Archives of Gerontology and Geriatrics Plus最新文献

Background

Visual impairment(VI) is a multifaceted condition that significantly impacts mental health, notably depression. With the population ageing, the incidence of VI is expected to rise, consequently increasing depression rates. This study aims to provide a comprehensive analysis of the pathways linking VI and depression among older adults in India.

Data & methods

This study uses data from the Longitudinal Ageing Survey of India (LASI Wave-1) with a sample of individuals aged 45 years and above (n=56,353). Binary logistic regression along with causal mediation analysis was conducted to assess the roles of mediating factors and other socio-demographic factors contributing to depression among older adults in India.

Results

An association between VI and an increased likelihood of depression was observed after accounting for functional, behavioural, psychosocial mediators and other covariates (OR:1.10, 95% CI: 1.01–1.19). The overall effect of visual impairment on depression, including both direct and indirect effects shows that visual impairment has a significant total effect on depression, with a coefficient of 1.11 (95 % CI: 1.01–1.10). The natural direct effect is significant, with an OR of 1.05 (95% CI: 1.01–1.10) for functional mediators, while the natural indirect effect through functional mediators suggests that a portion of the relationship between VI and depression is mediated through functional pathways.

Conclusion

Findings highlight the importance of addressing not only the direct impact of VI on individuals' well-being but also the various indirect effects mediated through functional limitations, behavioural, and psychosocial factors. This necessitates the interventions aimed at enhancing daily functional capacity and health perception among the visually impaired elderly. Findings suggest the need for fostering strong social ties and ensuring a supportive environment for older adults experiencing visual impairments.

The microorganisms residing the oral cavity, referred to as the oral microbiome, have been reported to have an association with health and disease in older adults. In the present review the state-of-the-art methodology was applied to investigate the association of the oral microbiome to systemic diseases, frailty and ageing. The methodology includes a six-step strategy, whereas inclusion criteria were articles in English, publication period between 2015 and December 2023, clinical studies, case series, in-vitro studies, and animal studies. Results indicated that the oral microbiome's composition is crucial for older adults with systemic diseases such as diabetes, Alzheimer's, or cardiovascular disorders. Moreover, there appears to be an association between the oral microbiome and frailty in older patients. The relationship between oral microbiome and ageing is bidirectional, since older adults experience a shift in the composition of the microbiome, whereas those bacteria promote inflammation remotely and rapid ageing of the individual. Further studies investigating the exact kind of phyla and genera of oral microorganisms are essential to better understand the interaction of the oral microflora with the human body in older individuals.

Background

Several previous studies have demonstrated that brain-derived neurotrophic factor (BDNF) and oxytocin are associated with dementia, depression, and mental health. The aim of this study was to measure the serum BDNF and oxytocin levels of community-dwelling older adults and evaluate the relationship between the two biomarkers in the study cohort.

Methods

This survey was conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, and the participants were community-dwelling older adults aged ≥ 65 years old. Their blood samples were collected for the measurement of their serum BDNF and oxytocin levels using enzyme-linked immunosorbent assays. The relationship between serum BDNF and oxytocin levels was analyzed using correlation and multiple regression analyses.

Results

A total of 95 participants (25 men and 70 women; mean age: 78.24 ± 3.85 years and 77.96 ± 5.52 years, respectively) were analyzed. The results of the analyses indicated that serum BDNF level was positively associated with serum oxytocin level, even after adjusting for age, sex, and years of education.

Conclusion

The results of this study suggest that BDNF and oxytocin may interact in older adults and may be associated with maintaining good mental health among them.

The article reviews recent research on new technologies for assisting the elderly based on Artificial Intelligence: Utilities for smart houses and Ambient Assisted Living, wearable and monitoring devices, virtual and augmented reality, and assistive robotics.

These smart technological tools can reduce the isolation of older adults by assisting them in their daily activities, but without completely replacing direct interventions, and requiring human support to facilitate interaction.

In determining the effectiveness of assistive technologies, older people's perceptions of them, acceptability, and willingness to use them are key variables. Also relevant is the perception by caregivers and healthcare professionals, and the socio-cultural dimension of acceptability.

Finally, the paper presents the ethical issues related to the use of technologies with the elderly population, to ensure the autonomy, safety, and dignity of the person. Some suggestions are offered for developers of new technologies for older adults.

