scholarly journals Diagnosis and Treatment of Elderly and Senile Chronic Constipation: an Expert Consensus

2021 ◽  
Vol 31 (4) ◽  
pp. 7-20
Author(s):  
V. T. Ivashkin ◽  
M. G. Mnatsakanyan ◽  
V. S. Ostapenko ◽  
А. P. Pogromov ◽  
V. M. Nekoval ◽  
...  
Keyword(s):  
Chronic Constipation ◽  
Cognitive Status ◽  
Activity Level ◽  
Total Risk ◽  
Efficient Management ◽  
Age Related ◽  
Fibre Diet ◽  
Key Points ◽  
Patient’S History ◽  
Perception Of Health

Aim. An appraisal of practitioners with chronic constipation management details in older and senile adults.Key points. Chronic constipation is a common issue in geriatrics. Aside to age-related physiological bowel disfunction, a higher constipation incidence is conditioned by declined physical activity and frailty, polypharmacy and a series of secondary constipation-developing chronic states and diseases. Chronic constipation is associated with a higher risk of cardiovascular disease and complications, impaired general perception of health and pain, growing alarm and depression, and reduced quality of life. The treatment tactics in chronic constipation is cause-conditioned and should account for the patient’s history and therapy line, overall clinical condition, cognitive status and functional activity level. An essential baseline aspect of constipation management is apprising the patient and his family of the underlying factors and methods for non-drug and drug correction. An higher-fibre diet is recommended as first measure, with osmotic laxatives added and titrated to clinical response if none observed towards the non-drug and high-fibre regimens. Stimulant laxatives and prokinetics should be recommended in patients reluctant to fibre supplements and osmotic laxatives. Subsidiary correction includes biofeedback, transanal irrigation, acupuncture, foot reflexology and percutaneous tibial nerve stimulation.Conclusion. Elderly and senile chronic constipation is a prevalent multifactorial state requiring an efficient management via assessment and correction of total risk factors and consistent use of non-medication and drug therapies.

scholarly journals The Longitudinal Association of Walking Efficiency With Brain Volumes in Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 783-783
Author(s):  
Jennifer Schrack ◽  
Fangyu Liu ◽  
Amal Wanigatunga ◽  
Yang An ◽  
Christos Davatzikos ◽  
...  
Keyword(s):  
Region Of Interest ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Intracranial Volume ◽  
Brain Volumes ◽  
Age Related ◽  
Lower Baseline ◽  
Longitudinal Association ◽  
Mri Scans ◽  
Walking Efficiency

Abstract Walking efficiency (WE) predicts mobility decline and is linked with higher fatigability. Fatigability is associated with cognitive decline and reduced brain volumes (BV), but the link between WE and BV is undefined. We examined associations between WE and BV in 860 participants of the BLSA (mean age 66.4(14.4) years, 54.5% women). WE was assessed during 2.5-minutes of usual-paced walking using indirect calorimetry and standardized per meter (ml/kg/m). BV measures were derived using MRI scans and an automated multi-atlas region-of-interest approach. In linear mixed models adjusted for demographics, education, BMI, intracranial volume, and cognitive status, lower baseline WE was associated with lower total, white, and gray matter, primarily in the frontal and temporal lobes (all p<0.05). Longitudinally, declining WE was associated with increasing ventricular and decreasing hippocampal volumes over follow-up (all p<0.01). Findings suggest rising age-related inefficiencies may reflect underlying brain atrophy and serve as a novel indicator for future interventions.

Age- and Activity-Related Differences in the Mechanisms Underlying Maximal Power Production in Young and Older Adults

2014 ◽  
Vol 30 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Thomas Korff ◽  
Ann H. Newstead ◽  
Renate van Zandwijk ◽  
Jody L. Jensen
Keyword(s):  
Older Adults ◽  
Knee Flexion ◽  
Power Production ◽  
Activity Level ◽  
Maximum Power ◽  
Maximal Power ◽  
Joint Power ◽  
Age Related ◽  
Peak Knee ◽  
Active Adults

The purpose of this study was to examine the interactions between aging, activity levels and maximal power production during cycling. Participants were divided into younger adults (YA), older active adults (OA,) and older sedentary adults (OS). Absolute maximum power was significantly greater in YA compared with OS and OA; no differences were found between OA and OS. The age-related difference in maximum power was accompanied by greater absolute peak knee extension and knee flexion powers. Relative joint power contributions revealed both age- and activity-related differences. YA produced less relative hip extension power than older adults, regardless of activity level. The OS participants produced less relative knee flexion power than active adults, regardless of age. The results show the age-related decline in muscular power production is joint specific and that activity level can be a modifier of intersegmental coordination, which has implications for designing interventions for the aging population.

