The Prevalence and Trends of Instrumental Activities of Daily Living Impairments in the United States from 2008-2018

Background

Instrumental activities of daily living (IADL) are neuropsychological-driven tasks that are linked to cognitive dysfunction. Examining population-based IADL deficits may reveal insights for the presence of these impairments in the United States.

Objective

This investigation sought to evaluate the prevalence and trends of IADL impairments in Americans.

Methods

A secondary analysis of data from the 2006-2018 waves of the Health and Retirement Study was conducted. The overall unweighted analytic sample included 29,764 Americans aged≥50 years. Respondents indicated their ability to perform six IADLs: manage money, manage medications, use a telephone, prepare hot meals, shop for groceries, and use a map. Persons reporting difficulty or an inability to complete an individual IADL were considered as having a task-specific impairment. Similarly, those indicating difficulty or an inability to perform any IADL were classified as having an IADL impairment. Sample weights were utilized to generate nationally-representative estimates.

Results

Having an impairment in using a map (2018 wave: 15.7% (95% confidence interval (CI): 15.0-16.4) had the highest prevalence in individual IADLs regardless of wave examined. The overall prevalence of IADL impairments declined during the study period (p < 0.001) to 25.4% (CI: 24.5-26.2) in the 2018 wave. Older Americans and women had a consistently higher prevalence of IADL impairments compared to middle-aged Americans and men, respectively. The prevalence of IADL impairments was also highest among Hispanics and non-Hispanic Blacks.

Conclusion

IADL impairments have declined over time. Continued surveillance of IADLs may help inform cognitive screening, identify subpopulations at risk of impairment, and guide relevant policy.

Abstract 1835: Phosphodiesterase 4D (PDE4D) selective inhibitors as candidate drugs for prostate cancer

Our laboratory used an insertional somatic mutagenesis screen in mice to identify novel genes that may drive prostate cancer initiation and progression. Using this screen, we have identified candidate prostate cancer genes including the candidate oncogene phosphodiesterase 4D (PDE4D). Investigation of PDE4D showed that it was over-expressed in human prostate cancer cell lines and in human prostate cancers. Stable knockdown of PDE4D by shRNA reduced the growth and migration of prostate cancer cells in vitro and in vivo. Several small molecule PDE4D-selective inhibitors have been developed, including cilomilast and NVP-ABE171, and we have used them as potential anti-prostate cancer drugs in vitro and in vivo. The inhibitors were able to reduce the growth of prostate cancer cells in the context of epithelial mono-cultures or co-cultures that modeled stromal-epithelial interactions. Daily oral administration of PDE4D inhibitors for 6 weeks also reduced the growth of several prostate cancer xenograft lines in vivo through a dramatic induction of apoptosis. Interestingly, NVP-ABE171 and cilomilast also reduced the size of the prostates of treated mice without impacting overall animal health or the sizes of other organs. Under in vitro conditions in which prostate cancer cell growth was inhibited by either NVP-ABE171 or cilomilast, we also observed changes in the activation of potential downstream molecular targets of PDE4D inhibition including the sonic hedgehog and mitogen-activated protein kinase pathways. We are continuing studies with these inhibitors to further support the use of NVP-ABE171 and cilomilast as anti-prostate cancer drugs and to understand their mechanism(s) of action in the prostate.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1835. doi:1538-7445.AM2012-1835

Abstract 3046: Phosphodiesterase 4D (PDE4D) as a new drug target for prostate cancer

Our laboratory used an insertional somatic mutagenesis screen in mice to identify novel genes that may drive prostate cancer initiation and progression. Using this screen, we have identified candidate prostate cancer genes including the candidate oncogene phosphodiesterase 4D (PDE4D). Investigation of PDE4D showed that it was over-expressed in human prostate cancer cell lines and in human prostate cancers. Stable knockdown of PDE4D by shRNA reduced the growth and migration of prostate cancer cells in vitro and in vivo. PDE4D has been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD). Several small molecule PDE4D selective inhibitors have been developed and tested in clinical trials for COPD. Although these studies showed that the inhibitors had modest efficacy as a therapy for COPD, they confirmed that the inhibitors were safe for use in humans at doses that inhibited PDE4D in vivo. Based on our previous studies with PDE4D, we postulated that PDE4D small molecule inhibitors would be candidate anti-prostate cancer drugs. Daily oral administration of PDE4D inhibitors, NVP-ABE171 or cilomilast, for 6 weeks significantly reduced the growth of LNCaP-C4 prostate cancer xenografts in immune-compromised mice. Under in vitro conditions in which prostate cancer cell growth was inhibited by either NVP-ABE171 or cilomilast, we also observed changes in the activation of potential downstream molecular targets of PDE4D inhibition. Affected pathways included the sonic hedgehog and mitogen-activated protein kinase pathways. We also tested the potential role of the PDE4D pathway in prostate cancer stromal-epithelial interactions by modeling these interactions using novel microchannel co-culture devices. In this context, PDE4D inhibitors reduced the activation of Shh pathway target genes in mesenchymal cells and reduced the proliferation of epithelial cancer cell lines, supporting the potential importance of the PDE4D pathway for prostate cancer stromal-epithelial interactions. We are continuing in vitro and in vivo studies with these candidate drugs to further support the use of NVP-ABE171 and cilomilast as anti-prostate cancer drugs and to understand their mechanism of action.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3046. doi:10.1158/1538-7445.AM2011-3046

