Telomere Length in Cystic Fibrosis Patients – Are Patients with CF Ageing Too Quickly?
Life expectancy for patients living with Cystic Fibrosis (CF) is increasing year on year and there is growing interest in the ageing process in CF. Telomeres are repetitive sequences of DNA that cap the ends of eukaryotic chromosomes and shorten with ongoing cell division, thus providing a marker of replicative history and biological ageing. We aimed to investigate whether telomere length as a function of age differs between patients with CF and healthy individuals and whether telomere length is associated with severity of the patient’s CF condition. Peripheral blood samples and demographic data were collected from 47 consenting patients (age 1 to 57 years) with CF attending their routine annual review appointment at the All Wales Adult CF Centre and Noah’s Ark Children’s’ Hospital in Cardiff, UK. Telomere length profiles were assessed from peripheral blood samples, using the high resolution single telomere length analysis technique (STELA) and compared to healthy control telomere length data. Patients with CF had significantly shorter telomere lengths than healthy individuals, when adjusting for age (p
Psychometric Characteristics of the Mini-Mental State Examination among Older Chinese Immigrants
Backgrounds: The recent growth of older adult immigrants and the increased burden of Alzheimer’s disease and related dementias (ADRD) call for validation of the assessment tools and timely detection of cognitive impairment. In particular, older Chinese Americans are among the fastest growing populations in the U.S., who are at high risk for delayed diagnosis and deficient management of ADRD due to limited knowledge of dementias and barriers to healthcare access. The value of the MMSE as a screening tool in detecting ADRD is well documented in western countries. Yet, little is known about the psychometric characteristics of a Chinese version of the MMSE (CMMSE) in older Chinese immigrants, whose cognitive test performances may relate to cultural and linguistic differences. Purpose: The study aims to assess factor structure and psychometric properties of CMMSE among older Chinese immigrants in the United States. Methods: Participants were recruited from the greater Chicago area in the Population-based Study of Chinese Elderly (PINE). The sample included 3,126 respondents aged 60 or over, who selected Chinese dialects in completing face-to-face interviews. A bifactor analysis was conducted to test unidimensionality of the CMMSE. Rasch modeling was used to assess scale properties. Age, sex, and education were tested for differential item functioning (DIF). Results: A bifactor analysis identified a unidimensional general factor with 30 items, reflecting a single underlying construct of cognitive capacity. We also found five concurrent subdomains with 19 items. The general factor explained 71 percent of the variance in the CMMSE. The Rasch model provided evidence of construct validity with acceptable item fit statistics. The DIF analysis showed that item biases were generally negligible. Conclusion: The CMMSE appeared to be a valid, reliable screening instrument for cognitive impairment in the US Chinese older adults. Findings provided support for the use of the CMMSE in detecting cognitive…
NEW APPROACHER IN THE DEVELOPMENT OF ALZHEIMER’S DISEASE MODIFYING DRUGS
Introduction: Alzheimer’s disease is a more common neurodegenerative disease, affecting 25 million people worldwide, or accounting for about 60 to 70% of all dementia cases. There is currently no exact mechanism to explain the pathophysiology of Alzheimer’s disease, however, cascading metabolic amyloid and post-translational review of tau protein are used as major hypotheses. Objective: To demonstrate in the literature new approaches in the development of Alzheimer’s disease modifiers. Methodology: For the accomplishment of this study made in the bibliographical survey of scientific literature and respect to the approached subject, in the databases PUBMED, ScienceDirect, Scielo and Scopus. Results: Alzheimer’s disease-modifying drugs are not yet available, but many patients may, however, develop phase III clinical trials and are intended to modify as pathological stages leading to the disease. As disease-modifying therapies under study, these changes also affect Aβ and tau protein and also cause inflammation and oxidative damage. The results obtained in the clinical trials performed were positive and promising and are still under study. The results show that there is still a long way to go in the development of Alzheimer’s disease modifying drugs. Conclusion: The results demonstrated that there is still a long way to go in the development of Alzheimer’s disease modifying drugs, but nevertheless levels at the research level should be continued in order to improve the pathophysiology of the disease and find an effective treatment for this disease the same.
