Aging Clinical and Experimental Research最新文献

Background

The presence of frailty is common in people with Parkinson’s disease, as is cognitive dysfunction. Previous research on frailty has focused on the physical aspects of the pathology.

Aims

To analyze the relationship between frailty and cognitive impairment in patients with Parkinson’s disease and to know which disease characteristics are associated with frailty.

Methods

An observational, correlational and cross-sectional study was conducted. Participants were recruited from a Home Rehabilitation Service and two Parkinson’s Associations. An individualized assessment was carried out by means of a structured interview. Frailty was assessed with the Fried scale and cognitive function with the Mini Mental State Examination and the Parkinson’s Disease Cognitive Rating Scale.

Results

90 patients were recruited, 60% men, with a mean age of 73.50 (6.71) years. Frailty was associated with age and disease severity (p < 0.05). Frail patients presented worse cognitive performance relative to pre-frail and robust patients. A negative correlation (coefficient − 0.503) was observed between frailty and measures of patients’ cognitive function (p < 0.05).

Discussion

The coexistence of frailty and cognitive impairment should be assessed, as PD patients with both conditions are more vulnerable and have a higher chance of experiencing adverse effects.

Conclusion

Frail patients with Parkinson’s disease present an impairment of cognitive functions dependent on cortical and subcortical regions, being these regions more preserved in the case of robust. The development of programs for early detection of frailty and cognitive function in these patients is necessary to implement strategic intervention plans focused on reversing frailty and cognitive impairment.

Protocol registration number

http://www.ClinicalTrials.gov ID: NCT05388526.

Recent discoveries indicating that the brain retains its ability to adapt and change throughout life have sparked interest in cognitive training (CT) as a possible means to postpone the development of dementia. Despite this, most research has focused on confirming the efficacy of training outcomes, with few studies examining the correlation between performance and results across various stages of training. In particular, the relationship between initial performance and the extent of improvement, the rate of learning, and the asymptotic performance level throughout the learning curve remains ambiguous. In this study, older adults underwent ten days of selective attention training using an adaptive algorithm, which enabled a detailed analysis of the learning curve's progression. Cognitive abilities were assessed before and after CT using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The findings indicated that: (1) Initial performance is positively correlated with Learning amount and asymptotic performance level, and negatively correlated with learning speed; (2) Age is negatively correlated with learning speed, while it is positively correlated with the other three parameters. (3) Higher pre-training MMSE scores predicted higher post-training MMSE scores but less improvement; (4) Higher pre-training MoCA scores predicted higher post-training MoCA scores and less improvement; (5) The parameters of the learning curve did not correlate with performance on the MMSE or MoCA. These results indicate that: (1)Selective attention training using adaptive algorithms is an effective tool for cognitive intervention; (2) Older individuals with poor baseline cognitive abilities require more diversified cognitive training; (3) The study supports the compensation hypothesis.

Introduction

As ageing accelerates, frailty increasingly impacts public health. Cough, sputum, wheezing and dyspnea are common respiratory symptoms, and the relationship to frailty is unclear. We aimed to analyze the relationship between respiratory symptoms and frailty.

Methods

Cross-sectional and Mendelian randomization (MR) studies were used. Cross-sectional data involved 14,021 participants from the National Health and Nutrition Examination Survey (NHANES). Logistic and linear regression were used to analyze the relationship between respiratory symptoms (cough, sputum, wheezing, dyspnea) and frailty. We adjusted for multiple variables and used propensity score matching (PSM). Mediation analysis was used to explore the role of inflammatory markers and age in the relationship between the two. We analyzed the relationship using a two-sample MR approach with data from genome-wide association studies (GWAS) to enhance causal inference.

Results

Observational studies have shown that cough (OR 1.74, 95 CI% 1.44, 2.09), sputum (OR 1.87, 95 CI% 1.57, 2.22), wheezing (OR 2.01, 95 CI% 1.68, 2.40), and dyspnea (OR 2.60, 95 CI% 2.28, 2.97) are associated with an elevated risk of frailty. The PSM results were stable. Mediation analyses indicated that elevated inflammatory markers and advancing age were mediators between respiratory symptoms and frailty. The results of the MR study showed that sputum and wheezing were associated with an elevated frailty index; and in the study of FI on respiratory symptoms, all respiratory symptoms were elevated with elevated FI.

