scholarly journals Relationship Between Sarcopenia and Cardiovascular Diseases in the Elderly: An Overview

2021 ◽  
Vol 8 ◽  
Author(s):  
Nana He ◽  
Yuelin Zhang ◽  
Lu Zhang ◽  
Shun Zhang ◽  
Honghua Ye

With the advent of population aging, aging-related diseases have become a challenge for governments worldwide. Sarcopenia has defined as a clinical syndrome associated with age-related loss such as skeletal muscle mass, strength, function, and physical performance. It is commonly seen in elderly patients with chronic diseases. Changes in lean mass are common critical determinants in the pathophysiology and progression of cardiovascular diseases (CVDs). Sarcopenia may be one of the most important causes of poor physical function and decreased cardiopulmonary function in elderly patients with CVDs. Sarcopenia may induce CVDs through common pathogenic pathways such as malnutrition, physical inactivity, insulin resistance, inflammation; these mechanisms interact. In this study, we aimed to investigate the relationship between sarcopenia and CVDs in the elderly. Further research is urgently needed to understand better the relationship, pathophysiology, clinical presentation, diagnostic criteria, and mechanisms of sarcopenia and CVDs, which may shed light on potential interventions to improve clinical outcomes and provide greater insight into the disorders above.

2018 ◽  
Vol 8 (3) ◽  
pp. 19-27
Author(s):  
E. S. Ilina ◽  
O. T. Bogova ◽  
I. I. Sinitsina ◽  
S. N. Puzin ◽  
D. A. Sychev

Background.The fall in the elderly is observed much more often than in younger people, and according to statistics the number of people over 65 years who have suffered a fall during the year reaches 30 %, while the probability of injury. Most of the falls in elderly patients does not lead to injury, but the developing at the same time unfavorable psychological discomfort can sharply limit the usual activity, lead to the formation of dependence on outside help, disadaptation in the home and form a fear of a possible fall. Falls, accompanied by the development of trauma, are observed in 10–15 % of cases.The objectivewas to study the relationship between polymorbidity, polypragmasia and the development of the fall in elderly patients cardiological profile.Results.Polymorbidity prevailed in the group of patients who suffered a fall in the hospital (8.9 ± 2.6 vs 7.5 ± 1.5 in men. 8.5 ± 2.2 vs 7.2 ± 1.6 in women). In patients undergoing a decline, it was also noted, and polypharmacy to a greater extent than cohort patients without falling (9.4 ± 1.9 vs 78.4 ± 2.2 in men. and 9.6 ± 2.7 vs 9.1 ± 2.5 for women). In addition, patients who suffered a fall in the hospital by age were older than patients in the comparison group (86 ± 6 vs 85 ± 5 in men, 87 ± 5 vs 84 ± 5 in women). We also revealed the tendency of the predominance of women in the subgroup of patients with the incidence and development of trauma.Conclusion.Minimizing the amount of drugs received, as the fight against polypragmasy can help reduce the incidence of falls in elderly patients. 


2020 ◽  
pp. 8-9
Author(s):  
E.O. Asanov ◽  
Yu.I. Holubova ◽  
I.A. Diba ◽  
S.O. Asanova ◽  
G.P. Voynarovskaya

Background. Age-related morphofunctional changes in the body lead to the development of arterial hypoxemia, tissue hypoxia and hypoxic changes. All this causes a decrease in the body’s resistance to hypoxia and contributes to the development of lung diseases, in particular, chronic obstructive pulmonary disease (COPD) in the elderly. With the development of COPD in the elderly due to bronchial obstruction and disorders of pulmonary gas exchange, age-related hypoxic shifts, arterial hypoxemia, tissue hypoxia and resistance to hypoxia are further reduced. However, the relationship between bronchial obstruction and resistance to hypoxia in elderly patients with COPD has not been studied. Objective. To identify the relationship between bronchial patency and resistance to hypoxia in elderly patients with COPD. Materials and methods. The study included 30 patients with COPD in the elderly (60-74 years), I-II stage, without exacerbation, with a disease duration of 7 to 26 years, risk groups A and B. The type and severity of pulmonary ventilation were assessed indicators of spirometry and the curve “flow/volume” of forced exhalation on the device Spirobank (Mir, Italy). To determine the body’s resistance to hypoxia, a hypoxic test with 12 % oxygen content was performed for 12 min with monitoring of blood saturation using the automated software and hardware complex Hypotron (Ukraine). Results. Researches have shown that under hypoxic exposure, blood saturation in elderly patients with COPD is reduced, on average, by 18.23±0.26 %. This decrease in blood saturation can be regarded as severe arterial hypoxemia. At the same time, in elderly patients with COPD with an increase in bronchial patency disorders, the saturation shifts in hypoxia, on average, also increase. There was a significant correlation (r=0.50; p=0.006) of blood saturation shifts in hypoxia with bronchial obstruction. Conclusions. In elderly patients with COPD, resistance to hypoxia is determined by bronchial obstruction.


