Hospital Universitario de Burgos, Burgos, Spain
| | - Alfredo Michán
- Internal Medicine Department, Hospital Jerez de la Frontera, Cadiz, Spain
| | - Juan D Mediavilla
- Internal Medicine Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio M Hernandez
- Department of Endocrinology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Lina Badimon
- Department of Endocrinology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, C/General Alvarez de Castro 14, 28010 Madrid, Spain
| | | |
Collapse
|
20
|
Barcın Güzeldere HK, Aksoy M. Anthropometric measurements and food consumption analysis of older people according to place of residence and gender: A cross-sectional study. Clin Nutr ESPEN 2021; 45:236-244. [PMID: 34620323 DOI: 10.1016/j.clnesp.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/20/2021] [Accepted: 08/17/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND & AIMS The older population across the world is rapidly increasing, raising the importance of a healthy and independent aging process and the factors affecting it. This study aimed to examine the food consumption habits and anthropometric measurements of older people according to their gender and the place of residence. METHODS A total of 121 healthy participants aged over 80 years who lived in rural (n:70) and urban (n:51) areas in the Aegean Region of Turkey were included in the study. A questionnaire was administered to determine the demographic data and nutritional status of the participants. Three-day food consumption was recorded and then analyzed using BeBiS 8.1. The participants' adherence to the Mediterranean diet and their Healthy Eating Index-2015 values were calculated based on their food consumption. The circumferences of the waist, hip, upper-mid arm and calf of the participants were measured by the researcher using an inelastic measuring tape. Weight, fat, muscle, water and basal metabolic rate were measured using the TANITA BC730 body impedance analyzer. RESULTS The mean weight, body mass index, circumferences of waist, hip and upper-mid arm,fat-free mass and basal metabolic rate were higher in the rural men than the urban ones (p < 0.05). The urban women had a higher waist-to-hip ratio than the rural ones (p < 0.05). There were no significant differences in the participants' adherence to the Mediterranean diet and their Healthy Eating Index values according to gender or the region they lived in. Nutrient intake was compared with the daily recommendations in the Turkish Nutrition Guide. It was found that the urban men consumed more carbohydrates, fats, vitamins A and C, and sodium. In contrast, energy, protein, fiber, vitamins E, D, B1, B2, B6 and B12, folic acid, magnesium, calcium, iron and zinc were consumed at lower amounts than recommendations. On the other hand, the rural men consumed more carbohydrates, fats, vitamins A, C and B2, folic acid, sodium and zinc. Similarly, the urban and rural women were found to have a higher intake of carbohydrates, fats, vitamins A and B2 and sodium and lower intake of other nutrients than recommendations. CONCLUSION Old age is one of the most sensitive periods in a person's life cycle. Place of residence during this period may physiologically affect food intake, physical activity, and therefore, anthropometric measurements. Healthcare providers should take into account that place of residence may alter older individuals' nutritional status and anthropometric measurements.
Collapse
Affiliation(s)
- Hatice Kübra Barcın Güzeldere
- Istanbul Medeniyet University, Department of Nutrition and Dietetic, Kartal, Istanbul, Turkey; Istanbul Medipol University, Institute of Health Science, Nutrition and Dietetic, Kavacık, Istanbul, Turkey.
