Constipation in patients with comorbidity

2021 ◽  
Author(s):  
Е.А. Лялюкова ◽  
Е.Н. Логинова
Keyword(s):  
Gastrointestinal Tract ◽  
Neurological Diseases ◽  
The Elderly ◽  
Lifestyle Changes ◽  
Secretory Cells ◽  
Endocrine Disorders ◽  
Silver Age ◽  
Functional Changes ◽  
Slowing Down ◽  
Age Related

Пациенты пожилого и старческого возраста в силу физиологических причин и коморбидной патологии имеют высокий риск развития запора. Причиной запора чаще всего являются алиментарные факторы и возраст-ассоциированные заболевания и повреждения толстой кишки (дивертикулярная болезнь, ишемия толстой кишки, ректоцеле, геморрой и другие); метаболические, эндокринные расстройства и неврологические заболевания. Возрастные анатомические, структурные и функциональные изменения пищеварительной системы вносят свой вклад в развитие запоров у пожилых. У пациентов «серебряного возраста» отмечено увеличение длины желудочно-кишечного тракта, прогрессирование атрофических, склеротических изменений слизистой и подслизистой оболочки, снижение количества секреторных клеток, замещение мышечных волокон соединительной тканью и др. Все это способствует замедлению транзита по желудочно-кишечному тракту и нарушению акта дефекации. Образ жизни пожилых людей также может способствовать развитию запора. Низкое содержание в рационе клетчатки, употребление преимущественно термически обработанной пищи, нарушение ритма питания (прием пищи 1-2 раза в день) являются одной из причин возникновения запоров у пожилых, чему способствуют трудности при жевании вследствие стоматологических проблем. Колоноскопия показана всем пациентам пожилого и старческого возраста с запором, а выявление «симптомов тревоги» необходимо проводить при каждом визите пациента. Вне зависимости от причины вторичного запора, все пациенты должны осуществлять ряд мер немедикаментозного характера, включающих изменение образа жизни, диету с включением достаточного количества клетчатки и потребление жидкости. Физические методы лечения могут включать лечебную гимнастику, массаж толстой кишки для стимуляции моторной активности кишечника в определенное время. При неэффективности немедикаментозных мероприятий рекомендуется использование осмотических слабительных, а также средств, увеличивающих объем каловых масс. Высокая эффективность и безопасность псиллиума позволяет рекомендовать его в лечении хронического запора у пожилых пациентов. Elderly and senile patients, due to physiological reasons and comorbid pathology, have a high risk of constipation. The causes of constipation are more often nutritional factors and age-associated diseases and damage to the colon (diverticular disease, colon ischemia, rectocele, hemorrhoids, and others); metabolic, endocrine disorders and neurological diseases. Age-related anatomical, structural and functional changes in the digestive system contribute to the development of constipation in the elderly. In patients of «silver age», there was an increase in the length of the gastrointestinal tract, the progression of atrophic, sclerotic changes in the mucous and submucosa, a decrease in the number of secretory cells, replacement of muscle fibers with connective tissue, etc. All this contributes to the slowing down of transit through the gastrointestinal tract and the violation of the act of defecation. Elderly lifestyles can also contribute to constipation. The low fiber content in the diet, the use of mainly thermally processed food, the violation of the rhythm of the diet (eating 1-2 times a day) are one of the causes of constipation in the elderly, which is facilitated by difficulty in chewing due to dental problems. Colonoscopy is ordered for all elderly and senile patients with constipation, and the identification of «anxiety symptoms» should be carried out at each patient visit. Regardless of the cause of secondary constipation, all patients should take a number of non-pharmacological measures, including lifestyle changes, a diet with adequate fiber, and fluid intake. Physical therapies may include medical gymnastics, colon massage to stimulate bowel movement at specific times. If non-drug measures are ineffective, it is recommended to use osmotic laxatives, as well as agents that increase the volume of feces. Psyllium supplementation is recommended for treatment of chronic constipation in elderly patients due to its high efficacy and safety.

scholarly journals Immunosenescence of Polymorphonuclear Neutrophils

2010 ◽  
Vol 10 ◽  
pp. 145-160 ◽  
Author(s):  
Inga Wessels ◽  
Judith Jansen ◽  
Lothar Rink ◽  
Peter Uciechowski
Keyword(s):  
Molecular Mechanisms ◽  
Adaptive Immune System ◽  
The Elderly ◽  
Polymorphonuclear Neutrophils ◽  
Traditional Role ◽  
Functional Changes ◽  
The Public ◽  
Age Related

