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JARCP Vol 6, 2018
SERUM 25-HYDROXY VITAMIN D, PHYSICAL ACTIVITY AND COGNITIVE FUNCTION AMONG OLDER ADULTS
H. Eymundsdottir, M. Chang, O.G. Geirsdottir, P.V. Jonsson, V. Gudnason, L. Launer, M.K. Jonsdottir, A. Ramel
J Aging Res Clin Practice 2018;7:143-148Show summaryHide summary
Objective: To investigate the association between 25-hydroxy vitamin D (25OHD) and cognitive function with particular consideration of physical activity (PA) in Icelandic older adults. Design: Cross-sectional study. Setting: Iceland. Participants: Old adults aged 65-96. The final analytical sample included 4304 non-demented participants. Measurements: Serum 25OHD was categorized into deficient (≤ 30 nmol/L, 8%), insufficient (31-49 nmol/L, 25%) and normal-high levels (>50 nmol/L, 67%). Cognitive function assessments included measurements of memory function (MF), speed of processing (SP) and executive function (EF) all categorized as low and high (divided by 50th percentile). Multivariate logistic regression analysis was used to calculate the odds ratio (OR) for having high cognitive function. Results: Serum 25OHD was positively associated with cognitive function. Adjustment for PA and other potential confounders diminished this association only partially. Compared to participants with normal-high levels of 25OHD, those with deficient levels had decreased odds for high SP (OR: 0.74, CI: 0.57-0.97), high MF (OR: 0.55; CI: 0.43-0.71) and high EF (OR: 0.76, CI: 0.57-1.0). Conclusion: Serum 25OHD below ≤30 nmol/L was associated with decreased odds for high cognitive function among community dwelling old adults as compared to those with 25OHD above > 50 nmol/L. Neither PA nor other potential confounders explained the associations between 25OHD and cognitive function. Future studies should explore mechanisms and the potential clinical relevance of this relationship.
H. Eymundsdottir ; M. Chang ; O.G. Geirsdottir ; P.V. Jonsson ; V. Gudnason ; L. Launer ; M.K. Jonsdottir ; A. Ramel (2018): Serum 25-hydroxy vitamin D, physical activity and cognitive function among older adults. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.24
DOES TAILORED NUTRITIONAL GUIDANCE ENCOURAGE OLDER CAREGIVERS TO INCREASE THEIR PROTEIN INTAKE? THE CARENUTRITION TRIAL (RCT)
S. Kunvik, R. Valve, M. Salonoja, M.H. Suominen
J Aging Res Clin Practice 2018;7:136-142Show summaryHide summary
Background: Older caregivers, males especially, are vulnerable to nutritional problems. Low intake of protein is common and can affect their nutrition and health. Objectives: The aim in this RCT was to investigate the effect of tailored nutritional guidance on protein intake among caregivers aged ≥65 years with protein intake under recommendations (≤1.2 g/kgBW/d). Subgroup analysis were made with male caregivers. Design: Data from the CareNutrition randomized controlled trial (RCT). Setting: Community-dwelling caregivers from the Western part of Finland. Participants: Total of 55 caregivers (n=28 intervention group (IG), n=27 control group (CG)) with protein intake of under 1.2 g/kgBW/d at baseline. 45.5% were male (n=12 male intervention group (MIG), n=13 male control group (MCG)). Intervention: During the six-month intervention tailored nutritional guidance was given to the intervention group during home visit (once) and in group meetings (2-4 times), complemented with written material. Written material was offered to control group. Measurements: Protein intake was assessed with three-day food diary at baseline and final measurements. Main outcome measure was change in protein intake (g/kg bodyweight (BW)/d), analysed among participants with protein intake under 1.2 g/kgBW/d at baseline. Participant characteristics were evaluated with validated methods. Results: Mean protein intake was 0.86 g/kgBW/d in IG and 0.85 g/kgBW/d in CG and among males, 0.89 g/kgBW/d in MIG and 0.79 g/kgBW/d in MCG. There was no significant difference in the change in protein intake between IG and CG. Protein intake increased among MIG by 0.11 g/kgBW/d and decreased in MCG group by -0.07 g/kgBW/d, p=0.007. There was also a significant increase in protein intake within the IG (+0.10 g/kgBW/d, p=0.038). Conclusions: Tailored nutritional guidance resulted in improved protein intake among older male caregivers. Group-based nutritional guidance may boost nutrition among older caregivers, especially males.
S. Kunvik ; R. Valve ; M. Salonoja ; M.H. Suominen (2018): Does tailored nutritional guidance encourage older caregivers to increase their protein intake? The CareNutrition trial (RCT) . The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.23
COPING WITH ANXIETY, DEPRESSION, BURDEN AND QUALITY OF LIFE IN INFORMAL PRIMARY CAREGIVERS OF COMMUNITY-DWELLING INDIVIDUALS WITH DEMENTIA
M. Muscat, C. Scerri
J Aging Res Clin Practice 2018;7:128-135Show summaryHide summary
Objective: This study aimed to investigate how informal primary caregivers of individuals with dementia living in the community cope with caring-related measures of anxiety, depression, burden and quality of life. Participants and Design: Participants included 60 informal caregivers (23 males and 37 females) of community-dwelling individuals with dementia who attended a state-run geriatric day hospital in Malta. Caregiver measures included the Hospital Anxiety and Depression Scale, the World Health Organization Quality of Life–BREF and Brief COPE questionnaires, and Zarit Burden Interview. The Mini Mental State Examination and Barthel Index of Activities of Daily Living scores were used to determine the degree of cognitive impairment and performance in activities of daily living of care-recipients. Results: Informal caregivers experienced anxiety and depression with both emotional distress states negatively affecting all quality of life domains. Depression and burden experienced by informal primary caregivers showed a strong association with individuals with dementia-related variables such as age, cognitive impairment and activities of daily living scores. The use of dysfunctional coping strategies was found to be related to caregivers’ emotional distress, low quality of life and burden. Conclusion: The findings indicate that informal primary caregivers experienced anxiety and depression, had a lower quality of life, and feel burdened during their caring role. However, caregivers making use of emotion-focused coping strategies were found to be protected against emotional distress. The results highlight the need of providing support services aimed at promoting the psychological wellbeing of informal carers of community-dwelling individuals with dementia.
