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02/2016 journal articles

DEVELOPMENT OF TECHNOLOGIES FOR HEALTHY AGING: SEARCHING FOR THE RIGHT WAY

A. Piau, E. Campo, B. Vellas, F. Nourhashemi

J Aging Res Clin Practice 2016;5(2):61-64

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Background: Medical imaging (e.g. PET-scan) and interventional (e.g. robotic surgery) technologies seem- to better fit the actual technological progress than do technologies for aging. The commercial market of aging care remains subdued since the introduction of low-technology devices decades ago (e.g. walker). Revisiting the evaluation and development methods of technologies to support healthy aging could help spread innovative technologies in this field. Methods and findings: In literature, a number of publications have been identified that addresses issues about technological devices that target the different needs of the older person. Nevertheless, a successful evaluation and development often remains unmet. This deficiency arises to a large extent from the confrontation of two worlds: that of technology which is not yet well versed in the field of healthy aging intervention, and the medical world which mainly uses the linear pharmaceutical drug development model. Many methods propose to tackle the global multidimensional evaluation of health technologies. However, they do not address the sequencing of the whole development and evaluation processes. In the present paper, we present a framework to help tackle the complexity of healthy aging technologies assessment and development. Conclusion: The evaluation and development methods usually adopted for healthy aging technologies are not appropriate and that all the collaborative multidisciplinary processes have to be revised.

CITATION:
A. Piau ; E. Campo ; B. Vellas ; F. Nourhashemi (2016): Development of technologies for healthy aging: searching for the right way. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.93

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ALZHEIMER’S DISEASE, CEREBROVASCULAR DISEASE AND DEMENTIA: THEIR ASSOCIATION AND PREVENTION

D.A. Davey

J Aging Res Clin Practice 2016;5(2):65-70

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Alzheimer’s disease (AD) and cerebrovascular disease (CVD) frequently co-exist and CVD acts additionally and synergistically with AD in ageing–related impairment of cognitive function and dementia. A significant number of men and women with normal cognition at the time of death have the neurodegenerative and cerebrovascular changes of AD and CVD and are regarded as having high cognitive reserve or cognitive resilience. Many measures used to prevent and treat cardiovascular disease, decrease the incidence, or delay the onset of ageing-related cognitive impairment and dementia. Ageing-related cognitive impairment and dementia are increased by adverse psycho-social factors and can be prevented or mitigated by appropriate psycho-social measures. There is now more than sufficient evidence to implement, as a matter of urgency, personal health and life-style measures and public health initiatives in the endeavor to prevent, postpone or ameliorate ageing-related cognitive impairment and dementia and to decrease its burden world-wide.

CITATION:
D.A. Davey (2016): ALZHEIMER’S DISEASE, CEREBROVASCULAR DISEASE AND DEMENTIA: THEIR ASSOCIATION AND PREVENTION. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.96

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ELDERLY-SPECIFIC REVISIONS OF DRUG PRESCRIBING INFORMATION IN THE POSTMARKETING ENVIRONMENT IN JAPAN

Y. Asahina, E. Sugiyama, H. Sugano, Y. Uyama

J Aging Res Clin Practice 2016;5(2):71-76

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Purpose: This study aimed to characterize elderly-specific revisions of prescribing information of a drug based on recent cases observed in postmarketing use in Japan. Methods: We analyzed all revisions of package inserts that were officially registered between the fiscal year (FY) 1998 and FY 2012. They were examined in terms of a description of the drug, therapeutic area for which the drug is targeted, the period between launch and revision, contents of the revisions, and the evidence sources of safety issues. Results: Of a total of 3,440 revisions occurring between FY 1998 and FY 2012, 2.1% were specific to drug use in the elderly. Drugs treating the “cardiovascular system” and a miscellaneous category of “various,” showed a higher frequency of revisions for elderly patients than those for non-elderly patients. Of elderly-specific revisions occurring between FY 2004 and 2012, the majority were triggered by spontaneous reports or regulatory action in other countries, although there were relatively a few examples of serious safety concerns being raised after initial drug approval. Conclusions: It is important that alternative approaches such as pharmacometrics or pharmacoeoidemiology should be more utilized in Japan for the early and better detection and evaluation of drug safety in elderly patients, especially for therapeutic areas that demonstrate increased susceptibility for risk among the elderly, such as drugs related to the cardiovascular system.

