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04/2014 journal articles

CONSIDERATIONS IN FAVOR OF THE USE OF FISH OIL FOR CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT IN OLDER ADULTS

I.M. Muo, M. Miller, A.P. Goldberg

J Aging Res Clin Practice 2014;3(4):191-195

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Omega-3 polyunsaturated fatty acids (fish oils) cause many metabolic benefits such as reductions in hypertriglyceridemia, blood pressure, markers of inflammation that may help to prevent or treat cardiovascular disease (CVD), particularly in older high risk patients. However, recent meta-analyses question these health benefits of fish oil supplementation. Studies show fish oil to be beneficial in cardiovascular health particularly when combined with physical activity and low cholesterol diet even though certain cardiovascular medications can interact with fish oil to affect its clinical response. In this review, we present clinical, behavioral and pharmacological factors such as age, genetics, gender, medications and lifestyle which can influence patients’ biological responses to fish oil supplementation. We conclude that these factors, which are not typically accounted for in many clinical trials, may significantly contribute to the negative findings of these meta-analyses.

CITATION:
I.M. Muo ; M. Miller ; A.P. Goldberg (2014): CONSIDERATIONS IN FAVOR OF THE USE OF FISH OIL FOR CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT IN OLDER ADULTS. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.33

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CARDIOPULMONARY EXERCISE TESTING RESPONSES AND PRO-BNP VALUES IN ADULTS WITH MILD DEGREES OF DIASTOLIC DYSFUNCTION

H.R. Ahmadian, J.R. Sherratt, K.M. Lochner, M. Dubois, K.M. Leclerc

J Aging Res Clin Practice 2014;3(4):197-199

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Diastolic dysfunction (DD) can range from a process of normal aging to overt heart failure (HF). Cardiopulmonary exercise testing (CPET) variables (VO2max and VE/VCO2 slope), and pro-BNP values are abnormal in diastolic HF patients. These CPET parameters have not previously been investigated in adults with varying degrees of DD without clinical HF. Ten subjects with grade 1, and twelve with grade 2 DD had pro-BNP values measured, and subseqeuntly underwent CPET assessment. No subjects with grade 3 or 4 DD were eligible for enrollment based on pre-existing HF or co-morbidities. CPET responses were normal for all individuals and without significant differences between grade I and II DD. Pro-BNP values were significantly higher in those with grade II dysfunction but still under a threshold consistent with HF. We conclude that adults with grade 1 or 2 DD have normal and prognostically favorable CPET responses and pro-BNP values.

CITATION:
H.R. Ahmadian ; J.R. Sherratt ; K.M. Lochner ; M. Dubois ; K.M. Leclerc (2014): CARDIOPULMONARY EXERCISE TESTING RESPONSES AND PRO-BNP VALUES IN ADULTS WITH MILD DEGREES OF DIASTOLIC DYSFUNCTION. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.34

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RAMADAN FASTING EFFECTS ON METABOLIC PARAMETERS IN ELDERLY PERSONS WITH CARDIOVASCULAR RISK FACTORS

H. Baccouche, I. Hellara, I. Khochtali, M.H. Grissa, H. Boubaker, K. Beltaief, W. Bouida, F. Najjar, R. Boukef, M. Hassine, S. Nouira

J Aging Res Clin Practice 2014;3(4):200-205

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Objective: Our study aims was to evaluate the effect of Ramadan fasting on routine biochemical parameters in elderly subjects with cardiovascular risk factors. Design : Cohort study. Setting: Subjects were prospectively recruited and screened at nine primary care clinics, three outpatients specialized clinics and an emergency departement. Participants: subjects aged ≥ 65 years (n=87) recruted in Ramadan month in 2010, 2011 and 2012. Measurements: Dietary intake using a 24 hour recall, biochemical tests including complete lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), renal function tests, serum uric acid, serum electrolytes (sodium, potassium, chloride and protein), glycaemia, and glycated hemoglobin (HbA1C). All data related to dietary intake and biochemical tests were performed one month before Ramadan, during the last week of Ramadan and one month after Ramadan. Comparison between the three time groups were made using standard statistical tests. Results: We showed a significant decrease of creatinine clearance and an increase of serum triglycerides and blood glucose during Ramadan. After Ramadan, we observed a significant increase in HDL-C was and a significant decrease in serum triglycerides and HbA1c. No correlation was found between glycaemia and total energy intake, neither between LDL-C/HDL-C ratio and total energy intake. Conclusion: In elderly subjects with cardiovascular risk factors, Ramadan seems to induce dual effects. During the fasting period, there is a potential risk of renal function decrease and an increase of glycaemia. In contrast, after Ramadan, our findings support the potential beneficial effect of fasting on lipid regulation and glycemic control.

