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Functional Status of Older Adults with Dementia at the End of Life: Is there Still Anything to do? Indian J Palliat Care 2019; 25:197-202. [PMID: 31114103 PMCID: PMC6504749 DOI: 10.4103/ijpc.ijpc_156_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aims: There is a lack of data on physical functional status near death of patients with different types of dementia that can contribute to decisions about what kind of care is needed. The aim of this study was to investigate the course of functional status along with the documented reasons for death in participants with dementia who had regularly been followed at a geriatric outpatient unit. Setting and Design: A retrospective observational cohort study was done using the database of a geriatric outpatient clinic. Subjects and Methods: Sociodemographic and medical records of patients with Alzheimer's disease (AD), vascular dementia, mixed dementia, and dementia with Lewy bodies (DLB)/Parkinson's disease dementia (PDD) who had received routine care in a geriatrics outpatient setting for a minimum of 12 months before death were analyzed. Scores for activities of daily living and documented probable causes of death were recorded. Results: Of the 258 participants, 111 (42 female and 69 male) were included in this study. AD was the leading cause of dementia (51.8%). The median duration of survival with dementia was 4 years. The leading causes of death were cardiovascular disease (CVD) (27.0%) and dementia (27.0%) followed by infections (21.6%) and stroke (10.8%). Disability was the highest in patients with DLB/PDD. Conclusions: This study found relatively shorter survival after the diagnosis of dementia when compared to other populations. CVD still appeared as a major cause of that in this particular disease. Most debilitating type of dementia was DLB/PDD.
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Assessment of geriatric predictors of adherence to Zoledronic acid treatment for osteoporosis: a prospective follow-up study. Acta Clin Belg 2018; 73:237-243. [PMID: 29251181 DOI: 10.1080/17843286.2017.1412863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives Discontinuation of bisphosphonate treatment remains high even with the long acting parenteral options. Whether there are some unidentified causes of noncompliance more specific to aged individuals is unknown. The aim of this study was to investigate baseline predictors of adherence to Zoledronic acid (ZOL) infusions among non-demented older adults with osteoporosis. Methods Patients aged ≥ 65 years who received a first ever ZOL infusion for osteoporosis were prospectively enrolled. Risk factors for osteoporosis and fractures, comorbidities, geriatric assessment measures, including depression, and anticholinergic burden were determined at baseline. Adherence was defined as taking the next ZOL infusion at 12 months. Results A total of 187 participants were included (mean age: 75.7 ± 6.3 years, female: 77.5%). Adherence to the next ZOL infusion was 66.8% (n = 125). Non-adherent participants (n = 62, 33.2%) had significantly higher frequency of historical height decrease and depression at baseline. Poor adherence was associated with height decrease, presence of depression, and higher anticholinergic burden in univariate analysis. After adjustment for relevant confounders, fragility fracture history (OR: 0.38, 95%CI: 0.17-0.86, p = 0.020), depression (OR: 0.32, 95%CI: 0.12-0.82, p = 0.018), and higher anticholinergic burden (OR: 0.67, 95%CI: 0.49-0.93, p = 0.017) were the predictors of lower adherence to ZOL infusion. Conclusions The rate of adherence to the next ZOL infusion was still suboptimal among older women and men in this study. Past osteoporotic fractures, depression, and higher anticholinergic drug burden predicted poor ZOL adherence. It was a novel finding that drug-related anticholinergic side effects adversely influenced adherence to another medication without anticholinergic properties.
