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GENETIC VARIANTS RELATED TO LIPID METABOLISM AS A RISK FACTOR TO LATE-ONSET ALZHEIMER’S DISEASE

M.A.S. Pinhel, A.M. Crestani, G.F. Sousa-Amorim, M.L. Gregório, J.C. Cação, W.A. Tognola, D. Rossi Silva Souza

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Background: Genetic polymorphisms in genes regulating cholesterol metabolism have been suggested to risk factor of developing Alzheimer’s disease (AD). Objective: to analyze the frequency of polymorphisms apolipoprotein E (APOE-HhaI) and adenosine triphosphate binding cassette transporter 1 (ABCA1-StyI) in patients with late-onset AD. Design: case-control study. Participants: We studied 166 subjects (≥65 years old): Study Group (SG)- 88 patients and Control Group (CG)- 88 without dementia. Setting: The polymorphisms were determined using the polymorphism chain reaction and restriction fragment length polymorphism (PCR-RFLP) methods. It was applied Fisher's exact/chi-square tests (P<0.05). Results: Genotypes with APOE*4 prevailed in SG. The genotypic combination between APOE-HhaI and ABCA1-StyI polymorphisms showed a prevalence of heterozygous genotypes of risk for AD. Conclusion: Although genetic variants for ABCA1-StyI alone does not differentiate patients and controls, the G allele in synergy with APOE*4 allele is highlighted in patients suggesting the influence of ABCA1 in the disease.

CITATION:
M.A.S. Pinhel ; A.M. Crestani ; G.F. Sousa-Amorim ; M.L. Gregório ; J.C. Cação ; W.A. Tognola ; D. Rossi Silva Souza (2017): Genetic variants related to lipid metabolism as a risk factor to late-onset Alzheimer’s disease. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2017.3

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HYDROGEN: THERAPEUTIC POTENTIAL IN WELLNESS AND MEDICINE

M. Lemaire, F. Barbier

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Persistent oxidative stress plays an important role in a variety of pathologies, and the search for an effective and well tolerated antioxidant agent continues. Molecular hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals. The non-specific mechanism of hydrogen as a therapeutic antioxidant gives it broad therapeutic potential across a wide range of medical applications, as has been shown by a substantial volume of preclinical data, as well as a growing body of clinical evidence. This review provides an overview of the therapeutic potential of hydrogen, in ageing and wellness applications as well as medical applications, including acute ischemia/reperfusion injury, inflammation and ulceration, metabolic disorders, neurodegenerative disorders, and cancer (anti-cancer effects, radiation toxicities, and side effects of cisplatin) with an emphasis on clinical data. Overall, this review shows that hydrogen is an effective antioxidant, anti-inflammatory and cytoprotective agent.

CITATION:
M. Lemaire ; F. Barbier (2017): Hydrogen: therapeutic potential in wellness and medicine. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2017.2

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IDEAL REDUCTION OF CALORIES FOR GREATEST REDUCTION OF BODY FAT AND MAINTENANCE OF LEAN BODY MASS

M. Lombardo, R. Magarotto, F. Marinelli, E. Padua, M. Caprio, G. Annino, A. Bellia, F. Iellamo

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Objectives: This retrospective clinical study was intended to assess the ideal number of calories in the Mediterranean-style diet (MD) required for maximum weight reduction through a greater decrease in fat mass (FM) and maintenance of fat-free mass (FFM). Methods: We analysed the data of 90 non-smoking subjects (56 females, age = 32.5 ± 9.6 years, BMI = 28.3 ± 5.4 kg/m2, data as mean ± SD). The participants underwent two-month individualised MDs with similar macronutrient composition (55% carbohydrate, 30% fat, 15% protein and fibre > 30 g) but different amounts of energy, which varied daily from 374 kcal to 1305 kcal compared with the total energy expenditure measured by metabolic Holter. The sample was divided into nine groups of 10 subjects in order to establish the amount of energy restriction that was most effective in terms of achieving fat loss and maintaining muscle mass. Results: All subject groups had significant improvements in body composition parameters (weight loss = 2.7 ± 1.8 kg, FM loss = 2.2 ± 1.2 kg and FFM loss = 0.5 ± 1.3 kg). Differences between the nine groups were not significant but higher FM loss was observed in groups one, three, six and eight. Groups one and four had the highest FFM increase and groups two, three and eight had the highest FFM loss. Conclusions: These data suggest that increasing the amount of energy restriction in a low-calorie MD might be useless in terms of obtaining a higher FM loss but a lower restriction could be more effective for maintaining FFM.