All immune cells are affected by aging, contributing to the high susceptibility to infections and increased mortality observed in the elderly. The effect of aging on cells of the adaptive immune system is well documented. In contrast, knowledge concerning age-related defects of polymorphonuclear neutrophils (PMN) is limited. During the past decade, it has become evident that in addition to their traditional role as phagocytes, neutrophils are able to secrete a wide array of immunomodulating molecules. Their importance is underlined by the finding that genetic defects that lead to neutropenia increase susceptibility to infections. Whereas there is consistence about the constant circulating number of PMN throughout aging, the abilities of tissue infiltration, phagocytosis, and oxidative burst of PMN from aged donors are discussed controversially. Furthermore, there are numerous discrepancies betweenin vivoandin vitroresults, as well as between results for murine and human PMN. Most of the reported functional changes can be explained by defective signaling pathways, but further research is required to get a detailed insight into the underlying molecular mechanisms. This could form the basis for drug development in order to prevent or treat age-related diseases, and thus to unburden the public health systems.

Epidemiologia zaburzeń neuropoznawczych u pacjentów w wieku podeszłym

2018 ◽  
Vol 21 (3) ◽  
Author(s):  
Wioletta Mędrzycka-Dąbrowska ◽  
Katarzyna Kwiecień-Jaguś ◽  
Renata Piotrkowska ◽  
Piotr Jarzynkowski
Keyword(s):  
The Elderly ◽  
Brain Dysfunction ◽  
Aging Brain ◽  
Psychomotor Slowing ◽  
Functional Changes ◽  
Slowing Down ◽  
Memory Functioning ◽  
Compensation Mechanisms ◽  
Key Issues ◽  
The Brain

The phenomenon of progressive impairment of cognitive functions is characteristic for the aging process. More than half of people over 50 complain about weakening of their previous intellectual performance, reduced mood, impaired memory, psychomotor slowing down, decreased ability to concentrate and divide attention, extend reaction time and reduce motor performance. The basis of mental changes in the elderly are changes in the brain. The changes arising in the aging brain are the result of pathological processes: metabolic and altered cerebral circulation. These changes, and mainly their extent, consequently cause brain dysfunction and are manifested mainly in the deterioration of mental functions. The brain is first and foremost the material basis of a mental life. With age, slow, cumulative and irreversible morphological and functional changes occur in the human brain. This process is slow, which is why it is accompanied by a number of compensation mechanisms. This phenomenon occurs regardless of gender. The aim of this article is to present the key issues related to memory functioning in the elderly, with particular emphasis on neurocognitive impairment after surgery.

scholarly journals Features of Retinal Neurogenesis as a Key Factor of Age-Related Neurodegeneration: Myth or Reality?

2021 ◽  
Vol 22 (14) ◽  
pp. 7373
Author(s):  
Darya V. Telegina ◽  
Oyuna S. Kozhevnikova ◽  
Anna K. Antonenko ◽  
Nataliya G. Kolosova
Keyword(s):  
De Novo ◽  
The Elderly ◽  
Developed Countries ◽  
Pathological Process ◽  
Age Related Macular Degeneration ◽  
Long Term Effects ◽  
Functional Changes ◽  
Age Related ◽  
Functional Features ◽  
Retinal Neurogenesis

Age-related macular degeneration (AMD) is a complex multifactorial neurodegenerative disease that constitutes the most common cause of irreversible blindness in the elderly in the developed countries. Incomplete knowledge about its pathogenesis prevents the search for effective methods of prevention and treatment of AMD, primarily of its “dry” type which is by far the most common (90% of all AMD cases). In the recent years, AMD has become “younger”: late stages of the disease are now detected in relatively young people. It is known that AMD pathogenesis—according to the age-related structural and functional changes in the retina—is linked with inflammation, hypoxia, oxidative stress, mitochondrial dysfunction, and an impairment of neurotrophic support, but the mechanisms that trigger the conversion of normal age-related changes to the pathological process as well as the reason for early AMD development remain unclear. In the adult mammalian retina, de novo neurogenesis is very limited. Therefore, the structural and functional features that arise during its maturation and formation can exert long-term effects on further ontogenesis of this tissue. The aim of this review was to discuss possible contributions of the changes/disturbances in retinal neurogenesis to the early development of AMD.

