Clinical Trial of Glutamate for the Improvement of Nutrition and Health in the Elderly

The growth of the elderly population in Indonesia from year to year has always increased, followed by the problem of decreasing physical strength and psychological health of the elderly. These problems can affect the increase in dependence and decrease the independence of the elderly in ADL. In previous studies, various factors affect independence in ADLs such as cognitive, psychological, economic, nutrition, and health. However, In general, these studies only focus on predictive analysis or correlation of variables, and no research has attempted to identify the casual relationship of the elderly independence factors. Therefore, this study aimed to determine the mechanism of the causal relationship of the factors that influence the independence of the elderly in ADLs using a casual method called the Stable Specification Search for Cross-Sectional Data With Latent Variables (S3C-Latent). In this research we found strong causal and associative relationships between factors.The causal relationship of elderly independence in ADLs was influenced by cognitive, psychological, nutritional and health factors and gender with α values respectively (0.61; 0.61;1.00, 0.65;0.70). Cognitive factors associated with psychological, economic, nutrition, and health with a value of α (0.77; 1.00; 1.00; 0.64). Furthermore, psychological factors associated with economy, nutrition, and health with a value of α (0.77; 0.95; 0.63). Bisides, economic factors are associated with nutrition and health with α values of ( 0.86; 0.75) and nutrition with health with α values of 0.64. The last association was found between nutritional factors and gender with a value of α 0.76. This research is expected to increase the independence of the elderly in carrying out daily activities.

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Ethics in Clinical Studies: The Dilemma of very Young and Old

10.46610/jcper.2021.v03i02.005 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Avisek Dutta ◽

Avisek Dutta

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Human Physiology ◽

Informed Consent ◽

Adverse Effects ◽

Age Groups ◽

The Elderly ◽

Infantile Spasms ◽

Care Givers ◽

Improve Health

The objectives of the research are to percolate knowledge which can improve health and improve understanding of human physiology. Pervasive exclusion of children and elderly in clinical trials as is happening today is not justified. Children have different physiology and pharmacology from adults; often adverse effects are also different and specific. Diseases like neonatal hyperbilirubinemia, infantile spasms are very age specific. Elderly too, have age specific issues like dementias, malignancies, weakened systems and polypharmacy that make them a special cohort. Clinical trials in these age groups are essential so as to gather comprehensive data about a medication across all age groups. Informed consent is a challenge in both these groups. It can be remedied by obtaining consent from parents, or legally acceptable representative in case of children and care givers and/or LARs in case of the elderly. Oral assent from 7 to 11 years, and written assent from 12 to 18 years and in the elderly, along with consent from the LAR, parents, care givers as the case may be, forms the bedrock of good clinical trial ethics.

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NACRE: A randomized study comparing short course radiotherapy with radiochemotherapy for locally advanced rectal cancers in the elderly—Preliminary results.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.4 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 4-4

Author(s):

Eric FRANCOIS ◽

Mandy Pernot ◽

Philippe Ronchin ◽

Elodie Nouhaud ◽

Isabelle Martel Lafay ◽

...

Keyword(s):

