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Old 13-12-2016, 03:11 AM   #201
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Default A Non Linear Scoring Approach for Evaluating Balance: Classification of Elderly as Fallers and Non-Fallers

http://journals.plos.org/plosone/art...l.pone.0167456

Abstract

Quote:
Almost one third of population 65 years-old and older faces at least one fall per year. An accurate evaluation of the risk of fall through simple and easy-to-use measurements is an important issue in current clinic. A common way to evaluate balance in posturography is through the recording of the centre-of-pressure (CoP) displacement (statokinesigram) with force platforms. A variety of indices have been proposed to differentiate fallers from non fallers. However, no agreement has been reached whether these analyses alone can explain sufficiently the complex synergies of postural control. In this work, we study the statokinesigrams of 84 elderly subjects (80.3+− 6.4 years old), which had no impairment related to balance control. Each subject was recorded 25 seconds with eyes open and 25 seconds with eyes closed and information pertaining to the presence of problems of balance, such as fall, in the last six months, was collected. Five descriptors of the statokinesigrams were computed for each record, and a Ranking Forest algorithm was used to combine those features in order to evaluate each subject’s balance with a score. A classical train-test split approach was used to evaluate the performance of the method through ROC analysis. ROC analysis showed that the performance of each descriptor separately was close to a random classifier (AUC between 0.49 and 0.54). On the other hand, the score obtained by our method reached an AUC of 0.75 on the test set, consistent over multiple train-test split. This non linear multi-dimensional approach seems appropriate in evaluating complex postural control.
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Old 13-12-2016, 11:04 PM   #202
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Default Nutrition Linked to Intelligence and Brain Health in Older People

http://neurosciencenews.com/nutritio...lligence-5737/

Quote:
A study of older adults links consumption of a pigment found in leafy greens to the preservation of “crystallized intelligence,” the ability to use the skills and knowledge one has acquired over a lifetime.
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Old 16-12-2016, 01:18 AM   #203
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Default The Rim and the Ancient Mariner: The Nautical Horizon Affects Postural Sway in Older Adults

http://journals.plos.org/plosone/art...l.pone.0166900

Abstract

Quote:
On land, the spatial magnitude of postural sway (i.e., the amount of sway) tends to be greater when participants look at the horizon than when they look at nearby targets. By contrast, on ships at sea, the spatial magnitude of postural sway in young adults has been greater when looking at nearby targets and less when looking at the horizon. Healthy aging is associated with changes in the movement patterns of the standing body sway, and these changes typically are interpreted in terms of age-related declines in the ability to control posture. To further elucidate the mechanisms associated with these changes we investigated control of posture in a setting that poses substantial postural challenges; standing on a ship at sea. In particular, we explored postural sway on a ship at sea when older adults looked at the horizon or at nearby targets. We evaluated the kinematics of the center of pressure in terms of spatial magnitude (i.e., the amount of sway) and multifractality (a measure of temporal dynamics). We found that looking at the horizon significantly affected the multifractality of standing body, but did not systematically influence the spatial magnitude of sway. We discuss the results in terms of age-related changes in the perception and control of dynamic body orientation.
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Old 16-12-2016, 01:22 AM   #204
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Default Frequent Use of Emergency Departments by the Elderly Population When Continuing Care Is Not Well Established

http://journals.plos.org/plosone/art...l.pone.0165939

Abstract

Quote:
Introduction

The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with “elderly frequent users”.

Material and Methods

A retrospective study was performed during the calendar year 2014 (1st January 2014 – 31st December 2014) analyzing all ED admissions to the University Hospital of Rome Tor Vergata. Variables collected included age, triage code, arrival data, discharge diagnosis, and visit outcome. We performed a risk analysis using univariate binary logistic regression models.

Results

A total number of 38,016 patients accessed the ED, generating 46,820 accesses during the study period, with an average of 1.23 accesses for patient. The elderly population represented a quarter of the total ED population and had an increased risk of frequent use (OR 1.5: CI 1.4–1.7) and hospitalization (OR 3.8: CI 3.7–4). Moreover, they showed a greater diagnostic complexity, as demonstrated by the higher incidence of yellow and red priority codes compared to other ED populations (OR 3.1: CI 2.9–3.2).

Discussion

Older patients presented clinical and social characteristics related to the definition of “elderly frail frequent users”. The fact that a larger number of hospitalizations occurred in such patients is indirect evidence of frailty in this specific population, suggesting that hospital admissions may be an inappropriate response to frailty, especially when continued care is not established.

Conclusion

Enhancement of continuity of care, establishment of a tracking system for those who are at greater risk of visiting the ED and evaluating fragile individuals should be the highest priority in addressing ED frequent usage by the elderly.
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Old 18-12-2016, 12:27 AM   #205
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Default Falls without a cause: Understanding risk factors for unexplained falls in older people

https://motorimpairment.neura.edu.au...-older-people/

Quote:
While older people most often fall because of a slip, trip or loss of balance, up to 25% of falls remain unexplained (Anpalahan & Gibson, 2012; Davies & Kenny, 1996; Lord et al., 1993). People who have had unexplained falls report having fallen because of a blackout, dizziness, feeling faint or “having found themselves suddenly on the ground”. Currently, knowledge regarding risk factors and effective prevention interventions for unexplained falls experienced by older people living in the community is uncertain. This is because studies to date have involved participants who were primarily attendees of hospital clinics specifically designed to investigate cardiovascular causes of falls. We therefore undertook a study in 529 older community-living men and women to examine the occurrence of unexplained falls and their potential causes across a broad range of putative demographic, physical, medical, physiological and psychological factors.


Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: A qualitative study

http://journals.plos.org/plosone/art...l.pone.0177530

Abstract

Quote:
Objective

To explore the perceptions of older people with mild dementia and mild cognitive impairment, and their family carers, about falling, falls risk and the acceptability of falls prevention interventions.

Design

Qualitative study involving thematic analysis of semi-structured interviews with patient and relative dyads.

Participants and setting

20 patient/ relative dyads recruited from Memory Assessment Services and Falls Prevention Services in the United Kingdom.

Results

The findings are presented under four key themes: attitudes to falls, attitudes to falls prevention interventions, barriers and facilitators, and the role of relatives. Participants’ attitudes to falls interventions were varied and sometimes conflicting. Some worried about falls, but many resisted identifying themselves as potential ‘fallers’, even despite having fallen, and rejected the idea of needing the help that structured interventions signify. Participants preferred to focus on coping in the present rather than anticipating, and preparing for, an uncertain future. Falls prevention interventions were acknowledged to be valuable in principle and if required in the future but often felt to be not necessary or appropriate at present.

Conclusions

This study of how persons with cognitive impairment, and their relatives, view falls risk and prevention mirror findings relating to the wider population of older persons without dementia. Participants did not generally see falls prevention interventions as currently relevant to themselves. The challenge for clinicians is how to present interventions with understanding and respect for the older person’s identity. They must identify and address goals that patients and relatives value. Simplistic or paternalistic approaches will likely fail. Individualised interventions which focus on maintaining independence and preserving quality of life are more likely to be acceptable by supporting a positive self-image for patients and their relatives.

Update 20/05/2017




Gait dynamics to optimize fall risk assessment in geriatric patients admitted to an outpatient diagnostic clinic

http://journals.plos.org/plosone/art...l.pone.0178615

Abstract

Quote:
Fall prediction in geriatric patients remains challenging because the increased fall risk involves multiple, interrelated factors caused by natural aging and/or pathology. Therefore, we used a multi-factorial statistical approach to model categories of modifiable fall risk factors among geriatric patients to identify fallers with highest sensitivity and specificity with a focus on gait performance. Patients (n = 61, age = 79; 41% fallers) underwent extensive screening in three categories: (1) patient characteristics (e.g., handgrip strength, medication use, osteoporosis-related factors) (2) cognitive function (global cognition, memory, executive function), and (3) gait performance (speed-related and dynamic outcomes assessed by tri-axial trunk accelerometry). Falls were registered prospectively (mean follow-up 8.6 months) and one year retrospectively. Principal Component Analysis (PCA) on 11 gait variables was performed to determine underlying gait properties. Three fall-classification models were then built using Partial Least Squares–Discriminant Analysis (PLS-DA), with separate and combined analyses of the fall risk factors. PCA identified ‘pace’, ‘variability’, and ‘coordination’ as key properties of gait. The best PLS-DA model produced a fall classification accuracy of AUC = 0.93. The specificity of the model using patient characteristics was 60% but reached 80% when cognitive and gait outcomes were added. The inclusion of cognition and gait dynamics in fall classification models reduced misclassification. We therefore recommend assessing geriatric patients’ fall risk using a multi-factorial approach that incorporates patient characteristics, cognition, and gait dynamics.
Update 03/06/2017
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Old 22-12-2016, 11:48 PM   #206
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Default For geriatric falls, 'brain speed' may matter more than lower limb strength

https://www.sciencedaily.com/release...1221090359.htm

Quote:
It's not only risk factors like lower limb strength and precise perception of the limb's position that determine if a geriatric patient will recover from a perturbation, but also complex and simple reaction times, say researchers.
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Old 24-12-2016, 10:37 AM   #207
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Default Supercharged Sprouts Vitamin Inspiration for New Alzheimer’s Drug Research

http://neurosciencenews.com/vitamin-...zheimers-5809/



A supercharged version of the acid derived from our Christmas dinner veg is the basis of new research aimed at developing a new drug to treat Alzheimer’s disease.

Quote:
Experts at the University of Aberdeen are working on a synthetic version of the beneficial acid created from vitamin A – a vitamin your body can get from eating a number of vegetables, including carrots and sprouts – which they hope may be used to treat neurological disorders.

In the body vitamin A is turned Into retinoic acid, which then interacts with specific receptors in the brain and plays a role in the development of the human central nervous system. It is particularly important for the eye and brain as the embryo is developing.