Endogenous levels of Echinacea alkylamides and ketones are important contributors to the inhibition of prostaglandin E2 and nitric oxide production in cultured macrophages

Because of the popularity of Echinacea as a dietary supplement, researchers have been actively investigating which Echinacea constituent or groups of constituents are necessary for immune-modulating bioactivities. Our prior studies indicate that alkylamides may play an important role in the inhibition of prostaglandin E2 (PGE(2)) production. High-performance liquid chromatography fractionation, employed to elucidate interacting anti-inflammatory constituents from ethanol extracts of Echinacea purpurea, Echinacea angustifolia, Echinacea pallida, and Echinacea tennesseensis, identified fractions containing alkylamides and ketones as key anti-inflammatory contributors using lipopolysaccharide-induced PGE(2) production in RAW264.7 mouse macrophage cells. Nitric oxide (NO) production and parallel cytotoxicity screens were also employed to substantiate an anti-inflammatory response. E. pallida showed significant inhibition of PGE(2) with a first round fraction, containing gas chromatography-mass spectrometry (GC-MS) peaks for Bauer ketones 20, 21, 22, 23, and 24, with 23 and 24 identified as significant contributors to this PGE(2) inhibition. Chemically synthesized Bauer ketones 21 and 23 at 1 microM each significantly inhibited both PGE(2) and NO production. Three rounds of fractionation were produced from an E. angustifolia extract. GC-MS analysis identified the presence of Bauer ketone 23 in third round fraction 3D32 and Bauer alkylamide 11 making up 96% of third round fraction 3E40. Synthetic Bauer ketone 23 inhibited PGE(2) production to 83% of control, and synthetic Bauer alkylamide 11 significantly inhibited PGE(2) and NO production at the endogenous concentrations determined to be present in their respective fraction; thus, each constituent partially explained the in vitro anti-inflammatory activity of their respective fraction. From this study, two key contributors to the anti-inflammatory properties of E. angustifolia were identified as Bauer alkylamide 11 and Bauer ketone 23.

Effect of ultraviolet B radiation on activator protein 1 constituent proteins and modulation by dietary energy restriction in SKH-1 mouse skin

The study examined the timing of modulation of activator protein 1(AP-1):DNA binding and production of AP-1 constituent proteins by ultraviolet B (UVB) radiation and effect of dietary energy restriction [DER, 40% calorie reduction from fat and carbohydrate compared to control ad libitum (AL) diet] in SKH-1 mouse epidermis. AP-1:DNA binding by electromobility shift assay (EMSA) was increased in a biphasic manner after treatment with a tumor-promoting suberythemal dose (750 mJ/cm(2)) of UVB light (311-313 nm) with peaks at 3 and 18 h postirradiation. DER overall reduced AP-1:DNA binding in mock-treated and UVB-treated skin at 3 and 18 h after UVB treatment. The timing of modulation of production of AP-1 constituent proteins by Western blot analysis was examined at 0 h (mock treatment), 3, 9, 18, and 24 h. We found that c-jun (9 h), jun-B (9 and 18 h), phosphorylated c-jun (3 h), and fra-1 (18 h) protein levels were increased after UVB treatment compared to mock controls. In a follow-up diet experiment, animals were placed on DER or AL diet for 10-12 wk and treated with UVB as before. DER was found to completely block the UVB-induced increase in phosphorylated c-jun protein levels and decrease in fra-2 protein levels at 18 h. In addition, DER enhanced UVB-induced increase in jun B levels and lowered basal levels of c-fos seen 18 h after UVB. These data suggest that DER may be able to assist in the prevention of UVB-induced skin carcinogenesis by modulating AP-1:DNA binding and AP-1 constituent protein levels.

