Showing papers in "Advances in Aging Research in 2013"

Relationships between gait properties on soft surfaces, physical function, and fall risk for the elderly

Abstract: The plantar aspect change caused by contact with soft surfaces creates and unstable gait and increases the risk of falling, especially in the elderly. This study aimed to analyze gait property by three-dimensional motion analysis on soft and normal surfaces and to clarify the relationship with physical function and fall risk. Twenty-four older people aged 65-88 years old and living independently without any assistive device (7 men, 17 women) performed 5 m of walking with own maximal speed on normal and soft surface walkways. The soft surface walkway used was a low rebound urethane foam mattress. The three-dimensional kinematic gait analysis by sixteen anatomic points was used to evaluate gait property on both walkways. The gait property on soft surfaces tended to be swinging up and down in each joint and to largely lean left and right as compared with the normal surface. Moreover, it tended to decrease in a step length and to increase in a step width. All gait parameters on soft surfaces correlated significantly with functional reach. On the other hand, that on normal surface correlated significantly with leg strength. Gait properties on soft surfaces which changes in plantar aspect during foot contact differs from those on normal surfaces. Walking on soft surfaces may cause an unanticipated inverted pendulum sway supporting a foot contact point because of the disturbance by a sagging walkway; in short, requiring more effort to keep a body balanced. In conclusion, gait on the soft surfaces requires balance ability (functional reach) rather than leg strength.

Purpose in life among very old men

Abstract: This paper provides very old men’s experiences of and reflections on purpose in life The answers from an interview question about purpose in life from 23 men were analyzed by using qualitative content analysis The results revealed three content areas: talking of purpose of life in general, talking of own purpose in life and reflections on purpose in life Our findings showed that very old men experienced purpose in life most strongly when remembering the past and describing their earlier work The old men reflected on purpose in life not just from their own individual perspectives, but also from a more reflective and analytic perspective

Increased vitamin D is associated with decline of naïve, but accumulation of effector, CD8 T cells during early aging

Abstract: Given the protective roles of 25-hydroxyvitamin D (25(OH)D or vitamin D) in musculoskeletal health and the potential beneficial effects of vitamin D supplementation in reducing the risk of various chronic diseases, intensive repletion of vitamin D has been widely advocated. Of note, CD8 T cells have the highest levels of the vitamin D receptor compared with other major immune cells. The effects of vitamin D on CD8 T cells during aging, however, remain unclear. This study determined the relationship between vitamin D levels and CD8 T cell status in 34 healthy female subjects (all >60 years old). The CD8 T-cell phenotype was defined by the surface expression of CD28 and CD95. The low-25(OH)D serum groups (≤30 ng/ml) had higher percentages of CD28+CD95–CD8+ (na?ve) T cells and lower percentages of CD28+CD95+CD8+ (effector) T cells. By contrast, subjects with high levels of 25(OH)D had very low percentages of na?ve CD8 T cells but very high percentages of effector CD8 T cells. There was a significant inverse correlation between 25(OH)D levels and the frequency of na?ve CD8 T cells. The results show that higher levels of vitamin D are correlated with decreased frequencies of na?ve CD8 T cells during early aging, suggesting that higher levels of 25(OH)D accelerate CD8 T cell senescence. These results warrant further evaluation of the effects of vitamin D supplementation in immune aging.

Handgrip strength and falls in community-dwelling Egyptian seniors

Abstract: Purpose: To establish a relationship between falls and handgrip strength (GS) in communitydwelling senior citizens in Egypt. Subjects: Crosssectional study enrolling 132 subjects, all ≥60 years old. Materials and Methods: History of falls in the past year and their number as well as GS measurement in both hands using Baseline ® pneumatic squeeze handheld dynamometer. Results: There is a highly significant difference between the GS of fallers and non-fallers in both hands (P = 0.000). There is a highly significant negative correlation between the mean GS and the number of falls (P = 0.003). There is a highly significant positive correlation between GS of the right hand with the number of falls (R = 0.226, P = 0.009), as for the correlation with the left GS it was a weaker positive correlation (R = 0.209, P = 0.16). Conclusion: Seniors with history of falls have a lower GS in both dominant and nondominant hands and it is directly related to the number of falls. GS is decreased in senior fallers even if within the normal range.