M. Muscat ; C. Scerri (2018): Coping with anxiety, depression, burden and quality of life in informal primary caregivers of community-dwelling individuals with dementia. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.22
THE NOVEL FRAILTY INDEX (NFI) CORRELATES WITH A VALUE OF PHASE ANGLE AND MNA IN HOSPITALISED AND FREELIVING ELDERLY - PRELIMINARY REPORT
E. Wernio, J.A. Dardzi?ska, H. Kujawska-Danecka, A. Hajduk, Z. Zdrojewski, S. Ma?gorzewicz
J Aging Res Clin Practice 2018;7:123-127Show summaryHide summary
Introduction: To improve the quality of life and health of the elderly, attention is paid to the early detection of frailty syndrome. Unfortunately, one simple and practical screening tool has not been established yet. Recently came the proposal of the Novel Frailty Index (NFI) created by Yamada and Arai. Therefore, the purpose of this study was to assess the relationship between nutritional status and NFI of the elderly. Materials and methods: In a group of 67 elderly patients (27 hospitalised and 40 living in the home environment) we used the NFI and evaluated nutritional status with the use of full-MNA together with SNAQ (appetite questionnaire), manual dynamometry and bioimpedance analysis. Results: Based on the NFI results, frailty syndrome was diagnosed in more than half of hospitalised elderly. The syndrome was significantly less prevalent in free-living older people (15% vs 63%, p<0.001).We found the significant correlations of NFI values with age (r=0.031, p=0.03), co-morbidity(r=0.295, p=0.016), phase angle (r=-0.407, p<0.001), full-MNA score (r=-0.515, p<0.001). Conclusions: Our preliminary results suggest the relevant association between NFI results and age, phase angle as well comorbidity and nutritional status. So further evaluation of NFI as a screening tool for frailty syndrome diagnose is needed.
E. Wernio ; J.A. Dardzińska ; H. Kujawska-Danecka ; A. Hajduk ; Z. Zdrojewski ; S. Małgorzewicz (2018): The Novel Frailty Index (NFI) correlates with a value of phase angle and MNA in hospitalised and free-living elderly - preliminary report. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.21
KNOWLEDGE AND PRACTICES GOVERNING THE IMPLEMENTATION OF NASOGASTRIC TUBE FEEDING AS A TEMPORARY UNDERNUTRITION MANAGEMENT MEASURE IN ACUTE GERIATRIC CARE: A QUALITATIVE RESEARCH-BASED ANALYSIS
E. Fercot, L. Marty, C. Bouteloup, Y. Lepley, J. Bohatier, M. Bonnefoy, B. Lesourd, Y. Boirie, S. Dadet
J Aging Res Clin Practice 2018;7:115-122Show summaryHide summary
Introduction: Nasogastric tube feeding appears underused in acute geriatric care units. The objective of this study was to identify the knowledge, practice, fears or behaviors of care givers governing implementation. Material and Methods: Multicentric qualitative research study based on interviews with geriatricians and care staff. Coding of patterns and thematic analysis of the data were used to extract key concepts tied to the objective. Results: Ten geriatricians and eleven care staff were interviewed individually and in a focus-group setting. Undernutrition was perceived as a prognosis-worsening comorbidity, not a disease. Early screening for undernutrition appeared essential, but care management and monitoring was within the remit of downstream structures. A handful of indications are reported to justify moves to start nasogastric tube feeding, often as part of adjuvant care, when real benefit is expected, when the individualized feeding plan is part of a comprehensive care plan, with the patient consciously involved and after consulting with the family. Patients' fear of complications, cognitive disorders, and uncertain life expectancy often fuel concerns of a form of unreasonable obstinacy. Finally, doctors and care staff alike think that decisions on nasogastric intubation in this patient population require a multidisciplinary-team process. Conclusion: Nasogastric tube feeding in acute geriatric care remains fraught with issues. It looks a viable option, but should be part of a comprehensive care plan, based on multidisciplinary decision-making by appropriately-trained teams, where the goals of care are the patient's comfort and quality of life.
E. Fercot ; L. Marty ; C. Bouteloup ; Y. Lepley ; J. Bohatier ; M. Bonnefoy ; B. Lesourd ; Y. Boirie ; S. Dadet (2018): Knowledge and practices governing the implementation of nasogastric tube feeding as a temporary undernutrition management measure in acute geriatric care: a qualitative research-based analysis . The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.20
DENTITION AND MALNUTRITION RISK IN COMMUNITYDWELLING OLDER ADULTS
R. Zelig, L. Byham-Gray, S.R. Singer, E.R. Hoskin, A. Fleisch Marcus, G. Verdino, D.R. Radler, R. Touger-Decker
J Aging Res Clin Practice 2018;7:107-114Show summaryHide summary
Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electronic health records of 107 patients aged 65 and older who attended an urban northeast US dental school clinic between June 1, 2015 and July 15, 2016. Odontograms and radiographs were used to identify teeth numbers and locations; malnutrition risk was calculated using the Self-Mini Nutritional Assessment (Self-MNA). Relationships between numbers of teeth and malnutrition risk were assessed using bivariate logistic regression. Results: Participants (N=107) were 72.6 years (SD=5.6) of age; 50.5% were female. Mean Self-MNA score was 12.3 (SD=2.0) reflective of normal nutrition status; 20.6% were at risk for malnutrition, 4.7% were malnourished. Greater than 87% were partially or completely edentulous. Those with 10-19 teeth had lower Self-MNA scores (mean=11.6, SD=2.5) than those with 0-9 teeth (mean=12.7, SD=1.3) or 20 or more teeth (mean=12.6, SD=1.8) and had an increased risk for malnutrition (OR=2.5, p=0.076). Conclusion: The majority of this sample of older adults were partially edentulous and of normal nutritional status. Those with 10-19 teeth were more likely to be at risk for malnutrition. Further studies are needed to examine relationships between tooth loss and malnutrition risk and the impact of impaired dentition on the eating experience in a larger sample and to inform clinical practice.