The Relations Between Physical Activity Level, Executive Function, and White Matter Microstructure in Older Adults

2021 ◽  
pp. 1-13
Author(s):  
Marissa A. Gogniat ◽  
Catherine M. Mewborn ◽  
Talia L. Robinson ◽  
Kharine R. Jean ◽  
L. Stephen Miller
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Executive Function ◽  
White Matter ◽  
Diffusion Tensor ◽  
Vigorous Physical Activity ◽  
Neuropsychological Testing ◽  
Activity Level ◽  
Average Intensity ◽  
Age Related

The population of older adults is increasing, indicating a need to examine factors that may prevent or mitigate age-related cognitive decline. The current study examined whether microstructural white matter characteristics mediated the relation between physical activity and executive function in older adults without any self-reported psychiatric and neurological disorders or cognitive impairment (N = 43, mean age = 73 y). Physical activity was measured by average intensity and number of steps via accelerometry. Diffusion tensor imaging was used to examine microstructural white matter characteristics, and neuropsychological testing was used to examine executive functioning. Parallel mediation models were analyzed using microstructural white matter regions of interest as mediators of the association between physical activity and executive function. Results indicated that average steps was significantly related to executive function (β = 0.0003, t = 2.829, P = .007), while moderate to vigorous physical activity was not (β = 0.0007, t = 1.772, P = .08). White matter metrics did not mediate any associations. This suggests that microstructural white matter characteristics alone may not be the mechanism by which physical activity impacts executive function in aging.

scholarly journals Elevated HDL Levels Linked to Poorer Cognitive Ability in Females With Parkinson’s Disease

2021 ◽  
Vol 13 ◽  
Author(s):  
Megan C. Bakeberg ◽  
Anastazja M. Gorecki ◽  
Jade E. Kenna ◽  
Alexa Jefferson ◽  
Michelle Byrnes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Cognitive Performance ◽  
Linear Models ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cognitive Status ◽  
Cross Sectional ◽  
Age Related

IntroductionCholesterol levels have been associated with age-related cognitive decline, however, such an association has not been comprehensively explored in people with Parkinson’s disease (PD). To address this uncertainty, the current cross-sectional study examined the cholesterol profile and cognitive performance in a cohort of PD patients.MethodsCognitive function was evaluated using two validated assessments (ACE-R and SCOPA-COG) in 182 people with PD from the Australian Parkinson’s Disease Registry. Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and Triglyceride (TRG) levels were examined within this cohort. The influence of individual lipid subfractions on domain-specific cognitive performance was investigated using covariate-adjusted generalised linear models.ResultsFemales with PD exhibited significantly higher lipid subfraction levels (TC, HDL, and LDL) when compared to male counterparts. While accounting for covariates, HDL levels were strongly associated with poorer performance across multiple cognitive domains in females but not males. Conversely, TC and LDL levels were not associated with cognitive status in people with PD.ConclusionHigher serum HDL associates with poorer cognitive function in females with PD and presents a sex-specific biomarker for cognitive impairment in PD.

scholarly journals Effects of Disseminated Mycobacterial Infection on Age-Related Macular Degeneration

2016 ◽  
Vol 7 (3) ◽  
pp. 534-542
Author(s):  
Geoffrey Collett ◽  
Natalia Lopez ◽  
Pedro F. Lopez
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Rare Event ◽  
Mycobacterial Infection ◽  
Age Related Macular Degeneration ◽  
Mycobacterium Chelonae ◽  
Age Related ◽  
Ocular Imaging ◽  
Inflammatory State ◽  
Patient’S History