Personality change in older adults with dementia: Occurrence and association with severity of cognitive impairment

Abstract: Personality change is among criteria for the diagnosis of dementia. We examine first whether personality changes are related to severity of cognitive impairment in a linear or an inverted-U fashion in 1132 demented older people from the Canadian Study of Health and Aging (CSHA) and 921 unimpaired older people. The proportion with reported change was larger for all measures in the demented group than in the cognitively unimpaired group, and was more consistent with a linear increase in personality change with increasing cognitive impairment than with an inverted-U relationship, as seen in only one variable. In our second (longitudinal) study, we evaluate which aspects of personality change most in dementia; changes in mood and an exaggeration of existing traits were the variables most closely related to the development of dementia.

Evaluation of Montreal cognitive assessment for the differential diagnosis of mild cognitive impairment and Alzheimer’s disease in elderly patients with more than 5 years of schooling: Data from a Brazilian sample

Abstract: Background: Diagnostic investigation of dementia is based on a series of tests which lie the neuropsychological evaluations The Montreal Cognitive Assessment (MoCA) was developed as an instrument to recognize Mild Cognitive Impairment (MCI) and initial cases of Alzheimer’s disease The present study aims to evaluate the predictive value of Brazilian MoCA test version in a sample of elderly above 5 years of education Methods: Cross-sectional study with 136 elderly, above 60 years old at least 5 years of education Diagnostic criteria is based on clinical and neuropsychological data classified Alzheimer’s disease n = 52, MCI n = 45 e normal controls n = 39 MoCA test was compared with Cambridge Cognitive Examination, Mini-Mental State Exam, Verbal Fluency, Clock Drawing Test, Geriatric Depression Scale and Pfeffer Functional Activities Questionnaire Accuracy was evaluated by receiver operating characteristic (ROC) curve analyses Pearson correlation coefficient was used to compare the MoCA with the other tests It was also used logistic regression analysis to identify the main risk factors for the diagnostic groups Results: MoCA was the best test to differentiate Alzheimer’s disease cases from MCI with 865% sensitivity and 756% specificity Furthermore, analyzes of correlation test showed that MoCA correlates robust way of already validated with other tests and wide application inBrazil Conclusions: It can be concluded that MoCA is a good screening tool for investigation of MCI among the elderly in Brazil with over 5 years of schooling Studies with larger numbers of participants are needed to further validate the test also for elderly people with low education

New antioxidant SkQ1 is an effective protector of rat neural retina under conditions of long-term organotypic cultivation

Abstract: During life human eye is constantly exposed to sunlight and artificial light, the sources of reactive oxygen species (ROS)—the main cause of age-related eye pathology. A novel mitochondria-targeted antioxidant SkQ1 has recently been invented to reduce mitochondrial ROS by cleaning the mitochondria matrix, “the dirtiest place in the cell” in respect of ROS production and accumulation. Earlier we studied SkQ1 effects upon retinal pigment epithelium and choroid in the rat eye posterior cups exposed to long-term 3D organotypic culturing. It was found that under in vitro conditions 20 nM SkQ1 effectively reduced cell death in retinal pigment epithelium and choroid and protected the tissues from disintegration and cell withdrawal. In the present study we used same ex vivo conditions to examine the effect of SkQ1 upon the rat neural retina kept in the content of the posterior eye cup. Eye cups were isolated and cultured in vitro during 7, 14, and 30 days under rotation in the presence and absence of 20 nM SkQ1 in the culture medium. Serial sections of cultivated eye cups were subjected to histology, computer morphometry and immunohistochemistry. Obtained results show that SkQ1 operates as a strong protective agent, preventing neuronal cell death and other degenerative processes in the neural retina. Cell rescue by SkQ1 was more vivid in the central part of the retina than at the periphery. That, in turn, suggests SkQ1 effectiveness in treatment of some age-related eye diseases when central part of the retina, including macula, is most susceptible to degeneration.

