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01/2012 journal articles

PREVALENCE AND PREDISPOSING FACTORS OF FRAILTY SYNDROME IN ELDERLY (> 75 YEARS) INDIAN POPULATION IN SUBACUTE CARE SETUP

P. Chatterjee, B. Krisaswamy

J Aging Res Clin Practice 2012;1(1):3-5

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Background: Purpose of the study was to find out prevalence and predisposing factors of “Frailty Syndrome” in 75 + Indian population. Methodology: Frailty was measured by using Fried criteria, data were then analyzed to look for the association between Frailty with various determinants. Result: Among 100 elderly patient, randomly chosen from Geriatric department of Madras Medical College, India, 21% were frail, 20% were Intermediate frail. Study shows significant association between frailty with ageing (p=0.012), slow gait speed (p=0), hand grip strength (p=0),Under nutrition (p =0.03), ADL impairment (p=0), recurrent hospitalization in last year for minor ailment (p=0.00003) and depression(p=0). Conclusion: Prevalence of frailty is high in 75 + population in hospital setup (sub acute care) which needs immediate attention. Age is the most important risk factor of frailty. Under-nutrition is one of the preventable but significant risk factor. Impaired ADL, Slow gait speed and low hand grip, are independent predictors of Frailty.

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CAROTID RESISTANCE, QUALITY OF LIFE AND FUNCTIONAL AUTONOMY OF ELDERLY INDIVIDUALS SUBMITTED TO AQUATIC TRAINING

Y. Pires da Silveira Fontenele de Meneses, R. Gomes de Sousa Vale, T.M. Campos, A. de Fátima Dornelas de Andrade

J Aging Res Clin Practice 2012;1(1):6-9

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The present study aimed to evaluate modifications in carotid resistance, quality of life and functional autonomy among elderly individuals submitted to water resistance training. The sample was composed of 34 women aged 66 ± 3.2 years, divided into2 groups, intervention (HG=21) and control group (CG=13). Arterial resistance was assessed using Doppler ultrasound, quality of life by applying the WHOQOL-100 questionnaire and functional autonomy through activities of daily living tests. Intervention lasted 12 weeks. No significant differences were found for carotid resistance and quality of life. The 10mWT test showed statistical significance with reduced execution time. Positive correlation was recorded between the RVDP test and the psychological and personal belief domains of QOL. In conclusion, 12 weeks of hydrogymnastic sessions was not sufficient to reduce carotid artery resistance and cause significant improvements in quality of life among sedentary elderly. Nevertheless, it did increase functional autonomy and demonstrated correlation between the walking test and quality of life in the aged.

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UPPER AGE LIMITS IN CLINICAL TRIALS: UNDER-REPRESENTATION OF THE ELDERLY POPULATION

A.A. Walter, J.T. Cramer

J Aging Res Clin Practice 2012;1(1):10-12

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The number of research studies and clinical trials conducted on the elderly (65+ years) has been increasing. There are growing concerns regarding age cutoffs as inclusion criteria in these studies. How old is too old to be a participant in a research study? If a clinical trial is studying the elderly population, should qualified, healthy participants be excluded simply because they are too old? Several recent reports have suggested that there is a lack of justification for setting upper age limits. Issues addressed in this paper include: (a) gender disparity, (b) comparison of “young-old” versus “old-old” subjects, (c) the external validity of extrapolating young results to old individuals, (d) the internal validity of subject mortality, and (e) verification of chronological age. Therefore, the purpose of this paper is to review the available data on ageism and make recommendations to rigorously justify or eliminate upper age cutoffs for studies examining the elderly based on the US Department of Health and Human Services (DHHS) and the US Food and Drug Administration (FDA) with safety and risk assessment in mind.