CITATION:
Y. Asahina ; E. Sugiyama ; H. Sugano ; Y. Uyama (2016): Elderly-specific revisions of drug prescribing information in the postmarketing environment in Japan. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.94

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EVALUATING THE PERFORMANCE OF AMPUTEE SERVICES AT NEIGHBOURING HOSPITALS: A RISK ADJUSTED PERFORMANCE ANALYSIS

B. Hordacre, M. Crotty, C. Pham, J. Karnon

J Aging Res Clin Practice 2016;5(2):77-83

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Background: Despite advances in vascular surgery techniques, ageing populations and increasing rates of vascular disease and diabetes have contributed to relatively steady amputation rates. Older amputees have limited life expectancies and often require expensive rehabilitation interventions on top of vascular procedures. Services warrant scrutiny with view to reducing clinical practice variations, improving hospital performance and securing the best patient outcomes. Objective: This study employed a novel methodology to assess 12-month hospital performance associated with provision of lower-limb amputee services at three neighbouring hospitals. Design and Setting: Routinely collected data on individuals having an initial lower-limb amputation from July 2001 to June 2008 at three hospital networks in Adelaide, South Australia were analysed. Observed and expected lengths of stay and patient outcomes were generated, from which relative performance across hospitals were compared. Results: Following amputation we observed a short time-to-death (0.8 years, IQR 0.21-2.12) and 12-month mortality rate of 25% (unadjusted). Risk-adjusted analyses indicated that one hospital with co-located vascular and rehabilitation services had greater performance with lower re-amputation rates and fewer deaths. However, length of stay at this hospital was longer than expected. Conclusion: The risk-adjusted performance analysis provided an approach which could inform further investigations around variation in hospital performance to inform best practice service delivery.

CITATION:
B. Hordacre ; M. Crotty ; C. Pham ; J. Karnon (2016): Evaluating the performance of amputee services at neighbouring hospitals: A risk adjusted performance analysis. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.91

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SPECIFIC NATURAL BIOACTIVE TYPE 1 COLLAGEN PEPTIDES ORAL INTAKE REVERSE SKIN AGING SIGNS IN MATURE WOMEN

L. Duteil, C. Queille-Roussel, Y. Maubert, J. Esdaile, C. Bruno-Bonnet, J.-P. Lacour

J Aging Res Clin Practice 2016;5(2):84-92

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Objective: To assess the anti-aging potential of three type I fish collagen hydrolysates (CH1=Naticol® BPMG, CH2=Naticol® HPMG, CH3=Naticol® 1000MG) on skin aging signs for three different body sites of mature women. Design: Double-blind, randomized and Placebo-controlled clinical study. Setting: Centre of Clinical Pharmacology Applied to Dermatology (CPCAD, Nice). Participants: Sixty women aged 46-69 years having skin aging signs on the face. Intervention: Participants were randomized to receive a once daily 5g dose of one of the CHs or Placebo for 8 weeks. Measurements: Skin biomechanics, skin hydration and visual assessment of the crow’s-feet wrinkles were evaluated after 4 and 8 weeks of treatment. Subject satisfaction questionnaire and Investigator global efficacy appreciation (IGEA) were also used. Results: Skin biomechanics indicated a significant improvement of skin firmness for the three CHs compared to Placebo, in particular for CH2. An increase of overall skin elasticity for CH3 (p = 0.017) and CH2 (p = 0.044) on the abdomen was also observed. This was corroborated by the significant decrease of the crow’s-feet wrinkle score at week 8 for both CH3 and CH2 (p=0.023 and p=0.014, respectively). Concerning the self-questionnaire, overall the number of positive responses was significantly higher for CH2 compared to Placebo and other CHs. For the IGEA, the number of favorable answers was greater for CH2 than for the Placebo group (80% vs. 36%, p= 0.025). A positive influence of CH treatments could be observed for skin hydration but failed to reach statistical significance. Conclusion: The tested type I fish collagen hydrolysates have beneficial effects on skin quality. In particular, CH2 demonstrated the greatest range of these effects including improvement of skin biomechanics, decrease of wrinkles, good subject satisfaction and no related adverse events.

