Gerontology

Published by Karger
Online ISSN: 1423-0003
Publications
Article
It is generally agreed that elderly subjects undergo progressive deterioration of their immune responsiveness, which leads to an increased susceptibility to autoimmune processes, neoplasm and inflammation. Thus there is a general consensus that regulation of inflammation results from a balance between pro-inflammatory and anti-inflammatory pathways. The present study aimed to investigate the possible alterations of cyclic AMP/protein kinase A (cAMP/PKA) and p38 mitogen-activated protein kinase (p38 MAPK) pathway signaling (reactive oxygen species (ROS) generation) and inositol 1,4,5-triphosphate (InsP3) production by neutrophils during the aging process. Age-induced ROS generation and InsP3 production were studied in healthy subjects ranging in age from 20 to 80 years. The subjects were divided into six age groups: (I) 20-29, (II) 30-39, (III) 40-49, (IV) 50-59, (V) 60-69, and (VI) 70-80 years old. The effect of cAMP, H89 (inhibitor PKA), and PD169316 (inhibitor p38 MAPK) on ROS production was quantified in a luminol-dependent chemiluminescence assay (relative light units/min) and by InsP3 release (cpm). Our results demonstrated a lack of dibutyryl cAMP inhibitory effects on ROS generation and InsP3 production by granulocytes from PKA-dependent 50-year-olds. However, the inhibitory effect of cAMP is restored in neutrophils after the age of 50 years when p38 MAPK signaling is inhibited. The present study may be important towards a better understanding of the high susceptibility to infections and age-related inflammatory and deregulation diseases. The alteration of cAMP/PKA and p38 MAPK signaling pathways enhances the inflammatory process.
 
Classification tree showing the factors which, at each step, had the strongest association with mortality among elderly patients within 24 months after hip fracture surgery (n = 1,941). The percentage deceased is counted on the total number of patients in each node (n), including those with partly missing data. The amounts of partly missing data for ASA and SPMSQ are given within parentheses and are treated as separate groups in the CHAID analysis used to build the tree. All Bonferroni adjusted p values were ! 0.01 for all nodes. 
Factors associated with mortality within 4 months (n = 1,944)
Factors associated with mortality within 24 months (n = 1,941)
Article
Hip fracture patients are reported to have an increased mortality rate compared to the general population. In order to be able to reduce the morbidity and mortality after a hip fracture, our efforts to identify the patients at risk already upon admission to the hospital need to be increased. For such a risk assessment, robust, validated, and reproducible criteria are mandatory. To determine preoperative factors associated with mortality and to evaluate the combined use of the American Society of Anesthesiologists (ASA) and the Short Portable Mental Status Questionnaire (SPMSQ) to identify patients with an increased mortality rate and to create a predictive model to assess the mortality risk after hip fracture surgery. A total of 1,944 consecutive patients aged 66 years or older admitted for a hip fracture were included in a prospective cohort study with a 24-month follow-up. The patients were assessed with regard to gender, age, type of hip fracture, smoking habits, comorbidities, general physical health according to the ASA classification, and cognitive function according to the SPMSQ. A higher ASA score indicates an increasingly severe systemic disease and a lower SPMSQ score indicates an increasingly severe cognitive dysfunction. We used Cox proportional hazard models and classification trees to identify the factors associated with mortality. The predictive model was created based on factors that were significantly associated with death and all readily accessible upon admission. The mortality rate during the acute hospitalization period was 4%, at 4 months 16%, and at 24 months 38%. The most prominent factors associated with mortality were high ASA scores, low SPMSQ scores, high age and male gender. The SPMSQ score provided additional information about the survival time, compared to when the ASA score was used alone. The combined use of the ASA classification for assessing physical health and the SPMSQ for assessing cognitive function effectively identified hip fracture patients with an increased mortality rate. We present a predictive model including age, gender, ASA, and SPMSQ that can be used to assess the mortality risk after hip fracture surgery.
 
Article
Although several studies have reported that C-reactive protein (CRP) is associated with physical performance, few studies have evaluated the relationships between CRP and physical performance among subjects who had a very low range of CRP. Therefore, it is still unclear whether a lower CRP is favorably associated with physical performance even within a very low range. The aim of this study was to investigate the relationships between CRP and physical performance among a Japanese population with a low serum CRP concentration (CRP <1.0 mg/l). We designed a cross-sectional survey for 775 persons aged 70 years and older living in Japan. High-sensitivity CRP was measured using a nephelometric method. The subjects whose serum CRP concentrations were higher than 10.0 mg/l were excluded. Physical performance was assessed using a 10-meter maximum walk test, leg extension power, and a timed 'up and go' test. The median value (interquartile range) of CRP was 0.55 (0.29-1.20) mg/l. After adjustment for potential confounding factors, an inverse relation of CRP with the 10-meter maximum walk test and leg power was observed in all subjects (p for trend = 0.10 and 0.04, respectively). For subjects who had a CRP <1.0 mg/l, these inverse relations were unchanged (p for trend = 0.03 and 0.02, respectively). Serum CRP concentration is favorably related to physical performance, even within a very low range in a community-based elderly population aged 70 years and over. The findings suggest that maintaining as low CRP levels as possible may potentially maintain better physical performance.
 
Article
Various factors are considered to influence sexual behavior in the elderly, but the role played by preservation of adequate cognitive functioning has not been adequately explored. The aim of this research, conducted on 352 older adults aged between 65 and 105 years, was to identify the specific role played by cognitive functioning in sexual activity and sexual interest in the elderly. The data were collected from elderly people attending the surgeries of 21 general practitioners in the city of Padua (Italy). Analysis of sexual functioning was based on two items, from the LEIPAD questionnaire: 'Are you interested in sex?' and 'Do you have sexual relations?'. Subjects cognitive status was assessed objectively through the Mini Mental State Examination (MMSE) and subjectively by the LEIPAD subscale on cognitive functioning. Subjects who were sexually active and interested in sex were more highly represented among the married elderly. The elderly who reported being active and interested in sex were significantly younger and had a significantly superior educational level and MMSE score. Mean scores for cognitive functioning and all quality-of-life indicators were in general significantly better for the active and interested. Univariate logistic regression analysis indicated that a higher MMSE score and cognitive functioning score influenced the maintenance of sexual interest. One third of the subjects reported being still sexually active and 40% being still interested in sex. This study seems to suggest that a significant role may be played by cognitive functioning in the maintenance of sexual interest in the elderly, especially older females in whom this dimension is evidently linked to far more diversified experiences than their male peers.
 
Article
As the number of bedridden elderly patients increases, prevention of pressure ulcers is becoming a more important issue. However, an approach to this problem using medication has not been considered sufficiently in the clinical context. To test the hypothesis that anti-platelet aggregation therapy administered to the elderly patients may be helpful in preventing pressure ulcer formation, the medical records of 132 bedridden elderly patients were analyzed. In addition, the propensity of platelets to aggregate was also measured in some of the bedridden patients. Patients were divided into two groups, with pressure ulcers (group P, 52 patients) and without (group N, 80 patients). Subsequently, six factors defining the clinical characteristics age and gender, underlying disease, cause of being bedridden, level of consciousness, mobility and activity as defined on the Braden scale, and frequency of anti-platelet aggregation medication were investigated in groups P and N. In addition, physical findings (three factors): body mass index, blood pressure (BP), and heart rate were investigated in both groups. Furthermore, laboratory data (seven factors): total protein (TP), albumin, total cholesterol, hemoglobin (Hb), hematocrit (Hct), platelets, and platelet aggregation were compared between two groups. There were no significant differences in clinical characteristics between the two groups with the exception of the frequency of anti-platelet aggregation medication (23.1% of group P vs. 40.0% of group N, chi(2) = 4.06, p < 0.05). There was also no significant difference in physical findings except a difference between systolic and diastolic BP (48.4 mm Hg in group P vs. 57.1 mm Hg in group N, p < 0.01). Values of TP, albumin, Hb, and Hct in both groups were lower than the normal range, but there was no significant difference between the two groups. The platelet count was significantly greater in group P than in group N after lying supine (p < 0.03), and platelet aggregation in group P was significantly higher compared with group N (p < 0.03). Although our hypothesis must be tested by a randomized prospective trial, these results indicate that increased platelet aggregation is possibly associated with the development of pressure ulcers; therefore anti-platelet aggregation therapy may prevent their occurrence in bedridden elderly patients.
 
