Behavioral and psychological symptoms of dementia

Over the last 10 years, there has been a growing interest in the relationship between gut microbiota, the brain, and neurologic-associated affections. As multiple preclinical and clinical research studies highlight gut microbiota’s potential to modulate the general state of health state, it goes without saying that gut microbiota plays a significant role in neurogenesis, mental and cognitive development, emotions, and behaviors, and in the progression of neuropsychiatric illnesses. Gut microbiota produces important biologic products that, through the gut-brain axis, are directly connected with the appearance and evolution of neurological and psychiatric disorders such as depression, anxiety, bipolar disorder, autism, schizophrenia, Parkinson’s disease, Alzheimer’s disease, dementia, multiple sclerosis, and epilepsy. This study reviews recent research on the link between gut microbiota and the brain, and microbiome’s role in shaping the development of the most common neurological and psychiatric illnesses. Moreover, special attention is paid to the use of probiotic formulations as a potential non-invasive therapeutic opportunity for prevention and management of neuropsychiatric-associated affections. Graphical Abstract

Guts Imbalance Imbalances the Brain: A Review of Gut Microbiota Association With Neurological and Psychiatric Disorders

Iron deficiency is common in older patients. We investigated whether iron deficiency is an independent risk factor for functional impairment, low muscle function, fatigue, and rehabilitation progress in older hospitalized patients. Two hundred twenty-four patients (age range 65–95 years; 67% females) who were consecutively admitted to a geriatric acute care ward participated in this prospective longitudinal observational study. Ferritin, iron, transferrin in serum, and blood hemoglobin were measured and current iron supplementation was recorded. Fatigue and comorbidity were measured using the fatigue severity scale and Charlson Comorbidity Index, respectively. Barthel Index, handgrip strength, and isometric knee extension strength were conducted at the time of hospital admission and before discharge. Ninety-one (41%) patients had iron deficiency in which the majority had functional iron deficiency (78/91, 86%). Absolute iron deficiency with and without anemia was diagnosed in 12 (13%) and one patients, respectively. Barthel Index and handgrip and knee extension strength significantly improved during hospitalization in iron deficiency and non-iron deficiency groups. Knee extension strength showed better improvement in iron-deficient patients receiving iron supplementation and iron supplementation during hospital stay was the main predictor for improvement in knee extension strength. Comorbidity, iron deficiency, and changes in handgrip strength were the major independent risk factors for poor improvement in Barthel Index during hospitalization. There were significant associations between patients’ fatigue and iron deficiency, comorbidity, and female gender. Iron deficiency is an independent risk factor for fatigue and poor functional recovery among older hospitalized patients. Iron supplementation seems to be capable of improving functional performance.

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Iron deficiency, fatigue and muscle strength and function in older hospitalized patients

Use of GRADE in evidence syntheses published in high-impact-factor nutrition journals: A methodological survey

COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi

Funding The authors have received funding to carry out a pilot RCT on management of IDA in older people from the Chief Scientist Office, Scotland.

https://journals.sagepub.com/doi/pdf/10.1177/2042098618769568

The pale evidence for treatment of iron-deficiency anaemia in older people:

The authors gratefully acknowledge the comments and suggestions by Dr Miles Witham, Clinical Reader in Ageing and Health, University of Dundee, Dundee, United Kingdom, and Prof Alison Avenell, Professor of Health Services Research, University of Aberdeen, Aberdeen, United Kingdom. Author contributions. A.I.C.D., A.M.J., L.S.A., A.L.G., B.D.R., and P.K.M., conceived the study. A.I.C.D. and S.A. performed screening, selecting, and extraction of data. A.I.C.D. and S.A. also performed quality assessment. A.I.C.D. and T.O.S. conducted analyses and drafted the manuscript. All authors contributed to the writing of the manuscript. Funding/support. No external funding supported this work. T.O.S. is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health. Declaration of interest. The authors have no relevant interests to declare. Disclaimer: The abstract of this review was presented as an oral presentation at the 2017 British Geriatrics Society Spring Meeting, April 26–28, 2017, and will be published in the forthcoming supplementary issue of Age and Ageing.

/pdf/effect-of-nonmeat-high-protein-supplementation-on-quality-of-2ia6bz0czn.pdf

Effect of nonmeat, high-protein supplementation on quality of life and clinical outcomes in older residents of care homes: a systematic review and meta-analysis

Role of protein in healthy ageing

Background:Iron deficiency anaemia in older adults is common, but its management presents unique challenges in diagnosis and management. Little is known about compliance with current best practice ...

https://journals.sagepub.com/doi/pdf/10.1177/2042098619854870

Variability in the clinical management of iron deficiency anaemia in older adults: results from a survey of UK specialists in the care of older people.

Alex Johnstone, Alison Donaldson, Karen Scott and Phyo Myint all contributed equally to the writing and preparation of the manuscript. This study is funded by Tenovus Scotland Research Project No. G16‐08 (start 1 June 2017, end date 31 January 2019) and NHS‐Grampian Research and Development Endowment Research Grants Project No: 16/11/043 (start date 1 April 2017, end date 31 January, 2019) and the Scottish government as part of the Strategic Research Programme at the Rowett Institute (start date 1 April 2016–31 March 2021).

/pdf/the-ageing-gut-brain-study-exploring-the-role-of-the-gut-1fnm04769x.pdf

Alison I C Donaldson

Papers

The pale evidence for treatment of iron-deficiency anaemia in older people:

Effect of nonmeat, high-protein supplementation on quality of life and clinical outcomes in older residents of care homes: a systematic review and meta-analysis

Role of protein in healthy ageing

Variability in the clinical management of iron deficiency anaemia in older adults: results from a survey of UK specialists in the care of older people.

The Ageing Gut–Brain study: Exploring the role of the gut microbiota in dementia