In the adult brain it is thought retinoic acid plays a different, more ‘focussed’ role and there are suggestions it could affect neural disorders, both degenerative and psychiatric.

Now, University of Aberdeen experts, in conjunction with the University of Durham and chemical development company High Force Research are set to begin a new two year, £250,000 project funded by the Biotechnology and Biological Sciences Research Council (BBSRC).

The researchers have designed synthetic versions of retinoic acid that interact with the body’s natural receptors in the brain in an even more powerful way than regular retinoic acid.
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Old 25-12-2016, 12:23 AM   #208
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Default Modular Brain Network Organization Predicts Response to Cognitive Training in Older Adults

http://journals.plos.org/plosone/art...l.pone.0169015

Quote:
Cognitive training interventions are a promising approach to mitigate cognitive deficits common in aging and, ultimately, to improve functioning in older adults. Baseline neural factors, such as properties of brain networks, may predict training outcomes and can be used to improve the effectiveness of interventions. Here, we investigated the relationship between baseline brain network modularity, a measure of the segregation of brain sub-networks, and training-related gains in cognition in older adults. We found that older adults with more segregated brain sub-networks (i.e., more modular networks) at baseline exhibited greater training improvements in the ability to synthesize complex information. Further, the relationship between modularity and training-related gains was more pronounced in sub-networks mediating “associative” functions compared with those involved in sensory-motor processing. These results suggest that assessments of brain networks can be used as a biomarker to guide the implementation of cognitive interventions and improve outcomes across individuals. More broadly, these findings also suggest that properties of brain networks may capture individual differences in learning and neuroplasticity.


Evidence for Narrow Transfer after Short-Term Cognitive Training in Older Adults

http://journal.frontiersin.org/artic...017.00041/full

Quote:
The degree to which “brain training” can improve general cognition, resulting in improved performance on tasks dissimilar from the trained tasks (transfer of training), is a controversial topic. Here, we tested the degree to which cognitive training, in the form of gamified training activities that have demonstrated some degree of success in the past, might result in broad transfer. Sixty older adults were randomly assigned to a gamified cognitive training intervention or to an active control condition that involved playing word and number puzzle games. Participants were provided with tablet computers and asked to engage in their assigned training for 30 45-min training sessions over the course of 1 month. Although intervention adherence was acceptable, little evidence for transfer was observed except for the performance of one task that most resembled the gamified cognitive training: There was a trend for greater improvement on a version of the corsi block tapping task for the cognitive training group relative to the control group. This task was very similar to one of the training games. Results suggest that participants were learning specific skills and strategies from game training that influenced their performance on a similar task. However, even this near-transfer effect was weak. Although the results were not positive with respect to broad transfer of training, longer duration studies with larger samples and the addition of a retention period are necessary before the benefit of this specific intervention can be ruled out.
Update 17/04/2017
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Old 04-01-2017, 01:35 PM   #209
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Default Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

http://journals.plos.org/plosone/art...l.pone.0168987

Abstract

Quote:
Background

Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions.

Methods and Findings

We conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients). Data were extracted from the electronic health records and reviewed. We identified 433 hospitalizations of patients with chronic pain and analyzed their combinations of chronic conditions (multimorbidity). We then classified all analgesic prescriptions according to the World Health Organization (WHO) analgesic ladder. Furthermore, we used a Swiss drug-drug interactions knowledge base to identify potential interactions between opioids and other drug classes, in particular coanalgesics and other concomitant drugs. Chronic pain was present in 38% of patients with multimorbidity. On average, patients with chronic pain were aged 65.7 years and had a mean number of 6.6 diagnoses. Hypertension was the most common chronic condition. Chronic back pain was the most common painful condition. Almost 90% of patients were exposed to polypharmacotherapy. Of the chronic pain patients, 71.1% received opioids for moderate to severe pain, 43.4% received coanalgesics. We identified 3,186 potential drug-drug interactions, with 17% classified between analgesics (without coanalgesics).

Conclusions

Analgesic drugs-related DDIs, in particular opioids, in multimorbid patients are often complex and difficult to assess by using DDI knowledge bases alone. Drug-multimorbidity interactions are not sufficiently investigated and understood. Today, the scientific literature is scarce for chronic pain in combination with multiple coexisting medical conditions and medication regimens. Our work may provide useful information to enable further investigations in multimorbidity research within the scope of potential interactions and chronic pain.
DDI = Drug Drug Interaction


It is significant.

If you are lucky as I once was to work with a genius physician who knows his drugs along with fully engaged co members of your multidisciplinary team, you can make a massive difference to outcomes and have fewer blocked beds.
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Old 05-01-2017, 12:24 AM   #210
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Default Mediterranean Diet May Have Lasting Effects on Brain Health

http://neurosciencenews.com/brain-he...ean-diet-5862/

Quote:
A new study shows that older people who followed a Mediterranean diet retained more brain volume over a three-year period than those who did not follow the diet as closely. The study is published in the January 4, 2017, online issue of Neurology. But contrary to earlier studies, eating more fish and less meat was not related to changes in the brain.
Quote:
Luciano noted that earlier studies looked at brain measurements at one point in time, whereas the current study followed people over time.

“In our study, eating habits were measured before brain volume was, which suggests that the diet may be able to provide long-term protection to the brain,” said Luciano. “Still, larger studies are needed to confirm these results.”
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Old 05-01-2017, 12:34 AM   #211
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Default Low serum 25-hydroxyvitamin D is associated with higher risk of frequent headache in middle-aged and older men

http://www.nature.com/articles/srep39697

Abstract
Quote:
Vitamin D has been suggested to have a role in various neurovascular diseases, but the data regarding headache is inconclusive. Our aim was to investigate the associations between serum 25-hydroxyvitamin D [25(OH)D], a marker for vitamin D status, and risk of frequent headache. The study population consisted of 2601 men from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) from eastern Finland, aged 42–60 years in 1984–1989. The cross-sectional associations with prevalence of self-reported frequent headache (defined as weekly or daily headaches) were estimated with multivariable-adjusted odds ratios. The average serum 25(OH) concentration was 43.4 nmol/L (SD 18.9, min-max 7.8–136.1 nmol/L). A total of 250 men (9.6%) reported frequent headache. The average serum 25(OH)D concentration among those with frequent headache was 38.3 nmol/L (SD 18.8) and 43.9 nmol/L (SD 18.9) among those without frequent headache, after adjustment for age and year and month of blood draw (P for difference <0.001). After multivariable adjustments, those in the lowest vs. the highest serum 25(OH)D quartile had 113% (95% CI 42, 218%; P for trend <0.001) higher odds for frequent headache. In conclusion, low serum 25(OH)D concentration was associated with markedly higher risk of frequent headache in men.
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Old 06-01-2017, 05:58 PM   #212
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Default The Association between Polypharmacy and Dementia: A Nested Case-Control Study Based on a 12-Year Longitudinal Cohort Database in South Korea

http://journals.plos.org/plosone/art...l.pone.0169463

Abstract

Quote:
Dementia is a major concern among growing chronic diseases in the aging society and its association with polypharmacy has not been adequately assessed. The objective of this study was to determine the association between polypharmacy and dementia through multiple statistical approaches. We conducted a nested case-control study for newly diagnosed dementia cases using the South Korean National Health Insurance Service sample cohort database (2002–2013, n = 1,025,340). Interactions between polypharmacy (an average use of ≥5 prescription drugs daily) and comorbidities or potentially inappropriate medications (PIMs) were tested. The odds ratios (ORs) for dementia were analyzed according to the presence of comorbidities, PIM uses, the average number of prescribed daily drugs, and significant interactions with polypharmacy using univariate and multiple logistic regression analyses. A higher prevalence of comorbidities, history of PIM use, higher PIM exposure, and higher proportion of polypharmacy were noted among cases than in controls. In the univariate analysis, the OR for dementia increased significantly with the increase in the number of prescribed drugs [1–<5 drugs: 1.72, 95% confidence interval (CI): 1.56–1.88; 5–<10 drugs: 2.64, 95% CI: 2.32–3.05; ≥10 drugs: 3.35, 95% CI: 2.38–4.71; <1 drug used as reference]. Polypharmacy was correlated with comorbidities and PIM use, and significant interactions were observed between polypharmacy and anticholinergics; H2-receptor antagonists; and comorbidities such as hypertension, peripheral or cerebrovascular disease, congestive heart failure, hemiplegia, diabetes, depression, all other mental disorders, chronic obstructive pulmonary disease, peptic ulcer disease, and chronic liver disease (p<0.001). In the multiple regression analysis, most cases exhibited increasing ORs for dementia with increasing polypharmacy levels. Moreover, the increase in OR was more evident in the absence of drugs or comorbidities that showed significant interactions with polypharmacy than in their presence. Polypharmacy increases the risk of PIM administration, and as some PIMs may have cognition-impairing effects, prolonged polypharmacy may result in dementia. Therefore, efforts are needed to limit or decrease the prescription of medications that have been associated with risk of dementia in the elderly.
See also post #227 on the bleachers thread and posts #75, 86, #199 and #200 on this thread.

Polypharmacy is a huge issue and insufficiently addressed. There is little point in rehab if our patients remain hobbled by poor prescribing.



