Background: Since the past decade, prevalence of Potentially Inappropriate Medication (PIM) among elderly inpatients has increased drastically. However, limited data is available on PIM indicators and PIMs use among the elderly in patients suffering from Chronic Kidney Disease (CKD).
Objective: The objective of this study is to determine the prevalence of PIMs in elderly hospitalized patients with CKD.
Methods: A cross-sectional study was carried out on 102 patients in a tertiary care hospital. PIMs were identified using Beers criteria 2019. Chi-square test was used to identify the association between variables and PIMs use.
Results: PIMs, as assessed according to AGS updated Beers criteria 2019 was found to be in more than 68.6% of patients of median age 65 years and 3 diagnoses and 7 days median length of stay. Most of the patients (47.1%) had ≥4 diagnosis. The most common comorbidities in patient were diabetes mellitus (n=54) and hypertension (n=55). Most of the subjects (66.7%) were on polypharmacy (5-9 medications/day) and 25.5% were on a higher level of polypharmacy (>10 medicines/day). Approximately 90% of the patients were having very low CrCl < 21ml/min (calculated with the help of Cockcroft- Gault formula). A significant association between PIM use and an increased number of diagnoses, polypharmacy or high-level polypharmacy, was observed.
Conclusion: The prevalence of PIMs in elderly inpatients suffering from CKD is quite high. The study clearly indicates negligence/ lack of awareness amongst physicians leading to increase in PIM use. Authors propose that the CKD patients should attract special attention of physician and should be treated as brand ambassadors/alarming bell for PIM use.
Background: Parkinsonism is a neurodegenerative disorder that affects elderly people worldwide.
Methods: Curcumin, adenosine A2AR antagonist (ZM241385) and Sinemet® (L-dopa) were evaluated against Parkinson's disease (PD) induced by rotenone in rats, and the findings were compared to our previous study on mice model.
Results: Rats injected with rotenone showed severe alterations in adenosine A2A receptor gene expression, oxidative stress markers, inflammatory mediator, energetic indices, apoptotic marker and DNA fragmentation levels as compared to the control group. Treatments with curcumin, ZM241385, and Sinemet® restored all the selected parameters. The brain histopathological features of cerebellum regions confirmed our results. By comparing our results with the previous results on mice, we noticed that mice respond to rotenone toxicity and treatments more than rats with regards to behavioral observation, A2AR gene expression, neurotransmitter levels, inflammatory mediator and apoptotic markers, while rats showed higher response to treatments regarding oxidative stress and energetic indices.
Conclusion: Curcumin succeeded in attenuating the severe effects of Parkinson's disease in the rat model and can be considered as a potential dietary supplement. Adenosine A2AR antagonist has almost the same pattern of improvement as Sinemet® and may be considered as a promising therapy against PD. To compare the role of animal species in response to PD symptoms and treatments, our previous report on mice explored the response of mice to rotenone toxicity in comparison with rats, where rats have shown a higher response to treatments. Therefore, no animal model can perfectly recapitulate all the pathologies of PD.
Background: Older adults living in nursing homes have an increased risk of adverse outcomes. However, the role of body composition in vital health and quality of life parameters such as functional capacity and cognitive function is less studied in this group of older adults compared to community-dwelling counterparts.
Objective: The aim of the present study was to examine the association of body composition with functional capacity and cognitive function in nursing home residents.
Methods: Fifty-three older adults (82.8 ± 7.3 years) were enrolled in this study and they underwent body composition evaluation, functional capacity and cognitive function measurements.
Results: The results showed a high prevalence of obesity accompanied by functional capacity limitations and cognitive impairment in older adults living in nursing homes. Partial correlations, controlling for age, showed that body fat percentage was positively correlated with sit-to-stand-5 (r = 0.310, p = 0.025) and timed-up-and-go (r = 0.331, p = 0.017), and negatively correlated with handgrip strength test results (r = -0.431, p<0.001), whereas greater lean body mass was associated with better sit-to-stand-5 (r = -0.410, p = 0.003), handgrip strength (r=0.624, p<0.001) and cognitive function performance (r = 0.302, p = 0.037).
Conclusions: These important associations reinforce the need to develop effective healthy lifestyle interventions targeting both lean mass and body fat to combat functional and cognitive decline in nursing home residents.
Background: Alzheimer's Disease (AD) is the most common cause of dementia. Genetics, excessive exposure to environmental pollutants, as well as unhealthy lifestyle practices are often linked to the development of AD. No therapeutic approach has achieved complete success in treating AD; however, early detection and management with appropriate drugs are key to improving prognosis.
Interventions: The pathogenesis of AD was extensively discussed in order to understand the reasons for the interventions suggested. The interventions reviewed include the use of different therapeutic agents and approaches, gene therapy, adherence to healthy dietary plans (Mediterranean diet, Okinawan diet and MIND diet), as well as the use of medicinal plants. The potential of nanotechnology as a multidisciplinary and interdisciplinary approach in the design of nano-formulations of AD drugs and the use of Superparamagnetic Iron Oxide Nanoparticles (SPIONs) as theranostic tools for early detection of Alzheimer's disease were also discussed.
Background: Destination memory defined as the ability to remember to whom we addressed a piece of information is found to be impaired in normal aging. Theories of affect development and research findings have shown that emotional charging improves performance on memory tasks, and also that Mu rhythm is desynchronized as an index of mirror neuron activation during such tasks.