Article
Background: In 1992, local municipalities in Sweden took over full responsibility for the long-term care of elderly. This has led to an increased care burden for the various assisted accommodation services run by the municipalities. Objective: Since ageing and chronic diseases are risk factors for protein-energy malnutrition, we evaluated the nutritional status of all individuals in assisted accommodation, i.e., service flats (SF), old people's homes (OPH), group living for the demented (GLD), and nursing homes (NH), in three Swedish municipalities. Methods: Of 994 eligible subjects, 872 were examined; the average age was 84.5+/-8 years, and 69% were female. The Mini Nutritional Assessment (MNA) scale (0-30 points) was used, consisting of 18 point-weighted questions in four categories, i.e., anthropometry, global and dietary issues, and self-assessment. Results: MNA <17, i.e., malnutrition, was noted in 36% of the study population. Divided according to accommodation type, the MNA scores were <17 in 21% of individuals in SF, 33% of those in OPH, 38% of those in GLD, and 71% of those in NH. The corresponding values for MNA scores 17-23.5 (risk for malnutrition) were 49, 51, 57, and 29%, respectively. Average body mass index (BMI) values were 24.2+/-5 (SF), 23.6+/-5 (OPH), 23.9+/-4 (GLD), and 22.3+/-4 (NH). BMI values < or =20 were found in 18% of those in SF, in 25% of those in OPH, in 19% of those in GLD, and in 33% of those in NH. Both MNA and BMI correlated with upper arm and calf circumference, with r values ranging from 0.4 to 0.7 (p<0.001). MNA and BMI correlated significantly (r = 0.52, p<0.001). Age correlated with MNA and BMI with r values of 0.1 (p<0.01) and 0.14 (p < 0.001), respectively. Subjects with significant help requirements during meals ate fewer whole meals per day than those who could feed themselves. Conclusions: Based on the MNA, one third of the study subjects living in assisted accommodation, and more than half of those living in NH, appeared to be malnourished. Further studies are necessary to assess to what extent these nutritional disturbances are reversible.
 
Article
Elderly people frequently have symptoms of fullness and appetite loss due to impaired gastric motor activity. These symptoms may cause malnutrition, immunosuppression and other complications. The effects of aging and daily activity on gastric motility in the elderly were investigated by electrogastrography and the (13)C-acetate breath test. We enrolled seven active elderly subjects (active elderly group), seven elderly subjects staying at a geriatric facility who had reduced mental and physical capacities (inactive elderly group) and seven healthy young volunteers (young group). Electrogastrography was recorded before and after ingestion of a (13)C-acetate-mixed liquid meal. Expired air was sampled every 10 min after the meal to measure the (13)CO(2) concentration. The ratio of the incidence of the 3-cpm wave (gastric intrinsic frequency) during the postprandial period compared to the fasting state was reduced in both elderly groups compared to young subjects, and the reduction was greater in the inactive elderly than in the active elderly group. The ratio of the amplitude of the peak frequency during the postprandial period to that in the fasting state (power ratio) was also lower in the elderly groups. The time of peak (13)CO(2) expiration was delayed in the active elderly and more so in the inactive elderly group. Postprandial peristalsis and gastric contractile force are reduced in the elderly, and gastric emptying is delayed indicating a reduction in gastric motor activity.
 
Article
Research into the welfare institutions for the elderly, which were established in the Byzantine Empire. The purpose of the study is the research into the texts of the Byzantine chroniclers and the contemporary historical sources so as to determine the social policy of the Byzantine State regarding the homes for the aged. The histories and chronicles of the Byzantine writers, written in the original Greek language, were studied and analysed, so as to locate the extracts in the texts concerning the interest shown by the Byzantine State to establish institutions for old and ailing people. The care for the elderly in Byzantium was undertaken in special infirmaries, called 'gerocomeia', which operated all over the empire mostly in or near the monasteries. All these nursing homes were highly esteemed and the governor of the institution seems to have been a person of high importance. The most important nursing home was located in Constantinople and was established by Emperor John II Comnenus in the 12th century in the famous monastery and hospital of the Pantocrator. The study and analysis of the historical texts of the Byzantine period (324-1453 AD) prove that human-oriented behaviour, which derived from the intervention of religion, contributed to the foundation of many welfare institutions for the elderly by the Byzantine emperors, the church and some individuals who showed great interest in them.
 
Article
The search for the roots of geriatric medicine, which has been considered a relatively new branch. The purpose of the study is the research of the original Byzantine medical texts and the contemporary historical sources so as to bring to light knowledge about ancient medical care. The medical texts of Byzantine physicians were studied and analysed, as well as the Histories and Chronicles of their contemporary writers, so as to locate the extracts in the texts concerning geriatric care from the scientific point of view and that of the 'vox populi' which the historians and chroniclers express. The problems of old age occupied physicians from earliest Byzantine times. They had dealt with the characteristics, symptoms and accompanying diseases of the aged and endeavoured to confront all the medical problems faced by the elderly, providing a special healthy regimen for the third age and taking steps for the prevention of diseases of this age group and their treatment. Parallel to this, the research of contemporary historical texts proves the concern of all society for the special problems of the aged and the significant impact of scientific geriatric medicine on the population. The study and analysis of the original medical and historical texts of the Byzantine period (324-1453 AD), written in Greek language, prove that the roots of medical care of old age could be traced from ancient Greek and Byzantine medicine.
 
Article
The influence of aging on some parameters of systemic host defense mechanisms, i.e. white cell counts, lymphocyte subpopulations, delayed-type hypersensitivity (DTH), polymorphonuclear and mononuclear leukocyte functions, was evaluated. One hundred and forty-six healthy volunteers (60 men and 86 women), aged 25-100 years, were enrolled. None of the subjects had taken any drug in the month before the study. Subjects were divided into three age groups: 25-45, 46-65 and 66-100 years. Groups were comparable in size, and sex distribution was similar throughout all age groups. Elderly people were 51 healthy volunteers between the ages of 66 and 100 years (mean age 79.2). Younger people were 41 subjects between the ages of 46 and 65 years (mean age 54.3) and 53 between the ages of 25 and 45 years (mean age 32.7). As for the comparison between sexes, no significant differences in the values of the studied parameters were found between males and females (p > 0.05). Only quantitative DTH data, i.e. the number of antigens producing positive reactions and the score (sum of positive reaction diameters), were significantly (p < 0.05) reduced in responsive females when compared to males. Aging did not affect white cell counts, lymphocyte subsets and many phagocytic functions, i.e. phagocytosis frequency and index, nitroblue tetrazolium reduction, superoxide production, microbicidal activity against bacteria and yeasts. A significant decrease (p < 0.05) in the chemotactic response to serum-derived chemotactic factors was observed in aged people in comparison to younger subjects. Anergy was more frequent in older (about 29%) than in younger (5-9.4%) healthy volunteers.(ABSTRACT TRUNCATED AT 250 WORDS)
 
Article
In Japan, vascular dementia (VD) has been responsible for the majority of all dementia cases in both epidemiological and neuropathological studies. Recently, however, several epidemiological investigations have shown that the rate of VD has decreased and senile dementia of the Alzheimer type (SDAT) is now the major cause of dementia, though few neuropathological investigations show that the majority of dementia is SDAT. The purpose of the study was to clarify the rates of dementia types in Japanese nursing home residents and to compare the ratio of SDAT to VD in the first and second halves of the study. One hundred and twenty-two demented nursing home residents (48 men and 74 women) were evaluated neuropathologically over a period of 17 years in Shimane prefecture, Japan. All subjects died between 1976 and 1992. The average age at death was 81.4 +/- 9.4 years for men, 85.0 +/- 7.2 for women and 83.6 +/- 8.3 for total samples. In classifying dementia type, SDAT accounted for 34% (41 cases); VD 35% (42); mixed dementia 11% (14); and 'other' dementia 20% (25) of all samples. Comparison of the first 9-year period with the second 8-year period revealed the ratio of SDAT to VD tended to increase (from 0.83 to 1.15). This increasing tendency was found both in men (from 0.53 to 0.7) and in women (from 1.13 to 1.44). These tendencies, however, were not statistically significant. There was no change statistically in the ratio of SDAT to VD between the first half of the study and the second half. However, there was an increasing tendency of the ratio in our study.
 