Type 2 diabetes, depressive symptoms and trajectories of cognitive decline in a national sample of community-dwellers: A prospective cohort study

http://journals.plos.org/plosone/art...l.pone.0175827

Abstract

Quote:
We examined the individual and synergistic effects of type 2 diabetes and elevated depressive symptoms on memory and executive function trajectories over 10 and eight years of follow-up, respectively. Our sample comprised 10,524 community-dwellers aged ≥50 years in 2002–03 from the English Longitudinal Study of Ageing. With respect to memory (word recall), participants with either diabetes or elevated depressive symptoms recalled significantly fewer words compared with those free of these conditions (reference category), but more words compared with those with both conditions. There was a significant acceleration in the rate of memory decline in participants aged 50–64 years with both conditions (-0.27, 95% CI, -0.45 to -0.08, per study wave), which was not observed in those with either condition or aged ≥65 years. With respect to executive function (animal naming), participants aged ≥65 years with diabetes or those with elevated depressive symptoms named significantly fewer animals compared with the reference category, while those with both conditions named fewer animals compared with any other category. The rate of executive function decline was significantly greater in participants with both conditions (-0.54, 95% CI, -0.99 to -0.10; and –0.71, 95% CI, -1.16 to -0.27, per study wave, for those aged 50–64 and ≥65 years, respectively), but not in participants with either condition. Diabetes and elevated depressive symptoms are inversely associated with memory and executive function, but, individually, do not accelerate cognitive decline. The co-occurrence of diabetes and elevated depressive symptoms significantly accelerates cognitive decline over time, especially among those aged 50–64 years.
Update 18/04/2017
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Old 07-01-2017, 01:45 PM   #213
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Default Biomarker signatures of aging

http://onlinelibrary.wiley.com/doi/1...cel.12557/full

Summary

Quote:
Because people age differently, age is not a sufficient marker of susceptibility to disabilities, morbidities, and mortality. We measured nineteen blood biomarkers that include constituents of standard hematological measures, lipid biomarkers, and markers of inflammation and frailty in 4704 participants of the Long Life Family Study (LLFS), age range 30–110 years, and used an agglomerative algorithm to group LLFS participants into clusters thus yielding 26 different biomarker signatures. To test whether these signatures were associated with differences in biological aging, we correlated them with longitudinal changes in physiological functions and incident risk of cancer, cardiovascular disease, type 2 diabetes, and mortality using longitudinal data collected in the LLFS. Signature 2 was associated with significantly lower mortality, morbidity, and better physical function relative to the most common biomarker signature in LLFS, while nine other signatures were associated with less successful aging, characterized by higher risks for frailty, morbidity, and mortality. The predictive values of seven signatures were replicated in an independent data set from the Framingham Heart Study with comparable significant effects, and an additional three signatures showed consistent effects. This analysis shows that various biomarker signatures exist, and their significant associations with physical function, morbidity, and mortality suggest that these patterns represent differences in biological aging. The signatures show that dysregulation of a single biomarker can change with patterns of other biomarkers, and age-related changes of individual biomarkers alone do not necessarily indicate disease or functional decline.
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Old 10-01-2017, 10:41 PM   #214
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Default Couch Potatoes Face Same Chance of Dementia as Those With Genetic Risk Factors

http://neurosciencenews.com/dementia...laziness-5907/

Quote:
Sedentary older adults with no genetic risk factors for dementia may be just as likely to develop the disease as those who are genetically predisposed, according to a major study which followed more than 1,600 Canadians over five years.

The findings, published in the Journal of Alzheimer’s Disease, shed new light on the relationship between genes, lifestyle risk factors and dementia.
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Old 11-01-2017, 12:45 AM   #215
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Default Glia, Not Neurons, Most Affected By Brain Aging

http://neurosciencenews.com/glia-brain-aging-5902/

Quote:
The difference between an old brain and a young brain isn’t so much the number of neurons but the presence and function of supporting cells called glia. In Cell Reports on January 10, researchers who examined postmortem brain samples from 480 individuals ranging in age from 16 to 106 found that the state of someone’s glia is so consistent through the years that it can be used to predict someone’s age. The work lays the foundation to better understand glia’s role in late-in-life brain disease.




Major Shifts in Glial Regional Identity Are a Transcriptional Hallmark of Human Brain Aging

http://www.cell.com/cell-reports/ful...247(16)31684-9

Highlights
Quote:
•Understanding the role of cell-type-specific changes in human brain aging
•Glial-specific genes shift their regional expression patterns during aging
•Oligodendrocytes and neuronal subpopulations are decreased in the aging neocortex
•Microglia-specific genes globally increase their expression during aging
Summary
Quote:
Gene expression studies suggest that aging of the human brain is determined by a complex interplay of molecular events, although both its region- and cell-type-specific consequences remain poorly understood. Here, we extensively characterized aging-altered gene expression changes across ten human brain regions from 480 individuals ranging in age from 16 to 106 years. We show that astrocyte- and oligodendrocyte-specific genes, but not neuron-specific genes, shift their regional expression patterns upon aging, particularly in the hippocampus and substantia nigra, while the expression of microglia- and endothelial-specific genes increase in all brain regions. In line with these changes, high-resolution immunohistochemistry demonstrated decreased numbers of oligodendrocytes and of neuronal subpopulations in the aging brain cortex. Finally, glial-specific genes predict age with greater precision than neuron-specific genes, thus highlighting the need for greater mechanistic understanding of neuron-glia interactions in aging and late-life diseases.
Having watched the building go up over a number of years, this is the first paper I have seen from "The Crick" and it's a beauty! Imo
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Old 13-01-2017, 10:17 AM   #216
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Default Rural dementia: We need to talk

https://www.sciencedaily.com/release...0111091437.htm

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English research into the experience of dementia in farming and farming families, and its impact on their businesses and home lives, has identified four areas of concern which need to be addressed if dementia in the countryside is to be managed. It is the first time that research has addressed this issue in farming.
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Old 16-01-2017, 01:33 PM   #217
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Default A bold theory places infection at the root of Alzheimer’s, explaining why decades of treatment have done little good

https://aeon.co/essays/how-microbial...366a4-69418129

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In a 2015 meta-analysis of 25 published studies, researchers in Australia reported that people who have been infected by certain types of bacteria are 10 times more likely to develop Alzheimer’s disease; in March 2016, 33 international researchers co-signed an editorial in the Journal of Alzheimer’s Disease imploring others to seriously consider that Alzheimer’s could have an infectious cause.

Yet most scientists continue to dismiss the pathogen hypothesis as far-fetched – it’s an idea, they say, supported mainly by correlative studies involving a small number of brains. That might be true, but it’s worth also contemplating the hurdles that researchers face when investigating unorthodox ideas and the burden of proof that would be needed to convince naysayers. The technological limitations of brain research are immense – scientists can’t just go prodding around inside the brains of living people – and hunting for microbes there is even harder because so many pathogens hide inside cells and sometimes embed themselves in our genomes. Even when scientists identify robust ways to investigate the pathogen hypothesis, they don’t always get funded to perform the experiment; if they do, they then struggle to get their findings published. Moir’s 2016 paper, for instance, was rejected six times without review before finally being accepted. ‘It was brutal,’ he recalls.

Complicating the issue further, if a relationship between infections and Alzheimer’s does exist, it will almost certainly be complex and multifactorial – microbes might just be a first step in a long cascade of events involving genes, inflammation and other environmental factors, which makes the idea still harder to investigate and easier to misunderstand.


Lifestyle changes, not a magic pill, can reverse Alzheimer’s

Reverse is too strong a word. There is no reason why people with neurological disease and co morbidities can't function well if they are highly motivated.

Update 03/05/2017
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Old 16-01-2017, 03:19 PM   #218
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Default Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer’s disease

https://academic.oup.com/brain/artic...ssociated-with

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Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer’s disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer’s disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer’s disease were calculated using summary statistics from the largest Alzheimer’s disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer’s disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer’s disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer’s disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer’s disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer’s disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance in individuals at genetic risk for Alzheimer’s disease, with the caveat that the order of causal effects cannot be inferred from cross-sectional studies. These results underscore the importance of documenting head injuries even within the mild range as they may interact with genetic risk to produce negative long-term health consequences such as neurodegenerative disease.
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Old 16-01-2017, 08:12 PM   #219
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Default Measurement of Tip Apex Distance and Migration of Lag Screws and Novel Blade Screw Used for the Fixation of Intertrochanteric Fractures

http://journals.plos.org/plosone/art...l.pone.0170048

Abstract

Quote:
Fixation with a dynamic hip screw (DHS) is one of the most common methods for stabilizing intertrochanteric fractures, except for unstable and reverse oblique fracture types. However, failure is often observed in osteoporotic patients whereby the lag screw effectively ‘cuts out’ through the weak bone. Novel anti-migration blades have been developed to be used in combination with a lag screw (‘Blade Screw’) to improve the fixation strength in osteoporotic intertrochanteric fractures. An in-vitro biomechanical study and a retrospective clinical study were performed to evaluate lag screw migration when using the novel Blade Screw and a traditional threaded DHS. The biomechanical study showed both the Blade Screw and DHS displayed excessive migration (≥10 mm) before reaching 20,000 loading cycles in mild osteoporotic bone, but overall migration of the Blade Screw was significantly less (p ≤ 0.03). Among the patients implanted with a Blade Screw in the clinical study, there was no significant variation in screw migration at 3-months follow-up (P = 0.12). However, the patient’s implanted with a DHS did display significantly greater migration (P<0.001) than those implanted with the Blade Screw. In conclusion, the Blade Screw stabilizes the bone fragments during dynamic loading so as to provide significantly greater resistance to screw migration in patients with mild osteoporosis.
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Old 18-01-2017, 06:19 PM   #220
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Default Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis

http://journals.plos.org/plosone/art...l.pone.0169548

Abstract

Quote:
Objective

The purpose of this study was to perform a systematic review to assess the short-, middle- and long-term consequences of sarcopenia.

Methods

Prospective studies assessing the consequences of sarcopenia were searched across different electronic databases (MEDLINE, EMBASE, EBM Reviews, Cochrane Database of Systematic Reviews, EBM Reviews ACP Journal Club, EBM Reviews DARE and AMED). Only studies that used the definition of the European Working Group on Sarcopenia in Older People to diagnose sarcopenia were included. Study selection and data extraction were performed by two independent reviewers. For outcomes reported by three or more studies, a meta-analysis was performed. The study results are expressed as odds ratios (OR) with 95% CI.