scholarly journals Urinary C-type natriuretic peptide excretion: a potential novel biomarker for renal fibrosis during aging

2011 ◽  
Vol 301 (5) ◽  
pp. F943-F952 ◽  
Author(s):  
S. Jeson Sangaralingham ◽  
Denise M. Heublein ◽  
Joseph P. Grande ◽  
Alessandro Cataliotti ◽  
Andrew D. Rule ◽  
...  
Keyword(s):  
Natriuretic Peptide ◽  
Renal Fibrosis ◽  
Structural Changes ◽  
Microscopic Analysis ◽  
The Elderly ◽  
Electron Microscopic ◽  
Functional Changes ◽  
Age Related ◽  
Increased Risk ◽  
Renal Aging

Renal aging is characterized by structural changes in the kidney including fibrosis, which contributes to the increased risk of kidney and cardiac failure in the elderly. Studies involving healthy kidney donors demonstrated subclinical age-related nephropathy on renal biopsy that was not detected by standard diagnostic tests. Thus there is a high-priority need for novel noninvasive biomarkers to detect the presence of preclinical age-associated renal structural and functional changes. C-type natriuretic peptide (CNP) possesses renoprotective properties and is present in the kidney; however, its modulation during aging remains undefined. We assessed circulating and urinary CNP in a Fischer rat model of experimental aging and also determined renal structural and functional adaptations to the aging process. Histological and electron microscopic analysis demonstrated significant renal fibrosis, glomerular basement membrane thickening, and mesangial matrix expansion with aging. While plasma CNP levels progressively declined with aging, urinary CNP excretion increased, along with the ratio of urinary to plasma CNP, which preceded significant elevations in proteinuria and blood pressure. Also, CNP immunoreactivity was increased in the distal and proximal tubules in both the aging rat and aging human kidneys. Our findings provide evidence that urinary CNP and its ratio to plasma CNP may represent a novel biomarker for early age-mediated renal structural alterations, particularly fibrosis. Thus urinary CNP could potentially aid in identifying subjects with preclinical structural changes before the onset of symptoms and disease, allowing for the initiation of strategies designed to prevent the progression of chronic kidney disease particularly in the aging population.

scholarly journals Features of Retinal Neurogenesis as a Key Factor of Age-Related Neurodegeneration: Myth or Reality?

2021 ◽  
Author(s):  
Darya Telegina ◽  
Oyuna Kozhevnikova ◽  
Anna Antonenko ◽  
Nataliya Kolosova
Keyword(s):  
De Novo ◽  
The Elderly ◽  
Developed Countries ◽  
Pathological Process ◽  
Age Related Macular Degeneration ◽  
Long Term Effects ◽  
Functional Changes ◽  
Age Related ◽  
Functional Features ◽  
Retinal Neurogenesis

Age-related macular degeneration (AMD) is a complex, multifactorial neurodegenerative disease that constitutes the most common cause of irreversible blindness in the elderly in developed countries. Incomplete knowledge about its pathogenesis prevents the search for effective methods of prevention and treatment of AMD, primarily its “dry” type, which is by far the most common (90% of all AMD cases). In recent years, AMD became younger: late stages of the disease are now detected in relatively young people. It is known that AMD pathogenesis—according to the age-related structural and functional changes in the retina—is linked with inflammation, hypoxia, oxidative stress, mitochondrial dysfunction, and an impairment of neurotrophic support, but the mechanisms that trigger the conversion of normal age-related changes to the pathological process as well as the reason for early AMD development remain unclear. In the adult mammalian retina, de novo neurogenesis is very limited. Therefore, the structural and functional features that arise during its maturation and formation can exert long-term effects on further ontogenesis of this tissue. The aim of this review is to discuss possible contributions of the changes/disturbances in retinal neurogenesis to the early development of AMD.

scholarly journals Dynamic tests in pituitary endocrinology: pitfalls in interpretation during aging

