scholarly journals Stenotic remodeling of coronary vessels in the elderly patients with high cardiovascular risk and the presence of multifocal atherosclerosis

2021 ◽  
Vol 12 (1) ◽  
pp. 15-22
Author(s):  
Azat K. Khasanov ◽  
Bulat A. Bakirov ◽  
Dmitry A. Kudlay ◽  
Irina M. Karamova

Aim. Identifying persons who are distinguished by an increased frequency of stenosing atherosclerosis of the coronary arteries also affects the process of identifying the features of the analyzed disease. Material and methods. The main research method was the method of hierarchical analysis of categorical variables. At the same time, they differentiated into 3 clusters depending on the age and duration of the disease. The age of the analyzed patients is from 61 to 75 years. For diagnostics, a general assessment of the clinical condition, coronary angiography, and echodopleroscopy of a number of carotid and lower limb arteries were performed. The research base is the Regional Vascular Center of Ufa. Results. The work revealed that the age-related feature of 65+ is a stable lesion of the coronary vessels. At the same time, it was determined that both men and women suffer from this. Conclusion. It has been shown that this is characterized by an increased frequency of stenosing-type remodeling.

2022 ◽  
Author(s):  
Yifan Li ◽  
Linghui Deng ◽  
Shi Qiu ◽  
Boyu Cai ◽  
Sheng Wang ◽  
...  

Abstract Background Age-related lower urinary tract symptoms (LUTS) is a common disease in the elderly. The reduction of urinary flow rate (UFR) as an assessment of LUTS is associated with cognitive impairment. The association between UFR and cognitive performance has not been studied to date. Methods We used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). Finally, 2,724 participants aged 65-80 with available data on UFR and cognitive assessments were included. The cognitive function assessment used the digit symbol substitution test (DSST), Animal Fluency Test (AFT) and the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) immediate recall test. Multivariate logistic regressions were used to assess the association between UFR (exposure) and cognitive performance (outcome). Additionally, to ensure the reliability of data analysis, we converted UFR into categorical variables through tertile and then calculated the P for trend. Results Among 2,724 participants, the mean (SD) age was 69.26 (6.65) years, and 54.56% were women. After adjusting for covariates, UFR showed a positive correlation with DSST score (β = 2.00, [95%Cl:1.20-2.80], P<0.0001), AFT score (β = 0.57,[95%Cl:0.28-0.87], P=0.0001), CERAD immediate score(β = 0.24, [95%Cl:0.01-0.47], P=0.0435). In addition, we found a similar linear trend when UFR was regarded as a categorical variable (tertile) (P for trend <0.0001(both in AFT and DSST); P for trend =0.0403 in CERAD immediate test). Conclusions The decrease of UFR is related to cognitive decline in the elderly, which may suggest that UFR may be a clinical marker of predicting cognitive decline.


2012 ◽  
Vol 26 (2) ◽  
pp. 15-21 ◽  
Author(s):  
Justyna Mazurek ◽  
Joanna Rymaszewska ◽  
Jurgen Lurbiecki

Abstract Introduction: The central issue of geriatrics amounts to determining the hierarchy of problems (whether health related or other) of people at old age. The healthcare offered to elderly people should be oriented at the possibly broadest approach to their needs Aim: The main goal of the research is developing knowledge about the areas of elderly people’s needs on the basis of a sample consisted of patients from two rehabilitation centers, situated in Poland (PL:Wroclaw) and in Germany (DE:Hamburg) respectively. Material and methods: The sample consists of 80 patients of the age 60+, divided into two groups, 40 patients in each. For the research method/technique the interview is chosen and the questionnaire CANE serves as the main research tool. Other tools used are: GDS, MMSE, Barthel Index and Socio-demographical and Clinical questionnaires. Results: Before the patients’ admission to the center the average estimate for their overall needs was: PL 4.33 (SD=3.52), DE 5.12 (SD=3.26), out of which met needs were estimated as: PL 3.35 (SD=1.03), DE 4.47 (SD=2.99), whereas unmet as: PL 0.97 (SD=1.33), DE 0.65 (SD=1.03) respectively. After the patients’ admission to the center the average estimate for overall needs increased both for PL: 8.93 (SD=2.08) and for DE: 6.53 (SD=2.54), out of which met needs amounted to: PL, 7.55 (SD=1.50) and DE, 5.95 (SD=2.37) respectively, whereas not unmet ones to: PL, 1.38 (SD=1.44) and DE, 0.57 (SD=0.96). Conclusions: The patterns of needs /met and unmet/ of the elderly patients from two researched centers were similar before the patients’ admission to the clinics, but after the admission differences were observed between the two groups. Much from the needs both met (e.g. looking after the home, physical health) and unmet (e.g. psychological distress), mentioned before the admission to the clinic remained in the area of needs also after the admission. That observation is valid both for PL group as for DE one.