In conclusion, the challenges for the future of assistive technologies are highlighted, so that they can best be used to assist large and differentiated elderly populations.

Objective

Nutritional intervention studies have indicated that whey protein- and leucine-enriched multi-nutrient formulas high in vitamin D3 are optimal medical nutrition recipes for treating sarcopenia. The present study undertakes a scoping review of research on whey protein- and leucine-enriched multi-nutrient formulas high in vitamin D3 in older adults with sarcopenia to highlight the impact of feeding and feeding with exercise on body composition, strength, and physical function.

Design

Online databases identified studies published from 2005-2023, for which we selected 11 English-language studies that experimented with a whey protein—and leucine-enriched multi-nutrient formula(e) high in vitamin D3 on measures of sarcopenia as the primary outcome variables in older adults diagnosed as sarcopenic.

Results

Nine registered human clinical trials and two unregistered human clinical trials were included in the analysis. All studies included sarcopenic older adults ages 66.5 y to 86.5 y. Two intervention types were identified: nutrition only or nutrition + exercise rehabilitation. The nutritional interventions improved lean mass, strength, and physical function.

Conclusion

There is evidence for the effectiveness of several types of whey protein- and leucine-enriched multi-nutrient formulas high in vitamin D3 in improving lean mass and physical performance in older adults recovering from sarcopenia. This is the first scoping review to show that specific formula(e) used with rehabilitation programs can alleviate sarcopenic obesity, support skeletal bone, and improve body composition, lean mass, and physical function with or without exercise (CRD42022342953).

Aim

To evaluate the applicability of the Clinical-Functional Vulnerability Index (IVCF-20) in monitoring the health of older people in primary health care (PHC), estimate the prevalence of functional decline and identify associated factors.

Methods

Cross-sectional descriptive study, with individuals aged 60 or over, from a PHC unit in Rio de Janeiro. The instrument included sociodemographic, health and lifestyle variables and the IVCF-20. A descriptive analysis was carried out, prevalence ratios (PR) were calculated, and Poisson multiple analysis was performed.

Results

The sample consisted of 120 individuals, mean age of 72.9 years (SD= 0.75), the majority were female. According to IVCF-20, 61 (50.8 %) of the individuals were robust, 41 (34.2 %) were in potential functional decline and 18 (15.0 %) were in established functional decline. In the bivariate analysis, not performing regular physical activity (RP 2.60 CI95 % 1.21–5.57), not believing that you live a healthy life (RP 4.39 CI95 % 1.92–10.06), not being satisfied with the way you live (RP 6.74 IC95 % 2.51–18.11) and reference to chronic illness (RP 4.57 IC95 % 1.22–17.14) showed an association with functional decline. In the Poisson model, the variables age (RP 1.37 95 % CI 1.07–1.75), not believing that you live a healthy life (RP 1.54 95 % CI 1.01–2.33) and lack of satisfaction with the way you live (RP 1.75 CI95 % 1.18–2.60) remained associated.

Conclusion

The study made possible to draw a profile of the older adults accompanied by a team at PHC, contributing to discussions on care proposals for the older people with a focus on preventing functional decline.

Background

Falls represent a prevalent yet often overlooked symptom in Parkinson's disease (PD) and other parkinsonisms believed to stem from a combination of motor, sensory, and cognitive impairments, in addition to environmental and social factors.

Research question

This study aimed to assess the impact of clinical and sociodemographic variables on the risk of falls in individuals diagnosed with PD or other parkinsonisms. Furthermore, the investigation sought to identify potentially modifiable risk factors associated with falls within this patients group.

Methods

The retrospective case-control study involved the analysis of an anonymized database comprising 735 patients with PD or different types of parkinsonism, including atypical parkinsonism, and other parkinsonism (drug-induced, vascular, parkinsonism of undetermined background).

Results

Age (OR: 1.039, p < 0.001), dementia (OR: 1.862, p = 0.012), vitamin B12 deficiency (OR: 2.667, p = 0.005), polypharmacy (OR: 2.493, p < 0.001), walking with assistance (OR: 3.248, p < 0.001), and posture deformities (OR: 2.199, p < 0.001) all contributed to falls in the study group. Additionally, patients with progressive supranuclear palsy (OR: 5.532, p < 0.001) and multiple system atrophy (OR: 4.993, p = 0.003) were significantly more prone to falls, whereas patients with PD (OR: 0.245, p < 0.001) experienced falls less frequently.

