Control of Elderly Hypertension with Merona Program

Hypertension is a silent killer is the most common health problem experienced by the elderly. Control of hypertension in the elderly is very necessary to reduce complications of hypertension. Based on these conditions, the MERONA Program was developed. The purpose is to provide an overview of the implementation of the blush program in the elderly with hypertension. The method used is a family case study and an aggregate using a family and community nursing process approach involving 10 foster families and 60 elderly people in the community selected using cluster random sampling. This program is an integration of hypertension self-management and relaxation therapy, namely music therapy, progressive muscle relaxation, and deep breathing relaxation which is carried out for 12 weeks. Evaluation of changes in behavior and family independence was carried out at the end of the 12th week using a questionnaire. Blood pressure measurements were carried out at weeks 4, 8, and 12. The results of the implementation were an increase in the behavior of the elderly, an increase in the level of family independence, and a significant decrease in systolic and diastolic blood pressure (p<0.05). The MERONA program is recommended to be applied in community health services.

Elevated CSF inflammatory markers in patients with idiopathic normal pressure hydrocephalus do not promote NKCC1 hyperactivity in rat choroid plexus

Background Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurological condition of unresolved etiology characterized by a clinical triad of symptoms; gait disturbances, urinary incontinence, and cognitive deterioration. In the present study, we aimed to elucidate the molecular coupling between inflammatory markers and development of iNPH and determine whether inflammation-induced hyperactivity of the choroidal Na+/K+/2Cl− cotransporter (NKCC1) that is involved in cerebrospinal fluid (CSF) secretion could contribute to the iNPH pathogenesis. Methods Lumbar CSF samples from 20 iNPH patients (10 with clinical improvement upon CSF shunting, 10 without clinical improvement) and 20 elderly control subjects were analyzed with the novel proximity extension assay technique for presence of 92 different inflammatory markers. RNA-sequencing was employed to delineate choroidal abundance of the receptors for the inflammatory markers found elevated in the CSF from iNPH patients. The ability of the elevated inflammatory markers to modulate choroidal NKCC1 activity was determined by addition of combinations of rat version of these in ex vivo experiments on rat choroid plexus. Results 11 inflammatory markers were significantly elevated in the CSF from iNPH patients compared to elderly control subjects: CCL28, CCL23, CCL3, OPG, CXCL1, IL-18, IL-8, OSM, 4E-BP1, CXCL6, and Flt3L. One inflammatory marker, CDCP1, was significantly decreased in iNPH patients compared to control subjects. None of the inflammatory markers differed significantly when comparing iNPH patients with and without clinical improvement upon CSF shunting. All receptors for the elevated inflammatory markers were expressed in the rat and human choroid plexus, except CCR4 and CXCR1, which were absent from the rat choroid plexus. None of the elevated inflammatory markers found in the CSF from iNPH patients modulated the choroidal NKCC1 activity in ex vivo experiments on rat choroid plexus. Conclusion The CSF from iNPH patients contains elevated levels of a subset of inflammatory markers. Although the corresponding inflammatory receptors are, in general, expressed in the choroid plexus of rats and humans, their activation did not modulate the NKCC1-mediated fraction of choroidal CSF secretion ex vivo. The molecular mechanisms underlying ventriculomegaly in iNPH, and the possible connection to inflammation, therefore remains to be elucidated.

Association Between Homocysteine and Vitamin Levels in Demented Patients

Background: Although it is known that the nutritional status among elderly persons and, in particular, patients with dementia, is compromised, malnutrition that results in insufficient uptake of several vitamins is often not diagnosed. Objective: An elevated homocysteine level is a known strong risk factor for vascular dementia (VaD) and Alzheimer’s disease (AD). Several B vitamins are involved in the metabolism of homocysteine. Therefore, we investigated the serum levels of vitamin B1, vitamin B6, folate, and vitamin B12 in 97 patients with mild cognitive impairment (MCI) or different forms of dementia and 54 elderly control persons without dementia. Results: Compared to aged non-demented people, vitamins B1, B6, B12, and folate were decreased in serum of patients with AD, and patients with Lewy body dementia had reduced vitamin B12 level. Vitamin B6 was diminished in VaD. Patients with frontotemporal dementia showed no alterations in vitamin levels. Age was identified as an important factor contributing to the concentrations of vitamin B1 and B6 in serum, but not vitamin B12 and folate. Increased levels of total homocysteine were detected especially in MCI and AD. Homocysteine correlated negatively with levels of vitamins B6, B12, and folate and positively with Q Albumin. Conclusion: Our data suggest that despite increased homocysteine already present in MCI, vitamin levels are decreased only in dementia. We propose to determine the vitamin levels in patients with cognitive decline, but also elderly people in general, and recommend supplementing these nutrients if needed.