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ANTI-AGING ACTIVITY OF THE GHK PEPTIDE - THE SKIN AND BEYOND

L. Pickart, A. Margolina

J Aging Res Clin Practice 2012;1(1):13-16

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The human copper binding peptide GHK has been extensively studied as a wound-healing agent and widely used in anti-aging cosmetic compositions. Recent studies demonstrated this substance has a broad range of anti-aging activity. GHK is normally used as its copper 2+ complex GHK-Cu which in low non-toxic concentrations facilitates skin healing and remodeling, reduces inflammatory mediators, and increases production of important growth factors and molecular regulators such as decorin. A series of facial studies conducted by different researchers demonstrated that GHK-Cu containing creams reduce signs of aging such as wrinkles, mottled pigmentation and skin laxity. Also, GHK-Cu increases the expression of epidermal stem cell markers such as integrins and p63. GHK-Cu also repairs DNA damage in irradiated fibroblasts restoring normal functions and growth. Recently GHK and plant alkaloid securinine, out of 1309 bioactive compounds tested, were found to suppress RNA production in 70% of 54 human genes overexpressed in patients with aggressive metastatic colon cancer. GHK-Cu possesses antioxidant activity, increasing the level of antioxidant enzymes, reducing proinflammatory cytokines and oxidative damage, as well as quenching toxic products of lipid peroxidation. In conclusion, the tripeptide GHK-Cu that has a long safety record in skin care formulations possesses a range of health benefits, including skin regeneration, repair of irradiated cells, maintenance of stem cells, as well as anti-inflammatory, antioxidant and anti-cancer activity.

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SKIN IMMMUNOSENESCENCE: THE CRITICAL INVOLVEMENT OF HORMONAL BALANCE AFFECTING SIGNAL TRANSDUCTION

E. Corsini, E. Buoso, E. Donetti, M. Racchi

J Aging Res Clin Practice 2012;1(1):17-22

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Objectives of review: This manuscript aims to review the state of the art on skin aging with particular attention on skin immunosenescence, hormonal changes and signal transduction. Recent findings: Skin immunosenescence accounts, in the elderly, for increased susceptibility to cutaneous infections and malignancies, and decreased response to vaccination. Many factors have been proposed to contribute to immunosenescence. We recently described an aging-related decrease in receptor for activated C kinase (RACK)-1 expression, defective protein kinease Cβ II (PKC) translocation and reduced TNF-a release in rat epidermal cells. Given the observation that adrenal hormones follow a decrease during aging, our group has also demonstrated that the decreased level of RACK-1 protein expression during aging and the observed immune deficits in rats could be restored in vivo by treatment with dehydroepiandrosterone (DHEA). Similar defects were also observed in human skin as demonstrated by reduced expression of RACK-1 measured by western blot and immunofluorescence. As the DHEA/cortisol imbalance is important during aging, we found that DHEA and cortisol antagonistically act on RACK-1 transcription and translation, and, indirectly, on the LPS-induced cytokine production. Conclusion: These observations on the control of a key element in the signal transduction cascade regulating immune function highlight a link with the hormonal changes in cell environment associated with aging, and the complex process of ageing of the skin and its immune system.

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PLASMA CONCENTRATIONS OF RETINOL, TOCOPHEROLS, AND CAROTENOIDS AND PLATELET FATTY ACIDS IN A GROUP OF FEMALE IOWA CENTENARIANS

S.A. Tanumihardjo, H.C. Furr, J.W. Stewart, M.J. Oakland, P.A. Garcia

J Aging Res Clin Practice 2012;1(1):23-28

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Objective: Dietary and biochemical assessment of nutritional status of centenarians in assisted care/nursing home settings. Methods: Twenty-four centenarian rural and small-town Midwestern, Caucasian women (98.4 ± 3.4 y, mean ± SD, range 95 to 108 y) were studied for dietary intake, plasma concentrations of retinol, retinol-binding protein (RBP), tocopherols, carotenoids, and platelet fatty acid (FAs) concentrations. Results: Diet provided a daily intake of 1710 kcal, 71 g protein, 58 g fat, and 234 g carbohydrate. Plasma retinol concentration was 1.95 ± 0.52 µM, RBP concentration was 2.48 ± 0.66 µM, and the percent saturation of RBP was 78%. Concentrations of α- and γ-tocopherol were 27.8 ± 11.0 and 5.23 ± 2.12 µM, respectively. The major plasma carotenoids were β-carotene (0.44 ± 0.21 µM), lycopene (0.43 ± 0.20 µM), lutein + zeaxanthin (0.32 ± 0.17 µM), and α-carotene (0.15 ± 0.06 µM). Plasma retinol and RBP concentrations were highly correlated (r = 0.982). There were significant positive correlations between plasma total cholesterol and retinol, RBP, γ-tocopherol, lutein, α-carotene, β-carotene, and platelet 18:2 (µg in 2x108 cells/mL). There were significant positive correlations between dietary 20:4 and platelet 18:0 FAs, dietary 20:4 and serum LDL cholesterol, platelet 18:1 (%FA) and serum HDL-cholesterol. Conclusions: Biochemical values were generally within normal/acceptable ranges, confirming that adequate nutritional status could be maintained in a long-term care setting among centenarians who did not have major chronic, wasting diseases.