Results

Of the 772 references identified through the database search, 17 were included in this systematic review. The number of participants in the included studies ranged from 99 to 6658, and the duration of follow-up varied from 3 months to 9.8 years. Eleven out of 12 studies assessed the impact of sarcopenia on mortality. The results showed a higher rate of mortality among sarcopenic subjects (pooled OR of 3.596 (95% CI 2.96–4.37)). The effect was higher in people aged 79 years or older compared with younger subjects (p = 0.02). Sarcopenia is also associated with functional decline (pooled OR of 6 studies 3.03 (95% CI 1.80–5.12)), a higher rate of falls (2/2 studies found a significant association) and a higher incidence of hospitalizations (1/1 study). The impact of sarcopenia on the incidence of fractures and the length of hospital stay was less clear (only 1/2 studies showed an association for both outcomes).

Conclusion

Sarcopenia is associated with several harmful outcomes, making this geriatric syndrome a real public health burden.
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Old 19-01-2017, 01:04 AM   #221
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Default Does Combined Physical and Cognitive Training Improve Dual-Task Balance and Gait Outcomes in Sedentary Older Adults?

http://journal.frontiersin.org/artic...016.00688/full

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Everyday activities like walking and talking can put an older adult at risk for a fall if they have difficulty dividing their attention between motor and cognitive tasks. Training studies have demonstrated that both cognitive and physical training regimens can improve motor and cognitive task performance. Few studies have examined the benefits of combined training (cognitive and physical) and whether or not this type of combined training would transfer to walking or balancing dual-tasks. This study examines the dual-task benefits of combined training in a sample of sedentary older adults. Seventy-two older adults (≥60 years) were randomly assigned to one of four training groups: Aerobic + Cognitive training (CT), Aerobic + Computer lessons (CL), Stretch + CT and Stretch + CL. It was expected that the Aerobic + CT group would demonstrate the largest benefits and that the active placebo control (Stretch + CL) would show the least benefits after training. Walking and standing balance were paired with an auditory n-back with two levels of difficulty (0- and 1-back). Dual-task walking and balance were assessed with: walk speed (m/s), cognitive accuracy (% correct) and several mediolateral sway measures for pre- to post-test improvements. All groups demonstrated improvements in walk speed from pre- (M = 1.33 m/s) to post-test (M = 1.42 m/s, p < 0.001) and in accuracy from pre- (M = 97.57%) to post-test (M = 98.57%, p = 0.005).They also increased their walk speed in the more difficult 1-back (M = 1.38 m/s) in comparison to the 0-back (M = 1.36 m/s, p < 0.001) but reduced their accuracy in the 1-back (M = 96.39%) in comparison to the 0-back (M = 99.92%, p < 0.001). Three out of the five mediolateral sway variables (Peak, SD, RMS) demonstrated significant reductions in sway from pre to post test (p-values < 0.05). With the exception of a group difference between Aerobic + CT and Stretch + CT in accuracy, there were no significant group differences after training. Results suggest that there can be dual-task benefits from training but that in this sedentary sample Aerobic + CT training was not more beneficial than other types of combined training.

Cognitive resources necessary for motor control in older adults are reduced by walking and coordination training
http://journal.frontiersin.org/artic...00156/abstract

Quote:
We examined if physical exercise interventions were effective to reduce cognitive brain resources recruited while performing motor control tasks in older adults. 43 older adults (63 to 79 years of age) participated in either a walking (n = 17) or a motor coordination (n = 15) intervention (1 year, 3 times per week) or were assigned to a control group (n = 11) doing relaxation and stretching exercises. Pre and post the intervention period, we applied functional MRI to assess brain activation during imagery of forward and backward walking and during counting backwards from 100 as control task. In both experimental groups, activation in the right dorsolateral prefrontal cortex (DLPFC) during imagery of forward walking decreased from pre- to post-test (Effect size: -1.55 and -1.16 for coordination and walking training, respectively; Cohen’s d). Regression analysis revealed a significant positive association between initial motor status and activation change in the right DLPFC (R² = .243, F(3,39) = 4.18, p=.012). Participants with lowest motor status at pretest profited most from the interventions. Data suggest that physical training in older adults is effective to free up cognitive resources otherwise needed for the control of locomotion. Training benefits may become particularly apparent in so-called dual-task situations where subjects must perform motor and cognitive tasks concurrently.
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Old 20-01-2017, 06:00 PM   #222
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Default A Pilot Randomized Controlled Trial of the Effects of Chair Yoga on Pain and Physical Function Among Community-Dwelling Older Adults With Lower Extremity Osteoarthritis

http://onlinelibrary.wiley.com/doi/1...14717/abstract

Abstract

Quote:
Objectives

To determine effects of Sit ‘N’ Fit Chair Yoga, compared to a Health Education program (HEP), on pain and physical function in older adults with lower extremity osteoarthritis (OA) who could not participate in standing exercise.
Design

Two-arm randomized controlled trial.
Setting

One HUD senior housing facility and one day senior center in south Florida.
Participants

Community-dwelling older adults (N = 131) were randomly assigned to chair yoga (n = 66) or HEP (n = 65). Thirteen dropped after assignment but prior to the intervention; six dropped during the intervention; 106 of 112 completed at least 12 of 16 sessions (95% retention rate).
Interventions

Participants attended either chair yoga or HEP. Both interventions consisted of twice-weekly 45-minute sessions for 8 weeks.
Measurements

Primary: pain, pain interference; secondary: balance, gait speed, fatigue, functional ability measured at baseline, after 4 weeks of intervention, at the end of the 8-week intervention, and post-intervention (1 and 3 months).
Results

The chair yoga group showed greater reduction in pain interference during the intervention (P = .01), sustained through 3 months (P = .022). WOMAC pain (P = .048), gait speed (P = .024), and fatigue (P = .037) were improved in the yoga group during the intervention (P = .048) but improvements were not sustained post intervention. Chair yoga had no effect on balance.
Conclusion

An 8-week chair yoga program was associated with reduction in pain, pain interference, and fatigue, and improvement in gait speed, but only the effects on pain interference were sustained 3 months post intervention. Chair yoga should be further explored as a nonpharmacologic intervention for older people with OA in the lower extremities.

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Old 20-01-2017, 09:56 PM   #223
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Default Evidence for Cognitive Aging in Midlife Women: Study of Women’s Health Across the Nation

http://journals.plos.org/plosone/art...l.pone.0169008

Abstract

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Although cross-sectional studies suggest that cognitive aging starts in midlife, few longitudinal studies have documented within-individual declines in cognitive performance before the seventh decade. Learning from repeat testing, or practice effects, can mask the decline in younger cohorts. In women, the menopause transition also affects test performance and can confound estimates of underlying decline. We designed this study to determine if, after controlling for practice effects, the menopause transition, and the symptoms associated with it, there is evidence of cognitive aging in midlife women. We used data from a longitudinal observational study in 2,124 participants from the Study of Women’s Health Across the Nation. Outcomes examined were scores on annual tests of processing speed, verbal episodic memory (immediate and delayed), and working memory. To reduce the impact of practice effects and of the menopause transition, we used the third cognition testing visit as the baseline. Average age at this baseline was 54 years, and the majority of the women were postmenopausal; half the cohort was 2 or more years beyond the final menstrual period. There were 7,185 cognition assessments with median follow-up time of 6.5 years. In mixed effects regression, adjusted for practice effects, retention, menopause symtoms (depressive, anxiety, vasomotor, and sleep disturbance), and covariates, scores on 2 of 4 cognition tests declined. Mean decline in cognitive speed was 0.28 per year (95% confidence interval [CI] 0.20 to 0.36) or 4.9% in 10 years, and mean decline in verbal episodic memory (delayed testing) was 0.02 per year (95% CI: 0.00 to 0.03) or 2% in 10 years. Our results provide strong, longitudinal evidence of cognitive aging in midlife women, with substantial within-woman declines in processing speed and memory. Further research is needed to identify factors that influence decline rates and to develop interventions that slow cognitive aging.
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Old 25-01-2017, 10:20 PM   #224
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Default Anna Lowe looks at the implications of people living and working longer, focusing on what it means for the physiotherapy profession.

http://www.csp.org.uk/blog/2017/01/2...-physiotherapy

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This blog post is heavily inspired by the book I’m reading: The 100-Year Life by Lynda Gratton and Andrew Scott. It is a fascinating exploration of what it means to live a longer life.

Life expectancy has risen steadily to the point that a baby born in 2007 has a 50 per cent chance of living to be 103.

The book is relevant to me from a personal perspective. Both my maternal and paternal grandmothers lived to be 99 so I was interested to read the authors' suggestions on how to plan for a longer life. This goes far beyond pension planning and considers the investments we should make in health, social networks and close relationships – acknowledging that these have been shown to be major players in happy lives.

From a professional perspective, it really brought home the reality of the change that is occurring. We all know that people are living longer but are not yet confronted with this on a daily basis – at least not yet. If the make-up of the population is changing, then there must be implications for physiotherapy.

If you live longer, you will probably work for a longer period longer too. While people will need to work for a longer span to finance a longer retirement, some might choose to do so to create challenge and meaning in retirement.

A longer retirement may not be sufficiently stimulating for many. If people are working longer then the working age population will grow. We should expect to see a higher incidence of the key issues that affect the health of people in this category.

Musculoskeletal problems account for 41 per cent of all cases of work-related ill health and the prevalence rate increases with age With a growing and ageing working population we can expect more demand for services to keep people well in employment.

We may well see more people working while managing long-term conditions and comorbidities, and, again, the rates increase with age. This may require a greater flexibility in employment options and more support to stay well at work. Physiotherapists should be central to this.