Conclusions

Our study identified a potential association between frailty and respiratory symptoms. Inflammation and ageing may be essential factors mediating this association.

Background

Korea is expected to become a super-aged society by 2025. Research has shown that regular participation in physical activity has a positive impact on older adults’ health and reduces national health costs.

Aims

Drawing on Bronfenbrenner’s ecological model, this study examines ecological systems that influence physical activity in older men and women.

Method

The data analysis included information on 537 older adults aged 65 years and older residing in South Korea. The regression analysis identified differences in the ecological systems that influence physical activity in older adults by sex.

Results

By examining the ecological systems that affect physical activity in older men, this study found that the macrosystem affected the exosystem (p <.001) and microsystem (p <.001), the exosystem affected the mesosystem (p <.01), and the microsystem affected individuals (p <.001). In the case of older women, the macrosystem affected the exosystem (p <.001), microsystem (p <.001), and individuals (p <.01); the exosystem affected the microsystem (p <.01), and the microsystem affected individuals (p <.001).

Conclusions

The microsystem commonly affects the physical activity of older men and women, whereas the macrosystem only affects the physical activity of older women, suggesting that older men may experience limited macrosystem support in fostering their participation in physical activity. To address this disparity, the study highlights the need for targeted policies to enhance macrosystem support for older men, such as developing tailored physical activity programs that promote positive attitudes and accessible opportunities for participation.

Background

Various biomarkers associated with sarcopenia have been identified. However, there is a scarcity of studies exploring and validating biomarkers in individuals with age-related sarcopenia.

Aims

This study aimed to investigate the proteome and identify potential biomarkers for age-related sarcopenia.

Methods

Proteomic analysis and experimental validation were conducted using plasma from hospitalized older adults. Sarcopenia diagnosis was based on the Asian Working Group for Sarcopenia 2019 criteria. Data-independent acquisition-based proteomics was performed on plasma from 60 participants, with 30 diagnosed with sarcopenia and 30 without sarcopenia. Differentially expressed proteins (DEPs) were selected and evaluated by Receiver Operating Characteristic (ROC) analysis. Biomarker candidates were further quantitatively validated by enzyme-linked immunosorbent assay (ELISA) utilizing plasma from 6 participants with sarcopenia and 6 without sarcopenia.

Results

A total of 39 DEPs were identified and 12 DEPs were selected for ROC analysis. 8 DEPs were included for ELISA validation based on their predictive performance. Paraoxonase-3 (PON3) consistently showed down-regulation in the sarcopenic group across both methodologies. Insulin-like growth factor-binding protein-2 (IGFBP2) showed inconsistency in the sarcopenic group, with up-regulation observed in proteomic analysis but down-regulation in ELISA.

Discussion

Decline in PON3 may result in an overload of oxidative stress in skeletal muscles and contribute to sarcopenia. Protein modifications of IGFBP2 might exhibit during sarcopenia pathogenesis.

Conclusions

Plasma proteins are implicated in sarcopenia pathogenesis. PON3 is highlighted as a potential biomarker for patients with age-related sarcopenia. Further studies are imperative to gain an in-depth understanding of PON3 and IGFBP2.

Introduction

Preparation methods are often used to improve performance (e.g., number of repetitions) within the resistance training session. However, there is still no consensus in the scientific literature on whether there is a superior preparation method for improving performance, particularly in older adults.

Methods

We compared the effects of preparation by specific warm-up (SW), static stretching (SS), and control condition (CC) on the total number of repetitions in four exercises: leg extension, triceps pushdown, seated leg curl, and preacher curl. Fifty-seven older women (≥ 60 years) performed the experimental protocols (SW and SS) and the CC in a cross-over and counterbalanced design. Following the preparation protocol, the main exercises were performed in two sets until volitional concentric failure, with a two-minute rest interval between sets and 2–3 min between exercises. The main outcome was the total number of repetitions.