CITATION:
H. Baccouche ; I. Hellara ; I. Khochtali ; M.H. Grissa ; H. Boubaker ; K. Beltaief ; W. Bouida ; F. Najjar ; R. Boukef ; M. Hassine ; S. Nouira (2014): RAMADAN FASTING EFFECTS ON METABOLIC PARAMETERS IN ELDERLY PERSONS WITH CARDIOVASCULAR RISK FACTORS. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.35

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EVALUATION OF THE BALANCE OF OBESE AND NON-OBESE ELDERLY WOMEN BY COMPUTED DYNAMIC POSTUROGRAPHY

E.B.Mantello, M.A. Hyppolito, E. Ferriolli, N.K. da Costa Lima, J.C. Moriguti

J Aging Res Clin Practice 2014;3(4):206-210

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Background: One of the main factors that currently limit the life of the elderly is the imbalance. Computed dynamic posturography, assesses the oscillation of the body by recording the pressure exerted by the feet on the force platform, and allows analyzing the postural reactions secondary to the shift of body weight. Objectives: Evaluate and compare the balance of obese and non-obese elderly women without vestibular symptoms by computed dynamic posturography. Design: prospective trial. Setting: data collected in a university hospital. Participants: 50 elderly females divided into 2 groups according to body mass index (BMI), between 18.5 and 24.9 kg/m2 for the non-obese group and greater than 30 kg/m2 for the obese group. Intervention: the participants were submitted to the Synapsys Static & Dynamic Posturography® test. Measurements: Sensory Organization Test calculates the average proprioceptive, visual and vestibular functions. Data were analyzed statistically by the Fisher exact test. Results: significant differences were observed between the obese and non-obese subjects regarding: maximum amplitude of the anteroposterior displacement of the patient with eyes open and closed, length and surface area used by the patient with eyes open, energy spent with eyes open and closed, proprioceptive activity in the anteroposterior direction, and vestibular activity in the lateral direction. There were a higher percentage of changes in the anteroposterior tests compared to the lateral tests in the obese subjects. Conclusion: The obesity interferes with the body balance in elderly women, especially in situations that require postural control in the AP direction, proprioceptive cues in the AP direction and vestibular cues in the LAT direction.

CITATION:
E.B.Mantello ; M.A. Hyppolito ; E. Ferriolli ; N.K. da Costa Lima ; J.C. Moriguti (2014): EVALUATION OF THE BALANCE OF OBESE AND NON-OBESE ELDERLY WOMEN BY COMPUTED DYNAMIC POSTUROGRAPHY. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.36

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SHORT-FORM MINI NUTRITIONAL ASSESSMENT AS A TOOL FOR NUTRITION EVALUATION IN ELDERLY INDIVIDUALS WITH CANCER IN BRAZIL

G. Marques Rodrigues, J.F. Santos da Silva, D. Bittencourt Ferreira, L.M. Santiago, L. Lima Luz, I.E. Mattos

J Aging Res Clin Practice 2014;3(4):211-217

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Objective: To analyze to role of the Short-Form Mini Nutritional Assessment in the nutritional assessment of elderly individuals with cancer. Study Design: Cross-sectional epidemiological study. Location: Outpatient services at eight cancer hospitals in the cities of Campo Grande and Rio de Janeiro, in Brazil. Participants: 333 individuals, aged 60 or older, with prostate cancer, interviewed in the period before the definition of cancer treatment. Methods: The nutritional profile was assessed with the Short Form Mini Nutritional Assessment (MNA-SF) and with the Body Mass Index (BMI), according to Lipschitz’s classification. Socio-demographic and clinical variables were also considered. We analyzed the distribution of elderly individuals by MNA-SF items according to MNA-SF and BMI categories and the Fisher’s exact test was applied for testing the statistical significance of the observed differences (p≤0.05). Results: Based on the MNA-SF, 235 (73.0%) individuals had an adequate nutritional status; 74 (23.0%) were at risk for malnutrition and 13 (4.0%) were considered malnourished. Based on the BMI, 49 elders (15.2%) were classified as low weight; 150 (46.4%) as normal weight and 124 (38.4%) as overweight. For each item in the MNS-SF, the frequency of answers corresponding to deficiencies was high among elderly individuals at risk for malnutrition, with statistical significance. With respect to the BMI, only “Food intake declined over the past 3 months” and “BMI” had statistically significant differences. Conclusion: MNA-SF showed a good relationship between its component items and proved to be an adequate tool to describe nutritional risk in elderly cancer patients. Early detection of this risk paves the way for an early nutritional approach and for preventing undesirable outcomes with respect to the health of those individuals. As other advantages, MNA-SF is easy to interpret, demands a short time for application and is well accepted by the elders.