CITATION:
M. Lombardo ; R. Magarotto ; F. Marinelli ; E. Padua ; M. Caprio ; G. Annino ; A. Bellia ; F. Iellamo (2017): Ideal reduction of calories for greatest reduction of body fat and maintenance of lean body mass. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2017.1

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INTERVENTIONS FOR INDIVIDUALS WITH YOUNG-ONSET DEMENTIA. A REVIEW OF THE LITERATURE

M. Aplaon, P. Belchior, I. Gélinas, N. Bier, A. Aboujaoudé

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Objective: The aim of this study was to conduct a scoping review of the literature to investigate non-pharmacological interventions for individuals with young-onset dementia and examine their success. Methods: A comprehensive review of the literature was conducted. The following databases were included in our search: Ovid Medline, PsycINFO, Pubmed, CINHAL. Studies were retained if they were 1) peer-reviewed; 2) published in English; 3) focused on non-pharmacological interventions; 4)designed for persons with dementia; and 5) diagnosis before the age of 65. Results: A total of 7 articles met our inclusion criteria and were included in the study. Of those, four consisted in social programs involving the community as part of the intervention, two focused on a cognitive based intervention and one focused on a cognitive behavioral intervention. The social interventions were successful in improving the mood and well-being of participants as well as providing respite for caregivers. The cognitive interventions were successful in improving perceived functional outcomes and affective symptoms of participants. Discussion: A discussion of each intervention including their benefits for individuals with young-onset dementia and their caregivers is presented.

CITATION:
M. Aplaon ; P. Belchior ; I. Gélinas ; N. Bier ; A. Aboujaoudé (2016): Interventions for individuals with young-onset dementia. A review of the literature. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.123

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COMPREHENSIVE GERIATRIC CARE VERSUS STANDARD CARE FOR ELDERLY REFERRED TO A REHABILITATION UNIT – A RANDOMIZED CONTROLLED TRIAL

D. Zintchouk, T. Lauritzen, E.M. Damsgaard

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Objective: To investigate the effect of comprehensive geriatric care (CGC) in elderly referred to a rehabilitation unit. This article describes the considerations behind the study. Design: Participants were randomized to either CGC or standard care. Setting: Participants were recruited from two community care rehabilitation units in Aarhus Municipality, Denmark, in the period between 2012 and 2015. Participants: Inclusion: Elderly patients aged 65 and older admitted from home or hospital. Exclusion: Persons receiving palliative care or assessed by a geriatrician during the past month. Intervention: Medical history, physical examination, blood tests, medication adjustment and follow-up by a geriatrician. The control group received standard care with the general practitioners (GPs) as back-up. Outcomes: Primary outcome: Hospital contacts drawn from national registers. Secondary outcomes: GPs contacts, institutionalization, medication status and mortality collected from national registers, activities of daily living (ADL), physical and cognitive function and quality of life measures collected by a blinded occupational therapist. All outcomes were assessed at day 10, 30 and 90 after arrival at the rehabilitation unit. Conclusion: A new model of care for elderly referred to community rehabilitation was developed and implemented. The potential benefits of this model were compared with usual care in a community rehabilitation unit in a pragmatic randomized clinical trial. We hypothesized that the geriatrician-performed CGC in elderly referred to a rehabilitation unit will reduce the hospital contacts by 25 % without increase in mortality and in contacts to GPs and home care services. We expect that this model will prevent deterioration in ADL, physical and cognitive functioning, and reduce the risk of institutionalization. If the results are positive, community rehabilitation services should be encouraged to change their routines for treatment of this population accordingly.

CITATION:
D. Zintchouk ; T. Lauritzen ; E.M. Damsgaard (2016): COMPREHENSIVE GERIATRIC CARE VERSUS STANDARD CARE FOR ELDERLY REFERRED TO A REHABILITATION UNIT – A RANDOMIZED CONTROLLED TRIAL. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.126

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PSYCHOMETRIC PROPERTIES OF THE SUBJECTIVE-OBJECTIVE MALNUTRITION RISK ASSESSMENT (SOMRA) IN A STUDY OF SWEDISH PEOPLE AGED ? 60 YEARS

