scholarly journals Older adults show biomarker evidence of PICS after sepsis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 674-674
Author(s):  
Robert Mankowski ◽  
Stephen Anton ◽  
Gabriela Ghita ◽  
Christiaan Leeuwenburgh ◽  
Lyle Moldawer ◽  
...  
Keyword(s):  
Older Adults ◽  
Performance Status ◽  
Adult Survivors ◽  
Prospective Longitudinal Study ◽  
Persistent Inflammation ◽  
Chronic Critical Illness ◽  
Young Adult Survivors ◽  
Hospital Deaths ◽  
Early Biomarker ◽  
Prospective Longitudinal

Abstract Background Hospital deaths after sepsis have decreased substantially and most young adult survivors rapidly recover (RAP). However, many older survivors develop chronic critical illness (CCI) with poor long-term outcomes. The etiology of CCI is multifactorial and the relative importance remains unclear. Sepsis is caused by a dysregulated immune response and biomarkers reflecting a persistent inflammation, immunosuppression and catabolism syndrome (PICS) have been observed in CCI after sepsis. Therefore, the purpose of this study was to compare serial PICS biomarkers in a) older (versus young) adults and b) older CCI (versus older RAP) patients to gain insight into underlying pathobiology of CCI in older adults. Methods Prospective longitudinal study with young (≤ 45 years) and older (≥ 65 years) septic adults who were characterized by a) baseline predisposition, b) hospital outcomes, c) serial SOFA organ dysfunction scores over 14 days, d) Zubrod Performance status at three, six and 12-month follow-up and e) mortality over 12 months. Serial blood samples over 14 days were analyzed for selected biomarkers reflecting PICS. Results Compared to the young, more older adults developed CCI (20% vs 42%) and had markedly worse serial SOFA scores, performance status and mortality over 12 months. Additionally, older (versus young) and older CCI (versus older RAP) patients had more persistent aberrations in biomarkers reflecting inflammation, immunosuppression, stress metabolism, lack of anabolism and anti-angiogenesis over 14 days after sepsis. Conclusion Older (versus young) and older CCI (versus older RAP) patient subgroups demonstrate early biomarker evidence of the underlying pathobiology of PICS.

Older adults demonstrate biomarker evidence of the persistent inflammation, immunosuppression and catabolism syndrome (PICS) after sepsis

2021 ◽  
Author(s):  
Robert T Mankowski ◽  
Stephen D Anton ◽  
Gabriela L Ghita ◽  
Babette Brumback ◽  
Dijoia B Darden ◽  
...  
Keyword(s):  
Older Adults ◽  
Performance Status ◽  
Adult Survivors ◽  
Prospective Longitudinal Study ◽  
Persistent Inflammation ◽  
Chronic Critical Illness ◽  
Young Adult Survivors ◽  
Hospital Deaths ◽  
Early Biomarker ◽  
Prospective Longitudinal

Abstract Background Hospital deaths after sepsis have decreased substantially and most young adult survivors rapidly recover (RAP). However, many older survivors develop chronic critical illness (CCI) with poor long-term outcomes. The etiology of CCI is multifactorial and the relative importance remains unclear. Sepsis is caused by a dysregulated immune response and biomarkers reflecting a persistent inflammation, immunosuppression and catabolism syndrome (PICS) have been observed in CCI after sepsis. Therefore, the purpose of this study was to compare serial PICS biomarkers in a) older (versus young) adults and b) older CCI (versus older RAP) patients to gain insight into underlying pathobiology of CCI in older adults. Methods Prospective longitudinal study with young (≤ 45 years) and older (≥ 65 years) septic adults who were characterized by a) baseline predisposition, b) hospital outcomes, c) serial SOFA organ dysfunction scores over 14 days, d) Zubrod Performance status at three, six and 12-month follow-up and e) mortality over 12 months. Serial blood samples over 14 days were analyzed for selected biomarkers reflecting PICS. Results Compared to the young, more older adults developed CCI (20% vs 42%) and had markedly worse serial SOFA scores, performance status and mortality over 12 months. Additionally, older (versus young) and older CCI (versus older RAP) patients had more persistent aberrations in biomarkers reflecting inflammation, immunosuppression, stress metabolism, lack of anabolism and anti-angiogenesis over 14 days after sepsis. Conclusion Older (versus young) and older CCI (versus older RAP) patient subgroups demonstrate early biomarker evidence of the underlying pathobiology of PICS.

scholarly journals FINANCIAL EXPLOITATION OF OLDER ADULTS: PRELIMINARY RESULTS FROM A PROSPECTIVE LONGITUDINAL STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Scott R Beach ◽  
Sara J Czaja ◽  
Richard Schulz ◽  
David Loewenstein ◽  
Peter Lichtenberg
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Psychosocial Factors ◽  
Cognitive Abilities ◽  
Self Report ◽  
Prospective Longitudinal Study ◽  
Preliminary Results ◽  
Financial Exploitation ◽  
Advance Theory ◽  
Prospective Longitudinal

