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Loneliness and older adults: psychological resilience and technology use during the COVID-19 pandemic-a cross sectional study. 孤独与老年人:2019冠状病毒病大流行期间的心理弹性和技术使用——一项横断面研究
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1184386
Eric Balki, Niall Hayes, Carol Holland

Introduction: This study investigated how psychological resilience influenced greater technology use among older adults, and whether they moderated the impact of social isolation on loneliness during the COVID-19 pandemic. We also explored whether technology mediates the impact of psychological resilience on loneliness. To explain the relationship between variables, the research drew upon the socio-emotional selective theory, which posits the notion that older adults are more focused on current and emotionally important relationships and goals concerning emotional regulation goals such as psychological well-being. Methods: Using a cross-sectional observational design, data were collected from 92 residents aged 65 to 89 in England from March 2020 to June 2021. Participants completed the Connor-Davidson Resilience Scale, Technology Experience Questionnaire, UCLA Loneliness Scale, and Lubben Social Network Index. Pearson correlation, mediation and moderation analyses were conducted to investigate the hypotheses. Results: Most participants experienced moderate to severe levels of loneliness, displaying higher levels than pre-pandemic. Psychological resilience predicted greater technology use, and lower levels of loneliness. Technology was found to mediate the relationship between psychological resilience and loneliness. Neither technology use, nor psychological resilience was found to moderate the impact of social isolation on loneliness. Discussion: Findings suggested that strategies directed towards screening older adults for psychological resilience levels and low technology experience may help identify those most at risk for adapting poorly when exposed to stressors in situations like the Covid-19 pandemic. Early interventions can be initiated to increase psychological resilience and technology use, including empirical interventions, that may help decrease loneliness, especially in times of elevated risks for loneliness.

本研究调查了心理弹性如何影响老年人更多地使用技术,以及它们是否缓解了2019冠状病毒病大流行期间社会隔离对孤独感的影响。我们还探讨了技术是否介导心理弹性对孤独感的影响。为了解释变量之间的关系,该研究借鉴了社会情感选择理论,该理论认为,老年人更关注当前和情感上重要的关系,以及与心理健康等情绪调节目标有关的目标。方法:采用横断面观察设计,收集2020年3月至2021年6月期间英格兰92名年龄在65至89岁之间的居民的数据。受试者完成了康诺-戴维森弹性量表、技术体验问卷、加州大学洛杉矶分校孤独感量表和鲁本社会网络指数。采用Pearson相关分析、中介分析和调节分析对假设进行检验。结果:大多数参与者经历了中度至重度的孤独感,表现出比大流行前更高的水平。心理弹性预示着更多的技术使用和更低的孤独感。研究发现,技术在心理弹性和孤独感之间起中介作用。研究发现,技术使用和心理弹性都不能缓和社会孤立对孤独感的影响。讨论:研究结果表明,针对老年人的心理弹性水平和低技术经验进行筛查的策略,可能有助于确定那些在面临Covid-19大流行等压力源时最容易适应不良的人。早期干预可以提高心理弹性和技术使用,包括经验性干预,这可能有助于减少孤独感,特别是在孤独感风险增加的时候。
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引用次数: 1
Feasibility of a pilot dyadic randomized controlled trial testing the effects of three behavioral interventions on older adults' cognitive, physical and everyday function. 一项测试三种行为干预对老年人认知、身体和日常功能影响的二元随机对照试验的可行性。
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1166338
Christine B Phillips, Ava McVey, Junyan Tian, Abigail T Stephan, W Bennett Davis, Erica L Aflagah, Lesley A Ross

Introduction: Maintaining functional abilities is critical for optimizing older adults' well-being and independence. This randomized controlled trial (RCT) pilot examined the feasibility of testing the effects of three commercially available interventions on function-related outcomes in older adults. Methods: Pairs of community-dwelling older adults (N=55, Mage=71.4) were randomized to a 10-week intervention (cognitive-COG, physical-EX, combined exergame-EXCOG, or control-CON). Cognitive, physical, and everyday function were assessed at baseline, immediately post-intervention, and 6-months post-intervention. Feasibility was evaluated using recruitment, enrollment, training adherence, and retention metrics. Variability and patterns of change in functional outcomes were examined descriptively. Results: A total of 208 individuals were screened, with 26% subsequently randomized. Across training arms, 95% of training sessions were completed and 89% of participants were retained at immediate post-test. Variability in functional outcomes and patterns of change differed across study arms. Discussion: Results support a fully powered RCT, with several modifications to the pilot study design, to investigate short- and long-term training impacts.