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GRIP STRENGTH AT AGE 58 AFTER PRENATAL EXPOSURE TO THE DUTCH FAMINE

M.V.E. Veenendaal, S.R. de Rooij, R.C. Painter, S. Robinson, C. Osmond, A. Aihie Sayer, T.J. Roseboom

J Aging Res Clin Practice 2012;1(1):29-32

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Background: Grip strength is a marker of current and future health. Small size at birth is associated with reduced grip strength and poor health in later life. Prenatal undernutrition may affect adult grip strength. We investigated the effect of prenatal undernutrition on grip strength in the Dutch famine birth cohort. Methods: We assessed grip strength in 334 men and 364 women at age 58, born as term singletons around the time of the 1944-45 Dutch famine. We compared grip strength among men and women who had been exposed to famine during different periods of gestation to unexposed subjects. Results: Men exposed to famine in early gestation had a 4.2 kg (95%CI 1.0 to 7.3) greater grip strength compared to unexposed men. After adjustment for adult height and timing of participation in the study, the association was no longer significant (2.9 kg (95%CI -0.2 to 6.0)). In women, prenatal exposure to famine was not significantly associated with grip strength. A 1 kilogram increase in birth weight was associated with an increase of 2.8 kg (95%CI 1.0 to 4.7) in grip strength in men and 1.5 kg (95%CI 0.1 to 2.8) in women, adjustment for adult body size explained this relationship. Conclusions: There was no evidence for significant independent associations between prenatal famine exposure and adult grip strength although men exposed in early gestation appeared to have increased grip strength explained by taller adult height. Consistent with previous studies, there was a relationship between small size at birth and lower grip strength.

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SERUM ß-CRYPTOXANTHIN AS A PREDICTOR OF BONE FORMATION MARKERS IN POST-MENOPAUSAL WOMEN

F. Granado-Lorencio, F.J. García-López, E. Donoso-Navarro, I. Blanco-Navarro, B. Pérez-Sacristán

J Aging Res Clin Practice 2012;1(1):33-36

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Objective: To assess the associations between fat-soluble vitamin and antioxidant status and levels of bone remodelling markers in post-menopausal women. Design: A cross-sectional study. Setting; A nutrition laboratory from a terciary hospital. Participants: Sixty-one post-menopausal women were contacted to participate in a dietary intervention trial and 36 women were finally included (age 45 to 65years, BMI <35 kg/m2, amenorrhea over 12 months, no hormone therapy, no anabolic or antiresorptive therapy). Mearurements: Baseline blood samples were processed for the assessment of retinol, α-tocopherol, 25-OH-D3, lutein/zeaxanthin, β-cryptoxanthin, lycopene, α-carotene and β-carotene (by UHPLC), parathyroid hormone and bone metabolism markers (osteocalcin, N-terminal peptide of procollagen I (P1NP) and β-crosslaps), sex hormones (17-β-estradiol, FSH, LH) and lipid profile. Results: Mean values of all the parameters except total cholesterol were within reference ranges even when mean concentrations of 25-OH-vitamin D could be considered as insufficient (mean, [95% confidence interval]: 47.7 nmol/l [41.1 to 54.2 nmol/l]). Bone remodelling markers in serum were not significantly correlated to age, age of menopause, weight, BMI, sex hormones, lipids, retinol, α-tocopherol (or α-tocopherol /cholesterol ratio) or 25-OH-vitamin D. Only crude concentrations and cholesterol-adjusted values of β-cryptoxanthin showed a positive and significant correlation with bone formation markers (r= 0.53, p=0.001 for osteocalcin; r=0.41, p=0.013 for P1NP) while lycopene showed an inverse trend with P1NP (r= -0.32, p=0.06). In the regression analysis, β-cryptoxanthin alone could explain 28% of the variation of serum osteocalcin (r2= 0.28; B= 0.60; p=0.001). Conclusion: Serum β-cryptoxanthin is a predictor of bone formation markers in post-menopausal women and dietary advice regarding β-cryptoxanthin-rich foods may be a safe and sustainable approach to improve bone health.

