Age Related Differences in Monocyte Subsets and Cytokine Pattern during Acute COVID-19—A Prospective Observational Longitudinal Study

The COVID-19 pandemic drastically highlighted the vulnerability of the elderly population towards viral and other infectious threats, illustrating that aging is accompanied by dysregulated immune responses currently summarized in terms like inflammaging and immunoparalysis. To gain a better understanding on the underlying mechanisms of the age-associated risk of adverse outcome in individuals experiencing a SARS-CoV-2 infection, we analyzed the impact of age on circulating monocyte phenotypes, activation markers and inflammatory cytokines including interleukin 6 (IL-6), IL-8 and tumor necrosis factor (TNF) in the context of COVID-19 disease progression and outcome in 110 patients. Our data indicate no age-associated differences in peripheral monocyte counts or subset composition. However, age and outcome are associated with differences in monocyte activation status. Moreover, a distinct cytokine pattern of IL-6, IL-8 and TNF in elderly survivors versus non-survivors, which consolidates over the time of hospitalization, suggests that older patients with adverse outcomes experience an inappropriate immune response, reminiscent of an inflammaging driven immunoparalysis. Our study underscores the value, necessity and importance of longitudinal monitoring in elderly COVID-19 patients, as dynamic changes after symptom onset can be observed, which allow for a differentiated insight into confounding factors that impact the complex pathogenesis following an infection with SARS-CoV-2.

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Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽

10.1161/str.45.suppl_1.tp136 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

George Howard ◽

Mary Cushman ◽

Maciej Banach ◽

Brett M Kissela ◽

David C Goff ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Stroke Risk ◽

Multivariable Analysis ◽

The Elderly ◽

Stroke Risk Factors ◽

Age Related ◽

Increased Risk ◽

The Impact ◽

Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

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A cross-sectional study on interference control: age affects reactive control but not proactive control

PeerJ ◽

10.7717/peerj.8365 ◽

2020 ◽

Vol 8 ◽

pp. e8365 ◽

Cited By ~ 1

Author(s):

Yanfang Peng ◽

Qin Zhu ◽

Biye Wang ◽

Jie Ren

Keyword(s):

Middle Ages ◽

Middle Age ◽

The Elderly ◽

Efficiency Score ◽

Interference Control ◽

Reactive Control ◽

Cross Sectional ◽

Age Related ◽

The Difference ◽

The Impact

Background Working memory updating (WMU), a controlled process to continuously adapt to the changing task demand and environment, is crucial for cognitive executive function. Although previous studies have shown that the elderly were more susceptible to cognitive interference than the youngsters, the picture of age-related deterioration of WMU is incomplete due to lack of study on people at their middle ages. Thus, the present study investigated the impact of age on the WMU among adults by a cross-sectional design to verify whether inefficiency interference control accounts for the aging of WMU. Methods In total, 112 healthy adults were recruited for this study; 28 old adults (21 female) ranging from 60 to 78 years of age; 28 middle-age adults (25 female) ranging from 45 to 59 years of age; 28 adults (11 female) ranging from 26 to 44 years of age; and 28 young adults (26 female) ranging from 18 to 25 years of age. Each participant completed a 1-back task. The inverse efficiency score was calculated in various sequences of three trials in a row to quantify the performance of WMU for adults of various ages. Results Inverse efficiency score of both young groups (young adult and adult) were significantly shorter than the old group in both Repeat-Alternate (RA, including □□○ and ○○□) and Alternate-Alternate (AA, including ○□○ and □○□) sequential patterns and they were additionally better than the middle-age group in AA sequential pattern. Conclusion With the increase of difficulty in the task, the difference in reactive interference control between young and middle age was gradually revealed, while the difference between young and old remained to apparent. The degradation of WMU aging may begin from middle-age and presents selective impairment in that only reactive interference control, but not proactive interference control, shows pronounced age-related decline. The preliminary results can inform future studies to further explore the whole lifespan trajectories of cognitive functions.

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Sarcopenia, obesity, osteoporosis and old age

Sechenov Medical Journal ◽

10.47093/2218-7332.2020.11.4.23-35 ◽

2021 ◽

Vol 11 (4) ◽

pp. 23-35

Author(s):

S. V. Topolyanskaya

Keyword(s):

Body Composition ◽

The Elderly ◽

Adverse Outcomes ◽

Mineral Density ◽

Term Care ◽

Visceral Fat Accumulation ◽

Age Related ◽

Diagnostic Approaches

Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.