简介:维持功能能力对于优化老年人的福祉和独立性至关重要。本随机对照试验(RCT)试点研究了测试三种市售干预措施对老年人功能相关结果影响的可行性。方法:对居住在社区的老年人(N=55, Mage=71.4)进行为期10周的随机干预(认知- cog、身体- ex、游戏- excog联合干预或对照- con)。在基线、干预后立即和干预后6个月评估认知、身体和日常功能。可行性通过招募、注册、培训依从性和保留指标进行评估。描述性地检查了功能结果的变异性和变化模式。结果:总共筛查了208人,其中26%随后被随机化。在整个训练组中,95%的训练课程完成,89%的参与者在测试后立即保留。在不同的研究组中,功能结果和变化模式的可变性有所不同。讨论:结果支持全动力随机对照试验,对试点研究设计进行了一些修改,以调查短期和长期训练的影响。
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引用次数: 0
Prioritizing research on over-the-counter (OTC) hearing aids for age-related hearing loss. 优先研究非处方助听器(OTC)治疗与年龄相关的听力损失。
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1105879
Vinaya Manchaiah, De Wet Swanepoel, Anu Sharma

Hearing aids are the most commonly used treatment for people with age-related hearing loss, however, hearing aid uptake is low, primarily due to high cost of the device, stigma, and a lack of perceived need. To address accessibility and affordability issues, the U.S. Food and Drug Administration created a new over-the-counter (OTC) hearing aid category. Various types of hearing devices are available for both individuals with hearing loss and for those with normal hearing, as hearing enhancement devices. Hearing aids (i.e., prescription hearing aids, self-fitting OTC hearing aids, and pre-set OTC hearing aids) are regulated by the FDA. The purpose of this article is to (a) provide a summary of existing research on direct-to-consumer (DTC) hearing devices such as Personal Sound Amplification Products (PSAPs) that informs OTC service delivery models; (b) provide an update on existing and ongoing randomized controlled trials on currently marketed OTC hearing aids; and (c) highlight the need for immediate research on OTC hearing aids and service delivery models to inform policy and clinical care. It remains to be seen what effect OTC hearing aids have on improving the uptake of hearing aids by individuals with mild-to-moderate hearing loss. However, there is scant research on all aspects of OTC hearing aids that are currently on the market. We conclude that high quality independent research must be prioritized to supplement evidence provided by the OTC hearing aid manufacturers for regulatory approval purposes.

助听器是与年龄相关的听力损失患者最常用的治疗方法,然而,助听器的使用率很低,主要是由于设备的高成本,耻辱感和缺乏感知需求。为了解决可获得性和可负担性问题,美国食品和药物管理局创建了一个新的非处方(OTC)助听器类别。听力损失人士和听力正常人士均可使用不同类型的助听器作为听力增强设备。助听器(即处方助听器、自配OTC助听器和预先设置OTC助听器)由FDA监管。本文的目的是(a)对直接面向消费者(DTC)的听力设备(如个人声音放大产品(psap))的现有研究进行总结,这些设备为OTC服务提供模式提供了信息;(b)提供目前已上市的非处方药助听器的现有和正在进行的随机对照试验的最新情况;(c)强调需要立即研究非处方助听器和服务提供模式,以便为政策和临床护理提供信息。OTC助听器对改善轻度至中度听力损失患者使用助听器的效果仍有待观察。然而,对目前市场上的OTC助听器的各个方面的研究很少。我们的结论是,必须优先考虑高质量的独立研究,以补充OTC助听器制造商提供的证据,以获得监管批准。
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引用次数: 2
Does the blunted stimulation of skeletal muscle protein synthesis by aging in response to mechanical load result from impaired ribosome biogenesis? 老化对骨骼肌蛋白质合成的钝化刺激是对机械负荷的反应,是核糖体生物发生受损的结果吗?
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1171850
Thomas Chaillou, Diego Montiel-Rojas