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BIOMETALS: NEW TOOLS FOR OBESITY TREATMENT AND ITS RELATED METABOLIC DISORDERS

M. Afzal, I. Kazmi, G. Gupta, R. Kaur, Z. Ahmed, M. Rahman, S. Saleem, A. Kazmi, M.M. Alam, F. Anwar

J Aging Res Clin Practice 2012;1(1):37-39

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Objective: Overweight and obesity have become an increasingly serious clinical and socioeconomic problem of world, and one of the greatest health challenges to man kind. It is estimated at least 1.1 billion adults are overweight, including 312 million individuals who are obese. Overweight and obese patients are at an increased risk for developing numerous cardiometabolic complications and certain types of cancers. There is much need to develop some newer pharmacological approaches for the treatments of obesity. One such pharmacological treatment for obesity may be through inorganic salts; these inorganic salts have been used in the treatments of various diseases. The inorganic salts of Vanadium, Chromium, Magnesium, Selenium, Calcium and Zinc etc., have been evaluated for their pharmacological activity. The present article is an effort on these inorganic salts to correlate and utilize them in the treatment of obesity.

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INFLAMMATORY CYTOKINES AND APPETITE IN HEALTHY PEOPLE

E. Dent, R. Visvanathan, C. Piantadosi, R. Adams, K. Lange, I. Chapman

J Aging Res Clin Practice 2012;1(1):40-43

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Background and Objectives: Inflammation has been associated with reduced appetite and body composition changes in populations with established diseases. However, it is not known if an association exists between appetite, body composition and inflammation in healthy people. Design: To explore associations of appetite with markers of inflammation and body composition, data from the Cytokines, Adiposity, Sarcopenia and Ageing (CASA) study was analysed. Setting: Western suburbs, Adelaide, Australia. Participants: 180, population representative, healthy participants, aged 18 – 82 years, were studied. Measurements: Body composition was measured by both Dual X-ray absorbiometry (DXA) and bioelectrical impedance analysis (BIA). Appetite was assessed by the Simplified Nutritional Appetite Questionnaire (SNAQ). Circulating cytokine concentrations were measured. Results: Multiple regression analysis showed appetite scores were increased in non-smokers (P = 0.031) and men (P = 0.024), negatively associated with serum levels of the pro-inflammatory IL-1β (β coefficient = - 0.379, P = 0.007), and positively associated with serum levels of the anti-inflammatory cytokine IL-10 (β coefficient = 0.25, P = 0.010). There was no association between appetite and body composition. Conclusions: Appetite loss may reflect background inflammation even in apparently healthy people, and probably occurs before consequent changes in body composition. Further explorations of longer term appetite changes with respect to inflammation and body composition changes are needed.

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CORRELATES OF THIGH MUSCLE INDEX WITH PHYSICAL PERFORMANCE IN AMBULATORY GERIATRIC PATIENTS

C.-I. Chang, C.-Y. Chen, C.-H. Wu, C.A. Hsiung, C.-Y. Chen

J Aging Res Clin Practice 2012;1(1):44-50

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Objective: 1) to validate the correlation between the estimated dominant thigh muscle volume using anthropometric measurements and the physical performance of lower limbs in elderly adults at ambulatory clinics; 2) to examine the association between dominant thigh muscle index and frailty. Design: Longitudinal observational study. Setting: Outpatients at family or geriatric medicine clinics. Participants: One hundred forty-eight elderly adults aged 65-90. Measurements: The anthropometric measurements (including weight and thigh circumference), appendicular skeletal muscle mass by bioelectrical impendence analysis (BIA), quadriceps muscle strength, physical performance (including timed Up & Go test, 5-meter walking time, and handgrip strength) were examined at baseline and 1-year follow-up with the Fried Frailty Index evaluated concurrently. Results: The estimated dominant thigh muscle volume was correlated positively with quadriceps muscle strength and the predicted appendicular skeletal muscle mass but negatively with physical performance (timed Up&Go and 5m walking time) (p≦0.01). Dominant thigh muscle index (quadriceps muscle strength per estimated thigh muscle volume*1000 of the dominant leg) was marginally different between genders (p=0.06). Additionally, older age, weaker quadriceps muscle strength, lower dominant thigh muscle index, and longer time for TUG (timed Up & Go) test were associated with frailty status (all p-values < 0.05). Dominant thigh muscle index was an independent and protective factor associated with frailty after age adjustment. Conclusion: Using the equation with anthropometric measurements to estimate thigh muscle volume is a simple and noninvasive method. Moreover, dominant thigh muscle index helps detect frailty at an early stage and minimize the impacts of gender difference on frailty.