Article
Testosterone and the testosterone precursors pregnenolone, progesterone, 17 alpha-hydroxyprogesterone, 17 alpha-hydroxypregnenolone, androstenedione, androstenediol and dehydroepiandrosterone were measured in the spermatic vein plasma and in the testicular tissue of young and old men. Testosterone and its precursors decreased in the testicular tissue of old men. However, progesterone and 17 alpha-hydroxyprogesterone increased in relation to testosterone in the testicular tissue and in the spermatic vein of old men. It is assumed that these age-dependent changes are caused by an impaired oxygen supply of the ageing testes. This hypothesis is supported by the observation that the same changes in steroid pattern seen in old age can be observed under reduced oxygen supply in in vitro incubation experiments with testicular tissue.
 
Article
Several recent epidemiological investigations have shown that the rate of vascular dementia (VD) has decreased and the rate of senile dementia of the Alzheimer type has increased in Japan. In our previous neuropathological examination, such a trend but no significant differences were shown in nursing home residents in Shimane Prefecture, Japan. The aim of this study was to clarify whether or not the frequency of cerebral infarctions (CI) and the ratio of CI [large infarction type (LI) and small multiple infarction (MI)] types changed between the first half of this study and the second half, corresponding to the decreasing trend of the rate of VD. Three hundred and ten aged nursing home residents (146 men and 164 women) were evaluated neuropathologically in Shimane prefecture, Japan. All subjects died between 1976 and 1992. The average age +/- standard deviation at death was 79.1+/-8.7 years for men, 83.4+/-7.8 for women, and 81.4+/-8.5 overall. They were placed into the first or second study group and compared. (1) The incidence of hypertension (HT) decreased significantly from the first half of the study to the second half in both men and women. (2) The frequencies of CI and CI with HT were not significantly different between the first and second half (both men and women). (3) There was a decreasing trend in the ratio of LI to MI from the first to the second period in men. There may be no effect of the incidence of HT on CI frequency and some effects on CI types. The incidence of CI in total lifespan (both men and women) has not changed in our study. The recent decreasing trend in LI in men may have contributed to the decreasing tendency in the prevalence of vascular dementia.
 
Article
To investigate the mechanisms of age-related decline in synthesis of adrenal androgen, we studied the contents of cortisol (F) and dehydroepiandrosterone (DHEA) and the amounts of cytochrome P450 17 alpha-hydroxylase (P450c17) mRNA and cytochrome P450 11 beta-hydroxylase (P450c11) mRNA in young (1 year old) and senescent (10-12 years old) bovine adrenal glands. We also examined effects of ACTH (10(-7) M) on the secretion of F and DHEA and on the induction of P450c17 and P450c11 mRNA expression in cultured adrenal cells from young and aged cows. The content of DHEA in adrenal glands and the secretion of DHEA in response to ACTH in cultured adrenal cells from senescent cow were lower than those from young cow, while the content and ACTH-stimulated secretion of F in senescent adrenals were of a similar level to those in young adrenals. The adrenal gland from aged cow showed a significantly lower level of P450c17 mRNA compared with young bovine adrenal. However, P450c11 mRNA was expressed in senescent adrenal glands at the same level as that in young adrenals. The induction of P450c17 mRNA by ACTH (10(-7) M for 24 h) in cultured adrenal cells from aged cow also showed a decline compared with that from young cow, although there was no difference the ACTH-induced accumulation of P450c11 mRNA in cultured adrenal cells between young and senescent cow. These results suggested that the expression of P450c17 mRNA decreased in aged bovine adrenal, which may cause the age-associated decline in biosynthesis of adrenal androgen.
 
Article
Serum 5alpha-androstane-3alpha, 17beta-diol was measured in 60 normal men aged 23-80 years using sensitive and reliable radioimmunoassay techniques developed in our laboratory. When these normal men were classified into three age groups of 20-40, 40-60 and 60-80 years the values (mean +/- SEM) for serum 5alpha-androstane-3alpha, 17beta-diol were 857.3 +/- 36.3, 878.1 +/- 33.8 and 645.6 +/- 26.6 pmol/l, respectively. There were significant differences between the level of this steroid in the age group 60-80 when compared to either the 20-40 group (p less than 0.001) or the 40-60 group (p less than 0.001). No significance difference was found between the values for the two younger groups. The decline of this steroid with age corresponds with the diminishing level of testosterone and dihydrotestosterone previously reported from this laboratory.
 
Article
To determine the influence of some cardiovascular risk factors (hypertension, diabetes mellitus, smoking habit, physical activity, obesity, adverse lipid profile) in elderly Chinese aged 70 years and over, on overall mortality and morbidity from stroke and ischaemic heart disease. Longitudinal study relating 18-month outcome to baseline values. 2,032 subjects (999 men, 1,033 women), mean age 80 years, recruited by random sampling of the Old Age and Disability Allowance Schemes, which covers 90% of the Hong Kong elderly subjects, stratified by sex and 5-year age groups from 70 years onwards. At baseline, subjects were visited by interviewers to collect information regarding medical conditions, smoking habit, physical activity, and to measure their height, weight, skinfold thickness, and waist/hip ratio. A follow-up survey was carried out 18 months later to establish the development of any new stroke or ischaemic heart disease, and to note any deaths and the cause of such deaths from death certification. In multivariate analysis overall mortality was negatively associated with body mass index and participation in physical activity, after adjusting for age and sex. Death from stroke was associated with a higher systolic blood pressure at baseline. Among survivors, the only significant associations observed were a negative association between body mass index and the development of heart disease, and a positive association between systolic blood pressure and development of stroke. Few associations between cardiovascular risk factors and morbidity and mortality were demonstrated in elderly Chinese with a mean age of 80 years. The only modifiable risk factor appears to be systolic blood pressure.
 
Article
Alterations with aging in the responses of heart rate (HR) and blood pressure (BP) reactivity were investigated during mild mental stress induced by undergoing a psychometric test, in 52 women and men aged 18-73 years, with no history of cardiovascular, renal or neurological deficits. HR and BP responses were measured before, during and after the test. Resting HR and diastolic BP (DBP) were not age-related while resting systolic BP (SBP) was. HR and SBP were increased during test performance. HR reactivity, measured during task execution as well as during recovery, was significantly decreased in older subjects. DBP recovery variation was lowered with age. These results indicate that age is an important determinant of the magnitude of cardiovascular adjustment during minor mental stress in women and men.
 