R. Zelig ; L. Byham-Gray ; S.R. Singer ; E.R. Hoskin ; A. Fleisch Marcus ; G. Verdino ; D.R. Radler ; R. Touger-Decker (2018): Dentition and Malnutrition Risk in Community-Dwelling Older Adults. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.19
METABOLIC SYNDROME OF FREE-LIVING ELDERLY FROM SHARPEVILLE, SOUTH AFRICA: A PROSPECTIVE COHORT STUDY WITH 10-YEAR FOLLOW-UP
W.H. Oldewage-Theron, A.A. Egal, C. Grobler
J Aging Res Clin Practice 2018;7:100-106Show summaryHide summary
Objective: This study aimed to provide evidence on the prevalence of the metabolic factors contributing to Metabolic Syndrome (MetS) among elderly people in South Africa. Design: An ethically approved, cross-sectional survey study conducted in a cohort of an elderly population in 2004 with follow-up in 2014. Setting: An elderly day-care center. Participants: A total of 170 men and women were randomly selected for the baseline survey (2004). Only 105 of the subjects included in the baseline study were available for the follow-up study (2014). The sample consisted of 83.2% (n=89) women and 16.8% (n=16) men with a mean±SD age of 95.8±6.2 and 71.8±5.7 years in 2014 and 2004 respectively. Measurements: Dietary intakes (24-hour recall questionnaire) were completed for a period of three non-consecutive days, including one weekend day and two week days. Other measurements included waist circumference (WC), blood pressure and fasting (>8 hours) venous blood samples that were analyzed for total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), tryglicerides (TGs) and glucose. The Friedewald formula was used to calculate LDL-C (16). Results: The prevalence of MetS was significantly (p=0.000) higher in 2014 (63.4%) compared to 2004 (48.8%). The most prominent risk factors were central obesity (85.9%), low serum HDL-C (71.0%) and high serum TG (68.1%) levels in 2004 compared to central obesity (82.5%), low serum HDL-C (94.3%) and hyperglycaemia (48.1%) in 2014. Conclusions: MetS is highly prevalent and rapidly increasing among these elderly people. A need for identifying preventative and treatment strategies to increase wellness and reduce morbidity has been highlighted by these results.
W.H. Oldewage-Theron ; A.A. Egal ; C. Grobler (2018): METABOLIC SYNDROME OF FREE-LIVING ELDERLY FROM SHARPEVILLE, SOUTH AFRICA: A PROSPECTIVE COHORT STUDY WITH 10-YEAR FOLLOW-UP. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.18
CHOLINE, SLEEP DISTURBANCES, AND ALZHEIMER’S DISEASE
V.M. Pak, S. Newton
J Aging Res Clin Practice 2018;7:91-99Show summaryHide summary
Existing studies identify a possible link between choline, sleep disturbance, and Alzheimer’s disease, however further exploration is needed to determine the nature of this association. As the precursor to the neurotransmitter acetylcholine, choline plays an integral role in several neuronal processes, including some responsible for memory and learning. Decreased cholinergic neuronal activity is associated with brain abnormalities consistent with Alzheimer’s disease, an aging disease that disproportionately affects the elderly, and is believed to contribute to the cognitive decline experienced by Alzheimer’s disease patients, however the mechanism for this is not well understood. In this narrative review, we explore the associations between sleep disturbances, choline and the cholinergic pathway, and Alzheimer’s disease. Current research shows that the connection between sleep disturbances, choline, and Alzheimer’s disease is worth exploring in greater depth. In this review, we demonstrate there is a need for further studies to understand the mechanism through which inadequate sleep may impair the cholinergic pathway in order to guide targeted treatments for Alzheimer’s disease.
V.M. Pak ; S. Newton (2018): Choline, Sleep Disturbances, and Alzheimer’s Disease. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.17
FRAILTY, LOSS OF NATURAL TEETH AND QUALITY OF LIFE
I.-C. Lee, S.-F. Weng, P.-S. Ho
J Aging Res Clin Practice 2018;7:85-90Show summaryHide summary
Objective: This study investigates whether the loss of natural teeth associate with elderly frailty, as well as their connection with quality of life. Design: This study collected data from January 2012 to April 2013, and the subjects were the elderly over the age of 65 living in community. Setting: Loss of natural teeth and frailty are common issues in elderly and it is noteworthy to address these issues while the investigation of healthy ageing. Participants: The research included 543 elderly people over the age of 65. Measurements: The face-to-face interviews with a structured questionnaire were performed. Results: Elderly people with no natural teeth are more likely to become frail (OR=1.87); the relationship between frailty and quality of life is more significant. After adjusting for all the independent variables, results showed that frailty in elderly leads to poorer quality of life, and oral health status is not correlated with quality of life (P>0.05). The remain of natural teeth is correlated with occurrence of frailty in the elderly. Conclusions: Frailty has a significant and strong influence on oral health-related quality of life. For the elderly, frailty shall be early diagnosed to ensure provision of proper preventive health care.