CITATION:
L. Duteil ; C. Queille-Roussel ; Y. Maubert ; J. Esdaile ; C. Bruno-Bonnet ; J.-P. Lacour (2016): Specific natural bioactive type 1 collagen peptides oral intake reverse skin aging signs in mature women. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.97

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DIETARY FLAVONOID INTAKE AND COGNITIVE PERFORMANCE IN OLDER ADULTS WITH ALZHEIMER’S TYPE DEMENTIA

K. Kent, S. Roodenrys, K.E. Charlton, R. Richards, O. Morgan, H. Gilbert

J Aging Res Clin Practice 2016;5(2):93-97

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Background: Dietary flavonoid intake and intake of flavonoid subclasses has been associated with improved cognitive performance. However, the association between flavonoid intake and cognitive performance in older adults with Alzheimer’s type dementia has not been investigated. Objectives: To estimate dietary total flavonoid intake and intake of flavonoid subclasses in older adults with Alzheimer’s type dementia and assess the relationship of flavonoid intake with measures of cognition. Design: Cross sectional analysis. Setting: Community dwelling older adults in NSW, Australia. Participants: Older adults (+65y) with mild to moderate dementia (n=49). Measurements: A 24h diet recall was collected with help from a carer and used to estimate flavonoid intake. A battery of cognitive tasks assessed cognitive performance of several cognitive domains. Results: Pearson and spearman correlation coefficients identified an association between flavonoid intake and executive function (r=0.319, p=0.025). After controlling for depression, the relationship was reduced. Conclusion: The identified association between cognitive functioning, depression and flavonoid intake in older adults with Alzheimer’s type dementia warrants further research in a larger sample.

CITATION:
K. Kent ; S. Roodenrys ; K.E. Charlton ; R. Richards ; O. Morgan ; H. Gilbert (2016): Dietary flavonoid intake and cognitive performance in older adults with Alzheimer’s type dementia. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.95

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DIETARY MILK FAT GLOBULE MEMBRANE WITH SEMIWEEKLY LIGHT EXERCISE IMPROVES CHOICE STEPPING REACTION TIME IN HEALTHY JAPANESE ELDERLY SUBJECTS: A RANDOMIZED DOUBLE BLIND, PLACEBO-CONTROLLED TRIAL

N. Ota, S. Soga, A. Shimotoyodome

J Aging Res Clin Practice 2016;5(2):98-101

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This study aimed to demonstrate the beneficial effects of nutritional supplementation with milk fat globule membrane combined with light exercise on agility, which predicts falls in the elderly. Twenty-five healthy volunteers (aged 60-74 years old; male/female = 11/14) were enrolled in a randomized, double-blind, placebo-controlled intervention study. The subjects ingested placebo or milk fat globule membrane (1 g/day) tablets daily for 5 weeks and engaged in a 30-min light exercise program semiweekly. After 5 weeks, agility was evaluated using the choice stepping reaction time. The milk fat globule membrane group had significantly shorter motion start and reaction times compared to the placebo group. The reduction in motion start and reaction times was significantly greater in the milk fat globule membrane compared to the placebo group. In conclusion, this study provides evidence that dietary milk fat globule membrane supplementation improves choice stepping reaction time and agility in the healthy elderly population.

CITATION:
N. Ota ; S. Soga ; A. Shimotoyodome (2016): Dietary milk fat globule membrane with semiweekly light exercise improves choice stepping reaction time in healthy Japanese elderly subjects: A randomized double blind, placebo-controlled trial. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.98

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NUTRITION DEFICIENCY RISK ASSESSMENT OF FREE-LIVING OLDER ADULTS IN SINGAPORE

M.E. Tay, S.H. Ong, X.L. Ho, S.Y. Tsen, G. Chu, C. Loong, R. Khaw, J.M.K. Lee, W.M. Loke

