Involvement of Irisin in age-related osteoporosis: positive correlation with BMD in older adult patients and inhibitory effect on the senescent marker p21 in osteoblasts

Abstract With improvements in medical care, the life expectancy of patients with bleeding disorders is approaching that of the general population. A growing population of older adult patients with bleeding disorders is at risk of age-related comorbidities and in need of various elective and emergent age-related procedures. The increased risk of thrombosis and volume overload in older adults complicates perioperative hemostatic management. Furthermore, antithrombotic treatment such as antiplatelet or anticoagulant therapy, which is frequently required for various cardiovascular interventions, requires a meticulous individualized approach. Evidence-based guidelines for the management of aging patients with bleeding disorders are lacking, largely due to the underrepresentation of older adult patients in clinical trials as well as the rarity of many such bleeding disorders. We discuss the current guidelines and recommendations in the perioperative hemostatic management of older adult patients with hemophilia and von Willebrand disease as well as other rare bleeding disorders. The optimal management of these patients is often complex and requires a thorough multidisciplinary and individualized approach involving hematologists, surgeons, anesthesiologists, and the specialists treating the underlying disorder.

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EPID-11. A MULTI-INSTITUTIONAL COMPARATIVE ANALYSIS OF THE CLINICAL, GENOMIC, AND SURVIVAL CHARACTERISTICS OF PEDIATRIC, YOUNG ADULT AND OLDER ADULT PATIENTS WITH IDH-MUTANT GLIOMA

Neuro-Oncology ◽

10.1093/neuonc/noaa215.329 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii80-ii81

Author(s):

Mary Jane Lim-Fat ◽

Jayne Vogelzang ◽

Eleanor Woodward ◽

Alana McGovern ◽

Clement Ma ◽

...

Keyword(s):

Malignant Transformation ◽

Older Adult ◽

Proportional Hazards ◽

Prognostic Significance ◽

Age Groups ◽

Cox Proportional Hazards ◽

Adult Patients ◽

Age Group ◽

Genomic Alterations ◽

Age Related

Abstract BACKGROUND Prognostic significance of IDH-mutation in glioma is incompletely understood in children and adolescents/young adults (YAs). We compared the clinico-genomic features, outcomes and prognostic factors observed in IDH-mutant gliomas across age groups. METHODS Clinical, histologic and molecular data of patients with IDH-mutant gliomas from 8 pediatric institutions (spanning twenty years) and adult patients from two institutions (from 2013–2019) were identified. Patients were grouped as pediatric (< 19y), YA (19y to < 40y) or older adult (≥ 40y). Genomic alterations, including somatic mutations and copy number variants, were captured with institutional next generation sequencing. Factors were compared across age categories using Fisher’s exact test or analysis-of-variance. Cox proportional-hazards regression tested factors for association with overall (OS) and progression-free survival (PFS). RESULTS Of 379 patients, 48(13%) were pediatric, 204(54%) YA and 127(33%) older adult. Histological subtype differed significantly by age group (p< 0.0001). YAs had higher rates of malignant transformation (p=0.01) and shorter time-from-diagnosis-to-malignant transformation (p=0.01) compared to other age groups. Analysis of genomic alterations revealed an age-related difference in distribution in ATRX mutations only (p=0.0018). Median PFS and OS for the entire cohort were 4.62 and 17.19 years. In univariate models, PFS differed by age group (p=0.0012), with YAs having the worst outcomes. Lack of MGMT methylation (p=0.024) predicted poorer OS. Upfront observant management was predictive of poorer PFS. Gene mutations were not associated with PFS. In multi-variable models, YAs had shorter PFS compared to pediatric (hazard ratio [HR]=2.03, p=0.01) and older adults (HR=1.59, p=0.003) after adjusting for histology, extent of resection, and initial therapy. Age at diagnosis was not associated with OS in multi-variable analysis. CONCLUSIONS Within our cohort, YA with IDH-mutant tumors progressed more quickly compared to their pediatric counterparts. Further study of YA patients with IDH-mutant glioma is critical to better define best practices for this group.

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Cognitive Aging in a Precision Sport Context

European Psychologist ◽

10.1027/1016-9040.1.3.166 ◽

1996 ◽

Vol 1 (3) ◽

pp. 166-179 ◽

Cited By ~ 6

Author(s):

Bo Molander ◽

Lars Bäckman

Keyword(s):

Older Adult ◽

Cognitive Abilities ◽

Cognitive Aging ◽

Motor Performance ◽

Intervention Programs ◽

Laboratory Studies ◽

High Arousal ◽

Memory And Attention ◽

Age Related ◽

Principal Finding

Highly skilled miniature golf players were examined in a series of field and laboratory studies. The principal finding from these studies is that young and young adult players (range = 15-38 years) score equally well or better in competition than in training whereas older adult players (range = 46-73 years) perform worse in competitive events than under training conditions. It was also found that the impairment in motor performance on the part of the older players is associated with age-related deficits in basic cognitive abilities, such as memory and attention. These results support the hypothesis that older players may be able to compensate for age-related deficits under relaxed conditions, but not under conditions of high arousal. The possibility of improving the performance of the older players in stressful situations by means of various intervention programs is discussed.

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