Effect of age on susceptibility to post-traumatic infection in the elderly

2003 ◽  
Vol 31 (2) ◽  
pp. 449-451 ◽  
Author(s):  
S.K. Butcher ◽  
V. Killampalli ◽  
H. Chahal ◽  
E. Kaya Alpar ◽  
J.M. Lord
Keyword(s):  
Bacterial Infections ◽  
The Elderly ◽  
Neutrophil Function ◽  
Superoxide Production ◽  
Trauma Patients ◽  
Fractured Neck Of Femur ◽  
Healthy Elderly ◽  
Age Related ◽  
Co Morbidity ◽  
Tract Infections

Previous work has demonstrated an age-related decline in neutrophil function, including a decline in phagocytic capacity, with age in healthy individuals. This decline in function may contribute to increased susceptibility to bacterial infections in the elderly population. The present study has investigated the effects of age on susceptibility to infection and neutrophil function in elderly humans following mild trauma. Specifically, we have measured neutrophil function in 44 patients, all of whom had no significant co-morbidity, were over 65 years old (mean age 82.5 years) and had sustained a fractured neck of femur. We obtained neutrophils and examined the process of microbial engulfment by phagocytosis and the bactericidal mechanism of superoxide production. In the 5-week period after trauma, almost half of the elderly trauma patients succumbed to bacterial or fungal infection, with a predominance of chest and urinary tract infections. When examining neutrophil function, a decline in superoxide production was observed in neutrophils from the elderly trauma group at the time of hip fracture when compared with those from healthy elderly controls, and this was maintained 5 weeks after trauma. This was accompanied by an age-related reduction in phagocytic function during this period. We propose that trauma and an age-related decline in neutrophil function combine to decrease the immune response to bacteria in the elderly.

scholarly journals Considerations for a Respiratory Syncytial Virus Vaccine Targeting an Elderly Population

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 624
Author(s):  
Laura M. Stephens ◽  
Steven M. Varga
Keyword(s):  
Respiratory Syncytial Virus ◽  
Disease Burden ◽  
Elderly Population ◽  
Vaccine Development ◽  
The Elderly ◽  
The United States ◽  
Susceptible Population ◽  
Age Related ◽  
Syncytial Virus ◽  
Tract Infections

Respiratory syncytial virus (RSV) is most commonly associated with acute lower respiratory tract infections in infants and children. However, RSV also causes a high disease burden in the elderly that is often under recognized. Adults >65 years of age account for an estimated 80,000 RSV-associated hospitalizations and 14,000 deaths in the United States annually. RSV infection in aged individuals can result in more severe disease symptoms including pneumonia and bronchiolitis. Given the large disease burden caused by RSV in the aged, this population remains an important target for vaccine development. Aging results in lowered immune responsiveness characterized by impairments in both innate and adaptive immunity. This immune senescence poses a challenge when developing a vaccine targeting elderly individuals. An RSV vaccine tailored towards an elderly population will need to maximize the immune response elicited in order to overcome age-related defects in the immune system. In this article, we review the hurdles that must be overcome to successfully develop an RSV vaccine for use in the elderly, and discuss the vaccine candidates currently being tested in this highly susceptible population.

Geriatric Trauma

2019 ◽  
Author(s):  
Sigrid Burruss ◽  
Lillian Min ◽  
Areti Tillou
Keyword(s):  
Risk Factors ◽  
Care Coordination ◽  
Unintentional Injury ◽  
The Elderly ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Age Related ◽  
Trauma Population ◽  
Downward Spiral ◽  
Risk Factors For Falls

The geriatric trauma population continues to grow as life expectancy and unintentional injury increase. Age-related physiologic changes and complex comorbidities may not only lead to injury but also may precipitate a downward spiral. The injury patterns, presentation of life-threatening injury, and response to injury are unique in the elderly trauma population, and dedicated evaluation of elderly trauma patients at a trauma center may be beneficial. Aggressive, early intervention with a focus on geriatric-specific needs and care coordination are an integral part of the management to reduce morbidity and mortality. Much of the unintentional injuries may be preventable with identification of risk factors for falls and fall prevention programs. Frailty measurements may be used to predict morbidity and functional status. Surgeons must become familiar with geriatric-specific issues and how best to treat the geriatric trauma population.  This review contains 3 figures, 2 tables, and 133 references. Key Words: care coordination, elderly, frailty, geriatric, injury, prevention, risk factors, trauma, triage