Age-related loss of skeletal muscle mass leads to a reduction of strength. It is likely due to an inadequate stimulation of muscle protein synthesis (MPS) in response to anabolic stimuli, such as mechanical load. Ribosome biogenesis is a major determinant of translational capacity and is essential for the control of muscle mass. This mini-review aims to put forth the hypothesis that ribosome biogenesis is impaired by aging in response to mechanical load, which could contribute to the age-related anabolic resistance and progressive muscle atrophy. Recent animal studies indicate that aging impedes muscle hypertrophic response to mechanical overload. This is associated with an impaired transcription of ribosomal DNA (rDNA) by RNA polymerase I (Pol I), a limited increase in total RNA concentration, a blunted activation of AKT/mTOR pathway, and an increased phosphorylation of AMPK. In contrast, an age-mediated impairment of ribosome biogenesis is unlikely in response to electrical stimulations. In human, the hypertrophic response to resistance exercise training is diminished with age. This is accompanied by a deficit in long-term MPS and an absence of increased total RNA concentration. The results addressing the acute response to resistance exercise suggest an impaired Pol I-mediated rDNA transcription and attenuated activation/expression of several upstream regulators of ribosome biogenesis in muscles from aged individuals. Altogether, emerging evidence indicates that impaired ribosome biogenesis could partly explain age-related anabolic resistance to mechanical load, which may ultimately contribute to progressive muscle atrophy. Future research should develop more advanced molecular tools to provide in-depth analysis of muscle ribosome biogenesis.

与年龄相关的骨骼肌质量损失导致力量下降。这可能是由于肌肉蛋白质合成(MPS)在响应合成代谢刺激(如机械负荷)时刺激不足所致。核糖体的生物发生是翻译能力的主要决定因素,对肌肉质量的控制至关重要。这篇综述旨在提出核糖体生物发生因机械负荷的老化而受损的假设,这可能导致与年龄相关的合成代谢抵抗和进行性肌肉萎缩。最近的动物研究表明,衰老会阻碍肌肉对机械负荷的肥厚反应。这与RNA聚合酶I (Pol I)对核糖体DNA (rDNA)的转录受损、总RNA浓度的有限增加、AKT/mTOR通路的激活减弱以及AMPK磷酸化增加有关。相反,年龄介导的核糖体生物发生损伤不太可能是对电刺激的反应。在人类中,抗阻运动训练的肥厚反应随着年龄的增长而减弱。这伴随着长期MPS的缺陷和总RNA浓度增加的缺失。研究结果表明,老年人肌肉中Pol i介导的rDNA转录受损,核糖体生物发生的几个上游调节因子的激活/表达减弱。总之,新出现的证据表明,核糖体生物发生受损可以部分解释与年龄相关的合成代谢抵抗机械负荷,这可能最终导致进行性肌肉萎缩。未来的研究应开发更先进的分子工具来深入分析肌肉核糖体的生物发生。
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引用次数: 1
Impact of hearing aid technology level at first-fit on self-reported outcomes in patients with presbycusis: a randomized controlled trial. 助听器技术水平对老年性耳聋患者自我报告结果的影响:一项随机对照试验。
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1158272
Sabina Storbjerg Houmøller, Anne Wolff, Li-Tang Tsai, Sreeram Kaithali Narayanan, Dan Dupont Hougaard, Michael Lyhne Gaihede, Tobias Neher, Christian Godballe, Jesper Hvass Schmidt

To provide clinical guidance in hearing aid prescription for older adults with presbycusis, we investigated differences in self-reported hearing abilities and hearing aid effectiveness for premium or basic hearing aid users. Secondly, as an explorative analysis, we investigated if differences in gain prescription verified with real-ear measurements explain differences in self-reported outcomes. The study was designed as a randomized controlled trial in which the patients were blinded towards the purpose of the study. In total, 190 first-time hearing aid users (>60 years of age) with symmetric bilateral presbycusis were fitted with either a premium or basic hearing aid. The randomization was stratified on age, sex, and word recognition score. Two outcome questionnaires were distributed: the International Outcome Inventory for Hearing Aids (IOI-HA) and the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ-12). In addition, insertion gains were calculated from real-ear measurements at first-fit for all fitted hearing aids. Premium hearing aid users reported 0.7 (95%CI: 0.2; 1.1) scale points higher total SSQ-12 score per item and 0.8 (95%CI: 0.2; 1.4) scale points higher speech score per item, as well as 0.6 (95%CI: 0.2; 1.1) scale points higher qualities score compared to basic-feature hearing aid users. No significant differences in reported hearing aid effectiveness were found using the IOI-HA. Differences in the prescribed gain at 1 and 2 kHz were observed between premium and basic hearing aids within each company. Premium-feature devices yielded slightly better self-reported hearing abilities than basic-feature devices, but a statistically significant difference was only found in three out of seven outcome variables, and the effect was small. The generalizability of the study is limited to community-dwelling older adults with presbycusis. Thus, further research is needed for understanding the potential effects of hearing aid technology for other populations. Hearing care providers should continue to insist on research to support the choice of more costly premium technologies when prescribing hearing aids for older adults with presbycusis. Clinical Trial Registration: https://register.clinicaltrials.gov/, identifier NCT04539847.