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ELOPEMENT EVALUATION ON ALZHEIMER DISEASE PATIENTS IN FRANCE. THE EVADE STUDY

D. Huvent-Grelle, I. Delabrière, J. Roche, C. Jacquet, D. Dulys, F. Puisieux

J Aging Res Clin Practice 2012;1(1):51-55

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Background: Elopement is frequently observed among older adults with AD. Little work has been done on this significant problem. Objectives: to analyse the prevalence of the phenomenon, to define the profile of those who run away and to describe intervention strategies employed to prevent new intent to elope. Design and setting: Prospective study over one year (2009) of 6,649 participants living in nursing homes or long-term care units in the North of France. Participants: Prospective survey of elopement incidents that occurred among 65 licensed representative facilities in the North of France. Measurements: Our survey describes the circumstances, environmental risks and injuries sustained in 66 elopement incidents involving our residents. Results: The distinctive features of people who elope and elopement incidents are described in our communication. All residents who eloped had been diagnosed with AD or other forms of dementia. 35 % had a history of elopement. No resident was found dead. Once the patients got back, caregivers made significant changes (36 %): by adapting organization levels, pharmacological interventions, and activity programmes. However for those who had run away (64 %) and whose carers did not change their strategies; we noted 15 new elopement incidents (versus 3 when changes had been made). There was no legal investigation involved in the course of our study. Conclusion: Elopement can be dangerous. It puts both families and caregivers under a lot of stress. Physical restraints are used to prevent wandering and elopement. The problem for physicians, administrators and caregivers is working out how to improve safety enough to prevent elopement incidents for residents without encroaching upon their rights.

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THE EFFECTS OF MULTIDISCIPLINARY TREATMENT ON THE FUNCTIONAL CAPACITY AND QUALITY OF LIFE IN OBESE, ELDERLY WOMEN

T.H. Sá, N. C. Horie, R.M.M. Moreira, W. Jacob-Filho

J Aging Res Clin Practice 2012;1(1):56-60

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Objectives: To verify the impacts of a multidisciplinary program on aerobic capacity, strength, weight loss, and quality of life, as a treatment for obesity among the elderly. Methods: Women (≥ 60 years old) with a body mass index (BMI) ≥ 30 kg/m2 participated in this noncontrolled clinical trial. For six months, 22 patients received geriatric and nutritional assistance and performed supervised physical activity twice a week. Lower limb strength was quantified through the Guralnik sit-to-stand test (SST), aerobic capacity was measured during a 12-minute walk/run test (12MWT), quality of life was measured by the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, and body composition, by electrical bioimpedance. Statistical Analysis: Student's t-test was applied for dependent samples and analysis of variance was used for repeated measures. Results: Initially, the patients presented a BMI of 36.79 (5.26) kg/m2 (average [standard deviation]), a fat mass (FM) of 42.41% (3.4%), a 12MWT distance of 963.9m (123.6m), and an SST of 8.71s (3.93s). After the intervention, there was an average reduction of 6.74% (2.9%) (p = 0.034) in body weight and an average BMI of 34.28 (4.83) kg/m2 (p = 0.047), largely due to a reduction of FM (40.27% [4.43%]; p= 0.008). There were improvements in the 12MWT (1081.95 [168.56] m; p<0.001), in the SST (7.72 s [2.86 ]s, p=0.047) and the WHOQOL-BREF as well as in the general (+38.2%, p<0.001), physical (+21.7%, p = 0.001), and social (+12.9%, p = 0.003) subscores. The reduction of body weight had a positive correlation with the improvement in the physical domain of the WHOQOL-BREF (r = 0.50; p =0.018). The SST decreased just between the patients with a weight loss ≥ 5% (p = 0.028). Conclusions: Elderly patients who underwent multidisciplinary treatment for obesity lost weight and improved their physical capacity and quality of life.

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SIX MINUTE WALK TEST AS A VALUABLE ASSESSMENT TOOL FOR EXERCISE CAPACITY IN HEALTHY KIBBUTZ ELDERLY

B. Narotzki, A.Z. Reznick, D. Navot-Mintzer, B. Dagan, Y. Levy

J Aging Res Clin Practice 2012;1(1):61-63

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Objective: To study six minute walk test sensitivity in monitoring exercise effects on healthy kibbutz elderly. Design and participants: Interventional trial conducted at two north eastern Israeli kibbutz communities involving 11 healthy men and 13 healthy women aged 61 and older. Methods: Exercise protocol included 30 min of moderate daily walks for 12 weeks. Six minute walk test was performed according to American Thoracic Society guidelines at baseline and after 12 weeks. Results: Six minute walk distance improved by 10.3% (p < 0.001). Participants BMI decreased significantly in men and in a greater extent in women (-0.5 and -1.2 Kg/m2, respectively, p < 0.05). Waist circumference also decreased less in men then women (3.4 and 6.3 cm, p < 0.01, respectively). Integration of baseline and end data showed significant correlations between six minute walk test results and height (positive, r=0.34, p <0.05), BMI, waist and hips circumferences (negative, r = -0.43, r = -0.43 r = -0.29, respectively, p < 0.05). Conclusion: Six minute walk test was able to demonstrate the efficacy of 12 weeks of exercise in elderly healthy kibbutz citizens. Exercise was sufficient to induce a promising decrease in body weight and circumferences.