Effect of ‘Autonomic Blockade’ on Cardiac β-Adrenergic Chronotropic Responsiveness in Healthy Young, Healthy Elderly and Endurance-Trained Elderly Subjects

1994 ◽  
Vol 87 (3) ◽  
pp. 297-302 ◽  
Author(s):  
G. A. Ford ◽  
O. F. W. James
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Geometric Mean ◽  
Cardiovascular Responses ◽  
The Elderly ◽  
Elderly Subjects ◽  
Healthy Elderly ◽  
Age Related ◽  
Autonomic Blockade ◽  
Young Subjects

1. Cardiac chronotropic responses to isoprenaline are reduced with ageing in man. It is unclear whether this is due to reduced cardiac β-adrenergic sensitivity or to age-associated differences in reflex cardiovascular responses to the vasodilatory effects of isoprenaline. Age-associated changes in physical activity are also reported to influence β-adrenergic sensitivity. 2. The aim of the present study was to determine the contribution of alterations in reflex changes in parasympathetic and sympathetic influences and physical fitness to the age-associated reduction in cardiac chronotropic responses to β-adrenergic agonists. 3. The effect of ‘autonomic blockade’ with atropine (40 μg/kg intravenously) and clonidine (4 μg/kg intravenously) on blood pressure, heart rate and chronotropic responses to intravenous bolus isoprenaline doses was determined in eight healthy young (mean age 21 years), nine healthy elderly (72 years) and 10 endurance-trained elderly (69 years) subjects. 4. Elderly subjects had a reduced increase in heart rate after atropine (young, 49 ± 9 beats/min; elderly, 36 ± 5 beats/min; endurance-trained elderly, 34 ± 12 beats/min; P < 0.01) and did not demonstrate the transient increase in systolic blood pressure after clonidine observed in young subjects (young, 11 ± 10 mmHg; elderly, −12 ± 16 mmHg; endurance-trained elderly, −18 ± 11 mmHg; P < 0.01). 5. Cardiac chronotropic sensitivity to isoprenaline after ‘autonomic blockade’ increased in the young but decreased in the elderly subjects. The isoprenaline dose that increased heart rate by 25 beats/min before and after autonomic blockade' was: young, before 1.6 μg, after 2.8 μg, P < 0.01 (geometric mean, paired test); elderly, before 6.9 μg, after 3.6 μg, P < 0.05; endurance-trained elderly, before 5.9 μg, after 4.0 μg, P < 0.05. Cardiac chronotropic sensitivity to isoprenaline was significantly reduced in elderly compared with young subjects before (P < 0.01) but was similar after (P = 0.09) ‘autonomic blockade’. Chronotropic sensitivity did not differ between healthy and endurance-trained elderly subjects before or after ‘autonomic blockade’. 6. The age-associated reduction in cardiac chronotropic responses to bolus isoprenaline is primarily due to an age-related reduction in the influence of reflex cardiovascular responses on heart rate and not to an age-related reduction in cardiac β-adrenergic sensitivity. Endurance training is not associated with altered β-adrenergic chronotropic sensitivity in the elderly. The transient pressor response to intravenously administered clonidine may be lost in ageing man.

scholarly journals Arginine behaviour after arginine or citrulline administration in older subjects

2015 ◽  
Vol 115 (3) ◽  
pp. 399-404 ◽  
Author(s):  
C. Moinard ◽  
J. Maccario ◽  
S. Walrand ◽  
V. Lasserre ◽  
J. Marc ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
The Elderly ◽  
Volume Of Distribution ◽  
Elderly Subjects ◽  
Healthy Elderly ◽  
Age Related ◽  
Loading Tests ◽  
Kinetics Of ◽  
Healthy Elderly Subjects

AbstractArginine (ARG) and its precursor citrulline (CIT) are popular dietary supplements, especially for the elderly. However, age-related reductions in lean body mass and alterations in organ functions could change their bioavailability. Pharmacokinetics and tolerance to amino acid (AA) loads are poorly documented in elderly subjects. The objective here was to characterise the plasma kinetics of CIT and ARG in a single-dosing study design. Eight fasting elderly men underwent two separate isomolar oral loading tests (10 g of CIT or 9·94 g of ARG). Blood was withdrawn over an 8-h period to measure plasma AA concentrations. Only CIT, ornithine and ARG plasma concentrations were changed. Volume of distribution was not dependent on AA administered. Conversely, parameters related to ARG kinetics were strongly dependent on AA administered: after ARG load, elimination was higher (ARG>CIT; P=0·041) and admission period+time at peak concentration was lower (ARG<CIT; P=0·033), and the combination of both phenomena results in a marked increase in ARG availability when CIT was administered (ARG<CIT; P=0·033) compared with ARG administration itself. In conclusion, a single CIT administration in the elderly is safe and well tolerated, and CIT proves to be a better in vivo ARG precursor than ARG itself in healthy elderly subjects.

Resistance training, insulin sensitivity and muscle function in the elderly

2006 ◽  
Vol 42 ◽  
pp. 75-88 ◽  
Author(s):  
Flemming Dela ◽  
Michael Kjaer
Keyword(s):  
Physical Activity ◽  
Muscle Strength ◽  
The Elderly ◽  
Activity Level ◽  
Elderly Individuals ◽  
Healthy Elderly ◽  
Age Related ◽  
Increased Risk ◽  
Improved Function ◽  
Improve Muscle Strength

Ageing is associated with a loss in both muscle mass and in the metabolic quality of skeletal muscle. This leads to sarcopenia and reduced daily function, as well as to an increased risk for development of insulin resistance and type 2 diabetes. A major part, but not all, of these changes are associated with an age-related decrease in the physical activity level and can be counteracted by increased physical activity of a resistive nature. Strength training has been shown to improve insulin-stimulated glucose uptake in both healthy elderly individuals and patients with manifest diabetes, and likewise to improve muscle strength in both elderly healthy individuals and in elderly individuals with chronic disease. The increased strength is coupled to improved function and a decreased risk for fall injuries and fractures. Elderly individuals have preserved the capacity to improve muscle strength and mass with training, but seem to display a reduced sensitivity towards stimulating protein synthesis from nutritional intake, rather than by any reduced response in protein turnover to exercise.

Effect of Age on Vascular α-Adrenoceptor Responsiveness in Man

1982 ◽  
Vol 63 (s8) ◽  
pp. 305s-308s ◽  
Author(s):  
Henry L. Elliott ◽  
David J. Sumner ◽  
Kathleen McLean ◽  
Peter C. Rubin ◽  
John L. Reid
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Pressure ◽  
The Elderly ◽  
Elderly Subjects ◽  
Comparable Amount ◽  
Healthy Elderly ◽  
Age Related ◽  
Significant Difference ◽  
Mean Heart Rate

1. The responsiveness of α-receptors was compared in six young and six healthy elderly subjects by evaluating the haemodynamic effects of the a, antagonist prazosin and the pressor responses to the a, agonist phenylephrine. 2. Oral prazosin (1 mg) lowered erect (but not supine) blood pressure in both groups by a comparable amount: in young and old groups the respective maximal falls in systolic pressure were 19.5 ± 15.7 and 29.3 ± 11.4 mmHg (mean ± sd) and for diastolic pressure the maximal falls were 13 ± 13.3 and 18 ± 11.1 mmHg. 3. This similar fall in blood pressure occurred in association with a significantly different heart rate response: in the young group mean heart rate increased to 103 beats/min but there was no corresponding increase in the elderly group, which had a mean heart rate of 80 beats/min. 4. Log dose-response curves were derived from incremental intravenous infusions of phenylephrine, and the doses required to raise mean arterial pressure by 20 mmHg (PD20) were compared: the mean PD20 was significantly different in the two groups: 2.5 ± 1.6 in the young compared with 4.6 ± 2.3 μg min−1 kg−1 in the elderly, consistent with reduced pressor responsiveness in the elderly. 5. No significant difference in PD20 was apparent when pressor responsiveness was determined after prazosin, but the elderly required a significantly smaller increase in phenylephrine dosage to overcome prazosin's α-receptor-blocking effects. 6. Although there is no evidence of an age-related increase in the sensitivity of α-adrenoceptor-mediated vasoconstriction, the results are not inconsistent with an age-related reduction in α-adrenoceptor responsiveness.

Noninvasive Brain Stimulation for the Study of Memory Enhancement in Aging

2016 ◽  
Vol 21 (1) ◽  
pp. 41-54 ◽  
Author(s):  
David Bartrés-Faz ◽  
Didac Vidal-Piñeiro
Keyword(s):  
Brain Stimulation ◽  
Early Stage ◽  
Synergistic Effects ◽  
The Elderly ◽  
Clear Understanding ◽  
Noninvasive Brain Stimulation ◽  
Beneficial Effects ◽  
Healthy Elderly ◽  
Age Related ◽  
Potential Benefits

Abstract. Noninvasive brain stimulation (NIBS) techniques have recently attracted interest due to their potential for transiently improving cognition. This may prove particularly valuable in aging, given the known impact of age-related cognitive dysfunction on quality of life. The present review summarizes the currently available evidence of working and episodic memory enhancements achieved using NIBS in healthy elderly people. The evidence reviewed indicates that research is still at an early stage and that there is a need to define the best procedures for operating and performing multicentre characterization of protocols. However, a limited number of sham-controlled studies have reported improvements in both cognitive domains. Furthermore, evidences of long-term beneficial effects opens up the possibility of using NIBS as an adjuvant therapeutic strategy. However, the relevance of certain variables involved and approaches used remains to be elucidated, including the potential benefits of single versus multiple NIBS sessions, the putative synergistic effects of using NIBS in combination with cognitive training, and the importance of individual differences. Overall, NIBS techniques represent a promising opportunity for psychologists seeking strategies to improve memory functions in the elderly. Nevertheless, their use requires appropriate technical knowledge coupled with a clear understanding of the neurophysiology and cognitive neuroscience of aging.

Differences in Conceptual Flexibility with Age as Measured by a Modified Version of the Visual Verbal Test

1994 ◽  
Vol 13 (3) ◽  
pp. 368-377 ◽  
Author(s):  
Barbara Collins ◽  
Andrée Tellier
Keyword(s):  
Cognitive Flexibility ◽  
The Elderly ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Healthy Elderly ◽  
Age Related ◽  
Perseverative Errors ◽  
Verbal Test ◽  
The Individual ◽  
Conceptual Flexibility

ABSTRACTAge-related changes in the capacity for cognitive flexibility should be considered in social planning for the expanding elderly population and in the functional assessment of the individual geriatric patient. Current means for assessing conceptual flexibility are not particularly appropriate for use with the elderly. In the current study, a briefer and more tolerable measure of conceptual flexibility was derived from the Visual Verbal Test (VVT). This index correlated significantly with the number of perseverative errors but not the number of nonperseverative errors on the Wisconsin Card Sorting Test (WCST), attesting to its validity as a specific measure of the ability to shift mental set. A significant relationship between age and both this VVT measure of conceptual shift and the number of perseverative errors on the WCST was observed in a sample of 60 healthy elderly volunteers between the ages of 55 and 84, suggesting that cognitive flexibility is indeed negatively associated with age.

scholarly journals The impact of age on outcome after surgery for colorectal adenocarcinoma

2011 ◽  
Vol 93 (6) ◽  
pp. 445-450 ◽  
Author(s):  
AL Widdison ◽  
S Wienand Barnett ◽  
N Betambeau
Keyword(s):  
Older Patients ◽  
Operative Mortality ◽  
Relative Proportion ◽  
The Elderly ◽  
Medical Complications ◽  
Related Factors ◽  
Percentage Points ◽  
Age Related ◽  
Co Morbidity ◽  
The Impact

INTRODUCTION The incidence of colorectal cancer (CRC) increases with age. The aim of this study was to investigate the impact of age and age-related factors on post-operative mortality and survival following CRC resections. METHODS A prospectively collected database of 459 CRC resections was analysed. RESULTS The mean age of the patients was 70 years (range: 25–95 years) and 54% were male. The relative proportion of female patients increased with age so that for patients aged over 77 more women were treated than men. The probability of undergoing an emergency resection (25%) did not change with age. In older patients the proportion of rectal cancers resected decreased and the proportion of hemicolectomies and Hartmann's operations performed increased. The 30-day mortality rate was 4% after elective and 11% after emergency resections. Most deaths were caused by medical complications, reflecting increased co-morbidity in the elderly. Post-operative mortality was 1% in patients under the age of 59. This increased by 3 percentage points every 10 years after elective resections and by 8 percentage points every 10 years after emergency resections. CRC-specific survival was independent of age whereas overall survival decreased so the likelihood of dying from CRC decreased with age: at age 50 half the deaths were from CRC, at age 70 a third and at age 80 a quarter. CONCLUSIONS CRC stage and the probability of presenting as an emergency did not change with age but older patients were more likely to be female and have colon cancer. Post-operative mortality progressively increased with age. Most deaths were caused by medical complications, reflecting increased co-morbidity. Older patients were less likely to die from CRC.

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