J Aging Res Clin Practice 2016;5(2):102-110

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Background: The need to identify those at risk of nutrition deficiency is critical in promoting good nutritional status in older adults. Objectives: The study aims to assess the risk of nutrition deficiency of free living, older adults in Singapore. Design, Setting and Participants: Free-living adults (aged 50 and above) were recruited from various community centres under the supervision of the Peoples’ Association of Singapore. Measurements: Nutrition deficiency risk assessment was performed with all participants in person using the validated 15-item Seniors in the Community Risk Evaluation for Eating and Nutrition II (SCREEN II) tool. Anthropometric assessments were also conducted. Results: Majority (88.1%) of the one hundred ninety three participants (83.9% women, 66.8±8.3 years of age) showed risk of nutrition deficiency. 68.4% of the participants fell under the “high risk” group. The women showed higher risk of nutrition deficiency than the men in the study group. Less than 12% of the participants consumed five or more servings of vegetables and fruits in a day, and approximately 25% ingested less than two servings per day. Almost half of the participants consumed dairy products less than once a day. Less than 20% of the participants consumed more than 2 servings of dietary protein source daily. More than 60% of the participants were overweight. Conclusions: A significant proportion of free-living older adults in Singapore community is experiencing high risk of nutrition deficiency as measured by the SCREEN II. The same older adults are overweight and thereby are exposed to the elevated health risk associated with obesity.

CITATION:
M.E. Tay ; S.H. Ong ; X.L. Ho ; S.Y. Tsen ; G. Chu ; C. Loong ; R.Khaw ; J.M.K. Lee ; W.M. Loke (2016): Nutrition Deficiency Risk Assessment of Free-Living Older Adults in Singapore. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.99

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PREDICTORS OF ORAL INTAKE DIFFICULTY IN OLDER PATIENTS WITH DYSPHAGIA

Y. Kuroda

J Aging Res Clin Practice 2016;5(2):111-113

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Abstract: The aim of this study was to identify the predictors of oral intake difficulty in older patients with dysphagia. The subjects were 133 hospitalized older individuals with dysphagia. They were divided into two groups according to the oral intake ability: the oral intake and non-oral intake groups. Swallowing function was measured with a graded water swallowing test and a food intake level scale. Functional status was evaluated with a physical dependency scale and a comprehension scale. Nutritional status was measured with anthropometric measures and serum albumin levels. The non-oral intake group was significantly impaired in the swallowing measures, physical dependency, and mid-upper arm circumference. Multivariate analysis revealed that impairment in mid-upper arm circumference and graded water swallowing test were independently associated with oral intake difficulty. In conclusion, swallowing impairment, advanced body mass reduction, and physical dependency were the significant predictors of oral intake difficulty in older patients with dysphagia.

CITATION:
Y. Kuroda (2016): Predictors of oral intake difficulty in older patients with dysphagia. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.92

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OLDER ADULTS’ ATTITUDES TO FOOD AND NUTRITION: A QUALITATIVE STUDY

J.E. Winter, S.A. McNaughton, C.A. Nowson

J Aging Res Clin Practice 2016;5(2):114-119

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Objective: To explore the factors that influence food choices of older adults and identify potential sources of dietary advice. Design: A qualitative research design using semi-structured, one on one interviews. Setting: A general medical practice in Victoria, Australia. Participants: Twelve community dwelling adults aged 75 to 89 (mean 82.8 ± 4.4) years, 92% living alone and 92% female. Measurements: Interview questions addressed usual daily food pattern, shopping routines, appetite, importance of diet and potential sources of dietary advice or assistance. Results: Thematic analysis identified key themes influencing food choices were maintaining independence; value of nutrition; childhood patterns; and health factors. Dietary restrictions and concerns with weight gain were expressed, and although these were managed independently, the GP was identified as the first source of information if required. Conclusion: This sample of older adults placed high value on eating well as they age, however a number followed self-imposed dietary restrictions which have the potential to compromise their nutritional status as dietary requirements change. Further research is needed into how to communicate changing nutritional needs to this group.

CITATION:
J.E. Winter ; S.A. McNaughton ; C.A. Nowson (2016): Older adults’ attitudes to food and nutrition: a qualitative study. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.100

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