The role of transesophageal echocardiography in the diagnosis of ischemic stroke in the elderly

Цель исследования - изучение роли цитокинов, соотношения нейтрофилов и лимфоцитов в развитии постинсультной депрессии (ПД) у больных пожилого возраста. В исследование были включены 110 больных с острым ишемическим инсультом, из них 60 человек среднего возраста (52±5 лет) и 50 - пожилого возраста (66±4 года). Контрольную группу составили 20 человек среднего возраста без инсульта в анамнезе. Через 3 мес наблюдения ПД в пожилом возрасте развилась у 28 (56 %) больных, в среднем возрасте - у 26 (43,3 %). Больные пожилого возраста с ишемическим инсультом, у которых развилась ПД, были достоверно старше (7,9 %, р<0,05), чаще имели артериальную гипертензию (12,4 %, р<0,05), уровень гликемии выше на 16,1 % (р<0,05), триглицеридов - на 14 % (р<0,05), ЛПНП - на 12,8 % (р<0,05). Больные среднего возраста с ПД имели ИМТ выше на 8,1 % (р<0,05), уровень гликемии - на 9,6 % (р<0,05), триглицеридов - на 10,9 % (р<0,05), ЛПНП - на 9,7 % (р<0,05), чем больные без депрессии. Пожилые больные с ишемическим инсультом и ПД имели более высокий уровень цитокинов - IL-1β был выше на 35,4 % (р<0,01), TNF-α - на 27 % (р<0,01), INF-γ - на 18 % (р<0,01), чем у больных без ПД. У больных пожилого возраста с ПД соотношение нейтрофилов и лимфоцитов (Н/Л) было на 46 % (p<0,001) выше, чем у больных без ПД. В группе больных пожилого возраста при наличии ПД соотношение Н/Л было на 50 % (p<0,001) выше, чем в аналогичной группе среднего возраста. Таким образом, у пожилых больных с ишемическим инсультом уровень маркеров воспаления может иметь прогностическое значение в развитии постинсультной депрессии. The aim of the study was to study the role of cytokines, the ratio of neutrophils and lymphocytes in the development of post-stroke depression in elderly patients. The study included 110 patients with acute ischemic stroke, including 60 middle-aged people (52±5 years) and 50 elderly people (66±4 years). The control group consisted of 20 middle-aged people without a history of stroke. After 3 months of follow-up, post-stroke depression (PSD) developed in the elderly in 28 patients (56 %), in the middle age in 26 patients (43,3 %). Patients with ischemic stroke in the elderly who developed PSD were significantly older (7,9 %, p<0,05), more often had arterial hypertension (12,4 %, p<0,05), the level of glucose was 16,1 % higher (p<0,05), triglycerides by 14 % (p<0,05), LDL-C by 12,8 % (p<0,05). In middle age, patients with post-stroke depression had a body mass index higher by 8,1 % (p<0,05), a glucose level by 9,6 % (p<0,05), triglycerides by 10,9 % (p<0,05), LDL-C by 9,7 % (p<0,05) than patients without PSD. Elderly patients with ischemic stroke and PSD had higher levels of cytokines - IL-1β was 35,4 % higher (p<0,01), TNF-α by 27 % (p<0,01), INF-γ by 18 % (p<0,01) than in patients without PSD. In elderly patients with PSD, the ratio of neutrophils and lymphocytes (N/L) is 46 % (p<0,001) higher than in patients without PSD. In the elderly, in the presence of PSD, the N/L ratio was 50 % (p<0,001) higher than in the same middle-aged group. Thus, in elderly patients with ischemic stroke, the level of inflammatory markers may have a prognostic value in the development of post-stroke depression.