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PREVALENCE AND RISK FACTORS OF SARCOPENIA IN NURSING HOME ELDERLY EVALUATED BY BIA: A COHORT STUDY

K. Van Puyenbroeck, T. Van Deun, L. Roelandts, P. Van Royen, V. Verhoeven

J Aging Res Clin Practice 2012;1(1):64-68

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Background: The decline in skeletal muscle is a major problem in elderly and can contribute to the development of functional limitations. The objective of this study was to provide data on sarcopenia prevalence in nursing homes and to assess influencing and associated factors to identify patients at risk for sarcopenia. Methods: This study was part of a longitudinal study in 52 nursing homes in Antwerp (Belgium). Between October 2007 to April 2008 a cohort study was conducted. 405 healthy people aged 65 years and older of both genders were included. Body composition was estimated using bio electrical impedance analysis (BIA). Gait speed was assessed using the timed get up and go test. Information on functional status was measured using the Katz score and nutritional assessment was made based on the MNA-SF (Mini Nutritional Assessment – Short Form). A blood sample for 25 (OH) vitamin D3 was collected at baseline. Results: The prevalence of sarcopenia in our nursing home population was 14.8%, with a significant gender difference i.e. 19.9% in women and 2.7% in men. Logistic regression analysis shows that older age (p=0.032), female gender (p=0.001) and poor nutritional status (p=0.000) are significantly associated with sarcopenia in nursing homes. Conclusions: This study shows that sarcopenia is an important problem in nursing home residents. Attention for this problem is needed especially in elderly women with a poor nutritional status.

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NUTRITIONAL STATUS OF RESIDENTS IN GROUP-LIVING CARE FOR DEMENTIA

T. Hamamukai, M. Kanauchi

J Aging Res Clin Practice 2012;1(1):69-73

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Background: The number of group-living home (GLH) in Japan has been increasing in recent years, but little information is available on how many residents living in GLH experience malnutrition. Objective: Using the Mini Nutritional Assessment (MNA), we investigated the nutritional status and its relationship to cognition, functional ability, and dietary intake in elderly residents with dementia in small-scale GLH. Methods: Subjects were 60 residents with dementia (49 women and 11 men; mean age, 83.6 years) in six GLH in Japan. The MNA, Clinical Dementia Rating (CDR), activities of daily living (ADL) score, and dietary intakes on 3 separate days were examined. Results: According to the MNA, subjects were divided into three categories: well-nourished (21.7%), at risk for malnutrition (63.3%), and malnourished (15.0%). By logistic regression analysis after adjustment for age, sex, and CDR, energy intake and protein intake were significantly associated with risk for malnutrition; additionally ADL score, emotional impairment, and feeding dependency were significantly associated with being malnourished. Conclusion: This is the first report to investigate the MNA nutritional status and associated factors among GLH residents with dementia in Japan. Many elderly patients with dementia living in GLH were at risk for malnutrition. Although most GLH offer a good living environment for people with dementia, more attention must be focused on early identification of malnutrition in these care settings.

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SMOKING, ALCOHOL CONSUMPTION, TEA CONSUMPTION, EXERCISE AND RISK OF DEPRESSION AMONG CHINESE NONAGENARIANS