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Undetected Peripheral Arterial Disease Among Older Adults With Alzheimer's Disease and Other Dementias. Am J Alzheimers Dis Other Demen 2018; 33:5-11. [PMID: 28786294 PMCID: PMC10852521 DOI: 10.1177/1533317517724000] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND Peripheral arterial disease (PAD) was reported to increase the risk of dementia(s) even more than stroke. We assessed the prevalence of PAD in a group with definite diagnosis of dementia. METHODS Patients aged 65 years or older with Alzheimer's disease (AD), vascular dementia (VaD), or AD-VaD were enrolled (n = 162, mean age: 78.87 [6.05] years). An age- and gender-matched control group was also included (n = 190). Peripheral arterial disease was diagnosed by the ankle-brachial index. RESULTS Frequency of PAD among patients with and without dementia was 35.2% and 16.3%, respectively ( P < .001), being similar among different types of dementia. After adjustment for covariates, dementia (odds ratio: 2.41, 95% confidence interval: 1.34-4.32; P = .003) was among the predictors of PAD diagnosis along with older age, female gender, and diabetes. CONCLUSIONS The prevalence of PAD was more than double in patients with dementia, with no difference among AD, VaD, and AD-VaD types.
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Effect of anticholinergic burden on the development of dementia in older adults with subjective cognitive decline. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1358130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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HIGH ANTICHOLINERGIC COGNITIVE BURDEN IS ASSOCIATED WITH URGENCY INCONTINENCE IN ELDERLY POPULATION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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THE EFFECTS OF EXERCISE TRAINING ON ACTIVITIES OF DAILY LIVING AND QUALITY OF LIFE IN FRAIL ELDERLY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Complex regional pain syndrome as an unusual cause of delirium in a dementia patient. LA TUNISIE MEDICALE 2017; 95:158-159. [PMID: 29424880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Remission in visual hallucinatory experiences after citalopram treatment in a patient with dementia. Geriatr Gerontol Int 2017; 17:347-348. [DOI: 10.1111/ggi.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/03/2016] [Accepted: 05/27/2016] [Indexed: 10/20/2022]
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Comment on "Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study". Med Princ Pract 2017; 26:199-200. [PMID: 27802445 PMCID: PMC5588353 DOI: 10.1159/000452955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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A Multidimensional Risk Score to Predict All-Cause Hospitalization in Community-Dwelling Older Individuals With Obstructive Lung Disease. J Am Med Dir Assoc 2016; 17:1157-1158. [PMID: 27594521 DOI: 10.1016/j.jamda.2016.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/01/2016] [Indexed: 11/20/2022]
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The Effects of Early Vitamin B12 Replacement Therapy on The Cognitive and Functional Status of Elderly Subjects. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10177833.2010.11790645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Efficacy of obesity in metastatic colorectal cancer patients treated with bevacizumab-based chemotherapy combinations: A Turkish Oncology Group Study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Do metabolic and inflammatory biomarkers vary depending on comorbidities and medications over the age of 90 years? J Gerontol A Biol Sci Med Sci 2016; 72:586-587. [DOI: 10.1093/gerona/glw177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 08/11/2016] [Indexed: 11/13/2022] Open
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Defining Randomly Measured Glycemic Values As a Risk Factor for Dementia: Accurate and Adequate? J Am Geriatr Soc 2016; 64:1925. [PMID: 27448627 DOI: 10.1111/jgs.14192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zoledronic Acid Use and Risk of Cognitive Decline among Elderly Women and Men with Osteoporosis. Endocr Metab Immune Disord Drug Targets 2016; 16:32-8. [PMID: 26530338 DOI: 10.2174/1871530315666151104115829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/21/2015] [Accepted: 11/02/2015] [Indexed: 11/22/2022]
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Galantamine improves sleep quality in patients with dementia. Acta Neurol Belg 2015; 115:563-8. [PMID: 25777522 DOI: 10.1007/s13760-015-0453-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
Abstract
The purpose of the study was to evaluate the influences of cholinesterase inhibitors on sleep pattern and sleep disturbance. A total of 87 mild to moderate stage dementia patients who were not on cholinesterase enzyme inhibitor and memantine treatment were included in the study. The dementia patients were treated with donepezil, galantamine or rivastigmine, depending on the preference of the clinician. Fifty-five dementia patients (63.2 %) completed the study. Twenty-three elderly subjects, who had normal cognitive functions, were included in the study as the control group. The Pittsburgh Sleep Quality Index was used for evaluating the sleep quality at the beginning and at the final assessment. The improvement in sleep quality was better with regard to changes in Pittsburgh Sleep Quality Index scores with galantamine treatment compared to the donepezil and the control groups. A significant decrease in Pittsburgh Sleep Quality Index scores was detected in the galantamine group after treatment. Although statistically not significant, rivastigmine decreased and donepezil increased the Pittsburgh Sleep Quality Index scores after treatment. Dementia patients who had a poor sleep quality (n: 36), the rate of improvement in sleep disturbance was 81.8 % in the galantamine group, 75 % in the rivastigmine, and 50 % in the donepezil group. Galantamine may be the first choice of cholinesterase inhibitor in mild to moderate dementia patients in terms of improving sleep quality.
