scholarly journals Polygenetic-Risk Scores Related to Crystallin Metabolism Are Associated with Age-Related Cataract Formation and Interact with Hyperglycemia, Hypertension, Western-Style Diet, and Na Intake

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3534
Author(s):  
Donghyun Jee ◽  
Suna Kang ◽  
ShaoKai Huang ◽  
Sunmin Park
Keyword(s):  
Large Scale ◽  
Crystalline Lens ◽  
Positive Association ◽  
The Elderly ◽  
Risk Scores ◽  
Nucleotide Polymorphisms ◽  
Multifactor Dimensionality Reduction Analysis ◽  
Coffee Intake ◽  
Age Related ◽  
The Impact

Age-related cataract (ARC) development is associated with loss of crystalline lens transparency related to interactions between genetic and environmental factors. We hypothesized that polygenetic risk scores (PRS) of the selected genetic variants among the ARC-related genes might reveal significant genetic impacts on ARC risk, and the PRS might have gene–gene and gene–lifestyle interactions. We examined the hypothesis in 1972 and 39,095 subjects aged ≥50 years with and without ARC, respectively, in a large-scale hospital-based cohort study conducted from 2004 to 2013. Single nucleotide polymorphisms (SNPs) of the genes related to ARC risk were identified, and polygenetic risk scores (PRS) were generated based on the results of a generalized multifactor dimensionality reduction analysis. Lifestyle interactions with PRS were evaluated. The PRS derived from the best model included the following six SNPs related to crystallin metabolism: ULK4_rs1417380362, CRYAB_rs2070894, ACCN1_rs55785344, SSTR2_rs879419608, PTN_rs322348, and ICA1_rs200053781. The risk of ARC in the high-PRS group was 2.47-fold higher than in the low-PRS group after adjusting for confounders. Age, blood pressure, and glycemia interacted with PRS to influence the risk of ARC: the incidence of ARC was much higher in the elderly (≥65 years) and individuals with hypertension or hyperglycemia. The impact of PRS on ARC risk was greatest in middle-aged individuals with hypertension or hyperglycemia. Na, coffee, and a Western-style diet intake also interacted with PRS to influence ARC risk. ARC risk was higher in the high-PRS group than in the low-PRS group, and high Na intake, Western-style diet, and low coffee intake elevated its risk. In conclusion, ARC risk had a positive association with PRS related to crystallin metabolism. The genetic impact was greatest among those with high Na intake or hypertension. These results can be applied to precision nutrition interventions to prevent ARC.

Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Mary Cushman ◽  
Maciej Banach ◽  
Brett M Kissela ◽  
David C Goff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Stroke Risk Factors ◽  
Age Related ◽  
Increased Risk ◽  
The Impact ◽  
Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

scholarly journals HUBUNGAN PANDEMI COVID-19 DAN PSBB DENGAN GANGGUAN DEPRESI PADA LANSIA DI PANTI WREDA HANA CIPUTAT JAKARTA

2021 ◽  
Vol 1 (1) ◽  
pp. 66
Author(s):  
Anggun Tsabitah Rachmah ◽  
Noer Saelan Tadjudin
Keyword(s):  
Nursing Home ◽  
Large Scale ◽  
Depressive Disorders ◽  
The Elderly ◽  
Elderly Subjects ◽  
Research Subjects ◽  
Chi Square ◽  
Cross Sectional ◽  
The Government ◽  
The Impact

