Gerontology最新文献

Introduction: Long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) has been shown to be involved in Parkinson's disease (PD) progression, but its mechanism needs to be further explored.

Methods: Mice were injected with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to induce PD mice models, and BV2 cells were treated with lipopolysaccharides (LPS) to mimic PD cell models. MALAT1 expression and suppressor of cytokine signaling 3 (SOCS3) protein level were examined using quantitative real-time PCR and Western blot, respectively. Cell functions were tested by cell counting kit 8 assay and flow cytometry. The interaction between MALAT1 and SOCS3 was confirmed using RNA pull-down and RIP assays.

Results: MALAT1 was upregulated in MPTP-induced PD mice and LPS-induced BV2 cells. Silencing of MALAT1 increased viability, while inhibiting apoptosis and inflammation in LPS-induced BV2 cells. Besides, MALAT1 enhanced the SOCS3 promoter methylation to decrease its expression by recruiting DNMT1, DNMT3A, and DNMT3B. Furthermore, SOCS3 knockdown eliminated sh-MALAT1-mediated the inhibition effect on LPS-induced BV2 cell injury. In vivo, MALAT1 silencing ameliorated neurological impairment and neuroinflammation in MPTP-induced PD mice.

Conclusion: Our data revealed that MALAT1 worsened PD processes via inhibiting SOCS3 expression by increasing its promoter methylation.

Introduction: Population aging and increasing long-term care needs call for designing and implementing better tools for assessing functional ability. In Chile, the Lawton and Brody (L&B) scale is used for identifying limitations with instrumental activities. This study compared the costs and acceptability of the L&B with a new instrument to measure instrumental activities of daily living (IADL): the Instrument for the Assessment of Functionality Stages (Instrumento de Evaluación de Estadios de Funcionalidad; IDEEF).

Methods: Phone surveys were carried out to apply the L&B and the IDEEF to a sample of 200 older people (60+) participating in public programs for older people in the Metropolitan Region, Chile. Besides the items assessed by each scale, the survey captured completion times and included a short questionnaire on acceptability, data that allowed comparisons between instruments.

Results: On average, the L&B takes around 4 min to be applied; the completion times for the IDEEF are 4 times longer. However, the IDEEF performs better in terms of acceptability and has neither gender bias nor dependency bias.

Conclusion: Both instruments have pros and cons, but the IDEEF appears as a feasible alternative to the L&B to improve the assessment of IADL in the country.

Introduction: Foot morphology in the general population has been shown to change with age, and active older adults have reported a need for wide-fitting footwear.

Methods: This study recruited 374 women active in racket sports and team sports in the UK who had their feet scanned while 50% weight bearing. Participants were grouped into 10-year age bands ranging from 18-29 years to 70-79 years. Data analysis was performed on the widths, heights, and circumferences of participants' right feet normalised to foot length, as well as an assessment of hallux valgus angle and deformity.

Results: The 18-29-year group had significantly smaller measures of foot width, ball of foot circumference and short heel circumference (p < 0.05, η2 = 0.042, η2 = 0.056) compared to the older groups. The foot dorsum height and circumference at 50% foot length were significantly less in the oldest age groups compared to the middle age groups (p = 0.0001, η2 = 0.055 and p = 0.0007, η2 = 0.044, respectively). There was some evidence of increased hallux valgus deformity with age.

Conclusion: Designers and manufacturers of athletic footwear should be aware of the changes in foot morphology with age in order to provide more inclusive footwear.

Background: Recently, the incidence of acute obstructive cholangitis caused by bile duct stones in patients aged 90 years and older (super-old) has been increasing, for which urgent endoscopic retrograde cholangiopancreatography (ERCP) treatment may be required. The aim of this study was to evaluate the efficacy and safety of urgent ERCP in super-old patients with acute cholangitis caused by bile duct stones.

Methods: A total 147 consecutive patients aged between 75 and 99 years who underwent urgent ERCP for acute cholangitis caused by bile duct stones were analyzed in a retrospective manner. They were divided into the old (age 75-89 years, control) and super-old (age 90-99 years) groups. Urgent ERCP efficacy and safety, including general status, ERCP-related findings and outcomes, cardiopulmonary monitoring during ERCP, and mortality, were compared between the groups.

Results: The physical status of the super-old group was worse than that of the old group. The success rates for biliary drainage and complete clearance of bile duct stones at the first attempt in the super-old group were lower as compared to the old group, while those after two attempts increased in the super-old group and were nearly the same as in the old group. No fatal cardiopulmonary complications during ERCP were observed in either group. Mortality rate within 2 months was higher in the super-old group, though recovered to the same level as in the old group after 2 months.

