Effects of Aging on Impairment Ratings: Part 2: Internal Medicine Issues

2018 ◽  
Vol 23 (6) ◽  
pp. 9-13
Author(s):  
Stephen L. Demeter
Keyword(s):  
Internal Medicine ◽  
Aging Process ◽  
Digestive System ◽  
The United States ◽  
Normal Aging ◽  
Infectious Hepatitis ◽  
Female Reproductive Tract ◽  
Ulcer Disease ◽  
Age Related ◽  
Impairment Ratings

Abstract This is the second of four articles that explore the effects of age-related changed in impairment evaluations according to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth and Sixth Editions; specifically, this article completes the review of the internal medicine sections. With respect to the digestive system, the normal aging process affects gastrointestinal impairment ratings as found in the AMA Guides, Fifth and Sixth Editions, for gastroesophageal reflux disease, peptic ulcer disease, pancreatitis, diverticulitis, irritable bowel syndrome, fecal incontinence, and hemorrhoids. Cancers of the digestive system and infectious hepatitis were reviewed by the National Institutes of Health in The Burden of Digestive Diseases in the United States (2008), which should be reviewed when an impairment rating or apportionment is needed or for an individual with these conditions alleged to be the result of a compensable injury or illness. The normal aging process does not significantly affect the impairment ratings for renal disease (upper urinary tract disease), but, for individuals over 70, an age adjustment should be incorporated into the impairment rating. The AMA Guides, Fifth and Sixth Editions, also do not provide age-related modifications for urinary incontinence, but a rating physician may apply a discretionary apportionment. For diseases of the scrotum, testicles, epididymis, and spermatic cord, as well as for prostatic hypertrophy, neither edition of the AMA Guides makes age-related modifications; neither are modifications because of aging are made for the female reproductive tract, although raters are told to consider the physiological differences.

Effects of Aging on Impairment Ratings: Part 1: Internal Medicine Issues

2018 ◽  
Vol 23 (5) ◽  
pp. 3-10
Author(s):  
Stephen L. Demeter
Keyword(s):  
Aging Process ◽  
Endocrine System ◽  
Normal Aging ◽  
Pulmonary System ◽  
Age Related ◽  
Metabolic Bone ◽  
Causative Factors ◽  
Impairment Ratings ◽  
Artery Disease ◽  
Effects Of Aging

Abstract This article is the first of four to explore the effects of age-related changes in impairment evaluations as defined by the fifth and sixth editions of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). With respect to the cardiovascular system, impairment ratings for the following conditions commonly are affected by the aging process: coronary artery disease, valvular heart disease, arrhythmias/dysrhythmias, hypertension, and peripheral vascular disease. Impairment ratings in the fifth and sixth editions of the AMA Guides for the pulmonary system apply corrections for age with respect to certain measurements such as forced vital capacity. The normal aging process does not significantly affect impairment ratings for either hematological impairments or the endocrine system, nor does normal aging significantly affect the impairment ratings for mammary glands. With careful attention to the diagnosis and causative factors, evaluators may find that the normal aging process can affect impairment ratings associated with metabolic bone disease. Evaluating physician typically must determine impairment secondary to a specific cause (eg, injury or exposure) and therefore must consider if other factors are contributing to the impairment.

Is the Age-Related Decline in Renal Function an Age-Associated Disease or Part of a Normal Aging Process?

Gerontology ◽  
2017 ◽  
Vol 63 (4) ◽  
pp. 325-326
Author(s):  
Fabian Braun ◽  
Paul Thomas Brinkkoetter
Keyword(s):  
Renal Function ◽  
Aging Process ◽  
Normal Aging ◽  
Age Related

A common link between aging, schizophrenia, and autism?

2004 ◽  
Vol 27 (4) ◽  
pp. 593-594
Author(s):  
Jocelyn Faubert ◽  
Armando Bertone
Keyword(s):  
Nmda Receptor ◽  
Neurological Disorders ◽  
Aging Process ◽  
Normal Aging ◽  
Perceptual Processing ◽  
Compelling Evidence ◽  
Systematic Assessment ◽  
Age Related ◽  
Perceptual Functioning ◽  
Perceptual Performance

Phillips & Silverstein (P&S, 2003) have proposed that NMDA-receptor hypofunction is the central reason for impaired cognitive coordination and abnormal gestalt-like perceptual processing in schizophrenia. We suggest that this model may also be applicable to non-pathological (or normal) aging given the compelling evidence of NMDA-receptor involvement during the aging process that results in age-related change in higher-level perceptual performance. Given that such deficits are present in other neurological disorders such as autism, an argument for a systematic assessment of perceptual functioning in these conditions may be posited.

