Incidence of Cognitive Decline and Association with Changes in Sociodemographic, Lifestyle, and Health Indicators in Individuals aged 50 years and older: Prospective Cohort
Objectives: To identify the incidence of cognitive decline (CD) in an urban community-dwelling population aged 50 years and older in a 4-year follow-up period and its prospective association with sociodemographic factors, lifestyle and health conditions as well as with changes in these factors. Methods: This is a prospective cohort with a representative sample of people aged 50 years and older (n = 206) from Cambé, PR, where baseline data collection occurred in the year 2011 and the follow-up occurred in 2015. The incidence of CD was the outcome of this study, and its evaluation occurred through the Mini-Mental State Examination. Results: The incidence of CD was 13.1% over the 4 years of follow-up, and adjusted Poisson regression models (sex, age and age range) showed that this condition was prospectively associated with depression (adjusted relative risk (RR) = 3, 50, 95% CI = 1.65-7.43). When analyzing the effect of sociodemographic factor changes on CD, it was verified that the risk of CD was 2.86 times higher among the group that stopped having a companion in the 4 years of follow-up when compared to the group that maintained a companion in that same period, independent of confounding factors. Conclusion: The data suggest that the CD process begins before the age of 60 y and that aggravation is associated with potentially modifiable factors that can be approached by health services from the perspective of promotion, prevention and care.
The Neuro Engraftment and Neuroregenerative effects of Hydrogen Sulphide Donor, Intracerebral MSCs, Ginko Biloba and Kefir in Attenuating Neuropathological hallmarks of Lipopolysaccharide induced Alzheimer’s disease Rat models
Background: Memory disorders have been characterized by being a devastating long term incurable diseases with a huge social impact in addition to a diminished efficient available medical treatments. Deep Brain stimulation via using neuroprotective inducers for treatment of brain structure degenerative diseases such as Alzheimer’s disease (AD) can be considered as being a promising successful therapy due to its various targets and underlying mechanisms for improving brain dysfunction. Objectives: The main aim of this study is to suggest therapeutic protocol having the potentials for restoring normal neurons diverse population and modifying neuropathological deposited hallmarks including both positive and negative lesions. Materials and Methods: Rats were divided into nine groups: (G1) control ;(G2) rats received LPS as a method of inducing nongenetically manipulated AD;(G3)AD rats received NaHS;(G4) AD rats received MSCs intracerebrally;(G5) AD rats received MSCs+NaHS;(G6)AD rats received kefir+GB;(G7)AD rats received MSCs+kefir+GB;(G8)AD rats received NaHS+kefir+GB; (G9) AD rats received MSCs+NaHS+kefir+GB. Results: AD induction resulted in down-regulation of CBS expression and GSH brain tissue level accompanied with overexpression in amyloid-β protein, MAPK, tau protein, ACAT expression and MDA brain tissue level in addition to elevated caspase-3 serum level. Conclusion: The implantation of amyloid reliving therapy that do have a wide clinical impact if initiated at benign plaques stage before irreversible brain damage occurs. The following effects have been observed following the administration of suggested medical protocol where a decrease in AD pathological deposited hallmarks has been observed with maintaining inflammatory brain factors by functioning as a potent neuroregenerative.
Alzheimer´s Disease and Age-related Macular Degeneration could simultaneously be treated or prevented with a single therapeutic intervention
Alzheimer ´s diseases becomes the most common type of dementia in the world. There is more of 5.4 million AD patients in America, more than 6 million patients in China, and 35.6 million patients worldwide. AD and other dementias worldwide will increase to 67.5 million by 2030 and 115.4 million by 2050. In the aging population, two of the most common neurodegenerative diseases, AD and AMD, could simultaneously treated or prevented with single therapeutic intervention.
This study aimed to analyze the disorders of depression and suicidal ideation in a population of institutionalized elderly in the city of Recife – PE. To measure the phenomena under study two standardized scales were adopted, the BECK SCALE FOR Suicide Ideation (BSI) and the Geriatric Depression Scale (GDS / GDS). The collected data were entered into a database, and statistical procedures performed using the Statistical Package for Social Sciences (SPSS) version 13.0 for Windows. After analysis of the data was possible to show that with the EDG, 48% of the interviewed elderly population is with some degree of depression. It was observed higher scores on the BSI scale for women. Among the elderly depression affects more the age less than 80 years, suicidal ideation was little evident in the population studied, being more related to female.