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SP330DETERMINANTS OF SERUM NEUTROPHIL GELATINASE ASSOCIATED LIPOKALIN (NGAL) IN GERIATRIC PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv191.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Memantine overdose in a non-demented older adult. Geriatr Gerontol Int 2015; 15:383. [DOI: 10.1111/ggi.12375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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P020: Hallucinations due to piracetam treatment. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70198-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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P4‐354: HEMORRHAGIC BULLOUS LESION AFTER RIVASTIGMINE PATCH TREATMENT. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.07.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cognitive and functional influences of vildagliptin, a DPP-4 inhibitor, added to ongoing metformin therapy in elderly with type 2 diabetes. Endocr Metab Immune Disord Drug Targets 2014; 13:256-63. [PMID: 23848558 DOI: 10.2174/18715303113139990037] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 06/27/2013] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Diabetes mellitus has been linked to cognitive decrement faster than usual. Medical management of diabetes can also interfere with the cognitive skills. The purpose of this study was to evaluate the effects of vildagliptin on cognition, as an add-on to metformin therapy in elderly patients with type 2 diabetes mellitus. MATERIALS AND METHODS This was a prospective and observational investigation conducted in 10 elderly type 2 diabetes mellitus patients who were started treatment with vildagliptin 50 mg twice daily to ongoing metformin. All participants underwent detailed clinical cognitive assessment and neuropsychological testing with mini mental state examination (MMSE) and clock drawing test (CDT), along with measurement of functional parameters at entry and study completion. RESULTS Mean follow-up time was 10.9±3.7 months. No subjects reported significant side effects during the study. At follow-up, in accordance with the clinical assessment, neither MMSE nor CDT showed significant changes after addition of vildagliptin to metformin. Basic and instrumental activities of daily living (BADL and IADL), mini nutrition assessment and geriatric depression scale scores also remained unchanged between the two evaluations. DISCUSSION In this pilot study, addition of vildagliptin to ongoing metformin therapy in elderly with diabetes was accompanied by stable cognitive and functional performance after almost one year of follow-up.
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Is segmental bioelectrical impedance analysis a valid tool to assess muscle mass in the elderly? Geriatr Gerontol Int 2013; 13:1085-6. [DOI: 10.1111/ggi.12089] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Re. Pre- and perioperative factors affecting infection after living donor liver transplantation. Nutrition 2013; 30:241-2. [PMID: 24035055 DOI: 10.1016/j.nut.2013.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
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Comment on "Impact of sarcopenia on survival in patients undergoing living donor liver transplantation". Am J Transplant 2013; 13:2505. [PMID: 23915024 DOI: 10.1111/ajt.12375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 05/08/2013] [Accepted: 05/09/2013] [Indexed: 01/25/2023]
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Establishing exercise habit is important when assessing lean body mass in elderly. Clin Nutr 2013; 32:658. [DOI: 10.1016/j.clnu.2013.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 04/09/2013] [Indexed: 11/30/2022]
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P4–204: The association of hand grip strength, skeletal muscle mass, 5‐meter walking speed and bone mineral densitometry in a small population of Turkish elderly. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.1596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Effect of vitamin D on insulin sensitivity in elderly patients with impaired fasting glucose. Geriatr Gerontol Int 2011; 12:454-60. [DOI: 10.1111/j.1447-0594.2011.00791.