An Overview of Fluoxetine in Geriatric Depression

1988 ◽  
Vol 153 (S3) ◽  
pp. 105-108 ◽  
Author(s):  
John P. Feighner ◽  
William F. Boyer ◽  
Charles H. Meredith ◽  
Gordon Hendrickson
Keyword(s):  
General Population ◽  
Plasma Concentrations ◽  
The Elderly ◽  
The Body ◽  
Elderly Subjects ◽  
Aging Brain ◽  
Efficacy And Safety ◽  
Geriatric Depression ◽  
Double Blind ◽  
Age Related

During the past 75 years, the proportion of elderly individuals in the USA has grown twice as fast as the general population. Depression in this age-group occurs four times more frequently than in the general population (Butler, 1975), and the suicide rate for people over 65 years of age is 15 times greater than that of the general population (Lehman, 1980).The elderly may be more susceptible to depression due to biological and/or psychosocial variables. Elderly people experience significant losses associated with increasing age, including death of spouse and friends, loss of work, social status, and physical and mental abilities (Lehman, 1980). The biogenic amine hypothesis suggests that the aging brain may experience a decrease in the functional availability of neurotransmitters (Lehman, 1980); this decrease may also play a role in the aetiology of depression.Due to age-related changes in the body, the elderly can be more sensitive to drug therapy. Older patients may require careful dosage adjustments and may also be more prone to experiencing drug-related adverse events. The elderly often receive medication for various indications, and drug interactions are a concern (Thompson et al, 1983). Therefore, efficacy and safety studies of new antidepressants in elderly patients are particularly important. We pooled data from both double-blind and open-label studies to evaluate the efficacy and safety of fluoxetine in geriatric outpatients with DSM-III major depression. Positive results of fluoxetine in the treatment of geriatric depression were reported in one of these studies (Feighner & Cohn, 1985). The favourable safety and side-effect profile of fluoxetine in the general population has been discussed elsewhere (Wernicke, 1985). Plasma concentrations of fluoxetine in elderly subjects are similar to those in younger individuals (I.emberger et al, 1985). These findings, combined with a lack of cardiovascular effects (Fisch, 1985), and low lethality with overdose, indicated promise for fluoxetine as a geriatric antidepressant.

scholarly journals Arginine behaviour after arginine or citrulline administration in older subjects

2015 ◽  
Vol 115 (3) ◽  
pp. 399-404 ◽  
Author(s):  
C. Moinard ◽  
J. Maccario ◽  
S. Walrand ◽  
V. Lasserre ◽  
J. Marc ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
The Elderly ◽  
Volume Of Distribution ◽  
Elderly Subjects ◽  
Healthy Elderly ◽  
Age Related ◽  
Loading Tests ◽  
Kinetics Of ◽  
Healthy Elderly Subjects

AbstractArginine (ARG) and its precursor citrulline (CIT) are popular dietary supplements, especially for the elderly. However, age-related reductions in lean body mass and alterations in organ functions could change their bioavailability. Pharmacokinetics and tolerance to amino acid (AA) loads are poorly documented in elderly subjects. The objective here was to characterise the plasma kinetics of CIT and ARG in a single-dosing study design. Eight fasting elderly men underwent two separate isomolar oral loading tests (10 g of CIT or 9·94 g of ARG). Blood was withdrawn over an 8-h period to measure plasma AA concentrations. Only CIT, ornithine and ARG plasma concentrations were changed. Volume of distribution was not dependent on AA administered. Conversely, parameters related to ARG kinetics were strongly dependent on AA administered: after ARG load, elimination was higher (ARG>CIT; P=0·041) and admission period+time at peak concentration was lower (ARG<CIT; P=0·033), and the combination of both phenomena results in a marked increase in ARG availability when CIT was administered (ARG<CIT; P=0·033) compared with ARG administration itself. In conclusion, a single CIT administration in the elderly is safe and well tolerated, and CIT proves to be a better in vivo ARG precursor than ARG itself in healthy elderly subjects.

scholarly journals Plasma lutein and zeaxanthin and the risk of age-related nuclear cataract among the elderly Finnish population