Pemerintah Indonesia selama pandemi COVID-19 menerapkan PSBB (Pembatasan Sosial Berskala Besar) dimana PSBB tersebut membuat aktivitas masyarakat dibatasi, dampaknya juga bisa dirasakan pada lansia di Panti Wreda sehingga dapat menyebabkan timbulnya gangguan depresi. Penelitian ini bertujuan untuk mengetahui hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. Penelitian ini menggunakan metode analitik observational dengan desain studi cross sectional. Penelitian ini dilakukan di Panti Wreda Hana Ciputat Jakarta terhadap lansia sejumlah 56 subjek penelitian yang terdiri dari perempuan 48 orang dan laki-laki 8 orang. Dari 56 subjek penelitian jumlah laki-laki 8 (14,3%) dan perempuan 48 (85,7%). Sebelum terjadinya pandemi COVID-19 dan PSBB, subjek penelitian yang tidak depresi sejumlah 49 subjek (87,5 %), kemungkinan besar depresi 6 subjek (10,7%), dan yang mengalami depresi 1 subjek (1,8%). Selama pandemi COVID19 dan PSBB, subjek penelitian yang tidak depresi 38 subjek (67,9%), kemungkinan besar depresi 14 subjek (25%), dan yang mengalami depresi 4 subjek (7,1%). Berdasarkan hasil uji Chi-square nilai p= 0,000. Dapat disimpulkan terdapat hubungan pandemi COVID-19 dan PSBB dengan gangguan depresi pada lansia di Panti Wreda Hana Ciputat Jakarta. The Government of Indonesia during the COVID-19 pandemic implemented PSBB (Large-Scale Social Restrictions) where the PSBB made community activities restricted, the impact can also be felt on the elderly in nursing home so that it can cause depressive disorders. This research was done in order to determine the relationship of the COVID-19 pandemic and PSBB with depressive disorders in the elderly at the Ciputat Hana Nursing Home in Jakarta. This study used an observational analytic method with a cross sectional study design. The research was conducted at the Ciputat Hana Nursing Home in Jakarta for 56 elderly subjects. In the nursing home consist of 48 women and 8 men. In 56 research subjects, there were 8 (14,3%) men and 48 (85,7%) women. Before the Pandemic of COVID-19 and PSBB, there were 49 (87,5%) research subjects who were not depressed, 6 (10,7%) research subjects who were most likely depressed, and 1 (1,8%) research subject who were depressed. During the Pandemic of COVID-19 and PSBB, there were 38 (67,9%) research subjects who were not depressed, 14 (25%) research subjects who were most likely depressed, and 4 (7,1%) research subjects who were depressed. Based on Chi-Square test result, the value of P = 0,000. In conclusion, there is a correlation between the pandemic of COVID-19 and PSBB with depression disorder in the elderly at Ciputat Hana Nursing Home in Jakarta.

scholarly journals A cross-sectional study on interference control: age affects reactive control but not proactive control

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8365 ◽  
Author(s):  
Yanfang Peng ◽  
Qin Zhu ◽  
Biye Wang ◽  
Jie Ren
Keyword(s):  
Middle Ages ◽  
Middle Age ◽  
The Elderly ◽  
Efficiency Score ◽  
Interference Control ◽  
Reactive Control ◽  
Cross Sectional ◽  
Age Related ◽  
The Difference ◽  
The Impact

Background Working memory updating (WMU), a controlled process to continuously adapt to the changing task demand and environment, is crucial for cognitive executive function. Although previous studies have shown that the elderly were more susceptible to cognitive interference than the youngsters, the picture of age-related deterioration of WMU is incomplete due to lack of study on people at their middle ages. Thus, the present study investigated the impact of age on the WMU among adults by a cross-sectional design to verify whether inefficiency interference control accounts for the aging of WMU. Methods In total, 112 healthy adults were recruited for this study; 28 old adults (21 female) ranging from 60 to 78 years of age; 28 middle-age adults (25 female) ranging from 45 to 59 years of age; 28 adults (11 female) ranging from 26 to 44 years of age; and 28 young adults (26 female) ranging from 18 to 25 years of age. Each participant completed a 1-back task. The inverse efficiency score was calculated in various sequences of three trials in a row to quantify the performance of WMU for adults of various ages. Results Inverse efficiency score of both young groups (young adult and adult) were significantly shorter than the old group in both Repeat-Alternate (RA, including □□○ and ○○□) and Alternate-Alternate (AA, including ○□○ and □○□) sequential patterns and they were additionally better than the middle-age group in AA sequential pattern. Conclusion With the increase of difficulty in the task, the difference in reactive interference control between young and middle age was gradually revealed, while the difference between young and old remained to apparent. The degradation of WMU aging may begin from middle-age and presents selective impairment in that only reactive interference control, but not proactive interference control, shows pronounced age-related decline. The preliminary results can inform future studies to further explore the whole lifespan trajectories of cognitive functions.