I.-C. Lee ; S.-F. Weng ; P.-S. Ho (2018): Frailty, Loss of natural teeth and Quality of Life. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.16
SHORT TERM (24 HOURS) AND LONG TERM (1 YEAR) ASSESSMENTS OF RELIABILITY IN OLDER ADULTS: CAN ONE REPLACE THE OTHER?
T. Abe, S.J. Dankel, S.L. Buckner, M.B. Jessee, K.T. Mattocks, J.G. Mouser, Z.W. Bell, J.P. Loenneke
J Aging Res Clin Practice 2018;7:82-84Show summaryHide summary
There may be some individuals who do not adapt favorably to an exercise stimulus. This is most commonly determined by assessing the error of the measurement across two separate testing sessions separated by a short period of time. It has been recommended that this error be assessed over the same time frame as the intervention. We examined the 24-h test-retest reliability (n=18, aged 42 to 64 years) of forearm muscle thickness, handgrip strength, and “muscle quality” and compared that to the reliability observed when visits are separated by 1-year (n=80, aged 60 to 79 years). The measurement errors were greater in all measured variables following test-retest separated by 1-year than the test-retest separated by 24-hours. Our findings suggest that a time-matched control group is likely important to fully capture the error of the tester as well as the error associated with random biological variability within a timed intervention.
T. Abe ; S.J. Dankel ; S.L. Buckner ; M.B. Jessee ; K.T. Mattocks ; J.G. Mouser ; Z.W. Bell ; J.P. Loenneke (2018): Short term (24 hours) and long term (1 year) assessments of reliability in older adults: Can one replace the other?. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.15
DIETARY PROTEIN INTAKE PATTERN AND SOURCES AND THEIR ASSOCIATIONS WITH MUSCLE AND PHYSICAL FUNCTION MEASURES IN OLDER CHINESE ADULTS WITH SARCOPENIA IN HONG KONG
L.-Y. Zhu, R. Chan, L. Li, T. Kwok, J. Woo
J Aging Res Clin Practice 2018;7:75-81Show summaryHide summary
Background: Protein intake is a major risk factor of sarcopenia. To combat sarcopenia, strategies focused on providing sufficient high quality dietary protein are required. Objectives: We aimed to identify the pattern of dietary protein intake and its association with muscle and physical functions among community-dwelling sarcopenic Chinese older adults in Hong Kong. Design: Baseline data of a randomized controlled trial in sarcopenia were analyzed. Setting: Participants who were ambulant and could travel to the assessment centre at a regional hospital in Hong Kong were recruited in nearby community elderly centers, nursing homes and other institutional settings. Participants: A total of 113 Chinese older adults aged 65 or above who had sarcopenia defined using The Asia Working Group Criteria for Sarcopenia were recruited. Measurements: Dietary data and muscle function tests were measured. Results: Although the energy intake (mean + standard deviation: 1491.7±338.6 kcal/d in female, 1738.1±392.9 kcal/d in male) was lower than the recommended daily energy requirement, protein intake averaged 1.6±0.5 g/kg body weight/day, which was high compared to the current Recommended Daily Allowance (RDA, 0.8 g/kg body weight/day for older people). Animal and plant sources contributed to 62% and 38% respectively of the total protein intake. Dietary protein intake was not evenly distributed throughout the day. Physical Activity Scale for the Elderly (PASE) score was more predictive of muscle mass and functions compared to protein intake and sources. Conclusions: Our findings showed that PASE was more predictive of muscle mass and functions compared to protein intake and sources, and there was a minimal association between protein intake and muscle performance measures in our community-dwelling sacropenic older adults. The protein replete state of our study population may explain these findings. The observations that an uneven distribution of protein intake throughout a day may suggest the need to increase protein intake at breakfast among Chinese sarcopenic older adults.
L.-Y. Zhu ; R. Chan ; L. Li ; T. Kwok ; J. Woo (2018): Dietary protein intake pattern and sources and their associations with muscle and physical function measures in older Chinese adults with sarcopenia in Hong Kong. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.14
INADEQUACY OF N-3 POLYUNSATURATED FATTY ACID DIETARY INTAKES IN THE GENERAL FRENCH POPULATION OF ELDERLY (65 TO 79 YEARS OLD): THE INCA 2 SURVEY
B. Buaud, J. Tressou, P. Guesnet, N. Simon, S. Pasteau
J Aging Res Clin Practice 2018;7:69-74Show summaryHide summary
Objectives: The aim of this study was to explore polyunsaturated fatty acid (PUFA) intakes in the French elderly population (65 to 79 years old). Design: The study used data on French food consumption issued from 348 elderly of the cross-sectional national French INCA 2 dietary survey performed in 2006 and 2007, combined with the nutritional content of food consumed updated in 2013 by the French Information Center on Food Quality. Results: It was observed for the French elderly population an adequate total fat daily intake and a linoleic acid (LA) daily intake close or superior to the recommended dietary intake (RDI) by the French authorities (from 4.1 to 4.4% of the total energy intake excluding alcohol (EIEA) vs 4% EIEA). By contrast, the French elderly have, regardless of age and gender, a low mean dietary alpha-linolenic acid (ALA) intake equal half of the RDI (0.5% EIEA vs 1% EIEA), and a mean dietary docosahexaenoic acid (DHA) intake close to two-thirds of the RDI (i.e. from 154 to 167 mg/d vs 250 mg/d). These translated into a LA/ALA ratio between 9.5 and 9.9, twice as high as the recommended threshold inferior to 5, and a mean dietary eicosapentaenoic acid (EPA) plus DHA intake (from 267 to 293 mg/d) slightly more than half of the RDI (500 mg/d). Conclusion: This study supports the need to promote higher intakes of n-3 PUFAs, as well as the setting of specific intake recommendations for these fatty acids for the French elderly population.
