Dementia is rapidly a growing challenge for elderly population throughout the globe. Caring for loved one with dementia is a burden and very much stressful for primary caregivers (family members) who are under the home care. It is a serious issue for family which is in lack economic resource. This study examines mental health and economy of a lower middle class family of slum colony of Kolkata metro city of India where has no separate shelter for elderly one and family’s financial condition is in thick and thin position. Elderly mother was about 76 years old. The family had been managing dementia for last 5 years. The study assessed that family members were depressed and their anxiety as well as depression had crossed the limit. Their mental health had been reflected in their daily life and interactional level had been worse affected. So, they were almost isolated from their neighbour. On the other hand, male of this family, only earner (daily wage labour) was unable to go outside for job. This study suggested that government should take effective policy for dementia care and a support to the family with dementia is needed.
Nitric oxide (NO) is a universal regulator of different processes, including vascular tone, hemostasis ?nd apoptosis. One of the important functions of NO as a signaling molecule is determined by a high capacity for diffusion through the cell membrane to synthesize it and penetrate into target cells by controlling their metabolism ?nd realizing intercellular interactions. For the purpose of estimation in elderly persons due to for determine the effect of nitric oxide and its products on the process of subclinical inflammation and apoptosis of endothelial cells in the development of endothelial dysfunction as a target organ in arterial hypertension 66 patients of elderly age with arterial hypertension (AH) of II stage and 24 persons of similar age without cardiovascular diseases were examined. The degree of endothelial dysfunction was examined by dopplerography of brachial artery, the endotheliocytemia level was estimated by the Hladovec and Rossmann method, the concentration of nitric oxide - in the Griess reaction, the levels of C-reactive protein, primary inflammatory mediator of TNF-a, apoptosis markers and nitrotyrosine - were determined by the immune enzyme method. It has been established that the synthesis of basal nitric oxide depends on the activity of endothelial constitutive NO - synthase and maintains the tone of the vessel in a state of light relaxation. In the progression of endothelial dysfunction (ED) a number of phases were identified: a compensation phase with increased secretory activity of endothelial cells, an intermediate phase when the balance is disrupted due to changes in the secretion process of production and inactivation of endothelial factors and a decompensation phase as a result of structural and metabolic disorders of endothelium resulting in its functional failure, death and desquamation. Regulatory effect of NO on subclinical inflammation and apoptosis intensity was confirmed by its strong inverse correlation with the level of TNF-a and caspase-3. It proved the change in the NO concentration, its auto- and paracrine effect on the formation of involutive changes in the vascular wall, its regulatory effect on the processes of subclinical inflammation and apoptosis of endothelial cells in the formation of hypertension, as well as its progression during aging.
The aim of this study was to evaluate the validity and reliability of the age scale for assessing activities of daily living (ADL) among community-dwelling adults aged 75 years or older. Participants comprised 89 older Japanese: 47 men (79.1±3.8 years) and 42 women (78.9±3.7 years). The ADL age (ADLA) equation is an instrument that estimates participants’ physical functioning regarding ADL using data obtained previously from 1006 subjects. The equation is as follows: ADLA for women = 0.447 (chronological age) -5.49ADLS + 44.17; and ADLA for men = 0.519CA – 4.27ADLS + 38.26. Validity was evaluated using cross-validation, and reliability was evaluated using internal consistency and test-retest methods. The correlation between the ADLA and chronological age (CA) in the cross-validation samples (r = 0.62 women, r = 0.61 men) was not significantly different from the relationship observed in the original sample (r = 0.72 women p = 0.636, and r = 0.75 men p = 0.571). Cronbach's alpha (< ) value (internal consistency) for the total ADLA was 0.97 for men and 0.92 for women, whereas the intra-class correlation coefficient (ICC) value (test-retest reliability) was 0.96 for men and 0.91 for women. The results suggest that the ADLA is a reliable and valid tool for the assessment of ADL with satisfactory psychometric properties and that is applicable for persons aged 75 years and older in Japan.
Objectives: We analyse the need for and the provision of care to individuals aged at least 50 years in their last year of life as compared with the previous year of life. Methods: We explain the functional status in ordered logit and who provides care in multinomial logit using the data from the Survey of Health, Ageing and Retirement in Europe. Results: We find a significant and heterogeneous in the cause of death increase in the number of daily living limitations between the previous and the last year of life. The percentage of respondents receiving care increases and more sources of care are observed between the previous and the last year of life. Regional disparities decline in the last year of life. Discussion: Correlates to functional status and care receipt differ between the last and the previous year of life. These differences are specific to region and cause of death.
Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984-1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with walking and balance, as well as among older individuals without dizziness or difficulty with walking. Furthermore, the examination of the relationships between items that are related to more challenging activities and the fall outcome revealed that higher functioning older adults who reported difficulty with the 6 items that yielded the highest risk ratios may also be at elevated risk for a fall.
Corpora amylacea (CA) are glycoprotein-based hyaline-like bodies that accumulate in normal aging brain, and to an even greater extent, in the brains of patients suffering from a variety of neurodegenerative disorders. Although many of the histochemical, tinctorial and structural properties of CAs have been described for more than a century and a half since their discovery, their pathogenic mechanisms, their subcellular origins and their functions are still debated. Two main theories have been advanced to explain the formation of CA, respectively the vascular and the metabolic theories, although pathogenically both mechanisms can be involved. The exact cellular source of CA in the nervous system is still under debate, although both a neuronal and glial origin has been suggested due to the presence of cell specific proteins. CAs contain around 90% glucose polymers (polyglucosan or polysaccharides), 3% phosphates and 5% proteins, most of them being aging or stress-related proteins. Ultrastructurally, CAs were described as masses of randomly oriented short linear electron-dense areas, situated in the cytoplasm of fibrous astrocytes, mainly in their distal processes. In transmission light microscopy they appear as circular bodies ranging from less than 2 µm to about 20 µm in diameter, with smooth surface or ragged appearance that typically have a concentric laminated or target-like patterns, with the cores staining rather more densely than the periphery. Besides their presence in aging brain, in many neurodegenerative disorders some similar structures called polyglicosan bodies, are morphologically indistinguishable from normal CAs, and were described in: Anderson’s disease, adult polyglucosan body disease, inflammatory demyelinating polyneuropathy, diabetic neuropathy, and in the neurons of patients with Lafora progressive myoclonus epilepsy. The differential diagnosis may include all the neuropathological diseases characterized by the production of peculiar materials with special morphology in the elderly. All together, these data come to show that these “enigmatic bodies” are far from being completely understood, thus further investigations are needed to better explain the brain aging and the pathogenesis of different degenerative neurological diseases, and perhaps they could provide novel therapeutic targets to counteract age-related brain disorders.
The increase of EEG alpha3/alpha2 frequency power ratio has been associated with AD-converters subjects with mild cognitive impairment (MCI) as well as a reduction in the regional cerebral blood flow (rCBF). In this study, the association between alpha3/alpha2 frequency power ratio with rCBF changes in subjects with MCI was evaluated. The alpha3/alpha2 frequency power ratio was computed in 27 subjects with MCI. Two groups were obtained according to the median values of alpha3/alpha2, at a cut-off of 1.17. In the groups so obtained, the correlation between brain perfusion and EEG markers were detected. In the MCI group with the alpha3/alpha2 frequency power ratio above 1,17 as compared to the group with alpha3/alpha2 frequency power ratio below 1.17 there was: 1) a constant trend to lower rCBF values; 2) smaller hippocampal volumes; 3) higher theta frequency power. The higher EEG alpha3 /alpha2 frequency power ratio individuates two different group of MCI subjects. A complex interplay between alpha and theta rhythms activity MCI patients is suggested in patients with prodromal Alzheimer's disease.
Background: Since 1990 and to date, four therapeutic methods have been used against aging. All of them, to increase the plasma growth hormone levels. Material and Method: We choose 38 patients to analyse the postoperative rejuvenation. Previously, all of them have been received omental transplantation on the optic chiasma, the carotid bifurcation and the anterior perforated space. Patients with stroke in 14 cases, Alzheimer´s disease (AD) in 23 and Huntington´s disease (HD) in 1. The clinical data of rejuvenation were obtained by observation, videotape and photography. Results: Neurological improvement in patients with stroke, AD and HD were better during the first weeks after surgery than in the following months or years. Besides this, between 1 to 4 months after surgery, 32 patients (84.21%) showed rejuvenation and in the rest, there were not changes. These 6 last patients presented dilation of the third ventricle. Conclusions: These results indicate that the primary cause of aging is of ischemic origin, in the arcuate nucleus of the hypothalamus. Because, in contrast to this, its revascularization by means of omental tissue produce rejuvenation. Therefore, our surgical method improve the function of the residual arcuate nucleus and adjacent zones.