Geriatrics intensive care unit: Outcome and risk factors for in hospital mortality

Abstract: OBJECTIVES: To evaluate outcome and risk factors, particularly the (APATCHE II) score in elderly patients after admission to a geriatrics intensive care unit (ICU). Methods: A cross sectional study of patients ≥ 60 years admitted to the intensive care unit (ICU) of the Geriatrics department at Ain Shams University Hospital over 2 years period. We recorded age, sex, previous medical history, primary diagnosis, date of admission and discharge or death and APACHE II score on admission. Results: 202 patients admitted to the ICU were studied. The mean ICU mortality rates for these patients were (32, 5%), the mean APATCHE II score was (19.07). 27.3% of patients who died had hypokalemia and 43.2% had hyponatremia. Conclusion: ICU mortality rate are higher in elderly patients particularly with long ICU stay and hyponatremia.

Evaluation of health determinants for sustaining workability in aging US workforce

Abstract: Growth of older population in United States requires multi-generational evaluation to characterize health measures for sustaining workability. Investigation of measures that working population would need and use with their work-life in an attempt to stay healthy and fit, could potentially reveal significant association that could extend workability and enhance work productivity such as performance, presenteeism, job satisfaction. Evaluation with selective longitudinal health profiling; employment prerequisites; socio-economic and psychological scales could characterize health measures significantly associated with work sustainability. Such health measures could potentially be employed by US working population early in their life and occupation to sustain and improve workability in their later epoch.

Barriers and facilitators to an outreach rehabilitation program delivered in nursing homes after hip fracture surgical repair

Abstract: Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services; 2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.

Neuroprotective role of 17 β estradiol with tachykinin neuropeptide NKB and A β (25 - 35) in aging female rat brain

Abstract: The brain experiences structural, molecular and functional alterations during aging. In aging brain tissue, the oxidative stress increases due to decreased activity of antioxidant enzymes and increased oxidative stress leading to neurodegeneration associated with excitotoxicity. In the present study, we observed the effect of tachykinin neuropeptide Neurokinin B (NKB) and amyloid beta fragment Aβ (25 - 35) on the activity of Acetylcholine esterase (AChE) and Lipid peroxidation (LPO) in brains of 17β estradiol (E2) treated aging female rat synaptosomes of different age groups. An in-vitro incubation of E2 treated brain synaptosomes with Aβ (25 - 35) showed toxic effects on all the parameters. The treatment of NKB and combined NKB and Aβ (25 - 35) increased the AChE enzyme activity and decreased the level of LPO in E2 treated aging rats. The treatment of NKB and combined NKB and Aβ (25 - 35) in a concentration dependent manner reversed the effects of aging and Aβ (25 - 35) on AChE and LPO. The present finding suggests that E2 along with NKB reverse aging and Aβ (25 - 35) induced toxicity as well as AChE and LPO levels. The results of the current study showed a possible beneficial role of NKB with E2 inthe age related neurological diseases.

Social integration: How is it related to self-rated health?

Abstract: Social integration has well-established health benefits among older adults in observational studies. However, interventions designed to increase social integration have not improved health suggesting important knowledge gaps on how social integration influences health outcomes. This study developed a new measure of social integration, daily social contact, capturing the interpersonal nature of social integration and mobility of individuals, and providing a direct assessment of individuals’ real-time access to companionship and social support. The data used is the 2006-2007 American Time Use Survey (ATUS), which surveyed 25,191 individuals aged 15 years and older (n = 4378 aged 65 years and older). Generalized ordinal logistic regression analyses revealed positive, but non-parallel relationships between daily social contacts and the ordinal categories of self-rated health among older adults. This study may be used to identify populations that experience social exclusion, such that future research can determine more precisely how to intervene to improve health outcomes.