为了给老年老年性耳聋患者的助听器处方提供临床指导,我们调查了高级助听器使用者和基本助听器使用者自我报告的听力能力和助听器效果的差异。其次,作为一项探索性分析,我们调查了经实耳测量验证的增益处方差异是否解释了自我报告结果的差异。该研究被设计为随机对照试验,其中患者对研究目的不知情。共有190名首次使用助听器(>60岁)的对称双侧老年性耳聋患者配戴了高级助听器或基本助听器。随机分组按年龄、性别和单词识别评分分层。发放了两份结果问卷:国际助听器结果清单(IOI-HA)和简短形式的语音、空间和听力质量量表(SSQ-12)。此外,所有助听器的插入增益都是通过首次配合时的实耳测量来计算的。高级助听器使用者报告0.7 (95%CI: 0.2;1.1) SSQ-12单项总分提高0.8分(95%CI: 0.2;1.4)量表分每项言语得分更高,以及0.6 (95%CI: 0.2;1.1)与基本功能助听器使用者相比,听力质量得分更高。使用IOI-HA的助听器有效性报告没有显着差异。在每个公司的高级助听器和基本助听器之间观察到1和2 kHz规定增益的差异。高级功能设备的自我报告听力能力略好于基本功能设备,但在7个结果变量中只有3个存在统计学上的显著差异,而且影响很小。该研究的普遍性仅限于居住在社区的老年性痴呆老年人。因此,需要进一步的研究来了解助听器技术对其他人群的潜在影响。听力保健提供者应继续坚持研究,以支持在为患有老年性耳聋的老年人开具助听器处方时选择更昂贵的优质技术。临床试验注册:https://register.clinicaltrials.gov/,标识符NCT04539847。
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引用次数: 0
Association of dietary patterns and sarcopenia in the elderly population: a cross-sectional study. 老年人饮食模式与肌肉减少症的关系:一项横断面研究。
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1239945
Boshi Wang, Yanan Wei, Lin Shao, Menghan Li, Xue Zhang, Wei Li, Shilong Zhao, Xin Xia, Peng Liu

Background: Sarcopenia, defined as the loss of muscle mass and strength, has been associated with increased hospitalization and mortality. Dietary pattern analysis is a whole diet approach which in this study was used to investigate the relationship between diet and sarcopenia. This study aims to estimate the prevalence of sarcopenia and explore possible factors associated with it among a large population in Beijing, China. Methods: A cross-sectional study with 1,059 participants aged more than 50 years was performed. Sarcopenia was defined based on the guidelines of the Asian Working Group for Sarcopenia. The total score of the MNA-SF questionnaire was used to analyse nutrition status. The baseline demographic information, diet structure and eating habits were collected by clinicians trained in questionnaire data collection and anthropometric and bioimpedance measurements. Results: The overall prevalence of sarcopenia was 8.8% and increased with age: 5%, 5.8%, 10.3% and 26.2% in the 50-59, 60-69, 70-79, and ≥80 years groups, respectively. Marital status (with or without a spouse) was not an independent factor associated with sarcopenia adjusted by age and sex. However, nutritional risk or malnutrition, vegetable diet, advanced age and spicy eating habits were risk factors for sarcopenia. Meanwhile, daily fruit, dairy and nut consumption were protective factors against sarcopenia adjusted by age, sex, income status and spouse status. Conclusion: Although further studies are required to explore the association between healthy dietary patterns and the risk of sarcopenia, the present study provides basic data for identifying correlates of sarcopenia in elderly Chinese individual.