2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Muhammad Bilal Tariq ◽  
Shekhar Khanpara ◽  
Eliana Bonfante Mejia ◽  
Liang Zhu ◽  
Christy T Ankrom ◽  
...  

Background: While tPA may be safe in the elderly, increasing age appears to augment risk of post-tPA symptomatic intracranial hemorrhage (sICH). Age-related white matter changes (ARWMC) are associated with increased sICH. Patients evaluated for acute ischemic stroke (AIS) via telestroke (TS) may not have access to MRI to allow incorporation of microbleeds in tPA decisions. We assessed if increased CT-based ARWMC was associated with increased sICH in elderly patients. Methods: Patients 80 years and older who received tPA for AIS at spoke hospitals were selected from our TS network registry from 9/2015 to 12/2018. TS spoke CT scans from patient presentation were reviewed by three of the authors for periventricular white matter (PWMC) and deep white matter (DWMC) changes. Total ARWMC score, based on the Fazekas score, was collected. Total ARWMC score was either mild (0-2), moderate (3-4), or severe (5-6). PWMC and DWMC were either mild (0-1) or moderate-severe (2-3). Logistic regression adjusted for age, sex, race, ethnicity, NIHSS and premorbid mRS was used to analyze relationship of ARWMC scores with sICH and patient-outcomes. Results: Of 241 patients, median age overall was 86 years (IQR 83-90), and 66% were female. The overall median ARWMC score was 3 (IQR 2-5). Regression analysis showed that more severe ARWMC scores did not lead to higher frequency of post-tPA ICH (moderate OR 0.57, CI 0.19-1.71; severe OR 1.32, CI 0.48-3.65) including sICH (moderate OR 0.78, CI 0.21-2.94; severe OR 2.09, CI 0.62-7.02). Similarly, severe PWMC and DWMC were not associated with increased risk of post-tPA ICH (PWMC OR 1.31, CI 0.51-3.38; DWMC OR 1.25, CI 0.52-3.01), including sICH (PWMC OR 1.61, CI 0.51-5.08; DWMC OR 1.81, CI 0.65-5.01). In our cohort, older patients had no difference in hemorrhage (ICH OR 0.93 CI 0.85-1.00: sICH OR 0.95 CI 0.86-1.04), and patients with less severe stroke were more likely to have hemorrhage (ICH OR 1.06 CI 1.02-1.10; sICH OR 1.08 CI 1.03-1.13). IRR among the CT scan readers was moderate (k=0.504). Conclusions: ARWMC scores were not associated with post-tPA ICH in the elderly. Our analysis lends support for the use of tPA despite severity of white matter disease. ARWMC should not be used to assist in tPA decision-making in elderly patients via telestroke.


1997 ◽  
Vol 272 (1) ◽  
pp. E139-E146 ◽  
Author(s):  
A. A. Portale ◽  
E. T. Lonergan ◽  
D. M. Tanney ◽  
B. P. Halloran

We examined the effect of aging on the relationship between the concentrations of blood ionized calcium and of serum parathyroid hormone (PTH) in 22 healthy men [9 elderly (age 74 +/- 2 yr) and 13 young (age 39 +/- 1 yr)] in whom the glomerular filtration rate was > 70 ml/min. Throughout a 24-h period, serum concentrations of PTH in the elderly men were twice those in the young men, whereas blood ionized calcium did not differ between the two groups. With intravenous infusion of calcium gluconate, the minimum PTH concentration was two- to threefold higher in the elderly men. With infusion of NaEDTA. the maximum PTH concentration was 20% higher in the elderly men. The calcium set point for PTH release was higher in the elderly than in the young men (4.71 +/- 0.04 vs. 4.54 +/- 0.03 mg/dl, respectively, P < 0.005). In these healthy men, the age-related increase in serum PTH could not be attributed to a sustained decrease in concentration of either blood ionized calcium or 1,25-hydroxyvitamin D. These findings suggest that, with aging, the relationship between calcium and PTH is altered such that at any given level of calcium, the concentration of PTH is higher.