Non-English speaking background patients in a predominantly English-speaking region may be more likely to present with a dementia other than Alzheimer’s disease

Abstract: Information on 54 patients was retrospectively collected to compare the presentation trends of cognitive disorders in those of non-English speaking background (NESB)to English speaking background(ESB)attending an Australian memory clinic that extensively uses fluorodeoxyglucose positron emission tomography(FDG PET) in the diagnosis of cognitive concerns. NESB patients were less likely to be diagnosed with Alzheimer’s disease(AD)as the sole neurodegenerative diagnosis (Fisher exact test, p = 0.08), and NESB patients with dementia were more likely to have non-AD dementia (Fisher exact test, p = 0.06). They experienced symptoms 18 months longer before receiving a formal diagnosis (t(46) = 2.2, p = 0.03). Older elderly NESB females were under represented in those presenting to the clinic (Fisher exact test, p = 0.04). The clinical work-up of NESB patients as opposed to those of ESB relied more heavily on FDG PET (Fisher exact test, p = 0.04). ESB and NESB patients may have different attitudes towards dementia, affecting how they present, and biomarkers may be more heavily relied on when language affects history taking and neuropsychological testing.

Relationship between peripheral arterial disease, carotid intima-media thickness and C-reactive protein in elderly diabetic patients

Abstract: Purpose: To study the association between carotid intima media thickness (CIMT) and high sensitivity CRP (hs-CRP) level as markers for PAD in elderly patients with DM. Subjects: A case-control study on 90 participants aged 60 years and older divided into 60 cases (30 patients with DM alone and 30 patients with DM and comorbidities) and 30 healthy controls. All were assessed by measuring CIMT, ankle brachial index (AB), and markers for cardiovascular disease such as high-sensitivity CRP (hs-CRP), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL). Results: hs-CRP levels showed statistically significant difference being highest among patients with DM and comorbidities and lowest among controls (P < 0.001). Also, symptoms of PAD were significantly higher among cases than controls. ABI was able to detect PAD in many asymptomatic patients. Color changes were present in only 43.30% (n = 26) of positive PAD cases while delayed wound healing, claudication pain, rest pain, cold extremities, and trophic changes were present in 23.30% (n = 14), 16.71% (n = 10), 16.71% (n = 10), 45.00% (n = 27), and 21.7% (n = 13). Using logistic regression analysis revealed that DM, CIMT, and hs-CRP were independent predictors for PAD (OR = 4.194, 7.236, 1.003; P value = 0.044, 0.25, 0.031) after adjustment of other coronary risk factors such as sex, smoking, hypertension, TC, and TG. Conclusion: Diabetic elderly have higher prevalence of asymptomatic PAD thannon-diabetics using solely ABI. DM, CIMT, and hs-CRP are independent predictors for the occurrence of PAD. Hs-CRP levels are highest among diabetics with comorbidities.

Effect of aging on the relationship between capillary supply and muscle fiber size

Abstract: A quantitative analysis of capillary supply to skeletal muscle is important for understanding the upper limit of the capacity for delivery of oxygen and substrates to muscle cells. It has been well documented that the number of capillaries is altered by several factors including development, aging, and alteration of muscle activity level such as exercise training and inactivation. There is, however, a contradiction in animal studies for aging-related change in the number of capillaries. Human studies using biopsy technique also displayed an inconsistency on that point, in which capillary supply was not influenced or decreased with aging. This review discussed an inconsistency among studies for aging-related change in muscle capillary supply. In conclusion, the relationship between capillary supply and muscle fiber size is similar for both young and elderly population, and the morpho- logical balance between capillaries and each muscle fiber was maintained with advancing age.