Prevalence of Polypharmacy and Association to Pharmacotherapy Complexity in Older HIV-Positive Patients. The Sevihlla Study
Background: Increased life expectancy of older HIV-positive patients has been associated to a parallel increase in age-related comorbidities. Objectives: To ascertain the prevalence of polypharmacy and its association to pharmacotherapy complexity, as measured by the Medication Regimen Complexity Index, in older HIV-positive patients; to calculate the median value of pharmacotherapy complexity; to identify polypharmacy and multimorbidity patterns; and to address adherence to antiretroviral and concomitant drugs. Methods: A cross-sectional, observational study was conducted in patients over 50 years of age receiving active antiretroviral drugs during 2014 at outpatient pharmacy services of a tertiary hospital in Spain. Data collected from the electronic medical record included demographic, clinical and comorbidity related endpoints. The primary endpoint was the proportion of patients with polypharmacy and major polypharmacy. Polypharmacy was defined as treatment with six or more drugs (including antiretroviral). Major polypharmacy (more than 11 drugs) was also considered. Patients was categorized according to their polypharmacy pattern. Three patterns were applied based on age of participants: cardiovascular, depression-anxiety, and chronic obstructive pulmonary (COPD) disease patterns. A patient was classified into a pattern when at least three drugs of the treatment were in the same pattern. Antiretroviral treatment adherence was measured using the SMAQ questionnaire and hospital dispensing records. Adherence to concomitant medication was measured using the Morisky-Green questionnaire and electronic pharmacy dispensing records. Pharmacotherapy complexity index, as assessed by MRCI, was also considered. Patients were classified as low MRCI (less than 14 points) or high MRCI (more than 14 points). Results: The study sample consisted of 223 patients (86.5% men), with a median age of 53.0 years. More than 80.0% of the patients were viro-inmunological controlled. Prevalence of polypharmacy was 56.1%. The median value of pharmacotherapy complexity was 11.0. The main contribution to this value was from the concomitant medication. The polypharmacy pattern mainly calculated…
Whey Protein Supplementation as a Strategy to Preserve Muscle Mass and Increase Protein Synthesis in the Elderly: a Review of Literature
INTRODUCTION: Aging often coincides with loss of muscle mass, strength and function, known as sarcopenia. Sarcopenia, a geriatric syndrome closely linked to physical frailty, has a substantial impact on the quality of life. Inadequate dietary intake, especially protein intake, has been associated with decreased lean body mass. Dietary protein affects muscle mass by the stimulation of muscle protein synthesis after absorption of amino acids into muscle cells AIMS: Verify the effectiveness of whey protein supplementation in increasing protein synthesis and muscle mass in elderly. METHODS: This is a systematic review conduced in the pubmed database, which sought clinical trials published between 2012 and 2016, with the combination of descriptors: Whey protein, muscle mass, protein synthesis, sarcopenia. RESULTS: We found 30 articles and after exclusion of non-relevant issues and duplicate articles were included 11 articles in this study. Of the selected material, 3 studies did not find positive effects with supplementation, this null response could have occurred because of dose and/or timing of supplementation, 1 study found the same effect with leucine supplementation and 7 studies found positive effects with whey protein supplementation for the protein synthesis and the increase of lean body mass in the elderly. CONCLUSIONS: Therefore, we can conclude that supplementation of whey protein shows positive results for increased protein synthesis and muscle mass in the elderly. However, the results differ between the sexes, quantity and timing of consumption, which after the need of new studies for the best understanding of the subject. It seems that the elderly respond best to higher amounts of supplement and the periods more distant from the practice of resistive exercise. In addition, after reviewing the articles it appears that men present better results than women do. The results give us another option to maintain the independence and quality of the elderly.