CITATION:
G. Marques Rodrigues ; J.F. Santos da Silva ; D. Bittencourt Ferreira ; L.M. Santiago ; L. Lima Luz ; I.E. Mattos (2014): SHORT-FORM MINI NUTRITIONAL ASSESSMENT AS A TOOL FOR NUTRITION EVALUATION IN ELDERLY INDIVIDUALS WITH CANCER IN BRAZIL. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.37

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SEVERE VITAMIN D DEFICIENCY, FUNCTIONAL IMPAIRMENT AND MORTALITY IN ELDERLY NURSING HOME RESIDENTS

V. Centeno Peláez, L. Ausín, M. Ruiz Mambrilla, M. Gonzalez-Sagrado, J.L. Pérez Castrillón

J Aging Res Clin Practice 2014;3(4):218-222

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Background: Vitamin D deficiency is independently associated with functional impairment in elderly patients and is an independent risk factor for mortality. Objective: To assess the influence of severe vitamin D deficiency on the functional status, falls, fractures, cardiovascular morbidity and mortality and all-cause mortality in elderly nursing home residents. Design: Non-interventional, prospective, observational study. Setting: Nursing home. Participants: Non-dependent elderly. Measurements: Urea, creatinine, cholesterol, triglycerides, calcium, phosphorus, 25-OH vitamin D, parathyroid hormone (PTH), and cystatin C were determined in blood and microalbuminuria in urine. All patients were administered the Katz Index of Independence in Activities of Daily Living (Katz ADL), the Tinetti Balance and Gait Evaluation, lower extremity function tests and the Mini-Mental State Examination. Patients were divided in two groups: those with 25-hydroxyvitamin D <12.48 nmol/l (severe vitamin D deficiency) and those with 25-hydroxyvitamin D ≥ 12.48 nmol/l. Falls, clinical fractures, and cardiovascular morbidity and mortality and all-cause mortality were recorded during the 20-month follow up. Results: Patients with severe vitamin D deficiency were older (87 ± 7 vs. 83 ± 7 yrs., p = 0.025) and more often female (96% vs 4%, p = 0.028) and had lower levels and calcium and albumin and higher levels of PTH, a higher frequency of heart disease (p = 0.02), and worse lower extremity function: Tinetti gait (10 ± 2.39 vs 11.21 ± 1.44, p = 0.034), Tinetti balance (1.83 ± 1.11 vs 2.5 ± 1.19, p = 0.011). These patients had a non-significant higher number of falls and clinical fractures, and significantly greater mortality (29% vs 2%, p = 0.01). Conclusions: Non-dependent elderly nursing home residents with severe vitamin D deficiency have greater mortality, functional impairment of the lower extremities and a trend to a greater number of falls and clinical fractures.

CITATION:
V. Centeno Peláez ; L. Ausín ; M. Ruiz Mambrilla ; M. Gonzalez-Sagrado ; J.L. Pérez Castrillón (2014): SEVERE VITAMIN D DEFICIENCY, FUNCTIONAL IMPAIRMENT AND MORTALITY IN ELDERLY NURSING HOME RESIDENTS. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.38

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SHORT-TERM EFFICACY OF A COMBINATION OF GLUCOSAMINE AND CHONDROITIN SULFATE COMPARED TO A COMBINATION OF GLUCOSAMINE, CHONDROITIN SULFATE AND CALCIUM FRUCTOBORATE (CFB) ON IMPROVEMENT OF KNEE DISCOMFORT CONDITIONS IN HEALTHY SUBJECTS. A COMPARATIVE, DOUBLE-BLIND, PLACEBO CONTROLLED ACUTE CLINICAL STUDY

T. Reyes-Izquierdo, M.J. Phelan, R. Keller, C. Shu, R. Argumedo, Z. Pietrzkowski

J Aging Res Clin Practice 2014;3(4):223-228

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Purpose: To compare and evaluate the effects of treatment with a blend of glucosamine and chondroitin sulfate, or a blend of glucosamine, chondroitin sulfate and calcium fructoborate as compared to a placebo, on joint discomfort. Methods: Individuals with self-reported knee discomfort were randomized and blinded to treatment with a combo containing glucosamine and chondroitin sulfate or glucosamine, chondroitin sulfate and calcium fructoborate. Both groups were compared to placebo. Symptoms of discomfort and joint function were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the McGill Pain Questionnaire (MPQ) before treatment and after 7 and 14 days of treatment. Results: Ninety individuals were selected for this study and were randomly assigned in groups of 30 containing 15 male and 15 female participants to each of three treatment conditions. Treatment with glucosamine combined with chondroitin sulfate and CFB resulted in a statistically significant 24% reduction of mean WOMAC score and a 25% reduction of mean McGill index at day 14 over baseline (p-value = 0.0006 and p-value < 0.0001, respectively). Treatment with placebo or with glucosamine and chondroitin material did not result in significant improvement of the conditions. Conclusions: Results showed that short-term treatment with glucosamine and chondroitin could be efficacious only if used in combination with CFB.

