ESTIMATING BODY FAT PERCENTAGE THROUGH BODY MASS INDEX AND HANDGRIP STRENGTH IN MIDDLE AND OLDER-AGED ASIAN ADULTS

Objectives: To determine the ability of handgrip strength combined with body mass index (BMI, kg/m2) to estimate body fat percentage (BF%) in middle-aged and older Asian adults. Methods: Middle-aged and older Asian adults (n=459, males=197) were randomly divided into a validation and model development group (n=303) and cross-validation group (n=156). A whole-body scan using dual energy x-ray absorptiometry measured BF%. Bland-Altman plots, standard error of the estimates, total errors and mean absolute errors were used to compare prediction equations. Stepwise regression analysis was used to determine a new prediction equation for middle-aged and older Asian adults. Right and left handgrip strength, age, sex and BMI were included in the analysis. Results: A previously developed prediction equation that included handgrip strength poorly predicted BF% in our current sample with the mean difference being -6.0 ± 4.2%. Predicted BF% values were significantly lower than measured BF% values (22.7% vs. 28.7%, p<0.05). A new prediction equation was developed that included sex, BMI, left handgrip strength and age. Validation of the new equation revealed a constant error of 0.2 ± 3.9% with there being no significant difference between measured and predicted BF% (28.2% vs. 28.5%, p=0.467). Previously developed BF% equations using BMI, but not handgrip strength, had similar constant errors and mean absolute errors compared to the new prediction equation. Conclusion: Handgrip strength does not appear to improve the estimation of body fat percentage from BMI prediction equations in middle and older-aged Asian adults.

Epithelial tissue response to pathological effects in various age groups. Participation of morphofunctional zones and Src-kinase in this process

The response of human organism tissues to various pathological effects depends to a large extent on the presence of the total amount of key protein in the organism – Src-kinase and the ratio of its active part to inactive. With a sharp preponderance of an inactive portion of this protein over the active, the proliferative activity of cells is suppressed, and with a significant preponderance of the active part, proliferation is inadequately increased. The amount of this protein is embedded in embryogenesis and individually in each person. In the age aspect, a decrease in the Src-kinase content in the human organism is observed. The epithelial tissue of two age groups: 20-40 and 75 years and older responds most acutely to pathological effects, including the entering of viruses, since in 20-40 years the number of Src-kinase is the greatest in relation to other age groups, and in 75 years and older – the least, which causes a decrease in the reactivity of organism tissues or, conversely, hyperactivity.

Mitochondrial Metabolism, Dysfunctions in Senescence Cell and the Possible Interventions through Herbal Medicines

The mitochondria are the cell`s powerhouse. They are considered ubiquitous organelles of all eukaryotic cells, being responsible for the cell’s life and death cycle. Through stimuli in the environment in which they live, mitochondria can modulate their own biogenesis as well as signal retrograde to the nucleus to modify the structure of their proteins. Since the mitochondrial genome contains only 37 genes, much of the encoding of its proteins depends on the nuclear genome. Thus, the communication between mitochondria and the nucleus seems to be a target of science in understanding the pathologies associated with this organelle. Some medicinal herbs have been shown to influence mitochondrial biogenesis, such as Gynostemma pentaphyllun (GP) and berberine, which increase the phosphorylation of proteins AMPactivated protein kinase (AMPK). Just as GP and berberine phosphorylate AMPK in signaling for mitochondrial biogenesis, the sesquiterpene beta-caryophyllene (BCP) demonstrated positive results in reorganizing mitochondrial transcription factors, being an agonist of the peroxisome proliferatoractivated alpha receptor (PPAR-α). Another plant derivative, the non-psychoactive cannabinoid known as cannabidiol (CBD), has been showing control in the metabolism of calcium in the mitochondrial matrix. In this review, we seek to get a closer look at the biochemical mechanisms of action of some of these plants, as well as their synergies in the results of different treatments. In the view of oriental medicines, the use of associated medicinal herbs has always been part of their treatment protocols. However, the effectiveness of these treatments in relation to plant synergy can be observed in future clinical trials for better understanding.

Development of Estimate Formulas for Waist Circumference Using Body Mass Index and Limb Circumferences in Hospitalized Older Adults

Background: Little research has been conducted on the estimate formulas for waist circumference using body mass index and limb circumferences in hospitalized older adults. Thus, we conducted the present study to develop estimate formulas of waist circumference using body mass index and limb circumferences in hospitalized older adults. Methods: Forty hospitalized older patients were recruited in this cross-sectional study. We measured waist circumference, body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference. The estimate formulas for waist circumference were developed using simple and multiple regression analysis. Results: Simple regression analysis indicated that body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference were independent explanators for waist circumference (p < 0.05 for all). In addition, body mass index, upper arm circumference, and forearm circumference but not thigh circumference and calf circumference were extracted as independent explanators for waist circumference in multiple regression analysis (p < 0.05). We were able to develop the estimate formulas using body mass index, upper arm circumference, forearm circumference, thigh circumference, and calf circumference. Conclusion: The results suggest that the estimate formulas for waist circumference may provide an opportunity to easily evaluate waist circumference, even in hospitalized older adults with kyphosis posture. However, future studies should be conducted to develop the estimate formulas for waist circumference with a lower error value.

