Age-related physiologic declines

2017 ◽  
pp. 303-310
Author(s):  
Elisa Fabbri ◽  
Marco Zoli ◽  
Luigi Ferrucci
Keyword(s):  
Adverse Outcomes ◽  
Physiological Changes ◽  
Cognitive Frailty ◽  
Multiple Systems ◽  
Adverse Health Outcomes ◽  
Multiple Organs ◽  
Progressive Loss ◽  
Age Related ◽  
Accelerate Ageing ◽  
Living Organisms

‘How and why living organisms age?’ This question has puzzled and challenged philosophers and scientists for centuries. Ageing can be defined as a progressive loss of anatomic and physiological integrity across multiple systems and organs, leading to impaired function and higher vulnerability to adverse health outcomes and death. Although the biological mechanisms that trigger and accelerate ageing are still not understood, enormous steps forward in delineating the effects of ageing has been made in recent years. Ageing induces morphological and physiological changes across multiple organs and systems, which result in progressive loss of resilience, increased vulnerability to stressors, disease susceptibility, and development of physical and cognitive frailty, disability, and adverse outcomes.

Effects of Probiotics and Prebiotics on Frailty and Ageing: A Narrative Review

2020 ◽  
Vol 15 (3) ◽  
pp. 183-192 ◽  
Author(s):  
Kulapong Jayanama ◽  
Olga Theou
Keyword(s):  
Older People ◽  
Health Outcomes ◽  
Cost Effective ◽  
Adverse Outcomes ◽  
Narrative Review ◽  
Deficit Accumulation ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
The Relationship ◽  
Health Deficit

Globally, the population over the age of 60 is growing fast, but people age in different ways. Frailty, shown by the accumulation of age-related deficits, is a state of increased vulnerability to adverse outcomes among people of the same chronological age. Ageing results in a decline in diversity and homeostasis of microbiomes, and gut flora changes are related to health deficit accumulation and adverse health outcomes. In older people, health deficits including inappropriate intake, sarcopenia, physical inactivity, polypharmacy, and social vulnerability are factors associated with gut dysbiosis. The use of probiotics and prebiotics is a cost-effective and widely available intervention. Intake of probiotics and prebiotics may improve the homeostasis of gut microflora and prevent frailty and unhealthy aging. However, health effects vary among probiotics and prebiotics and among individual populations. This narrative review summarizes recent evidence about the relationship between prebiotic and probiotic consumption with health outcomes in older people.

scholarly journals The Influence of Multiple Frailties on Institutionalization and Mortality in Community-Living Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 257-257
Author(s):  
Yunhwan Lee
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Accelerated Aging ◽  
Predictive Ability ◽  
Adverse Outcomes ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Adverse Health Outcomes ◽  
Nationally Representative ◽  
Social Vulnerabilities

Abstract Frailty is a hallmark of accelerated aging, predisposing the older person to increased vulnerability to adverse health outcomes. Physical frailty is closely linked to other health dimensions, such as cognitive, psychological, and social functions. This study aims to examine the influence of multiple dimensions of frailty in predicting institutionalization and mortality. A nationally representative sample of Koreans 65 years or older from the Living Profiles of Older People Survey in 2008 was followed up for three years (n = 11,265). Physical frailty was defined as being prefrail or frail using the Fried phenotype model. Those with cognitive impairment, depressive symptoms, and social vulnerabilities, in addition to physical frailty, were considered to have cognitive frailty, psychological frailty, and social frailty, respectively. The proportional hazards model was used to analyze the risk of institutionalization and mortality by the total number and different combinations of frailties, adjusting for covariates. More than half (50.1%) of the participants exhibited multiple frailties, with 8.1% concurrently displaying frailty in all four domains (mixed frailty). The risk of adverse outcomes was elevated with a higher number of frailties, with hazard ratios of 2.59 (95% confidence interval [CI]: 1.52, 4.42) for institutionalization and 3.40 (95% CI: 2.50, 4.63) for mortality among those presenting mixed frailty. Whereas psychological frailty demonstrated a stronger predictive ability of mortality than institutionalization, the reverse was observed for social frailty. Multiple frailties are prevalent in late life. Acquiring more frailties raises the risk of adverse outcomes, with varying effects according to multidimensional frailty profiles.