Conclusions: Efficacy and safety of urgent ERCP treatment in super-old patients were comparable to those seen in old patients, though the overall trend indicated greater difficulty. Urgent ERCP treatment can be useful for acute cholangitis caused by bile duct stones in super-old patients.

Background: Approximately one-third of adults over the age of 65 experience falls annually, with half resulting in injury. Peak bodies have recommended the use of fall-risk screening tools in the emergency department (ED) to identify patients requiring in-depth assessment and potential fall-prevention intervention. This study aimed to examine the scope of published studies on fall-risk screening tools used in the ED and evidence of associations between screening and future falls.

Summary: PubMed, Embase and CINAHL were searched for peer-reviewed journal articles published since 2012 that examined one or more screening tools to identify patient-level fall risk. Eligible studies described fall-risk tools applied in the ED. Data extracted included sample information, variables measured, and statistical analysis. Sixteen studies published since 2012 were included after full-text review. Fourteen unique screening tools were found. Eight tools were fall-risk screening tools, one tool was a functional screening tool, one tool was a frailty-screening tool, two tools were rapid physical tests, one tool was a trauma triage tool, and one tool was a component of a health-related quality-of-life measure. Studies that evaluated prognostic performance (n = 11) generally reported sensitivity higher than specificity. Previous falls (n = 10) and high-risk medications (n = 6) were consistently associated with future falls. Augmentation with additional variables from the electronic medical record (EMR) improved screening tool prognostic performance in one study.

Key messages: Current evidence on the association between the use of fall-risk screening tools in the ED for future falls consistently identifies previous falls and high-risk medications as associated with future falls. Comparison between tools is difficult due to different evaluation methods and different covariates measured. Augmentation of fall-risk screening using the EMR in the ED requires further investigation.

Comprehensive "senior-friendly hospital" (SFH)-programs have been developed to counteract negative health outcomes in hospitalized older adults. The aim of this narrative review was to provide an overview of published SFH-programs and their elements, and to summarize evidence of their effect on quality of care and patient satisfaction. A search of the databases Pubmed/Medline from inception to July 2023, and of governmental, regional and hospital websites was performed. Programs were earmarked as SFH-programs if they primarily focused on the hospital setting, and comprised a hospital-wide, multi-level approach and consisted of multiple elements. Articles and reports were included if participants were hospitalized and aged 60 years and older, and described the effect on quality of care or patient satisfaction. Articles focusing on specific patient groups or wards, or on a health system or network were excluded. Ten SFH-programs were identified, with mutual elements like 'organizational support', 'social climate and services', 'processes of care', and 'physical environment'. Only for the "Acute Care for Elders" program (USA), evidence was found showing positive effects on functional abilities, falls, delirium, length of stay, and patient satisfaction; effectiveness of other SFH-programs could not be found. Elements of SFH-programs may improve care for hospitalized older adults, but the evidence of their effectiveness is scarce.

Introduction: The association between specific motor capacity variables obtained in a laboratory and parameters of daily-life mobility performance (MP) obtained via wearables is still unclear. The Timed Up-and-Go (TUG) test is a widely used motor capacity tests available either as traditional hand-stopped TUG or as instrumented TUG (iTUG), providing specific information about its subphases. This study aimed to: (1) estimate the association between the TUG and specific parameters reflecting average and maximum daily-life MP, (2) estimate the benefits of the iTUG in terms of explaining MP in daily life compared to the TUG.

Methods: The present study was a cross-sectional analysis using baseline data of 294 older persons (mean age: 76.7 ± 5.3 years). Univariate linear regression analysis was performed to delineate the coefficient of determination between TUG time and participants' MP. MP variables containing mean cadence (MCA) to represent average performance and the 95th percentile of mean cadence of walks with more than three steps (p95>3stepsMCA) to represent maximum performance. To determine whether the iTUG variables give more information about MP, a stepwise multivariate regression analysis between iTUG variables and the p95>3stepsMCA variable to represent maximum performance was conducted.

Results: The univariate regression models revealed associations of the TUG with MCA (adjusted R2 = 0.078, p < 0.001) and p95>3stepsMCA (adjusted R2 = 0.199, p < 0.001). The multivariate stepwise regression models revealed a total explanation of maximum daily-life MP (p95>3stepsMCA) of the TUG (adjusted R2 = 0.199, p < 0.001) versus iTUG (adjusted R2 = 0.278, p < 0.010).

Discussion/conclusion: This study shows that the TUG better reflects maximum daily-life MP than average daily-life MP. Moreover, we demonstrate the added value of the iTUG for a more accurate estimation of daily MP compared to the traditional TUG. The iTUG is recommended to estimate maximum daily-life MP in fall-prone older adults. The study is a step toward a specific assessment paradigm using capacity variables from the iTUG to estimate maximum daily-life MP.