2011 ◽  
Vol 108 (1) ◽  
pp. 148-154 ◽  
Author(s):  
Jouni Karppi ◽  
Jari A. Laukkanen ◽  
Sudhir Kurl
Keyword(s):  
Elderly Population ◽  
Proportional Hazards Model ◽  
Disease Risk ◽  
Plasma Concentrations ◽  
The Elderly ◽  
Cox Proportional Hazards Model ◽  
Elderly Subjects ◽  
Nuclear Cataract ◽  
Age Related ◽  
History Of

Oxidative stress plays an important role in cataractogenesis. Previous studies have shown that long-term dietary intake of antioxidants (lutein and zeaxanthin) may decrease the risk of age-related cataracts. The aim of the present study was to examine whether plasma concentrations of lutein and zeaxanthin are related to age-related nuclear cataract in the elderly population. Subjects were participants in the Kuopio Ischaemic Heart Disease Risk Factor Study and they were classified into tertiles according to plasma concentrations of lutein and zeaxanthin. The association of plasma lutein and zeaxanthin concentrations with age-related nuclear cataract in 1689 elderly subjects (aged 61–80 years) was investigated in the present cross-sectional study by using the Cox proportional hazards model. A total of 113 cases of incident age-related cataracts were confirmed, of which 108 cases were nuclear cataracts. After adjustment for age, examination year, sex, BMI, smoking, alcohol consumption, serum LDL-cholesterol, serum HDL-cholesterol, years of education, use of oral corticosteroids, history of diabetes and history of hypertension with current use of antihypertensive medication, subjects in the highest tertiles of plasma concentrations of lutein and zeaxanthin had 42 and 41 % lower risks of nuclear cataract, respectively, compared with those in the lowest tertiles (relative risk (RR) = 0·58, 95 % CI 0·35, 0·98; P = 0·041 for lutein and RR = 0·59, 95 % CI 0·35, 0·99; P = 0·046 for zeaxanthin). In conclusion, we suggest that high plasma concentrations of lutein and zeaxanthin were associated with a decreased risk of age-related nuclear cataract in the elderly population.

scholarly journals Sonoelastographıc assessment of the age-related changes of the Achilles tendon

2015 ◽  
Vol 17 (1) ◽  
pp. 58 ◽  
Author(s):  
Aynur Turan ◽  
Mehmet Akif Teber ◽  
Zeynep Ilerisoy Yakut ◽  
Havva Akmaz Unlu ◽  
Baki Hekimoglu
Keyword(s):  
The Elderly ◽  
The Body ◽  
Elderly Subjects ◽  
Reference Tissue ◽  
Traumatic Injuries ◽  
Age Related ◽  
High Prevalence ◽  
History Of ◽  
Radiologic Investigation ◽  
Young Subjects

Aims: Tendons are crucial for optimal muscle force transfer and subject to changes with aging which may impair func- tional ability of elderly individuals. Achilles is the largest and the strongest tendon in the body; therefore it is an excellent site for the radiologic investigation of aging of tendons. Sonoelastography (SE) is a new ultrasound-based imaging technique that provides information on elastic properties and stiffness of tissues. The aim of our study was to investigate the age-related alterations in Achilles tendons using SE. Material and methods: Forty five geriatric (age≥ 65 years) and 42 young (age 18-40 years) healthy consecutive subjects were enrolled. Subjects with known history of metabolic or endocrine diseases, sports or traumatic injuries, peripheral vascular disorders were excluded. Both Achilles tendons were scanned with a real-time SE probe at a frequency of 6–15 MHz. Strains of Achilles tendons’ proximal, middle and distal parts were assessed semi-quantitatively with comparing a reference tissue. Results: Both SE methods -color coded evaluation and strain measurement- showed a re- markably stiffer tendon in the elderly subjects compared to young subjects in all thirds of Achilles tendons. In young subjects 84.9 % tendon thirds were blue, and 15.1% were green whereas, in elders 93.7% were blue and 6.3% were green (p=0.024). There was a significant correlation between age and stiffness of tendons assessed with strain indices. Conclusion: Our result showed increased tendon stiffness in elderly subjects which might be responsible for the high prevalence of Achilles tendi- nopathies observed in elderly subjects.

scholarly journals Dehydroepiandrosterone Treatment Is Not Beneficial to the Immune Response to Influenza in Elderly Subjects*