Gout is currently a very widespread metabolic joint disease. In the course of the long history of gout treatment since Hippocrates the opinion of this disease have changed many times, especially concerning frequency, cause and therapy. Now we are far from thinking that gout occurs only in the “upper class” male population. This article comments the occurens of gout tophi in atypical locations in females, which occur not only on the typical sites, namely 1st metatarsal joint of the foot thumb as a typical for the primary gout. It is also necesary to note that gout currently occurs in females more often than before, including also the tophi gout, which appears not only as primary but also as a secondary gout. It occurs in patiens with chronic renal failure, on the basis of long-term renal disease with longlasting hyperuricaemia. The crystals may settle in a remote damaged hand joint at sites of long lasting osteo-arthritis. This especially applies to Heberden´s nodes (distal interphalangeal joint), mainly on the index fingers. Rarely also can applies to the proximal interphalangeal joint (Bouchard´s nodes). Similar observation has not been found so far in the literature.
Introduction: Olfactory dysfunction is an early warning and most common symptom of Parkinson's disease (PD). It is a promising marker mainly at the early stage of the disease for PD. The purpose of the survey was to evaluate the deficits in odor detection in Elderly with PD. We hypothesized that trigeminal sensitivity dysfunction would be less important than olfactory sensitivity impairment in elderly with PD and could improve diagnostic accuracy. Experimental procedure: Olfactory detection thresholds to Phenyl ethyl alcohol (PEA) [activating only the olfactory system] and n- Butanol (BUT) [activating both olfactory and trigeminal systems], were determined in twenty four patients with PD aged over 65 years old [mean age: 75 +/-4.5 years, range: 70-86 years] and in twenty-four healthy controls who were matched for age and gender [mean age: 73 +/-7.1 years, range: 65- 84 years]. The study also included neuropsychological evaluations and stage of PD estimations. Results: Results show a trend towards an impaired olfactory (CN I) detection sensitivity in relation to PEA thresholds in patients with PD compared to controls independently of age and stage of PD, although no significant difference was observed. Furthermore, no significant difference was observed for BUT thresholds between PD’s patients and controls. PEA and BUT thresholds were significantly correlated in both patients with PD and controls. Conclusion: These findings suggest that the olfactory senescence and decreased detection threshold in elderly (both patients with PD and controls) may influence our results by reducing detection olfactory threshold differential between the two groups, contrary to previous findings in young adults with PD and controls. Trigeminal sensitivity seems to be preserved in Elderly with PD. Future investigations should focus on odorants with higher properties to highlight a potential difference between the two groups.
Motor features traditionally define Parkinson’s disease (PD), but non-motor characteristics such as cognitive impairment and dementia have been gradually documented as a core part of PD. Mild cognitive impairment, as a pre-dementia phase of cognitive dysfunction, is recognised as common in non-demented PD patients. In any case, before Parkinson’s Disease-Mild Cognitive Impairment (PD-MCI) diagnostic criteria proposed by the Movement Disorder Society (MDS) Task Force in 2012, there was no agreement in the scientific community about definition, clinical features and evolution of PD-MCI. It explains why epidemiological data reported by many studies provide contrasting results. Nevertheless, many investigations have pointed out that a large amount of PD patients without dementia present a specific neuropsychological impairment, mainly characterized by executive, visuospatial and memory deficits. This review focuses on mild cognitive impairment in PD (PD-MCI). To clarify the characterization of PD-MCI neuropsychological profile, a MEDLINE literature search was carried out. Data were extracted from studies published since 1980. The neurocognitive profile of PD patients was heterogeneous. Cognitive impairment was common in PD even at the time of diagnosis and before drug treatment and it was associated with functional impairment. Primary findings reported that single domain impairment with executive dysfunction was more common than multiple domain impairment, but, nowadays, those results are largely criticized. Moreover, visual-space abilities deteriorated very early during the pathology. Patients with posterior cortical deficits seemed to be associated with the development of Parkinson’s Disease Dementia (PD-D), whereas patients with front striatal deficits were not, hence suggesting the presence of two distinct cognitive syndromes with different aetiologies and prognoses. However, several questions regarding PD-MCI criteria remain currently unanswered. More attention must be paid to the definition of best cut-off scores and to accurate, specific and sensitive tests for discriminating between patients with and without PD-MCI. Further investigations should define the exact prevalence of PD-MCI across different sites/cohort types, estimate PD-MCI subtypes prevalence and even link the clinical phenotype (akinetic-rigid vs tremor-dominant) to the different neuropsychological profiles. Furthermore, research needs to focus on detecting the neuropsychological predictors of PD-MCI conversion into PD-D. Poor efficacy of non-pharmacological intervention to delay the onset of PD-D in PD-MCI patients is also discussed.
