Current Geriatrics Reports 

About: Current Geriatrics Reports is an academic journal published by Springer Science+Business Media. The journal publishes majorly in the area(s): Population & Health care. It has an ISSN identifier of 2196-7865. Over the lifetime, 350 publications have been published receiving 2828 citations.

Interventions to Improve Walking in Older Adults

Abstract: Interventions to improve walking in older adults have historically been multifactorial (i.e., strengthening, endurance and flexibility programs) focusing on improving the underlying impairments. These impairment-based programs have resulted in only modest improvements in walking. In older adults, walking is slow, less stable, inefficient, and the timing and coordination of stepping with postures and phases of gait is poor. We argue the timing and coordination problems are evidence of the loss of motor skill in walking. Taking a lesson from the sports world and from neurorehabilitation, task-oriented motor learning exercise is an essential component of training to improve motor skill and may be a beneficial approach to improving walking in older adults. In this article we: (1) briefly review the current literature regarding impairment-based interventions for improving mobility, (2) discuss why the results have been only modest, and (3) suggest an alternative approach to intervention (i.e., task-oriented motor learning).

Spectrin Breakdown Products (SBDPs) as Potential Biomarkers for Neurodegenerative Diseases

Abstract: The expected lifespan of the world’s human population grows rapidly thanks to the great advance in modern medicine. While more and more body system diseases become treatable and curable, age-related neurodegenerative diseases remain poorly understood mechanistically, and are desperately in need of preventive and therapeutic interventions. Biomarker development consists of a key part of concerted efforts in combating neurodegenerative diseases. In many chronic neurodegenerative conditions, neuronal damage/death occurs long before the onset of disease symptoms, and abnormal proteolysis may either play an active role or be an accompanying event of neuronal injury. Increased spectrin cleavage yielding elevated spectrin breakdown products (SBDPs) by calcium-sensitive proteases such as calpain and caspases has been established in conditions associated with acute neuronal damage such as traumatic brain injury (TBI). In this article, we review literature regarding spectrin expression and metabolism in the brain, and propose a potential use of SBDPs as biomarkers for neurodegenerative diseases such as Alzheimer’s disease.

Biomarkers of Cognitive Training Effects in Aging

Abstract: An increasing number of studies have relied on brain imaging to assess the effects of cognitive training in healthy aging populations and in persons with early Alzheimer’s disease or mild cognitive impairment (MCI) At the structural level, cognitive training in healthy aging individuals has been associated with increased brain volume, cortical thickness, and density and coherence of white matter tracts At the functional level, task-related brain activation (using fMRI and PET) and fluorodeoxyglucose positron emission tomography (FDG-PET) were found to be sensitive to the effects of training In persons with MCI, cognitive training increased brain metabolism and task-related brain activation, whereas healthy older adults showed patterns of increased and decreased activation Further studies are required to generalize these findings to larger groups and to investigate more diverse training protocols Research will also need to address important methodological issues regarding the use of biomarkers in cognitive aging, including reliability, clinical validity, and relevance to the pathophysiological process

Colonization with Multidrug-Resistant Organisms in Nursing Homes: Scope, Importance, and Management

Abstract: Bacterial infections are among the most common causes of morbidity and mortality in nursing homes (NHs) and other long-term care facilities. Multidrug-resistant organisms (MDROs) represent an ever-increasing share of causative agents of infection, and their prevalence in NHs is now just as high as in acute care facilities, or even higher. Indeed, NHs are now considered a major reservoir of MDROs for the community at large. Asymptomatic colonization is usually a prerequisite to development of symptomatic infection. While progress has been made in defining epidemiology of MDROs in NHs, few studies have evaluated the role of changing health care delivery in introducing and further transmitting MDROs in this setting. Furthermore, the factors influencing the spread of colonization and the key prognostic indicators leading to symptomatic infections in the burgeoning short stay population need to be explored further. The difficulty of this task lies in the heterogeneity of NHs in terms of focus of care, organization and resources, and on the diversity among the many MDRO species encountered, which harbor different resistance genes and with a different prevalence depending on the geographic location, local antimicrobial pressure, and residents risk factors such as use of indwelling devices, functional disability, wounds, and other comorbidities. We present literature findings on the scope and importance of colonization as a pathway to infection with MDROs in NHs, underline important open questions that need further research, and discuss the strength of the evidence for current and proposed screening, prevention, and management interventions.

Recent Advances in Cholinergic Imaging and Cognitive Decline—Revisiting the Cholinergic Hypothesis of Dementia

Abstract: Although the cholinergic hypothesis of dementia provided a successful paradigm for the development of new drugs for dementia, this hypothesis has waned in popularity. Cholinergic brain imaging may provide novel insights into the viability of this hypothesis. Cholinergic receptor and forebrain volumetric studies suggest an important role of the cholinergic system in maintaining brain network integrity that may deteriorate with cognitive decline in Alzheimer disease (AD) and Lewy body disorders (LBD). Bidirectional changes in regional receptor expression may suggest the presence of compensatory responses to neurodegenerative injury. Cholinergic system changes are more complex in LBD because of additional subcortical degenerations compared to AD. Cholinergic-dopaminergic interactions affect attentional, verbal learning, and executive functions, and impairments in these two transmitter systems may jointly increase the risk of dementia in Parkinson’s disease. The cholinergic hypothesis is evolving from a primary focus on memory toward expanded cognitive functions modulated by regionally more complex and interactive brain networks. Cholinergic network adaptation may serve as a novel research target in neurodegeneration.