Clinical Trial ◽

Overall Survival ◽

Locally Advanced ◽

The Elderly ◽

R0 Resection ◽

Resection Rate ◽

Logrank Test ◽

Delayed Surgery ◽

Short Course ◽

Short Course Radiotherapy

4 Background: Neoadjuvant therapy followed by total mesorectal surgery is the standard of care for locally advanced rectal carcinoma (RC). In the elderly, often underrepresented in clinical trials, but who represent a very large number of patients, therapeutic proposals are not based on high levels of evidence. The NACRE study investigated the role of short course radiotherapy with delayed surgery in this population. Methods: The PRODIGE 42-GERICO 12 NACRE is a multicenter randomized clinical trial aimed at comparing Arm A preop radiochemotherapy (RCT) (50 Gy, 2Gy/fraction [fr]; 25 fr + capecitabine) and delayed surgery and Arm B short course radiotherapy (25 gy, 5Gy/fr, 5fr) and delayed surgery. Eligible patients (pts) had cT3 or cT4 (or cT2 of the very low rectum), M0 rectal adenocarcinomas <12 cm from the anal verge, age ≥75years, and WHO PS ≤2. Randomization was stratified by center, T (T2/T3-T4) stage and Age (≤80 or >80 years). Two primary end-points will be analyzed according to the hierarchical sequential procedure: firstly R0 resection rate (non-inferiority test with a 8% non-inferiority margin), secondly preservation of autonomy using IADL score (superiority test with 15% absolute difference margin); secondary end-point will be survival and toxicity. We present here the results for R0 resection, survival and toxicities. Results: 29 sites randomized 101 patients from 01/2016 to 08/2019, 59 were males (58.4%), median age was 80 years (range 75-91). Pts characteristics were well balanced. 14% of pts in arm A did not receive all of the planned neoadjuvant treatment compared to 0% in arm B. The R0 resection rate in arm B (86.0% [IC95% 73-94%]) was not-inferior to the R0 resection rate in arm A (89.8% [ic95% 77-97%]), p=0.04 (non inferiority test). With a median follow-up of 15.8 months (CI95%: 14.8-26.0), the 6 months death rate was 10.0% (CI95%: 3.0-22.0) in arm A and 3.92% (CI95%: 0 -13.0) in arm B. There is a significant difference in overall survival between the two arm in favor of arm B (p=0.04, LogRank test), and there is a trend in favor of arm B for specific survival (p=0.06 LogRank test). Disease free survival is not statistically different (p=0.9). 13 serious adverse events were observed in arm A during preoperative phase, 7 in arm B, 16 and 10 respectively during the post-operative phase. Conclusions: These preliminary results show that short course radiotherapy with delayed surgery is associated with better compliance than radiochemotherapy in elderly patients and could give an advantage in overall survival. This regimen may be preferred in elderly patients. Clinical trial information: NCT02551237.

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A Meta-Analysis on the Effect Size of Physical Activity, Nutrition and Health Education-related Intervention for Sarcopenia in the Elderly

Korean Journal of Gerontological Social Welfare ◽

10.21194/kjgsw.75.1.202003.65 ◽

2020 ◽

Vol 75 (1) ◽

pp. 65-97

Author(s):

Hyeonjeong Lee ◽

Aejung Kim

Keyword(s):

Physical Activity ◽

Health Education ◽

Effect Size ◽

Meta Analysis ◽

The Elderly ◽

Nutrition And Health

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The effect of lavender herbal tea on the anxiety and depression of the elderly: A randomized clinical trial

Complementary Therapies in Medicine ◽

10.1016/j.ctim.2020.102393 ◽

2020 ◽

Vol 50 ◽

pp. 102393

Author(s):

Mohammad-Rafi Bazrafshan ◽

Mozhgan Jokar ◽

Nasrin Shokrpour ◽

Hamed Delam

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

The Elderly ◽

Anxiety And Depression ◽

Herbal Tea

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Drugs for Targeted Therapies of Alzheimer’s Disease

Current Medicinal Chemistry ◽

10.2174/0929867325666180430150940 ◽

2019 ◽

Vol 26 (2) ◽

pp. 335-359 ◽

Cited By ~ 4

Author(s):

Chit Tam ◽

Jack Ho Wong ◽

Tzi Bun Ng ◽

Stephen Kwok Wing Tsui ◽

Tao Zuo

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trial ◽

Drug Targets ◽

The Elderly ◽

Dependent Manner ◽

Cell Replacement Therapy ◽

Drug Candidates ◽

Amyloid A ◽

Potential Drug Targets

Alzheimer’s disease (AD) is one type of neurodegenerative diseases, which is prevalent in the elderly. Beta-amyloid (Aβ) plaques and phosphorylated tau-induced neurofibrillary tangles are two pathological hallmarks of this disease and the corresponding pathological pathways of these hallmarks are considered as the therapeutic targets. There are many drugs scheduled for pre-clinical and clinical trial that target to inhibit the initiators of pathological Aβ and tau aggregates as well as critical Aβ secretases and kinases in tau hyperphosphorylation. In addition, studies in disease gene variations, and detection of key prognostic effectors in early development are also important for AD control. The discovery of potential drug targets contributed to targeted therapy in a stage-dependent manner, However, there are still some issues that cause concern such as the low bioavailability and low efficacy of candidate drugs from clinical trial reports. Therefore, modification of drug candidates and development of delivery agents are essential and critical. With other medical advancements like cell replacement therapy, there is hope for the cure of Alzheimer’s disease in the foreseeable future.

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