M. Naseer, C.Fagerström

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Objective: This study aimed to investigate the risk of malnutrition and to evaluate the psychometric properties of the Subjective-Objective Malnutrition Risk Assessment (SOMRA), SOMRA cut-offs and Swedish-Guidelines on Malnutrition Risk Assessment (SGMRA) for Swedish people aged ≥ 60 years. Setting: This study included both older people living at home and those in special housing. Participants: 1222 of the 1402 subjects aged ≥ 60 years who had participated in the baseline survey (2001–2003) as part of the ongoing National Study on Aging and Care-Blekinge (SNAC-B) were included because they had provided complete information on Mini-Nutritional Assessment (MNA). Measurements: The risk of malnutrition was estimated by the SOMRA, MNA, and SGMRA. To measure concurrent validity, the Receiver Operating Characteristics (ROC) curve, Cohen’s kappa (κ) and Spearman’s rank correlation coefficient rho (rs) were used. Youden’s index (J) was computed to assess the optimal cut-off on SOMRA. Cronbach’s alpha (α) was used to test reliability. Results: The risks of malnutrition measured by SOMRA, MNA and SGMRA were 6.5%, 8.6% and 20.9%, respectively. The risk was higher among older people living in special housing compared to those at home (p < 0.05). Different optimal cut-offs on SOMRA were observed for residents living at home (≥ 1) and those in special housing (≥ 3). Compared to SGMRA, the SOMRA and SOMRA cut-off ≥ 3 gave higher values for J (0.68, 0.81, and 0.84, respectively), κ (0.59, 0.77, and 0.84, respectively) and rs (0.64, 0.78, and 0.84, respectively) for the older people in special housing. The reliability for SOMRA was α = 0.71. Conclusion: The risk of malnutrition was higher among older people in special housing than among those living at home. For the people in special housing, the SOMRA and SOMRA cut-off ≥ 3 showed higher concurrent validity with MNA compared to the SGMRA, but not for older people living at home. SOMRA includes six items, takes less time to implement and is composed of both subjective and anthropometric measurements; therefore, it is suitable for use in special housing and/or clinical settings to identify the risk of malnutrition or the need for nutritional support.

CITATION:
M. Naseer ; C.Fagerström (2016): Psychometric Properties of the Subjective-Objective Malnutrition Risk Assessment (SOMRA) in a Study of Swedish People Aged ≥ 60 Years. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.125

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KNOWLEDGE OF ALZHEIMER’S DISEASE AND TRAINING NEEDS IN FINAL YEAR MEDICAL AND PHARMACY STUDENTS

C. Scerri

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Although a significant number of medical and pharmacy professionals come into contact with an increasing number of individuals with Alzheimer’s disease and other dementias, there is concern on the lack of knowledge and skills received during their undergraduate training programmes with the consequence of not providing the required hospital and community care for these individuals following programme completion. The aim of this report is to describe the results of a small scale study investigating the level of knowledge of Alzheimer’s disease and training needs in medical and pharmacy students at the end of their final year of undergraduate training. The findings indicated a lack of in-depth knowledge for both categories of students, in particular on risk factors and pharmacotherapeutic management highlighting an urgent need of refining existent training programmes that equip future medical and pharmacy professionals with the necessary skills in providing adequate care and management for individuals with the disease.

CITATION:
C. Scerri (2016): Knowledge of Alzheimer’s disease and training needs in final year medical and pharmacy students. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.122

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EFFECT OF INCREASED DAILY INTAKE OF PROTEIN, COMBINED WITH A PROGRAM OF RESISTANCE EXERCISES, ON THE MUSCLE MASS AND PHYSICAL FUNCTION OF COMMUNITY-DWELLING ELDERLY WOMEN

H. Mori, Y. Tokuda

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Background: In elderly women, significant loss of muscle mass due to declining levels of estrogen secretion is a health concern. Increasing the recommended dietary allowance of protein intake has been included as a general health guideline to prevent age-related sarcopenia. Objectives: To investigate effects of light-to-moderate resistance training combined with increased protein intake on the muscle mass, strength, and physical function of community-dwelling elderly women. Design: The 12-week training program combined weight-bearing and resistance band exercises, performed 3 times per week. Setting: Hyogo Prefecture, in either City K or Town H. Practical Intervention: Women were randomly allocated to three groups: exercise with protein intake adjusted to the recommended daily allowance (RDA) of 1.0–1.1 g/kg body weight/day (MP+EX group); exercise with protein intake adjusted above the RDA level at 1.2–1.3 g/kg body weight/day (HP+EX group); and a control group receiving classroom-based session on nutrition management, with protein intake adjusted to the RDA level (MP group). Measurements: Body weight and physical composition were measured by multi-frequency bioelectrical impedance analysis. Results: Exercise prevented decreases in muscle mass and strength and in performance of physical function tasks (p<0.05). Increasing dietary intake of protein above RDA level increased muscle mass (p<0.01), walking speed (p<0.01) and knee extensor strength (p<0.05). Conclusion: Adjusting protein intake to 1.2–1.3 g/kg body weight/day, in combination with light-to-moderate resistance training, can improve body composition and physical function in elderly women. The result of this study could be effective in lowering the incidence of age-related sarcopenia.