The Impact of COVID-19 on Informal Caregivers in the US
Background: Caregiver burden has negative effects on mental and physical health along with quality of life. Meanwhile, social and physical distancing protocols during the COVID-19 pandemic have created additional impacts on informal caregiving in a rapidly changing environment. Early research over the past year suggests that the pandemic has caused increased caregiver burden as well as caregiving intensity among these individuals. Purpose: Our primary purpose in this informational literature review is to describe the impacts of the pandemic on informal caregiver burden and the sudden shift in roles and responsibilities as a result of pandemic-related changes in caregiving. This review will describe emerging effects on various aspects of health among informal caregivers and explore the growing need to support unpaid caregiving during this time. Methods: A streamlined search was conducted to fit the scope of this review, with key terms determined to identify relevant publications. Common research databases and up-to-date mainstream resources were utilized. Notably, we focused on research published or released since March 2020, primarily rapidly reviewed studies, to align with the timing of the COVID-19 pandemic in the US. Results: Early research suggests that the pandemic has worsened caregiver burden and increased caregiving intensity and hours of care among unpaid, informal family caregivers. Reported health impacts include higher stress, pain, and depression, along with decreased social connectedness and quality of life. Notably, however, COVID-related research generally does not focus on the positive aspects of caregiving, such as its role as a source of purpose in life, creating an opportunity to explore ways to boost certain valuable personal resources among caregivers. Conclusions: Informal family caregivers face their own negative health outcomes and distress as a result of greater caregiver burden, intensity, and the changing landscape of caregiving during the ongoing COVID-19 pandemic. Immediate policy and support recommendations should be…
The Effects of A Cognitive Training Program for Older Adults: A Brief Preliminary Report
As one ages, some degree of cognitive decline is expected. Despite this, declines in cognitive abilities and the possibility of dementia is a common concern among older adults. In response to these concerns, a variety of cognitive training programs have been developed that aim to improve or maintain cognitive functioning. Prior literature has shown mixed or limited findings on cognitive changes after implementation of cognitive training. This study evaluated the effectiveness of a cognitive training program designed for older adults with no to minimal cognitive decline. The current study included 17 participants who engaged in two one-hour cognitive training sessions each week for 12 weeks. Each session required participants to complete activities that targeted the following cognitive domains: attention, visual and verbal memory, visual spatial skills, processing speed and executive functioning, and language. These cognitive domains, along with depression and memory self-efficacy, were assessed prior to and immediately after completion of the program. Small to large effect sizes on the majority of cognitive outcome measures were observed following participation in the program. Small reductions in depressive symptoms were also found. These findings provide preliminary support for the use of a comprehensive cognitive training program for cognitively-intact older adults.
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.
Older Adults’ Engagement in Mindfulness Practices
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.
Potentially Inappropriate Medications for Older Adults in Dental Practice
Objective: The present study aimed to review the medications frequently prescribed in dental practice that are potentially inappropriate for the elderly population due to the risks presented. Methods: An integrative literature review was carried out, based on the Guidance Manual: Prescription and Dispensing of Medicines Used in Dentistry, which reports the main drugs prescribed in dental practice (2017). From this, medications described in the Beers list of the American Society of Geriatrics (2019) were extracted, in order to identify medications that are potentially inappropriate in the elderly, what are the main consequences of use and appropriate management in view of the need for prescription. Results: The prescription and dispensing guidance manual for medicines used in dentistry has a list of 142 medicines, containing anti-inflammatories, antibacterials, opioids, benzodiazepines and other types of drugs. Of the drugs listed, 27 are considered inadequate and the most common therapeutic class among the drugs was anti-inflammatory drugs, being equivalent to 44.5% of the inadequacies found. Conclusion: Despite the risks associated with medications, it appears that they are widely prescribed in dental practice, making these groups worthy of special attention due to their potential for serious adverse events and negative impacts on the elderly and the health system, in addition to to emphasize the importance of the professional regarding the best indications and pharmacotherapeutic follow-up by the clinical pharmacist in caring for the elderly.
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.