Zeitschrift fur Alternsforschung最新文献

Just like in other organs, e.g. in the skin or in the supporting tissue, in the CNS too the reactions to diverse noxae or causes are always stereotyped. The mental or motor retardations are distinguished by a deterioration of the neuropils, especially by the recession of the dentritic branching and their spinae. Also during physiological aging the dendritic apparatus decreases. The neuropilic differences during physiological and pathological aging, however, are rather quantitative than qualitative ones. Dendritic proliferation as a compensation mechanism for neuron recession in old age is of particular importance.

Concerning 150 patients suffering from acute cerebrovascular insufficiency we asked the following questions: 1. How often did cardiac decompensation occur, 2. How often did hypertension and hypertrophic symptoms occur in the electrocardiogram, and 3. How often did arteriosclerosis of the cerebral and coronary vessels occur together in deceased patients? Among the patients examined were 47.3% who showed symptoms of cardiac decompensation. Hypertension was found in 60.7% of the patients. The combination of symptoms of hypertrophy in the electrocardiogram and cardiac dysrhythmia was registered 39 times (26.0%). Arteriosclerosis was found in 68.2% of the post-mortem examinations. A high correlation was found between the sclerosis of the intracranial cerebral vessels (65.9%) and the sclerosis of the coronaries (75.0%). The possibilities of the prevention and deceleration, resp., of cerebrovascular insufficiency by early therapy of hypertension and of cardiac decompensation are pointed out.

Based on a survey of different age theories, the complex character of the aging process is demonstrated in the experience of the individual as well as in its social connections (DORNER, 1988). On this basis the peculiarities of experiencing the disease and of mastering the disease by older patients with coronary heart disease are shown, taking various test results into account. Depending on experiencing the disease, but also depending on learned forms of mastering stress situations, different mastering mechanisms could be found with patients with angiocardiopathies which may be of decisive importance to the further rehabilitative success. Recommendations for the behaviour of the physician towards the old-aged patient with coronary heart disease are concluded.

Findings regarding the multi-infarction dementia in 34 long-lived persons from Sofia aged 92.4 years on average are introduced. The patients were observed until they died. Three clinical variants of multi-infarction dementia have been found (the lacunar variant, the amnestic variant, and the pseudoparalytic variant). The clinical peculiarities of the disease are stronger pronounced with physically active long-lived patients. In the terminal stage the patients approached the vegetative state. It is justified to speak of an unfavourable course of multi-infarction dementia in long-lived people.

The levels of serum total cholesterol, LDL- and HDL-cholesterol, triglycerides and apolipoprotein B were determined in urban and rural persons of Ethiopia in dependency on age. Regarding total and LDL cholesterol a comparable age-dependency as in the population of other countries is observed. On the other hand higher values of these parameters were found in the serum of urban persons in comparison with rural subjects which may be a reflection of the different life style.

Starting from the physiological involution processes and the pathophysiological disorders of the cardiological functions, performance-limiting factors have been worked out. Any physical conditioning taking the mentioned limiting factors into account may have a function-improving and performance-improving effect (extension of the performance amplitude, economization of master in loads, psychic stabilization, reduction of risk factors, etc.). In the planning and organization of physical conditioning specific methodical aspects for training have to be taken into account, for example, preferred endurance exercises (running, walking, swimming, etc.), physiological design of the training hours, individual level of intensity, and an indication-related planning of the extent of training. Furthermore, also contra-indication have to be observed which may restrict exercise tolerance (stage of performance, regulation of blood pressure, dysrhythmia, etc.).

The percentage of older patients with AMI in the total of patients is predominating and is still increasing differentiatedly. The essential cause of there is an increase in complications and in mortality until the 28th day. In a prospective study over 48 months with n = 390 patients we analyzed the age groups less than 65 years (A) and greater than or equal to 65 years (B) regarding their different rates of complications. For the semiquantitative determination of myocardial infarction sizes we used: -Monitoring of ECG, creatinine kinase (CK), and ejection fraction global (EFg). In group A 81% survived, whereas in group B only 60% survived. The average age of the surviving patients was 56.2 years, that of the deceased 64.4 years. The percentage of surviving patients with transmural AMI was 96% in A and 57% in B. In both A and B. CKmax with p less than 0.01 was to be differentiated between non-transmural and transmural AMI. In the deceased CKmax was 89.7 (A) to 59.3 mumol/lxs (B) (p less than 0.05). The percentage with AMI extension was 4% in A and 43% in B, p less than 0.005. Patients of group B showed a significant difference (p less than 0.001) of EFg for non-transmural AMI 59.1 (36-70)%, transmural AMI 31.5%, and deceased 17.3%. In patients with Re-AMI EFg was generally measured to be less than 45%. Re-AMI could be diagnosed in 13% of A and in 29% of B (p less than 0.001). The ICU stay of the surviving patients of the total number of patients could be reduced by 1.1 days in the period from 1984 through 1987. With group B it could be reduced by 0.8 days. The overall stay in hospital (1984-1987) was 19.6 days (A = 18.3; B = 22.4). AMI extension and the Re-AMI result are the decivise factors to the essential increase in complications and cases of death with AMI at older age. The semiquantitative determination of the myocardial infarction size by monitoring makes up an efficient basis for the early assessment of the residual function of the myocardium and of the risk classification.

Results on fitness and exercise tolerance of patients undergoing rehabilitation after myocardial infarction are shown in dependence on age. The fitness data of the patients recovering from myocardial infarction can be classified with the lower reference region of untrained normal populations and are subject to the same regularities in the ageing process. For sports therapy a versatile endurance training with average blood lactate concentrations of 2.5-3.5 mmol/l is recommended. The greater strain on the aerobic-anaerobic metabolism in older infarction patients during sports therapy emphasizes the necessity of the age-specific design of exercises.