Impact of Tuberculosis in Elderly Population

2018 ◽  
pp. 326-338
Author(s):  
Gagan Chooramani ◽  
Pooja Singh
Keyword(s):  
Clinical Characteristics ◽  
Elderly Population ◽  
The Elderly ◽  
World Health ◽  
Tuberculosis Patients ◽  
Disease Outcomes ◽  
Age Related ◽  
Health Organization ◽  
The Impact ◽  
Poor Memory

The World Health Organization has declared that the spread of tuberculosis is a global emergency. Despite the implementation of strong tuberculosis-control initiatives by WHO, this highly infectious disease continues to affect all vulnerable populations, including the elderly population. Adverse social factors and poor living conditions also affect the elderly much more than the young. The clinical characteristics of tuberculosis in older adults can be unusual and may be confused with age-related illnesses. Various factors related to old age can also cause complications in the diagnosis, treatment, and disease outcomes for tuberculosis patients. The contributory factors may be poor memory, deafness, mental confusion, or impairment of speech. In addition, therapy for tuberculosis in elderly individuals is challenging because of the increased incidence of adverse drug reactions. Hence, understanding the impact of these substantial aspects will help to overcome the problem of tuberculosis in the elderly population.

Conclusion

2016 ◽  
Author(s):  
Maria A. Sullivan
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
The Elderly ◽  
Social Consequences ◽  
Individual Therapy ◽  
Older Individuals ◽  
Prescribing Practices ◽  
Elderly Age ◽  
Age Related ◽  
The Impact

Addiction in older adults very often goes unrecognized, for several reasons: social biases about the elderly, age-related metabolic changes, and the inappropriate use of prescription benzodiazepines and opioids to address untreated anxiety and mood conditions. Alcohol or substance-use disorders (SUDs) in older individuals may present in subtle and atypical ways. Strategies to overcome such difficulties include systematic screening using validated instruments, patient education regarding the impact of psychoactive substances on health, and cautious prescribing practices. Relying on standard DSM criteria may result in a failure to detect an SUD that presents with cognitive symptoms or physical injury, as well as the absence of work or social consequences. Older individuals can benefit from the application of risk-stratification measures, and they can be referred, e.g., to age-appropriate group therapy and non-confrontational individual therapy focusing on late-life issues of loss and sources of social support, as well as be offered medication management for alcohol or substance use disorder. Although research has been limited in this population, treatment outcomes have been found to be superior in older adults than younger adults.

scholarly journals Applicability of Obesity-Related SNPs and Their Effect Size Measures Defined on Populations with European Ancestry for Genetic Risk Estimation among Roma

Genes ◽  
2020 ◽  
Vol 11 (5) ◽  
pp. 516 ◽  
Author(s):  
Erand Llanaj ◽  
Péter Pikó ◽  
Károly Nagy ◽  
Gábor Rácz ◽  
Sándor János ◽  
...  
Keyword(s):  
Effect Size ◽  
Genetic Risk ◽  
Association Studies ◽  
Strong Association ◽  
European Ancestry ◽  
Risk Scores ◽  
Nucleotide Polymorphisms ◽  
Continuous Variables ◽  
Roma Population ◽  
The Impact

Investigations on the impact of genetic factors on the development of obesity have been limited regarding the Roma population—the largest and most vulnerable ethnic minority in Europe of Asian origin. Genetic variants identified from genetic association studies are primarily from European populations. With that in mind, we investigated the applicability of data on selected obesity-related single nucleotide polymorphisms (SNPs), obtained from the Hungarian general (HG) population of European origin, on the Hungarian Roma (HR) population. Twenty preselected SNPs in susceptible alleles, known to be significantly associated with obesity-related phenotypes, were used to estimate the effect of these SNPs on body mass index (BMI) and waist circumference (WC) in HG (N = 1783) and HR (N = 1225) populations. Single SNP associations were tested using linear and logistic regression models, adjusted for known covariates. Out of 20 SNPs, four located in FTO (rs1121980, rs1558902, rs9939609, and rs9941349) showed strong association with BMI and WC as continuous variables in both samples. Computations based on Adult Treatment Panel III (ATPIII) and the International Diabetes Federation’s (IDF) European and Asian criteria showed rs9941349 in FTO to be associated only with WC among both populations, and two SNPs (rs2867125, rs6548238) in TMEM18 associated with WC only in HG population. A substantial difference (both in direction and effect size) was observed only in the case of rs1801282 in PPARγ on WC as a continuous outcome. Findings suggest that genetic risk scores based on counting SNPs with relatively high effect sizes, defined based on populations with European ancestry, can sufficiently allow estimation of genetic susceptibility for Roma. Further studies are needed to clarify the role of SNP(s) with protective effect(s).