Results

The SS improved performance compared to the SW and the CC in the leg extension and seated leg curl resistance exercises. In contrast, the SW impaired performance compared to the SS and CC in the triceps pushdown and preacher curl exercises.

Conclusion

Our results suggest that SS may improve performance in lower-limb exercises, while the SW appears to negatively affect performance in upper-limb exercises in resistance-trained older women.

The Geriatric Nutritional Risk Index (GNRI) plays a crucial role in assessing nutritional status and predicting clinical outcomes in older patients. This study explores the GNRI as a prognostic tool for clinical outcomes in older inpatients. Spanning from August 2013 to December 2020, the research involved 573 older patients at Tianjin Third Central Hospital, China. The study assessed the association of GNRI with 6-month hospital readmission and 3-year all-cause mortality rates. Our findings reveal that higher GNRI scores significantly correlate with reduced hospital readmissions and mortality, underscoring the utility of GNRI in predicting clinical outcomes and guiding interventions in geriatric care. The study highlights the potential of integrating GNRI assessments into routine clinical evaluations to enhance patient care and optimize resource utilization in healthcare settings.

Background & aims

Surgery combined with chemotherapy remains the mainstay of treatment for advanced epithelial ovarian cancer. It is important to evaluate the occurrence of postoperative complications before operation and to prevent them. The purpose of this study is to investigate the role of sarcopenia diagnosed by CT scans in predicting postoperative complications in patients with ovarian cancer.

Methods

Patients with PDS or IDS in the First Affiliated Hospital of Wenzhou Medical University from August 2017 to August 2022 were included. Sarcopenia was identified using CT scans at the T12 level. According to the Clavien-Dindo classification, postoperative complications are considered to have occurred in grades 2 and above. Logistic regression analysis was used to identify risk factors contributing to postoperative complications. P < 0.05 was considered statistically significant.

Results

A total of 139 patients were included. Sarcopenia was observed in 24(17.27%) patients with advanced epithelial ovarian cancer. Compared to the non-sarcopenia group, the sarcopenia group had a higher incidence of postoperative complications (62.50% VS 42.61%, p = 0.032). Multivariate logistic analysis confirmed sarcopenia (OR = 3.241, p = 0.026), age over 65 years (OR = 3.296, p = 0.005), and intraoperative bleeding (OR = 1.002, p < 0.001) as independent predictors of postoperative complications in ovarian cancer.

Discussion & conclusions

Sarcopenia diagnosed based on CT body composition analysis may serve as a potential predictor for postoperative complications. Further research is warranted to explore preventive strategies and interventions to improve outcomes in this population.

Aims

We conducted this study to investigate the impact of muscle loss on musculoskeletal health, fall and fracture risks, and activities of daily living (ADL) in elderly patients with osteoporosis.

Materials and methods

This age- and sex-matched cross-sectional study analyzed data from a medical center involving patients aged ≥ 50 from 2020 to 2022. The included participants were formed into three groups: 100 with osteoporosis only, 100 with osteosarcopenia, and 50 control individuals without osteoporosis and sarcopenia. We compared groups based on their baseline characteristics, bone and muscle health measurements, and the risks of falls and fractures using the STRATIFY scale and FRAX, respectively. Additionally, ADL was assessed using the Barthel Index. A multivariate analysis was performed to identify factors associated with declined ADL in osteosarcopenic patients.

Results

The mean age was 76.17 years, and 82% were female. The osteosarcopenic group demonstrated poorer bone and muscle quality and quantity, with greater risks of major osteoporotic-related fractures, hip fractures, and falls, as well as significantly decreased ADL than other groups. When comparing sexes, females exhibited worse performance than males across groups. Slow gait speed and high STRATIFY score are independent predictors of declined ADL in osteosarcopenic patients.

Conclusion

Sarcopenia exacerbates osteoporotic patients, particularly women, worsening bone deterioration, increasing fall and fracture risks, and significantly impairing daily activities. Enhancing walking speed and reducing fall risk can boost independence in individuals with osteosarcopenia. Early detection, proper management, and preventive measures are essential for mitigating these adverse outcomes in high-risk individuals.