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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The relationship between body mass index and incidental mild cognitive impairment, Alzheimer's disease and vascular dementia in elderly. J Nutr Health Aging 2010; 14:834-8. [PMID: 21125201 DOI: 10.1007/s12603-010-0113-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the association between body mass index (BMI) and cognitive decline (CD) due to Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD), and Vascular Dementia (VaD). DESIGN AND SETTING The subjects aged ≥ 65 years were recruited prospectively from the Geriatrics Clinic of Gulhane Medical School, between 2004 and 2008 years. PARTICIPANTS 1302 patients were included in the study. MEASUREMENTS Cognitive status, clinical diagnosis of CD (MCI, AD, and VaD) and clinical and environmental risk factors were evaluated by comprehensive geriatric assesment. Finally, the subjects were categorized into two groups according to having CD or not. RESULTS 905 (69.5%) subjects were not having CD whereas 397 (30.5%) patients with CD. Of the patients with CD, 140 (10.4%) had MCI, 227 (16.9%) AD, and 30 (2.2%) VaD. After adjustment for confounding with a model for multiple regression analysis, age (OR=1.054; CI:1.027-1.083; p < 0.001) and family history of dementia (OR=1.662; CI:1.038-2.660; p=0.034) were found to be independent risk factors for CD. Also, overweight (OR=0.594; CI:0.370-0.952; p=0.03) and obese (OR=0.396; CI:0.242-0.649; p < 0.001), and high education level (OR=0.640; CI:0.451-0.908; p=0.012) were found to be independent protective factors for CD. CONCLUSIONS We found the risk of CD decreases in overweight and obese elderly. The results indicate that the primary prevention should not only consider risk factors, but must also take anthropometric data into consideration in order to identify persons at high risk for CD.
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DO ADIPONECTIN ISOFORMS IN OLDER ADULTS WITH OR WITHOUT CORONARY ARTERY DISEASE DIFFER ACCORDING TO GLUCOSE TOLERANCE STATES AND LIFESTYLE FACTORS? J Am Geriatr Soc 2010; 58:2235-6; author reply 2236. [DOI: 10.1111/j.1532-5415.2010.03117.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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An elderly diabetic case of ochronosis with depression and chronic pain. ENDOKRYNOLOGIA POLSKA 2010; 61:710-713. [PMID: 21104647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Alkaptonuria (ochronosis) is a rare autosomal recessive disorder featuring a genetic error in the amino acid metabolism. A defect in the tyrosine metabolism results in the accumulation and deposition of homogentisic acid in connective tissue, causing a blue-black discolouration. Degenerative arthropathy of the spine, knee, and hip are common signs of ochronosis in older age. An association between ochronosis and depression has not previously been discussed in the literature. This case report describes a 69 year-old woman with diabetes mellitus, ochronosis, depression and chronic pain.
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Adipocytokines and the metabolic syndrome among older persons with and without obesity - the InCHIANTI Study. Clin Endocrinol (Oxf) 2010; 73:422. [PMID: 20507340 DOI: 10.1111/j.1365-2265.2010.03820.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
OBJECTIVES Cholinesterase inhibitors for the treatment of Alzheimer's Disease (AD) and antimuscarinic agents for the treatment of urge urinary incontinence (UUI) may reduce the potential effect of each other in the patients with both diseases. Trospium has a relatively low lipophilicity and low CNS penetration, and galantamine, a cholinesterase inhibitors, has also allosterically modulates nicotinic cholinergic receptors. This study was designed to evaluate the effects of dual use of trospium and galantamine for 6 months in the elderly patients with AD and UUI. SETTING/PARTICIPANTS One hundred and seventy eight elderly patients: 99 UUI patients (Group I, treated with trospium), 43 AD patients (Group II, treated with galantamine) and 36 AD and UUI patients (Group III, treated with galantamine and trospium) were evaluated by geriatric assessments, the Global Perception Index (GPI), Patients' Satisfaction Question (PSQ), Estimated Patients' Improvement (EPI), nocturia and pads/day at baseline and in the 6th month. RESULTS Trospium increased the satisfaction of the patients in Groups I and III according to the EPI, PSQ, GPI, number of nocturia and pads/day. Decreasing in the GDS score was significant in the Group I and III (p < 0.05). Decreasing in the ADL score was significant in the Group III (p < 0.05). The MMSE scores were not significantly changed in the all groups during the 6 months. CONCLUSION Consequently, we have thought that a combination of trospium and galantamine could be recommended for the management of the elderly patients with UUI and AD, which are common problems in the elderly.
