Advances in Gerontology最新文献

In spite of numerous studies, pathogenesis of the sporadic (not inherited) form of Alzheimer’s disease (AD) still remains largely unclear; nevertheless, there is general consensus as regards the complex involvement of neurotrophic factors and neurotransmitters in the mechanisms of this disease. In light of recent data on the physical interaction between serotonin (5-HT) receptors and receptors of the brain-derived neurotrophic factor (BDNF), the reciprocal modulation between 5-HT and BDNF systems is of particular interest, inter alia, in the context of AD development. The OXYS lineage of prematurely aging rats is a unique model of sporadic AD. Previously, it has been reported on the changed neurotrophin balance in the brain of these animals; however, the changes in the expression of BDNF and its receptors in the dynamics of development of AD symptoms has been studied insufficiently. Even less is known about the patterns of expression of 5-HT receptors in OXYS rat brain. In the present work, we have compared the expression of BDNF and its receptors, TrkB and p75^NTR, as well as serotonin 5-НТ_1А, 5-НТ_2А, 5-НТ₄ and 5-НТ₇ receptors in the brain of OXYS and Wistar rats aged 20 days, 3.5 and 18 months. The frontal cortex of 20-day-old OXYS rats demonstrated a significant increase in the mRNA level of the Bdnf, Htr2a and Htr7 genes and, at the same time, a decrease in the ratio of phosphorylated and nonphosphorylated forms of the TrkB receptor. In the hippocampus of 20-day-old OXYS rats, the mRNA levels of the Bdnf, Htr1a, Htr2a and Htr4 genes are also elevated. A substantially higher mRNA level of the above genes for 5-HT receptors was observed in the hippocampus of OXYS rats also at the age of 3.5 months, in the period of manifestation of the first AD symptoms. The nature of change in gene expression patterns indicates the potential involvement of 5-HT receptors in suppression of the TrkB receptor function in the early period of postnatal development of OXYS rats, which may be one of the mechanisms, through which 5-HT receptors are involved in the development of pathological process in the period of manifestation of AD symptoms in OXYS rats.

Circadian rhythms ensure the synchronization of the physiology of cells and tissues in accordance with daily changes in the environment. These rhythms are maintained by transcriptional oscillators located in various organism cells. One of the rhythm sensors for the circadian clock is the intake of nutrients, this synchronizer is especially important in peripheral tissues. With age, the work of both the central and peripheral clock is disturbed. In old age, the amplitude of rhythms decreases and the peaks of expression of clock genes shift. Such changes affect not only the circadian, but also other rhythms. Promising ways to maintain circadian rhythms are a variety of dietary patterns, including both calorie restriction, well known for its ability to prolong the lifespan of laboratory animals, and time-restricted feeding. It is now known that intracellular metabolic sensors are also involved in regulation of the circadian clock. Among these sensors, it should be especially noted AMPK, which coordinates many catabolic and anabolic processes and participates in the implementation of the effect of calorie restriction. It is assumed that non-drug modulation of AMPK activity will not only help fight metabolic disorders, but also maintain circadian rhythms. The review considers the role of AMPK and some other metabolic sensors in the regulation of the circadian clock.

The opposition between reductionism and holism can be seen as an overarching theme in the history of aging, longevity and rejuvenation research. As a rule, the initial fascination with reductionist rejuvenation and life extension attempts, striving to tweak and rearrange parts of the human “machine,” in time, is superseded with more holistic perceptions of health maintenance in old age, emphasizing hygienic regulation of behavior and the revitalizing power of the mind. The initial high hopes for dramatic reductionist rejuvenation are often succeeded by more skeptical and cautious visions, yet the optimism may return later on. The cycle of hopefulness will be exemplified by the works of some of the prominent French and German-speaking researchers of aging, in the first half of the 20th century. The present work (the second part in a sequence of two) will focus on the recoil process from reductionist toward holistic conceptual preferences, in this time and area. Several open philosophical and practical questions will be posed with reference to the opposition between reductionism and holism in the history of aging research and anti-aging practice.

The study investigated the effect of refraining from going out during the coronavirus disease 2019 pandemic on physical function in community-dwelling older adults. The study included 49 patients who underwent home-visit rehabilitation. Four parameters of physical function—grip strength, five-times sit-to-stand test, single-leg stance test, and standing test for imbalance and disequilibrium (SIDE)—were assessed. They were evaluated before (March 2020) and after (May 2020) the state emergency was imposed, and the results were compared. The grip strength decreased significantly. A significant difference was also observed in the proportion of different SIDE levels in the study group before and after the implementation of the state emergency. The number of SIDE 2a or lower patients increased during the state emergency (p < 0.001). Comprehensive community support and rehabilitation are necessary to maintain physical function in older individuals. In particular, we believe that there is a need to utilize remote rehabilitation using digital devices (such as internet-based guidance) so that older adults can continue to exercise at home.