Risk assessment of and targeted intervention for falls in the elderly based on the relationship between physical function levels and risk factors for falls

Abstract: Although fall experience is an important predictor of future falls, clinicians place too much emphasis on this factor during risk assessment of falls. This study aimed to determine individuals with high and low fall risk on the basis of the relationship between physical function levels [competence in performing activities of daily living (ADL)] and risk factors for falls (fall experience, locomotive organ impairment, and potential for falling). Participants were 1057 independent community-dwelling elderly individuals. ADL competence and the status of risk factors for falls were evaluated using a questionnaire and the relationship between the two was determined. We calculated the cumulative relative frequency curves for ADL scores after categorizing the participants into several groups according to combinations of risk factors and analyzed those combinations that showed wide individual differences in the cumulative relative frequency curves. Intergroup differences when the participants were categorized on the basis of fall experience alone were small; however, those when the participants were categorized on the basis of locomotive impairment and potential for falling were much greater. On classifying the participants into eight groups on the basis of locomotive organ health, fall risk, and fall experience, we found that fallers with locomotive impairment and a high fall risk exhibited the lowest ADL scores while fallers without locomotive impairment and with a low fall risk exhibited the highest ADL scores. Fall risk assessments that are overtly dependent on fall experience are fundamentally limited. Grouping key risk factors can help in determining target groups, including highrisk fallers, low-risk fallers, and high-risk nonfallers, which require primary preventive measures among the community-dwelling elderly.

Effects of tachykinin neuropeptide NKB and A β (25-35) on antioxidant enzymes status in 17 β estradiol treated aging female rats

Abstract: Aging is the leading risk factor for neurodegenerative diseases and oxidative stress involved in the pathophysiology of these diseases. These changes increase during menopausal condition in females when the level of estradiol is decreased. The aim of the present study was to determine the effect of tachykinin neuropeptide, Neurokinin B (NKB) and Amyloid beta fragment Aβ (25 - 35) on 17β estradiol (E2) treated aging female rat synaptosomes of different age groups. Aging brain functions were assayed by measuring the activities of antioxidant enzymes—superoxide dismutase (SOD) and monoamine oxidase (MAO) with neuropeptides. An in-vitro incubation of Aβ (25 - 35) in E2 treated brain synaptosomes showed toxic effects on all the parameters. However, NKB and NKB combined with Aβ (25 35) showed stimulating effects in E2 treated rat brain synaptosomes. In the present study, an increase in activity of SOD and decrease in the level of MAO, in the presence of NKB and combined NKB and Aβ in E2 treated brain synaptosomes of aging rats. This study elucidates that treatment of NKB and Aβ with E2 incombination exerts more protective influence than their individual application, against excitotoxicity in age related changes.

The effects of fall experience by tripping on the movement of stepping over an obstacle

Abstract: This study examines the effects of fall experience caused by tripping on the movement of stepping over an obstacle. The participants were divided into 3 groups (26 fallers caused by tripping, 24 fallers caused by other causes, and 145 non-fallers). Participants stepped forward over a 10 cm high obstacle with one leg, and then returned to their original position five times as quickly as possible. The OSFS (obstacle single leg forward step) test was measured in the following 2 phases: the OSFS-F phase, in which participants stepped out on one leg, and the OSFS-R phase, in which they returned it. Significant differences among the three groups were found in all parameters, and the fallers by tripping were significantly inferior to the non-fallers. There were no significant differences between the fallers by other reasons and the non-fallers in all parameters. The fallers by tripping were slower in the obstacle step movement than the non-fallers.