Article
Previous studies have shown that colour preferences change from early childhood to adulthood. The main objective of this study was to assess whether colour preferences undergo further changes during adult life. Cross-sectional data on colour preferences were collected in 842 adults (aged 19-90 years) living in Mainz, Germany. The sample was split by age into younger (183 men, 232 women) and older (157 men, 270 women) adults. The subgroups were compared for their most and least preferred colours that they had chosen by name out of four given colours (blue, green, red, yellow). Differences in the pattern of frequencies between sexes and age groups were assessed for statistical significance using chi-square analyses. Both age groups and both sexes chose blue as most preferred colour and yellow as least preferred one; green and red fluctuated in the middle position of the rank order of preferences. All frequency distributions departed significantly from chance (p < 0.001). In both younger and older adults, significant sex differences did not exist for the ranking of the most preferred colours (p > 0.2), but were evident in the ranking of the least preferred colours (p < 0.01); men stated more often yellow and less often red as least preferred than women did. Age group differences in colour preferences were highly significant. With advancing age, the preference for blue decreased steadily, whereas the popularity of green and red increased (p < 0.001). The results suggest that colour preferences change during the course of the adult life span. These changes seem to be a reversal of the trend reported in the literature for children. Changed colour preferences in the aged might be attributed to alterations in colour discrimination and visual imagery, the yellowing of the crystalline lens, and the decreased function of the blue cone mechanism with ageing.
 
Article
Birth weight throughout the normal range correlates with cognitive ability in childhood. Some studies suggest this may persist into adulthood, but it is unclear whether this continues into old age. To investigate the relationship between birth parameters (birth weight, birth length, placental weight and social class) and cognitive ability in old age. 128 community-dwelling volunteers born in one hospital in Edinburgh, UK, between 1921 and 1926 had birth details extracted from the records. All aged 75-81 underwent cognitive tests. The National Adult Reading Test (NART) was used to estimate prior ability. Tests of fluid cognitive ability showed positive intercorrelations, and therefore a general cognitive factor (g) was extracted using principal components analysis. Estimated prior ability (NART) correlated with birth length (r = 0.25, p = 0.02), and non-significantly with birth weight (r = 0.15, p = 0.19). There were no statistically significant correlations between birth parameters and cognitive ability aged around 80 (birth weight r = 0.12, p = 0.27; length r = 0.19, p = 0.08). Placental weight was not associated with cognitive ability. There was a trend towards an association between social class at birth and prior cognitive ability (more deprivation predicting poorer performance) (rho = -0.17, p = 0.06). Social class was not significantly associated with cognitive ability in old age (rho = 0.07, p = 0.47), or with estimated cognitive change (rho = -0.03, p = 0.73). In a small sample of community-dwelling older people, an influence was detected from birth to earlier cognitive ability using a test of crystallized intelligence. However, this effect was not significant into old age. In this sample, social class at birth did not affect later cognitive ability. The effect size of early life influences on cognition is small, with birth parameters explaining about 1% of the variance. Research with larger samples should consider influences operating across the whole life course, and their relative importance over time.
 
Mean values of variables for SMS47 participants with data available at all three waves 
Pearson correlation coefficients (p value) between systo- lic (SBP) and diastolic (DBP) blood pressures and cognitive tests at baseline, wave 1 
Article
The relationship between blood pressure and cognition in old age remains unclear. Some data indicate that elevated blood pressure causes cognitive deficits whilst others show that lower early life mental ability predicts high blood pressure in adulthood. Longitudinal studies in which mental ability earlier in life is known are needed to clarify the relationship. To measure the effect of blood pressure on cognition in late adulthood after adjusting for early life mental ability. The sample comprised survivors of the 1947 Scottish Mental Survey who had validated IQ scores at age 11. Six cognitive tests - Mini-Mental State Examination, Raven's Progressive Matrices, Rey Auditory Verbal Learning Test, Uses of Common Objects Test, Digit Symbol Test and Block Design - were administered at ages 64, 66 and 68 years. Sitting and standing blood pressure was also measured at each wave of follow-up. Mixed general linear models were constructed with each cognitive test treated as a repeated measure of an underlying cognitive trait and with wave of testing also set as a repeated measure. Mental ability at age 11 was entered as a covariate. 504 participants were tested at wave 1 with 368 returning at wave 2 and 300 at wave 3. Age 11 mental ability did not predict any of the blood pressure measures. There were several significant associations between blood pressure variables and cognitive test scores in univariate models. After adjusting for significant effects of wave of testing, type of cognitive test, the interaction between these, age 11 mental ability, age, gender and occupation in a multivariate model, the main effect of BP trait was no longer significant (p = 0.44) nor its effect over time (p = 0.26), though there was a significant interaction between blood pressure trait (BP) and test type with a distinctly negative effect of BP on Auditory Verbal Learning Test (p = 0.007, -0.13 points per mm Hg higher, 95% CI -0.22 to -0.033). The effects of blood pressure on cognition in old age are finely nuanced. Multivariate repeated measures models reveal a differential effect of blood pressure on verbal recall.
 
Article
Causes of death have changed greatly in the United States during the 20th century. To detail these changes in elderly people during 1950-1990. The source of data was 'Vital Statistics of the United States' for the years discussed. Mortality rates for several causes were calculated for the 85-89 age group, and the percentage of deaths attributed to several causes was calculated. There are large peaks about 1970 in both the mortality rate of ischemic heart disease and the percentage of total deaths attributed to this cause. The peaks have been followed by declines. Death rates from cancer and the percent of deaths attributed to cancer have increased during 1950-1990. The above changes coincide with major changes in medical science and care, the identification of the risk factors predisposing to ischemic heart disease and cerebrovascular diseases, and the implementation of Medicare, a program of health care benefits to all people 65 and over that is supported by the United States government.
 
Article
During a winter epidemic of A/H1N1 influenza virus, we evaluated the protection conferred by vaccination of 285 residents of a nursing home. Fifteen of 204 members of the nursing staff were also vaccinated. Serological determinations were performed before and after vaccination using radial hemolysis (RH) and neuraminidase inhibition (NI) tests. In the outbreak period, only one influenza case was noted in the vaccinated elderly and none among the vaccinated nursing staff. On the other hand, 38 cases (20%) occurred in the unvaccinated hospital personnel. Twenty-one percent of the elderly people exhibited seroconversion to the vaccinal strain by RH and NI while 27 and 20% of the vaccinated nursing staff seroconverted by the same tests, respectively. Thus, the clinical protection conferred by influenza vaccination was excellent and much greater than expected from serological results.
 
Article
In a prospective study, incidences of hip fractures among the aged in urban and rural populations were compared in two health care regions in Finland in 1989. Both the administrative and the more informative functional classification of the municipalities were used. During 1989, a total of 366 patients, aged 55 years and above, who had a permanent place of domicile in either one of the two health care regions, were treated for a fresh hip fracture. In both regions women sustained 80% of the fractures. No significant differences were found in the incidences of hip fractures between the urban and rural populations. However, a significant difference was found in the mean incidence between the towns of the two health care regions (t = 4.228, d.f. = 6, p < 0.01).
 
Article
Concern about poor responsiveness to influenza vaccination by institutionalized elderly people. To determine whether institutionalized elderly volunteers develop a significant antibody response following influenza vaccine and to compare this response with that of non-institutionalized subjects. The haemagglutination-inhibiting antibody response after 1995-1996 influenza vaccination [A/Shangdong/9/93 (H3N2), A/Taiwan/1/86 (H1N1), B/Panama/45/90] was estimated in 80 elderly women living in a nursing home and compared with that of 51 non-institutionalized women. No differences were found in the prevaccination status, and, after vaccination, a significant humoral response was elicited both in institutionalized and non-institutionalized elderly subjects against all three influenza strains tested. The immune response of institutionalized patients was satisfactory and significantly higher than that observed in non-institutionalized women. These results were confirmed both by a separate analysis of homogeneous subgroups stratified according to the presence in the two cohorts of potential causes of differential antibody response (prevaccination antibody titre, age, long-term drug treatment, risk factors for influenza infection, and physical disability) and by logistic regression analysis in order to adjust immune responses for the different variables. Influenza vaccination is effective in elderly people living in nursing homes. However, the postvaccination antibody response to influenza vaccine is influenced by different factors directly or indirectly related to residence.
 
