Moatassem Salah Amer’s research while affiliated with Ain Shams University and other places

PurposeThe underlying pathology for cognitive decline in diabetic patients is uncertain. It was originally linked to vascular causes; however, possible contribution of Alzheimer’s pathology was debated. This study explored the link between salivary amyloid β42 level (as a surrogate marker for Alzheimer’s pathology) and mild cognitive impairment (MCI) among old diabetic patients.MethodsA case–control study included 90 diabetic participants, ≥ 60 years of age, divided into 45 cases with MCI and 45 controls. Patients with history of head trauma, any central nervous system pathology, depression, dementia or delirium, those who received anticholinergic drugs, or refused to participate in the study were excluded. Assessment of the relationship between salivary Aβ42 level and neuropsychological performance was done using a battery consisting of the logical memory test, forward and backward digit span tests, category fluency test, go/no go test, stick design test, and second-order belief.ResultsSalivary Aβ42 levels were higher in MCI diabetics versus controls (P = 0.014), it predicted MCI among aged diabetics, even after adjustment for confounding vascular risk factors. Salivary Aβ42 had moderate accuracy to identify MCI (area under curve = 0.654, P = 0.008). At cut-off ≥ 47.5 pg/ml, sensitivity, specificity, positive predictive value and negative predictive value were 80%, 47%, 60% and 70%, respectively.Conclusion Current data support that MCI in diabetics, without CNS disorders, is associated with a surrogate marker of Alzheimer’s pathology.

ABSTRACT Background: frailty is defined as a multifactorial syndrome leading to difficulties in maintaining homeostasis, and vulnerability to stressors. Depression shares many manifestations, risk factors and consequences with frailty. Some studies included cognitive assessment as a component to evaluate frailty. Aim of the work: this study aimed to assess depression and cognition in frail elderly and to assess if depression could be underlying link between cognitive function and frailty. Patients and methods: this case control study included 102 males and females elderly living in geriatric homes in Cairo and excluded those who were bedridden or had sensory impairment interfering with communication, stroke, Parkinsonism, severe osteoarthritis, or dyspnea on ordinary exertion. All patients were subjected to comprehensive geriatric assessment. Frailty was diagnosed using a modified version of Fried criteria. We used the physical activity metric that was constructed by Avila-Funes. Conclusion: this study showed that cognitive impairment and depression did not differ between frail and non-frail subjects.

Background: Frailty as well as atherosclerotic diseases are commonly prevalent among elderly subjects and usually share both complex pathway and risk factors. Hence it was important to study if there is an association between frailty and risk factors of atherosclerosisat its early stages (subclinical atherosclerosis) using the Ankle Brachial Index (ABI), carotid intima media thickness (CIMT) and Abdominal Aortic Diameter (AAD) as markers of subclinical atherosclerosis. Material and Methods: A cross-sectional study conducted on 90 elderly participants (60-year-old and above), free of cardiovascular symptoms. They were dividedaccording to modified Fried criteria into: non-frail, pre-frail and frail groupsand they were subjected to comprehensive geriatric assessment, calculation of ABI, and radiological investigations including: carotid duplex to measure CIMT and abdominal ultrasound to measure AAD. Results: The study showed that frail participants had lower mean ABI value than non-frail group. Frail and pre-frail participants had higher maximum CIMT values than non-frail group. The mean AAD increased from 19.88 mm in the non-frail to 20.40 mm in the pre-frail group and 21.17 mm in the frail group, but this difference still not reaching a statistical significance. Conclusion: The study concluded that frailty is associated with subclinical atherosclerosis.

Background: Thickening of arterial wall is an early indicator of atherosclerosis which is mostly a poly vascular disease. Thickened carotid intima media thickness is now well accepted as a surrogate marker for cardiovascular, cerebrovascular, and peripheral vascular affection. Some data exists regarding the relationship between intima media thickness of the common femoral artery as a predictor of different vascular beds atherosclerosis. .Aim: To evaluate the ability of common femoral artery intima media thickness to predict subclinical peripheral arterial disease in elderly patients with type 2 diabetes mellitus. Methods: 60 elderly subjects with type 2 diabetes were examined for the presence of asymptomatic PAD. All were assessed by measuring Common Femoral Artery Intima Media Thickness CFA IMT, ankle brachial index (ABI). Results: The patients with reduced ABI (N=9) had greater CFA-IMT than those without (N=51). The correlation between CFA-IMT and ABI was highly significant. CFA IMT≥ 8.5 mm had an area under the curve of 0.962 (95% CI; 0.917- 1.007, p = 0.000*) for predicting subclinical PAD in patients with type 2 diabetes. Conclusions: This data suggests that thickened CFA IMT is a significant predictor of asymptomatic PAD in patients with type 2 diabetes

Aims: To study the levels of magnesium (Mg), zinc (Zn), copper (Cu) and high-sensitivity C-reactive protein (hs-CRP) in elderly diabetics versus controls and their influence upon the relationship between Bone Mineral Density (BMD) and type 2 diabetes mellitus (DM). Materials and methods: A case control study (50 diabetic patients and 50 non-diabetic participants) was conducted among elderly, aged ≥ 60 years, recruited from geriatric outpatient clinic in Ain Shams University Hospital. Patients were subjected to comprehensive geriatric evaluation followed by assessment of BMD by dual energy x-ray absorptiometry in femoral neck and lumbar spine, and T score recording. Zn, Cu, Mg and hs-CRP blood levels were measured for all participants. Results: Diabetic patients had significantly lower values of Zn and Mg and higher values of Cu and hs-CRP than non diabetics (P < 0.001 for all parameters). In the studied group, type 2 DM is not alone a risk factor for osteoporosis and low Mg level is a significant predictor of the lumbar spine T score (P= 0.023) rather than the femoral neck one (P= 0.51), after adjusting for other covariates. Conclusion: Diabetics have lower Zn and Mg and higher Cu and hs-CRP levels than non diabetics. In elderly low Mg is a significant predictor of low BMD only in the lumbar spine, and standalone type 2 DM can't be considered as a risk factor for osteoporosis.