背景:肌肉减少症,定义为肌肉质量和力量的损失,与住院率和死亡率增加有关。饮食模式分析是一种整体饮食方法,在本研究中用于研究饮食与肌肉减少症之间的关系。本研究旨在估计中国北京大量人群中肌肉减少症的患病率,并探讨与之相关的可能因素。方法:对1059名年龄在50岁以上的参与者进行横断面研究。肌少症是根据亚洲肌少症工作组的指南定义的。采用MNA-SF问卷总分分析营养状况。基线人口统计信息、饮食结构和饮食习惯由接受过问卷数据收集、人体测量和生物阻抗测量培训的临床医生收集。结果:骨骼肌减少症的总患病率为8.8%,随年龄增长而增加:50-59岁、60-69岁、70-79岁和≥80岁组分别为5%、5.8%、10.3%和26.2%。根据年龄和性别调整,婚姻状况(有无配偶)不是与肌肉减少症相关的独立因素。然而,营养风险或营养不良、蔬菜饮食、高龄和辛辣饮食习惯是肌肉减少症的危险因素。同时,受年龄、性别、收入状况和配偶状况的影响,每日水果、乳制品和坚果的摄入量是预防肌肉减少症的保护因素。结论:虽然健康饮食模式与骨骼肌减少症风险之间的关系尚需进一步研究,但本研究为识别中国老年人骨骼肌减少症的相关因素提供了基础数据。
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引用次数: 0
Markers of aging: Unsupervised integrated analyses of the human plasma proteome. 衰老的标记:人类血浆蛋白质组的无监督综合分析。
Q2 GERIATRICS & GERONTOLOGY Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1112109
L Coenen, B Lehallier, H E de Vries, J Middeldorp

Aging associates with an increased susceptibility for disease and decreased quality of life. To date, processes underlying aging are still not well understood, leading to limited interventions with unknown mechanisms to promote healthy aging. Previous research suggests that changes in the blood proteome are reflective of age-associated phenotypes such as frailty. Moreover, experimentally induced changes in the blood proteome composition can accelerate or decelerate underlying aging processes. The aim of this study is to identify a set of proteins in the human plasma associated with aging by integration of the data of four independent, large-scaled datasets using the aptamer-based SomaScan platform on the human aging plasma proteome. Using this approach, we identified a set of 273 plasma proteins significantly associated with aging (aging proteins, APs) across these cohorts consisting of healthy individuals and individuals with comorbidities and highlight their biological functions. We validated the age-associated effects in an independent study using a centenarian population, showing highly concordant effects. Our results suggest that APs are more associated to diseases than other plasma proteins. Plasma levels of APs can predict chronological age, and a reduced selection of 15 APs can still predict individuals' age accurately, highlighting their potential as biomarkers of aging processes. Furthermore, we show that individuals presenting accelerated or decelerated aging based on their plasma proteome, respectively have a more aged or younger systemic environment. These results provide novel insights in the understanding of the aging process and its underlying mechanisms and highlight potential modulators contributing to healthy aging.

衰老与疾病易感性增加和生活质量下降有关。迄今为止,衰老背后的过程仍然没有得到很好的理解,导致有限的干预措施和未知的机制,以促进健康老龄化。先前的研究表明,血液蛋白质组的变化反映了与年龄相关的表型,如虚弱。此外,实验诱导的血液蛋白质组组成的变化可以加速或减缓潜在的衰老过程。本研究的目的是利用基于适配体的SomaScan平台,通过整合四个独立的大规模数据集,在人类衰老血浆蛋白质组中识别一组与衰老相关的蛋白质。使用这种方法,我们在这些由健康个体和合并症个体组成的队列中确定了273种与衰老显著相关的血浆蛋白(衰老蛋白,APs),并强调了它们的生物学功能。我们在一项使用百岁老人人群的独立研究中验证了年龄相关效应,显示出高度一致的效应。我们的研究结果表明,与其他血浆蛋白相比,APs与疾病的关联更大。血浆ap水平可以预测实际年龄,减少15个ap的选择仍然可以准确预测个体的年龄,突出了它们作为衰老过程生物标志物的潜力。此外,我们发现基于血浆蛋白质组的加速或减缓衰老的个体分别具有更衰老或更年轻的系统环境。这些结果为理解衰老过程及其潜在机制提供了新的见解,并突出了有助于健康衰老的潜在调节剂。
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引用次数: 3
The time-course linkage between hemolysis, redox, and metabolic parameters during red blood cell storage with or without uric acid and ascorbic acid supplementation. 红细胞储存过程中溶血、氧化还原和代谢参数与补充或不补充尿酸和抗坏血酸之间的时间过程联系。
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1161565
Alkmini T Anastasiadi, Konstantinos Stamoulis, Effie G Papageorgiou, Veronica Lelli, Sara Rinalducci, Issidora S Papassideri, Anastasios G Kriebardis, Marianna H Antonelou, Vassilis L Tzounakas