Bone Marrow Mesenchymal Stem Cells Derived From Juvenile Macaques Reversed Ovarian Aging in Elderly Macaques

Background Female sex hormone secretion and reproductive ability decrease with ageing. Bone marrow mesenchymal stem cells (BMMSCs) have been postulated to play a key role in treating ovarian senescence; however, the curative effect and mechanism are not clear. Methods We used the macaque ovarian senescence model and observed the structural and functional effects of juvenile BMMSCs in the treatment of ageing macaque ovaries. Moreover, to elucidate the molecular regulatory mechanism by which BMMSCs reverse ovarian senescence, RNA sequencing (RNA-seq) of the ovaries was used to identify key genes and signalling pathways associated with transcriptome profile changes. Results (1) The Rhesus monkey ovarian aging models were an average of 24 years old and had the following sex hormone levels: 0.28 ± 0.11 mIU/mL hFSH, 0.017 ± 0.009 mIU/mL hLH, 0.24 ± 0.042 ng/mL Testo, 51.86 ± 18.37 pg/mL ESTRDL, 0.13 ± 0.012 ng/mL Prog, 0.013 ± 0.012 hCG, and 11.96 ± 2.96 pmol/l AMH. The ovarian organ index was 0.057 ± 0.021, and the HE staining results showed almost no follicular structure, with only local atresia follicles observed. For young rhesus monkeys, the average age was 7 years old, and sex hormone levels were as follows: 0.043 ± 0.03 mIU/mL hFSH, 0.007 ± 0.009 mIU/mL hLH, 0.57 ± 0.15 ng/mL Testo, 123.2 ± 26.26 pg/mL ESTRDL, 0.28 ± 0.014 ng/mL Prog, 0.05 ± 0.012 hCG and 11.96 ± 2.96 pmol/l AMH. The ovarian organ index was 0.011 ± 0.005, and the HE staining results showed all levels of follicles, suggesting that senile ovaries occur in old macaques. (2) P4 generation BMMSCs presented a typical cell morphology, staining positive for Oil Red O, Alizarin Red, and Alcian Blue. The positive rates of CD29, CD34, CD90, and CD105 on the cell surface were 98, 0.98, 98.8, and 99.8%, respectively, in line with mesenchymal stem cell standards. (3) The PET-CT results showed that the ovarian volume in the elderly treatment group increased, the lesions decreased, and the metabolism was vigorous. (4) The level of sex hormone secretion generally recovered to the level of the follicular phase for the 3rd, 6th and 8th months after the treatment of BMMSCs. (5) The HE results showed that all levels of follicles were observed in the young control group, and the medulla and stroma were neatly arranged, whereas primitive, primary, secondary, and atretic follicles were observed in the elderly treatment group. In addition, the medulla and stroma had obvious boundaries with a small amount of calcium nodules in the young control group. while those in the elderly control group had essentially no follicular structure, with only atretic follicles were seen locally that were filled with connective tissue. Masson staining results showed that the proportion of collagen fibres was 10.61 ± 1.83% in the young control group, 56.79 ± 3.58% in the elderly control group, and 23.71 ± 2.4% in the elderly treatment group. TUNEL staining results showed that cell apoptosis was 1.07 ± 0.04%, in the young control group was, 25.93 + 2.49% in the old control group, and 6.98 + 1.35% in the old treatment group. The immunohistochemistry results showed 114 ± 17, 73 ± 6, and 118 ± 18 blood vessels in the young control group, the elderly control group, and the elderly treatment group, respectively. Immunofluorescence staining showed a lack of expression of enhanced green fluorescence protein (E-GFP) in BMMSCs without from the old control group, while green fluorescence was observed in the old treatment group. (6) After the treatment of BMMSCs, 1258 genes were identified as being differentially expressed. The 3D-PCA trace showed that the ovaries of the macaques in the elderly treatment group shifted to that observed in the young group. The genes that were upregulated with age were downregulated after the stem cell treatment. Genes that are downregulated with age were upregulated after stem cell therapy, and the top 20 PPI network genes were enriched for the progesterone-mediated maturation of follicles, oocytes, and cell cycle categories. Conclusions BMMSCs derived from juvenile macaques can reverse ovarian aging in elderly macaques