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Impact of Tuberculosis in Elderly Population

Handbook of Research on Geriatric Health, Treatment, and Care - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-3480-8.ch018 ◽

2018 ◽

pp. 326-338

Author(s):

Gagan Chooramani ◽

Pooja Singh

Keyword(s):

Clinical Characteristics ◽

Elderly Population ◽

The Elderly ◽

World Health ◽

Tuberculosis Patients ◽

Disease Outcomes ◽

Age Related ◽

Health Organization ◽

The Impact ◽

Poor Memory

The World Health Organization has declared that the spread of tuberculosis is a global emergency. Despite the implementation of strong tuberculosis-control initiatives by WHO, this highly infectious disease continues to affect all vulnerable populations, including the elderly population. Adverse social factors and poor living conditions also affect the elderly much more than the young. The clinical characteristics of tuberculosis in older adults can be unusual and may be confused with age-related illnesses. Various factors related to old age can also cause complications in the diagnosis, treatment, and disease outcomes for tuberculosis patients. The contributory factors may be poor memory, deafness, mental confusion, or impairment of speech. In addition, therapy for tuberculosis in elderly individuals is challenging because of the increased incidence of adverse drug reactions. Hence, understanding the impact of these substantial aspects will help to overcome the problem of tuberculosis in the elderly population.

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Conclusion

10.1093/med/9780199392063.003.0012 ◽

2016 ◽

Author(s):

Maria A. Sullivan

Keyword(s):

Older Adults ◽

Substance Use ◽

The Elderly ◽

Social Consequences ◽

Individual Therapy ◽

Older Individuals ◽

Prescribing Practices ◽

Elderly Age ◽

Age Related ◽

The Impact

Addiction in older adults very often goes unrecognized, for several reasons: social biases about the elderly, age-related metabolic changes, and the inappropriate use of prescription benzodiazepines and opioids to address untreated anxiety and mood conditions. Alcohol or substance-use disorders (SUDs) in older individuals may present in subtle and atypical ways. Strategies to overcome such difficulties include systematic screening using validated instruments, patient education regarding the impact of psychoactive substances on health, and cautious prescribing practices. Relying on standard DSM criteria may result in a failure to detect an SUD that presents with cognitive symptoms or physical injury, as well as the absence of work or social consequences. Older individuals can benefit from the application of risk-stratification measures, and they can be referred, e.g., to age-appropriate group therapy and non-confrontational individual therapy focusing on late-life issues of loss and sources of social support, as well as be offered medication management for alcohol or substance use disorder. Although research has been limited in this population, treatment outcomes have been found to be superior in older adults than younger adults.

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Carotenoids: How Effective Are They to Prevent Age-Related Diseases?

Molecules ◽

10.3390/molecules24091801 ◽

2019 ◽

Vol 24 (9) ◽

pp. 1801 ◽

Cited By ~ 14

Author(s):

Bee Ling Tan ◽

Mohd Esa Norhaizan

Keyword(s):

Oxidative Stress ◽

Healthy Aging ◽

The Elderly ◽

Antioxidant Systems ◽

Potential Intervention ◽

Healthy Longevity ◽

Age Related ◽

Underlying Mechanisms ◽

Endogenous Antioxidant

Despite an increase in life expectancy that indicates positive human development, a new challenge is arising. Aging is positively associated with biological and cognitive degeneration, for instance cognitive decline, psychological impairment, and physical frailty. The elderly population is prone to oxidative stress due to the inefficiency of their endogenous antioxidant systems. As many studies showed an inverse relationship between carotenoids and age-related diseases (ARD) by reducing oxidative stress through interrupting the propagation of free radicals, carotenoid has been foreseen as a potential intervention for age-associated pathologies. Therefore, the role of carotenoids that counteract oxidative stress and promote healthy aging is worthy of further discussion. In this review, we discussed the underlying mechanisms of carotenoids involved in the prevention of ARD. Collectively, understanding the role of carotenoids in ARD would provide insights into a potential intervention that may affect the aging process, and subsequently promote healthy longevity.