| | | |
Collapse
|
21
|
von Fingerhut G, Mizukami K, Yam D, Makarov K, Kim Y, Kondyurina E, Yakovleva L. Social and physical factors related to depression in the older population of Siberia, Russia: a cross-sectional study. BMC Geriatr 2021; 21:272. [PMID: 33892638 PMCID: PMC8066855 DOI: 10.1186/s12877-021-02225-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/14/2021] [Indexed: 11/21/2022] Open
Abstract
Background Depression and suicide rates are relatively high in the colder regions of Russia. Older individuals in these regions are especially susceptible to these issues and are understudied in this regard. This study aims to better understand the current depression prevalence, and the factors related to depression, among the older individuals in these colder regions of Russia by studying a population in Novosibirsk oblast. Methods A questionnaire survey was administered to 422 older individuals, assessing basic attributes and health status, and employing the following standardized scales: 8-item Short-Form Health Survey, Pittsburgh Sleep Quality Index, and 15-item Geriatric Depression Scale (GDS). Participants were divided in two groups (GDS ≤ 6, GDS > 6) and compared, using Student’s t test, χ2 test, and logistic regression analysis. Results Young old (YO) adults showed significant correlation of depression with asthma (P = 0.005, OR = 6.40, 95%CI: 1.74–23.5), having a spouse (P = 0.016, OR = 1.99, 95%CI: 1.14–3.48), and daily communication with others (P < 0.001, OR = 0.336, 95%CI: 0.197–0.572). Among old old (OO) adults, significant correlation with depression was found for the variables work status (P = 0.047, OR = 0.115, 95%CI: 0.014–0.974), and weekly walking (P = 0.014, OR = 0.288, 95%CI: 0.106–0.778). Conclusions Twenty eight percent of the participants have depression. In YO adults, frequent communication and social ties with individuals outside of the family can mitigate depression prevalence. As for OO adults, the factors that have the highest impact on mitigating depression are related to daily activity, including both frequent walking and working or self-employment. Asthma patients are one of the more sensitive groups towards depression, but further research on this topic is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02225-7.
Collapse
Affiliation(s)
- Georg von Fingerhut
- Department of Gerontological Nursing and Caring, Human Care Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Comprehensive Research Building D-310, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.
| | - Katsuyoshi Mizukami
- Faculty of Health and Sport Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Comprehensive Research Building D-311, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Dorothy Yam
- Department of Neuroscience, Brown University, 185 Meeting St, Providence, RI, 02912, USA
| | - Konstantin Makarov
- Department of Obstetrics and Gynecology, Novosibirsk State Medical University, 52, Krasny Prospect, Novosibirsk, Russian Federation, 630091
| | - Yuriy Kim
- Department of Nursing, Novosibirsk State Medical University, 52, Krasny Prospect, Novosibirsk, Russian Federation, 630091
| | - Elena Kondyurina
- Department of Pediatrics, Novosibirsk State Medical University, 52, Krasny Prospect, Novosibirsk, Russian Federation, 630091
| | - Lyudmila Yakovleva
- Department of Nursing, Novosibirsk State Medical University, 52, Krasny Prospect, Novosibirsk, Russian Federation, 630091
| |
Collapse
|
22
|
Mantzoukas S, Kotrotsiou S, Mentis M, Paschou A, Diamantopoulos E, Kotrotsiou E, Gouva M. Exploring the Impact of Shame on Health-Related Quality of Life in Older Individuals. J Nurs Scholarsh 2021; 53:439-448. [PMID: 33870602 DOI: 10.1111/jnu.12663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people. DESIGN AND METHODS A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software. RESULTS Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = -0.173, pW = .004, effect on men bM = -0.138, pM = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = -0.392, pW = .002 and bM = -0.384, pM = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033). CONCLUSION Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame. CLINICAL RELEVANCE These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.
Collapse
Affiliation(s)
| | | | - Manolis Mentis
- Assistant Professor, Department of Education and Social Work, University of Patra, Greece
| | - Athina Paschou
- Teaching Fellow, Department of Nursing, University of Ioannina, Greece
| | | | | | - Mary Gouva
- Professor, Department of Nursing, University of Ioannina, Greece
| |
Collapse
|
23
|
Hida Y, Nishida T, Taniguchi C, Sakakibara H. Association between swallowing function and oral bacterial flora in independent community-dwelling elderly. Aging Clin Exp Res 2021; 33:157-63. [PMID: 32152814 DOI: 10.1007/s40520-020-01521-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Increasing incidences of swallowing dysfunction, or dysphagia, a risk factor for aspiration pneumonia, are being reported in aging populations. AIMS To investigate the relationship between swallowing function and oral bacteria in independent, community-dwelling elderly. METHODS This study recruited 139 community-dwelling individuals aged ≥ 70 years with poor swallowing function. The presence of anaerobic (Prevotella spp. and Fusobacterium spp.) and aerobic bacteria was examined in the participants' oral cavity flora. Swallowing function was evaluated using a 30 mL water swallowing test. Multivariate logistic regression analyses were performed to examine the association between oral bacteria and swallowing function. RESULTS Swallowing function was assessed as abnormal in 2.9% and as abnormal in 47.5% of the subjects. The colony-forming units (CFUs/ml) of Prevotella spp. were associated with the swallowing dysfunction (odds ratio [OR] 3.45, 95% confidence interval [CI] 1.49-8.11). Further, CFUs/ml of Fusobacterium spp. and aerobes did not correlate with the swallowing dysfunction but were related with the number of teeth (OR 2.71; 95% CI 1.28-5.74, and OR 0.40; 95% CI, 0.18-0.91, respectively) CONCLUSIONS: Swallowing dysfunction in community-dwelling elderly is associated with increased abundance of Prevotella spp., which indirectly may be an increased risk factor for aspiration pneumonia.