Article
PMID: 9592692 *** This study has been prompted by the relatively small body of knowledge on the media use of the elderly. The aim of this study was to show how people 50 years and older use the medium television in Germany. Therefore, the 1996 television usership data collected in a representative 'peoplemeter' panel of about 4,800 German television households have been surveyed, processed and analyzed using standard audience research software. In 1996, Germans 50 years and above watched on average 233 min television per day. The older a person, the longer he or she watches television. Individuals 65 years and older watch television for 253 min per day. This subgroup appears to comprise the most intensive users of the medium. Men 65 years and above may be depicted as the heaviest weekend TV watchers, older women as the medium's closest followers from Monday to Friday. Television program broadcast late in the afternoon and early in the evening have by far the best chances to be chosen by seniors. The affinity of the elderly for the medium can be explained by its potential for offering entertainment, information, and companionship, being a substitute for primary interpersonal communication, a tool for structuring time patterns and keeping up the rhythms of long-established everyday rituals. On the one hand, television can be a 'lifeline' and a 'window to the outside world' for people with little opportunity for direct, unmediated social contact, thus possibly raising their satisfaction of life. On the other hand, prolonged TV use may be seen as an indicator for the degree of loneliness and neglect of the elderly.
 
Article
Both cognitive function and gait speed are important correlates of disability. However, little is known about the combined effect of cognitive function and gait speed on multiple domains of disability as well as about the role of gait speed in the association between cognitive function and late-life disability. To investigate (1) how cognition and habitual gait speed are related to late-life disability; (2) the role of habitual gait speed in the cognitiondisability association; and (3) the combined effect of cognitive function and habitual gait speed on late-life disability. Participants (>60 years, n = 2,481) were from the National Health and Nutrition Examination Survey 1999-2002. Disability in activities of daily living (ADL), instrumental ADL (IADL), leisure and social activities (LSA), and lower extremity mobility (LEM) was obtained by self-report. Cognitive function was measured by a 2-min timed Digit Symbol Substitution Test (DSST), an executive function measure from the Wechsler Adult Intelligence Test. Habitual gait speed was obtained from a 20-foot timed walk. Multiple logistic regression was used to assess the association between cognitive function and disability. Cognitive function was associated with decreased likelihood for disability in each domain. The odds ratios (ORs) for disability in ADL, IADL, LSA, and LEM for each standard deviation (SD) increase in the DSST score were 0.47 (95% confidence interval [CI] = 0.34-0.64), 0.53 (95% CI = 0.42-0.67), 0.61 (95% CI = 0.47-0.79), and 0.73 (95% CI = 0.61-0.86), respectively, in the multi-variable models. After additional adjustment for habitual gait speed in the cognition-disability relationship, DSST score was no longer a significant correlate for LSA and LEM disability. The strength of the association between DSST score and disability in ADL/IADL was also diminished. The attenuated association between cognition and disability implies that limitation in gait speed likely mediates the association between cognitive function and disability. We found additive effects of cognition and habitual gait speed on late-life disability. The OR of disability in respective domains were lowest among participants with high-DSST score (high executive function) and with high gait speed. In contrast, the OR tended to be highest among participants with low-DSST score (low executive function) and low gait speed. Cognitive function was associated with multiple domains of disability. There was a joint effect of cognitive function and gait speed on late-life disability. This study also suggested that habitual gait speed partially mediated the inverse association between cognitive function and late-life disability, providing a mechanistic explanation in the context of disablement process.
 
Article
Sarcopenia is age-associated deterioration of muscle mass and function caused by a wide scope of physiological and pathological changes ranging from hormonal disorders to loss of subcellular homeostasis. Recent research indicates that mitochondrial dysregulation with advanced age plays a central role in the development of sarcopenia due to the multifactorial functions of this organelle in energy supply, redox regulation, crosstalk with nuclear gene expression and apoptosis. In order to fulfill these roles, it is crucial that mitochondria maintain their own structural and functional integrity through biogenesis, antioxidant defense, fusion/fission dynamics and autophagy (mitophagy). Unfortunately, mitochondria undergo age-associated changes that compromise the above-mentioned properties that eventually contribute to the development of sarcopenia. The peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) is involved in the transcriptional regulation of numerous nuclear and mitochondrial gene products participating in the cellular events that control muscle mass and function. Thus, it is not surprising that maintaining an optimal intracellular PGC-1α level and signaling activity is crucial in protecting the muscle from many degradative and destructive processes, such as proteolysis, oxidative damage, inflammation, uncontrolled autophagy and apoptosis. Physical exercise is a powerful stimulus to PGC-1α expression and signaling. Recent research indicates that PGC-1α-controlled mitochondrial biogenesis is not limited by old age per se and that elderly individuals can still benefit from increased muscular activity in terms of skeletal muscle health that ultimately contributes to quality of life in old age. © 2014 S. Karger AG, Basel.
 
Article
Conversion of 25-hydroxyvitamin D3 (25(OH)D3) to the active vitamin D3, 1 alpha,25-dihydroxyvitamin D3 (1 alpha,25(OH)2D3) is catalyzed by 25(OH)D3, 1 alpha-hydroxylase(1 alpha-hydroxylase). It has been suggested that this enzyme is cytochrome P450 (P450). We purified 1 alpha-hydroxylase 430-fold from cholate-solubilized kidney mitochondria of vitamin D-deficient chickens by utilizing hydrophobic and ion-exchange column chromatographies. Enzymatic activity was assessed by measuring on HPLC the formation of 1 alpha,25(OH)2D3 from 25(OH)D3 in the assay mixture containing NADPH, adrenodoxin reductase, adrenodoxin as a reducing system. The purified enzyme showed a CO-difference spectrum characteristic of P450. The molecular activity of this preparation was calculated to be 8.7 pmol/min/pmol P450. This value was higher by more than 87-fold than those reported so far. The present preparation was found to contain several proteins on SDS-PAGE. Among them, only the 54-kD protein became undetectable when kidney mitochondria from normal and vitamin D-replete chickens, where 1 alpha-hydroxylase activities were 15 and 0% of that found in vitamin D-deficient chicken, respectively, were used as the starting enzyme sources. Furthermore, the band intensity of the 54-kD protein accounted for the spectrophotometrically determined amount of P450 in the preparation. These results suggest that the 54-kD protein is 1 alpha-hydroxylase.
 
Potential causes and pathophysiological consequences of sarcopenia. Agerelated changes in physiological properties and social behavior favor molecular adaptations that could contribute to the causation and progression of sarcopenia. The resulting frailty, immobility and weakness further feed the vicious cycle and ultimately increase morbidity and mortality. 
Myokine production and putative effects on muscle and distal organs. Myokines are produced and secreted by skeletal muscle and exert subsequent auto-, para-and endocrine effects. Physical activity (through PGC-1 ?) and an inactive lifestyle as observed in sarcopenia control the production of myokines. FA = Fatty acid. 
Article
Aging is associated with far-reaching changes in physiological functions resulting in morbidity and ultimately death. Age-related frailty, insecurity and reduced physical activity contribute to a progressive loss of muscle mass and function, commonly referred to as sarcopenia. Due to the increase in life expectancy in many countries, loss of muscle mass and its consequences gain in relevance for public health. At the same time, the molecular mechanisms that underlie sarcopenia are poorly understood and therefore, therapeutic approaches are limited. Interestingly though, endurance, strength and stretching exercise is significantly superior to all known pharmacological, nutritional and hormonal interventions for stabilizing, alleviating and reversing sarcopenia. Thus, increased knowledge about the plastic changes of skeletal muscle after physical activity and the signaling factors that mediate the beneficial effects of exercise on other organs might yield a better understanding of the disease and open new avenues for treatment. Here, we discuss how current discoveries about the peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α), a key exercise factor in muscle, and myokines, factors produced and secreted by active muscle fibers, expand our view of the pathological changes and the therapeutic options for sarcopenia.
 