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Abstract
The study was conducted to investigate the effect of diabetes mellitus upon female sexual function, and to detect possible risk factors that might predict sexual dysfunction. The study consisted of 127 married women: 21 women with type 1 diabetes, 50 women with type 2 diabetes and 56 healthy women as a control. Female sexual functions were evaluated with a questionnaire to assess sexual desire, arousal, lubrication, orgasm, satisfaction and pain. The prevalence of sexual dysfunction was 71% in the type 1 diabetic group, 42% in the type 2 diabetic group and 37% in the control subjects. The scores for sexual desire, arousal and lubrication were significantly lower in the type 1 diabetes group than in the control subjects (p < 0.05). The scores of orgasm, satisfaction, dyspareunia and total sexual function were slightly lower in the type 1 diabetic group than in the other groups. No factor predicted sexual dysfunction in the diabetic women while further age, poor education, absence of occupation and menopause predicted sexual dysfunction in the control subjects. The prevalence of sexual dysfunction was significantly higher in the type 1 diabetic women than in the type 2 diabetics and control subjects. However, no risk factors that might cause sexual dysfunction could be predicted in diabetic women.
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P2‐268: Galantamine is safe as well as metoprolol on cardiac electrophysiology of patients with Alzheimer's disease. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.04.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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P2‐234: The interactions of trospium and galantamine with late onset Alzheimer disease and urinary incontinence. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.04.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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P2‐269: The effects of galantamine and rivastigmine on cardiac electrophysiology in patients with Alzheimer's disease. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.04.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Oral and Poster Papers Submitted for Presentation at the 5th Congress of the EUGMS “Geriatric Medicine in a Time of Generational Shift September 3–6, 2008 Copenhagen, Denmark. J Nutr Health Aging 2008. [DOI: 10.1007/bf02983206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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P4‐374: Curcumin reverses impaired insulin/IGF signaling and memory in streptozotocin induced memory deficit. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.2444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Is there any relation between insulin resistance and cognitive function in the elderly? Int Psychogeriatr 2007; 19:745-56. [PMID: 17502006 DOI: 10.1017/s1041610207005406] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Accepted: 02/19/2007] [Indexed: 02/05/2023]
Abstract
BACKGROUND Vascular risk factors are blamed as being involved in the pathogenesis of cognitive dysfunction in the elderly. Alzheimer's disease or vascular-type dementia could be part of a metabolic syndrome. The aim of this study was to evaluate whether there is any relation between insulin resistance and cognitive status of the elderly regarding normal, mild cognitive impairment (MCI), Alzheimer's disease (AD), vascular dementia (VaD) and mixed dementia. METHODS 267 elderly patients admitted to an outpatient geriatrics clinic were evaluated medically and cognitively in this study. The patients were diagnosed using ARDRA and DSM-IV criteria for AD; NINDS-AIREN and DSM-IV criteria for VaD; and Petersen criteria for MCI. Insulin resistance was calculated using both the homeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) formulas. RESULTS The mean values of HOMA and QUICKI scores were 2.79 (SD+/-3.56) and 0.346 (SD+/-0.036) for the normal group, 2.81 (SD+/-3.06) and 0.354 (SD+/-0.047) for AD group, 2.20 (SD+/-1.82) and 0.360 (SD+/-0.048) for VaD group, 2.87 (SD+/-1.81) and 0.339 (SD+/-0.038) for mixed dementia group, 2.79 (SD+/-2.81) and 0,349 (SD+/-0.042) for MCI group, respectively. There were no statistically significant differences between HOMA and QUICKI scores of all the groups. CONCLUSION This is the first study of the possible relation between insulin resistance and cognitive function in people categorized according to five forms of cognitive status. Unfortunately the results do not allow generalizations. Further prospective cohort studies that follow a normal cognitive group and MCI patients with and without insulin resistance are necessary.