An increasing proportion of the physiotherapy workforce may focus on working with older people, we may see less specialisation and the rise of the generalist based on the broad skill set required to support a population with complex multimorbidities. All this has implications for the training and education of the current and future workforce.

In the same way that saving for pensions needs to start early, investing in our future health should do so too. If we are to live to 100, the way we spend our last 30 years will be heavily influenced by how we spend the first 70 years.

While some factors, such as gender and genetics, lie beyond our control there is much that we can influence. Modifiable health behaviours are thought to account for up to 40 per cent of our overall health (McGinnis 2002). It is interesting to reflect on how well our current practice equips patients to age successfully and how we might embed this more firmly into our interventions.

Thinking of everyone as a future centenarian has brought this into sharp focus for me.
Some of my patients continue to work into their 90s
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Old 27-01-2017, 01:18 AM   #225
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Default Combined Impact of Traditional and Non-Traditional Healthy Behaviors on Health-Related Quality of Life: A Prospective Study in Older Adults

http://journals.plos.org/plosone/art...l.pone.0170513

Abstract

Quote:
Combined exposure to several healthy behaviors (HB) is associated with reduced mortality in older adults but its impact on health-related quality of life (HRQL) is uncertain. This is a cohort study of 2,388 individuals aged ≥60 recruited in 2000–2001, whose data were updated in 2003 and 2009. At baseline, participants reported both traditional HB (non-smoking, being very or moderately active, healthy diet) and non-traditional HB (sleeping 7–8 h/d, being seated <8 h/d, and seeing friends every day). HRQL was measured with the SF-36 questionnaire at baseline, in 2003 (short-term) and in 2009 (long-term); a higher score on the SF-36 represents better HRQL. Linear regression models were used to assess the association between HB at baseline and HRQL in 2003 and 2009, with adjustment for the main confounders including baseline HRQL. In the short-term, being physically active, sleeping 7–8 h/d, and being seated <8 h/d was associated with better HRQL. Compared to having ≤1 of these HB, the β (95% confidence interval) for the score on the physical component summary of the SF-36 in 2003 was 1.42 (0.52–2.33) for 2 HB, and 2.06 (1.09–3.03) for 3 HB, p-trend <0.001. Corresponding figures for the mental component summary score were 1.89 (0.58–3.21) for 2 HB and 3.35 (1.95–4.76) for 3 HB, p-trend <0.001. Non-smoking, a healthy diet or seeing friends did not show an association with HRQL. In the long-term, being physically active was the only HB associated with better physical HRQL. As a conclusion, a greater number of HB, particularly more physical activity, adequate sleep duration, and sitting less, were associated with better short-term HRQL in older adults. However, in the long-term, being physically active was the only HB associated with better physical HRQL.
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Old 27-01-2017, 03:13 PM   #226
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Default Anti-inflammatory diet could reduce risk of bone loss in women

https://www.sciencedaily.com/release...0126124119.htm

Quote:
Researchers examined data from the landmark Women's Health Initiative to compare levels of inflammatory elements in the diet to bone mineral density and fractures and found new associations between food and bone health. The study, led by Tonya Orchard, an assistant professor of human nutrition at The Ohio State University, appears in the Journal of Bone and Mineral Research.

Women with the least-inflammatory diets (based on a scoring system called the Dietary Inflammatory Index) lost less bone density during the six-year follow-up period than their peers with the most-inflammatory diets. This was despite the fact that they started off with lower bone density overall.

Furthermore, diets with low inflammatory potential appeared to correspond to lower risk of hip fracture among one subgroup of the study -- post-menopausal white women younger than 63.

The findings suggest that women's bone health could benefit when they choose a diet higher in beneficial fats, plants and whole grains, said Orchard, who is part of Ohio State's Food Innovation Center.
Quote:
Women with the least-inflammatory diets had lower bone mineral density overall at the start of the study, but lost less bone than their high-inflammation peers, the researchers found. The lower bone density to start could be because women with healthier diets are more likely to be of a smaller build, Orchard said. Larger people have higher bone density to support their larger frames.

"These women with healthier diets didn't lose bone as quickly as those with high-inflammation diets, and this is important because after menopause women see a drastic loss in bone density that contributes to fractures," Orchard said.
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Old 31-01-2017, 05:47 PM   #227
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Default An overview of osteoporosis and frailty in the elderly

https://bmcmusculoskeletdisord.biome...891-017-1403-x

Abstract

Quote:
Osteoporosis and osteoporotic fractures remain significant public health challenges worldwide. Recently the concept of frailty in relation to osteoporosis in the elderly has been increasingly accepted, with emerging studies measuring frailty as a predictor of osteoporotic fractures. In this overview, we reviewed the relationship between frailty and osteoporosis, described the approaches to measuring the grades of frailty, and presented current studies and future research directions investigating osteoporosis and frailty in the elderly. It is concluded that measuring the grades of frailty in the elderly could assist in the assessment, management and decision-making for osteoporosis and osteoporotic fractures at a clinical research level and at a health care policy level.
Keywords

Osteoporosis Osteoporotic fractures Frailty Geriatrics Ageing
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Old 31-01-2017, 11:15 PM   #228
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Default Glucose Deprivation in the Brain Sets Stage for Alzheimer’s

http://neurosciencenews.com/alzheime...rivation-6035/

Quote:
One of the earliest signs of Alzheimer’s disease is a decline in glucose levels in the brain. It appears in the early stages of mild cognitive impairment — before symptoms of memory problems begin to surface. Whether it is a cause or consequence of neurological dysfunction has been unclear, but new research at the Lewis Katz School of Medicine at Temple University now shows unequivocally that glucose deprivation in the brain triggers the onset of cognitive decline, memory impairment in particular.
Quote:
The findings also lend support to the idea that chronically occurring, small episodes of glucose deprivation are damaging for the brain. “There is a high likelihood that those types of episodes are related to diabetes, which is a condition in which glucose cannot enter the cell,” he explained. “Insulin resistance in type 2 diabetes is a known risk factor for dementia.”
Diabetes denial can be a problem in those reluctant to change their preferred lifestyle. Some of my patients won't go for tests.
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Old 02-02-2017, 08:40 PM   #229
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Default More on polypharmacy.

Is Polypharmacy Associated with Frailty in Older People? Results From the ESTHER Cohort Study

http://onlinelibrary.wiley.com/doi/1...jgs.14718/full

Abstract

Quote:
Objectives

To investigate the relationship between polypharmacy and frailty.
Design

Longitudinal, observational cohort study.
Setting

Saarland, Germany.
Participants

3,058 community-dwelling adults aged between 57 and 84 years.
Measurements

Frailty was assessed according to the frailty phenotype, described by Fried et al. Polypharmacy and hyperpolypharmacy were defined as the concomitant use of five or more and 10 or more drugs, respectively. We assessed associations between polypharmacy and prevalent and incident frailty within 3 years of follow-up by logistic regression models controlled for multiple potential confounders including comorbidity. Additionally, cubic splines were used to assess dose–response associations.
Results

Polypharmacy was reported in 39.1% (n = 1,194), and hyperpolypharmacy in 8.9% (n = 273) of participants. Prevalent frailty was present in 271 (8.9%) participants; 186 (9.3%) of 1,998 non-frail participants with follow-up data became frail within 3 years. After adjustment, polypharmacy and hyperpolypharmacy were associated with prevalent frailty with adjusted odds ratios (95% confidence interval) of 2.30 (1.60–3.31) and 4.97 (2.97–8.32), respectively. Polypharmacy (odds ratio (OR) 1.51 (1.05–2.16)) and hyperpolypharmacy (OR 1.90 (1.10–3.28)) were also independent predictors of incident frailty. Furthermore, there was a moderate exposure–response relationship between the number of medicines and prevalent as well as incident frailty.
Conclusion

Our study showed that polypharmacy is associated with frailty. Further research should address the potential benefit of reducing of inappropriate polypharmacy and better pharmacotherapeutic management for preventing medication-associated frailty.
C'mon !!!!!

I thought we had this one done and dusted in the late '70s.

Our elders need and deserve admission to an acute assessment ward under an expert multidisciplinary team. It used to take us between a week and ten days to sort out the glitches.
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Old 02-02-2017, 09:21 PM   #230
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Studies like this could be more informative if they also had looked at the NNT of every "pharmacy item" ie pill/medication
One could hypothesize that higher NNT in polypharmacy and hyperpolypharmacy may be associated with higher prevalency of frailty.
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Old 02-02-2017, 09:58 PM   #231
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I agree. NHS Scotland put out regular PDFs on this.

http://www.polypharmacy.scot.nhs.uk/...effectiveness/

When it comes down to the individual, it is difficult to know what may happen if one tinkers around with drug dosages and combinations, which is why we used to admit them.

The physician was a genius with regards to the drugs and used to take them off everything he could before working out which combinations worked best. In those days there were few limitations as to what could be prescribed and he didn't have to stick to whatever the NHS was currently ordering in bulk.

Admittedly, the local GPs were not as good or as up to date as they are now and their prescription methods were a lottery.
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Old 02-02-2017, 10:23 PM   #232
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Default A retirement ‘hobby’

http://science.sciencemag.org/conten...et_cid=1140823

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After flunking out of undergraduate premed in 1957, spending 4 years growing up in the Marine Corps, returning to academic life, and falling in love with insects, I spent 37 happy years as a faculty member at a research-intensive university. When I turned 65 in 2003, I was shocked to face the looming doom of mandatory retirement. I still had my health and energy, and I wasn't ready for lawn bowling. I wanted to work. Hanging around the university was not an option; the department chair had already claimed my office. So, with some trepidation, I moved to industry. I'm now in my 14th year on the “dark side”—and it has been a great adventure.
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Old 03-02-2017, 04:50 PM   #233
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Default Physical activity and trajectories of frailty among older adults: Evidence from the English Longitudinal Study of Ageing

http://journals.plos.org/plosone/art...l.pone.0170878

Abstract

Quote:
Background

Frail older adults are heavy users of health and social care. In order to reduce the costs associated with frailty in older age groups, safe and cost-effective strategies are required that will reduce the incidence and severity of frailty.