B. Buaud ; J. Tressou ; P. Guesnet ; N. Simon ; S. Pasteau (2018): Inadequacy of n-3 polyunsaturated fatty acid dietary intakes in the general French population of elderly (65 to 79 years old): the INCA 2 survey. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.13
SARCOPENIA VERSUS DYNAPENIA: FUNCTIONAL PERFORMANCE AND PHYSICAL DISABILITY IN CROSS SECTIONAL STUDY
T. Neves, M. Bomfim Martin Lopes, M.G. Crespilho Souza, E. Ferriolli, C.A. Fett, W.C. Rezende Fett
J Aging Res Clin Practice 2018;7:60-68Show summaryHide summary
Background: The magnitude of “Sarcopenia” and “Dynapenia” as a public health problem is not well established, nor is the relationship of declines strength and muscle mass to physical disability and/or loss of mobility. Objectives: Test the hypothesis that the elderly with sarcopenia are more likely to physical disability than are those with dynapenia. Design: Cross-sectional study. Setting/Participants: A total of 387 older adults (≥65 years old) from the FIBRA Study in Cuiabá, Mato Grosso, Brazil. Measurements: Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP), which includes the presence of low muscle mass, plus low muscle strength or low physical performance. Dynapenia was defined as handgrip strength <30kgf (men) and <20kgf (women). Data relating to socio-demographic, behavioral, health conditions, physical disability, the level of physical activity, body composition, hand grip strength and the Short Physical Performance Battery were collected. Results: Regarding the loss of mobility, sarcopenia was associated with age ≥75 years, female, sedentary lifestyle, stroke, arthritis, and falls (OR = 2.95, 95% CI: 1.07 – 8.09); with no association for physical disability in BADL and IADL. Dynapenia had no association with loss of mobility; however, for disability in BADL and IADL, it was associated with the elderly aged ≥80 years old and arthritis (OR = 2.35, 95% CI: 1.42 – 3.88). Conclusion: Dynapenia is more sensitive to the prevention of future self-reported physical disability, in comparison to sarcopenia which can be used in clinical practice as a screening tool for the early decline in mobility.
T. Neves ; M. Bomfim Martin Lopes ; M.G. Crespilho Souza ; E. Ferriolli ; C.A. Fett ; W.C. Rezende Fett (2018): Sarcopenia versus Dynapenia: Functional Performance and Physical Disability in Cross Sectional Study. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.12
DEFINING SARCOPENIA USING MUSCLE QUALITY INDEX
C.-D. Lee, E. Dierickx
J Aging Res Clin Practice 2018;7:55-59Show summaryHide summary
Objectives: Although low muscle quality is a strong predictor of sarcopenia, defining sarcopenia using muscle quality remains unknown. This study investigated the cut-points to define sarcopenia using muscle quality index (MQI) in the young reference population. Methods: Fifty healthy young (20 to 29 years) and forty elderly adults (60 to 79 years) were recruited in this study. Dual-energy X-ray absorptiometry was used to assess appendicular skeletal muscle mass. Hand grip and leg dynamometers were used to measure muscle strengths in the arm and leg. Muscle quality in the arm (MQIArm, kg/kg) and leg (MQILeg, Nm/kg) were computed as muscle strength per lean mass in the arm and leg, respectively. Total muscle quality (MQITotal) was computed as the combination of MQIArm and MQILeg, while standardized muscle quality (MQIStd) was computed as the combination of z-scores in MQIArm and MQILeg. Sarcopenia was defined as ≤2 SD below from the mean values in the young reference group. Results: The cut-points for defining sarcopenia using MQIArm, MQILeg, MQITotal, and MQIStd in men were ≤8.37, ≤12.07, 22.06, and <-3.35, and in women were ≤10.09, ≤13.97, 28.22, and <-2.25, respectively. In the elderly adults, the frequencies of sarcopenia using MQIArm, MQILeg, MQITotal, and MQIStd were 15%, 27.5%, 32.5%, and 35%, respectively. Conclusion: This study establishes new values for defining sarcopenia using MQIs. The proposed new MQI cut-points may be a role in detecting sarcopenia across individual and population level.
C.-D. Lee ; E. Dierickx (2018): Defining Sarcopenia using Muscle Quality Index. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.11
LONG SUN-EXPOSURES INFLUENCING HIGH SUB-CUTANEOUS SYNTHESIS OF VITAMIN-D3 MAY BE ASSOCIATED WITH EXACERBATION OF SYMPTOMS IN ALLERGIC-ASTHMA
L.G. D\'Cruz, S.A. Husain, T. Wells, C. Morgan, P.J. Stanczyk, A. Satgunarajah, J. Kashir, B.L. Calver, L.M. Blayney, F.A. Lai
J Aging Res Clin Practice 2018;7:47-54Show summaryHide summary
Objectives: Does excessive sun-exposure, non-use of sunscreen and/or high doses of vitamin-D3 supplements provoke exacerbation of asthma? Design: Clinical examinations, retrospective records-access and questionnaire surveys were distributed to a convenience sample of allergic-asthma patient (n=183). Setting: Patients (19-89 years) attending the outpatient respiratory clinics at Maidstone Hospital were enrolled. Results: 90.3% of patients (total IgE levels ≥75 kU/L ; n=103) exposed to direct sunlight of ≥ 15 minutes per day continuously for 6-7 days presented with wheeze (χ2(1) = 7.46; p< 0.05) compared to only 9.7% patients of similar atopy-status, presenting with wheeze if exposed to sunlight of < 15 minutes per day for 6-7 days. 68.9% patients (with IgE levels ≥ 75 kU/L ; n=103), non-users of sunscreen (SPF 30 and above), exposed to direct sunlight of ≥ 15 minutes per day continuously for 6-7 days developed a wheeze, compared to fewer users of sunscreen (9.7%, n=103), exposed to the same duration of sunlight who developed asthma symptoms (p< 0.05). Vitamin-D3 supplementation in asthma-patients with clinical signs of hypovitaminosis-D (n=21), produced symptoms of morning chest-tightness (76.2%), allergic rhinitis (61.9%) and wheeze (100%), 2 weeks after initiation of treatment. Conclusions: Our results advocate direct sunlight exposure < 15 minutes per day and use of sunscreen as a novel approach to preventing atopic-asthma symptoms in allergic-asthma patients.. Activated vitamin-D3 is well-recognised to shift the immune-balance towards Th2 predominance, favouring allergic asthma. These results suggest that limiting subcutaneous synthesis of vitamin-D3 in asthma patients and re-addressing dosage of vitamin-D3 supplementation is necessary may contribute to prevent exacerbation of symptoms.