The senescence of species and species groups is a real phenomenon similar to the senescence of an individual. The most remarkable evidence of it is an extinction of numerous species groups, which cannot be explained by negative impact of environmental changes. The mechanism of species senescence can be characterized as follows: the organisms tend to produce the copies of themselves, but they cannot reproduce their exact copes for indefinitely long time, that is why the species inevitably change in process of change of generations of its representatives, even if the species is already well adapted to environment; such a continuous species transformation takes place in definite directions because of various constraints even if such directions are not rational and lead to extinction. The species senescence indicates on the fractal properties of ageing: it is scaleless, and existing at all biological objects, one of which is a part of the other.
In the era of globalization growing elderly faces multifaceted problems regardless of social, economical, cultural as well as religion in their retired life. Among such health problem is a prime concerned. The mental crises among them are a major issue. Thus thinking about their end of life they usually try to fulfill their many desires like eating. The present study was conducted to explore the relationship of eating disorder with increasing incidents heart attack among elderly. For the purpose of this study, 100 elderly populations of 60-70 years selected regardless of their gender, socio-economy, education, family relation and so forth. They were interviewed in a reputed hospital namely Rabindranath Tagore Institute of Cardiac Sciences of Kolkata Metro City of eastern India where they took admission for their treatment after their heart attack. The data was also collected from medical practitioners and family members of elderly patients. The simple random sampling method was used with case study. From the study, it was revealed that 70% of them was suffering from heart problem after taking heavy fatty foods and of them 40% was diabetic. They used to control their eating habits with strict monitoring of their family members. But they faced heart attacked after taking food from ceremonial party or otherwise. Among them, 22% were experienced for second time. So, the control of eating habits might longer their survival and for this they need counseling and guidance with supervision of their family members or immediate caregivers.
This paper tries to examine the social, demographic, and behavioral factors on obesity in three Gulf Coast states, namely Alabama, Louisiana, and Mississippi, which has shown higher obesity prevalence in the U.S. One assumes that contributing factors on obesity in this area would follow the national trend: the lower the socioeconomic status, being a minority, African American, and less exercise increases the odds of having obesity. By using the logistic regression, the study found that the Gulf Coast Area did not fully follow the national trend from the 2012 BRFSS data. Rural older males are less likely to be obese, which is surprising. The effect of SES and female African American in the Gulf Coast Area were greater than those in the U.S. The SES variables constructed by education and household income here estimated the unequal effect of SES on obesity clearer: only the highest SES category was statistically significant, unlike the education showed a linear relationship in other studies. It would be appropriate to consider the result of this study for more effective policies and/or programs.
The number of individuals aged 65 and older is expected to more than double from 2012 to 2060. The role of vitamin D in the prevention and treatment of diseases associated with aging has not been well studied. Traditionally, the role of vitamin D focused on the maintenance of skeletal health in the older adult. With the discovery of vitamin D receptors in the nervous, cardiovascular and endocrine systems, the role of vitamin D and its impact on these systems has become an important area of research. Older adults are at risk for lower levels of vitamin D as a result of decreased cutaneous synthesis and dietary intake of vitamin D. Epidemiologic evidence indicates an association between low levels of vitamin D and diseases associated with aging such as cognitive decline, depression, osteoporosis, cardiovascular disease, hypertension, type 2 diabetes, and cancer. Clinical trials to determine the benefit of vitamin D supplementation in preventing and treating such diseases are in progress. This paper highlights current evidence regarding the role that vitamin D may play in diseases associated with aging and addresses the need for well-designed randomized trials to examine its benefit on health outcomes in the older adult.
Transglutaminases are ubiquitous enzymes which catalyze posttranslational modifications of proteins. Recently, transglutaminase-catalyzed post-translational modifications of proteins have been shown to be involved in molecular mechanisms responsible for human diseases. Transglutaminase-catalyzed post-translational modifications of proteins have been hypothesized to be involved also in the pathogenetic mechanisms responsible for several human neurodegenerative diseases. Alzheimer’s disease and other neurodegenerative diseases, such as Parkinson’s disease, supranuclear palsy, Huntington’s disease, and other polyglutamine diseases, are characterized in part by aberrant cerebral transglutaminase activity and by increased cross-linked proteins in affected brains. This review focuses on the possible molecular mechanisms by which transglutaminase activity could be involved in the pathogenesis of Alzheimer’s disease and other neurodegenerative diseases, and on the possible therapeutic effects of selective transglutaminase inhibitors for the cure of patients with diseases characterized by aberrant transglutaminase activity.