Objective

We investigated whether self-reported intensity of physical activity (sedentary, mild, moderate or vigorous) performed at least once a week can significantly reduce trajectories of frailty in older adults who are classified as non-frail at baseline (Rockwood’s Frailty Index [FI] ≤ 0.25).

Methods

Multi-level growth curve modelling was used to assess trajectories of frailty in 8649 non-frail adults aged 50 and over and according to baseline self-reported intensity of physical activity. Frailty was measured in five-year age cohorts based on age at baseline (50–54; 55–59; 60–64; 65–69; 70–74; 75–79; 80+) on up to 6 occasions, providing an average of 10 years of follow-up. All models were adjusted for baseline sex, education, wealth, cohabitation, smoking, and alcohol consumption.

Results

Compared with the sedentary reference group, mild physical activity was insufficient to significantly slow the progression of frailty, moderate physical activity reduced the progression of frailty in some age groups (particularly ages 65 and above) and vigorous activity significantly reduced the trajectory of frailty progression in all older adults.

Conclusion

Healthy non-frail older adults require higher intensities of physical activity for continued improvement in frailty trajectories.



Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies

http://journals.plos.org/plosone/art...l.pone.0178383

Abstract

Quote:
Introduction

Frailty is one of the greatest challenges facing our aging population, as it can lead to adverse outcomes such as institutionalization, hospitalization, and mortality. However, the factors that are associated with frailty are poorly understood. We performed a systematic review of longitudinal studies in order to identify the sociodemographic, physical, biological, lifestyle-related, and psychological risk or protective factors that are associated with frailty among community-dwelling older adults.

Methods

A systematic literature search was conducted in the following databases in order to identify studies that assessed the factors associated with of frailty among community-dwelling older adults: Embase, Medline Ovid, Web of Science, Cochrane, PsychINFO Ovid, CINAHL EBSCOhost, and Google Scholar. Studies were selected if they included a longitudinal design, focused on community-dwelling older adults aged 60 years and older, and used a tool to assess frailty. The methodological quality of each study was assessed using the Quality of Reporting of Observational Longitudinal Research checklist.

Results

Twenty-three studies were included. Significant associations were reported between the following types of factors and frailty: sociodemographic factors (7/7 studies), physical factors (5/6 studies), biological factors (5/7 studies), lifestyle factors (11/13 studies), and psychological factors (7/8 studies). Significant sociodemographic factors included older age, ethnic background, neighborhood, and access to private insurance or Medicare; significant physical factors included obesity and activities of daily living (ADL) functional status; significant biological factors included serum uric acid; significant lifestyle factors included a higher Diet Quality Index International (DQI) score, higher fruit/vegetable consumption and higher tertile of all measures of habitual dietary resveratrol exposure; significant psychological factors included depressive symptoms.

Conclusions

A broad range of sociodemographic, physical, biological, lifestyle, and psychological factors show a longitudinal association with frailty. These factors should be considered when developing interventions aimed at preventing and/or reducing the burden associated with frailty among community-dwelling older adults.
Update 16/06/2017
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Old 03-02-2017, 05:00 PM   #234
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Default Improving posture-motor dual-task with a supraposture-focus strategy in young and elderly adults

http://journals.plos.org/plosone/art...l.pone.0170687

Abstract

Quote:
In a postural-suprapostural task, appropriate prioritization is necessary to achieve task goals and maintain postural stability. A “posture-first” principle is typically favored by elderly people in order to secure stance stability, but this comes at the cost of reduced suprapostural performance. Using a postural-suprapostural task with a motor suprapostural goal, this study investigated differences between young and older adults in dual-task cost across varying task prioritization paradigms. Eighteen healthy young (mean age: 24.8 ± 5.2 years) and 18 older (mean age: 68.8 ± 3.7 years) adults executed a designated force-matching task from a stabilometer board using either a stabilometer stance (posture-focus strategy) or force-matching (supraposture-focus strategy) as the primary task. The dual-task effect (DTE: % change in dual-task condition; positive value: dual-task benefit, negative value: dual-task cost) of force-matching error and reaction time (RT), posture error, and approximate entropy (ApEn) of stabilometer movement were measured. When using the supraposture-focus strategy, young adults exhibited larger DTE values in each behavioral parameter than when using the posture-focus strategy. The older adults using the supraposture-focus strategy also attained larger DTE values for posture error, stabilometer movement ApEn, and force-matching error than when using the posture-focus strategy. These results suggest that the supraposture-focus strategy exerted an increased dual-task benefit for posture-motor dual-tasking in both healthy young and elderly adults. The present findings imply that the older adults should make use of the supraposture-focus strategy for fall prevention during dual-task execution.
Single leg stance at the sink while doing the dishes works nicely. Machines don't do dishes as well as humans can.
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Old 03-02-2017, 05:05 PM   #235
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Default Chronic multimorbidity impairs role functioning in middle-aged and older individuals mostly when non-partnered or living alone

http://journals.plos.org/plosone/art...l.pone.0170525

Abstract

Quote:
Background

Due to the aging of the population, society includes a growing proportion of older individuals prone to chronic morbidity. This study aimed to investigate the adverse effects of single and multiple chronic morbidity on psychosocial health and whether these effects are more pronounced in individuals who are non-partnered or living alone.

Materials and methods

Baseline data from the ‘Lifelines Cohort Study’ collected between 2006 and 2013 in the Netherlands were used. Individuals aged 50+ (n = 25,214) were categorized according to their health status (healthy, single chronic morbidity, multiple chronic morbidity), relationship status (partnered, non-partnered), and living arrangement (living with someone, living alone). Analyses of covariance (ANCOVA) were performed to study the main- and the interaction-effects on mental health and role functioning as assessed with the RAND-36.

Results

Irrespective of having chronic morbidity, having a partner was associated with better mental health when partners shared a home. Individuals with single and especially multiple chronic morbidity had impaired role functioning. Having a partner mitigated the adverse effects of multimorbidity on role functioning, but only in individuals who shared a home with their partner. Non-partnered individuals with multimorbidity and those not sharing a home with their partner demonstrated impaired role functioning.

Conclusions

The results demonstrate that multimorbidity negatively affects role functioning, but not the mental health, of middle-aged and older individuals. Sharing a home with a partner can mitigate these adverse effects, while other combinations of relationship status and living arrangement do not. Offering intervention to those individuals most vulnerable to impaired functioning may relieve some of the increasing pressure on the health care system. An individual’s relationship status along with one’s living arrangement could foster the identification of a target group for such interventions attempting to sustain physical functioning or to adapt daily goals.
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Old 07-02-2017, 02:46 PM   #236
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Default Compliant flooring to prevent fall-related injuries in older adults: A scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety

http://journals.plos.org/plosone/art...l.pone.0171652

Abstract

Quote:
Background

Compliant flooring, broadly defined as flooring systems or floor coverings with some level of shock absorbency, may reduce the incidence and severity of fall-related injuries in older adults; however, a lack of synthesized evidence may be limiting widespread uptake.

Methods

Informed by the Arksey and O’Malley framework and guided by a Research Advisory Panel of knowledge users, we conducted a scoping review to answer: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries in healthcare settings? We searched academic and grey literature databases. Any record that discussed a compliant flooring system and at least one of biomechanical efficacy, clinical effectiveness, cost-effectiveness, or workplace safety was eligible for inclusion. Two independent reviewers screened and abstracted records, charted data, and summarized results.

Results

After screening 3611 titles and abstracts and 166 full-text articles, we included 84 records plus 56 companion (supplementary) reports. Biomechanical efficacy records (n = 50) demonstrate compliant flooring can reduce fall-related impact forces with minimal effects on standing and walking balance. Clinical effectiveness records (n = 20) suggest that compliant flooring may reduce injuries, but may increase risk for falls. Preliminary evidence suggests that compliant flooring may be a cost-effective strategy (n = 12), but may also result in increased physical demands for healthcare workers (n = 17).

Conclusions

In summary, compliant flooring is a promising strategy for preventing fall-related injuries from a biomechanical perspective. Additional research is warranted to confirm whether compliant flooring (i) prevents fall-related injuries in real-world settings, (ii) is a cost-effective intervention strategy, and (iii) can be installed without negatively impacting workplace safety. Avenues for future research are provided, which will help to determine whether compliant flooring is recommended in healthcare environments.
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Old 09-02-2017, 02:42 PM   #237
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Default Nearly one in four adults aged 65 and older has trouble walking or climbing stairs -- and 3.4 million older adults have trouble taking care of their personal needs, such as dressing or bathing.

https://www.sciencedaily.com/release...0208164701.htm

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Based on the proven health benefits of exercise for older adults, a team of researchers theorized that exercise might also help adults prevent or delay disabilities that interfere with independent living. The team designed a study to test that theory, and their results were published in the Journal of the American Geriatrics Society.

The researchers enrolled 1,635 adults between the ages of 70 and 89. All of the participants were at high-risk for becoming physically disabled. At the beginning of the study, the participants were able to walk about five city blocks (one-quarter of a mile) without assistance. The participants were split into two groups. One group was encouraged to exercise regularly. In addition to taking a daily 30-minute walk, they performed balance training and muscle strengthening exercises. The other group attended weekly workshops for 26 weeks, followed by monthly sessions. The workshops provided information about accessing the healthcare system, traveling safely, getting health screenings, and finding reliable sources for health and nutrition education. The workshop instructors also led the participants in 5- to 10-minute flexibility or stretching exercise sessions.
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Old 09-02-2017, 02:50 PM   #238
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Default Poor and less educated suffer the most from chronic pain

https://www.sciencedaily.com/release...0208160411.htm

Quote:
The results, based on 12 years of data from more than 19,000 subjects aged 51 and over, excluding those diagnosed or treated for cancer, provide several kinds of bad news about chronic pain in the United States, according to Hanna Grol-Prokopczyk, an assistant professor of sociology at UB and the paper's author, published in this month's issue of the journal Pain.

