Efforts to find treatments for chronic brain disorders such as the dementia-Alzheimer syndrome 2 are imperative, given the growing psycho-social challenges and escalating expenses associated with caring for affected individuals on a global scale.The aim of eradicating the dementia-Alzheimer syndrome from the world is a top priority for public health systems globally.However, there is still no clear path to achieving this goal.Despite significant investments in research for over 40 years, there are only a few effective interventions available to slow down the progression of the disease or delay the onset of cognitive impairment and other disabling symptoms.One of the main challenges in developing therapies for chronic brain disorders like dementia is the complexity of the neurobiology involved.Another is the lack of a conceptual framework connecting the components and variables involved.These two factors contribute to the difficulty of discovering effective interventions.Over the past four decades, studies on the dementia-Alzheimer syndrome have uncovered a wealth of information about the aging of the brain and the process of neurodegeneration.However, the field lacks a unifying theory 3 that can connect the dots and guide the exploration, testing, and validating of new interventions.Therefore, the calcium hypothesis, which was originally proposed as a potential unifying concept, has been restructured as a set of testable postulates based on system theory.This approach may eventually lead to a comprehensive theory that links aging and neurodegenerative disorders, such as the dementia-Alzheimer syndrome.The task of formulating a comprehensive theory of aging and dementia-Alzheimer syndromic continuum is fraught with several conceptual, scientific, and methodological impediments.Among these the most relevant include the nature of the disease itself (i.e., an ambiguous and shifting definition), the lengthy
Palliative chemotherapy prolongs survival and improves quality of life. However, a variety of chemotherapeutics including oxaliplatin can cause severe side effects during treatments, leading to painful symptoms that might result in the interruption of cancer treatment. Although adding oxaliplatin to fluorouracil and leucovorin in adjuvant chemotherapy for colon and rectal cancer may improve disease-free survival, it also increases grade 3–4 sensory neuropathy. Our study aimed to determine whether oral Mecobalamin is neuroprotective against oxaliplatin-induced neuropathy. Forty-six stage III colon and rectal cancer patients receiving adjuvant biweekly oxaliplatin were randomized to oral Mecobalamin (1,500 mg; case group) or placebo (control group). Clinical neurological and electrophysiological evaluations were performed at baseline and after 4, 8, and 12 treatment cycles. Treatment-related toxicity was evaluated based on National Cancer Institute (NCI) criteria. After four cycles of chemotherapy, 9 of 23 patients in the control group and 8 of 23 patients in case group experienced grade 1 sensory neuropathy. After eight cycles, 13 patients experienced sensory neuropathy (grade 2–4 toxicity) in the control group; however, no patients in the case group experienced sensory neuropathy (P < 0.05). After 12 cycles, grade 2–4 sensory neuropathy was observed in 20 patients in the control group, but only in 4 patients in the case group (P < 0.05). We did not observe any significant electrophysiological changes in the case group after 4, 8, or 12 cycles of chemotherapy. Thus, we demonstrated that oral Mecobalamin reduces the incidence of neuropathy in colon and rectal cancer patients receiving oxaliplatin-based adjuvant chemotherapy.
Hand strength and dexterity begin to diminish as we age, and holding everyday items like a traditional coffee mug can become difficult. The inability to properly grasp a mug of hot liquid is a common cause of burn injuries for the elderly. Brandy mitigated this home safety risk by designing a new mug that, although comfortable for elderly hands to hold, would be a pleasure for anyone to enjoy.
Purpose: To evaluate mental health, cognitive function, and living quality of colon and rectal carcinoma patients with oxaliplatin-induced neurotoxicity. Methods: Fifty recurrence-free colorectal cancer (CRC) patients with oxaliplatin chemotherapy while 50 control patients without oxaliplatin chemotherapy were enrolled in this study. Subjective and objective aspects of oxaliplatin chemotherapy symptoms were assessed with oxaliplatin neurotoxicity classification. Psychological assessment was measured via the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Cognitive function was measured via Montreal Cognitive Assessment (MoCA). Quality of Life (QOL) was assessed using the World Health Organization’s Quality of Life (WHOQOL-BREF) shortened instrument. Results: Of the patients with oxaliplatin chemotherapy, 41 patients had depression and 42 patients had anxiety. Patients with oxaliplatin chemotherapy scored higher on average on both the SDS (64.36 ± 7.22) and SAS (67.49 ± 9.41) compared to those without oxaliplatin chemotherapy (SDS, 57.86 ± 5.27, p=0.006; SAS, 61.57 ± 10.06, p = 0.004). Patients with oxaliplatin chemotherapy, on average, scored lower on the MoCA (23.46 ± 3.17) compared to patients without oxaliplatin chemotherapy (27.49 ± 2.03, p < 0.05). In addition, patients with oxaliplatin chemotherapy scored significantly lower on measures of physical health (18.9 ± 7.8 vs. 37.8 ± 6.2, p<0.05), psychological health (19.3 ± 8.2vs. 39.8 ± 8.1, p<0.05), and social relationship (50.2 ± 10.1 vs. 70.6 ± 10.5, p<0.05) compared to patients without oxaliplatin chemotherapy. Multivariate linear regression analysis demonstrated that anxiety and cognitive impairment performance significantly predicted for global Quality of Life (QOL). Conclusions: colorectal cancer (CRC)patients with oxaliplatin chemotherapy experience mood disorders, cognitive impairment, and reduced Quality of Life (QOL). The clinical symptoms severity of oxaliplatin cemotherapy plays an important role in mood change and cognitive function. Decreased Quality of Life (QOL) was associated with anxiety and cognitive impairment.