Stem cells are cells with the potential to develop into many different types of cells in the body. They serve as a repair system for the body. There are two main types of stem cells: embryonic stem cells and adult stem cells. Doctors and scientists are excited about stem cells because they have potential in many different areas of health and medical research. Immunoablative therapy and hematopoietic stem cell transplantation (HSCT) is an intensive treatment modality aimed at‘resetting’ the dysregulated immune system of a patient with immunoablative therapy and allow outgrowth of a nonautogressive immune system from reinfused hematopoietic stem cells, either from the patient (autologous HSCT) or a healthy donor (allogeneic HSCT). Animal studies have demonstrated that HSCs play an important role in the pathogenesis of autoimmune diseases AD. Adoptive transfer of HSCs after immunoablative therapy caused, prevented, or cured AD. Multipotent mesenchymal stromal cells (MSCs) are of a rapidly moving field in rheumatology, initially based on their cartilage/bone differentiation potential now partly eclipsed by their capacity to counteract adverse host immune responses, improve angiogenesis and prevent fibrosis. Indeed, MSCs are the progenitors of multiple tissues including bone, cartilage, muscle, fat and tendon. At present, MSCs seem to be the best candidates for cell therapy to regenerate injured tissue as they are easily isolated from bone marrow (BM) or adipose tissue and can be rapidly amplified. This has open novel therapeutic applications for various diseases including RA, bone and cartilage genetic disorders as well as bone metastasis. In this review I discuss role of stem cell therapy in various rheumatic diseases.
Wet age-related macular degeneration is associated with chronic ischemia and inflammation that upregulate several inflammatory cytokines and growth factors, particularly vascular endothelial growth factor and fibroblast growth factor which promote the growth of choroidal neovascularization. Only with the introduction of drugs that directly inhibit the actions of vascular endothelial growth factor have ophthalmologists been able to offer patients with wet age-related macular degeneration reasonable hope for improvement of vision. However, intravitreal administration of anti-vascular endothelial growth factor drugs could be associated with unexpected ocular and systemic side effects. We present consecutive case series of 64 eyes of 64 patients with wet age-related macular degeneration treated with a single intravitreal injection of Dobesilate, a synthetic fibroblast growth factor inhibitor. The end points were the improvement from baseline visual acuity and normalization of retinal histology at 1 month. Intravitreal Dobesilate injection results in a significant improvement in functional and anatomic outcomes from the first month after injection. There were no cases of treatment-associated complications.
This study investigated the influence of forest walking on blood pressure (BP), profile of mood states (POMS) and salivary cortisol in both young and aged people. Twenty-three young people (Men=11, Women=12) with a mean age of 22 yrs and twenty-five aged people (M=10, W=15) with a mean age of 59 yrs participated in this study voluntarily. Each participant walked about three hours in the forest according to their comfortable walking pace. After forest walking, systolic BP (SBP) and mean BP (MAP) had significantly decreased in aged people (-10±3 mmHg in SBP, and -5±2 mmHg in MBP, P<0.05, respectively) while remained unchanged in young people. The scores for the “tension-anxiety” and “confusion” subscales of POMS were significantly improved in both young and aged people; moreover, the score for the “anger–hostility” subscale in aged people was also improved significantly. Salivary cortisol significantly decreased in young people (-0.22±0.03?g/dl, P<0.05) and had a tendency to decrease in aged people (-0.05±0.03?g/dl, P=0.099). BP variables at baseline were associated with the changes in BP variables (r=0.575 in systolic BP, r=0.581 in diastolic BP, r=0.582 in MAP, and r=0.582 in pulse pressure), respectively. Furthermore, the baseline salivary cortisol was also related to the forest walking-induced changes in that value (r=0.882). Thus, people with higher BP and higher stress markers may show greater effects from forest walking. Collectively, these results suggested that forest walking may have the possibility to reduce resting BP, mental stress and stress markers in both young and aged people; moreover, significant deceases in BP of aged people indicate that forest walking can be an important and novel exercise therapy if undertaken at a comfortable pace.