L.G. D'Cruz ; S.A. Husain ; T. Wells ; C. Morgan ; P.J. Stanczyk ; A. Satgunarajah ; J. Kashir ; B.L. Calver ; L.M. Blayney ; F.A. Lai (2018): Long sun-exposures influencing high sub-cutaneous synthesis of vitamin-D3 may be associated with exacerbation of symptoms in allergic-asthma. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.10
GHRELIN ACTIVATION BY INGESTION OF MEDIUM-CHAIN TRIGLYCERIDES IN HEALTHY ADULTS: A PILOT TRIAL
Y. Yoshimura, S. Shimazu, A. Shiraishi, F. Nagano, S. Tominaga, T. Hamada, M. Kudo, Y. Yamasaki, S. Noda, T. Bise
J Aging Res Clin Practice 2018;7:42-46Show summaryHide summary
Objective: To investigate the efficacy of dietary supplementation of medium-chain triglycerides (MCTs) and its effects on ghrelin activation in healthy adults. Methods: The present study examined two protocols with six healthy volunteers: 1) 12-hour profiles of the plasma levels of acylated and desacyl ghrelin without MCT ingestion, and 2) changes in serum ghrelin levels after oral ingestion of 45 g/day of MCTs for 1 week. Results: At baseline, serum acylated and desacyl ghrelin levels were 18.2±10.3 and 77.1±23.4 fmol/mL, respectively. The ratio of acylated/desacyl ghrelin was 19%. There were no significant differences in the 12-hour profiles of acylated and desacyl ghrelin. Significant increases were observed in all sampling times of serum acylated ghrelin after 1-week MCTs ingestion. The ratio of acylated/desacyl ghrelin increased to 37.7%. Conclusions: Oral ingestion of MCTs increased serum acylated ghrelin levels in healthy adults, suggesting that MCTs administration stimulates food intake.
Y. Yoshimura ; S. Shimazu ; A. Shiraishi ; F. Nagano ; S. Tominaga ; T. Hamada ; M. Kudo ; Y. Yamasaki ; S. Noda ; T. Bise (2018): Ghrelin activation by ingestion of medium-chain triglycerides in healthy adults: A pilot trial. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.9
POOR BODY COMPOSITION IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT COMPARED TO HEALTHY OLDER CONTROLS
J. Willers, A. Hahn, T. Köbe, S. Gellert, V. Witte, V. Tesky, J. Pantel, A. Flöel, J.P. Schuchardt
J Aging Res Clin Practice 2018;7:37-41Show summaryHide summary
In this cross-sectional study, body composition of fifty-eight mild cognitive impairment (MCI) patients (single and multiple domain) and fifty healthy older control subjects by the use of bioelectrical impedance analysis (BIA) was assessed. Measurements were: height, weight, body mass index, BIA: phase angle (PA), total body water (TBW), lean body mass (LBM), body cell mass (BCM), extracellular mass (ECM), body fat mass (BFM), apolipoprotein E4, and physical activity level. Compared to BIA reference values and healthy subjects, MCI patients had significant differences in PA (only female), BCM and ECM/BCM index. Differences were more pronounced in females compared to males. The low levels of BCM and PA suggest that MCI patients, especially of female sex, have a poor nutritional status. BIA-derived PA might be a suitable indicator, that could enhance evaluation of nutritional status in patients with cognitive decline.
J. Willers ; A. Hahn ; T. Köbe ; S. Gellert ; V. Witte ; V. Tesky ; J. Pantel ; A. Flöel ; J.P. Schuchardt (2018): Poor body composition in patients with mild cognitive impairment compared to healthy older controls. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.8
EFFECTS OF ONCE-DAILY VERSUS TWICE DAILY DOSING OF CALCIUM FRUCTOBORATE ON KNEE DISCOMFORT. A 90 DAY, DOUBLE-BLIND, PLACEBO CONTROLLED RANDOMIZED CLINICAL STUDY
Z. Pietrzkowski, A. Roldán Mercado-Sesma, R. Argumedo, M. Cervantes, B. Nemzer, T. Reyes-Izquierdo
J Aging Res Clin Practice 2018;7:31-36Show summaryHide summary
Importance: Previous research showed that a twice-daily 108 mg dose of calcium fructoborate (CFB) improved knee discomfort during a 2-week supplementation period. This current double-blind, placebo-controlled randomized study investigates the effects of CFB supplementation on knee discomfort during 90 days of supplementation. Purpose: To evaluate the comparative effects of once-daily and twice-daily dosing of calcium fructoborate on knee joint discomfort for ninety days. Design: 120 participants with self-reported knee discomfort were recruited and randomized into three groups (each N=40). Participants received: 108 mg CFB twice per day (CFB-G1); or, 216 mg CFB in a single dose (CFB-G2); or, placebo. Setting: Subjects were recruited through advertisement in local papers. The researchers assessed intake and within-study levels of knee discomfort by using the McGill Pain Questionnaire (MPQ) and the Western Ontario and McMaster University Arthritis Index (WOMAC). Results: 62 female and 59 male subjects completed the study. Subjects’ average age was (52.84 ± 8.19 years) and average BMI was (26.76 ± 2.50 kg/m2). Statistical differences between groups were calculated using a two-sided, two-sample t-test. Analysis of variance (ANOVA) was used to estimate within-group changes in mean WOMAC and MPQ scores as well as against the control group. When compared to placebo, CFB-G1 showed a significant decrease in reported discomfort on day 14 (P=0.02,) day 30 (P=0.003), day 60 (P<0.0001) and day 90 (P<0.0001) according to WOMAC Scores. A similar decrease was observed for CFB-G2 WOMAC Scores on day 14 (P=0.02), day 30 (P=0.0003), day 60 (P<0.0001) and day 90 (P<0.0001). When compared to placebo, the MPQ score for CFB-G1 group decreased on day 7 (P=0.002), day 14 (P=0.001), day 30 (P<0.0001), day 60 (P<0.0001) and day 90 (P<0.0001). MPQ score decreases were also observed for CFB-G2 group on day 7 (P=0.02), day 14 (P=0.01), day 30 (P<0.0001), day 60 (P<0.0001) and day 90 (P<0.0001). When comparing CFB-G1 and CFB-G2, no significant differences were observed. Importantly, no changes were observed in the WOMAC and MPQ scores within the placebo group. Conclusion: Both CFB groups showed early and significantly improved levels of knee comfort. Knee comfort continued to significantly improve throughout the duration of this 90-day study. No significant differences were observed between the once-daily and the twice–daily doses of CFB.