Chronic pain levels are also rising by period and not just by age, meaning people who were in their 60s in 2010 reported more pain than people who were in their 60s in 1998. "There are a lot of pressures right now to reduce opioid prescription," says Grol-Prokopczyk. "In part, this study should be a reminder that many people are legitimately suffering from pain. Health care providers shouldn't assume that someone who shows up in their office complaining of pain is just trying to get an opioid prescription. "We have to remember that pain is a legitimate and widespread problem," she says.

The study also serves as an argument for investing more into research for other treatments.

"We don't have particularly good treatments for chronic pain. If opioids are to some extent being taken off the table, it becomes even more important to find other ways of addressing this big public health problem."
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Old 13-02-2017, 02:57 PM   #239
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Default What matters for life satisfaction among the oldest-old? Evidence from China

http://journals.plos.org/plosone/art...l.pone.0171799

Abstract

Quote:
Objective

The world population is aging rapidly and the well-being of older people is of great interest. Therefore, this study investigates the determinants of life satisfaction among the oldest-old (i.e. individuals aged 80 or over) in China.

Materials and methods

We use the 2011/2012 Chinese Longitudinal Healthy Longevity Survey data (n = 6530) for this paper. Logistic regression is used to analyse the effects of socio-demographic, economic, health, instrumental activities of daily living, family and community factors on life satisfaction and depression among the oldest-old in China.

Results

Our analysis confirms the significance of many factors affecting life satisfaction among the oldest-old in China. Factors that are correlated with life satisfaction include respondent’s sex, education, place of residence, self-rated health status, cognitive ability (using mini mental state examination), regular physical examination, perceived relative economic status, access to social security provisions, commercialized insurances, living arrangements, and number of social services available in the community (p<0.05 for all these variables). Although life satisfaction is negatively associated with instrumental activities of daily living (β = -0.068, 95%CI = -.093—.043), and depression (β = -0.463, 95%CI = -.644—.282), the overall effect of self-rated health status is positive (p<0.001). This confirms the primacy of health as the determinant of well-being among the oldest-old.

Conclusions

Majority of the oldest-old in China rated their life satisfaction as good or very good. Our findings show that health and economic status are by far the most significant predictors of life satisfaction. Our finding on the primacy of health and relative income as determinants of well-being among the oldest-old, and the greater influence of self-rated health status over objective health measures is consistent with the findings of many past studies. Our results suggest that efforts should be directed at enhancing family support as well as health and social service provisions in the community to improve life satisfaction of older people.
Besides health and economic status, having work and/or a meaningful role to fulfil is important for my patients, they are liable to become stressed if families take them for granted though. Some complain that their adult children expect too much in the way of financial handouts and childcare at short notice.
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Old 14-02-2017, 05:23 PM   #240
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Default How eating less can slow the aging process

https://www.sciencedaily.com/release...0213151306.htm

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Recent research published in Molecular & Cellular Proteomics offers one glimpse into how cutting calories impacts aging inside a cell. The researchers found that when ribosomes -- the cell's protein makers -- slow down, the aging process slows too. The decreased speed lowers production but gives ribosomes extra time to repair themselves.
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Old 15-02-2017, 01:08 PM   #241
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Default ASA Ruling on Alzheimer’s Research UK

https://www.asa.org.uk/Rulings/Adjud...x#.WKQ9GzuLRQI

Quote:
Ad
A TV ad, shown on various channels, for an Alzheimer's charity, was seen in November 2016. It depicted an animated story of a young girl being told that Santa had stopped delivering presents because he had developed a disease. She then travelled to see the elves, who explained that research could find a way to fix him. A voice-over at the end of the ad stated Alzheimer's disease can affect anyone. Only research has the power to change the future."

The ad was cleared by Clearcast with an ex-kids timing restriction, whereby it should not be transmitted in or adjacent to programmes commissioned for, principally directed at or likely to appeal to children under 16 years of age.

Issue
Thirty-six complainants challenged whether the ad, particularly the depiction of Santa as suffering from Alzheimer's disease, was offensive, could cause distress to children and whether it was suitable to be broadcast at times when children could see it.
Young children cope well with injury, illness, disability and ageing provided that the adults around them have positive attitudes.

Many years ago while I was buying fruit in a supermarket, I noticed that my three year old had run up to a guy in a wheelchair and was insisting that she be allowed to examine it in order to see the engine. He explained that he was the engine and gave her a very impressive demonstration of what he could do in the way of spins, jumps and wheelies. Had her questioning become impolite, I would have removed her and apologized.

She now works with autistic adults, some of whom have complex medical conditions and mobility issues.
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Old 16-02-2017, 09:57 AM   #242
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Default 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 exert distinct effects on human skeletal muscle function and gene expression

http://journals.plos.org/plosone/art...l.pone.0170665

Abstract

Quote:
Age-associated decline in muscle function represents a significant public health burden. Vitamin D-deficiency is also prevalent in aging subjects, and has been linked to loss of muscle mass and strength (sarcopenia), but the precise role of specific vitamin D metabolites in determining muscle phenotype and function is still unclear. To address this we quantified serum concentrations of multiple vitamin D metabolites, and assessed the impact of these metabolites on body composition/muscle function parameters, and muscle biopsy gene expression in a retrospective study of a cohort of healthy volunteers. Active serum 1,25-dihydroxyvitamin D3 (1α,25(OH)2D3), but not inactive 25-hydroxyvitamin D3 (25OHD3), correlated positively with measures of lower limb strength including power (rho = 0.42, p = 0.02), velocity (Vmax, rho = 0.40, p = 0.02) and jump height (rho = 0.36, p = 0.04). Lean mass correlated positively with 1α,25(OH)2D3 (rho = 0.47, p = 0.02), in women. Serum 25OHD3 and inactive 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) had an inverse relationship with body fat (rho = -0.30, p = 0.02 and rho = -0.33, p = 0.01, respectively). Serum 25OHD3 and 24,25(OH)2D3 were also correlated with urinary steroid metabolites, suggesting a link with glucocorticoid metabolism. PCR array analysis of 92 muscle genes identified vitamin D receptor (VDR) mRNA in all muscle biopsies, with this expression being negatively correlated with serum 25OHD3, and Vmax, and positively correlated with fat mass. Of the other 91 muscle genes analysed by PCR array, 24 were positively correlated with 25OHD3, but only 4 were correlated with active 1α,25(OH)2D3. These data show that although 25OHD3 has potent actions on muscle gene expression, the circulating concentrations of this metabolite are more closely linked to body fat mass, suggesting that 25OHD3 can influence muscle function via indirect effects on adipose tissue. By contrast, serum 1α,25(OH)2D3 has limited effects on muscle gene expression, but is associated with increased muscle strength and lean mass in women. These pleiotropic effects of the vitamin D ‘metabolome’ on muscle function indicate that future supplementation studies should not be restricted to conventional analysis of the major circulating form of vitamin D, 25OHD3.
Introduction

Quote:
The effects of vitamin D on calcium homeostasis and bone health are well established. In recent years there has been great interest in its non-skeletal actions, with growing evidence from epidemiological, basic and clinical studies that vitamin D status is associated with effects including those on muscle function, body fat, immunity and cardiovascular disease risk [1]. Myopathy has long-been recognised to co-exist with reduced bone mineralization in the severe vitamin D deficiency states of rickets and osteomalacia [2]. In view of the great public health burden of so-called ‘sarcopenia’ and age-associated declines in muscle strength and function, there is significant interest in whether vitamin D may have a role in improving the healthy lifespan. Recent meta-analyses indicate that vitamin D supplementation in deficient elderly individuals reduces risk of falls [3]. There is also some evidence of beneficial effects on muscle strength and physical performance, however this is limited by heterogeneity of study designs, so that current guidelines do not recommend vitamin D supplementation for this indication [4–6].
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Old 25-02-2017, 01:06 AM   #243
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Default To Drink or Not To Drink: The Aging Brain and Alcohol

http://neurosciencenews.com/alcohol-brain-aging-6156/

Quote:
Wisdom and grace come with age, but so do mental slowing and increased risk for dementia. As the elderly population continues to grow, preserving brain health to maintain independence and quality of life into older age is a pressing concern. Researchers have identified some unsurprising factors that reduce one’s risk for cognitive decline, including education, exercise or a healthy diet. But a more controversial question that continues to perplex scientists is whether alcohol consumption might also stave off cognitive impairment with age.
Quote:
Despite overwhelming evidence that moderate alcohol intake can be healthy for the aging brain, there are striking incongruences across findings–which may be due to differences in study design or confounding factors*–that muddle our understanding of alcohol’s benefits. ‘Survival bias,’ in which healthier individuals participate in studies for longer, is an unavoidable complication in longitudinal studies of aging. This could significantly skew results if unhealthy drinkers drop out early, leaving only “healthy” drinkers to be studied in very old age. Furthermore, most human studies on alcohol and brain aging rely on observed associations, which can be replete with confounding factors. For instance, it’s known that drinkers tend to live more healthy lifestyles (e.g., they may exercise more or follow a Mediterranean diet), or may drink more often simply because they’re more socially active, which alone is known to be brain-healthy. What’s more, effects of alcohol on cognitive aging may depend on the type of alcohol consumed, how alcohol intake is measured, or the definition of “non-drinkers.”
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Old 02-03-2017, 10:27 PM   #244
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Default Elderly people who choose the wrong shoes have a lower quality of life 83% use the wrong shoes