Abstract This paper presents study design and preliminary results from a new study funded by the National Institute on Aging that is examining financial exploitation (FE) among 720 White, African-American and Hispanic adults age 60+ (240 per group; 120 age 60-79; 120 age 80+). A conceptual model linking socio-demographics, physical health, social support / integration, cognitive function, financial skills / supports, and psychosocial factors to FE is being evaluated. Three assessments (baseline, 12; 24 mos.) include: a detailed cognitive battery, web-based banking simulation tasks, scam scenarios, and a standardized battery of self-report measures assessing socio-demographic and psychosocial variables. Preliminary baseline results from ~200 participants show support for the proposed model. Exposure to sales, remote purchasing behavior, and telemarketer receptivity (scam exposure); and scam vulnerability as measured by credibility ratings of “legitimate” and “fake” scam scenarios are positively associated with reports of both stranger-initiated and trusted other FE. Older adults with smaller social networks and less social support were more likely to report both exposure and vulnerability to scams. Higher general cognitive abilities, financial skills, and numeracy; and better performance on online banking tasks correlate with less scam exposure and vulnerability. Preliminary analyses of psychosocial factors also show that more depressed, impulsive, and trusting older adults report more exposure and scam vulnerability. The paper will present updated analyses of ~500 baseline participants. Understanding multiple pathways to FE is important to advance theory and for the development of interventions to minimize risk.

Accelerated sarcopenia and outcomes in older adults with cancer: The Health ABC Study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11526-11526
Author(s):  
Grant Richard Williams ◽  
Yanjun Chen ◽  
Kelly Kenzik ◽  
Andrew Michael McDonald ◽  
Shlomit S. Shachar ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
Cancer Diagnosis ◽  
Cox Regression ◽  
Community Dwelling ◽  
Mixed Effect ◽  
Prospective Longitudinal Study ◽  
Targeted Interventions ◽  
Prospective Longitudinal ◽  
Time Varying Covariates

11526 Background: Progressive loss of muscle mass and strength (sarcopenia) is a well-known phenomenon of aging; however, little is known about the contribution of a cancer diagnosis to sarcopenia and its subsequent impact on disability. Using a prospective cohort of older adults from pre- to post-cancer diagnosis and a similarly-followed non-cancer cohort, we examined the trajectory of sarcopenia measures and their association with overall survival (OS) and major disability among those with cancer. Methods: The Health, Aging, and Body Composition (Health ABC) Study is a prospective longitudinal study where 3,075 community-dwelling older adults (70-79y) underwent 6 annual assessments of body composition and were followed for development of sentinel events (cancer, disability, death). Appendicular lean mass (ALM [kg]) was a sum of DXA-based lean tissue of all extremities. Hand grip strength (HGS [kg]) was averaged from 2 trials per hand. Gait speed (GS) was evaluated over a 20m course. We used linear mixed effect models to compare the change in ALM, HGS, and GS between individuals who subsequently developed cancer and those who did not, adjusting for age, race, gender, enrollment site. Among patients with cancer, we used multivariable cox regression for time from cancer diagnosis to mortality and major disability (cane/walker, inability to walk 0.25 mile/climb 10 steps, assistance with activities of daily living) treating sarcopenia measures as time-varying covariates. Results: Mean age at enrollment was 75y; 52% female; 42% black; 515 new cancers (prostate: 23%, colorectal: 15%, lung: 13%, breast: 11%). Compared with non-cancer controls, we found significantly steeper declines in HGS ( p= 0.03) and GS ( p< 0.001), and a trend in ALM ( p= 0.07) prior to cancer diagnosis; and a significantly steeper decline in ALM ( p< 0.001), but no difference in HGS ( p= 0.6) or GS ( p= 0.4) after cancer diagnosis. Slow GS was associated with a 44% increase in mortality ( p= 0.02) and a 70% increase in disability ( p= 0.02), but not ALM or HGS. Conclusions: Accelerated loss in sarcopenia measures both prior to and after a cancer diagnosis, and association with disability and mortality in older adults with cancer, present opportunities for targeted interventions.

scholarly journals Increasing mixed-berry flavonoid intake may reduce depressive symptoms in older adults: Framingham Heart Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 864-864
Author(s):  
Courtney Millar ◽  
Alyssa Dufour ◽  
Marian Hannan ◽  
Shivani Sahni
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Framingham Heart Study ◽  
Randomized Clinical Trials ◽  
Epidemiological Studies ◽  
Prospective Longitudinal Study ◽  
Heart Study ◽  
Flavonoid Intake ◽  
Prospective Longitudinal ◽  
Dietary Flavonoids