1997 ◽  
Vol 82 (9) ◽  
pp. 2911-2914
Author(s):  
H. D. Danenberg ◽  
A. Ben-Yehuda ◽  
Z. Zakay-Rones ◽  
D. J. Gross ◽  
G. Friedman
Keyword(s):  
Immune Response ◽  
Antibody Titer ◽  
Human Subjects ◽  
Serum Levels ◽  
The Elderly ◽  
Elderly Subjects ◽  
Double Blind Study ◽  
Double Blind ◽  
Age Related ◽  
Dhea Treatment

Abstract Background. Dehydroepiandrosterone (DHEA) is a native steroid with an immunomodulating activity that was suggested to counterregulate some phenomena of immunosenescence. Recently, it was shown to reverse the age-associated decline of immune response against influenza vaccine in aged mice. The present study was designed to evaluate the effect of DHEA on the immunization of elderly volunteers against influenza. Methods. Seventy-one elderly volunteers age 61–89 yr were enrolled in a prospective randomized, double-blind study to receive either DHEA (50 mg qd p.o. for four consecutive days starting two days before immunization) or placebo. Antibody response to the vaccine was measured before and 28 days after vaccination. Results. DHEA treatment significantly increased serum DHEA-sulfate (DHEA-S). No enhancement in established immunity was observed. A significant decrease in attainment of protective antibody titer (1:40 or higher) against the A/Texas strain in subjects with nonprotective baseline antibody titer was recorded following DHEA treatment compared with placebo (52% vs. 84%, P &lt; 0.05). Baseline DHEA-S serum levels were inversely related to attainment of immunization in DHEA-treated subjects. Influenza-like morbidity during the winter was low in the study group with no difference between the DHEA and placebo groups. Conclusions. Although highly effective in aged rodents, a short course of DHEA treatment did not improve the age-related declined response to immunization against influenza in human subjects. Higher baseline DHEA-S levels are not predictive of better immunization against influenza in the elderly.

scholarly journals Extra Virgin Olive Oil Prevents the Age-Related Shifts of the Distribution of HDL Subclasses and Improves Their Functionality

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2235
Author(s):  
Alyann Otrante ◽  
Amal Trigui ◽  
Roua Walha ◽  
Hicham Berrougui ◽  
Tamas Fulop ◽  
...  
Keyword(s):  
Olive Oil ◽  
Virgin Olive Oil ◽  
Density Lipoprotein ◽  
Extra Virgin Olive Oil ◽  
The Elderly ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Elderly Subjects ◽  
Age Related ◽  
Young Subjects

High-density lipoproteins (HDL) maintain cholesterol homeostasis through the role they play in regulating reverse cholesterol transport (RCT), a process by which excess cholesterol is transported back to the liver for elimination. However, RCT can be altered in the presence of cardiovascular risk factors, such as aging, which contributes to the increase in the incidence of cardiovascular diseases (CVD). The present study was aimed at investigating the effect of extra virgin olive oil (EVOO) intake on the cholesterol efflux capacity (CEC) of HDL, and to elucidate on the mechanisms by which EVOO intake improves the anti-atherogenic activity of HDL. A total of 84 healthy women and men were enrolled and were distributed, according to age, into two groups: 27 young (31.81 ± 6.79 years) and 57 elderly (70.72 ± 5.6 years) subjects. The subjects in both groups were given 25 mL/d of extra virgin olive oil (EVOO) for 12 weeks. CEC was measured using J774 macrophages radiolabeled with tritiated cholesterol ((3H) cholesterol). HDL subclass distributions were analyzed using the Quantimetrix Lipoprint® system. The HDL from the elderly subjects exhibited a lower level of CEC, at 11.12% (p < 0.0001), than the HDL from the young subjects. The CEC of the elderly subjects returned to normal levels following 12 weeks of EVOO intake. An analysis of the distribution of HDL subclasses showed that HDL from the elderly subjects were composed of lower levels of large HDL (L-HDL) (p < 0.03) and higher levels of small HDL (S-HDL) (p < 0.002) compared to HDL from the young subjects. A multiple linear regression analysis revealed a positive correlation between CEC and L-HDL levels (r = 0.35 and p < 0.001) as well as an inverse correlation between CEC and S-HDL levels (r = −0.27 and p < 0.01). This correlation remained significant even when several variables, including age, sex, and BMI as well as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose levels (β = 0.28, p < 0.002, and β = 0.24, p = 0.01) were accounted for. Consuming EVOO for 12 weeks modulated the age-related difference in the distribution of HDL subclasses by reducing the level of S-HDL and increasing the level of intermediate-HDL/large-HDL (I-HDL/L-HDL) in the elderly subjects. The age-related alteration of the CEC of HDL was due, in part, to an alteration in the distribution of HDL subclasses. A diet enriched in EVOO improved the functionality of HDL through an increase in I-HDL/L-HDL and a decrease in S-HDL.