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Preclinical and clinical evidence of IGF-1 as a prognostic marker and acute intervention with ischemic stroke

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x211000894 ◽

2021 ◽

pp. 0271678X2110008

Author(s):

Cellas A Hayes ◽

M Noa Valcarcel-Ares ◽

Nicole M Ashpole

Keyword(s):

Ischemic Stroke ◽

Animal Models ◽

The Elderly ◽

Clinical Settings ◽

Mortality And Morbidity ◽

Routes Of Administration ◽

Insulin Growth Factor ◽

Cellular Processes ◽

Preclinical Animal Models

Ischemic strokes are highly prevalent in the elderly population and are a leading cause of mortality and morbidity worldwide. The risk of ischemic stroke increases in advanced age, corresponding with a noted decrease in circulating insulin growth factor-1 (IGF-1). IGF-1 is a known neuroprotectant involved in embryonic development, neurogenesis, neurotransmission, cognition, and lifespan. Clinically, several studies have shown that reduced levels of IGF-1 correlate with increased mortality rate, poorer functional outcomes, and increased morbidities following an ischemic stroke. In animal models of ischemia, administering exogenous IGF-1 using various routes of administration (intranasal, intravenous, subcutaneous, or topical) at various time points prior to and following insult attenuates neurological damage and accompanying behavioral changes caused by ischemia. However, there are some contrasting findings in select clinical and preclinical studies. This review discusses the role of IGF-1 as a determinant factor of ischemic stroke outcomes, both within the clinical settings and preclinical animal models. Furthermore, the review provides insight on the role of IGF-1 in mechanisms and cellular processes that contribute to stroke damage.

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Prevention of ischemic Stroke

KYAMC Journal ◽

10.3329/kyamcj.v2i1.13512 ◽

2013 ◽

Vol 2 (1) ◽

pp. 96-108

Author(s):

Badrul Haque ◽

Quazi Deen Mohammad ◽

Shah Md Keramot Ali

Keyword(s):

Ischemic Stroke ◽

Vitamin E ◽

Carotid Atherosclerosis ◽

Ace Inhibitor ◽

Beta Carotene ◽

The Elderly ◽

College Hospital ◽

Medical College ◽

Color Duplex Ultrasonography

Carotid atherosclerosis is associated with ischemic stroke. It is common in the elderly and the condition can be controlled or improved by drugs. In order to find out the role of antioxidant vitamins (beta carotene [USP 6 mg], Vitamin C [BP 200 mg] and Vitamin E [BP 50 mg]) and aspirin, aspirin and ACE- inhibitor (Ramipril) or aspirin alone in prevention of ischaemic stroke due to plaque in or near carotid artery bifurcation diagnosed by carotid color duplex ultrasonography and patients attended in Dhaka Medical College Hospital were studied to justify that these are effective.DOI: http://dx.doi.org/10.3329/kyamcj.v2i1.13512 KYAMC Journal Vol.2(1) 2011 pp.96-108

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The role of lipid profile in determining the risk of ischemic stroke in the elderly: a case–control study

Archives of Gerontology and Geriatrics ◽

10.1016/s0167-4943(03)00020-7 ◽

2003 ◽

Vol 37 (1) ◽

pp. 51-62 ◽

Cited By ~ 10

Author(s):

Licia Denti ◽

Alessandra Cecchetti ◽

Valentina Annoni ◽

Maria Francesca Merli ◽

Fabrizio Ablondi ◽

...

Keyword(s):

Ischemic Stroke ◽

Lipid Profile ◽

Case Control Study ◽

The Elderly ◽

Case Control ◽

Control Study

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Prospective Memory Development Across the Lifespan

European Psychologist ◽

10.1027/1016-9040/a000380 ◽

2020 ◽

Vol 25 (3) ◽

pp. 162-173 ◽

Cited By ~ 1

Author(s):

Sascha Zuber ◽

Matthias Kliegel

Keyword(s):

Prospective Memory ◽

Healthy Aging ◽

Present Model ◽

Current Knowledge ◽

Well Being ◽

The Elderly ◽

Cognitive Factors ◽

Everyday Functioning ◽

Integrative Framework

Abstract. Prospective Memory (PM; i.e., the ability to remember to perform planned tasks) represents a key proxy of healthy aging, as it relates to older adults’ everyday functioning, autonomy, and personal well-being. The current review illustrates how PM performance develops across the lifespan and how multiple cognitive and non-cognitive factors influence this trajectory. Further, a new, integrative framework is presented, detailing how those processes interplay in retrieving and executing delayed intentions. Specifically, while most previous models have focused on memory processes, the present model focuses on the role of executive functioning in PM and its development across the lifespan. Finally, a practical outlook is presented, suggesting how the current knowledge can be applied in geriatrics and geropsychology to promote healthy aging by maintaining prospective abilities in the elderly.

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