New Approacher in the Development of Alzheimer’s Disease Modifying Drugs

Introduction: Alzheimer’s disease is a more common neurodegenerative disease, affecting 25 million people worldwide, or accounting for about 60 to 70% of all dementia cases. There is currently no exact mechanism to explain the pathophysiology of Alzheimer’s disease, however, cascading metabolic amyloid and post-translational review of tau protein are used as major hypotheses. Objective: To demonstrate in the literature new approaches in the development of Alzheimer’s disease modifiers. Methodology: For the accomplishment of this study made in the bibliographical survey of scientific literature and respect to the approached subject, in the databases PUBMED, ScienceDirect, Scielo and Scopus. Results: Alzheimer’s disease-modifying drugs are not yet available, but many patients may, however, develop phase III clinical trials and are intended to modify as pathological stages leading to the disease. As disease-modifying therapies under study, these changes also affect Aβ and tau protein and also cause inflammation and oxidative damage. The results obtained in the clinical trials performed were positive and promising and are still under study. The results show that there is still a long way to go in the development of Alzheimer’s disease modifying drugs. Conclusion: The results demonstrated that there is still a long way to go in the development of Alzheimer’s disease modifying drugs, but nevertheless levels at the research level should be continued in order to improve the pathophysiology of the disease and find an effective treatment for this disease the same.

The Impact of COVID-19 on Informal Caregivers in the US

Background: Caregiver burden has negative effects on mental and physical health along with quality of life. Meanwhile, social and physical distancing protocols during the COVID-19 pandemic have created additional impacts on informal caregiving in a rapidly changing environment. Early research over the past year suggests that the pandemic has caused increased caregiver burden as well as caregiving intensity among these individuals. Purpose: Our primary purpose in this informational literature review is to describe the impacts of the pandemic on informal caregiver burden and the sudden shift in roles and responsibilities as a result of pandemic-related changes in caregiving. This review will describe emerging effects on various aspects of health among informal caregivers and explore the growing need to support unpaid caregiving during this time. Methods: A streamlined search was conducted to fit the scope of this review, with key terms determined to identify relevant publications. Common research databases and up-to-date mainstream resources were utilized. Notably, we focused on research published or released since March 2020, primarily rapidly reviewed studies, to align with the timing of the COVID-19 pandemic in the US. Results: Early research suggests that the pandemic has worsened caregiver burden and increased caregiving intensity and hours of care among unpaid, informal family caregivers. Reported health impacts include higher stress, pain, and depression, along with decreased social connectedness and quality of life. Notably, however, COVID-related research generally does not focus on the positive aspects of caregiving, such as its role as a source of purpose in life, creating an opportunity to explore ways to boost certain valuable personal resources among caregivers. Conclusions: Informal family caregivers face their own negative health outcomes and distress as a result of greater caregiver burden, intensity, and the changing landscape of caregiving during the ongoing COVID-19 pandemic. Immediate policy and support recommendations should be considered to alleviate informal caregiver burden and provide ongoing resources over the longer term. In addition, future work should explore the potential of boosting positive resources such as resilience and purpose to ease caregiver burden.

The Usefulness of Short Physical Performance Battery Score for Predicting the Ability of Toilet Activity in Hospitalized Older Patients

Background: It has been still unclear whether the cut-off value of the short physical performance battery for predicting the ability of the toilet activity in the hospitalized older patients. The aim of this study was to reveal the relationship between the short physical performance battery and the ability of toilet activity, and also to determine the cut-off value of the short physical performance battery score for the ability of toilet activity in the hospitalized older patients. Methods: In this cross-sectional study, 71 hospitalized older patients were recruited. The short physical performance battery and the ability of toilet activity using the Barthel index (BI) were measured. The patients were split into two groups, according to the ability of toilet activity (Group 1: 10 point; Group 2: 5 point or less in BI score). A multiple logistic regression analysis was used to assess the relationship between the two groups. Moreover, the cut-off value for dividing into two groups, (Group 1 and Group 2) using the short physical performance battery score, which was calculated by a receiver operating characteristic curve. Results: The short physical performance battery score was an independent explanator for the ability of toilet activity using multiple logistic regression analysis. Besides, the cut-off value of the short physical performance battery for the ability of toilet activity was set in this study. Conclusion: The findings of this study suggest that the cut-off value of the short physical performance battery score could be a useful index to predict the ability of toilet activity in the hospitalized older patients.