Decreased Neutrophil Cyclic AMP Response to Isoprenaline Stimulation in the Elderly

1983 ◽  
Vol 65 (2) ◽  
pp. 155-157 ◽  
Author(s):  
T. G. Cotter ◽  
K. O'Malley
Keyword(s):  
Monoclonal Antibodies ◽  
Cyclic Amp ◽  
The Elderly ◽  
Population Heterogeneity ◽  
Elderly Subjects ◽  
Age Related ◽  
Significant Difference ◽  
Young Subjects ◽  
Drug Free

1. Neutrophils from drug-free elderly subjects produced approximately 50% less cyclic AMP in response to isoprenaline than did neutrophils from young subjects. A significant difference in basal cyclic AMP levels was also evident (elderly 2.8 ± 0.37; young 4.9 ± 0.36 pmol of cAMP/107 cells; P < 0.05). 2. With a range of anti-neutrophil monoclonal antibodies no evidence of age-related neutrophil population heterogeneity was found. 3. These findings indicate that the age-related decline in β-adrenoceptor responsiveness is not due to changes in the neutrophil population. 4. The present results support the hypothesis that there is a generalized decline in β-adrenoceptor-mediated responsiveness in the elderly.

Evidence for diminished visceral pain with aging: studies using graded intraesophageal balloon distension

1997 ◽  
Vol 272 (1) ◽  
pp. G1-G3 ◽  
Author(s):  
H. Lasch ◽  
D. O. Castell ◽  
J. A. Castell
Keyword(s):  
Pain Threshold ◽  
Visceral Pain ◽  
Threshold Value ◽  
The Elderly ◽  
Mean Value ◽  
Elderly Subjects ◽  
Pain Thresholds ◽  
Age Related ◽  
Balloon Distension ◽  
Intraesophageal Balloon Distension

Graded intraesophageal balloon distension (IEBD) has been utilized in the past to evaluate esophageal pain thresholds. With use of a technique that we have found to provide reproducible results for pain thresholds, two groups of normal individuals without esophageal symptoms or diabetes were studied. Group 1 included 10 "young" (age < 65 yr) individuals (mean age 27 yr, range 18-57 yr). Group 2 included 17 individuals age 65 yr or greater (mean age 72.5 yr, range 65-87 yr). Catheters with latex balloons (Wilson-Cook) were used in all 27 subjects with the balloon located 10 cm above the lower esophageal sphincter. Sequential inflations of 2-ml increments were performed until a total volume of 2 ml above the point of pain or to a maximum of 30 ml was reached. A series of two sequential inflations were performed on each subject on the day of the testing, and the mean value was taken to indicate pain threshold volumes for all 27 subjects. In the group of elderly volunteers, 5 subjects felt no pain even at the maximum inflatable volume of the balloon (30 ml) and were assigned a maximum threshold value of 30 ml. Mean pain threshold volumes for the young subjects was 17 +/- 0.8 ml of air (+/- SE) and for the elderly subjects was 27 +/- 1.4 ml (P < 0.01 and 95% confidence interval = 7.1-13.3). Our conclusion is that IEBD results in the esophagus indicate an age-related decrease in human visceral pain threshold.