Our patient, in the 7th decade of life, presented with worsening blurry vision over 3 weeks. The pertinent history included nonexudative age-related macular degeneration, recent pulmonary mycobacterial infection, and autoimmune pancreatitis. The patient had decreased visual acuity in both eyes; the remaining findings of our examination were relatively benign. The diagnosis of bilateral exudative age-related macular degeneration was aided by ocular imaging. Not only were exudative changes confirmed, but one modality suggested an underlying occult choroiditis, which presumably fueled a local inflammatory drive leading to evolution of the disease. Given the choroiditis developed in the setting of a recent Mycobacterium chelonae infection, dissemination of the organism must be considered a potential culprit. Additionally, a chronic inflammatory state perhaps played a simultaneous immunologic role. We feel the proposed pathogenic mechanism outlined sufficiently accounts for the rare event, that is, development of subacute bilateral exudative maculopathy. The patient responded well to bilateral intravitreal aflibercept injections. After 1 month, visual acuity was found to be near baseline and ocular imaging showed significant resolution of the exudative changes. An additional follow-up 3 months after confirmed similar stability. This case required thorough investigation of seemingly unrelated components within the patient’s history. We stress the importance of obtaining appropriate documentation from fellow health care teams when suspicious clinical presentations arise. During our investigation, we identified cryptic retinal lesions by way of angiography – leading us to recommend usage of such methods in complex cases. We also summarize the implemented aflibercept course and the favorable response to such treatment.

Estimation of Cognitive Plasticity in Old Adults Using Dynamic Assessment Techniques

2009 ◽  
Vol 8 (1) ◽  
pp. 38-51 ◽  
Author(s):  
Elena Navarro ◽  
María Dolores Calero
Keyword(s):  
Older Adults ◽  
Cognitive Functioning ◽  
Dynamic Assessment ◽  
Cognitive Status ◽  
Diagnostic Utility ◽  
Old Adults ◽  
Age Related ◽  
Assessment Techniques ◽  
Cognitive Plasticity

In recent years, research has provided extensive data concerning the use, utility, and appropriateness of dynamic assessment techniques as a way of determining cognitive plasticity in old adults. Current research in this area is focused on three principle lines of investigation: (a) determining neurological correlates of cognitive plasticity evaluated through dynamic assessment techniques; (b) establishing the diagnostic utility of such procedures; and (c) analyzing age-related limits with regard to quantity and domains of plasticity. In this context, the present study was undertaken using a sample of 274 older adults, who were evaluated through two dynamic assessment techniques and one cognitive functioning screening test over a period of 3 consecutive years. Results show differences in plasticity related to both age and cognitive status. The study also demonstrates the capacity of plasticity to predict maintenance and decline in a follow-up period of 3 years.

Neuropsychological Assessment of an Aging Population of Great Lakes Fisheaters

1996 ◽  
Vol 12 (3-4) ◽  
pp. 403-417 ◽  
Author(s):  
Susan L. Schantz ◽  
Anne M. Sweeney ◽  
Joseph C. Gardiner ◽  
Harold E.B. Humphrey ◽  
Robert J. McCaffrey ◽  
...  
Keyword(s):  
Great Lakes ◽  
Motor Function ◽  
Neuropsychological Assessment ◽  
Fish Consumption ◽  
Activity Level ◽  
Neurological Dysfunction ◽  
Coplanar Pcbs ◽  
Assessment Battery ◽  
Age Related ◽  
Pcb Exposure