Z. Pietrzkowski ; A. Roldán Mercado-Sesma ; R. Argumedo ; M. Cervantes ; B. Nemzer ; T. Reyes-Izquierdo (2018): Effects of once-daily versus twice daily dosing of Calcium Fructoborate on knee discomfort. A 90 day, double-blind, placebo controlled randomized clinical study. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.7
SENILE ANOREXIA AND HYPERALDOSTERONISM
D. Schwerthöffer, T. Grimmer, I. Bauer
J Aging Res Clin Practice 2018;7:27-30Show summaryHide summary
Objective and Method: A case presentation of a 73-year-old delirious patient diagnosed with hyperaldosteronism and Anorexia Nervosa. A possible pathophysiological relationship between a decades-long uncontrolled eating disorder (so called Senile Anorexia) and a resulting transformation of the adrenal gland is discussed. Results and Conclusion: Senile anorexia can remain undetected for decades only to then manifest itself through somatic complications, e.g. symptoms of hyperaldosteronism. In older, underweight patients with unclear neuropsychiatric symptoms, the diagnosis of Anorexia Nervosa should be considered.
D. Schwerthöffer ; T. Grimmer ; I. Bauer (2018): Senile Anorexia and Hyperaldosteronism. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.6
DO MULTIPLE CHRONIC CONDITIONS INFLUENCE PERSONAL VIEWS ON THE AGEING PROCESS? A QUALITATIVE ANALYSIS
R.E. Pel-Littel, M. van Rijn, P.W. Vermunt, J.C.M. van Weert, M.M. Minkman, G. ter Riet, W.J. Scholte op Reimer, B.M. Buurman
J Aging Res Clin Practice 2018;7:20-26Show summaryHide summary
Objectives: For older persons with two or more chronic diseases (multiple chronic conditions) insight into what they perceive as important in their lives is essential when discussing preferences in the shared decision making process. The aims of this study were to 1) investigate the personal views on the ageing process communicated by older persons and 2) compare the personal views of older persons with and without multiple chronic conditions. Design: Using structured interviews participants were asked five questions about what they perceived as important in terms of ageing, worries, their future, healthy ageing and quality of life. Two independent researchers coded the data and performed content analyses. A stratified content analysis was performed to explore whether persons with and without multiple chronic conditions expressed different personal views with regard to the ageing process. Participants & setting: 547 community dwelling older persons aged 70 years and above. Results: The mean (SD) age was 78.9 (5.9) years, and 60.3% were female. Multiple chronic conditions were present in 72% of the study sample. There were no significant differences in demographic characteristics between persons with and without multiple chronic conditions . However persons with multiple chronic conditions more often had polypharmacy (43% vs 24%; p<0.001), more difficulties with (instrumental) activities of daily living (mean number of impairments 2.4 vs 0.8; p< 0.001) and reported more falls (35% vs 23% p = 0.01) than those without multiple chronic conditions. The qualitative analysis identified the following main themes: ageing was associated with acceptance of ageing, (further) deterioration and worries about limitations and family. A healthy lifestyle, keeping busy, maintaining social contacts and a positive attitude were considered prerequisites to healthy ageing. In 24 out of 28 sub-themes no significant differences were found between participants with and without multiple chronic conditions (MCC). Persons with multiple chronic conditions more often expressed that ageing for them meant having to cope with deterioration and limitations, they had more worries and feared more deteriorations compared to those without multiple chronic conditions. Also persons with multiple chronic conditions less often considered a positive attitude to life a prerequisite to healthy ageing. Conclusions: Acceptance of ageing, (further) deterioration and worries about limitations and family were important themes on the ageing process communicated by older persons. Overall, we found no major differences between persons with and without multiple chronic conditions. The results of this study may help raising awareness amongst health care professionals that eliciting and understanding an older persons’ views on the ageing process is an important first step in making health decisions that support older persons’ personal goals and expectations.