Changes in processing adverbial conjuncts throughout adulthood

1996 ◽  
Vol 17 (1) ◽  
pp. 105-116
Author(s):  
Ronald L. Bloom ◽  
Jeanne Mullin ◽  
Peter J. Paternostro
Keyword(s):  
Life Span ◽  
The Elderly ◽  
Education Level ◽  
Significant Decline ◽  
Elderly Subjects ◽  
Linguistic Processing ◽  
Middle Aged ◽  
Age Related ◽  
Processing Abilities

ABSTRACTThis study examines the use and understanding of concordant (e.g., consequently, moreover) and discordant (e.g., rather, contrastively) adverbial conjuncts in the later part of the life span. The participants, 75 neurologically healthy young (mean age 21.8), middle-aged (mean age 51.7), and elderly (mean age 73.1) adults, were examined using procedures by Nippold, Schwarz, and Undlin (1992). Groups were matched for education level. The results indicate a significant decline in processing adverbial conjuncts in the elderly. Discordant adverbial conjuncts especially challenged the linguistic processing abilities of the elderly subjects. The age- related decline in processing adverbial conjuncts.appears to be a specific deficit in linguistic processing that is independent of problems in memory or the effects of exposure to sophisticated language forms.

Aging and immune response to exercise

1998 ◽  
Vol 76 (5) ◽  
pp. 562-572 ◽  
Author(s):  
Shoji Shinkai ◽  
Masamitsu Konishi ◽  
Roy J Shephard
Keyword(s):  
Cellular Immunity ◽  
Acute Exercise ◽  
Cell Function ◽  
Nk Cell ◽  
Cell Activity ◽  
The Elderly ◽  
Strenuous Exercise ◽  
Elderly Subjects ◽  
Older Individuals ◽  
Age Related

Human immune function undergoes adverse changes with aging. The T cells, which have a central role in cellular immunity, show the largest age-related differences in distribution and function, with thymus involution as the apparent underlying cause. The immune responses to acute exercise and training have not been studied extensively in the elderly. The natural killer (NK) cell response to a single exercise challenge is normal in older individuals, but immediately after exercise the elderly subjects manifest less suppression of phytohemagglutinin (PHA)-induced lymphocyte proliferation than younger individuals. In contrast, a strenuous exercise seems to induce a more sustained postexercise suppression of cellular immunity in older individuals than in their young peers. A few cross-sectional comparisons of immune status between physically fit elderly individuals and young sedentary controls suggest that habitual physical activity may enhance NK cell activity, checking certain aspects of the age-related decline in T cell function, such as reduced mitogenesis in response to plant lectins and decreases in the production of certain types of cytokine. The clinical implications, however, remain to be clarified by future study.Key words: immune senescence, innate immunity, adaptive immunity.

Neuroendocrine rhythms and sleep in aging men

1991 ◽  
Vol 260 (4) ◽  
pp. E651-E661 ◽  
Author(s):  
A. van Coevorden ◽  
J. Mockel ◽  
E. Laurent ◽  
M. Kerkhofs ◽  
M. L'Hermite-Baleriaux ◽  
...  
Keyword(s):  
Young Male ◽  
Extended Period ◽  
The Elderly ◽  
Thyroid Stimulating Hormone ◽  
Temporal Organization ◽  
Elderly Subjects ◽  
Elderly Men ◽  
Age Related ◽  
Aging Men ◽  
Effects Of Aging

To delineate the physiological effects of aging on basal levels and temporal patterns of neuroendocrine secretions, the 24-h profiles of cortisol, thyroid-stimulating hormone (TSH), melatonin, prolactin, and growth hormone (GH) levels were simultaneously obtained at frequent intervals in eight healthy, active elderly men, age 67-84 yr and in eight young male adults, age 20-27 yr. The study was preceded by an extended period of habituation to laboratory conditions, and sleep was polygraphically recorded. Mean cortisol levels in the elderly were normal, but the amplitude of the circadian rhythm was reduced. Circulating levels of daytime and nighttime levels of both TSH and GH were greatly diminished in old age. In contrast, prolactin and melatonin concentrations were decreased during the nighttime only. The circadian rises of cortisol, TSH, and melatonin occurred 1-1.5 h earlier in elderly subjects, and the distribution of rapid-eye-movement stages during sleep was similarly advanced, suggesting that circadian timekeeping is modified during normal senescence. Despite perturbations of sleep, sleep-related release of GH and prolactin occurred in all elderly men. Age-related decreases in hormonal levels were associated with a decrease in the amplitude, but not the frequency, of secretory pulses. These findings demonstrate that the normal process of aging involves alterations in the central mechanisms controlling the temporal organization of endocrine release in addition to a reduction of secretory outputs.

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