scholarly journals Differential Patterns of Gyral and Sulcal Morphological Changes During Normal Aging Process

2021 ◽  
Vol 13 ◽  
Author(s):  
Hsin-Yu Lin ◽  
Chu-Chung Huang ◽  
Kun-Hsien Chou ◽  
Albert C. Yang ◽  
Chun-Yi Zac Lo ◽  
...  
Keyword(s):  
White Matter ◽  
Aging Process ◽  
Morphological Changes ◽  
Normal Aging ◽  
Quadratic Model ◽  
Imaging Data ◽  
Cortical Folding ◽  
Brain Functioning ◽  
Age Related ◽  
Morphological Model

The cerebral cortex is a highly convoluted structure with distinct morphologic features, namely the gyri and sulci, which are associated with the functional segregation or integration in the human brain. During the lifespan, the brain atrophy that is accompanied by cognitive decline is a well-accepted aging phenotype. However, the detailed patterns of cortical folding change during aging, especially the changing age-dependencies of gyri and sulci, which is essential to brain functioning, remain unclear. In this study, we investigated the morphology of the gyral and sulcal regions from pial and white matter surfaces using MR imaging data of 417 healthy participants across adulthood to old age (21–92 years). To elucidate the age-related changes in the cortical pattern, we fitted cortical thickness and intrinsic curvature of gyri and sulci using the quadratic model to evaluate their age-dependencies during normal aging. Our findings show that comparing to gyri, the sulcal thinning is the most prominent pattern during the aging process, and the gyrification of pial and white matter surfaces were also affected differently, which implies the vulnerability of functional segregation during aging. Taken together, we propose a morphological model of aging that may provide a framework for understanding the mechanisms underlying gray matter degeneration.

Age and Blood Pressure

PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 1055-1056
Author(s):  
L. Jerome Krovetz
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Cardiac Catheterization ◽  
Aging Process ◽  
Normal Subjects ◽  
The United States ◽  
Normal Aging ◽  
Recent Editorial

This is written in corroboration of a recent editorial by Dr Forrest H Adams on blood pressure in children in the United States. Dr Adams stated that "the blood pressure should remain stable for life in the absence of disease.... The normal aging process is unaccompanied by an increase in blood pressure." In 1972, we published a study on hemodynamic data1 obtained on normal subjects undergoing cardiac catheterization. A total of 365 normal subjects, 1 day to 69 years of age, were analyzed.

scholarly journals Differential patterns of gyral and sulcal morphological changes during normal aging process

2020 ◽  
Author(s):  
Hsin-Yu Lin ◽  
Chu-Chung Huang ◽  
Kun-Hsien Chou ◽  
Albert C. Yang ◽  
Chun-Yi Zac Lo ◽  
...  
Keyword(s):  
White Matter ◽  
Aging Process ◽  
Morphological Changes ◽  
Normal Aging ◽  
Quadratic Model ◽  
Imaging Data ◽  
Cortical Folding ◽  
Brain Functioning ◽  
Age Related ◽  
Morphological Model

ABSTRACTThe cerebral cortex is a highly convoluted structure with distinct morphologic features, namely the gyri and sulci, which are associated with the functional segregation or integration in the human brain. During the lifespan, the brain atrophy that is accompanied by cognitive decline is a well-accepted aging phenotype. However, the detailed patterns of cortical folding change during aging, especially the changing trajectories of gyri and sulci, which is essential to brain functioning, remain unclear. In this study, we investigated the morphology of the gyral and sulcal regions from pial and white matter surfaces using MR imaging data of 417 healthy participants across the lifespan (21-92y). To elucidate the age-related changes in the cortical pattern, we fitted cortical thickness and intrinsic curvature of gyri and sulci using the quadratic model to evaluate their trajectories during normal aging. Our findings show that comparing to gyri, the sulcal thinning is the most prominent pattern during the aging process, and the gyrification of pial and white matter surfaces were also affected differently, which implies the vulnerability of functional segregation during aging. Taken together, we propose a morphological model of aging that may provide a framework for understanding the mechanisms underlying the gray matter degeneration.

scholarly journals Sexuality in Later Life and Mental Health Among Older Black Gay Men