Collapse
|
24
|
Coutinho ER, Miname MH, Rocha VZ, Bittencourt MS, Jannes CE, Tada MT, Lima IR, Filho WS, Chacra AP, Pereira AC, Krieger JE, Santos RD. Familial hypercholesterolemia and cardiovascular disease in older individuals. Atherosclerosis 2020; 318:32-37. [PMID: 33450476 DOI: 10.1016/j.atherosclerosis.2020.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is characterized by high LDL-cholesterol (LDL-C) and early atherosclerotic cardiovascular disease (ASCVD). With a lipid lowering therapy (LLT), most individuals with FH may have a longer ASCVD-free survival. However, there is scant data about older individuals with FH. METHODS We compared characteristics of genetically defined FH older individuals with age-matched non-FH counterparts. RESULTS From 4111 genotyped individuals, 462 older than 60 years were included (198 positive and 264 negative for FH variants). There were no differences regarding median age [%25; 75%] 66.0 (62.0; 71.0) and 66.0 (62.2; 71.0) years, p = 0.68 for FH and non-FH, respectively. In both groups, there was a higher frequency of females, however, there were more males in the FH group 37.4% vs. 24.2%, p = 0.002. No differences were seen between FH and non-FH in LLT use: 88.5% vs. 91.5%, p = 0.29. Despite a longer LLT duration in FH patients (with 11.0 (7.0; 20.0) vs. 7.0 (3.0; 13.0) years, p < 0.001), treatment was started late in both groups: at 54.0 (47.0; 61.0) and 59.0 (52.0; 64.0) years, p < 0.001, in FH and non-FH, respectively. FH had greater frequencies of previous and early ASCVD (40.9% vs. 27.3%, p = 0.002, and 22.2% vs. 9.0%, p < 0.001). In FH, male sex [HR (95%CI)] 2.67 (1.50-4.73), p = 0.001, and LLT onset age 0.96 (0.93-0.99), p = 0.009, were independently associated with ASCVD. CONCLUSIONS Among hypercholesterolemic older individuals participating in a cascade screening program, the genetic diagnosis of FH was associated with higher ASCVD rates, emphasizing the relevance of a monogenic defect as the cause of long-lasting hypercholesterolemia and ASCVD risk, particularly in men.
Collapse
Affiliation(s)
- Elaine R Coutinho
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Marcio H Miname
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Viviane Z Rocha
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Marcio S Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Cinthia E Jannes
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Mauricio T Tada
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Isabella R Lima
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Wilson Salgado Filho
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Ana P Chacra
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Alexandre C Pereira
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Jose E Krieger
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil
| | - Raul D Santos
- Heart Institute (InCor), University of São Paulo, Medical School Hospital (FMUSP), Sao Paulo, Brazil; Academic Research Organization, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
| |
Collapse
|
25
|
Shimrock S, Ferrand C. Listener Perceptions of Women With Voice Disorders: Vocal Stereotyping and Negative Personality Attribution. J Voice 2020; 35:934.e1-934.e6. [PMID: 32299637 DOI: 10.1016/j.jvoice.2020.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of the study was to determine if the age and amount of background knowledge of listeners affects perceptual judgments of women with voice disorders. METHOD Forty participants in three different age groups (children, young adults, and older adults) rated five female voice samples representing various types of dysphonia. One group of young adults had background knowledge of voice disorders based on a graduate-level course in Voice Disorders. A semantic differential scale was used to rate the speakers on 24 attributes. RESULTS Results indicated that age of listeners was not a significant factor, and that listeners' ratings depended on the specific type of dysphonia. No significant differences emerged between the perceptions of individuals with and without background knowledge of voice disorders. DISCUSSION This study agrees with the findings of similar research showing that listeners judge speakers with voice disorders more negatively than they do those with normal voices. This is so regardless of the age and background knowledge of the listener.