Oxidative phenomena are considered to lie at the root of the accelerated senescence observed in red blood cells (RBCs) stored under standard blood bank conditions. It was recently shown that the addition of uric (UA) and/or ascorbic acid (AA) to the preservative medium beneficially impacts the storability features of RBCs related to the handling of pro-oxidant triggers. This study constitutes the next step, aiming to examine the links between hemolysis, redox, and metabolic parameters in control and supplemented RBC units of different storage times. For this purpose, a paired correlation analysis of physiological and metabolism parameters was performed between early, middle, and late storage in each subgroup. Strong and repeated correlations were observed throughout storage in most hemolysis parameters, as well as in reactive oxygen species (ROS) and lipid peroxidation, suggesting that these features constitute donor-signatures, unaffected by the diverse storage solutions. Moreover, during storage, a general "dialogue" was observed between parameters of the same category (e.g., cell fragilities and hemolysis or lipid peroxidation and ROS), highlighting their interdependence. In all groups, extracellular antioxidant capacity, proteasomal activity, and glutathione precursors of preceding time points anticorrelated with oxidative stress lesions of upcoming ones. In the case of supplemented units, factors responsible for glutathione synthesis varied proportionally to the levels of glutathione itself. The current findings support that UA and AA addition reroutes the metabolism to induce glutathione production, and additionally provide mechanistic insight and footing to examine novel storage optimization strategies.

氧化现象被认为是在标准血库条件下储存的红细胞(rbc)中观察到的加速衰老的根源。最近的研究表明,在保存介质中添加尿酸(UA)和/或抗坏血酸(AA)有利于影响红细胞的储存特性,这些特性与处理促氧化剂触发因素有关。这项研究是下一步,旨在研究不同储存时间的对照和补充红细胞单位的溶血、氧化还原和代谢参数之间的联系。为此,对每个亚组的早、中、晚贮藏的生理和代谢参数进行了配对相关分析。在整个存储过程中,大多数溶血参数以及活性氧(ROS)和脂质过氧化都观察到强烈且重复的相关性,这表明这些特征构成了供体特征,不受不同存储溶液的影响。此外,在储存过程中,同一类别的参数(如细胞脆弱性和溶血或脂质过氧化和ROS)之间普遍存在“对话”,突出了它们之间的相互依赖性。在所有组中,前时间点的细胞外抗氧化能力、蛋白酶体活性和谷胱甘肽前体与即将到来的氧化应激损伤呈负相关。在补充单位的情况下,负责谷胱甘肽合成的因素与谷胱甘肽本身的水平成比例地变化。目前的研究结果支持UA和AA添加改变代谢诱导谷胱甘肽的产生,并为研究新的储存优化策略提供了机制见解和基础。
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引用次数: 0
Long-term care units: a Portuguese study about the functional profile. 长期护理单位:一项关于功能概况的葡萄牙研究。
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1192718
César Fonseca, Ana Ramos, Bruno Morgado, Paulo Quaresma, José Garcia-Alonso, Anabela Coelho, Manuel Lopes

Aim: In this study, we analyze the relationship between the functional profile of older people admitted to long-term care units in Portugal and some demographic variables such as education level, sex, and age as well as the emotional state of mind. Methods: A sample of 59,516 older people from the National Network of Integrated Continuous Care of Portugal were analyzed in this longitudinal study. All the retrospective data of the older people were collected during the period of hospitalization at the long-term care units. The database records of these units were analyzed, and a functional profile spanning the period of hospitalization was calculated. Results: Activities of daily living and cognitive states improved, in the first 90 days of hospitalization, while mobility and instrumental activities of daily living worsened for the same period of 90 days. Generally, there was a decline in all domains after 450 days of hospitalization. The older women that did not attend school, those over 85 years old, and those who suffered from anxiety were pre-dominantly placed in the group of those with greater dependence (severe/complete dependence). Conclusion: The participants hospitalized between 90 and 360 days presented the best results in the long-term care units of the National Network of Integrated Continuous Care of Portugal. With this study, we highlight the importance of evaluating the functional status of persons in long-term hospitalizations and the influence exerted by the level of education on the recovery and rehabilitation of dependence.