CITATION:
T. Reyes-Izquierdo ; M.J. Phelan ; R. Keller ; C. Shu ; R. Argumedo ; Z. Pietrzkowski (2014): SHORT-TERM EFFICACY OF A COMBINATION OF GLUCOSAMINE AND CHONDROITIN SULFATE COMPARED TO A COMBINATION OF GLUCOSAMINE, CHONDROITIN SULFATE AND CALCIUM FRUCTOBORATE (CFB) ON IMPROVEMENT OF KNEE DISCOMFORT CONDITIONS IN HEALTHY SUBJECTS. A COMPARATIVE, DOUBLE-BLIND, PLACEBO CONTROLLED ACUTE CLINICAL STUDY. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.39

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AN EXPLORATORY STUDY OF THE MEALTIME EXPERIENCE OF OLDER PEOPLE WITH DYSPHAGIA

S. Ullrich, J. Buckley, J. Crichton, A. Esterman

J Aging Res Clin Practice 2014;3(4):229-236

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People with dysphagia are at high risk of malnutrition. To maintain safe oral intake, solid food may be texture modified but this is associated with a reduction in the enjoyment of the eating experience. A recent approach to improving the enjoyment of eating texture-modified food has been to mould the food into the shape of the food that has been modified. The aim of this exploratory study was to describe and explain the mealtime experience of older people with dysphagia. Design: Qualitative and exploratory. Participants: In total, thirty five participants (nursing, care workers, lifestyle assistants, catering staff and residents) were involved in non-participant observations and individual interviews for the qualitative assessment of the eating experience. Intervention: Moulded texture-modified food. The intervention occurred at lunchtime for a period of 3 consecutive days. Qualitative assessment: Non-participant observations and individual interviews were conducted before and after the intervention. Analysis: Interpretative, descriptive and explanatory. Findings: Residents with dysphagia are separated from the dining experience and fostering good relationships between residents at mealtimes may lessen the effects of the challenging eating behaviours that often isolate residents with dysphagia from the dining environment. Non-moulded texture-modified food was viewed negatively by all participants and contributed to problems of interaction between care staff and residents by weakening those conversations and interactions that underpin the social dining experience. Residents also experienced difficulties adjusting to texture-modified food. Conclusion: Residents’ experience of adjustment to texture-modified food is difficult and non-moulded texture-modified meal that is unrecognisable and indescribable creates a problem of interaction between care staff and residents during mealtimes. The implementation of moulded texture-modified food has resulted in positive qualitative outcomes in the perception of texture-modified food and has improved the verbal interaction between care staff and residents.

CITATION:
S. Ullrich ; J. Buckley ; J. Crichton ; A. Esterman (2014): AN EXPLORATORY STUDY OF THE MEALTIME EXPERIENCE OF OLDER PEOPLE WITH DYSPHAGIA. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.40

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SPOUSES’ EXPERIENCES OF MEALTIMES WITH A PARTNER SUFFERING FROM DEMENTIA

L. Johansson, A. Björklund, B. Sidenvall, L. Christensson

J Aging Res Clin Practice 2014;3(4):237-244

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Background: As difficulties in performing daily activities occur among persons with dementia, their spouses are also affected. This is also true for mealtimes, yet there is a lack of knowledge and research into how couples manage this situation at home. Objective: The aim of the study was to explore and describe spouses’ experiences of mealtimes in couples in which one partner has dementia. Design, Setting and Participants: Ten spouses were interviewed in their home in respect to their experiences regarding mealtimes when living with a partner diagnosed with dementia. To identify themes across the data set, thematic analysis was conducted. Results: One major theme, Recognizing and managing the range of mealtime change, was identified and showed that depending on where the families were in the dementia process their experienced varied. As progression occurred in the partners disease, routines, responsibilities and relationships were affected within the couple. Strategies the participants used to manage mealtimes at home regarding these problems were highlighted such as getting support from social services, but also strategies they had learnt by themselves. Conclusion: These results generate an insight into what couples face, and their needs for support. Spouses experiences varied which indicates that it is important that support is based on individual needs. Hence, nursing staff should continuously pay attention to couples mealtime situation. Further it increases staff´s knowledge regarding possible solutions on how to involve persons with dementia in mealtime activities and maintain their nutritional intake.

CITATION:
L. Johansson ; A. Björklund ; B. Sidenvall ; L. Christensson (2014): SPOUSES’ EXPERIENCES OF MEALTIMES WITH A PARTNER SUFFERING FROM DEMENTIA. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.41

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