Sociodemographic attributes of pet owners and non-owners, and pet carers and non-carers; means and 95% confi dence inter- vals 
Measures of health and GP service use for pet owners and non-owners, and pet carers and non-carers: estimated marginal means and 95% confi dence intervals controlling for sex and marital status 
Personality measures of pet owners and non-owners, and pet carers and non-carers: estimated marginal means and 95% confi - dence intervals 
Measures of health and GP service use for pet owners and non-owners, and pet carers and non-carers: estimated marginal means and 95% confi dence intervals controlling for personality traits, sex and marital status 
Article
It is commonly assumed that owning a pet provides older residents in the community with health benefits including improved physical health and psychological well-being. It has also been reported that pet owners are lower on neuroticism and higher on extraversion compared with those without pets. However, findings of research on this topic have been mixed with a number of researchers reporting that, for older people, there is little or no health benefit associated with pet ownership. To identify health benefits associated with pet ownership and pet caring responsibilities in a large sample of older community-based residents. Using survey information provided by 2,551 individuals aged between 60 and 64 years, we compared the sociodemographic attributes, mental and physical health measures, and personality traits of pet owners and non-owners. For 78.8% of these participants, we were also able to compare the health services used, based on information obtained from the national insurer on the number of general practitioner (GP) visits they made over a 12-month period. Compared with non-owners, those with pets reported more depressive symptoms while female pet owners who were married also had poorer physical health. We found that caring for a pet was associated with negative health outcomes including more symptoms of depression, poorer physical health and higher rates of use of pain relief medication. No relationship was found between pet ownership and use of GP services. When we examined the personality traits of pet owners and carers, we found that men who cared for pets had higher extraversion scores. Our principal and unexpected finding, however, was that pet owners and carers reported higher levels of psychoticism as measured by the Revised Eysenck Personality Questionnaire. We conclude that pet ownership confers no health benefits for this age group. Instead, those with pets have poorer mental and physical health and use more pain relief medication. Further, our study suggests that those with pets are less conforming to social norms as indicated by their higher levels of psychoticism.
 
Age-and sex-adjusted prevalence of disability among US-and foreign-born Arab Americans: PUMS 2000, n = 4,225. 
Distribution (%) of selected characteristics for US-and foreign-born Arab Americans 65 years of age and older: PUMS 2000, n = 4,225 
Age-and sex-adjusted prevalence of physical and self-care disability among Arab Americans by place of birth: PUMS 2000, n = 4,225. 
Crude and adjusted ORs and 95% CIs for having a physical disability among foreign-born Arab Amer- icans 65 years of age and older: PUMS 2000, n = 1,137 
Crude and adjusted ORs and 95% CIs for having a self-care disability among foreign-born Arab Amer- icans 65 years of age and older PUMS 2000, n = 402 
Article
Although the prevalence of disability for various racial and ethnic groups has been documented, little attention has been paid to Arab Americans in the United States. We estimated the age- and sex-adjusted prevalence of disability among older Arab Americans and examined the association between nativity status and self-reported physical and self-care disability before and after controlling for covariates. We used data from the 5% Public Use Microdata Samples of the 2000 US Census. Our sample included 4,225 individuals 65 years of age and older who identified with an Arab ancestry. Of these, 2,280 were foreign-born and 1,945 were US-born. The age- and sex-adjusted prevalence of having a physical disability was 31.2% for foreign- and 23.4% for US-born older Arab Americans, and the age- and sex- adjusted prevalence of having a self-care disability was 13.5% for foreign- and 6.8% for US-born Arab Americans. Iraqis reported the highest estimates for both disabilities (physical, 36.2%; self-care, 19.8%) compared to other Arab ethnic groups. In the crude model, foreign-born Arab Americans were more likely (OR=1.32; 95% CI=1.28, 1.36) to report a physical disability compared to US-born Arab Americans. When adjusting for English language ability in the final model, the odds of having a physical disability for foreign-born Arab Americans was protective compared to US-born Arab Americans (OR=0.92; 95% CI=0.88, 0.96). In the crude model, foreign-born Arab Americans were 1.82 times (95% CI=1.74, 1.90) more likely to report a self-care disability compared to US-born Arab Americans. In the fully adjusted model, this association was slightly attenuated (OR=1.32; 95% CI=1.24, 1.41). These findings indicate English language ability is associated with variations in reporting a physical disability. Future studies should include better measures of acculturation. Arab Americans are heterogeneous and should be disaggregated both by subgroups and from the white category in order to reveal a more accurate health and disease status profile for these groups. These efforts will assist in tailoring more effective interventions in reducing or preventing disability among Arab Americans 65 years of age and older.
 
Article
To describe total and yearly demographic trends relative to aging, dysphagia referral rates and oral feeding status in hospitalized patients from 2000 through 2007. We evaluated a prospective, consecutive, referred sample of 4,038 hospitalized patients in an urban, tertiary, acute care teaching hospital. Dysphagia referral rates are described according to year, age (decade), sex, admitting diagnostic category, results of dysphagia evaluations and oral feeding status. Diagnosis of dysphagia and feeding status were assessed objectively with fiberoptic endoscopic evaluation of swallowing. Dysphagia referral rates doubled between 2000 and 2007, with increases of 20% per year and increases in all decades from 2002 through 2007. Over 70% of dysphagia referrals were for older patients of 60 years and above, and over 42% of these were old old patients over 80 years. Referrals for 80 to 89-year-old patients almost doubled and for patients over 90 years more than tripled between 2000 and 2007. Of older patients over 60 years, 62.3% (1,771/2,843) did not exhibit dysphagia, 18.0% (513/2,843) benefited from specific diet modifications to reduce aspiration risk and 19.7% (559/2,843) were made nil-by-mouth due to severe dysphagia and aspiration. From 2000 to 2007, dysphagia referrals across all ages increased by 20% each year, with more referrals for older (70.4%) than younger patients (29.6%). Referrals almost doubled for 80 to 89-year-old patients and more than tripled for patients over 90 years. This increase will necessitate additional trained dysphagia specialists at least through 2050 and probably longer.
 
Article
Background: Polypharmacy and hyperpolypharmacy are proxy indicators for inappropriate medicine use. Inappropriate medicine use in older people leads to adverse clinical outcomes. Objective: The objectives of this study were to investigate the prevalence and trends of polypharmacy and hyperpolypharmacy in older people in New Zealand from 2005 to 2013, analyzing the pharmaceutical collections maintained by the Ministry of Health. Methods: A repeated cross-sectional analysis of population-level dispensing data was conducted from January 1, 2005 to December 31, 2013. Polypharmacy and hyperpolypharmacy in individuals were defined as the use of 5-9 medicines and ≥10 medicines, respectively, dispensed concurrently for a period of ≥90 days. Differences in polypharmacy and hyperpolypharmacy between 2005 and 2013 were examined. A multinomial regression model was used to predict sociodemographic characteristics associated with polypharmacy and hyperpolypharmacy. Results: Polypharmacy and hyperpolypharmacy were found to be higher in 2013 compared to 2005 (polypharmacy: 29.5 vs. 23.4%, p<0.001; hyperpolypharmacy: 2.1 vs. 1.3%, p<0.001). The risk of polypharmacy and hyperpolypharmacy was higher in females, in those aged 80-84 years, in the Māori population (for polypharmacy) and the Middle Eastern, Latin American, or African population (for hyperpolypharmacy), in people living in the Southern-district health board, and in individuals with increasing deprivation. Conclusion: The population of New Zealand is aging and the number of older people with multiple chronic conditions is increasing. The proportion of older people exposed to polypharmacy and hyperpolypharmacy has increased in 2013 compared to 2005. Our study provides important information to alert health policy makers, researchers, and clinicians about the dire need to reduce the medication burden in older New Zealanders.
 