scholarly journals Management of frailty at individual level – Frailty prevention

2018 ◽  
Vol 52 (4) ◽  
Author(s):  
Branko Gabrovec ◽  
Brigita Skela-Savič
Keyword(s):  
Functional Decline ◽  
Adverse Outcomes ◽  
Geriatric Syndrome ◽  
Negative Consequences ◽  
Individual Level ◽  
Targeted Interventions ◽  
Multiple Organs ◽  
Age Related ◽  
Prevention Interventions ◽  
Physiological Reserve

Introduction: Frailty is a geriatric syndrome characterized by a diminished physiological reserve of multiple organs, which means increased of vulnerability of older people to adverse outcomes. As the process which leads to frailty can be decelerated or even completely reversed, early prevention interventions are crucial. Methodology: A systematic literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and  UpToDate. The criterion in selecting the literature was that articles were published from 2002 to 2017. From 391.910 initial hits, 31 publications were selected. Results: Early diagnosis of frailty and functional decline are considered effective measures against age-related comorbidities. Targeted interventions have a significant impact on preventing the progression of frailty and the negative consequences of frailty. Lifestyle, including physical activity (particularly resistance exercise) and nutrition (higher protein intake and vitamin D supplement), is a good measure for preventing disorders associated with age. Conclusion: Targeted interventions have a significant modifiable influence on preventing frailty. Frailty management and early interventions comprise comprehensive and multidisciplinary approach including clinical management with physical management, nutrition and drugs.  

scholarly journals Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)—A Condition Associated with Heightened Sympathetic Activation

2021 ◽  
Vol 22 (8) ◽  
pp. 4241
Author(s):  
Revathy Carnagarin ◽  
Kearney Tan ◽  
Leon Adams ◽  
Vance B. Matthews ◽  
Marcio G. Kiuchi ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Metabolic Diseases ◽  
Treatment Strategies ◽  
Adverse Outcomes ◽  
Metabolic Dysfunction ◽  
Sympathetic Activation ◽  
Beneficial Effects ◽  
Adverse Health Outcomes

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common liver disease affecting a quarter of the global population and is often associated with adverse health outcomes. The increasing prevalence of MAFLD occurs in parallel to that of metabolic syndrome (MetS), which in fact plays a major role in driving the perturbations of cardiometabolic homeostasis. However, the mechanisms underpinning the pathogenesis of MAFLD are incompletely understood. Compelling evidence from animal and human studies suggest that heightened activation of the sympathetic nervous system is a key contributor to the development of MAFLD. Indeed, common treatment strategies for metabolic diseases such as diet and exercise to induce weight loss have been shown to exert their beneficial effects at least in part through the associated sympathetic inhibition. Furthermore, pharmacological and device-based approaches to reduce sympathetic activation have been demonstrated to improve the metabolic alterations frequently present in patients with obesity, MetSand diabetes. Currently available evidence, while still limited, suggests that sympathetic activation is of specific relevance in the pathogenesis of MAFLD and consequentially may offer an attractive therapeutic target to attenuate the adverse outcomes associated with MAFLD.

scholarly journals Corticobasal Degeneration Misdiagnosed As Musculoskeletal Disease: A Challenging Diagnosis of Higher-Level Gait Disease

2020 ◽  
Vol 11 (04) ◽  
pp. 640-642
Author(s):  
Halil Onder
Keyword(s):  
Corticobasal Degeneration ◽  
The Elderly ◽  
Gait Disorders ◽  
Physiological Changes ◽  
Gait Abnormality ◽  
Age Related ◽  
Musculoskeletal Problems ◽  
Neurological Exam ◽  
Long Time ◽  
High Level