As organs age morpho-functional changes of organs and tissues become pathological disrupting the quality of life and providing an aggravating effect on the course of underlying disease which requires a special treatment approach. The research purpose is the study of particular features of the clinical, immunological and morphological manifestations of the venous trophic ulcers in the elderly and senile aged patients. All 375 patients are suffering from venous trophic ulcers have been examined. All the patients are divided into three age groups according to the WHO classification: 1st group (middle-aged)—94 patients; 2nd group (elderly)—146 patients; 3rd group (seniors)—135 persons. Levels of IgA, IgG, IgM, IL-1β, TNF-α were measured in wound exudate. The content of vascular endothelial growth factor in wound exudate samples had been studied as well. The morphological examination of the bottom and edge parts of trophic ulcers has been carried out. It has been revealed that elderly and senile aged patients with involutional changes and long-term chronic inflammation in the zone of trophic ulcers had more prominent morphological changes and disruption synthesis of non-specific immunity proteins that slow down processes of recovery.

Based on available publications, the article systematizes information about some forms of lesions of the central nervous system (CNS), their pathogenesis and clinical manifestations in the case of COVID-19. The risk factors, mechanisms of development, diagnostic approach, and the age characteristics of patients with neurological complications of COVID-19 are discussed. The specific mechanisms of the neuroinvasiveness and neurovirulence of the SARS-CoV-2 virus, regardless of the age of patients and the presence of risk factors, lead to systemic damage to the endothelium of small-caliber vessels, generalized thrombovasculitis, and an increased risk of ischemic and hemorrhagic strokes. At the same time, the most vulnerable category is elderly and senile patients with cardiovascular and metabolic disorders (arterial hypertension, obesity, diabetes mellitus), which sharply worsen treatment outcomes. The clinical experience accumulated during the COVID-19 pandemic indicates the development of the following most frequent post-covid neurological complications and consequences in mainly elderly and senile patients: cranial mononeuropathies, chemosensory dysfunction, encephalopathy, insomnia, stroke, acute meningoencephalitis, acute disseminated encephalomyelitis, acute polyneuropathy Guillain–Barré syndrome, and transverse myelitis. The benefits of vaccination against COVID-19 far outweigh the risks of possible post-vaccination neurological complications and consequences, especially in elderly and senile patients.

The review presents the analysis of publications about the peculiarities of the manifestation of systemic lupus erythematosus (SLE) in individuals of older age groups. The probable reasons and mechanisms of the development of neurological manifestations of the disease are reflected in the work. The clinical pattern in elderly patients is described in detail and the peculiarities of immune indices are noted. This article considers different variants of nervous-system damage with SLE that differ in a wide spectrum of clinical manifestations. Neurobehavioral disorders with SLE are one of the least studied aspects and can be both a manifestation of the main disease (including those coinciding with the processes of immunoaging) and adverse events during the treatment. At the same time, knowledge of the peculiarities of neurological manifestations with SLE with its onset in late ontogenesis in comparison with the data of laboratory and instrumental methods of examination allow early diagnosis to be carried out and adequate therapy for elderly patients to be established in a timely manner.

The health of a population is an important indicator of the general well-being of the population, and it has its practical significance, as it determines the costs of providing care, and social and medical assistance for the elderly. The study presents an assessment of healthy life-expectancy indicators of people over age 65 based on the results of the Russian epidemiological study EVCALIPT and a comparison of this results with data from other surveys in Russia and European countries.

The article presents the results of the treatment of elderly and senile patients with complications of colon cancer, in the perioperative care of which a multidisciplinary approach is used. The peculiarity of patients of older age groups is caused by polymorbidity, the phenomenon of mutual burdening. This requires the use of a non-standard approach in the treatment of complicated colon cancer. A comparative analysis of the results of the treatment of 289 elderly and senile patients with complicated colon cancer with a traditional method and using a multidisciplinary approach is conducted. The patients are distributed into two groups (main and control). In addition to introducing the principles of a multidisciplinary approach, additional diagnostic methods for more specific determination of the type, severity of complications and functional operability are used in the main group. Taking into account the implementation of a multidisciplinary approach, the operations for patients of the main group are performed using endovideosurgical technologies. A more favorable course of the postoperative period with a decrease in post-surgical complications (from 44.9 to 27.8%) and mortality (from 8.9 to 5.3%) is noted in the group of patients, in which a multidisciplinary approach and modern methods of diagnostics and treatment are used.