Collapse
Affiliation(s)
- Shannon Shimrock
- Encompass Health Rehabilitation Hospital of Western Massachusetts, Ludlow, Massachusetts
| | - Carole Ferrand
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, New York.
| |
Collapse
|
26
|
Abstract
The last few decades have witnessed a global rise in the number of older individuals. Despite this demographic shift, morbidity within this population group is high. Many factors influence healthspan; however, an obesity pandemic is emerging as a significant determinant of older people's health. It is well established that obesity adversely affects several metabolic systems. However, due to its close association with overall cardiometabolic health, the impact that obesity has on cholesterol metabolism needs to be recognised. The aim of the present review is to critically discuss the effects that obesity has on cholesterol metabolism and to reveal its significance for healthy ageing.
Collapse
|
27
|
Abstract
The prevalence of hypertension and depression is high in older populations. Moreover, their comorbidity may significantly increase morbidity and mortality. However, the risk factors contributing to both health conditions are not well understood. Older individuals are prone to insomnia; thus we hypothesized that having more insomnia symptoms increases risk for incident hypertension and depression over time. The sample consisted of a longitudinal population-based study of community-dwelling older individuals, from the 2008-2016 waves of the Health and Retirement Study, sampled across the United States. A total of 18,123 subjects, aged 50+, were stratified into three age groups, ages 50-60, 61-74, and 75 and older years. Subjects were excluded for reporting baseline hypertension or depression at the first wave 2008. Center for Epidemiologic Studies-Depression (CES-D) score ≥ 4 was the cutoff for elevated depressive symptomatology. Subjective insomnia symptoms were evaluated. Cox proportional hazards regression revealed that SBP (1.02[1.01, 1.02]) and more insomnia symptoms (1.11[1.01, 1.21]) were significant predictors of hypertension for all age groups. For depression, only insomnia symptoms were significant predictors (9.91[6.37, 15.41]). Kaplan-Meier curves revealed that 9.2% of the overall cohort had both hypertension and depression within 8 years and more insomnia symptoms predicted greater incidences of both conditions (p-values <0.001). In this older prospective cohort, insomnia symptoms are consistent predictors of future hypertension and depression in all age groups, who were not hypertensive and depressed at baseline. Insomnia may contribute to the etiology and comorbidity of hypertension and depression in older individuals.
Collapse
Affiliation(s)
- Yutong Dong
- School of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Frances Margaret Yang
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
| |
Collapse
|
28
|
Torfadottir JE, Aspelund T, Valdimarsdottir UA, Cotch MF, Tryggvadottir L, Harris TB, Gudnason V, Adami HO, Mucci LA, Giovannucci EL, Stampfer MJ, Steingrimsdottir L. Pre-diagnostic 25-hydroxyvitamin D levels and survival in cancer patients. Cancer Causes Control 2019; 30:333-342. [PMID: 30805814 DOI: 10.1007/s10552-019-01143-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 02/11/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Our main aim was to explore whether pre-diagnostic circulating levels of 25-hydroxyvitamin D (25(OH)D) among older individuals with cancer were associated with overall and cancer-specific survival after diagnosis. DESIGN We used data from the Reykjavik-AGES Study on participants (n = 4,619) without cancer at entry, when blood samples were taken for 25(OH)D standardized measurements. The association with cancer risk, all-cause- and cancer-specific mortality was assessed among those later diagnosed with cancer, comparing four 25(OH)D categories, using 50-69.9 nmol/L as the reference category. RESULTS Cancer was diagnosed in 919 participants on average 8.3 years after blood draw. No association was observed between the reference group and other 25(OH)D groups and total cancer incidence. Mean age at diagnosis was 80.9 (± 5.7) years. Of those diagnosed, 552 died during follow-up, 67% from cancer. Low pre-diagnostic levels of 25(OH)D < 30 nmol/L were significantly associated with increased total mortality (HR: 1.39, 95% CI 1.03, 1.88) and non-significantly with cancer-specific mortality (HR: 1.33, 95% CI 0.93, 1.90). Among patients surviving more than 2 years after diagnosis, higher pre-diagnostic 25(OH)D levels (≥ 70 nmol/L) were associated with lower risk of overall (HR: 0.68, 95% CI 0.46, 0.99) and cancer-specific mortality (HR: 0.47, 95% CI 0.26, 0.99). CONCLUSIONS Among elderly cancer patients, low pre-diagnostic serum 25(OH)D levels (< 30 nmol/L) were associated with increased overall mortality.