Palliative chemotherapy prolongs survival and improves quality of life. However, a variety of chemotherapeutics including oxaliplatin can cause severe side effects during treatments, leading to painful symptoms that might result in the interruption of cancer treatment. Although adding oxaliplatin to fluorouracil and leucovorin in adjuvant chemotherapy for colon and rectal cancer may improve disease-free survival, it also increases grade 3–4 sensory neuropathy. Our study aimed to determine whether oral Mecobalamin is neuroprotective against oxaliplatin-induced neuropathy. Forty-six stage III colon and rectal cancer patients receiving adjuvant biweekly oxaliplatin were randomized to oral Mecobalamin (1,500 mg; case group) or placebo (control group). Clinical neurological and electrophysiological evaluations were performed at baseline and after 4, 8, and 12 treatment cycles. Treatment-related toxicity was evaluated based on National Cancer Institute (NCI) criteria. After four cycles of chemotherapy, 9 of 23 patients in the control group and 8 of 23 patients in case group experienced grade 1 sensory neuropathy. After eight cycles, 13 patients experienced sensory neuropathy (grade 2–4 toxicity) in the control group; however, no patients in the case group experienced sensory neuropathy (P < 0.05). After 12 cycles, grade 2–4 sensory neuropathy was observed in 20 patients in the control group, but only in 4 patients in the case group (P < 0.05). We did not observe any significant electrophysiological changes in the case group after 4, 8, or 12 cycles of chemotherapy. Thus, we demonstrated that oral Mecobalamin reduces the incidence of neuropathy in colon and rectal cancer patients receiving oxaliplatin-based adjuvant chemotherapy.
Universal Design is a broadly applied approach within the industrial design (ID) field that has, as its hallmark characteristic, the goal of inclusivity. This design philosophy allows the ID professional to play a role as an extended member of the caregiving team for older adults by creating products, services and solutions with a design ethic that has direct effects on their health and well-being.
We investigated the effect of mousse meals on improvement in nutritional status.We conducted a 12-week, prospective, structured clinical trial on 11 elderly patients with psychiatric disorders.We compared the participants' body mass index, blood protein and albumin levels, activities of daily living, and swallowing function, as well as presence of pneumonia, urinary-tract infection, and incidences of gastrointestinal symptoms due to consumption of mousse meals during the baseline and 12-week follow up.Results showed that Body Mass Index levels significantly increased, while blood protein and albumin levels, activities of daily living, and swallow function varied.One patient with pneumonia and another with urinary-tract infection could resume eating mousse meals within one week from the onset of infection.No participant suffered from gastrointestinal symptoms.The results of this study indicate that mousse meals are a viable choice for improving low nutritional status of elderly patients with psychiatric disorders.
Background: Intentional weight loss has been shown to have health benefits, whereas, unintentional weight loss is a strong risk factor for morbidity and mortality.The prevalence of unintentional weight loss in an American national sample has not been described in the past quarter century.Objectives: To describe the distribution of unintentional and intentional weight loss and its associations with demographics, smoking, and weight status.Design: A nationally representative population-based cross-sectional study. Setting: The National Health and Nutrition Examination Survey (NHANES 1999-2016).Participants: 41,603 adults who aged ≥21 years and were not pregnant during the year prior to the survey.Measurements: Participants reported their current body weight, their weight one year earlier, and if they tried to lose weight in the past year.A weight loss was defined as a ≥5% of reduction in weight.Demographics, smoking, and weight status were determined for the beginning of the weight change interval.We used survey frequency analysis to examine prevalences and survey multinomial logistic regression analysis to compare odds ratios in subgroups.Results: Over a one year period, 18.2% of American adults lost weight, and 6.2% lost weight unintentionally.The prevalence of unintentional weight loss was stable over the 18-year period studied.Adults who were older were more likely to subsequently lose weight unintentionally than their younger counterparts, and the highest risk was in those who were 79 years or older.Other risk factors included lower education level (vs.college educated) and smoking (vs.nonsmoking).Adults who were overweight or obese were more likely to report unintentional weight loss than normal weight. Conclusion:Studies examining weight loss need to assess and carefully consider the distribution and correlates of intentionality, and expect that even elderly cohorts will exhibit both unintentional and intentional weight loss.