Q. Hao, B. Dong, C. Huang, Z. Yanling, L. Luo, J. Yue

J Aging Res Clin Practice 2012;1(1):74-79

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Objective: Depression symptom was common among the oldest-old people and there is no study to observe the association of depression with habits of smoking, alcohol consumption, tea consumption and exercise among very old people. The present was conducted to analysis the association of depression with these habits. Design, Setting, Participants: A cross-sectional study conducted in Dujiangyan Sichuan China, 692 unrelated Chinese nonagenarians and centenarians (67.34% women, mean age 93.50 years) resident in Dujiangyan. Measurements: A brief 23-item geriatrics depression scale Chinese-edition (GDS-CD) test was used to diagnose depression and these habits were collected. Results: In the whole population, compared subjects with depression, participates those without depression had significantly higher prevalence of exercise habit. However, in women, there was no significant difference in prevalence of these habits between subjects with and without depression except the habit of former alcohol consumption. After adjustment for age, gender, educational levels, religion habits and cognitive function and BP levels and BMI, we found that current habit of exercise had a significant odds ratio (OR=0.31 95% CI (0.11, 0.83)) for depression in oldest old men. Conclusions: Among Chinese Nonagenarians/Centenarians, among habits (current and former) of smoking, alcohol consumption, tea consumption and exercise, there seems to be significant association of depression only with exercise and former habits of alcohol consumption. Former habit of alcohol consumption in women might be associated with a greater risk of depression, but exercise habit in men might be associated with a lower risk of depression.

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DIETARY INTAKE AMONG USERS OF A HEALTH PROMOTION SERVICE: DIFFERENCES BETWEEN ADULTS AND ELDERLY PEOPLE

A.C. Souza Lopes, A. Nunes Lima Reyes, C.C. César, L.C. dos Santos

J Aging Res Clin Practice 2012;1(1):80-83

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Objectives: To identify the dietary profile according to the age classification of users of a health promotion service. Design: Transversal study assessing dietary profile according to age. Setting: One health promotion service which provides both opportunities to practice physical activities and receive nutritional follow-ups for free. Individuals, of age 20 years and over, who were assisted by these services from February to September 2007 (n=300). Measurements: Anthropometry, food habits, and nutrient intake were evaluated. Results: Out of 300 individuals of mean age 49.7±14.1 years, 26.7% were elderly (> 60 years) and 87.3% were women; 44.0% were overweight and 33.7% were obese. The elderly individual presented greater risk of developing cardiovascular diseases, according to waist/hip ratio (42.5% vs. 30.5% among adults; p=0.050), greater prevalence of arterial hypertension (71.8% vs. 41.4%;p<0.001) and dyslipidemia (46.2% vs. 32.4%;p=0.026). Dietary inadequacy was more prominent among the adults, as the habit of eating while watching television (62.3% vs. 41.3% for elderly people; p<0.001), insufficient iron intake (49.1% vs. 32.5%; p=0.010), excessive zinc intake (42.2% vs. 27.5%; p=0.020) and excessive vitamin A (27.5% vs. 16.3%; p=0.049). Conclusion: Elderly individuals presented greater prevalence of chronic diseases, while dietary inadequacy was more prevalent among adults. This emphasizes the importance of healthcare actions between adults with the aim of preventing future complications.

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ASSOCIATION OF DENTAL STATUS WITH VEGETABLE INTAKE IN AN ELDERLY POPULATION

T. Hirotomi, A. Yoshihara, H. Ogawa, H. Miyazaki

J Aging Res Clin Practice 2012;1(1):84-87

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Objective: To investigate the association of dental status with fruit and vegetable intake in a Japanese elderly population. Design: A cross-sectional survey on a household basis. Setting: A prefecture in Japan: Niigata. Participants: A total of 123 edentulous and 541 dentulous Japanese elderly people aged 65 years and older. Measurements: During a single day of the survey period, each individual household member recorded the type and amount of food eaten and each record was confirmed by dietitians. Data regarding the number of teeth present were collected by questionnaire. Results: The adjusted mean of vegetable intake was significantly lower in the edentulous (351.6 +/- 17.1 g, P = 0.042) and those with 1-9 teeth (344.6 +/- 16.3 g, P = 0.013) than in those with 20 teeth or more (394.9 +/- 11.3 g). A significantly higher adjusted level of consumption of sweets was found in the edentulous (32.6 +/- 3.7 g, P = 0.033) than in those with 20 teeth or more (22.8 +/- 2.4 g). While total fruit intake did not differ by dental status, edentulous elderly consumed significantly more oranges (33.1 +/- 4.9 g, P = 0.021), less cabbage (17.3 +/- 4.8 g, P = 0.001) and tended to eat fewer apples. Conclusions: Retention of even a few teeth could help in terms of the intake of some kinds of fruit for the elderly.