Because of the decline in central nervous system function that occurs with age, older people may be at greater risk of neurological dysfunction following exposure to neurotoxic contaminants in the environment. This study wasdesigned to assess the neuropsychological functioning of a group of 50-90- year-old fisheaters exposed to polychlorinated biphenyls (PCBs) through Great Lakes fish consumption, and a group of age- and sex-matched nonfisheaters selectedfrom the Michigan Department of Public Health's established cohort of fisheaters and nonfisheaters. A neuropsychological assessment battery, demographic interview, and fish consumption questionnaire were developed and piloted on similarly aged men and women in the Lansing and Detroit, Michigan, areas. The assessment battery included tests of motor function, memory and learning, executive functions, and visual-spatial functions, and took approximately two hours to administer. Most of the tests included in the battery have been shown to be sensitive to subtle, age-related declines in cognitive and motor function. The demographic questionnaire included questions on a number of important control variables that could influence the neuropsychological end points that were assessed in the study. These included demographic background, alcohol consumption, tobacco use, prescription and nonprescription drug use, medical history (including psychiatric illnesses), employment history, and activity level. The fish consumption questionnaire asked about historical and current consumption of specific fish species from each of the Great Lakes and its tributaries and was based on the fish consumption advisories published in the 1992 Michigan Fishing Guide. The questionnaire also asked about consumption of wild game, fish preparation and cooking methods, serving size, and changes in fish consumption patterns over time. After each subject completed the neuropsychological assessment, demographic interview, and fish consumption questionnaire, a blood sample was collected for analysis of PCBs, dichloro diphenyl dichloroethene (DDE), and ten other contaminants frequently detected in Great Lakes fish. Subject recruitment for the study began in July 1993 and was completed in November 1995. The data will be analyzed in two steps: first, to assess differences in confounding variables between fisheaters and nonfisheaters; and secondly, to determine the independent effects of Great Lakes fish consumption, as well as serum PCB and DDE levels, on cognitive and motor function after controlling for all identified covariates. Three indices of PCB exposure—total PCBs, total ortho-substituted PCBs and total coplanar PCBs—will be assessed. These studies should shed light on three questions: 1) Does consumption of contaminated fish from the Great Lakes exacerbate or accelerate the normal age-related decline in cognitive and motor function? 2) Do serum PCB or DDE concentrations predict the degree of behavioral dysfunction? and 3) If PCB exposure is related to behavioral outcomes, which class of PCB congeners, ortho-substituted or coplanar, are responsible for the cognitive and motor deficits?

Age-related lymphoma patient experience: Results from the Lymphoma Coalition 2018 Global Patient Survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e20071-e20071
Author(s):  
Raul Cordoba ◽  
Natacha Bolanos ◽  
Lorna Warwick ◽  
Natalie Dren
Keyword(s):  
Patient Experience ◽  
Age Groups ◽  
Well Being ◽  
Patient Survey ◽  
Activity Level ◽  
Age Group ◽  
Lymphoma Patient ◽  
Medical Issues ◽  
Age Related ◽  
Patient Reported

e20071 Background: Over the past two decades, the incidence of lymphoma has increased by 8-10% per year in older adults. Despite the growing population of older cancer patients, there are a limited number of studies that focus on the experience of these patients. Lymphoma Coalition (LC) saw the need in the 2019 Report Card on Lymphomas to examine the age-related lymphoma patient experience. The objectives of this study were to identify: 1) informational needs and understanding levels, 2) physical conditions and medical issues, 3) psychosocial issues, and 4) barriers in patient-doctor communication. Methods: Using a subset of data from the LC 2018 Global Patient Survey on Lymphomas and CLL (LC 2018 GPS), this study will specifically examine the experiences of newly diagnosed lymphoma patients within the following age categories: 1) Young (18-59) (n = 1473); Mid (60-69) (n = 371); Old (70+) (n = 162). Results: From January to March 2018, 2,006 participants were included in this analysis from 47 countries. The majority of all three patient groups wanted additional medical information beyond what was provided at their diagnosis meeting with the doctor, with the greatest need for information in the young patient group (73%). The highest proportion of poor understanding was reported by the mid-age group (14%) and the highest proportion of very good understanding was reported by the old age group (53%). Across all three age groups, fatigue was the top reported physical condition affecting well-being. Regarding older patients, hair loss was reported in 36% vs 54% in younger patients (p = 0.01), and muscle weakness was reported in 40%. A greater proportion of those in the old group reported that their lifestyle (86%) and general activity level (87%) had been affected. The reported prevalence of medical issues was highest in the young group and lowest in the old group, both during and after treatment. Fear of relapse was the top reported psychosocial issue following treatment for patients in all three age groups. Of those who discussed their fear of relapse with their doctor (young 42% vs old 21%, p = 0.0022), less than one third of patients felt their discussion helped alleviate the fear. Conclusions: This study emphasizes that lymphoma patients in all age groups need more information and support beyond what is currently being provided. While certain age-specific trends were identified, the majority of patient-reported issues span across all three of the age groups examined.