目的:在本研究中,我们分析了葡萄牙长期护理单位老年人的功能特征与一些人口统计变量(如教育水平、性别、年龄以及情绪状态)之间的关系。方法:在这项纵向研究中,对来自葡萄牙国家综合连续护理网络的59,516名老年人进行了分析。所有老年人的回顾性数据均收集于长期护理病房住院期间。分析了这些单位的数据库记录,并计算了跨越住院期间的功能概况。结果:患者在入院前90天的日常生活活动和认知状态均有所改善,而在入院前90天的同一时间内,患者的日常生活活动能力和工具活动能力均有所下降。一般来说,在住院450天后,所有领域都有所下降。未上学的老年妇女、85岁以上的妇女和患有焦虑症的妇女主要被置于依赖程度较高(严重/完全依赖)的群体中。结论:住院90至360天的参与者在葡萄牙国家综合连续护理网络的长期护理单位中表现出最佳效果。通过这项研究,我们强调了评估长期住院患者功能状态的重要性,以及教育水平对依赖恢复和康复的影响。
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引用次数: 0
Discrepancies in perception of fall risk between patients with subacute stroke and physical therapists in a rehabilitation hospital: a retrospective cohort study. 亚急性脑卒中患者与康复医院物理治疗师对跌倒风险感知的差异:一项回顾性队列研究
Pub Date : 2023-01-01 DOI: 10.3389/fragi.2023.1204488
Seigo Inoue, Yohei Otaka, Yukari Horimoto, Hidehiko Shirooka, Masafumi Sugasawa, Kunitsugu Kondo

Objective: Falls are one of the most common complications of a stroke. This study aimed to clarify the discrepancy between the perceived fall risk of hospitalized patients with stroke and the clinical judgment of physical therapists and to examine the changes in discrepancy during hospitalization. Design: Retrospective cohort study. Patients: This study included 426 patients with stroke admitted to a Japanese convalescent rehabilitation hospital between January 2019 and December 2020. Methods: The Falls Efficacy Scale-International was used to assess both patients' and physical therapists' perception of fall risk. The difference in Falls Efficacy Scale-International scores assessed by patients and physical therapists was defined as the discrepancy in fall risk, and its association with the incidence of falls during hospitalization was investigated. Results: Patients had a lower perception of fall risk than physical therapists at admission (p < 0.001), and this trend continued at discharge (p < 0.001). The discrepancy in fall risk perception was reduced at discharge for non-fallers and single fallers (p < 0.001), whereas the difference remained in multiple fallers. Conclusion: Unlike physical therapists, patients underestimated their fall risk, especially patients who experienced multiple falls. These results may be useful for planning measures to prevent falls during hospitalization.

目的:跌倒是中风最常见的并发症之一。本研究旨在厘清住院脑卒中患者跌倒风险感知与物理治疗师临床判断之间的差异,并探讨差异在住院期间的变化。设计:回顾性队列研究。患者:该研究包括2019年1月至2020年12月期间入住日本一家康复康复医院的426名中风患者。方法:采用国际跌倒疗效量表评估患者和物理治疗师对跌倒风险的感知。由患者和物理治疗师评估的跌倒疗效量表-国际评分的差异被定义为跌倒风险的差异,并研究其与住院期间跌倒发生率的关系。结果:入院时患者对跌倒风险的感知低于物理治疗师(p < 0.001),出院时这种趋势持续(p < 0.001)。非跌倒者和单跌倒者在出院时跌倒风险感知的差异减小(p < 0.001),而多跌倒者的差异仍然存在。结论:与物理治疗师不同,患者低估了自己的跌倒风险,尤其是多次跌倒的患者。这些结果可能有助于制定预防住院期间跌倒的措施。
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引用次数: 1
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Frontiers in aging
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