2005 ◽  
Vol 39 (11) ◽  
pp. 1852-1860 ◽  
Author(s):  
William R Garnett

OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic–clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic–clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug–drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients’ cognitive functioning and their tendency to respond to lower AED concentrations.


2019 ◽  
Vol 70 (7) ◽  
pp. 2415-2419 ◽  
Author(s):  
Valeria Carmen Albu ◽  
Raluca Elena Sandu ◽  
Andreea Lili Barbulescu ◽  
Elena-Anca Tartea ◽  
Emilia Burada ◽  
...  

The aim of the study was to assess the correlations between the acute confusing syndrome and different comorbidities found in a group of 126 elderly patients with this diagnosis, who were admitted to the Neurology Clinic of the Neuropsychiatry Hospital of Craiova. The main syndromes highlighted at the neurological examination were confusing, pyramidal and vestibular syndromes. The acute confusing syndrome has a multifactorial etiology, due to the wide range of comorbidities encountered in elderly patients. In our study the most frequent comorbidities were cardiovascular pathology, diabetes mellitus, dyslipidemia, cerebrovascular renal, hepatic pathology.


2020 ◽  
Author(s):  
Dali Ning

Slogan has a sound mass base in China for thousands of years,functioning as guidelines for civic practice. Even today, Chinese slogans are often employed by the government to promote policies and socio-cultural values. This paper, adopting an ecolinguistic approach, explores the development of Chinese slogans during the four economic stages since the foundation of PRC (People’s Republic of China) to find out how slogans influence the relationship between men, and man and the ecosystem. It is discovered that Chinese slogans in the recent decades have experienced great changes in terms of discourse type, the beneficial degree of discourse and the ecosophy they carry. They changed gradually from destructive discourse to harmonious discourse and they reflect the transition of Chinese ecological philosophy—from ‘anthropocentrism’, ‘growthism’, and ‘classism’ to ‘harmonism’. It is hoped that this study can shed light on the eco-discourse analysis to policy language and will bring insight into its future creation.


2019 ◽  
Vol 33 (06) ◽  
pp. 611-615 ◽  
Author(s):  
Lasun O. Oladeji ◽  
John R. Worley ◽  
Brett D. Crist

AbstractTibial plateau fractures account for approximately 8% of fractures in the elderly population. Treatment strategies in the elderly are similar to those for younger patients; however, practitioners must account for the elevated comorbidity burden in this population. To date, few studies have analyzed age-based outcomes in patients with tibial plateau fractures. Therefore, the purpose of this study was to determine age-related variances in demographics, fracture characteristics, mechanism of injury, and complications. A 10-year retrospective review was conducted to identify patients who received treatment for a tibial plateau fracture. There were 351 patients (360 tibial plateau fractures) who were identified and subsequently stratified according to their age at the time of injury. Patients were classified as elderly if they were 65 years of age or older at the time of injury; all other patients were included in the control cohort. These two cohorts were analyzed using bivariate analysis to isolate for age-related variations with respect to risk factors, mechanism of injury, and complications. There were 351 patients (360 tibial plateau fractures) with a median follow-up of 1.84 ± 2.44 years who met inclusion criteria. There were a greater proportion of women in the elderly cohort as compared with the younger cohort (60.0 vs. 43.4%, p = 0.06). Elderly patients were significantly more likely to present with diabetes (33.3 vs. 16.1%, p = 0.01) or osteoporosis (14.3 vs. 1.6%, p = 0.001). Younger patients were significantly more likely to require further surgery to address ligament (12.6 vs. 0%, p = 0.008), meniscus (20.9 vs. 7.1%, p = 0.036), or cartilage pathology (13.6 vs. 0%, p = 0.005). There was no difference in the arthroplasty conversion rate (4.8% elderly vs. 7.9% control, p = 0.755). While elderly patients presented with a greater comorbidity burden, they had equivalent or better short-term outcomes when compared with their younger peers when treated with open reduction and internal fixation (ORIF). Despite the recent interest in primary total knee arthroplasty for elderly patients with tibial plateau fractures, the results of this study suggest that elderly patients may respond well when treated with ORIF following a tibial plateau fracture.


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