Abstract Depression affects more than 250 million people worldwide. Although epidemiological studies have linked higher dietary flavonoids with depression prevention in older women, it is unknown if increasing dietary flavonoids could effectively reduce depression. Mixed berries (blueberry, blackberry, and raspberry) are a rich source of flavonoids, particularly anthocyanin, flavanol, and flavan-3-ol subclasses. Our aim was to determine the association of mixed-berry flavonoid intake with change in depressive symptoms over ~8 years in older adults from the Framingham Heart Study. This community-based prospective longitudinal study included 1,278 adults with assessments on diet (food frequency questionnaire) and depressive symptoms (Center for Epidemiologic Studies Depression, CES-D) at baseline (1998-2001) and follow-up (2005-2008). Absolute change in mixed-berry flavonoid intake (defined as sum of anthocyanin, flavanol, and flavon-3-ols, mg/day) and change in CES-D scores were calculated. Linear regression estimated beta and standard error (SE) for change in CES-D scores per 250 mg/day increase in mixed-berry flavonoids (obtained from ~3/4 cup of mixed berries), adjusting for baseline age, sex, energy-intake, current smoking, body mass index, physical activity, cardiovascular disease, and non-melanoma cancer. Mean age was 59±9 years (range: 33-81), 57% female and mean change in mixed-berry flavonoid intake was 15.0±72.8 mg/day over ~8 years. In adjusted models, each 250 mg/day increase in mixed-berry flavonoid intake was associated with a 1-point reduction in depressive symptoms (beta: -1.06, SE: 0.61, p=0.08) over ~8 years, although this was not statistically significant. These data highlight the need for randomized clinical trials of flavonoid-rich berries to target depressive symptoms in older adults.

Quality of life (QOL) and physical function in one-year adult and elderly survivors of acute myeloid leukemia (AML).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7071-7071
Author(s):  
Shabbir M.H. Alibhai ◽  
Henriette Breunis ◽  
Narhari Timilshina ◽  
Mark D. Minden ◽  
Vikas Gupta ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Grip Strength ◽  
Age Groups ◽  
Cell Transplant ◽  
Prospective Longitudinal Study ◽  
Younger Patients ◽  
Eortc Qlq ◽  
Prospective Longitudinal ◽  
Over Time

7071 Background: The treatment of AML with intensive chemotherapy (IC) is associated with significant short-term toxicities. We previously showed similar impairments in QOL and physical function among younger (age 18-59) and older (age 60+) patients with AML at diagnosis, with similar recovery over 3 cycles of IC. We now comprehensively describe QOL and physical function recovery over 1 year from diagnosis. Methods: Younger and older AML patients undergoing IC without stem cell transplant were enrolled in a prospective, longitudinal study. Assessments were done at baseline (pre-IC) and at 7 time points over the next year. At each visit, patients completed the EORTC QLQ-C30 and the FACT-Fatigue to measure QOL and fatigue, respectively, in addition to 3 physical function tests (grip strength, 2-minute walk test (2MWT), and timed chair stands). Analyses involved multivariable linear regression analyses stratified by age group. Results: 243 patients were recruited (147 younger and 96 older, 56% male). Attrition was greater in older adults due to death or disease progression/relapse. Among patients remaining in remission after IC, global QOL and fatigue improved significantly over time (p<0.001 for both); trends were similar between older and younger patients. All 5 QOL domains improved or remained stable over time; the greatest improvements were seen in social function and role function and were similar in both age groups. Grip strength increased slightly over time (p=0.04) whereas both timed chair stands (p<0.001) and the 2MWT (p<0.001) had moderate to large improvements, with trends toward greater improvement in younger patients (p=0.07 and 0.09, respectively). Results were similar when missing data were imputed. Conclusions: Survivors of AML after successful conventional chemotherapy achieve significant improvements in QOL, fatigue, and physical function over time. The course of recovery is remarkably similar in younger and older AML patients, although significant attrition in older adults is a noteworthy limitation. These data suggest that appropriately selected older patients do well following IC for AML.

scholarly journals Specific Measures of Executive Function Predict Cognitive Decline in Older Adults

2011 ◽  
Vol 18 (1) ◽  
pp. 118-127 ◽  
Author(s):  
Lindsay R. Clark ◽  
Dawn M. Schiehser ◽  
Gali H. Weissberger ◽  
David P. Salmon ◽  
Dean C. Delis ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Decline ◽  
Rating Scale ◽  
Prospective Longitudinal Study ◽  
Switching Condition ◽  
Interference Test ◽  
Design Fluency ◽  
Spatial Fluency ◽  
Prospective Longitudinal