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 313-314
Author(s):  
Darlingtina Esiaka ◽  
Alice Cheng ◽  
Candidus Nwakasi
Keyword(s):  
Mental Health ◽  
Gay Men ◽  
Later Life ◽  
The United States ◽  
Mental Wellbeing ◽  
Self Identity ◽  
Sexual Identities ◽  
Age Related ◽  
Wide Range ◽  
Black Gay Men

Abstract Self-acknowledgement and integration of racial and sexual identities are significant to one’s overall sense of identity because of their implications for mental health and wellbeing. These issues are important as one ages because older people experience a wide range of factors that add layers to their ability to (re)integrate subsets of their identity into their overall self-identity such as age and age-related disabilities. This study examined the intersection of race and sexual identities on overall health status in older Black gay men, a demographic group that has historically received less attention. Data from the Social Justice Sexuality (SJS) survey of LGBTQ+ people of color which occurred over a 12-month period in the United States were analyzed. Participants (N=160), 50 years and over, responded to questions about their sexuality, social identity, family dynamics, community connection and engagement, and mental and physical health. Results show an association of mental wellbeing with racial and sexual identities. Further, results show that a strong sense of connection to other sexual minorities is positively associated with mental health in older Black gay men. We discuss the implication of findings for mental health interventions targeting this gendered population.

scholarly journals Age-Related Chronic Diseases and Alzheimer’s Disease in Texas: A Hispanic Focused Study

2021 ◽  
Vol 5 (1) ◽  
pp. 121-133
Author(s):  
Shyam Sheladia ◽  
P. Hemachandra Reddy
Keyword(s):  
United States ◽  
Risk Factors ◽  
Chronic Diseases ◽  
Hispanic Americans ◽  
The United States ◽  
Modifiable Risk Factors ◽  
American Population ◽  
Hispanic American ◽  
West Texas ◽  
Age Related

The emergence of age-related chronic diseases within the United States has led to the direct increase of Alzheimer’s disease (AD) as well as other neurological diseases which ultimately contribute to the development of dementia within the general population. To be specific, age-related chronic diseases such as cardiovascular disease, high cholesterol, diabetes, and kidney disease contribute greatly to the advancement and rapid progression of dementia. Furthermore, unmodifiable risk factors such as advancing age and genetics as well as modifiable risk factors such as socioeconomic status, educational attainment, exercise, and diet further contribute to the development of dementia. Current statistics and research show that minority populations such as Hispanic Americans in the United States face the greatest burden of dementia due to the increase in the prevalence of overall population age, predisposing genetics, age-related chronic diseases, low socioeconomic status, as well as poor lifestyle choices and habits. Additionally, Hispanic Americans living within Texas and the rural areas of West Texas face the added challenge of finding appropriate healthcare services. This article will focus upon the research associated with AD as well as the prevalence of AD within the Hispanic American population of Texas and rural West Texas. Furthermore, this article will also discuss the prevalence of age-related chronic diseases, unmodifiable risk factors, and modifiable risk factors which lead to the progression and development of AD within the Hispanic American population of the United States, Texas, and rural West Texas.

scholarly journals Considerations for a Respiratory Syncytial Virus Vaccine Targeting an Elderly Population

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 624
Author(s):  
Laura M. Stephens ◽  
Steven M. Varga
Keyword(s):  
Respiratory Syncytial Virus ◽  
Disease Burden ◽  
Elderly Population ◽  
Vaccine Development ◽  
The Elderly ◽  
The United States ◽  
Susceptible Population ◽  
Age Related ◽  
Syncytial Virus ◽  
Tract Infections

Respiratory syncytial virus (RSV) is most commonly associated with acute lower respiratory tract infections in infants and children. However, RSV also causes a high disease burden in the elderly that is often under recognized. Adults >65 years of age account for an estimated 80,000 RSV-associated hospitalizations and 14,000 deaths in the United States annually. RSV infection in aged individuals can result in more severe disease symptoms including pneumonia and bronchiolitis. Given the large disease burden caused by RSV in the aged, this population remains an important target for vaccine development. Aging results in lowered immune responsiveness characterized by impairments in both innate and adaptive immunity. This immune senescence poses a challenge when developing a vaccine targeting elderly individuals. An RSV vaccine tailored towards an elderly population will need to maximize the immune response elicited in order to overcome age-related defects in the immune system. In this article, we review the hurdles that must be overcome to successfully develop an RSV vaccine for use in the elderly, and discuss the vaccine candidates currently being tested in this highly susceptible population.

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