Objective: In this paper, we sought to investigate the differences in Mu rhythm during an emotional destination memory task, between younger and older adults.
Methods: 16 cognitively normal older adults, recruited from Alzheimer's disease day center and 16 young adults, recruited via advertisements, participated in this experimental study. We investigated destination memory of emotionally charged faces (Emotional Destination Memory, EDM) while applying electroencephalograph (EEG) in real time in young versus older adults. We measured Mu rhythm in frontal, fronto-temporal and central areas. EEG data has been pre-processed, segmented in non-overlapping epochs, and independent component analysis (ICA) has been conducted to reject artifacts.
Results: Results showed that young adults performed better than older adults in remembering facts associated with angry faces. Also, different neurophysiological activation was found, with older adults showing Mu suppression in frontal and fronto-temporal regions, specifically in F3, F7 and F8 electrodes, in contrast with young adults who showed Mu enhancement. Regarding within group differences, it was found that in the older adults group, electrodes F8 and central C3 were the most activated, while in the young adults group, C3 was the most activated electrode.
Conclusion: The findings suggest better behavioral performance of young adults as a result of better cognitive state and adaptive bias. On a neurophysiological level, it is suggested that older adults employ Mu suppression, thus possible activation of mirror neurons, as a compensatory mechanism while mirroring properties are not spontaneously activated in young adults.
Background: Psychological stress may be a risk factor for dementia, but the association between exposure to stressful life events and the development of cognitive dysfunction has not been conclusively demonstrated. We hypothesize that if a stressful event has an impact on the subjects, its effects would be different in the three diseases.
Objective: This study aims to assess the effects of stressful events in senior patients who later developed ischemic stroke, Alzheimer's, or Parkinson's disease.
Material and methods: Together with demographic variables (age, sex, race, socioeconomic and cultural levels), five types of past stressful events, such as death or serious illness of close relatives, job dismissal, change of financial status, retirement, and change of residence, were recorded in 1024 patients with Alzheimer's disease, Parkinson's disease, and ischemic stroke. Time-todiagnosis (months from the event to the first symptoms: retrospective study) and evolution time (years of follow-up of each patient: prospective study) were recorded. The variance and nonparametric methods were analyzed to the variables time-to-diagnosis and evolution time to analyze differences between these diseases.
Results: The demographic variables, such as age, sex, race, economic and cultural levels, were found to be statistically non-significant; differences in the economic level were significant (P<0.05). Significant differences (P<0.001) were found in the mean time-to-diagnosis between diseases (Alzheimer's disease>Parkinson's disease >Stroke), and minor differences (P<0.05) in evolution time.
Conclusion: Differences in time-to-diagnosis between the diseases indicate that the stressful effect of having experienced the death or serious illness of a close relative has an impact on their emergence. The measurement of time-to-diagnosis and evolution time proves useful in detecting differences between diseases.
Transport of materials and information across cellular boundaries, such as plasma, mitochondrial and nuclear membranes, happens mainly through varieties of ion channels and pumps. Various biophysical and biochemical processes play vital roles. The underlying mechanisms and associated phenomenological lipid membrane transports are linked directly or indirectly to the cell health condition. Mitochondrial membranes (mitochondrial outer membrane (MOM) and mitochondrial inner membrane (MIM)) host crucial cellular processes. Their malfunction is often found responsible for the rise of cell-originated diseases, including cancer, Alzheimer's, neurodegenerative disease, etc. A large number of ion channels active across MOM and MIM are known to belong to vital cell-based structures found to be linked directly to cellular signaling. Hence, their malfunctions are often found to contribute to abnormalities in intracellular communication, which may even be associated with the rise of various diseases. This article aims to pinpoint ion channels that are directly or indirectly linked to especially aging and related abnormalities in health conditions. An attempt has been made to address the natural structures of these channels, their mutated conditions, and the ways we may cause interventions in their malfunctioning. The malfunction of ion channel subunits, especially various proteins, involved directly in channel formation and/or indirectly in channel stabilization leads to the rise of various channel-specific diseases, which are known as channelopathies. Channelopathies in aging will be discussed briefly. This mini-review may be found as an important reference for drug discovery scientists dealing with aging-related diseases.
Aging is an inevitable process of nature. The age of living organisms contributes to the appearance of chronic diseases, which not only reduce the quality of life but also significantly damage it. Modern medicines can successfully fight multiple diseases and prolong life. At the same time, medications have a large number of side effects. New research indicates that bioactive phytochemicals have great potential for treating even the most severe diseases and can become an alternative to medicines. Despite many studies in this area, the effects of many plant ingredients on living organisms are poorly understood. Analysis of the mechanisms through which herbal preparations influence the aging process helps to select the right active substances and determine the optimal doses to obtain the maximum positive effect. It is preferable to check the effectiveness of plant extracts and biologically active components with geroprotective properties in vivo. For these purposes, live model systems, such as Rattusrattus, Musmusculus, Drosophila melanogaster, and Caenorhabditis elegans are used. These models help to comprehensively study the impact of the developed new drugs on the aging process. The model organism C. elegans is gaining increasing popularity in these studies because of its many advantages. This review article discusses the advantages of the nematode C. elegans as a model organism for studying the processes associated with aging. The influence of various BAS and plant extracts on the increase in the life span of the nematode, its stress resistance, and other markers of aging is also considered. The review shows that the nematode C.elegans has a number of advantages over other organisms and is a promising model system for studying the geroprotective properties of BAS.
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