Potentially Inappropriate Medications for Older Adults in Dental Practice

Objective: The present study aimed to review the medications frequently prescribed in dental practice that are potentially inappropriate for the elderly population due to the risks presented. Methods: An integrative literature review was carried out, based on the Guidance Manual: Prescription and Dispensing of Medicines Used in Dentistry, which reports the main drugs prescribed in dental practice (2017). From this, medications described in the Beers list of the American Society of Geriatrics (2019) were extracted, in order to identify medications that are potentially inappropriate in the elderly, what are the main consequences of use and appropriate management in view of the need for prescription. Results: The prescription and dispensing guidance manual for medicines used in dentistry has a list of 142 medicines, containing anti-inflammatories, antibacterials, opioids, benzodiazepines and other types of drugs. Of the drugs listed, 27 are considered inadequate and the most common therapeutic class among the drugs was anti-inflammatory drugs, being equivalent to 44.5% of the inadequacies found. Conclusion: Despite the risks associated with medications, it appears that they are widely prescribed in dental practice, making these groups worthy of special attention due to their potential for serious adverse events and negative impacts on the elderly and the health system, in addition to to emphasize the importance of the professional regarding the best indications and pharmacotherapeutic follow-up by the clinical pharmacist in caring for the elderly.

Social prescription for those living with dementia; does MedTech have a role to play?

Ageing is the major risk factor for dementia and nearly every country has seen its life expectancy rise from the beginning of the 21st century. Remaining socially connected has positive health and social implications and may be even more significant for marginalized group of people like those living with dementia. If appropriately used, social prescriptions can help deliver value-based social engagement and primary care by maximising the utilisation of resources and addressing social determinants of health, decreasing dependency on the biomedical model and thus providing a way for health care systems to deal with social determinants of health. More frequently, however, those seeking access to these programmes do not tend to do so simply due to lack of understanding and knowledge of the availability of such services. So, provision of social activities involves more than developing a program and hoping people will attend, and considering the particular situations of those living with dementia as marginalised group of people, and taking into account that there is no treatment for dementia, societies need to move toward social prescription, integrating appropriate MedTech support- targeting on those living with dementia- into such programs.

CORRELATION OF BODY MASS INDEX WITH THE HAND GRIP STRENGTH AND ADDUCTOR POLLICIS MUSCLE THICKNESS IN ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERITEMATOSUS IN A BRAZIL NORTHEAST REFERENCE CENTER

Introduction: Rheumatoid arthritis and systemic lupus erythematosus are autoimmune, chronic and progressive diseases, which can be get worst in the presence of muscle mass loss due to physical inactivity and continuous inflammatory. Therefore, estimate body composition can assist in the treatment of these diseases. Objective: To evaluate the correlation of body mass index with handgrip strength and adductor pollicis muscle thickness in elderly patients with rheumatoid arthritis and systemic lupus erythematosus followed in a reference center in Brazil. Material and Methods: Cross-sectional study carried out in a rheumatology outpatient clinic in a reference center in Northeastern Brazil (Recife / PE). Elderly patients with rheumatoid arthritis and systemic lupus erythematosus. Anthropometric measurements of weight, height and Body Mass Index (BMI) were taken, in addition to the measurement of body composition: calf circumference (CC), arm circumference (MUAC), adductor pollicis muscle thickness (APMT) and strength of hand grip (HGS). The data were treated using the SPSS version 17.0 for Windows and Excel 2010. Pearson correlation and the Chi-square test were used for analysis. The level of significance was set at 5%. The IMIP Research Bioethics Committee approved the present study under No. 19163619.1.0000.5201 the participants’ guardians signed the Free and Informed Consent Form (ICF). Results: The study included 19 patients aged 60 to 85 years and a mean age of 70.05 years +/- 8.47 SD, 94.74% of whom were female. The BMI, MUAC, CC, APMT and HGS mean of (26.93g / m2 ± 5.75DP), (28.85 ± 4.06DP), (34.79 ± 3.62DP), (11.52 ± 4.437DP) and (10.81 ± 6.77DP) respectively. The BMI showed that 31.26 were overweight, while HGS showed that 66.7% had a deficit in handgrip strength justified by the high prevalence of depletion of the adductor pollicis muscle, which identified that 97.4% showed signs of depletion of this musculature. There was a moderate correlation between BMI, MUAC and CC (r = 0.453) and (r = 0.426), respectively, while for BMI and APMT the correlation was weak (r = 0.348), as well as the correlation between BMI and HGS was r = 0.005. Conclusions: There was a prevalence of eutrophic and overweight elderly people, however with loss of muscle mass and decreased hand grip strength. This may suggest a greater risk for the development of senile sarcopenia.