Impact of Age on the Functional Evaluation of Intermediate Coronary Stenoses With Instantaneous Wave-Free Ratio and Fractional Flow Reserve

Angiology ◽  
2020 ◽  
Vol 72 (1) ◽  
pp. 62-69
Author(s):  
Monica Verdoia ◽  
Rocco Gioscia ◽  
Matteo Nardin ◽  
Federica Negro ◽  
Francesco Tonon ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Fractional Flow Reserve ◽  
Large Scale ◽  
The Elderly ◽  
Functional Evaluation ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Minimal Lumen Diameter ◽  
Coronary Stenoses ◽  
The Impact

The optimal strategy for assessing the ischemic significance of intermediate coronary stenoses with adenosine-induced fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) is still debated. Few studies have previously assessed the impact of age on FFR and iFR, which was the aim of our study. Patients undergoing FFR and iFR evaluation for intermediate (40%-70%) coronary lesions were included and divided according to age. Fractional flow reserve was performed by intracoronary boluses of adenosine (60-1440 μg). Instantaneous wave-free ratio was automatically calculated. Among 148 patients undergoing FFR measurement of 166 lesions, 45.3% were ≥70 years. Elderly patients had higher minimal lumen diameter ( P = .03). We also observed a linear relationship between iFR and FFR independently of age. Fractional flow reserve values were higher in the elderly patients, whereas iFR was not related to age. A total of 33 lesions had a positive iFR with no difference for age (17.3% vs 22%, P = .56), while FFR <0.80 was more infrequent in the elderly patients (17.1% vs 34.8%, P = .02). In intermediate coronary stenoses, iFR and FFR correlation is unaffected by age. Fractional flow reserve is higher in the elderly patients, whereas iFR is less affected by age. Future large-scale studies are needed to define whether iFR should be the preferred choice in elderly patients.

scholarly journals 315 Cardiac surgery in the elderly: the underestimate role of frailty in the decision making

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Pasquale Campana ◽  
Maddalena Conte ◽  
Maria Emiliana Palaia ◽  
Laura Petraglia ◽  
Adele Ferro ◽  
...  
Keyword(s):  
Decision Making ◽  
Cardiac Surgery ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Frailty Index ◽  
The Elderly ◽  
Risk Scores ◽  
Surgical Risk ◽  
The Impact

Abstract Aims Elders represent the most common population with indication to cardiac surgery, also presenting the highest mortality/disability after interventions. Both for valve and coronary artery surgery the estimation of the surgical risk, including the frailty assessment, is recommended to guide the decision making. However, frailty results not exhaustively assessed by the commonly used surgical risk scores such as EuroSCORE I-II and score of the Society of Thoracic Surgeons and is mostly used the Kat’s Index (included in the latest European guidelines). This study aims at establishing the feasibility and the value of a Comprehensive Geriatric Assessment (CGA) in elderly undergoing cardiac surgery. Methods From June 2021we consecutively enrolled 50 elderly patients undergoing cardiac surgery (age &gt; 65 years old). All patients underwent CGA with an expert geriatrician and the demographic, biometrics, clinical and echocardiographic data were collected. We evaluated frailty and disability (Kats index, Barthel Index and Frailty Index FI), cognitive status (Montreal Cognitive Assessment MOCA, Mini Mental State Examination MMSE and Geriatric Depression Scale), physical status (Tinetti test, Short Performance Physical Battery SPPB, Physical Activity Scale for the Elderly PASE and 6-min Walking test), delirium condition, sarcopenia and nutritional status (Mini-Nutritional Assessment MNA). A clinical, echocardiographic, and geriatric 3-month follow-up is planned. In particular, we are evaluating the impact of frailty, assessed by CGA, on peri-surgical outcome and the potential additive value of a CGA on the commonly used surgical risk-scores and Kat’s Index. Furthermore, we are assessing the impact of cardiac surgery of frail elderly at GCA. Results The CGA was feasible in all patients and lasted 1 h/patient. In our baseline data, only 23% of the enrolled patients resulted ‘frail’ according to Kat’s Index. However, in the remaining 77% of the study population, the CGA have identified 30% of patients with increased frailty index and 30% with disability, assessed by Barthel Index and physical function indexes (PASE and SPPB). In these patient, frailty and disability were associated to impaired nutritional status, assessed at MNA. Furthermore, 40% of the patients of this group resulted sarcopenic at the hand grip test. The cognitive valuation has shown a cognitive impairment in the 20% of patients at the MMSE and the 70 % at the MOCA. Of note, the 40% of the patients resulted to suffer of depression, not diagnosed before the GCA. At mid-November 2021 the follow-up will be completed. Conclusions The preliminary results of the presents study suggest that in patients undergoing cardiac surgery frailty is currently underdiagnosed. The follow-up analysis will establish if a CGA has an additive value on common surgical risk estimators. This study has a potential impact on the risk stratification of elderly patients undergoing invasive procedures and defines the need of a geriatrician in the heart team.