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UNDERNUTRITION IN VERY ELDERLY PEOPLE: ASSESSMENT USING DIFFERENT ANTHROPOMETRIC INDICATORS

D. Fares, A.L. Danielewicz, K.C. Garcia, L.S. Ferreira, A.R. Barbosa

J Aging Res Clin Practice 2012;1(1):88-92

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Objective: To verify the prevalence of undernutrition among very elderly persons in the municipal area of Antônio Carlos, Santa Catarina, using different anthropometric indicators. Methods: Cross-sectional study carried out with 133 elderly persons (78 women) ≥ 80 years of age. The anthropometric indicators assessed were TSF (≤ 15 mm, women and ≤ 8 mm, men), AC (≤ 26 cm, women and ≤ 25 cm, men) AMA (≤ 32.76 cm2, women and ≤ 37.16 cm2, men), CC (≤ 31 cm, women and men) and BMI (≤ 22.4 kg/m2, women and ≤ 21.1 kg/m2, men), according to gender and age group. Results: BMI, AC, TSF were higher (p < 0.05) in the youngest as compared to eldest elderly women. Mean BMI, AC and TSF was higher (p < 0.05) in women compared to men (80-89 age group and total elderly). Mean AMA was lower in the oldest than in the youngest individuals (p < 0.05) and was greater (p < 0.05) in men than in women. The prevalence of undernutrition varied according to the indicator used. AMA was the anthropometric indictor that identified the highest prevalence (63.8%) of men and women (55%) suffering with undernutrition. Conclusion: The very elderly people of Antônio Carlos have a vulnerable nutritional status, both in relation to muscle reserve and fat reserve, with differences according to gender and age group.

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MEASUREMENT AND DISTRIBUTION OF PHYSICAL FUNCTIONAL STATUS IN OLDER ADULTS USING OBJECTIVE AND SUBJECTIVE TESTS: DIFFERENCES BY SEX

M. Sánchez-Martínez, M.V. Castell, M.T. Sánchez-Santos, M.V. Zunzunegui, A. Otero, M.C. de Hoyos

J Aging Res Clin Practice 2012;1(1):93-97

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Background: Knowledge of physical status in older adults makes it possible to plan actions that promote healthy ageing. This study aimed to use a hierarchical classification of the physical status and to assess sex differences of physical function using objective and subjective measures. Methods: Data come from a representative random sample of 814 persons age 65 and over living in a neighbourhood of Madrid and were collected between June 2007 and June 2008. The dependent variable was physical function classified into four levels: good, limited, mobility disability, and disability in the activities of daily living (ADL) and was measured by self-reported questionnaire. Physical performance was assessed by the SPPB (Short Physical Performance Battery). The independent variables were age and sex. Results: The prevalence of good physical function in the study population based on self-reports was almost three times higher in men than in women (40.2% versus 15.2%). A larger proportion of women were dependent in mobility (44.1% versus 25.5%) and in ADL (14.1 versus 6.9%). This association persisted after adjustment for age. Using as dependent variable the objective performance score (SPPB), sex differences remained after adjusting for age (regression coefficient: 1.22 IC95% 0.87-1.58). The four groups are classified hierarchically. A staged reduction in total SPPB and each of its components found with decreasing level of self-reported physical function. Conclusion: The physical function classification presented is hierarchical, suggesting that before becoming disabled, one first has physical limitations and mobility disability. Women showed worse physical function in self reported disability and objective measures of physical performance.

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INDIVIDUALLY ADAPTED NUTRITIONAL INTERVENTION REDUCES DIETARY PROBLEMS AND IMPROVES PHYSICAL FUNCTION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

A.M. Grönberg, L. Hulthén, S. Larsson, F. Slinde

J Aging Res Clin Practice 2012;1(1):98-100

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Dietary problems are common in patients with severe chronic obstructive pulmonary disease (COPD) and affect energy intake and nutritional status. The aim was to investigate effects of dietary counselling on dietary problems during a 12-month rehabilitation programme for patients with COPD. In 73 subjects with severe COPD, nutritional status was assessed by body mass index (BMI) and fat free mass index (FFMI) by single frequency bioelectrical impedance. Energy intake was calculated. The subjects were asked to describe any dietary problem they experienced. A six-minute walking test (6MWT) was performed to assess physical function. After 12 months of individually adapted nutritional intervention, 67 subjects were assessed by the same parameters. The number of dietary problems was reduced from 98 to 68. A significantly smaller group reported ” Fear of gaining weight” and ”Diarrhoea” (p<0.05). The patients succeeding in reducing their dietary problems also improved physical function indicated by significant improvements in 6MWT (mean 29.4 meters) after 12 months compared to baseline (p=0.023). Individually adapted dietary counselling can reduce the number of dietary problems. The results underline the importance of identifying dietary problems specific to the individuals as a means for improving nutritional status and physical function.

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