CITATION:
H. Mori ; Y. Tokuda (2016): Effect of increased daily intake of protein, combined with a program of resistance exercises, on the muscle mass and physical function of community-dwelling elderly women. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.124

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ANTIOXIDANT SUPPLEMENTS IN ALZHEIMER’S DEMENTIA AND MILD COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW

E.J. Pegg

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Objective: Current treatments have only a modest effect on impairment in Alzheimer’s Dementia (AD) and there is no treatment currently licensed for Mild Cognitive Impairment (MCI). Oxidative stress is postulated to play a role in the pathogenesis of AD and MCI and this provides a rationale for treatment with antioxidant supplements. The aim of this review is to evaluate the effect of antioxidant supplements in people with AD and MCI. Methods: A systematic review of published randomised controlled trials was carried out. 4 electronic databases were searched. Studies were included if they compared the use of a placebo with the following antioxidant supplements in people with AD or MCI: Vitamin e, vitamin c, selenium, alpha lipoic acid, phenols, zinc, curcumin, beta carotene, coenzyme Q10, melatonin. The primary outcome measure was cognitive impairment. Secondary outcome measures included functional impairment, behavioural disturbance and safety. Results: 10 trials were identified which met the inclusion criteria. Outcome data was not suitable for meta-analysis. 5 studies reported a small positive treatment effect on cognition and 1 reported a negative effect. 2 reported a positive treatment effect on functional ability and 1 on behaviour. There were no consistent adverse effects found overall however two studies raised concern of possible worsening of cognition in certain circumstances. Conclusions: The findings of this systematic review do not support the use of antioxidant supplements to slow cognitive, functional or behavioural deterioration in people with AD or MCI. However the majority of included studies had a high or unknown risk of bias. In the one study which had a low overall risk of bias, there was evidence that antioxidant supplements may have a positive effect on functional decline in AD. The overall risk of harm associated with short term antioxidant supplementation appears to be low however caution is warranted. Further studies evaluating the role of oxidative stress in the pathogenesis of AD are suggested.

CITATION:
E.J. Pegg (2016): Antioxidant supplements in Alzheimer’s dementia and mild cognitive impairment: A systematic review. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.121

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JARCP N°04 - december 2016

 

DIABETES STATUS IS ASSOCIATED WITH POOR COGNITIVE PERFORMACE IN SAUDI POPULATION AT HIGH METABOLIC RISK

T. Alaama, M. Basheikh, A. Khiyami, M. Mutwalli, S. Batawi, G. Watfa

J Aging Res Clin Practice 2016;5(4):170-174

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Objective: Previous studies have shown that Diabetes mellitus (DM) is associated with an increased risk of cognitive impairment, but little data is available on Arabic populations, inspite of their remarkably high prevalence of DM. In this study we attempt to study the effect of DM on cognitive performance in middle-aged and elderly patients. Design: Observational cross sectional study. Setting: Outpatient clinics in King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Participants: The study included 241 volunteers aged 59.6 ± 9.2 years; 171 outpatients with DM, matched with 70 controls without. Measurements: Volunteers underwent cognitive assessment using the Montreal Cognitive Assessment Test (MoCA) and the Rowland Universal Dementia Assessment Scale (RUDAS). Results: RUDAS score was poorer in diabetics (25,25 ± 2,78 vs. 26,71 ± 2,57 in controls; p<0.0001) who are more likely to have cognitive impairment 16% , than those who are not diabetics 3%; p=0.004. This association was confirmed in multivariate analyses and shown to be independent of female gender and low education level, all of which were associated with worse RUDAS cognitive score.The results were not significant when the MoCA was used, as 85 % of the cases and 78 % of the controls had abnormal results;p=0.194.Among diabetics, there was no statistically significant effect found for glycemic control or DM duration on either one of the tests.The prevalence of obesity was similar in the two groups with 63% in diabetics and 62% in controls. Conclusion: In our population with an alarming prevalence of obesity, diabetes was associated with poorer cognitive performance independent of female gender or low education level, drawing attention to this under-recognized problem of cognitive impairment that could result in significant health and social problems, particularly in areas with high diabetes prevalence. RUDAS was found to be a very reasonable and convenient test to assess cognition in our sample characterized by a low educational level.

