Mitochondrial Metabolism, Dysfunctions in Senescence Cell and the Possible Interventions through Herbal Medicines
The mitochondria are the cell`s powerhouse. They are considered ubiquitous organelles of all eukaryotic cells, being responsible for the cell’s life and death cycle. Through stimuli in the environment in which they live, mitochondria can modulate their own biogenesis as well as signal retrograde to the nucleus to modify the structure of their proteins. Since the mitochondrial genome contains only 37 genes, much of the encoding of its proteins depends on the nuclear genome. Thus, the communication between mitochondria and the nucleus seems to be a target of science in understanding the pathologies associated with this organelle. Some medicinal herbs have been shown to influence mitochondrial biogenesis, such as Gynostemma pentaphyllun (GP) and berberine, which increase the phosphorylation of proteins AMPactivated protein kinase (AMPK). Just as GP and berberine phosphorylate AMPK in signaling for mitochondrial biogenesis, the sesquiterpene beta-caryophyllene (BCP) demonstrated positive results in reorganizing mitochondrial transcription factors, being an agonist of the peroxisome proliferatoractivated alpha receptor (PPAR-α). Another plant derivative, the non-psychoactive cannabinoid known as cannabidiol (CBD), has been showing control in the metabolism of calcium in the mitochondrial matrix. In this review, we seek to get a closer look at the biochemical mechanisms of action of some of these plants, as well as their synergies in the results of different treatments. In the view of oriental medicines, the use of associated medicinal herbs has always been part of their treatment protocols. However, the effectiveness of these treatments in relation to plant synergy can be observed in future clinical trials for better understanding.
Objective: To determine the predictors of in-hospital mortality in critically ill older patients. Participants and Methods: A prospective cohort study including 305 critically ill older adults (age ≥60 years) who were admitted to High Dependency Units (HDUs) in a tertiary care university hospital from March 22, 2019 to January 4, 2020. Demographic, clinical and laboratory data of participants were collected thought a review of medical records and clinical observation at HDUs till either death or discharge alive. Statistical analysis included univariate analysis of selected potential predictors such as various comorbidities, C- reactive protein / Albumin ratio (CAR), Neutrophil-lymphocyte ratio (NLR), Red cell distribution width (RDW), Po2/Fio2 ratio (PFR), Simplified acute physiology score II (SAPS II), Charlson comorbidity index (CCI) and multidrug-resistant Gram-negative bacterial (MDR-GNB) infection to ascertain their association with mortality, followed by multivariable logistic regression to derive the final prediction model. The discriminative ability of the model was evaluated by using the receiver operating characteristic (ROC) curve. RESULTS: Overall mortality was 53.1%. Multivariate regression analysis revealed independent predictors of mortality including dementia in clinical history with an odds ratio (OR) of 4.86 (95% CI: 1.28-18.34), total protein with an OR of .53 (95% CI: .30-.95) and the use of mechanical ventilation (MV) and/or intravenous cardiovascular support with an OR of 148.34 (95% CI: 34.28-641.77), formulating a novel prognostic model with an area under the ROC curve of .93 (95% CI: .89-.96, P.000). CONCLUSION: History of dementia, total protein and the use of MV and/or intravenous cardiovascular support are predictors of mortality in critically ill geriatric patients. It provides a novel prognostic model which needs validation in other multicenter prospective studies.
Development of Estimate Formulas for Waist Circumference Using Body Mass Index and Limb Circumferences in Hospitalized Older Adults
Background: Little research has been conducted on the estimate formulas for waist circumference using body mass index and limb circumferences in hospitalized older adults. Thus, we conducted the present study to develop estimate formulas of waist circumference using body mass index and limb circumferences in hospitalized older adults. Methods: Forty hospitalized older patients were recruited in this cross-sectional study. We measured waist circumference, body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference. The estimate formulas for waist circumference were developed using simple and multiple regression analysis. Results: Simple regression analysis indicated that body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference were independent explanators for waist circumference (p < 0.05 for all). In addition, body mass index, upper arm circumference, and forearm circumference but not thigh circumference and calf circumference were extracted as independent explanators for waist circumference in multiple regression analysis (p < 0.05). We were able to develop the estimate formulas using body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference. Conclusion: The results suggest that the estimate formulas for waist circumference may provide an opportunity to easily evaluate waist circumference, even in hospitalized older adults with kyphosis posture. However, future studies should be conducted to develop the estimate formulas for waist circumference with a lower error value.
Ageing is the major risk factor for dementia and nearly every country has seen its life expectancy rise from the beginning of the 21st century. Remaining socially connected has positive health and social implications and may be even more significant for marginalized group of people like those living with dementia. If appropriately used, social prescriptions can help deliver value-based social engagement and primary care by maximising the utilisation of resources and addressing social determinants of health, decreasing dependency on the biomedical model and thus providing a way for health care systems to deal with social determinants of health. More frequently, however, those seeking access to these programmes do not tend to do so simply due to lack of understanding and knowledge of the availability of such services. So, provision of social activities involves more than developing a program and hoping people will attend, and considering the particular situations of those living with dementia as marginalised group of people, and taking into account that there is no treatment for dementia, societies need to move toward social prescription, integrating appropriate MedTech support- targeting on those living with dementia- into such programs.
Exergaming improves functional fitness in MCI patients. Does the APOE genotype moderate the outcome?
