Epithelial tissue response to pathological effects in various age groups. Participation of morphofunctional zones and Src-kinase in this process
The response of human organism tissues to various pathological effects depends to a large extent on the presence of the total amount of key protein in the organism – Src-kinase and the ratio of its active part to inactive. With a sharp preponderance of an inactive portion of this protein over the active, the proliferative activity of cells is suppressed, and with a significant preponderance of the active part, proliferation is inadequately increased. The amount of this protein is embedded in embryogenesis and individually in each person. In the age aspect, a decrease in the Src-kinase content in the human organism is observed. The epithelial tissue of two age groups: 20-40 and 75 years and older responds most acutely to pathological effects, including the entering of viruses, since in 20-40 years the number of Src-kinase is the greatest in relation to other age groups, and in 75 years and older – the least, which causes a decrease in the reactivity of organism tissues or, conversely, hyperactivity.
There is substantial evidence to suggest that mindfulness practices positively affect older adults’ physical, emotional, and cognitive wellbeing. However, there is still little information available about the interest and inclination among older adults for performing mindfulness-related exercises. We conducted a survey study aimed at exploring the prevalence of older adults engaged in such activities. Data were collected from 174 older adults (Males: 48; Females:126) who responded using a self-constructed survey, and analyzed using SPSS. Results indicate that almost two-thirds of older adult respondents engage in at least one mindfulness practice and almost a third engage in more than one, with meditation, deep breathing, and yoga being the most prevalent.
The Usefulness of Short Physical Performance Battery Score for Predicting the Ability of Toilet Activity in Hospitalized Older Patients
Background: It has been still unclear whether the cut-off value of the short physical performance battery for predicting the ability of the toilet activity in the hospitalized older patients. The aim of this study was to reveal the relationship between the short physical performance battery and the ability of toilet activity, and also to determine the cut-off value of the short physical performance battery score for the ability of toilet activity in the hospitalized older patients. Methods: In this cross-sectional study, 71 hospitalized older patients were recruited. The short physical performance battery and the ability of toilet activity using the Barthel index (BI) were measured. The patients were split into two groups, according to the ability of toilet activity (Group 1: 10 point; Group 2: 5 point or less in BI score). A multiple logistic regression analysis was used to assess the relationship between the two groups. Moreover, the cut-off value for dividing into two groups, (Group 1 and Group 2) using the short physical performance battery score, which was calculated by a receiver operating characteristic curve. Results: The short physical performance battery score was an independent explanator for the ability of toilet activity using multiple logistic regression analysis. Besides, the cut-off value of the short physical performance battery for the ability of toilet activity was set in this study. Conclusion: The findings of this study suggest that the cut-off value of the short physical performance battery score could be a useful index to predict the ability of toilet activity in the hospitalized older patients.
Efficacy of Doll thErapy compared with standard treatment in the control of behavioral and psychologic Symptoms and CaRegIver Burden in dEmentia: DESCRIBE a randomized, controlled study
Behavioral and psychologic symptoms of dementia (BPSD) are frequent and represent a burden for patients and caregivers; in particular, the presence of agitation and aggression (A/A) has an important impact on patients’ quality of life. As psychotropic drugs can induce severe collateral effects, the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) on A/A in geriatric patients with moderate to severe dementia hospitalized in an acute geriatric unit. We enrolled fifty-two acute in-patients with dementia and A/A. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured agitation and caregiver burden with standard clinical scales at baseline and during treatment. In order to evaluate the effect of DT withdrawal, we carried out a telephonic follow-up interview after 1 and 4 weeks from hospital discharge. DT is more effective than ST in the control of agitation, but not in reducing the professional caregiver burden. The use of pro re nata psychotropic drugs was reduced in patients treated with DT. After DT withdrawal, A/A progressively increased. In conclusion we show that DT may be more effective than ST in the control of A/A in acute geriatric in-patients affected by dementia. Our results suggest that, in patients affected by severe to moderate forms of dementia with A/A, DT may be used as a first line treatment, not only in nursing home residents, but also in acute care geriatric in-patients.
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.