Significance

Factors such as low vitamin B12 concentration and polypharmacy are potentially modifiable and, therefore, may constitute viable targets for the prevention of falls in patients with PD and other parkinsonisms.

Objectives

The aim was to determine the knowledge of men about prostate cancer and screening methods, and the influence of these factors on participation in prostate cancer screening.

Participants and methods

Participants in this observational and cross-sectional study were men aged 40 to 79 years. Participation in the study was voluntary. Data were collected in May 2023 via an anonymous online survey.

Results

There is a lack of knowledge about prostate cancer among men in Istria. Most receive information from the media, while a smaller number receive information from physicians. Most have heard that there is a PSA test, but few know that it is a method for early detection. Subjects have different perceptions of digital rectal examination and other screening methods. Some men are afraid of discomfort and pain during the examination, while others do not consider this a problem. Most indicate that they intend to participate in screening in the future and that early detection of prostate cancer is important and a positive attitude towards it influences the decision to participate in the screening program.

Conclusion

The lack of knowledge about prostate cancer among men in Croatia is evident. Although most of the respondents do not consider themselves as a risk group, a positive attitude towards early detection affects the participation in prevention programs. Raising awareness and educating men about prostate cancer and available screening methods are key to increasing the number of participants in prevention programs and reducing the incidence of this disease.

Objectives

This study aimed to explore whether there might exist an interaction between using antidepressants and the influence of depressive symptoms on the recurrence of falls.

Design

Cross-sectional study using secondary data from a randomized clinical trial.

Setting and participants

Community-dwelling older adults (n = 609, aged 73.4 ± 7.4 years) who had experienced at least one fall in the past 12 months.

Methods

Depressive symptoms were measured using the Geriatric Depression Scale, and information about antidepressant usage was collected. Mediation models were built to decompose the effects of depressive symptoms on fall risk into direct effects and indirect effects mediated by antidepressant use.

Results

Depressive symptoms were reported by 29.1 % of the participants, and 27.4 % were using antidepressants. Those with depressive symptoms had 1.86 times the likelihood of being recurrent fallers (OR_TE: 1.861, 95 % CI: 1.197, 2.895), and there was no significant interaction between depressive symptoms and antidepressant use on recurrent falls (P _interaction = 0.989). Antidepressant use might be a significant mediator in the relationship between depressive symptoms and recurrent falls (OR_NIE: 1.140, 95 % CI: 1.007, 1.291), accounting for 21.1 % of the total effect.

Conclusions/implications

Antidepressants probably do not add a significant risk of recurrent falls beyond what is already contributed by the presence of depressive symptoms. A longitudinal study could clarify whether it might be safe to use antidepressants to treat older people with depressive symptoms without increasing the risk of falls the disease leads by itself.

Introduction

Polypharmacy, the concurrent use of multiple medications, poses significant risks to geriatric patients due to increased susceptibility to side effects and interactions. This narrative review addresses the challenges posed by polypharmacy in older adults, emphasizing the importance of reducing adverse effects. The article examines explicit, implicit, and mixed assessment tools used to identify potentially inappropriate medications (PIMs) and minimize adverse effects in geriatric populations.

Conclusion

The article underscores the critical need for accurate assessment and intervention to mitigate the negative consequences of polypharmacy in geriatric patients. The PRISCUS 2.0 List, an extensively updated version of the original PRISCUS list, emerges as a comprehensive tool to aid healthcare professionals in identifying PIMs. Its expanded medication list, incorporation of new evaluation criteria, disease-specific considerations, and enhanced classification system contribute to better identification of inappropriate medications. When we compared with other PIM criteria in previous studies, the EU(7)-PIM list was one of the most comprehensive, and with the PRISCUS 2.0 list update, it was determined that it contains partially more drugs that are inappropriate for the elderly in the Turkish pharmaceutical market. Comparisons between various criteria reveal their varying detection rates and strengths, highlighting the significance of using multiple criteria for a more holistic assessment. Additionally, the advent of online applications offers accessible solutions by consolidating multiple explicit criteria into a single platform, aiding practitioners in making well-informed decisions. The study emphasizes the need for ongoing updates, validation, and suitability assessments for these tools in diverse healthcare settings to ensure their effectiveness.