Article
Using the National Statistics ('DRG-Statistik') published by the Federal Statistical Office, we analyzed prevalences of pressure ulcers coded as principal or as additional diagnosis separately and describe differences in ulcer characteristics. Age-adjusted prevalence and tables for gender and age distribution of pressure ulcers separately for the principal diagnosis and for additional diagnoses were provided by the Federal Statistical Office. In 2005, about 16 million patients were treated as full-time patients in German hospitals. 9,941 (0.06%) were referred with pressure ulcer as principal diagnosis and 191,040 (1.19%) had at least one additional diagnosis pressure ulcer. People >65 years of age had the highest risk for pressure ulcers (per 100,000 population principal diagnosis: females 52 and males 37; additional diagnosis: females 1,076 and males 947). Up to 80% of those who had the principal diagnosis pressure ulcer had ulcers grade 3 and 4, whereas 60% of the pressure ulcers documented as additional diagnosis were grade 1 and 2 (p < 0.001). The most frequent localizations of pressure ulcers were the ischium, the sacrum and the heel. In patients <65 years of age with the principal diagnosis pressure ulcer, the mortality rate is <0.1%. In the older age groups it increases gradually up to 10% in the 8th decade of life. Pressure ulcers are still a relevant problem in Germany. Although patients 65 years and older are at the highest risk, all age groups are affected. Younger people seem to struggle with different problems compared to older people.
 
Article
Background: As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. Objectives: The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. Methods: Data were obtained from the multicenter 'Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. Results: Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. Conclusion: These findings strengthened the idea of an association other than by chance of diseases in the elderly population.
 
Article
Mice were standardized to 12 h of light exposure alternating with 12 h of darkness and were fed ad libitum. The mice in the first group were 8 weeks old and in the other 104-116 weeks old. Subgroups of 7 animals from each age group were killed at 6 circadian stages. Enzyme activities of 23 enzymes from liver or brain were measured by an analysis of variance for each age group. All but 1 enzyme from young mice, and all but 9 from older mice showed significant changes over time (p less than 0.01). The data from the 22 enzymes from young mice and the 14 enzymes from old mice were fit to the cosinor regression model to further characterize the rhythm. 15 enzymes from the young and 8 from the aged mice showed a significant regression to a 24-hour cosine curve (p less than 0.01); of the 8, 7 were the same enzymes in both groups. Amplitude changes, where they could be compared from the cosinor data (7 enzymes), were not statistically different. When total variance was compared, 12 enzymes showed unequal variance. Of these, old mice had the larger variance in 9 enzymes. Another difference between the young and the old was changes in mean enzyme activities. 12 enzymes from aged mice had decreased mesors, 2 had increased mesors, and 9 were unchanged. In general, our data suggest that some enzyme activity rhythms were lost, others were altered and a few were not affected by aging. In the case of many enzymes, older mice have a diminished ability to synchronize to the light signals.
 
Article
This review highlights the need to optimize 5-HT3-receptor-antagonist-based antiemetic therapy for elderly cancer patients, particularly during the first 24 h after receiving chemotherapy, based on knowledge of the chemotherapeutic regimen, comorbidity, polypharmacy, dosing convenience and age-related health. The proportion of elderly people (over 65 years of age) in the general population is increasing. Compared with the general population, elderly people have a greater risk of serious diseases, such as cancer and cardiovascular disease. Their chemotherapy can be compromised by factors including comorbidity, declining organ function, polypharmacy, drug-drug interactions and cognitive impairments. The use of aprepitant in this elderly population with many concomitant medications is not discussed. Many chemotherapeutic regimens are highly emetogenic, and nausea and vomiting are rated among the most distressing side effects of chemotherapy. The emetogenic potential of various chemotherapy regimens is reviewed, demonstrating clear differences in severity and time of symptom onset. Such differences are particularly important during the first 24 h after administration, when control of emetic symptoms can help to prevent the occurrence of subsequent episodes. The matter is further complicated by inter-patient differences in susceptibility to nausea and vomiting resulting from multiple factors including gender, age and alcohol intake. Individual patient evaluation is essential to identify those patients most at risk. Elderly patients may also be particularly sensitive to the serious physiological and physical effects of nausea and vomiting. Education about symptom management needs to recognize specific learning barriers in the elderly, such as declining sensory perception or cognitive impairment. 5-HT3-receptor antagonists have long been the gold standard for treating chemotherapy-induced nausea and vomiting. Pharmacological differences between 5-HT3-receptor antagonists suggest the need for careful consideration of individual patient characteristics. Selection of the most appropriate agent will optimize antiemetic therapy for elderly cancer patients. Chemotherapy-induced emesis in elderly cancer patients needs optimal control by a 5-HT3-receptor antagonist with uncomplicated 24-hour efficacy and good tolerability. Choosing a 5-HT3-receptor antagonist with a long duration of action, low risk of drug-drug interactions and once-daily dosing is important to ensure effective prophylaxis against nausea and vomiting in the elderly and simplify management for patients with cognitive impairment, declining organ function and comorbidity.
 
Article
A chronobiological study was carried out in 10 elderly male subjects (78-83 years) to evaluate the 24-hour thyroid-stimulating hormone (TSH) secretory pattern. 10 young adult males (26-35 years) made up the control group. Hourly blood samples were drawn from each subject for a 24-hour period. TSH levels in elderly subjects showed blunted circadian fluctuations compared to those seen in young adult subjects. Mean 24-hour TSH values in elderly (3.1 +/- 0.3 microU/ml) and young adult subjects (3.5 +/- 0.1 microU/ml) did not differ statistically, but nighttime TSH values observed in elderly subjects (3.2 +/- 0.3 microU/ml) were lower (p less than 0.05) than those recorded in young adults (4.1 +/- 0.1 microU/ml).
 
Article
Mechanism of lysosomal storage of mitochondrial ATP synthase subunit c in late infantile form of NCL was studied. Morphological and biochemical examinations with patient fibroblasts showed that subunit c, not other mitochondrial proteins was specifically localized in lysosomes. The biosynthetic rate of subunit c and mRNA levels for P1 and P2 genes that code for it were almost the same in both control and patient cells. Measurement of labeled subunit c in mitochondrial and lysosomal fractions showed a specific delay of degradation of subunit c in patient cells with late infantile form of NCL and lysosomal transfer of radioactive mitochondrial subunit c after chase for 1-2 weeks, suggesting that subunit c is transfered to lysosomes through an autophagic process and accumulated as a consequence of abnormal catabolism in lysosomes.
 
Article
Reference values are usually defined based on blood samples from healthy men or nonpregnant women in the age range of 20-50 years. These values are not optimal for elderly patients, as many biological markers change over time and adequate reference values are important for correct clinical decisions. To validate NORIP (Nordic Reference Interval Project) reference values in a 70-year-old population. We studied 27 frequently used laboratory tests. The 2.5th and 97.5th percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry on the statistical treatment of reference values. Reference values are reported for plasma alanine aminotransferase, albumin, alkaline phosphatase, pancreas amylase, apolipoprotein A1, apolipoprotein B, aspartate aminotransferase, bilirubin, calcium, chloride, cholesterol, creatinine, creatine kinase, C-reactive protein, glucose, gamma-glutamyltransferase, HDL-cholesterol, iron, lactate dehydrogenase, LDL-cholesterol, magnesium, phosphate, potassium, sodium, transferrin, triglycerides, urate and urea. Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% CI of a Scandinavian population (NORIP).
 