2021 ◽  
Author(s):  
Marina Caputo ◽  
Chiara Mele ◽  
Alice Ferrero ◽  
Ilaria Leone ◽  
Tommaso Daffara ◽  
...  
Keyword(s):  
Critical Role ◽  
Endocrine System ◽  
The Elderly ◽  
Endocrine Function ◽  
Endocrine Disorders ◽  
Dynamic Tests ◽  
Age Related ◽  
Genetic And Environmental Factors ◽  
Complex Relationships ◽  
And Function

Aging and age-related diseases represent hot topics of current research. Progressive damage in morphology and function of cells and tissue characterizes the normal process of aging, that is influenced by both genetic and environmental factors. The ability of each individual to adapt to these stressors defines the type of aging and the onset of age-related diseases (i.e. metabolic syndrome, inflammatory disorders, cancer and neurodegenerative diseases). The endocrine system plays a critical role in this process, because of its complex relationships with brain, immune system, and skeletal muscle; thus, alterations in hormonal networks occur during aging to maintain homeostasis, with consequent under- or overactivity of specific hypothalamic-pituitary-peripheral hormone axes. On the other hand, the increase in life expectancy has led to increasing incidence of age-related diseases, including endocrine disorders, which may prompt assessment of endocrine function in aging individuals. In this context, there is growing awareness that natural changes of endocrine physiology and physiopathology occurring with increasing age may necessitate age-driven diagnostic cut-offs requiring validation in the elderly. This review aims to analyse the available literature on the hormone response to the most important dynamic tests currently used in the clinical practice for the screening of anterior pituitary-related diseases, to underline pitfalls in interpretation during aging.

scholarly journals Impact of COVID-19 on Mitochondrial-Based Immunity in Aging and Age-Related Diseases

2021 ◽  
Vol 12 ◽  
Author(s):  
Riya Ganji ◽  
P. Hemachandra Reddy
Keyword(s):  
Immune Cells ◽  
Molecular Mechanisms ◽  
Clinical Symptoms ◽  
Mitochondrial Dynamics ◽  
Neurological Diseases ◽  
The Elderly ◽  
Mortality Rates ◽  
Chronic Obstructive ◽  
Age Related ◽  
Cell Immunity

The coronavirus disease 2019 (COVID-19) has become a deadly pandemic with surging mortality rates and no cure. COVID-19 is caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) with a range of clinical symptoms, including cough, fever, chills, headache, shortness of breath, difficulty breathing, muscle pain, and a loss of smell or taste. Aged individuals with compromised immunity are highly susceptible to COVID-19 and the likelihood of mortality increases with age and the presence of comorbidities such as hypertension, diabetes mellitus, cardiovascular disease, or chronic obstructive pulmonary disease. Emerging evidence suggests that COVID-19 highjacks mitochondria of immune cells, replicates within mitochondrial structures, and impairs mitochondrial dynamics leading to cell death. Mitochondria are the powerhouses of the cell and are largely involved in maintaining cell immunity, homeostasis, and cell survival/death. Increasing evidence suggests that mitochondria from COVID-19 infected cells are highly vulnerable, and vulnerability increases with age. The purpose of our article is to summarize the role of various age-related comorbidities such as diabetes, obesity, and neurological diseases in increasing mortality rates amongst the elderly with COVID-19. Our article also highlights the interaction between coronavirus and mitochondrial dynamics in immune cells. We also highlight the current treatments, lifestyles, and safety measures that can help protect against COVID-19. Further research is urgently needed to understand the molecular mechanisms between the mitochondrial virus and disease progression in COVID-19 patients.

Age-related changes in the feedback regulation of gonadotrophin secretion by sex steroids in men

1981 ◽  
Vol 96 (2) ◽  
pp. 154-162 ◽  
Author(s):  
Kazuo Muta ◽  
Ken-ichi Kato ◽  
Yasuo Akamine ◽  
Hiroshi Ibayashi
Keyword(s):  
Sex Steroids ◽  
Regulatory System ◽  
Feedback Regulation ◽  
Serum Levels ◽  
The Elderly ◽  
Elderly Group ◽  
Functional Changes ◽  
Age Related ◽  
Serum Lh ◽  
Gonadotrophin Secretion