Objectives: Mild cognitive impairment could be defined as the condition between healthy aging and dementia. MCI patients seem to retain the neuroplasticity to benefit from Physical Exercise (PE) interventions delaying the progression to dementia. The present study investigates the impact of PE via “Exergaming” on the functional fitness of MCI adults, depending on the presence of the APOEɛ4 allele. Methods: 159 MCI participants were recruited. They were separated to two groups (performing PE or not). The Fullerton Functional Test was used as a primary outcome measure in two-time points (prior to and after PE). Results: The Active group showed more considerable improvement compared to the Passive group in all Fullerton components despite the presence of APOEε4. Discussion: ΡΕ via exergaming has a beneficial functional effect in MCI patients, whether carrying the APOEɛ4 allele or not.
Basic needs are the fundamental human rights recognized by national and international law. This study is an attempt to reveal the picture of human rights violations of the elderly people in Bangladesh focusing particularly on the deprivation of the basic needs of the aged people. In this study, data have been collected from both primary and secondary sources. It reviews the right to basic needs, such as adequate food, clothes, shelter, healthcare, and education. As a human being, everybody deserves these basic needs as fundamental human rights and it is a fundamental responsibility of the state to secure these rights according to the constitution of Bangladesh, Article 15(a). But the study found that these basic rights are not implemented properly in the case of elderly people of the study area. Lacks of moral education and humanity have been identified as mainly responsible hindrances in this sphere. Corruption and poverty are also strong impediments in this regard. The paper proposes some workable suggestions. The government, responsible institutions, and concerned families should come forward to ensure proper education, to ensure proper and sound socialization with native culture, and to raise far-reaching consciousness regarding the welfare of elderly people.
Objectives: Legacy allows individuals to make meaning of their lives by passing on their experiences and beliefs to younger people and influencing their perspectives, perceptions, and actions. This mixed-methods study investigated: (1) What is important for older adults to share as legacy with families, friends and others, based on the types and features of their digital stories ? and (2) How do older adults’ digital stories affect story viewers? Methods: One hundred adults aged between 55 and 95 years participated in ten-week Elder’s Digital Storytelling courses and created short digital stories. Using the content analysis approach, the story transcripts were thematically analyzed and iteratively coded by three researchers and the results were quantified. A diverse group of 60 viewers at a public event provided their reactions to the digital stories. Results: The findings revealed that character, place, and family were chosen as the primary types by the older adults for their legacy digital stories. Accomplishment and career/school were the next most prominent story types. Moreover, these digital stories appeared to have a powerful impact on the viewers. Discussion: A digital story is a powerful artifact to communicate an older person’s legacy because it is based on familiar forms of communication, such as speech and photographs. The major legacy themes chosen by the older adults align with the findings of the research literature. The feedback from the viewers of the digital stories reflects these as a source of life wisdom and legacy for younger generations. Funding details: This work was supported by the AGE-WELL National Centre of Excellence (AW CRP 2015-WP4.3).
Older Adult Perspectives towards Health Literacy and Knowledge of Chronic Diseases in Nepal: A case study
Background: The individual level of health literacy directly affects the health outcomes of any people. Older adult people are more vulnerable to chronic diseases than other groups of people. Also they have low health literacy and poor understanding of diseases than any other age group of people. Aim: This study aim is to explore older adult perspectives towards health literacy and knowledge of chronic diseases. Methods: The study was taken during December 2019 in the Budhanilkantha Municipality of Kathmandu district of Nepal. Semi-structured interview was conducted in four older adult participants with chronic diseases. It included health knowledge, level of understanding of chronic disease conditions, and the use of health services. Inductive analysis was followed for the patterns, themes, and categories of analysis to emerge. Results: Health literacy and knowledge of chronic diseases, health belief system, and experience of health problems were the emerging themes included here. The study results finds that lack of disease knowledge, low health literacy, health belief system, socio-economic, and cultural factors were influencing factors to chronic diseases among older adults. Participants had a minor knowledge of chronic diseases; they had lack in knowledge regarding their own chronic diseases. Conclusion: Health literacy is an important factor of understanding, accessing and utilizing health knowledge and health services. It is most important that the health literacy of the people is necessary to improve for positive health and gaining the knowledge of chronic diseases. To overcome the chronic health problems it is most important to improve the health knowledge, understanding of chronic diseases, and literacy level to the older adult people.
Psychosocial support for families of persons with dementia through home based care programme from a developing country: Process of intervention development and pilot testing
In India, person with dementia continue to live with their families all through their illness period. It is common in India that because of the family relationships and cultural values the caregiving process is a joint effort made by the adult members in the family. Thus understanding the psychosocial issues of the caregivers of persons with dementia in the Indian context and providing appropriate psychosocial support for the caregivers is essential in the holistic approach for the care for persons with dementia.The current paper shares the process of development of psychosocial intervention for the families of persons with dementia and findings from the pilot study in urban Bangalore. The findings were helpful in systematically developing the content for the proposed homebased care programme for caregivers of persons with dementia. The pilot results show that the psychosocial support through home based programme for the family caregivers of persons with dementia is feasible and effective.
Dementia is a syndrome that occurs due to the difficulty of a patient in doing his cognitive and instrumental activities of daily life with the same performance as before, bringing him losses. This syndrome is caused by numerous primary and secondary etiologies. The most common primary cause of dementia is Alzheimer’s disease (AD), which reaches almost 50% of dementia cases. The DA it consists of biological fragments of the amyloid precursor protein that are deposited in the brain 10 years or more, before the first symptoms appear. The period before the onset of symptoms is called the preclinical stage. The transition between the silence of symptoms and their appearance, usually due to memory loss for recent events, is known as the prodromal phase. Continuing the pathophysiological process, the stage of mild dementia takes place, when the patient has one more cognitive component associated with memory loss; follows the moderate, severe, profound and terminal phase of dementia.