https://www.sciencedaily.com/release...0301130822.htm

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As people get older, they experience changes in their foot morphology. If they do not change their shoe size along with these transformations, older people -- most of whom choose the wrong shoes -- suffer, among other things, anxiety, apathy, loss of balance and falls, according to a study by the University of A Coruña.
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Old 03-03-2017, 11:37 PM   #245
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Default Physical activity behavior predicts endogenous pain modulation in older adults

http://journals.lww.com/pain/Fulltex...ogenous.5.aspx

1. Introduction
Quote:
The experience of pain depends on complex interactions between ascending peripheral signals and modulation of those signals in the central nervous system by descending inhibitory and facilitatory systems.40 A dysregulated pattern of endogenous pain modulation, characterized by greater facilitation of pain and a reduced capacity to inhibit pain on dynamic quantitative sensory tests, is a shared characteristic of many chronic pain syndromes (eg, fibromyalgia, back pain, and osteoarthritis17,19,26,41), is associated with increased reports of clinical pain in healthy adults,9,11 and predicts the transition from acute to chronic postoperative pain.47 Accumulating evidence indicates that aging is associated with a dysregulated pain profile as well,9,10,13,24,28,31 and the age-related imbalance of pain inhibition and facilitation places older adults at a greater risk of developing chronic pain compared with younger adults. Alarmingly, the prevalence estimates of chronic pain among the elderly may be as high as 60% to 75% in the United States.20 Determining modifiable and behavioral factors contributing to this dysregulated pattern of pain modulation in older adults is crucial to the development of strategies to prevent persistent pain in older people.

A growing body of evidence has begun to link physical activity behavior to endogenous pain modulatory function,12,18,30,43 with generally more efficacious pain modulation observed in more active individuals. Importantly, older adults are the least physically active cohort of all age groups.29 Reduced physical activity facilitates the aging process and physiological decline, and hence could play an important role in the decline of endogenous pain inhibitory and facilitatory systems observed in older adults. Supporting this notion, we recently showed that self-reported levels of vigorous and total physical activity were related to the functioning of endogenous pain modulatory systems in healthy younger and older adults.30 Individuals who reported more vigorous and total physical activity demonstrated enhanced pain inhibition during the conditioned pain modulation test and less temporal summation (TS) of pain. However, a major limitation of this study was that physical activity was assessed by a questionnaire rather than by objective methods, which often results in highly variable estimations of the amount of physical activity reported.16,28 In addition, only a portion of the participants were older adults. Thus, studies using objective measures of physical activity are needed to substantiate the relationship between physical activity behavior and endogenous pain modulatory function in a full sample of older adults.

The purpose of this study was 2-fold. We sought to determine whether objective measures of physical activity in healthy older adults predicted (1) pain facilitatory function as tested by TS of pain, and (2) pain inhibitory function as tested by conditioned pain modulation (CPM). Temporal summation of pain and CPM are the 2 most extensively studied dynamic quantitative sensory tests and are considered human behavioral correlates of ascending facilitatory and descending inhibitory limbs of central pain modulation, respectively.1 We hypothesized that older adults who did greater amounts of moderate to vigorous physical activity (MVPA) would exhibit reduced TS of pain, and greater inhibition of pain on the CPM test.
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Old 08-03-2017, 08:30 PM   #246
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Default Resting-State Network Topology Differentiates Task Signals across the Adult Life Span

http://www.jneurosci.org/content/37/10/2734?etoc=

Abstract

Quote:
Brain network connectivity differs across individuals. For example, older adults exhibit less segregated resting-state subnetworks relative to younger adults (Chan et al., 2014). It has been hypothesized that individual differences in network connectivity impact the recruitment of brain areas during task execution. While recent studies have described the spatial overlap between resting-state functional correlation (RSFC) subnetworks and task-evoked activity, it is unclear whether individual variations in the connectivity pattern of a brain area (topology) relates to its activity during task execution. We report data from 238 cognitively normal participants (humans), sampled across the adult life span (20–89 years), to reveal that RSFC-based network organization systematically relates to the recruitment of brain areas across two functionally distinct tasks (visual and semantic). The functional activity of brain areas (network nodes) were characterized according to their patterns of RSFC: nodes with relatively greater connections to nodes in their own functional system (“non-connector” nodes) exhibited greater activity than nodes with relatively greater connections to nodes in other systems (“connector” nodes). This “activation selectivity” was specific to those brain systems that were central to each of the tasks. Increasing age was accompanied by less differentiated network topology and a corresponding reduction in activation selectivity (or differentiation) across relevant network nodes. The results provide evidence that connectional topology of brain areas quantified at rest relates to the functional activity of those areas during task. Based on these findings, we propose a novel network-based theory for previous reports of the “dedifferentiation” in brain activity observed in aging.

SIGNIFICANCE STATEMENT Similar to other real-world networks, the organization of brain networks impacts their function. As brain network connectivity patterns differ across individuals, we hypothesized that individual differences in network connectivity would relate to differences in brain activity. Using functional MRI in a group of individuals sampled across the adult life span (20–89 years), we measured correlations at rest and related the functional connectivity patterns to measurements of functional activity during two independent tasks. Brain activity varied in relation to connectivity patterns revealed by large-scale network analysis. This relationship tracked the differences in connectivity patterns accompanied by older age, providing important evidence for a link between the topology of areal connectivity measured at rest and the functional recruitment of these areas during task performance.
aging connectivity dedifferentiation networks resting-state task activity
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Old 11-03-2017, 01:05 AM   #247
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Default Rapid Blood Pressure Drops in Middle Age Linked to Dementia in Old Age

http://neurosciencenews.com/blood-pr...ia-aging-6228/

Quote:
Temporary episodes of dizziness or light-headedness when standing could reduce blood flow to the brain with lasting impacts.

Middle-aged people who experience temporary blood pressure drops that often cause dizziness upon standing up may be at an increased risk of developing cognitive decline and dementia 20 years later, new Johns Hopkins Bloomberg School of Public Health research suggests.

The findings, being presented March 10 at the American Heart Association’s EPI|LIFESTYLE 2017 Scientific Sessions in Portland, Ore., suggest that these temporary episodes – known as orthostatic hypotension – may cause lasting damage, possibly because they reduce needed blood flow to the brain. Previous research has suggested a connection between orthostatic hypotension and cognitive decline in older people, but this appears to be the first to look at long-term associations.

“Even though these episodes are fleeting, they may have impacts that are long lasting,” says study leader Andreea Rawlings, PhD, MS, a post-doctoral researcher in the Department of Epidemiology at the Bloomberg School. “We found that those people who suffered from orthostatic hypotension in middle age were 40 percent more likely to develop dementia than those who did not. It’s a significant finding and we need to better understand just what is happening.”
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Old 13-03-2017, 02:10 PM   #248
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Default Ageing causes prominent neurovascular dysfunction associated with loss of astrocytic contacts and gliosis

http://onlinelibrary.wiley.com/doi/1...form=hootsuite

Abstract

Quote:
Aims

Normal neurovascular coupling, mediated by the fine interplay and communication of cells within the neurovascular unit, is critical for maintaining normal brain activity and cognitive function. This study investigated whether, with advancing age there is disruption of neurovascular coupling and specific cellular components of the neurovascular unit, and whether the effects of increasing amyloid (a key feature of Alzheimer's disease) would exacerbate these changes.

Methods

Wild-type mice, in which amyloid deposition is absent, were compared to transgenic APP littermates (TgSwDI) which develop age-dependent increases in amyloid. Baseline cerebral blood flow and responses to whisker stimulation were measured. Components of the neurovascular unit (astrocytes, end-feet, pericytes, microglia) were measured by immunohistochemistry.

Results

Neurovascular coupling was progressively impaired with increasing age (starting at 12months) but was not further altered in TgSwDI mice. Aged mice showed reduced vascular pericyte coverage relative to young but this was not related to neurovascular function. Aged mice displayed significant reductions in astrocytic end-feet expression of aquaporin-4 on blood vessels compared to young mice, and a prominent increase in microglial proliferation which correlated with neurovascular function.

Conclusions

Strategies aimed to restore the loss of astrocytic end feet contact and reduce gliosis may improve neurovascular coupling.
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Old 13-03-2017, 02:56 PM   #249
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Default Physical activity and exercise as countermeasures to physical frailty and sarcopenia

https://link.springer.com/article/10...520-016-0705-4

Abstract
Quote:
The identification of cost-effective interventions that improve the health status and prevent disability in old age is one of the most important public health challenges. Regular physical activity is the only intervention that has consistently been shown to improve functional health and energy balance and to reduce the risk of cardiovascular disease, stroke, diabetes, several cancers, depression and falls. In advanced age, physical activity is also effective at mitigating sarcopenia, restoring robustness, and preventing/delaying the development of disability. On the other hand, physical inactivity is recognized as one of the leading causes of several chronic degenerative diseases and is also a major contributing factor to sarcopenia and functional disability. This compelling evidence has prompted the World Health Organization to recommend engaging in regular physical activity throughout one’s life course. The present review summarizes the available evidence in support of physical activity as a remedy against physical frailty and sarcopenia. The relevant pathways through which the benefits of physical activity are conveyed are also discussed.
Keywords

Skeletal muscle Physical performance Exercise Resistance training Endurance training

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Old 14-03-2017, 02:44 PM   #250
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Default Contested spaces: we need to see public space through older eyes too

https://theconversation.com/conteste...eyes-too-72261

Quote:
Participation, interaction and physical activity hold the promise of promoting health and independence and reducing the risk of disablement for older people.

Our participants identified several key design considerations that help make public spaces usable and comfortable places. Many of these aspects are linked to walkability.
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