scholarly journals Enhanced Calcium Buffering in F344 Rat Cholinergic Basal Forebrain Neurons Is Associated With Age-Related Cognitive Impairment

2009 ◽  
Vol 102 (4) ◽  
pp. 2194-2207 ◽  
Author(s):  
David Murchison ◽  
Angelika N. McDermott ◽  
Candi L. LaSarge ◽  
Kathryn A. Peebles ◽  
Jennifer L. Bizon ◽  
...  
Keyword(s):  
Basal Forebrain ◽  
Cholinergic Neurons ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Aged Rats ◽  
Middle Aged ◽  
Cholinergic Basal Forebrain ◽  
Age Related ◽  
Forebrain Neurons ◽  
Firing Properties

Alterations in neuronal Ca2+ homeostasis are important determinants of age-related cognitive impairment. We examined the Ca2+ influx, buffering, and electrophysiology of basal forebrain neurons in adult, middle-aged, and aged male F344 behaviorally assessed rats. Middle-aged and aged rats were characterized as cognitively impaired or unimpaired by water maze performance relative to young cohorts. Patch-clamp experiments were conducted on neurons acutely dissociated from medial septum/nucleus of the diagonal band with post hoc identification of phenotypic marker mRNA using single-cell RT-PCR. We measured whole cell calcium and barium currents and dissected these currents using pharmacological agents. We combined Ca2+ current recording with Ca2+-sensitive ratiometric microfluorimetry to measure Ca2+ buffering. Additionally, we sought changes in neuronal firing properties using current-clamp recording. There were no age- or cognition-related changes in the amplitudes or fractional compositions of the whole cell Ca2+ channel currents. However, Ca2+ buffering was significantly enhanced in cholinergic neurons from aged cognitively impaired rats. Moreover, increased Ca2+ buffering was present in middle-aged rats that were not cognitively impaired. Firing properties were largely unchanged with age or cognitive status, except for an increase in the slow afterhyperpolarization in aged cholinergic neurons, independent of cognitive status. Furthermore, acutely dissociated basal forebrain neurons in which choline acetyltransferase mRNA was detected had the electrophysiological profiles of identified cholinergic neurons. We conclude that enhanced Ca2+ buffering by cholinergic basal forebrain neurons may be important during aging.

scholarly journals Age-related mild cognitive deficit: a ready-to-use concept?

2003 ◽  
Vol 5 (1) ◽  
pp. 61-76
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Elderly Patients ◽  
Cognitive Deficit ◽  
Magnetization Transfer ◽  
Cognitive Status ◽  
Resonance Spectroscopy ◽  
First Line ◽  
Frequent Type ◽  
Age Related

For better management of mild cognitive impairment in elderly patients, clinicians should be provided with instruments to detect early changes and predict their progression. To define this cognitive status between optimal and pathological aging, many concepts have been proposed, which actually describe various conditions and provide more or less precise criteria, leaving room for variable implementation. As a consequence, application of these criteria gave highly variable prevalence rates, Neuropathological studies indicate that the different criteria have variable power in detecting incipient Alzheimer's disease (AD) and suggest that the transition between mild cognitive impairment and ÀD is not merely quantitative. Follow-up studies have produced, according to the criteria used, a 2.5% to 16,6% annual rate for progression toward dementia, and have also shown that the criteria differ in their stability and predictive power. Baseline cognitive performances have some predictive value, but are difficult to apply in first-line medicine. Investigational techniques (structural and functional imaging, magnetic resonance spectroscopy, magnetization transfer imaging, cerebrospinal fluid neuro-chemistry, and apolipoprotein E genotype) are promising tools in the early diagnosis of AD, which remains the most frequent type of dementia in elderly people and probably the most frequent type developed by patients with mild cognitive deficit. The final goal is to offer early treatment to those patients who will evolve towards dementia, once they can be identified, in the case of AD, recent findings question the adequacy of cholinergic replacement therapies. In its current state, the criteria for mild cognitive deficit are hardly transferable to first-line medicine. However, disseminating the concept could help increase the sensitivity of general practitioners to the importance of cognitive complaints and signs in their elderly patients.

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