CITATION:
T. Alaama ; M. Basheikh ; A. Khiyami ; M. Mutwalli ; S. Batawi ; G. Watfa (2016): DIABETES STATUS IS ASSOCIATED WITH POOR COGNITIVE PERFORMACE IN SAUDI POPULATION AT HIGH METABOLIC RISK. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.120

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DIETETIC MANAGEMENT OF MALNUTRITION IN A HEALTHCARE SETTING: A SIX MONTH PRAGMATIC RANDOMISED CONTROLLED TRIAL WITH A 24 MONTH FOLLOW-UP

M. Milosavljevic, S. Bowden, A. Ferguson, L. Barone, S. Mason, L. Tapsell, G. Noble

J Aging Res Clin Practice 2016;5(4):175-180

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Background: This study explored approaches to long term dietetic management of disease related malnutrition, a growing problem across hospitals in the industrialised world. Objectives: The aim of this study was to compare the effectiveness of two current models of dietetic care for patients with Disease Related Malnutrition. Design: A six month pragmatic randomised controlled trial was conducted with a 24 month follow up. Setting: All patients referred to the dietitian from two general medical and two surgical wards at a major public regional referral centre who met the inclusion criteria were invited to participate. This included being identified on admission as “at risk” of malnutrition or malnourished. Participants: Dietitians attended to 1222 patients during the recruitment period. From 320 eligible participants, 241 (78%) were recruited; of these only 85 (27%) completed the study. Intervention: It compared extended community–based dietetic management with the more traditional short-term hospital care alone. Measurements: A series of variables were recorded at enrolment, six months and then a follow up at 24 months. These included: nutritional assessment, level of satisfaction with the dietetic service, bed day utilisation, readmission and mortality rates. Results: An intention to treat analysis showed both groups had a significant improvement in nutritional status at six months and this was maintained at 24 months. When patients received an extended community care dietetic service they were significantly more satisfied with the dietetic service than those who did not receive the service (P<0.001). Conclusion: The current standard dietetic care of patients admitted to our institution led to significant improvements in their nutritional status at six months and two years from initial contact. The patient’s level of satisfaction with the dietetic service was high when they were seen in the community.

CITATION:
M. Milosavljevic ; S. Bowden ; A. Ferguson ; L. Barone ; S. Mason ; L. Tapsell ; G. Noble (2016): Dietetic management of malnutrition in a healthcare setting: a six month pragmatic randomised controlled trial with a 24 month follow-up. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.119

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COMPARING OLDER ADULTS PRESENTING WITH DEHYDRATION AS A PRIMARY DIAGNOSIS VERSUS A SECONDARY DIAGNOSIS IN THE EMERGENCY DEPARTMENT

J.C. Mentes, H. Aronow

J Aging Res Clin Practice 2016;5(4):181-186

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Objectives: We compared clinical data of older adults, >65 years of age who presented to a large urban ED with a primary diagnosis of dehydration, ICD code 276.5 (PD) to those with dehydration as a secondary diagnosis (SD). Design: Comparative study using a large hospital emergency room administrative database (2008-2009). Setting: Large urban hospital. Participants: 231 participants mean age 81 years, 86 with PD were matched on age, gender and ethnicity to 145 with SD. Measurements: We collected data on chief complaints, laboratory tests, medical diagnoses, and medications as listed in the database. Results: Among major diagnoses, those with SD were more likely to have an infection. A logistic regression with SD as dependent variable and using variables significant at the univariate level revealed that infections (AOR= 6.7, 95% CI 2.92, 15.08) and difficulties with activities of daily living (AOR= 2.19, 95% CI 1.02-4.66) were more likely in those presenting with SD than with PD. Patients with SD were less likely to have a diabetes diagnosis (AOR=.32, 95% CI .14, .72), have diarrhea (AOR= .50, 95% CI .22, 1.19), and present with a dry mouth (AOR= .39, 95% CI, .19, .78). Those with SD were significant more likely to be repeat ED users, have longer hospital stays and have higher hospital costs than those with PD. Conclusions: Comorbid dehydration is often obscured by the seriousness of the presenting condition in the ED. This creates a missed opportunity to educate the patients and their families about the importance of maintaining adequate hydration, which may prevent rehospitalization.