Collapse
Affiliation(s)
- Johanna E Torfadottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland. .,Unit for Nutrition Research, Faculty for Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.,The Icelandic Heart Association, Kopavogur, Iceland
| | - Unnur A Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.,Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mary Frances Cotch
- Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Laufey Tryggvadottir
- The Icelandic Cancer Registry, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Vilmundur Gudnason
- The Icelandic Heart Association, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lorelei A Mucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Meir J Stampfer
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Laufey Steingrimsdottir
- Unit for Nutrition Research, Faculty for Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| |
Collapse
|
29
|
Mitchell R, Harvey L, Draper B, Brodaty H, Close J. Risk factors associated with residential aged care, respite and transitional aged care admission for older people following an injury-related hospitalisation. Arch Gerontol Geriatr 2017; 72:59-66. [PMID: 28599139 DOI: 10.1016/j.archger.2017.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/26/2017] [Accepted: 05/27/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To identify factors associated with admission to residential aged care (RAC), respite RAC and transitional care (TC) for older individuals following an injury hospitalisation. METHOD A retrospective analysis was conducted of individuals aged ≥65 years who had an injury hospitalisation and who were admitted to RAC during 1 July 2008 and 30 June 2013 in New South Wales, Australia. Multinominal logistic regression was used to examine the factors associated with admissions to aged care services compared to returning to the community. RESULTS Of 191,301 injury hospitalisations, 41,085 (21.5%) individuals either returned or were new admissions to long-term or respite RAC and 3,218 individuals were admitted to TC. Older individuals newly admitted to long-term RAC were four times more likely (OR: 4.36; 95%CI 4.15-4.57), those admitted to respite RAC were twice as likely (OR: 2.37; 95%CI 2.21-2.54) and people admitted to TC were less likely (OR: 0.60; 95%CI 0.53-0.68) to have dementia compared to individuals who returned to the community. Overall, individuals who were admitted to long-term or respite RAC had a higher likelihood of experiencing limitations associated with their physical, cognitive or social abilities, with individuals admitted to TC having a higher likelihood of issues with hygiene and mobility, compared to individuals returning to the community. CONCLUSION Understanding the profile and predictive risk factors for injured older individuals using RAC (long-term, respite or TC services) can inform current and future aged care service resource use needs and can be used to understand factors associated with service use.
Collapse
Affiliation(s)
- Rebecca Mitchell
- Australian Institute of Health Innovation, Macquarie University, Australia.
| | - Lara Harvey
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Australia
| | - Brian Draper
- Dementia Collaborative Research Centre - Assessment and Better Care, University of New South Wales, Sydney, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - Henry Brodaty
- Dementia Collaborative Research Centre - Assessment and Better Care, University of New South Wales, Sydney, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia
| | - Jacqueline Close
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, Australia
| |
Collapse
|
30
|
Schmid S, Bruhin B, Ignasiak D, Romkes J, Taylor WR, Ferguson SJ, Brunner R, Lorenzetti S. Spinal kinematics during gait in healthy individuals across different age groups. Hum Mov Sci 2017; 54:73-81. [PMID: 28410535 DOI: 10.1016/j.humov.2017.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 11/24/2022]
Abstract
Most studies investigating trunk kinematics have not provided adequate quantification of spinal motion, resulting in a limited understanding of the healthy spine's biomechanical behavior during gait. This study aimed at assessing spinal motion during gait in adolescents, adults and older individuals. Fourteen adolescents (10-18years), 13 adults (19-35years) and 15 older individuals (≥65years) were included. Using a previously validated enhanced optical motion capture approach, sagittal and frontal plane spinal curvature angles and general trunk kinematics were measured during shod walking at a self-selected normal speed. Postural differences indicated that lumbar lordosis and thoracic kyphosis increase throughout adolescence and reach their peak in adulthood. The absence of excessive thoracic kyphosis in older individuals could be explained by a previously reported subdivision in those who develop excessive kyphosis and those who maintain their curve. Furthermore, adults displayed increased lumbar spine range of motion as compared to the adolescents, whereas the increased values in older individuals were found to be related to higher gait speeds. This dataset on the age-related kinematics of the healthy spine can serve as a basis for understanding pathological deviations and monitoring rehabilitation progression.