AbstractGait disorders are common in the elderly as there are various causes of neurological and non-neurological conditions. On the other hand, most of the gait parameters do change with advancing age which is identified as age-related physiological changes in gait. At this point, the discrimination between age-related physiological changes and gait disorders may be strictly challenging. After identifying gait as an abnormal pattern, classification of it and making the responsible pathophysiology also require high-level expertise in this regard. Herein, we present a rare patient with corticobasal degeneration (CBD) who had admitted initially due to complaints of gait problems. Over a long time, the patient had received the misdiagnosis of gait abnormality due to musculoskeletal problems by multiple physicians. However, the detailed neurological exam showed a higher level gait disorder (HLGD). Further investigations at this point yielded the diagnosis of CBD.

scholarly journals Sleep in Normal Aging, Homeostatic and Circadian Regulation and Vulnerability to Sleep Deprivation

2021 ◽  
Vol 11 (8) ◽  
pp. 1003
Author(s):  
Jacques Taillard ◽  
Claude Gronfier ◽  
Stéphanie Bioulac ◽  
Pierre Philip ◽  
Patricia Sagaspe
Keyword(s):  
Older Adults ◽  
Sleep Deprivation ◽  
Health Management ◽  
Nrem Sleep ◽  
Early Morning ◽  
Subcortical Structures ◽  
Wake Time ◽  
Adverse Health Outcomes ◽  
Neurobehavioral Function ◽  
Age Related

In the context of geriatric research, a growing body of evidence links normal age-related changes in sleep with many adverse health outcomes, especially a decline in cognition in older adults. The most important sleep alterations that continue to worsen after 60 years involve sleep timing, (especially early wake time, phase advance), sleep maintenance (continuity of sleep interrupted by numerous awakenings) and reduced amount of sigma activity (during non-rapid eye movement (NREM) sleep) associated with modifications of sleep spindle characteristics (density, amplitude, frequency) and spindle–Slow Wave coupling. After 60 years, there is a very clear gender-dependent deterioration in sleep. Even if there are degradations of sleep after 60 years, daytime wake level and especially daytime sleepiness is not modified with age. On the other hand, under sleep deprivation condition, older adults show smaller cognitive impairments than younger adults, suggesting an age-related lower vulnerability to extended wakefulness. These sleep and cognitive age-related modifications would be due to a reduced homeostatic drive and consequently a reduced sleep need, an attenuation of circadian drive (reduction of sleep forbidden zone in late afternoon and wake forbidden zone in early morning), a modification of the interaction of the circadian and homeostatic processes and/or an alteration of subcortical structures involved in generation of circadian and homeostatic drive, or connections to the cerebral cortex with age. The modifications and interactions of these two processes with age are still uncertain, and still require further investigation. The understanding of the respective contribution of circadian and homeostatic processes in the regulation of neurobehavioral function with aging present a challenge for improving health, management of cognitive decline and potential early chronobiological or sleep-wake interventions.

The Association Between Sarcopenia and Postoperative Outcomes Among Older Adults With Hip Fracture: A Systematic Review

2021 ◽  
pp. 073346482110065
Author(s):  
Ming-Hsiu Chiang ◽  
Yi-Jie Kuo ◽  
Yu-Pin Chen
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Hip Fracture ◽  
Postoperative Mortality ◽  
Clinical Event ◽  
High Morbidity ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
Study Selection ◽  
And Function

Hip fracture is a serious clinical event with high morbidity and mortality. Sarcopenia is characterized by age-related loss of muscle mass and function, leading to several adverse health outcomes. In this systematic review, no limitation criteria were used for study selection and 327 studies were identified in the initial search. Of these, 11 studies comprising a total of 2,314 patients were selected. The overall proportion of older adults with hip fracture having sarcopenia was 44%, with a disparity of approximately 10% between men and women. Most studies have indicated that older adults with sarcopenia had poorer postoperative functional recovery than those without sarcopenia; the association between sarcopenia and high postoperative mortality or long hospital stay was heterogeneous. Well-organized studies with longer follow-up periods are warranted.