Abstract. In order to clarify the age-related functional changes of the hypothalamic-pituitary-gonadal axis in men, the negative feedback control of serum gonadotrophin by sex steroids was studied in 39 young (18–34 years) and 49 elderly (62–95 years) men. Mean basal LH and FSH levels and the responsiveness to synthetic LRH were determined before and after daily im injection of testosterone propionate (TP; 5, 10 or 50 mg/day) or oestradiol benzoate (OeB; 50, 100 or 500 μg/day) for 3 days. After the administration of TP or OeB, serum levels of testosterone or oestradiol were more elevated in the elderly than in the younger group. In the latter, basal LH level decreased significantly at 10 mg/day of TP and so did basal levels of both LH and FSH at 50 and 100 μg/day of OeB. Responses of serum LH and FSH to LRH were inhibited significantly by TP at a dose of 50 mg/day and by OeB at doses of 100 and 500 μg/day. Whereas in the elderly group, basal LH levels and responses of both LH and FSH were not suppressed significantly by TP regardless of the dose. At a dose of 500 μg OeB, serum LH response was decreased remarkably. Per cent suppression of serum LH response at 50 mg TP, as well as those of serum LH and FSH responses at 500 μg OeB in the elderly group, was significantly less than in the younger group. These data indicate that in the elderly men the regulatory system of gonadotrophin secretion appears to manifest a more marked resistance to inhibitory effects of sex steroids, and also suggest that the set-point to sex steroids in the hypothalamic-pituitary axis is reset at a higher level in male senescence.

scholarly journals Structural and functional changes in the kidneys and their effect on cardiovascular risk in elderly patients

2020 ◽  
Vol 43 (4) ◽  
pp. 539-548
Author(s):  
Natalya I. Golovina ◽  
◽  
Yury A. Lykov ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Structural Changes ◽  
Interstitial Fibrosis ◽  
The Elderly ◽  
Functional Changes ◽  
Age Related ◽  
Organ Systems

Like other organ systems, the kidneys also go through process of normal senescence, including both anatomical and physiological changes. Normal physiological aging is characterized by the expected age-related changes in the kidneys. With age, the kidneys are subject to structural changes, for example, there is a decrease in the number of functional glomeruli due to an increase in the prevalence of nephrosclerosis (atherosclerosis, glomerulosclerosis, atrophy of the tubules with interstitial fibrosis) and to some extent compensatory hypertrophy of the remaining nephrons. Older age is also associated with reduced cortical volume, increased medullary, and larger and more numerous renal cysts. Changes in normal aging are important in clinical practice. Against the background of suppression of reparative capabilities, the elderly are more prone to acute damage and chronic kidney disease, aggravation of the course of chronic kidney disease. The elderly have less renal functional reserve when they do actually develop chronic kidney disease and they are also at higher risk for acute kidney injury. Cardiovascular disease is a leading cause of death and a common comorbidity among patients with kidney disease. In this review, we have identified the most characteristic structural and functional changes in the kidneys in elderly patients and their impact on cardiovascular risk.

scholarly journals Gastrointestinal Tract Disorders in Older Age

2019 ◽  
Vol 2019 ◽  
pp. 1-19 ◽  
Author(s):  
Igor Dumic ◽  
Terri Nordin ◽  
Mladen Jecmenica ◽  
Milica Stojkovic Lalosevic ◽  
Tomica Milosavljevic ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Elderly Population ◽  
The Elderly ◽  
Daily Basis ◽  
Clinical Implications ◽  
Age Group ◽  
Gi Tract ◽  
Age Related ◽  
Age Related Changes

Considering an increase in the life expectancy leading to a rise in the elderly population, it is important to recognize the changes that occur along the process of aging. Gastrointestinal (GI) changes in the elderly are common, and despite some GI disorders being more prevalent in the elderly, there is no GI disease that is limited to this age group. While some changes associated with aging GI system are physiologic, others are pathological and particularly more prevalent among those above age 65 years. This article reviews the most important GI disorders in the elderly that clinicians encounter on a daily basis. We highlight age-related changes of the oral cavity, esophagus, stomach, small and large bowels, and the clinical implications of these changes. We review epidemiology and pathophysiology of common diseases, especially as they relate to clinical manifestation in elderly. Details regarding management of specific disease are discussed in detail if they significantly differ from the management for younger groups or if they are associated with significant challenges due to side effects or polypharmacy. Cancers of GI tract are not included in the scope of this article.

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