scholarly journals Age-Related Diseases and Driving Safety

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 80
Author(s):  
Michael Falkenstein ◽  
Melanie Karthaus ◽  
Ute Brüne-Cohrs
Keyword(s):  
Diabetes Mellitus ◽  
Driving Simulator ◽  
The Elderly ◽  
Cognitive Disorder ◽  
Driving Safety ◽  
Elderly Drivers ◽  
Age Related ◽  
Independent Life ◽  
Driving Fitness ◽  
The Impact

Due to demographic changes, the number of older drivers is steadily increasing. Mobility is highly relevant for leading an independent life in the elderly. It largely depends on car driving, which is a complex task requiring a multitude of cognitive and motor skills vulnerable to age- related functional deterioration. The almost inevitable effects of senescence may be potentiated by age-related diseases, such as stroke or diabetes mellitus. Respective pharmacological treatment may cause side effects, additionally affecting driving safety. The present article reviews the impact of age-related diseases and drug treatment of these conditions on driving fitness in elderly drivers. In essence, we focus on diseases of the visual and auditory systems, diseases of the central nervous system (i.e., stroke, depression, dementia and mild cognitive disorder, and Parkinson’s disease), sleep disorders, as well as cardiovascular diseases, diabetes mellitus, musculoskeletal disorders, and frailty. We will outline the role of functional tests and the assessment of driving behavior (by a driving simulator or in real traffic), as well as the clinical interview including questions about frequency of (near) accidents, etc. in the evaluation of driving fitness of the elderly. We also address the impact of polypharmacy on driving fitness and end up with recommendations for physicians caring for older patients.

Pharmacologic Considerations in the Elderly Surgical Patient

2016 ◽  
Author(s):  
Linda Sohn ◽  
Joe C. Hong ◽  
Michael W. Yeh ◽  
Tara A. Russell ◽  
Marcia M. Russell
Keyword(s):  
Older Adults ◽  
Surgical Procedures ◽  
Postoperative Delirium ◽  
Medication Management ◽  
The Elderly ◽  
The United States ◽  
Surgical Patient ◽  
Age Related ◽  
The Impact ◽  
Preoperative Medication

The most rapidly growing segment of the elderly population corresponds to persons age 85 and over. As of 2006, elderly patients accounted for 35.3% of the inpatient and 32.1% of the outpatient surgical procedures occurring in the United States. Because age-related changes occur in each organ system in all elderly individuals, this population merits special consideration when undergoing surgical procedures. Furthermore, there is a high probability that older adults will have multiple chronic medical problems, which may present a complex medication management challenge. This review covers the pharmacologic impact of physiologic changes associated with aging, preoperative assessment, preoperative medication management, delirium and the impact of perioperative medications in the elderly, anesthesia and related medications, and specific drug classes and their use in the elderly surgical patient. Figures show an overview of the management of the elderly surgical patient, and preoperative medication management. Tables list medications that should be avoided in older patients with reduced renal function, drugs that exhibit additive adverse effects, medications with high anticholinergic activity, medications that inhibit and induce the CYP450 system, herbal supplements, 2015 Beers Criteria summary of potentially inappropriate medication use in older adults, drugs associated with postoperative delirium, risk factors for postoperative delirium, and clinical pharmacology of commonly used anesthetic agents.   This review contains 2 highly rendered figures, 9 tables, and 61 references

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