The effects of aging on muscle loss and tissue-specific levels of NF-κB and SIRT6 proteins in rats

Abstract: The objective of this study was to examine the influence of aging on food intake, tissue and organ mass and NF-κB and SIRT6 levels in various tissues. The transcription factor, Nuclear Factor Kappa-B (NF-κB), is associated with both catabolic and anabolic pathways of muscle metabolism and may be involved in age-related muscle loss. SIRT6 is a member of the sirtuin family of proteins that function as protein lysine deacetylases and are associated with longevity in a number of organisms. Male Sprague-Dawley rats, aged 6 months (Adult) and 21 months (Old) were fed a commercially available diet for 10-17 days. Old rats consumed less food per body weight (BW) each day than Adult rats (1.45% g diet/g BW vs. 2.4% g diet/g BW). However, when intake data were expressed as g/diet per day there was no significant difference between groups. For skeletal muscle tissue, the average mass of gastrocnemius and soleus (g muscle/g BW) was significantly lower in Old rats. Levels of NF-κB (p65/RelA) and SIRT6 were measured by Western blot analysis in gastrocnemius, tibialis anterior, quadriceps, soleus, lung, heart, kidney and liver. NF-κB levels were higher in gastroc- nemius of Old rats compared to Adult rats. No significant age-specific differences in SIRT6 protein levels were noted in the tissues examined. Interestingly, when examined independent of age, levels of SIRT6 were significantly different between certain tissues. Data from this study suggest that aging affects muscle loss and NF-κB in a tissue-specific manner. Furthermore, these findings indicate tissue-specific but not age-specific differences in SIRT6 protein levels.

Assessing symptoms profile and correlates of very late-onset schizophrenia-like psychosis (VLOSLP)

Abstract: Objective: While the most common causes of late life psychosis are factors other than primary psychosis, but the nosology and clinical features of late life, primary psychotic is a matter of controversy. The goal of this study was to define some correlates and symptoms profile of very late-onset schizophrenia-like psychosis among an Iranian elderly population presenting with psychosis. Method: From 201 psychotic elderly patients, 39 (19.4%) subjects with the most possible diagnosis of very late-onset schizophrenia-like psychosis were selected. Socio demographic characteristics, past psychiatric history, family history of psychiatric problems, personality traits, cognitive status, history of stressful life events, and burden of medical problems assessed and compared between patients and 39 age and sex mathed controls. Results: The mean age of study sample was 76.9 years. Of 39 patients with VLOSLP, 13 (33.3%) were male and 26 (66.6%) were female. In 32 patients (82.05%) some sorts of hallucinatory experiences were detected. Visual hallucinations were the most common types of hallucinations (69.2%) followed by auditory hallucinations (51.35%) and tactile hallucinations (4%). Persecutory delusions (59%); delusions of references (20.5%); and partition delusions (15.4%) were the most common types of delusions. Significant proportion suffered from some sort of sensory deficit like visual or auditory deficits. There was no significant difference in terms of history of traumatic life events, cognitive function; cumulative burden of medical conditions and personality traits between patients and healthy controls (P > 0.05) Conclusions: Female involved two times more than male. The most common types of psychotic symptoms were visual hallucinations and persecutory delusions. Except sex, exploring other demographics, psychological and physical correlates for VLSOLP patients was not conclusive. More controlled studies using neuroimaging and biomarkers are needed in this issue.

Profiling users and non-users of senior services

Abstract: The goal of this study was to determine whether or not older adults who utilized community nutrition services were more or less able to perform Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADLs), or Physical Activities (PA) than non-users. In surveying older adults aged 60 - 103 (n = 1065), it was determined that service users were older, frailer, living alone, and less able to perform ADLs, IADLs, or PAs than non-users. However, within the non-service user group, a subset of nonusers was identified as those who were infirm, malnourished, less active, and unable to perform ADLs. Both users and non-users of community nutrition programs would benefit greatly, with services recalibrated to serve these community-dwelling, but needy older adults.