R.E. Pel-Littel ; M. van Rijn ; P.W. Vermunt ; J.C.M. van Weert ; M.M. Minkman ; G. ter Riet ; W.J. Scholte op Reimer ; B.M. Buurman (2018): Do multiple chronic conditions influence personal views on the ageing process? A qualitative analysis. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.5
OIL OR FLAXSEED FLOUR REDUCES PANCREATIC ISLET AREA BUT DOES NOT AFFECT SERUM INSULIN, AT WEANING, IN MALE WISTAR RATS
A. D’Avila Pereira, D. Cavalcante Ribeiro, A. de Sousa dos Santos, B. Ferolla da Camara Boueri, C. Ribeiro Pessanha, M. Duque Coutinho de Abreu, L. Pessoa Rozeno, C. Cristina Alves do Nascimento-Saba, L. Guillermo Coca Velarde, C.A. Soares da Costa, Gilson Teles Boaventura
J Aging Res Clin Practice 2018;7:17-19Show summaryHide summary
The aim of the present study evaluated the influence of oil or flaxseed flour in pancreas morphology of pups, whose mothers were fed with oil or flaxseed flour during lactation, at weaning. After birth, the lactating rat males were randomly assigned: control (C, n=12 pups), flaxseed oil (FO, n=12 pups) and flaxseed flour (FF, n=12). At 21 days, the pups were weaning and anesthetized. Body mass, length, serum glucose, insulin, pancreas mass and pancreatic islet area were assessed. FO and FF showed higher (p<0.05) mass and length and lower glucose (p<0.05) when compared with C. Insulin (p=0.094) and pancreas mass (p=0.054) not differ between groups. FO and FF showed lower (p<0.05) pancreatic islet area when compared with C. A fed with FO or FF, during lactation may improve function pancreatic, as insulin sensitivity. These findings emphasize that oil or flaxseed flour during lactation may improve pancreatic function in early life.
A. D’Avila Pereira ; D. Cavalcante Ribeiro ; A. de Sousa dos Santos ; B. Ferolla da Camara Boueri ; C. Ribeiro Pessanha ; M. Duque Coutinho de Abreu ; L. Pessoa Rozeno ; C. Cristina Alves do Nascimento-Saba ; L. Guillermo Coca Velarde ; C.A. Soares da Costa ; Gilson Teles Boaventura (2018): Oil or flaxseed flour reduces pancreatic islet area but does not affect serum insulin, at weaning, in male Wistar rats. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.4
FIT & STRONG! PLUS: DESCRIPTIVE DEMOGRAPHIC AND RISK CHARACTERISTICS IN A COMPARATIVE EFFECTIVENESS TRIAL FOR OLDER AFRICAN-AMERICAN ADULTS WITH OSTEOARTHRITIS
M. L Fitzgibbon, L. Tussing-Humphreys, L. Schiffer, R. Smith-Ray, A.D. Demott, M. Martinez, M.L. Berbaum, G.M. Huber, S.L. Hughes
J Aging Res Clin Practice 2018;7:9-16Show summaryHide summary
Objectives: The prevalence of osteoarthritis (OA) has increased in the US. We report on a comparative effectiveness trial that compares Fit & Strong!, an existing evidence-based physical activity (PA) program, to Fit & Strong! Plus, which combines the Fit & Strong! intervention with a weight management intervention. Methods: Participants included 413 overweight/obese (BMI 25-50 kg/m²) adults with lower extremity (LE) OA. The majority of the sample was African-American and female. Both interventions met 3 times weekly for 8 weeks. Primary measures included diet and weight. Results: The baseline mean BMI for all participants was 34.8 kg/m², percentage of calories from fat was high, and self-reported PA was low. Discussion: This sample of overweight/obese African-American adults had lifestyle patterns at baseline that were less than healthful, and there were differences between self-report and performance-based measures as a function of age.
M. L Fitzgibbon ; L. Tussing-Humphreys ; L. Schiffer ; R. Smith-Ray ; A.D. Demott ; M. Martinez ; M.L. Berbaum ; G.M. Huber ; S.L. Hughes (2018): Fit & Strong! Plus: Descriptive demographic and risk characteristics in a comparative effectiveness trial for older African-American adults with osteoarthritis. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.3
A SYSTEMATIC REVIEW ON FACTORS INFLUENCING THE HEALTHY AGING: A KOREAN PERSPECTIVE
J.H. Park, Y.J. Park
J Aging Res Clin Practice 2018;7:3-8Show summaryHide summary
An increasing number of researches on gerontology has emphasized an aging process without impairments of physical and/or cognitive function, alongside with an increase of life expectancy. However, studies to date on a healthy aging have suggested limited information on normal and usual aging in an inconsistent manner. Here, we review characteristics to define a healthy aging and, moreover, suggest effective elements to achieve the healthy aging through systematic review. Based on two databases including RISS and PUPMED, we collected original articles showing links between health-related traits and associated factors in Korean population aged 65 years or older. After screening the titles and abstracts, full texts of 186 articles were reviewed, and the remaining 109 papers meeting the inclusion criteria were analyzed to extract aging characteristics and factors of healthy aging. Here, we focus on two themes: 1) definition of a healthy aging and 2) effective determinants influencing the healthy aging. Our results suggest that a healthy aging is a multidisciplinary concept involving objective, subjective and comprehensive definitions. We classify the healthy aging-associated factors into physical, emotional, mental, social and economic domains, and identify that dietary patterns and nutrients among the multi-layer elements become good modifiable factor to achieve the healthy aging.
J.H. Park ; Y.J. Park (2018): A systematic review on factors influencing the healthy aging: A Korean perspective. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.2
NUTRITIONAL AND NONNUTRITIONAL FACTORS WITH POSITIVE AND NEGATIVE EFFECTS ON THE EYE HEALTH BASED ON IRANIAN TRADITIONAL MEDICINE
J Aging Res Clin Practice 2018;7:1-2Show summaryHide summary
S. Parvinroo (2018): Nutritional and nonnutritional factors with positive and negative effects on the eye health based on Iranian Traditional Medicine. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2018.1