2006 ◽  
Vol 19 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Myriam Juda ◽  
Mirjam Münch ◽  
Anna Wirz-Justice ◽  
Martha Merrow ◽  
Till Roenneberg

Abstract: Among many other changes, older age is characterized by advanced sleep-wake cycles, changes in the amplitude of various circadian rhythms, as well as reduced entrainment to zeitgebers. These features reveal themselves through early morning awakenings, sleep difficulties at night, and a re-emergence of daytime napping. This review summarizes the observations concerning the biological clock and sleep in the elderly and discusses the documented and theoretical considerations behind these age-related behavioral changes, especially with respect to circadian biology.


2019 ◽  
Vol 25 (28) ◽  
pp. 3005-3010
Author(s):  
Georges Samouri ◽  
Alexandre Stouffs ◽  
Lionel V. Essen ◽  
Olivier Simonet ◽  
Marc De Kock ◽  
...  

Introduction: The monitoring of the curarisation is a unique opportunity to investigate the function of the neuromuscular junction (NMJ) during cancer surgery, especially in frailty-induced and age-related sarcopenia. Method: We conducted a comprehensive literature review in PubMed, without any limit of time related to frailty, sarcopenia, age and response to neuromuscular blockers in the context of cancer surgery. Results: Several modifications appear with age: changes in cardiac output, a decrease in muscle mass and increase in body fat, the deterioration in renal and hepatic function, the plasma clearance and the volume of distribution in elderly are smaller. These changes can be exacerbated in cancer patients. We also find modifications of the NMJ: dysfunctional mitochondria, modifications in the innervation of muscle fibers and motor units, uncoupling of the excitation-contraction of muscle fibers, inflammation. : Neuromuscular blocking agents (NMBAs) compete with acetylcholine and prevent it from fixing itself on its receptor. Many publications reported guidelines for using NMBAs in the elderly, based on studies comparing old people with young people. : No one screened frailty before, and thus, no studies compared frail elderly and non-frail elderly undergoing cancer surgery. Conclusion: Despite many studies about curarisation in the specific populations, and many arguments for a potential interest for investigation, no studies investigated specifically the response to NMBAs in regard of the frailty-induced and age-related sarcopenia.


Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 183
Author(s):  
Anna Izzo ◽  
Elena Massimino ◽  
Gabriele Riccardi ◽  
Giuseppe Della Pepa

Type 2 diabetes mellitus (T2DM) represents a major health burden for the elderly population, affecting approximately 25% of people over the age of 65 years. This percentage is expected to increase dramatically in the next decades in relation to the increased longevity of the population observed in recent years. Beyond microvascular and macrovascular complications, sarcopenia has been described as a new diabetes complication in the elderly population. Increasing attention has been paid by researchers and clinicians to this age-related condition—characterized by loss of skeletal muscle mass together with the loss of muscle power and function—in individuals with T2DM; this is due to the heavy impact that sarcopenia may have on physical and psychosocial health of diabetic patients, thus affecting their quality of life. The aim of this narrative review is to provide an update on: (1) the risk of sarcopenia in individuals with T2DM, and (2) its association with relevant features of patients with T2DM such as age, gender, body mass index, disease duration, glycemic control, presence of microvascular or macrovascular complications, nutritional status, and glucose-lowering drugs. From a clinical point of view, it is necessary to improve the ability of physicians and dietitians to recognize early sarcopenia and its risk factors in patients with T2DM in order to make appropriate therapeutic approaches able to prevent and treat this condition.