CITATION:
J.C. Mentes ; H. Aronow (2016): Comparing older adults presenting with dehydration as a primary diagnosis versus a secondary diagnosis in the emergency department. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.118

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CARNITINE INSUFFICIENCY IS ASSOCIATED WITH ADVERSE OUTCOMES IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION

Y. Kinugasa, S. Sugihara, K. Yamada, M. Miyagi, K. Matsubara, M. Kato, K. Yamamoto

J Aging Res Clin Practice 2016;5(4):187-193

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Background: L-carnitine is an essential nutrient that plays a vital role in fatty acid energy metabolism of the heart and skeletal muscles. Primary or secondary carnitine insufficiency contributes to progressive left ventricular systolic dysfunction and physical frailty. However, the clinical features of patients with heart failure with preserved ejection fraction (HFpEF) and carnitine insufficiency remain unclear. Objectives: The present study aimed to evaluate the clinical characteristics and outcomes of these patients. Design: A prospective cohort study. Setting: Tottori University hospital. Participants: 117 patients who were hospitalized with HFpEF (ejection fraction ≥45%). Measurement: All measurements were obtained at hospital discharge. Carnitine insufficiency was defined as the lowest quantile of free carnitine level (<56.3 μmol/L) or the highest quantile of acylcarnitine to free carnitine ratio (≥0.35). Nutritional status and physical activity were assessed by the Geriatric Nutritional Risk Index (GNRI) and Barthel index (BI). Left ventricular diastolic function was assessed by echocardiography. The composite endpoints were hospitalization for heart failure and death from cardiac causes. Results: Patients with carnitine insufficiency (44.4%) had lower values of GNRI and BI, higher B-type natriuretic peptide levels, and lower early diastolic mitral annular velocity in the subgroups with sinus rhythm compared with those with preserved carnitine (all p<0.05). During a mean follow-up of 472±249 days, composite endpoints occurred in 26.5% of patients. Multivariate Cox hazard analysis showed that carnitine insufficiency was an independent predictor of cardiac events (p<0.05). Conclusions: Carnitine insufficiency is associated with adverse outcomes in patients with HFpEF.

CITATION:
Y. Kinugasa ; S. Sugihara ; K. Yamada ; M. Miyagi ; K. Matsubara ; M. Kato ; K. Yamamoto (2016): Carnitine Insufficiency is Associated with Adverse Outcomes in Patients with Heart Failure with Preserved Ejection Fraction. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.116

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ATROPHIC GASTRITIS (AG) AND ITS CLINICAL SEQUELS AMONG ELDERLY PEOPLE IN FINLAND AND ESTONIA. A COMPARATIVE STUDY USING GASTROPANEL AND B12- VITAMIN TESTING OF THE RESIDENTS IN ASSISTED-HOUSING FACILITIES

R. Aine, E. Kahar, K. Aitokari, J. Salminen, C. Eklund, L. Paloheimo, A. Peetsalu, K. Syrjänen

J Aging Res Clin Practice 2016;5(4):194-202

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Objective: Atrophic gastritis (AG) is associated with severe clinical sequels, including malabsorption of vitamin-B12, calcium, iron, magnesium, and zinc, with potential to develop irreversible neurological complications (e.g. dementia). To assess the prevalence of AG and its clinical sequels by serum biomarker testing and B12-vitamin measurement in elderly people in Estonia and Finland. Methods: In total, 209 residents of assisted-housing facilities (mean age 82 years) were screened by GastroPanel (Biohit Oyj, Finland) and active B12-vitamin test, the results linked with their medical history. Results: Study subjects in Tampere (n=106) and Tartu (n=103) differed in many characteristics of their medical history, including previously diagnosed B12-vitamin deficiency (p=0.006). Data requested for GastroPanel testing disclosed significantly less use of PPI medication and B12-vitamin supplementation in Tartu (p=0.0001). GastroPanel diagnostic profile (5 categories) was significantly different (p=0.0001), most markedly the HP-prevalence (all cases) (52.4%% vs 24.5%). AG in Finland (12.3%) and Estonia (15.6%) was not different (p=0.494), but manifest B12-vitamin deficiency was more common in Tartu (23.3% vs. 3.8%)(p=0.0001). Of all known complications of AG, only i) the diagnosed vitamin B12 deficiency (OR=3.5), and ii) diagnosed pernicious anaemia (OR=9.4) were significantly associated with AG. Conclusions: In Estonia, the majority (92%) of B12-vitamin deficient cases remained undiagnosed as compared to Finland (23.5%). To prevent irreversible complications, early diagnosis and adequate supplementation of vitamin B12 deficiency is essential. This is best done by detecting the subjects at risk (AG patients) by targeted GastroPanel screening, even years before the development of protean clinical manifestations.