Objective: To use mid upper arm circumference (MUAC) as a proxy measure of undernutrition in elderly males of Punjab, India.Design and measurements: Male participants in old age homes (n=215) and community based (n=239) were measured for standing height, weight and mid upper arm circumference (MUAC) during … from different areas of Punjab.Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI<18.5 kg/m 2 and normal as BMI≥18.5 kg/m 2 .Descriptive statistics and percentiles were calculated and multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI.Receiver-operating characteristic curve (ROC) analysis was performed to determine the best MUAC cut-off values to identify CED status.The χ2 test was used to assess significance of the difference in CED prevalence across MUAC categories.Setting: Old age homes and selected community based elderly of Punjab State, India.Participants: Elderly males in old age homes (n=215) and community based (n=239) were chosen after obtaining the informed consent.Results: MUAC cut-off value of 22.9 cm among the elderly in old age home and 23.4 cm among the community based elderly were the best cut-off points to differentiate between CED and non-CED individuals.Conclusions: The present study proposes the MUAC of 23.5 cm to differentiate between CED and non-CED male elderly individuals.There is a greater need to establish statistically appropriate MUAC cutoff values to predict undernutrition and morbidity in elderly across different ethnic groups.
Objectives: Explore the effects of vitamin D supplementation on global cognition, executive function and episodic memory among older community dwellers.Design: Parallel group, double-blind pretest-posttest placebo-controlled randomized pilot study.Setting/Participants: Robustly aging older community dwellers: Osher Lifelong Institute members of the
This narrative review describes the distinct nutritional needs of middle-aged and older adults in the European Union.Literature reviews were conducted to identify sources evaluating nutritional status and interventions relevant to these populations.Emphasis was placed on dietary guidelines, systematic reviews, and meta-analyses examining relevant macronutrients and micronutrients and important diseases or conditions related to aging (e.g.cardiovascular disease, infections, osteoporosis, cognition, immunity).Middle-aged and older adults in the European Union frequently do not obtain recommended amounts of key macronutrients and micronutrients necessary for maintaining health.In addition to the nutritional benefits of a healthful diet and contact with professionals to identify nutritional barriers, problem-solving techniques and micronutrient and macronutrient goals can improve the outcomes of dietary interventions in these individuals.Nutrition education programs, particularly those with specific recommendations, are effective for improving the nutritional status of these populations.For those who do not obtain adequate amounts of macronutrients and micronutrients from their diets, adhering to dietary guidelines and, when warranted, supplementation should be considered to improve nutritional status.The findings from randomized, controlled trials suggest that dietary interventions and supplementation can correct nutritional deficiencies and inadequacies that are important to the health of middle-aged and older adults.However, it is important to evaluate nutrient intake from the diet, supplementation, and fortified food to avoid exceeding tolerable upper intake levels of certain nutrients and limit potential adverse outcomes.Medical histories, medication use, dietary patterns, and other risk factors should be considered when recommending dietary improvements and supplements in these populations.
Today's health and social care systems are facing a challenge in how to effectively address caregiving for ageing populations facing cognitive disorders and frailty.Scholars and policy makers are now identifying a rise of "hidden form of care", e.g.informal caregiving, as a phenomenon in support for ageing populations.Across Europe for instance, the rise in the older old adult population has led to a rapid expansion of the number of carers, both professional (formal) and informal.The latter, representing mostly family members caring for their loved ones, truly represents a "hidden form of care".This can be a problem if formal and informal caregivers are not fully integrated into the healthcare continuum or are not given a systematic support to carry out caregiving in a relevant and safe way.There is currently no comprehensive European-wide legal framework and support mechanisms, in terms of training and education for this group.CARE Campus, an EIT Health programme within the Educational Campus Pillar, is a new model of collaboration between academic institutions, the private sector, and the public sector whose main aim is to support the development of a comprehensive training for formal and informal caregivers in Europe.The initial phase of the development encompasses nine (09) online training modules with a quality control process to ensure that the curriculum is evidence-based, compliant with the national and local regulations, and addresses the needs of caregivers across Europe.The objective is to support formal, informal, and family caregivers and reduce the burden on health care systems, whilst improving the quality of care for older adults.
Psychoeducational approaches such as Therapeutic patient education (TPE) have increased substantially in the field of Alzheimer's disease.There is evidence to think they can be useful for both patients and caregivers.Such approaches, addressing the patient and the caregiver's needs, have to be designed in keeping the challenges of the dyad (patient/caregiver) in mind.This article summarize the most important results in the literature, as regards the impact of psychoeducational interventions as TPE on caregivers 'outcomes (stress, well-being, health in general) but also patient's outcomes (quality of life, behaviour).Person-centered and tailored informations delivered to caregivers by specifically trained professionals using pedagogic methods and innovative tools, could improve the quality of care delivered to AD patients.TPE seems to have a place in an integrated care type of approach for AD patient's and caregivers.