Maintaining and Supporting Seniors’ Wellbeing through Foreign Language Learning: Psycholinguistics of Second Language Acquisition in Older Age

This study concerns aspects of positive psychology connected to foreign language learning (FLL) in an older healthy generation. The positive psychology perspective stresses the positive aspects of improved wellbeing in participants who engage in various activities, particularly mental and brain-training practices. Therefore, the aim of this study was to explore older people’s subjective feelings connected to their FLL as one of the crucial ways to improve their quality of life (QoL). The objective of the research was to determine the subjective satisfaction level of the participants of a second language (L2) acquisition course. The research sample (experimental group) consisted of 105 respondents who were Czech citizens and 55+ years old. Two control groups were set up. The first (young control) consisted of 102 young adults (university students), also Czech citizens, aged between 19 and 23 years. The second control group (elderly control) consisted of 102 subjects older than 55 years, similar in age to the experimental group. A standardized online questionnaire survey was the principal research method, identical both for the experimental and control groups. The findings clearly showed that language training significantly improved the subjective positive feelings and wellbeing of the older participants, regardless of their objective progress in FLL itself. These results stood in opposition to the young control group and were different from the elderly control group. The results revealed that FLL is an effective tool for enhancing the overall wellbeing of older people, which was shown in their expression of their feelings of happiness, satisfaction, and positive motivation to learn an L2. In addition, FLL objectively affected their mental health in a positive way and expanded their social networks. Moreover, FLL was a meaningful activity for them, despite the weak objective learning outcomes due to the decline of cognitive functions, helping them find their general purpose of life, as well as life motivation as expressed in the survey. These findings are crucial, as it has already been proven that wellbeing is directly connected with good health and longevity. Therefore, national governments and all stakeholders dealing with the present issue of the aging population should pay undivided attention to the enhancement of older people’s wellbeing by all possible intervention approaches, including FLL. There is limited research into the issue and the findings of this investigation could be an impetus for further research into the topic from the perspectives of cognitive science, psychology, and psycholinguistics.

Effect of Emotion and Type of Encoding on Memory for Actions: Verbal and Subject-Performed Tasks

Background: The present study examines whether the interaction between emotion and the enactment effect (body involvement) improves memory in people with Alzheimer disease (AD). Methods: Two experiments with drawings of actions were conducted, in which two types of encoding were used: motor and verbal. In experiment 1, with 13 AD patients and 13 older healthy adults, the encoding was incidental. In experiment 2, with 17 mild AD patients and 21 older healthy adults, it was intentional. Results: In experiment 1, no effect of enactment or emotion was observed in the AD patients. In experiment 2, effects of enactment and emotion (better recall for negative actions) were observed in the AD patients. This pattern of results was also observed in the elderly control adults in both experiments. Conclusion: These results confirm effects observed in normal ageing and indicate a more subtle effect on AD.

Postural Control of Healthy Elderly Individuals Compared to Elderly Individuals with Stroke Sequelae

A stroke and aging process can modify the postural control. We aimed to compare the postural control of health elderly individuals to that of individuals with stroke sequelae. This cross-sectional transversal study was made with individuals capable of walking without any assistance and that were considered clinically stable. The study had 18 individuals in the group with stroke sequelae (SG) and 34 in the healthy elderly control group (CG). The participants were evaluated for the timed up and go test (TUG) and force platform. The SG showed the worst results in relation to the time of execution of the TUG and the force platform evaluation. The displacement of center of pressure was worse for both groups in the eyes-closed situation, especially in the anteroposterior direction for the CG. The GS showed worse results in the static and dynamic postural control. The healthy elderly showed more dependence on sight to maintain their static balance and there was no difference in the balance tests in relation to the side affected by the stroke.

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control

Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease.