scholarly journals Circulatory and Urinary B-Vitamin Responses to Multivitamin Supplement Ingestion Differ between Older and Younger Adults

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3529
Author(s):  
Pankaja Sharma ◽  
Soo Min Han ◽  
Nicola Gillies ◽  
Eric B. Thorstensen ◽  
Michael Goy ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Vitamin B6 ◽  
Pantothenic Acid ◽  
Area Under The Curve ◽  
Research Unit ◽  
Open Label ◽  
Clinical Research Unit ◽  
B Vitamin ◽  
Older Populations

Multivitamin and mineral (MVM) supplements are frequently used amongst older populations to improve adequacy of micronutrients, including B-vitamins, but evidence for improved health outcomes are limited and deficiencies remain prevalent. Although this may indicate poor efficacy of supplements, this could also suggest the possibility for altered B-vitamin bioavailability and metabolism in older people. This open-label, single-arm acute parallel study, conducted at the Liggins Institute Clinical Research Unit in Auckland, compared circulatory and urinary B-vitamer responses to MVM supplementation in older (70.1 ± 2.7 y, n = 10 male, n = 10 female) compared to younger (24.2 ± 2.8 y, n = 10 male, n = 10 female) participants for 4 h after the ingestion of a single dose of a commercial MVM supplement and standardized breakfast. Older adults had a lower area under the curve (AUC) of postprandial plasma pyridoxine (p = 0.02) and pyridoxal-5′phosphate (p = 0.03) forms of vitamin B6 but greater 4-pyridoxic acid AUC (p = 0.009). Urinary pyridoxine and pyridoxal excretion were higher in younger females than in older females (time × age × sex interaction, p < 0.05). Older adults had a greater AUC increase in plasma thiamine (p = 0.01), riboflavin (p = 0.009), and pantothenic acid (p = 0.027). In older adults, there was decreased plasma responsiveness of the ingested (pyridoxine) and active (pyridoxal-5′phosphate) forms of vitamin B6, which indicated a previously undescribed alteration in either absorption or subsequent metabolic interconversion. While these findings cannot determine whether acute B6 responsiveness is adequate, this difference may have potential implications for B6 function in older adults. Although this may imply higher B vitamin substrate requirements for older people, further work is required to understand the implications of postprandial differences in availability.

scholarly journals Hyperglycemia and Metformin Use Are Associated With B Vitamin Deficiency and Cognitive Dysfunction in Older Adults

2019 ◽  
Vol 104 (10) ◽  
pp. 4837-4847 ◽  
Author(s):  
Kirsty M Porter ◽  
Mary Ward ◽  
Catherine F Hughes ◽  
Maurice O’Kane ◽  
Leane Hoey ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin B12 ◽  
Cognitive Dysfunction ◽  
Vitamin B6 ◽  
Vitamin Deficiency ◽  
Community Dwelling ◽  
Metformin Treatment ◽  
Fortified Foods ◽  
B Vitamin ◽  
The Impact

AbstractContextEmerging evidence suggests that deficiencies of folate-related B vitamins can arise with metformin treatment and are independently linked with cognitive dysfunction, a comorbidity of diabetes.ObjectiveTo determine the impact of hyperglycemia and metformin use on relevant B vitamin biomarkers and cognitive outcomes in older adults.Setting and ParticipantsCommunity-dwelling older adults (74.1 ± 8.3 years, n = 4160) without dementia, recruited to the Trinity, Ulster and Department of Agriculture cohort study in 2008 to 2012, were classified as normoglycemic (n = 1856) or hyperglycemic, based on HbA1c ≥5.7% (39 mmol/mol), either with (n = 318) or without (n = 1986) metformin treatment.Main Outcome MeasuresBiomarkers of folate, vitamin B12, vitamin B6, and riboflavin were measured. Cognitive assessments included the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and the Frontal Assessment Battery (FAB).ResultsMetformin use was associated with higher risk of deficiency of vitamin B12 (combined B12 index ≤−1; OR 1.45; 95% CI, 1.03 to 2.02) and vitamin B6 (plasma pyridoxal 5-phosphate <30.0 nmol/L; OR 1.48; 95% CI, 1.02 to 2.15). Fortified foods when eaten regularly had a positive impact on all relevant B vitamin biomarkers, even with hyperglycemia. After adjustment for relevant covariates, metformin use was associated with an increased risk of cognitive dysfunction as assessed with the RBANS (OR 1.36; 95% CI, 1.03 to 1.80) and FAB (OR 1.34; 95% CI, 1.03 to 1.74).ConclusionsUse of metformin by older adults is associated with poorer cognitive performance; B vitamin deficiency may be implicated. Fortified foods can optimize B vitamin status and may be beneficial for maintaining better cognitive health in older people with or at risk for diabetes.

Single- and Multiple-Dose Pharmacokinetics of an Oral Mixed Amphetamine Salts Extended-Release Formulation in Adults

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S20) ◽  
pp. 6-15 ◽  
Author(s):  
Susan B. Clausen ◽  
Stephanie C. Read ◽  
Simon J. Tulloch
Keyword(s):  
Multiple Dose ◽  
Extended Release ◽  
Research Unit ◽  
Dose Proportionality ◽  
Open Label ◽  
Release Formulation ◽  
Extended Release Formulation ◽  
Clinical Research Unit ◽  
Multiple Dose Pharmacokinetics ◽  
Oral Doses

AbstractObjectives: Assess the bioavailability of mixed amphetamine salts extended-release (MAS XR) 30-mg capsules and the dose proportionality of pharmacokinetic measures for MAS XR 20,40, and 60 mg.Methods: Study A, an open-label single-period study, and Study B, a randomized, open-label, three threeway crossover study, were conducted in healthy adults in a clinical research unit. In Study A, 20 subjects received a single MAS XR 30-mg capsule by mouth daily for 7 days. In Study B, 12 subjects received single oral doses of MAS XR 20,40, and 60 mg separated by 7-14-day washout periods.Findings: Plasma dextroamphetamine (D-amphetamine) and levoamphetamine (L-amphetamine) concentrations were measured using a validated LC-MS/MS method. In Study A, a 3:1 ratio of D-amphetamine to L-amphetamine was observed for AUC0-∞ and Cmax. Tmax was 4.2 and 4.3 hours for D-amphetamine to Lamphetamine, respectively. In Study B, for D- and Lamphetamine, statistically significant differences were observed for AUC0-t, AVC0-∞, and Cmax between all doses; there was a linear relationship between pharmacokinetic variables and dose and Tmax was similar for each isomer (range: 4.5–5.3 hours) with all given MAS XR doses.Conclusion: The extent of exposure as assessed by mean AUC0-24 and Cmax reflected the 3:1 ratio of D-amphetamine to L-amphetamine in MAS XR 30-mg capsules. The pharmacokinetic profiles of MAS XR 20, 40, and 60 mg are dose proportional for the isomers.

scholarly journals Challenging and Dismantling Ageist Attitudes, Beliefs, and Behaviors Through Intergenerational Programs

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 480-480
Author(s):  
Tia Rogers-Jarrell ◽  
Brad Meisner
Keyword(s):  
Older Adults ◽  
Older People ◽  
Emerging Adults ◽  
Negative Stereotypes ◽  
Age Stereotypes ◽  
Intergroup Contact Theory ◽  
Intergenerational Programs ◽  
Negative Beliefs ◽  
Age Segregation ◽  
Older Populations

Abstract Age stereotypes are complex and multifaceted: individuals can demonstrate and embody numerous and varied positive and negative stereotypes. Therefore, solutions to combat age stereotypes must also be complex and multifaceted. Additionally, both social and physical forms of age segregation are common in our society. This causes fewer and fewer opportunities for younger and older people to interact. Intergroup Contact Theory suggests age stereotypes can be reduced through increased intergenerational contact. One way to encourage contact between younger and older populations is through intergenerational programming. However, there is a lack of literature investigating the effects of intergenerational programs on perceptions of aging. The purpose of this paper was to critically review and explore literature on intergenerational programs to understand how they influence age stereotypes and ageist attitudes. The available literature suggests that intergenerational programs involving young children (ages 4-8), adolescents (ages 11-18), or emerging adults (ages 19-26) interacting with older adults (ages 65+) can significantly reduce age stereotypes towards older adults. Additionally, older adults (ages 65+) negative beliefs and attitudes towards younger people (ages 4-26) can also be deconstructed after participation in intergenerational programs. Intergenerational programs act to break down age barriers and promote connections and understandings between generations. These programs challenge the belief that older and younger people should live and participate in spaces that are separate from one another. Providing opportunities for younger and older people to participate in intergenerational programs is one way to promote respectful relationships and enhance the quality of life and health of all generations.

Replacement of Amino Acid and Protein Losses with 1.1% Amino Acid Peritoneal Dialysis Solution

1998 ◽  
Vol 18 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Michael R. Jones ◽  
Todd W. Gehr ◽  
John M. Burkart ◽  
Richard J. Hamburger ◽  
Alfred P. Kraus ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Amino Acid ◽  
Membrane Transport ◽  
Research Unit ◽  
Total Proteins ◽  
Open Label ◽  
Dialysis Solution ◽  
Wide Range ◽  
Clinical Research Unit ◽  
The Difference

Objective Losses of nutrients into dialysate may contribute to malnutrition. Peritoneal dialysis (PD) patients are reported to lose 3 -4 g/day of amino acids (AAs) and 4 -15 g/day of proteins. The extent to which one exchange with a 1.1% AA dialysis solution (Nutrineal, Baxter, Deerfield, IL, U.s.A.) offsets these losses was investigated in a 3-day inpatient study in 20 PD patients. Design Simple, open-label, cross-over study on consecutive days in a clinical research unit. On day 1 all patients were given a peritoneal equilibration test (PET). On day 2 they received 1.5% dextrose Dianeal (Baxter) as the first exchange of the day and their usual regimen thereafter. On day 3, the first exchange of the day was the 1.1% AA solution in place of 1.5% Dianeal and the usual PD regimen thereafter. On days 2 and 3 all dialysate effluent was collected and analyzed for AAs and proteins. Patients were maintained on a constant diet. Results Losses of AAs and total proteins on day 2 were 3.4 ± 0.9 g and 5.8 ± 2.4 g, respectively, totaling 9.2 ± 2.7 g. The net uptake of AAs on day 3 was 17.6 ± 2.6 g (80 ± 12% of the 22 g infused). Mean gains of AAs on day 3 exceeded losses of proteins and AAs on day 2, p < 0.001. Losses of total proteins, but not losses of AAs, and the net absorption of AAs from the dialysis solution were correlated directly with peritoneal membrane transport characteristics, obtained from the PET. Conclusion Daily losses of AAs and proteins into dialysate are more than offset by gains of AAs absorbed from one exchange with 1.1% AA-based dialysis solution. Net gains of AAs exceeded losses of proteins and AAs in all patients studied. The difference was relatively constant across a wide range of membrane transport types. Net AA gains were approximately two times the total AA and protein losses.

scholarly journals How long should older people take antidepressants to prevent relapse?

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 70-73 ◽  
Author(s):  
Jon Spear
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Clinical Practice ◽  
High Risk ◽  
Depressive Disorder ◽  
Older People ◽  
Future Research ◽  
Open Label ◽  
Psychotherapeutic Interventions ◽  
Risk Of Relapse

Patients with depressive disorder have a high risk of relapse after recovery from a depressive episode. Can the relapse of depressive disorder be prevented or delayed for older adults? This paper reviews the evidence from randomised clinical trials and open label trials of the effectiveness of maintenance antidepressant therapy for older adults with depressive disorder. It also examines the evidence for the effectiveness of psychosocial and psychotherapeutic interventions. The paper concludes with recommendations for clinical practice and future research.

scholarly journals Osteoporosis-Related Randomized Clinical Trials With Middle-Aged and Older Adults Registered on the International Clinical Trials Registry Platform

2021 ◽  
Vol 12 ◽  
Author(s):  
Fenghua Lai ◽  
Ling Pei ◽  
Xinwen Chen ◽  
Jin Li
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Publication Rate ◽  
Middle Aged ◽  
Open Label ◽  
Or Education ◽  
Clinical Trial Designs ◽  
Clinical Trials Registry ◽  
Older Populations

BackgroundA better understanding of the current features of osteoporosis-related randomized clinical trials (RCTs) is important for improving clinical trial designs and promoting the translatability of results into benefits for patients. However, there is a lack of thorough evaluation of osteoporosis-related RCTs in middle-aged and older populations. Therefore, this study aimed to investigate the characteristics of registered RCTs on osteoporosis among middle-aged and older adults on the International Clinical Trials Registry Platform (ICTRP).MethodsOsteoporosis-related RCTs registered on the ICTRP were searched on December 31, 2020. The main features of eligible RCTs were assessed. We searched PubMed, Google scholar, Medline, and Embase databases for the publication status of completed RCTs.ResultsA total of 537 osteoporosis-related RCTs were identified for analysis. The number of registered RCTs increased rapidly in 2005 (N = 47). Of these, 346 (64.4%) RCTs involved only women and 275 (51.2%) were retrospectively registered. Most RCTs were of open-label design (61.3%). The most common primary purpose of osteoporosis-related RCTs was treatment (72.3%). Intervention investigated was mainly focused on medication (62.8%), followed by lifestyle or education (19.0%), and dietary supplement (10.4%). After trial completion, the results of only 140 (35.5%) RCTs were available on the ICTRP, and the publication rate after trial completion was 30.5%.ConclusionsRCTs on osteoporosis among middle-aged and older adults were dominated by retrospectively registered and open-label trials. Most trials lacked available results and associated publications. More awareness of prospective registration and blinding design in osteoporosis-related RCTs is needed. Further, publication and dissemination of RCTs results should be promoted.

scholarly journals Effectiveness of a fortified drink in improving B vitamin biomarkers in older adults: a controlled intervention trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Maria Heffernan ◽  
Leanne C. Doherty ◽  
Roberta Hack Mendes ◽  
Michelle Clarke ◽  
Stephanie Hodge ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin B12 ◽  
Vitamin B6 ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Serum Vitamin ◽  
B Vitamins ◽  
Serum Folate ◽  
Vitamin Status ◽  
B Vitamin