Collapse
|
31
|
Momeni Z, Sadraei J, Kazemi B, Dalimi A. Trichomoniasis in older individuals: a preliminary report from Iran. J Parasit Dis 2016; 40:1597-1600. [PMID: 27876991 DOI: 10.1007/s12639-015-0737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022] Open
Abstract
Infection with Trichomonas vaginalis is one of the most common sexually transmitted diseases (STDs) in humans. The prevalence of infection in Iran has been reported 0.009-8 % depending on deferent socio-cultural conditions. This study aimed to determine the frequency of T. vaginalis according to age in patients referred to clinics, hospitals and medical diagnostic laboratories in Karaj city, Iran. For this purpose, fifty positive samples were collected from July 2012 to June 2014 from clinics, medical diagnostic laboratories and hospitals, then transferred to laboratory of parasitology and cultured in TYM medium. The results showed that all isolates were successfully cultured. Among 50 positive specimens, 43 cases were female and 7 cases male. The most positive cases (34 %) belonged to the ages over 50 year's group. The lowest positive cases (2 %) belonged to the ages of less than 20 years group. In Conclusion, unlike other STDs, which have a higher prevalence among adolescents and young adults, the rates of trichomoniasis are more evenly distributed among sexually active women of all age groups. However, frequency of this infection in women aged over 50 years (age of menopause) is notable and complementary studies are needed.
Collapse
Affiliation(s)
- Zohreh Momeni
- Parasitology and Entomology Department, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran
| | - Javid Sadraei
- Parasitology and Entomology Department, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran
| | - Bahram Kazemi
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolhossein Dalimi
- Parasitology and Entomology Department, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
32
|
Abstract
Stimulus over-selectivity describes a phenomenon where only a subset of the relevant stimuli present in the environment, control an individual's behavior. The current experiment explored the degree to which over-selectivity increases in old age. The level of over-selectivity in a visual discrimination task in 60 individuals aged 60-89 years was assessed, as well as the degree to which this reflected attentional control. In addition, the intellectual functioning and cognitive flexibility of the participants were assessed. Results showed that, as age increased, three effects were revealed: levels of stimulus over-selectivity increased, IQ scores decreased, and cognitive flexibility decreased. However, over-selectivity was not related to IQ or cognitive flexibility, and appeared related most to attentional impairments. Thus, ageing is related to significant declines in effective stimulus control. These effects can have a serious impact on the physical and psychological health of old adults, as well as their quality of life, and, therefore, this area of research warrants further exploration. The results are discussed in relation to the attention-deficit and comparator theory of over-selectivity.
Collapse
Affiliation(s)
- Michelle P Kelly
- School of Psychology, National University of Ireland, Galway, University Road, Galway, Ireland.
- Counseling, Health and Special Education Division, Emirates College for Advanced Education, P.O. Box 126662, Abu Dhabi, United Arab Emirates.
| | - Geraldine Leader
- School of Psychology, National University of Ireland, Galway, University Road, Galway, Ireland
| | - Phil Reed
- Department of Psychology, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| |
Collapse
|
33
|
Abstract
The aim of this study is to analyse and compare the levels of job satisfaction reported by self-employed and salaried workers (aged 50-64) by disability status across Europe. Particular attention is paid to testing whether the effect of self-employment on job satisfaction is greater for disabled workers as compared to non-disabled ones. Using the first two waves (2004 and 2007) of the Survey of Health, Ageing and Retirement in Europe (SHARE) for eleven countries, we estimate job satisfaction equations for older workers with and without disabilities. The results show that self-employed persons are more satisfied with their jobs. However, there is no evidence that the association between self-employment and job satisfaction is different for disabled and non-disabled older persons. Policy makers can promote self-employment among older workers with disabilities to increase their employment and income rates and levels of job satisfaction.
Collapse
Affiliation(s)
- Ricardo Pagán-Rodríguez
- Department of Applied Economics, University of Malaga, Plaza de El Ejido s/n, 29.071, Malaga, Spain
| |
Collapse
|