Sister chromatid exchanges in rotogravure printing plant workers

OBJECTIVE

The individual burden of inhaled ambient-air toluene and its link to genotoxic phenomena in exposed printing workers.

METHOD

The influence of toluene on sister chromatid exchange (SCE) was investigated by monitoring of the individual toluene burden of 42 exposed printing workers. Therefore, the urinary hippuric acid (HA) excretion was measured directly after the work shift. The results were compared with those recorded for a control group consisting of 45 blood donors. SCE frequencies were determined from peripheral lymphocytes for both groups.

RESULTS

The median HA excretion of the exposed and nonexposed groups amounted to 1.94 and 0.45 g/g creatinine, respectively. For both groups, different SCE rates were detected: 10.13 and 6.84 counts/lymphocyte for exposed and nonexposed persons, respectively. The independence of the measured values proved to be significant at a high confidence level (P = 0.000) for both groups. The influences of smoking and alcohol consumption on SCE as well as on HA values could be clearly separated from those induced by toluene.

CONCLUSIONS

The results of our study indicate a strong relationship between the individual toluene burden and the genotoxic risk of the exposed persons. Since toluene was used for dilution of the letter-press ink, the influence of ink mist on the genotoxic effects could not be completely excluded.

[Do soluble organic nitrogen compounds cause unusual algal blooms in seawater?]

Up to now the nature and importance of the macromolecular forms of organic nitrogen in the marine environment is poorly understood. There is no doubt on the capacity of phytoplankton to utilize low molecule weight dissolved organic nitrogen compounds competitively with bacteria. In marine ecosystems the members of the plankton community show a complex close coupling with biological substances. In spite of trace concentrations the high dynamics in uptake and release processes cause strong fluxes of these compounds. In the case of inorganic nutrient deprivation or reduced photosynthesis under light deficiency algal utilization of organic nitrogen becomes noteworthy. Even under high nitrate supply an algal development occurred which was mainly triggered by amino acid uptake as was demonstrated during field experiments in the German Bight. The consumption of amino acids is controlled by several uptake systems, which are specified for transportation of different groups of amino acids through the cell wall. Since the uptake systems can also differ among species, the amino acid composition of the environment could preferentially enhance the growth of some selected species in comparison with other components of natural phytoplankton assembles. In the scope of increasing water pollution and the resulting shift in nutrient distribution one may expect the development of phytoplankton species, which had not been supported so far. In estuaries and costal zones photosynthesis is effected by light absorbance from particulate material. This phenomenon additionally will sustain algae, which are able to compensate a photosynthesis deficit by heterotrophic uptake. Though interrelationships are not clear up to now, it becomes evident that increasing impact of dissolved organic substances cause strong changes in species composition of marine ecosystems.

An automated fluorescence assay for subnanogram quantities of protein in the presence of interfering material

An automated assay for measuring nanogram and subnanogram quantities of protein in microliter samples was developed with the fluorometric reagent omicron-phthaldialdehyde/mercaptoethanol. Low molecular weight interfering substances were separated within the analysis by gel filtration. The technique allowed measurement of biological fluids without any sample pretreatment. The method presented proved to be linear within the range 1.2 ng to 1.4 microgram with a standard deviation of +/- 4.2%. The minimum detectable protein concentration was 1 microgram/liter. Special care was taken to prevent any determination errors caused by losses of protein during adsorption to surfaces. The simple analytical apparatus constructed can be used for field studies and ran several weeks when continuously used for seawater analysis aboard ship.

[Primary oxidation mechanisms in degradation of aliphatic hydrocarbons by bacterial enzyme systems (author's transl)]

The bacterial dissimilation of aliphatic hydrocarbons is catalysed by a monooxygenase mechanism with incorporation of molecular oxygen. Numerous publications have shown the cytochrome P 450-dependent hydroxylation of hydrocarbons, but there is considerably less information of hemo-protein-independent hydroxylations by alkanhydroxylases. In a marine Pseudomonad we found a system sensitive to cyanide: The oxygenase could be divided into three protein fractions. A cytochrome P 450 type spectrum was not detected. The NADH-dependent hydroxylation of n-decane can be activated by Mg2+ and Fe2+ ions. A noncompetitive product inhibition occurs which deserves special attention. An alcohol-dehydrogenase is closely associated with the oxygenase system by a kind of multienzyme-complex. Studies on kinetics and substrate specificity of this enzyme show an inhibition by excess substrate increasing with the chain length of the alcohols. The whole complex (alkanhydroxylase, alcoholdehydrogenase and aldehyddehydrogenase) is induceable by bacterial growth on alkanes, primary alcohols and fatty acids as sole carbon source.