Abstract Background Older adults are reported to have sub-optimal B vitamin status; targeted food-based solutions may help to address this. The objectives of the OptiAge food intervention study were to develop and investigate the effectiveness of a B vitamin-fortified drink in improving B vitamin biomarkers in older Irish adults with a primary outcome of change in the B vitamin biomarker status. Methods A double-blinded randomised controlled trial was performed in parallel at University College Dublin and Ulster University. Participants aged > 50 years were recruited following screening for exclusion criteria (i.e. taking medications known to interfere with B vitamin metabolism, supplements containing B vitamins, consuming > 4 portions of B vitamin-fortified foods per week or diagnosed with gastrointestinal, liver or pulmonary disease). Recruited participants meeting the inclusion criteria were randomised (by sex and study centre) to receive daily for 16 weeks either B vitamin-fortified or placebo drinks as developed by Smartfish, Norway. Each B vitamin-fortified drink (200 ml) contained 200 µg folic acid, 10 µg vitamin B12, 10 mg vitamin B6 and 5 mg riboflavin, while the placebo was an identical, isocaloric formulation without added B vitamins. Fasting blood samples were collected pre- and post-intervention which were used to measure the primary outcome of change in B vitamin biomarker levels. Results A total of 95 participants were randomised, of which 81 commenced the trial. Of these, 70 completed (37 in the active and 33 in the placebo groups). Intention to treat (ITT) analysis of the B vitamins demonstrated a significant improvement in all B vitamin biomarkers in the active compared to placebo groups: p < 0.01 for each of serum folate, serum vitamin B12 and plasma pyridoxal 5′-phosphate (vitamin B6) and the functional riboflavin biomarker, erythrocyte glutathione reductase activation coefficient (EGRac). Correspondingly, a significant lowering of serum homocysteine from 11.9 (10.3–15.1) µmol/L to 10.6 (9.4–13.0) µmol/L was observed in response to the active treatment (P < 0.001). Similar results were seen in a per-protocol analysis. Conclusions The results demonstrate that a B vitamin-fortified drink was effective in optimising B vitamin status, making this a useful intervention option to improve B vitamin status in older adults. Trial registration ISRCTN, ISRCTN61709781—Retrospectively registered, https://www.isrctn.com/ISRCTN61709781

Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults

2020 ◽  
Vol 13 ◽  
Author(s):  
Lucia Maria Andreis ◽  
Fernando de Aguiar Lemos ◽  
Lorenna Walesca de Lima Silva ◽  
Cassiana Luiza Pistorello Garcia ◽  
Gabrielli Veras ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Activity Level ◽  
Area Under The Curve ◽  
The Elderly ◽  
Activity Level ◽  
General Motor ◽  
Body Scheme ◽  
Significant Difference ◽  
Global Coordination

Background: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity level can be associated differently with each motor domains. Objective: We analyzed the relationship between physical activity level and motor aptitude, and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. Methods: Participated in the study 385 elderly people of both sexes. For the evaluation of the subjects were adopted the International Questionnaire on Physical Activity and the Motor Scale for Older Adults. Results: The majority of the elderly were active. In the comparison of motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the area under the curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

scholarly journals INTERNET USE AND LONELINESS OF OLDER ADULTS OVER TIME: THE MEDIATION EFFECT OF SOCIAL CONTACT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S194-S194
Author(s):  
Kexin Yu ◽  
Kexin Yu ◽  
Shinyi Wu ◽  
Iris Chi
Keyword(s):  
Older Adults ◽  
Older People ◽  
Internet Use ◽  
Social Contact ◽  
Total Effect ◽  
Mediation Effect ◽  
Health And Retirement Study ◽  
Longitudinal Association ◽  
Retirement Study ◽  
Over Time

Abstract Internet is increasingly popular among older adults and have changed interpersonal interactions. However, it remains controversial whether older people are more or less lonely with internet use. This paper tests the longitudinal association of internet use and loneliness among older people. One pathway that explains the association, the mediation effect of social contact, was examined. Data from the 2006, 2010 and 2014 waves of Health and Retirement Study was used. Hierarchical liner modeling results showed internet use was related to decreased loneliness over 12-year period of time (b=-0.044, p&lt;.001). Internet use was associated with more social contact with family and friends overtime (b=0.261, p&lt;.001), social contact was related to less perceived loneliness longitudinally (b=0.097, p&lt;.001). The total effect of internet use on loneliness is -0.054 and the mediated effect is -0.025. The findings imply that online activities can be effective for reducing loneliness for older people through increased social contact.

Comparison of actigraphy and polysomnography to assess effects of zolpidem in a clinical research unit

2012 ◽  
Vol 13 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Barry T. Peterson ◽  
Ping Chiao ◽  
Eve Pickering ◽  
Jon Freeman ◽  
Gary K. Zammit ◽  
...  
Keyword(s):  
Clinical Research ◽  
Research Unit ◽  
Clinical Research Unit
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