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Age-Related Diseases and Driving Safety

Geriatrics ◽

10.3390/geriatrics5040080 ◽

2020 ◽

Vol 5 (4) ◽

pp. 80

Author(s):

Michael Falkenstein ◽

Melanie Karthaus ◽

Ute Brüne-Cohrs

Keyword(s):

Diabetes Mellitus ◽

Driving Simulator ◽

The Elderly ◽

Cognitive Disorder ◽

Driving Safety ◽

Elderly Drivers ◽

Age Related ◽

Independent Life ◽

Driving Fitness ◽

The Impact

Due to demographic changes, the number of older drivers is steadily increasing. Mobility is highly relevant for leading an independent life in the elderly. It largely depends on car driving, which is a complex task requiring a multitude of cognitive and motor skills vulnerable to age- related functional deterioration. The almost inevitable effects of senescence may be potentiated by age-related diseases, such as stroke or diabetes mellitus. Respective pharmacological treatment may cause side effects, additionally affecting driving safety. The present article reviews the impact of age-related diseases and drug treatment of these conditions on driving fitness in elderly drivers. In essence, we focus on diseases of the visual and auditory systems, diseases of the central nervous system (i.e., stroke, depression, dementia and mild cognitive disorder, and Parkinson’s disease), sleep disorders, as well as cardiovascular diseases, diabetes mellitus, musculoskeletal disorders, and frailty. We will outline the role of functional tests and the assessment of driving behavior (by a driving simulator or in real traffic), as well as the clinical interview including questions about frequency of (near) accidents, etc. in the evaluation of driving fitness of the elderly. We also address the impact of polypharmacy on driving fitness and end up with recommendations for physicians caring for older patients.

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Pharmacologic Considerations in the Elderly Surgical Patient

DeckerMed Surgery ◽

10.2310/surg.2193 ◽

2016 ◽

Author(s):

Linda Sohn ◽

Joe C. Hong ◽

Michael W. Yeh ◽

Tara A. Russell ◽

Marcia M. Russell

Keyword(s):

Older Adults ◽

Surgical Procedures ◽

Postoperative Delirium ◽

Medication Management ◽

The Elderly ◽

The United States ◽

Surgical Patient ◽

Age Related ◽

The Impact ◽

Preoperative Medication

The most rapidly growing segment of the elderly population corresponds to persons age 85 and over. As of 2006, elderly patients accounted for 35.3% of the inpatient and 32.1% of the outpatient surgical procedures occurring in the United States. Because age-related changes occur in each organ system in all elderly individuals, this population merits special consideration when undergoing surgical procedures. Furthermore, there is a high probability that older adults will have multiple chronic medical problems, which may present a complex medication management challenge. This review covers the pharmacologic impact of physiologic changes associated with aging, preoperative assessment, preoperative medication management, delirium and the impact of perioperative medications in the elderly, anesthesia and related medications, and specific drug classes and their use in the elderly surgical patient. Figures show an overview of the management of the elderly surgical patient, and preoperative medication management. Tables list medications that should be avoided in older patients with reduced renal function, drugs that exhibit additive adverse effects, medications with high anticholinergic activity, medications that inhibit and induce the CYP450 system, herbal supplements, 2015 Beers Criteria summary of potentially inappropriate medication use in older adults, drugs associated with postoperative delirium, risk factors for postoperative delirium, and clinical pharmacology of commonly used anesthetic agents. This review contains 2 highly rendered figures, 9 tables, and 61 references

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HIV infection and aging of the innate immune system

Sexual Health ◽

10.1071/sh11028 ◽

2011 ◽

Vol 8 (4) ◽

pp. 453 ◽

Cited By ~ 20

Author(s):

Anna C. Hearps ◽

Thomas A. Angelovich ◽

Anthony Jaworowski ◽

John Mills ◽

Alan L. Landay ◽

...

Keyword(s):

Immune System ◽

Hiv Infection ◽

Immune Cells ◽

Inflammatory Diseases ◽

The Elderly ◽

Innate Immune ◽

Innate Immune Cells ◽

Telomere Attrition ◽

Age Related ◽

The Impact

The increased life expectancy of HIV-infected individuals due to improved treatment has revealed an unexpected increase in non-AIDS comorbidities that are typically associated with older age including cardiovascular disease, dementia and frailty. The majority of these diseases arise as the result of dysregulated systemic inflammation, and both the aged and HIV-infected individuals exhibit elevated basal levels of inflammation. In the elderly, increased inflammation and age-related diseases are associated with a state of impaired immunity called immunosenescence, which is thought to result from a lifetime of immune stimulation. It is now apparent that HIV induces premature immunosenescence within T-cells; however, the impact of HIV on aging of cells of the innate arm of the immune system is unknown. Innate immune cells play a central role in inflammation and are thus critical for the pathogenesis of inflammatory diseases. Limited evidence suggests HIV infection mimics age-related changes to innate immune cells; however, the extent of this effect and the mechanism underlying these changes remain to be defined. This review focuses on the impact of HIV infection on the function and aging of innate immune cells and discusses potential drivers of premature immunosenescence including chronic endotoxaemia, residual viraemia, telomere attrition and altered cellular signalling.

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