Background: The principles of motor learning (PML) emerged from studies of limb motor skills in healthy, young adults. The applicability of these principles to speech motor learning, and to older adults, is uncertain. Aims: The purpose of this study was to examine one PML, feedback frequency, and its effect on retention and generalization of a novel speech and comparable tracing task. Methods: Sixty older adults completed a speech motor learning task requiring the production of a novel phrase at speaking rates 2 times and 3 times slower than habitual rate. Participants also completed a limb motor learning task requiring the tracing of a sine wave 2x and 3x slower than habitual rate. Participants were randomly assigned to receive feedback every trial, every 5th trial, or every 10th trial. Mean absolute error was measured to examine immediate generalization, delayed generalization, and 2-day retention. Findings: Results suggested that feedback frequency did not have an effect on the retention and generalization of the speech or manual task, supporting the small but growing literature highlighting the constraints of generalizing the PML to other modalities and populations. Funding: This research was supported by the National Institute on Deafness and Other Communication Disorders Grants T32 DC000033, P30DC04661, and the University of Washington Royalty Research Fund (A70442) awarded to Dr. Kristie Spencer. The authors gratefully acknowledge Sara Savaglio, Christopher Woollcott, and all participants for their contributions to this study. The content is solely the responsibility of the authors and only represents their views.
Nutrition Care for Residents with Dementia in Long-Term Care Homes: Umbrella Review of Care Aide and Registered Dietitian Services
Recent attention has highlighted the distinct food and nutrition needs of residents with dementia living in long-term care (nursing homes). Nutrition care involves assessment of nutritional need, along with providing safe and appropriate food that fulfills nutritional requirements. Within long-term care, much of the direct care responsibilities lies with care aides who provide the day-to-day assistance including at mealtimes; however, it is the registered dietitian (RD) who provides specialized nutrition care. We sought to examine how roles and responsibilities of care aides and dietitians were described in long-term care settings. As many systematic reviews addressing nutrition care in dementia have appeared in the past two decades, we examined these using an Umbrella Review protocol. Ten papers were retrieved which examined nutrition services for dementia residents. These were diverse in nature. While all addressed some aspect of nutrition and the need for appropriate staffing, only three noted and discussed care aides and only three either noted or made recommendations for involvement of dietitians. Thus, the lack of attention to RDs and care aides represents a true gap that must be addressed in order for recommendations to enhance nutrition care for residents with dementia to be effective. Funding statement: This work was supported by scholarship awards to A.C. from Alzheimer Society of Canada Quality of Life Doctoral Fellowship, a Public Health and the Rural Agricultural Ecosystem (PHARE) graduate trainee fellowship, CIHR-STIHR, University of Saskatchewan.
The effects of a walking program in long-term care (LTC) are affected by multiple comorbidities and the LTC milieu. We randomly assigned residents 60 years and older into three groups (walking, socializing and control). Interventions were delivered five days weekly up to 30 minutes daily. Measurements were performed at baseline, 8, 16, 24 and 32 weeks, and included falls, grip strength, Berg Balance Scale, Senior Fitness Test, and Geriatric Depression Scale Short Form. Survival analysis with 168 participants for time to first injurious fall showed a significant (p=0.001) interaction between age and sex, with fall risk increasing with age in females, but lowest in the oldest age group in males. The hazard ratio for first injurious fall was more than doubled by the use of an antidepressant (HR=2.198, p=0.005), decreased by the score on the Berg Balance high fall risk rating (HR=0.471, p=0.010), but not affected by the activity-socialization intervention. The increased hazard of injurious falls related to antidepressants, but not depressive symptoms, suggests that the high prevalence of antidepressants in LTC needs re-evaluation. Further research efforts will need to control for alternate physical activities. This work was supported by the Saskatchewan Health Research Foundation Health Research (SHRF) Team Grant. Trial registration: ClinicalTrials.gov NCT01277809
The Effects of Cognitive Training Program for Cognitively Impaired Older Adults: A Pilot Randomized Control Trial
Objective: This pilot investigation evaluated the effectiveness of a cognitive training program for older adults with cognitive impairment. Methods: A sample of 23 individuals were randomly assigned to either a 24-session cognitive training program or a wait-list control group. Cognitive training sessions required participants to complete activities that targeted the following cognitive domains: attention, visual and verbal memory, visual spatial skills, processing speed, executive functioning, and language. A battery of cognitive tests were administered prior to and immediately after completion of the program. Depression, quality of life, agitated behavior, and daily functioning were also assessed. Results: Small to large effect sizes on half of the cognitive outcome measures were observed following participation in the program. No positive effects were found with regard to non-cognitive outcomes. Discussion: These results warrant further investigation into the benefits of this cognitive training program in larger randomized control trials. Clinical Implications: The cognitive training program may provide activity staff in assisted living or memory care settings a highly structured, manualized, and user-friendly intervention for older adults experiencing cognitive decline.