Nocturia: Impact on quality of life in an Egyptian adult population

Abstract: OBJECTIVE: To estimate the effects of nocturia on quality of life (QoL) and to assess the associated effects of sleep problems. Background: Nocturnal urination (nocturia) is such a commonplace occurrence in the lives of many older adults that it is frequently overlooked as a potential cause of sleep disturbance. Methods: The current study was carried out to assess the prevalence of nocturia in elderly males and its impact on sleep quality and QoL. The study enrolled 200 elderly males aged 60 years old and above. All participants were recruited from geriatric clubs in Cairo. All participants in the study were subjected to: comprehensive geriatric assessment, American Urological Association (AUA) score used to measure the severity of nocturia ,assessment of sleep quality using Pittsburgh Sleep Quality Index (PSQI) and assessment of QoL using “SF-12 Short Form Health Survey”. Results: The study showed that the prevalence of nocturia in elderly males aged ≥60 years old was 68% with significant association between nocturia and diabetes mellitus, heart failure, stroke, prostatism, recurrent UTI and diuretic use. As regard sleep quality, the current study showed that the prevalence of poor sleep in the studied subjects is 70.5% with significant association between nocturia and poor sleep quality. Nocturia significantly affects sleep latency, sleep efficiency and daytime dysfunction, high significantly affecting sleep disturbance. Also diabetes mellitus, ischemic heart disease, heart failure, prostatism, recurrent UTI, osteoarthritis and diuretic use are significantly associated with poor sleep quality. As regard quality of life, the current study showed significant association between nocturia and physical and mental health components of HRQL in the univariate analysis. But after multivariate analysis, nocturia is not an independent risk factor for poor quality of life. Nocturia affects QoL through its effect on sleep quality which is an independent risk factor for poor physical and mental health components of QoL. Conclusion: Nocturia may lead to sleep insufficiency and consequently to a decrease in mental and physical health. Patients who consult a doctor for nocturia should thus be treated adequately. In addition, it is worthwhile for doctors to routinely check if patients’ who contact them for sleep problems also have nocturia.

Age changes of antyoxidant system and free-radical processes in rats at formation of postinfarction cardiosclerosis

Abstract: Estimation of age dependent changes of the lipid peroxidation (LPO) intensity, content of stable metabolites of nitrogen oxides (NO) and antioxidant enzyme activities in rat blood serum in conditions of experimental postinfarction cardiosclerosis (PICS) is carried out. Initiation of the postinfarction remodeling of animals has been carried out with coronary occlusion, definition of LPO and NO metabolites indices has been performed after 45 days. Investigations have been carried out on 40 four and twelve-month-old male Wistar rats with mass 200-250 gand 400 -450 g, accordingly. Statistical analysis of the results was performed using the Mann-Whitney-Wilcoxone criterion. It has been found that already intact animals have age specificity of indices under consideration. The expressed activity of LPO processes on the background of reduction of endogenous fermentative antioxidant (SOD and catalase) activity as well as nitrite concentration in blood serum is characteristic for PICS of 4-month-old animals. PICS of 12 month-old rats is accompanied with suppression of the LPO processes on the back- ground of reduction of the antioxidant enzyme intensity and increase of NO metabolites production. The following conclusions have been drawn. Process of ontogenesis is characterized by imbalance between pro-and antioxidant processes in rat blood. Increase in catalase activity and concentration of the TBC-active products at simultaneous decrease of SOD activity and content of diene conjugates has been noted. The organism of young animals responds with persistent increase of LPO processes and decrease of SOD and catalase activity on formation of postinfartion cardioslerosis. The less expressed increase of lipid peroxidation activation and decrease of catalase activity has been noted in the organism of old animals within 45 day after PICS formation.

Mortality and morbidity due to the failure to treat mild anemia unrelated to cancer in elderly Americans—Review of the literature and case presentation

Abstract: Even mild iron deficiency anemia, as defined by the World Health Organization, is associated with increased mortality and significant morbidity in elderly individuals who are cancer free. Yet, anemia in the elderly is often dismissed as a benign sign of aging. This problem is exacerbated by the fact that elderly individuals often suffer from gastrointestinal complaints that preclude treatment with iron supplements by mouth. The FDA has approved two brands of injectable iron for treating such patients. Nonetheless, a major American health maintenance organization refuses to treat elderly patients with injectable iron, even when it is indicated, unless their anemia is associated with cancer. This may well reflect a public health crisis afflicting many elderly residents of the United States.