CITATION:
R. Aine ; E. Kahar ; K. Aitokari ; J. Salminen ; C. Eklund ; L. Paloheimo ; A. Peetsalu ; K. Syrjänen (2016): Atrophic gastritis (AG) and its clinical sequels among elderly people in Finland and Estonia. A comparative study using GastroPanel and B12-vitamin testing of the residents in assisted-housing facilities. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.115

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DIETARY HABITS AND FUNCTIONAL LIMITATION OF OLDER BRAZILIAN ADULTS: EVIDENCE FROM THE BRAZILIAN NATIONAL HEALTH SURVEY (2013)

E. Alves Valle, J. Vaz de Melo Mambrini, S. Viana Peixoto, D. Carvalho Malta, C. de Oliveira, M.F. Lima-Costa

J Aging Res Clin Practice 2016;5(4):203-208

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Objective: To compare the consumption of selected healthy and unhealthy food groups among elderly Brazilians with daily living activity limitations relative to those with no limitations. Design: Cross-sectional analyses of a nationally representative survey. Setting: The Brazilian National Health Survey, conducted in 2013. Subjects: 11,177 Brazilians aged 60 and over. Results: The prevalence of daily living limitations was 29% (95% CI 27.6,30.5). The consumption of daily meat, beans on a regular basis, and recommended fruit and vegetables intake were 67.1% (95% CI 66.5,68.7), 71.3% (95% CI 69.9,72.8) and 37.3% (95% CI 35.6,39.9), respectively. Compared to those without functional limitation, the consumption of these three food groups was significantly lower among those older adults with functional limitation (Prevalence Ratio = 0.89, 95% CI 0.80,0.98; 0.90, 95% CI 0.82,0.99 and PR 0.86, 95% CI, 0.76,0.96, respectively), independently of age, sex, marital status, living arrangements and education. Level of education showed a strong positive association with fruit and vegetable consumption, and a negative association with bean consumption, a staple diet in Brazil. Conclusions: Our findings highlight the need for public health policies to increase consumption healthy food consumption among those older adults with functional limitations, especially fruit and vegetable intake among those who have low education levels.

CITATION:
E. Alves Valle ; J. Vaz de Melo Mambrini ; S. Viana Peixoto ; D. Carvalho Malta ; C. de Oliveira ; M.F. Lima-Costa (2016): Dietary habits and functional limitation of older Brazilian adults: evidence from the Brazilian National Health Survey (2013). The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.114

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PLASMA LEVELS OF INTERLEUKIN-6 AND SOLUBLE TUMOR NECROSIS FACTOR RECEPTOR ARE ASSOCIATED WITH MUSCLE PERFORMANCE IN PRE-FRAIL COMMUNITY-DWELLING OLDER WOMEN?

L. Paccini Lustosa, L. Souza Máximo Pereira, P. Parreira Batista, D.A. Gomes Pereira, J.M. Domingues Dias, A. Netto Parentoni

J Aging Res Clin Practice 2016;5(4):209-213

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Aim: Increased plasma levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α have been associated with frailty syndrome and reduced muscle strength in older. Sarcopenia influenced loss of mobility and functional independence, and contributed to frailty syndrome. Furthermore, sarcopenia mainly entails a decrease in type II muscle fibers, with consequent loss of muscle power; this could occur as a result of a lack of physical activity. Objective: To examine the correlation of muscular performance and the plasma levels of IL-6 and soluble TNF receptor (sTNFr) in pre-frail community-dwelling women. Methods: The study included 32 pre-frail women (≥ 65ys). The measurements were plasma concentrations of IL-6 and sTNFr1 (ELISA); muscle strength (isokinetics Biodex System). The muscle resistance program constituted 75% of maximum load (3 times/week, 10 weeks). Statistical analysis were made through Pearson and Spearman correlation (α = 5%). Results: There was a significant inverse correlation between sTNFr1 and muscle strength, pre- (r = −0.36, P = .04) and post-training (r = −0.37, P = .04) and, a significant positive correlation between IL-6 and muscle strength (r = 0.45, P = .01). Conclusion: The correlations found between the inflammatory mediators and the measures of muscular performance evaluated before and after training suggest that, as the muscles increase their ability to generate power, sTNFr concentrations decrease, and the levels of IL-6 increase. Muscle resistance exercises should be encouraged in pre-frail older women to induce the release of cytokines.