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Abstract
18622 Background: The purpose of this study was determine the clinical significance of lymphopenia and monocytopenia in terms of its duration and depth in patients with febrile neutropenia (FEN) and MASCC scores parametres. Methods: Sixty-six patients with FEN were prospectively analysed. Recurrent FEN episodes were excluded in this trial. Twenty-four patients had solid tumors, 42 patients had lymphoma-leukemia. Patients with MASCC-scores ≥21 evaluated as low-risk (LR) and the ones with their scores <21 were high-risk (HR). Results: Thirty-six patients had HR and the rest had LR. Lymphocyte count <700/mm3 and monocyte count <100/mm3 were found as 91.6% and 86.6% in HR and in LR groups, respectively.The rate of refractory fever(RF) in HR patients was clearly high.Patients with protracted neutropenia (PN) had higher rate of RF (p = 0.007). Patients with longer duration of neutropenia and monocytopenia tended to have RF (p = 0.052, p = 0.018). The rate of administered AFT was significantly high in HR patients (p = 0.005). AFT was administered to one third of HR patients, but no patient received AFT in LR-group (p < 0.001). In group with neutropenia duration (ND) <10 days, one patient received AFP (p < 0.001). AFT was given to most of the patients who had longer duration of lymphopenia or monocytopenia (respectively; p = 0.002, p = 0.001), and who had leukemia (p = 0.001). The most important parameters effecting the duration of antibiotic therapy (DAT) was found to be ND. DAT >14 days was found more than fourfold in patients PN (p = 0.007). Fifty-five percent out of patients with solid tumor or lymphoma were given <14 days antibiotic therapy. But, most of patients with leukemia had antibiotics >14 days (p = 0.002).The rate of antibiotic therapy >14 days was higher in patients with longer duration of lymphopenia and monocytopenia (respectively; p = 0.073, p = 0.062). The most important parameter that influences on antibiotic modification (AM) was severity of monocytopenia on the first day of FEN. The rate of AM was found in aproximately nine-fold in patients that had monocyte counts ≤100/ mm3 as compared to monocyte ≥100/ mm3 (p = 0.01). Conclusions: The depth of monocytopenia and durations of lymphopenia and monocytopenia were the important parameter influencing antibiotic modification in FEN. No significant financial relationships to disclose.
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Hyperbaric oxygen-induced changes in bacterial translocation and acinar ultrastructure in rat acute necrotizing pancreatitis. J Gastroenterol 2005; 40:980-6. [PMID: 16261435 DOI: 10.1007/s00535-005-1653-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2004] [Accepted: 05/10/2005] [Indexed: 02/05/2023]
Abstract
BACKGROUND We aimed to investigate the effects of hyperbaric oxygen therapy on bacterial translocation and acinar cell ultrastructure in a rat model of acute necrotizing pancreatitis. METHODS Forty-eight male Sprague-Dawley rats were randomly divided into three groups. Acute pancreatitis was induced in groups II and III. Groups I and II did not receive any treatment, and group III was treated with hyperbaric oxygen. All surviving animals were killed 48 h after the induction of pancreatitis. Bacterial translocation and histological and ultrastructural changes were determined. RESULTS The incidence of bacterial translocation in group III was significantly lower in comparison with group II (P<0.001). Histopathological and ultrastructural injury scores were also significantly lower in group III (P<0.001 and P<0.04, respectively). CONCLUSIONS Hyperbaric oxygen therapy displayed beneficial effects on pancreatic superinfection and or histopathological and ultrastructural changes in experimental necrotizing pancreatitis.
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The evaluation of the hydrotalcite effectiveness on prophylaxis and treatment of mucositis due to high dose methotrexate treatment in osteosarcoma patients: A prospective crossover trial. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Irinotecan plus oral etoposide (IRET) combination is an highly active and promising treatment in heavily pre-treated small cell lung cancer patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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