Association between Frailty and 90-Day Outcomes amongst the Chinese Population: A Hospital-Based Multicentre Cohort Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Jing Jiao ◽  
Na Guo ◽  
Lingli Xie ◽  
Qiaoyan Ying ◽  
Chen Zhu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Outcomes ◽  
Hospital Ward ◽  
Adverse Health Outcomes ◽  
Multicentre Cohort Study ◽  
Older Inpatients ◽  
Ward Clustering ◽  
Clustering Effect ◽  
The Relationship ◽  
Multicentre Cohort

<b><i>Introduction:</i></b> Frailty has gained increasing attention as it is by far the most prevalent geriatric condition amongst older patients which heavily impacts chronic health status. However, the relationship between frailty and adverse health outcomes in China is far from clear. This study explored the relation between frailty and a panel of adverse health outcomes. <b><i>Methods:</i></b> We performed a multicentre cohort study of older inpatients at 6 large hospitals in China, with two-stage cluster sampling, from October 2018 to April 2019. Frailty was measured according to the FRAIL scale and categorized into robust, pre-frail, and frail. A multivariable logistic regression model and multilevel multivariable negative binomial regression model were used to analyse the relationship between frailty and adverse outcomes. Outcomes were length of hospitalization, as well as falls, readmission, and mortality at 30 and 90 days after enrolment. All regression models were adjusted for age, sex, BMI, surgery, and hospital ward. <b><i>Results:</i></b> We included 9,996 inpatients (median age 72 years and 57.8% male). The overall mortality at 30 and 90 days was 1.23 and 1.88%, respectively. At 30 days, frailty was an independent predictor of falls (odds ratio [OR] 3.19; 95% CI 1.59–6.38), readmission (OR 1.45; 95% CI 1.25–1.67), and mortality (OR 3.54; 95% confidence interval [CI] 2.10–5.96), adjusted for age, sex, BMI, surgery, and hospital ward clustering effect. At 90 days, frailty had a strong predictive effect on falls (OR 2.10; 95% CI 1.09–4.01), readmission (OR 1.38; 95% CI 1.21–1.57), and mortality (OR 6.50; 95% CI 4.00–7.97), adjusted for age, sex, BMI, surgery, and hospital ward clustering effect. There seemed to be a dose-response association between frailty categories and fall or mortality, except for readmission. <b><i>Conclusions:</i></b> Frailty is closely related to falls, readmission, and mortality at 30 or 90 days. Early identification and intervention for frailty amongst older inpatients should be conducted to prevent adverse outcomes.

scholarly journals Insights into preventing female genital mutilation/cutting in Sri Lanka: a qualitative interpretative study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Angela Dawson ◽  
Kumudu Wijewardene
Keyword(s):  
Sri Lanka ◽  
Complete Removal ◽  
Cultural Practice ◽  
Adverse Outcomes ◽  
Detailed Knowledge ◽  
The Sustainable Development ◽  
Genital Mutilation ◽  
Adverse Health Outcomes ◽  
Template Analysis ◽  
Role Of Religion

Abstract Background FGM/C is a cultural practice associated with adverse health outcomes that involves the partial or complete removal of the external female genitalia or injury to the genitalia. FGM/C is a form of violence against women and girls. There are no laws that specifically outlaw FGM/C in Sri Lanka and no national prevalence data. There is a lack of evidence about this practice to inform prevention efforts required to achieve the Sustainable Development Goal (SDG) target 5.3.2, which focuses on the elimination of all harmful practices, including FGM/C. Methods We undertook a qualitative interpretative study to explore the knowledge and perceptions of community members, religious leaders and professionals from the health, legal and community work sectors in five districts across Sri Lanka. We aimed to identify strategies to end this practice. Results Two-hundred-and twenty-one people participated in focus group discussions and key informant interviews. A template analysis identified five top-level themes: Providers, procedures and associated rituals; demand and decision-making; the role of religion; perceived benefits and adverse outcomes; ways forward for prevention. Conclusions This study delivered detailed knowledge of FGM/C related beliefs, perceptions and practitioners and provided opportunities to develop an integrated programming strategy that incorporates interventions across three levels of prevention.

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