CITATION:
L. Paccini Lustosa ; L. Souza Máximo Pereira ; P. Parreira Batista ; D.A. Gomes Pereira ; J.M. Domingues Dias ; A. Netto Parentoni (2016): Plasma Levels of Interleukin-6 and Soluble Tumor Necrosis Factor Receptor Are Associated with Muscle Performance in Pre-Frail Community-Dwelling Older Women?. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.113

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EXPLORING CENTENARIANS’ PERCEPTION OF NUTRITION

E.C. Holston, B. Callen

J Aging Res Clin Practice 2016;5(4):214-216

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Background/Objective: Centenarians’ dietary habits have been associated with healthy aging, although it is centenarians’ perceptions about their diet that influence what they eat and in what amounts. However, there is little research on centenarians’ viewpoints about their past and current eating patterns and their impact on centenarians’ current nutritional status. Thus, this study explored the perceptions about lifetime dietary habits of community-dwelling Appalachian centenarians. Design: A qualitative descriptive design. Setting: Home or the facility where participants lived. Participants: A convenience sample of community-dwelling centenarians. Measurements: Face-to-face interviews were used. Transcripts were analyzed with the Nuendorf’s method of content analysis. Results: Emerging themes were source of food, food preferences, food consumption, balanced diet, food preparation & storage, responsibility for nutrition of family, and longevity. Conclusion: Centenarians’ perceptions about their dietary behaviors need to be considered when adjusting their diets and eating patterns for clinical purposes.

CITATION:
E.C. Holston ; B. Callen (2016): Exploring Centenarians’ Perception of Nutrition. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.111

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ACCURACY OF 24-HR FOOD-REGISTRY METHOD IN ELDERLY SUBJECTS: ROLE OF A SURROGATE RESPONDENT

J. Pardío, P. Arroyo, A. Loría, S. Torres-Castro, M. Agudelo-Botero, B.L. Jiménez Herrera, A.T. Serrano Miranda

J Aging Res Clin Practice 2016;5(4):217-219

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Importance: There are problems in the dietary assessment of elders due to the aging process. Objective: To assess the comparativity of dietary diversity reported by an elder with that reported independently by his/her Caregiver. Design: Comparison of foods consumed by elder in the previous 24-h reported by elder and caregiver. Outcome variable: % of foods reported and unreported by either. Setting: A Housing Development Unit, and a Geriatric Rehabilitation Clinic. Participants: 26 elders of 65-94 years of age, plus 26 caregivers. Results: The %foods unreported was more than double in elders than in caregiver (37% vs 17%). Regression models using sociodemographic variables of elders and caregivers as predictor variables showed only one significant variable [Caregiver cooked for the elder] associated with %unreported by caregiver and with %reported by either. No association with age, sex, being next-of-kin, schooling, cognitive level or setting was observed. Conclusion: The use of surrogates in dietary evaluation of elders should be carried out using the person in charge of preparing foods for the elder.

CITATION:
J. Pardío ; P. Arroyo ; A. Loría ; S. Torres-Castro ; M. Agudelo-Botero ; B.L. Jiménez Herrera ; A.T. Serrano Miranda (2016): Accuracy of 24-Hr food-registry method in elderly subjects: role of a surrogate respondent. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.112

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GENDER DIFFERENCES IN PRACTICE, KNOWLEDGE AND ATTITUDES REGARDING FOOD HABITS AND MEAL PATTERNS AMONG COMMUNITY DWELLING OLDER ADULTS

J. Johannesson, E. Rothenberg, S. Dahlin Ivanoff, F. Slinde

J Aging Res Clin Practice 2016;5(4):220-228

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Objective: To study gender differences in older adults according to practice, knowledge and attitudes regarding food habits and meal patterns. Design: Cross-sectional study. Setting: Two urban districts of Gothenburg, Sweden. Participants: A total of 297 individuals were included, 102 men and 195 women. They were 80 years or older and living in ordinary housing without being dependent upon the municipal home help services or help from another person in Activities of Daily Life, and cognitively intact, defined as having a score of 25 or higher in the Mini Mental State Examination. Measurements: Telephone interviews regarding food habits and meal patterns were conducted. Results: Almost all participants (99%) ate their main meal at home and men preferred company at meals more often (p<0.001). Women had the sole responsibility to shop for food more often (p<0.000), and generally regarded cooking as a routine or something they just had to do. Among men, few (13%) took a great interest in cooking and 36 % of the men stated that cooking was something they were not capable of performing (p<0.000). Men had company at meals every day more often (71% vs 40%). Respondents stated that loneliness took away the enjoyment of cooking and changed their habits when becoming a widow or widower. Conclusion: Women take greater responsibility for the household than men, regardless of marital status. A large proportion of the men thought cooking was something they were not able to do. The findings in this study may indicate a possible gender difference in the need for societal support.

CITATION:
J. Johannesson ; E. Rothenberg ; S. Dahlin Ivanoff ; F. Slinde (2016): Gender differences in practice, knowledge and attitudes regarding food habits and meal patterns among community dwelling older adults. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.117

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