Infarct volume as mean B SEM. ** p ! 0.01, * p ! 0.05 versus the 24 h after MCAO. 
Comparison of mean B SEM ipsilateral and contalateral hemisphere areas. Values 1 1 indicate enlarged, values ! 1 indicate reduced ipsilateral hemisphere. ** p ! 0.01 versus the 24 h after MCAO. 
Cumulative mortality rate in different recovery time peri- ods for young and old MCAO rats 
Article
Despite the impressive increased understanding of the ischemic brain damage in general, the study of effects on different age groups, young versus old, using comparable ischemic insults is clearly lacking. To investigate the mortality rate and neurological outcome among young and old rats, through a model of cerebral ischemia by middle cerebral artery occlusion (MCAO). Twenty-three old (22-24 months of age) and 16 young (3-4 months of age) male rats underwent a MCAO procedure for 60 min. Surviving rats were randomly assigned to the 24-hour or 28-day resting group. The mortality rate and neurological outcome in different recovery time periods were determined for comparison between the young and old rats. The overall mortality rate in old rats (43.5%) was significantly higher than that of the young rats (6.3%) (p = 0.01). The infarct volume for the 24-hour post-MCAO was 181.86 +/- 11.87 mm(3) for the young rats, and 204.64 +/- 27.18 mm(3) for the old rats. For the 28-day post-MCAO, the value was 91.16 +/- 3.59 mm(3) for the young rats, and 103.38 +/- 26.43 mm(3) for the old rats. A significant reduction in infarct volume is noted in both young (p < 0.01) and old (p < 0.05) rats after 28 days of recovery compared to that after 24 h of recovery. There was no meaningful difference in infarct volume between the young and old rats measured at 24 h or 28 days after the ischemic procedure. The right volume was larger than the left volume at 24 h post-MCAO for both the young and the old rats, whereas the quotient approached unity for the young rats at 28 days post-MCAO. For the old rats, the quotient was negative at 28 days post-MCAO, representing the ipsilateral hemisphere was smaller than the contralateral hemisphere. The mortality risk to ischemic damage is greater for old rats. If an old rat survives the high-risk mortality in a short period after the MCAO procedure, the recovery would be of no difference to that of a young rat.
 
Article
Event-related potentials particularly the P3 component have been noted to be abnormal in illnesses affecting cognitive processes, such as dementia. The relationship between the P3 latency and objective tests of mental function in patients with Alzheimer's disease and vascular dementia has been studied. A significant correlation was demonstrated between P3 latency and automated psychometric tests in patients with Alzheimer's disease.
 
Article
Background: Hearing impairment (HI) is a very common condition in elderly people and the epidemiology together with hearing-related problems is still poorly investigated. Moreover, the cognitive status may be impaired in relation to hearing function. Objective: The goal of the study was to evaluate: (a) the prevalence of HI in a random sample of elderly people aged 65 and over (n = 1,750) living in Campania, a region of southern Italy; (b) the cross-sectional relationship between hearing function and cognitive status and also depressive symptomatology and disability, and (c) to assess the role of hearing aids on depressive symptomatology. Methods: Cross-sectional study on a random sample of elderly population. Results: The overall participation rate in the study was 74.8% (n = 1,332, mean age was 74.2 +/- 6.4 years). The prevalence rate of HI (evaluated by questionnaire) was 27.2%, cognitive impairment prevalence (evaluated by the Mini-Mental State Examination (MMSE)) was 27.9%, mean depressive symptomatology score (evaluated by Geriatric Depression Scale (GDS)) was 11.4 +/- 6.6, while disability assessed by Activity of Daily Living (ADL) was present in 7.0% of the whole population. A strong relationship was found between both decreasing hearing function and MMSE decline, independently by the effect of age and education (r = 0.97; p < 0.01). A positive relationship (r = 0.85; p < 0.01) between GDS score and hearing function was also found. Moreover, at an increased level of hearing loss, a lower ADL score was recorded (r = 0.98; p < 0.01). Finally, the use of hearing aids reduced GDS score. In logistic regression analysis, gender, age and educational level indicate that hearing loss risk increased with age (odds ratio 1.60; 95% confidence interval 1.53-1.71), whereas education plays a protective role (odds ratio 0.75; 95% confidence interval 0.72-0.80). Conclusion: HI is very prevalent among elderly people and is associated with either cognitive impairment and/or depression and reduction of functional status. This study suggests that hearing aids may protect against cognitive impairment and disability, improving quality of life of aged people. Copyrightz1999S.KargerAG,Basel
 
Article
The purpose of this study was to determine whether the major thiol-disulfide oxidoreductase activities of the rat liver were altered as a consequence of aging, and whether the alterations had any consequences in terms of hepatic thiol concentrations. Liver fractions were prepared from male and female Fischer 344 rats at ages representing young adulthood (5 months), middle age (15 months) and old age (24-29 months), and the activities of the major thiol-disulfide exchange enzymes, together with protein and nonprotein sulfhydryl contents, were measured using spectrophotometric procedures. Thioltransferase, protein disulfide isomerase and thioredoxin reductase activities in livers of male and female rats were unchanged with aging, while glutathione disulfide (GSSG) reductase activity remained the same (in male livers) or increased (in female livers) as a consequence of aging. Both protein and nonprotein sulfhydryl concentrations were well maintained in old age. The absence of age-dependent alterations in the thiol-protein disulfide exchange enzymes and the lack of compromise in the glutathione GSSG reductase system suggest that aged livers retain their capacity to regulate their thiol-disulfide redox balance under normal physiological conditions.
 
Article
The major aim of the present study was to examine cardiovascular tissues and to determine if norepinephrine (NE) stores declined in aged (22-30 months old) male Fischer 344 (F344) rats. NE content was measured by HPLC in the whole heart, ventricle, atria, caudal artery, renal arteries, portal vein and kidney. The release of [3H]NE from the caudal artery of adult and aged rats was assessed as a functional index of sympathetic innervation. Renal alpha 2-adrenergic binding sites were also determined using 2.0 nM [3H]rauwolscine. In general, total NE content per organ was not altered in aged rats. The exception was the ventricle of aged rats which exhibited a 25% decrease in NE content. In contrast, NE content per gram of tissue weight was significantly decreased in the whole heart, atria, ventricle, kidney and caudal artery of aged rats when compared to that of adults (6-8 months old). Neither basal nor potassium-stimulated NE release was altered in the caudal artery of aged rats. Presynaptic regulation of NE release by taurine and alpha 2-adrenoceptors was also not affected by age. Renal alpha 2-adrenergic binding sites were decreased 23% in aged rats. Tissue growth that occurs as a function of aging does not appear to receive a concomitant increase in sympathetic growth as indexed by NE content. The findings of the present study would lead to the conclusion that with the exception of the ventricle, sympathetic nerve terminals of the aged male F344 rat are relatively intact.
 
Article
(Na+-K+)-ATPase is an enzyme responsible for ionic homeostasis in excitable tissues. Thus, the activity of this enzyme is essential for the maintenance of optimal function of the cerebral cortex. Although abnormalities of cerebral oxidative metabolism have been described in aging, these abnormalities do not appear to be associated with changes in the in vitro enzyme characteristics of (Na+-K+)-ATPase. Specifically, there were no significant differences between preparations from the cerebral cortex of 3- and 28-month-old Fischer-344 rats in their: (i) high-affinity binding to [3H]-ouabain, (ii) number of ouabain-binding sites, or (iii) K+-p-nitrophenylphosphatase activity.
 
Article
The effect of aging on vasopressin (VP) clearance was studied in male Fischer 344 rats 2 (young), 12 (adult) and 30 (old) months of age using in situ liver perfusion technique. The liver was perfused with Krebs-Henseleit bicarbonate buffer containing 1% bovine serum albumin and VP (2 ng/ml), at a constant temperature of 37 +/- 0.5 degrees C and a flow rate of 150 ml/h for 120 min. Expressed per whole liver and per gram tissue, VP declined exponentially over the studied period fitting well to the curve y = bekx (p = 0.0001) in all three groups. The analysis of covariance revealed the slope of the VP decay curve to be steepest in old rats, significantly different from that of young (p = 0.0001 expressed per whole liver or per gram tissue) and adult (p = 0.0001 and p = 0.001, expressed per whole liver and per gram tissue, respectively) rats. This suggests that, at least in male Fischer 344 rats, the hepatic clearance of VP was fastest in old rats.
 
Top-cited authors
Reto W. Kressig
  • Felix Platter Hospital
Urs Granacher
  • University of Freiburg
Thomas Muehlbauer
  • University of Duisburg-Essen
Bijan Najafi
  • Baylor College of Medicine
Michael Schwenk
  • Universität Heidelberg