2020 ◽  
Vol 11 (04) ◽  
pp. 640-642
Author(s):  
Halil Onder

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shigeru Honda ◽  
Yasuo Yanagi ◽  
Hideki Koizumi ◽  
Yirong Chen ◽  
Satoru Tanaka ◽  
...  

AbstractThe chronic eye disorder, neovascular age-related macular degeneration (nAMD), is a common cause of permanent vision impairment and blindness among the elderly in developed countries, including Japan. This study aimed to investigate the disease burden of nAMD patients under treatment, using data from the Japan National Health and Wellness surveys 2009–2014. Out of 147,272 respondents, 100 nAMD patients reported currently receiving treatment. Controls without nAMD were selected by 1:4 propensity score matching. Healthcare Resource Utilisation (HRU), Health-Related Quality of Life (HRQoL), and work productivity loss were compared between the groups. Regarding HRU, nAMD patients had significantly increased number of visits to any healthcare provider (HCP) (13.8 vs. 8.2), ophthalmologist (5.6 vs. 0.8), and other HCP (9.5 vs. 7.1) compared to controls after adjusting for confounding factors. Additionally, nAMD patients had reduced HRQoL and work productivity, i.e., reduced physical component summary (PCS) score (46.3 vs. 47.9), increased absenteeism (18.14% vs. 0.24%), presenteeism (23.89% vs. 12.44%), and total work productivity impairment (33.57% vs. 16.24%). The increased number of ophthalmologist visits were associated with decreased PCS score, increased presenteeism and total work productivity impairment. The current study highlighted substantial burden for nAMD patients, requiring further attention for future healthcare planning and treatment development.


Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 624
Author(s):  
Laura M. Stephens ◽  
Steven M. Varga

Respiratory syncytial virus (RSV) is most commonly associated with acute lower respiratory tract infections in infants and children. However, RSV also causes a high disease burden in the elderly that is often under recognized. Adults >65 years of age account for an estimated 80,000 RSV-associated hospitalizations and 14,000 deaths in the United States annually. RSV infection in aged individuals can result in more severe disease symptoms including pneumonia and bronchiolitis. Given the large disease burden caused by RSV in the aged, this population remains an important target for vaccine development. Aging results in lowered immune responsiveness characterized by impairments in both innate and adaptive immunity. This immune senescence poses a challenge when developing a vaccine targeting elderly individuals. An RSV vaccine tailored towards an elderly population will need to maximize the immune response elicited in order to overcome age-related defects in the immune system. In this article, we review the hurdles that must be overcome to successfully develop an RSV vaccine for use in the elderly, and discuss the vaccine candidates currently being tested in this highly susceptible population.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2235
Author(s):  
Alyann Otrante ◽  
Amal Trigui ◽  
Roua Walha ◽  
Hicham Berrougui ◽  
Tamas Fulop ◽  
...  

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.


Immuno ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 231-239
Author(s):  
Alexander I. Mosa

Discrepancies in lifespan and healthy-life span are predisposing populations to an increasing burden of age-related disease. Accumulating evidence implicates aging of the immune system, termed immunosenescence, in the pathogenesis of multiple age-related diseases. Moreover, immune dysregulation in the elderly increases vulnerability to infection and dampens pathogen-specific immune responses following vaccination. The health challenges manifesting from these age related deficits have been dramatically exemplified by the current SARS-CoV-2 pandemic. Approaches to either attenuate or reverse functional markers of immunosenescence are therefore urgently needed. Recent evidence suggests systemic immunomodulation via non-specific vaccination with live-attenuated vaccines may be a promising avenue to at least reduce aged population vulnerability to viral infection. This short review describes current understanding of immunosenescence, the historical and mechanistic basis of vaccine-mediated immunomodulation, and the outstanding questions and challenges required for broad adoption.


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