AbstractDecline in executive function has been noted in the prodromal stage of Alzheimer's disease (AD) and may presage more global cognitive declines. In this prospective longitudinal study, five measures of executive function were used to predict subsequent global cognitive decline in initially nondemented older adults. Of 71 participants, 15 demonstrated significant decline over a 1-year period on the Dementia Rating Scale (Mattis, 1988) and the remaining participants remained stable. In the year before decline, the decline group performed significantly worse than the no-decline group on two measures of executive function: the Color-Word Interference Test (CWIT; inhibition/switching condition) and Verbal Fluency (VF; switching condition). In contrast, decliners and non-decliners performed similarly on measures of spatial fluency (Design Fluency switching condition), spatial planning (Tower Test), and number-letter switching (Trail Making Test switching condition). Furthermore, the CWIT inhibition-switching measure significantly improved the prediction of decline and no-decline group classification beyond that of learning and memory measures. These findings suggest that some executive function measures requiring inhibition and switching provide predictive utility of subsequent global cognitive decline independent of episodic memory and may further facilitate early detection of dementia. (JINS, 2012, 18, 118–127)

Preservation of the Semantic Verbal Fluency Advantage in a Large Population-Based Sample: Normative Data from the TILDA Study

2016 ◽  
Vol 22 (5) ◽  
pp. 570-576 ◽  
Author(s):  
Roisin M. Vaughan ◽  
Robert F. Coen ◽  
RoseAnne Kenny ◽  
Brian A. Lawlor
Keyword(s):  
Older Adults ◽  
Normative Data ◽  
Population Based ◽  
Community Dwelling ◽  
Semantic Fluency ◽  
Prospective Longitudinal Study ◽  
Phonemic Fluency ◽  
Discrepancy Scores ◽  
Prospective Longitudinal ◽  
Community Dwelling Older Adults

AbstractObjectives: It is widely believed that phonemic fluency is more difficult than naming exemplars from a semantic category. Normative data in this regard are scarce, and there is considerable disagreement in the literature regarding the pattern in normal ageing and neurodegenerative conditions. Our objective was to provide normative data for semantic phonemic discrepancy scores from a large sample of older adults. Methods: A total of 5780 community-dwelling older adults were included in this prospective, longitudinal study. Discrepancy scores were calculated by subtracting phonemic fluency score from semantic fluency score for each participant. Quantile regression was used to estimate normative values stratified for age. Results: Subjects did better on testing of semantic fluency. The average discrepancy score was 9.18±6.89 words, (range, −20 to 37; n=5780). At the fiftieth percentile, those in their fifth decade produced 10 more “animals” than “letter F” words. Subjects scored one word less per decade, with an average of seven more “animal” words produced by those in their eighth decade. Conclusions: Our study is the first to provide normative data and confirms that, for animal versus letter F fluency, the semantic advantage persists into later life in a population-based sample of community-dwelling older adults. Given that a majority of clinical samples have confirmed a reverse of this pattern in Alzheimer’s dementia (i.e., loss of semantic advantage in Alzheimer’s disease, yielding a phonemic advantage), our findings support the clinical utility of brief fluency tests and encourage further research into their use in diagnosis and prediction of progression to dementia. (JINS, 2016, 22, 1–7)

scholarly journals Randomised Study of The Effectiveness Of A Training Programme In Everyday Cognition In Older Adults

2020 ◽  
Author(s):  
Celia Sánchez Gómez ◽  
Eduardo José Fernández Rodríguez
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Cognitive Skills ◽  
Training Programme ◽  
Control Group ◽  
Specific Domain ◽  
Prospective Longitudinal Study ◽  
Everyday Cognition ◽  
Prospective Longitudinal ◽  
Experimental Group

Abstract Background: Everyday cognition is the application of basic cognitive skills and knowledge of the specific domain for the resolution of problems that are integrated within the instrumental domains of functioning. The main objective to evaluate the effectiveness of a Training Programme in Everyday Cognition in order to improve the levels of everyday cognition and global cognitive performance in older adults.Methods: Experimental, randomised, stratified, prospective, longitudinal study using a fixed-assignment parallel scheme with an experimental group and a control group. The sample was composed of healthy older adults. The intervention of the experimental group consisted of an Everyday Cognition Training Programme, and the intervention of the control group consisted of a Traditional Cognitive Psycho-stimulation Programme. The Rapid Assessment of Cognitive Functions test (ERFC, for its acronym in French) and the Everyday Cognition Battery test (ECB) were used for the assessment.Results: Total sample (n=237) composed of 44 men and 223 women, with a mean age of 73.45 years. Statistically significant differences (p<0.001) were observed between both groups in both the ECB and the ERFC variables.Conclusion: The use of a Daily Cognition Training Programme presents greater benefits in terms of both global cognitive performance and everyday cognition than the use of a Traditional Cognitive Psycho-stimulation Programme in elderly adults.Trial registration: ClinicalTrials.gov: NCT04041999 (https://clinicaltrials.gov/ct2/show/NCT04041999)Retrospectively registered.

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