Advances in geriatric medicine and research最新文献

The skeletal system is generated and maintained by its progenitors, skeletal stem cells (SSCs), across the duration of life. Gradual changes associated with aging result in significant differences in functionality of SSCs. Declines in bone and cartilage production, increase of bone marrow adipose tissue, compositional changes of cellular microenvironments, and subsequent deterioration of external and internal structures culminate in the aged and weakened skeleton. The features and mechanisms of skeletal aging, and of its stem and progenitor cells in particular, are topics of recent investigation. The discovery of functionally homogeneous SSC populations with a defined cell surface phenotype has allowed for closer inspection of aging in terms of its effects on transcriptional regulation, cell function, and identity. Here, we review the aspects of SSC aging on both micro- and macroscopic levels. Up-to-date knowledge of SSC biology and aging is presented, and directions for future research and potential therapies are discussed. The realm of SSC-mediated bone aging remains an important component of global health and a necessary facet in our understanding of human aging.

Advanced age escalates post-burn complications and older burn patients, and even those with relatively minor burns, have worse clinical outcomes after injury. While the mechanism(s) responsible for the compounding effects of age and burn injury have not been defined, in this viewpoint, we highlight the emerging data suggesting that age-mediated impairment of gut barrier integrity and dysbiosis of the fecal microbiome in older subjects may play a role in the heightened multi-organ responses seen in older patients. Studies aimed at exploring the contribution of intestinal dysfunction in age-related exacerbations of post-burn inflammatory responses could highlight novel therapeutic interventions that can be used to treat victims of burns and other traumatic injuries.

Loneliness imposes significant risks to physical, mental and brain health in older adulthood. With the social distancing regimes implemented during the COVID-19 pandemic, there is even greater urgency to understand the human health costs of social isolation. In this viewpoint we describe how the experience of loneliness may alter the structure and function of the human brain, and how these discoveries may guide public health policy to reduce the burden of loneliness in later life.

Every second of every day, an older adult suffers a fall in the United States (>30 million older adults fall each year). More than 20% of these falls cause serious injury (e.g., broken bones, head injury) and result in 800,000 hospitalizations and 30,000 deaths annually. Bhasin and colleagues recently reported results from a pragmatic, cluster-randomized trial designed to evaluate the effectiveness of a multifactorial intervention to prevent fall injuries. The intervention did not result in a significantly lower rate of a first adjudicated serious fall injury among older adults at increased risk for fall injuries as compared with enhanced usual care. In this commentary we briefly review and highlight these recent findings. Additionally, we argue that the findings should not be discounted just because of the lack of statistical significance. The approximately 10% reduction compared to enhanced usual care is, arguably, meaningful at both the individual and public health level, especially when one considers that the control group had better outcomes than expected based on prior work. Moreover, we encourage future research as well as practitioners to give strong consideration to the nuances of the exercise interventions for reducing falls and fall-related injuries particularly as it relates to exercise programming specifics, namely intensity and volume, to enhance neuromuscular function and also to neurorehabilitation approaches to enhance motor function (e.g., balance, motor planning, and coordination).

Understanding the role of genetic factors in non-Mendelian traits characteristic for post-reproductive life, herein referred to as age-related traits, is lagged behind the understanding of the genetic architecture of Mendelian traits. This lag calls for new, more comprehensive approaches in the analyses of age-related traits leveraging their characteristic features. This paper discusses the role of the inherent heterogeneity in genetic predisposition to age-related traits and pleiotropy. It shows that the comprehensive analyses leveraging such heterogeneity can substantially increase the efficiency and accelerate the progress in uncovering genetic predisposition to such traits.

Lower urinary tract (LUT) dysfunction is common in the older adult. Aging is associated with a number of both storage and voiding problems which are classified into syndromes with overlapping symptoms. Despite the prevalence and consequences of these syndromes, LUT disorders continue to be undertreated as few therapeutic options exist. Here, we propose that dysregulated metabolism of purine nucleotides results in an accumulation of uro-damaging hypoxanthine (a source of reactive oxygen species or ROS), which provides a mechanism for defects in sensory signaling and contractility, culminating in abnormal urodynamic behavior.

Platelets provide life-saving functions by halting external and internal bleeding. There is also a dark side to platelet biology, however. Recent reports provide evidence for increased platelet reactivity during aging of mice and humans, making platelets main suspects in the most prevalent aging-related human pathologies, including cardiovascular diseases, stroke, and cancer. What drives this platelet hyperreactivity during aging? Here, we discuss how hematopoietic stem cell differentiation pathways into the platelet lineage offer avenues to understand the fundamental differences between young and old platelets. Recent advances begin to unravel how the cellular and molecular regulation of the parent hematopoietic stem and progenitor cells likely imbue aging characteristics on the resulting Plt progeny. The resulting mechanistic insights into intrinsic platelet reactivity will provide strategies for selectively targeting age-related pathways. This brief viewpoint focuses on current concepts on aging hematopoiesis and the implications for platelet hyperactivity during aging.

Yoga, one of the world's oldest health systems is receiving new attention for claims that it can contribute to healthy aging. Until recently, scientific evidence for its efficacy has relied heavily on small and poorly-designed research, but this is changing. Multiple, well-designed studies provide data showing that yoga practice has positive effects on cellular aging, mobility, balance, mental health, and prevention of cognitive decline-all areas of concern for older adults. Since the cost of implementing yoga-based community and home-based interventions is low-policymakers are also eyeing yoga practice as a cost-effective way to reduce medical costs and improve outcomes among a growing aging population. This commentary reviews the evidence for both physical and mental health benefits from yoga, as well as concerns about injuries that have been associated with certain types of yoga practice. It reveals a surprising range of yoga programs and difficulty levels that provide opportunities for almost anyone to participate and gain health benefits with practice.