1,078 Works

The association between daily walking behavior and self-reported physical function in community-dwelling older adults

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Many older people do not participate in organized exercise, and daily walking may be the most substantial contributor to physical activity. To investigate the association between daily walking behavior and self-reported health-related physical function, older community-dwelling volunteers wore activity-registering sensors for three days. Self-reported health-related physical functioning was measured using the SF36 10-item Physical Function subscale. Forty-six participants wore a sensor (mean age 77.6, SD 3.6, 61 % women). In a multiple regression model, steps...

Effects of indirect nutritional intervention by a registered dietitian through visiting nurses in nutritionally at-risk older home-care recipients: a randomized pilot study

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Objectives: Home-visit nutritional support services by registered dietitians for home-care patients are not popular due to a shortage of visiting registered dietitians. This study examined the effects of indirect nutritional intervention by a registered dietitian through visiting nurses in community-dwelling older home-care recipients. Design: A randomized, open-label, controlled clinical trial. Setting: Community. Participants: Thirty-four nutritionally at-risk older home-care recipients aged 65 years or older who were receiving home-visit nursing care services. Intervention: Dietary counseling promoting...

Gender and age differences in levels, types and locations of physical activity among older adults living in car-dependent neighborhoods

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Background: A thorough understanding of gender differences in physical activity is critical to effective promotion of active living in older adults. Objectives: To examine gender and age differences in levels, types and locations of physical activity. Design: Cross-sectional observation. Setting: Car-dependent urban and rural neighborhoods in Worcester County, Massachusetts, USA. Participants: 111 men and 103 women aged 65 years and older. Measurements: From 2012 to 2014, participants were queried on type, frequency and location of...

Primary Prevention of Dementia: The Future of Population-based Multidomain Lifestyle Interventions

Dementia affects 46.8 million of the world’s population, and is projected to increase to 131.5 million by 2050 (1). Increasingly, with no available disease-modifying drug or cure for the disease, preventive strategies are being pursued to curb the worldwide epidemic. Accumulating evidence supports the importance of dementia prevention, with seven risk factors (diabetes mellitus, midlife obesity, midlife hypertension, physical inactivity, depression, smoking, and low education) estimated to contribute to 9.6 million cases, equivalent to a...

The Relationship of Omega 3 Polyunsaturated Fatty Acids in Red Blood Cell Membranes with Cognitive Function and Brain Structure: A Review Focussed on Alzheimer’s Disease

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Significant research attention has focussed on the identification of nutraceutical agents for the prevention of cognitive decline as a natural means of cognitive preservation in the elderly. There is some evidence for a reduction of brain omega 3 polyunsaturated fatty acids (n-3 PUFAs) in normal aging and in Alzheimer’s disease. n-3 PUFAs exhibit anti-inflammatory and anti-amyloidogenic properties as well as being able to reduce tau phosphorylation. Many observational studies have demonstrated a link between n-3...

Frailty syndrome and anthropometric measurements in the elderly living at home

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Disturbance in the nutritional status in the elderly can change anthropometric measurements. These changes on their body could associated with frailty syndrome. The aim was to assess the frailty syndrome and its association with demographic variables and anthropometric measures. Cross-sectional study with 235 elderly people living at home. Descriptive statistics applied were measures of central tendency and dispersion, with frequencies for the qualitative variables. Student’s t test was used to compare the means of sex...

Effects of Omega-3 Fatty Acids on Resting Cerebral Perfusion in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial

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Alteration of cerebral perfusion can be considered as a possible therapeutic target in mild cognitive impairment. This randomized, placebo-controlled, double-blind proof-of-concept study assessed effects of omega-3 fatty acids on cerebral perfusion in patients with mild cognitive impairment. In thirteen patients (omega:n=5; placebo:n=8) cerebral perfusion was measured before and after 26-weeks intervention within posterior cortical regions using magnetic resonance imaging. There was a medium effect of intervention on cerebral blood flow (η2=0.122) and blood volume (η2=0.098)....

Clinical Effects of Oral Tramiprosate in APOE4/4 Homozygous Patients with Mild Alzheimer’s Disease Suggest Disease Modification

Abushakra and colleagues (1) report on the effects of oral tramiprosate on apolipoprotein E (APOE) ε4 allele (APOE4) homozygotes. Tramiprosate is an oral amyloid anti-aggregation agent that reduces oligomer formation and fibrillar (plaque) amyloid deposition in transgenic animal models (1-4). Tramiprosate has been shown to inhibit β-amyloid (Aβ) fibrillation and to reduce soluble Aβ. It prevents Aβ formation and deposition by interfering with glycosaminoglycans. It has also been reported to inhibit the inflammatory response. More...

Potential Utility of Practice Effects in Preventive Trials

By the time an individual fulfills clinical criteria for Alzheimer’s disease (AD) dementia, extensive and likely irreversible neurodegeneration has already occurred. While we might be able to slow disease progression at this late stage, there is minimal likelihood of completely restoring brain and cognitive function once extensive neurodegeneration is present. Accordingly, most clinical trials for AD have shifted toward the prodromal (before dementia) or even the preclinical (before symptom onset) phase of the disease. With...

The potential role of dietary factors on urinary incontinence in the elderly

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Maintenance of urinary continence is a complex physiological process. Multiple morbidities can alter this process including polypharmacy, and age-related loss of physiological function. An increasing body of evidence suggests the importance of dietary factors and ingested substances. Modification of nutrients and ingested substances might prove beneficial adjunctive therapies in the treatment of incontinence, but remain unproven. Extrapolation of the results of epidemiologic studies of the relationship of excess caloric intake to continence, from the general...

VARIOUS DIAGNOSTIC MEASURES OF FRAILTY AS PREDICTORS FOR FALLS, WEIGHT CHANGE, QUALITY OF LIFE, AND MORTALITY AMONG OLDER FINNISH MEN

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The present study was designed to evaluate intra-abdominal adiposity in rats subjected to early weaning and subsequently treated with diet containing flour or flaxseed oil until young life. Pups were weaned for separation from mothers at 14 days (early weaning, EW), and 21 days (control, C). After 21 days, control (C60) was fed with control diet. EW was divided into control (EWC60); flaxseed flour (EWFF60); flaxseed oil (EWFO60) diets until 60 days. At 21-60 day,...

IMPLICATIONS OF ICD-10 FOR SARCOPENIA CLINICAL PRACTICE AND CLINICAL TRIALS: REPORT BY THE INTERNATIONAL CONFERENCE ON FRAILTY AND SARCOPENIA RESEARCH TASK FORCE

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Establishment of an ICD-10-CM code for sarcopenia in 2016 was an important step towards reaching international consensus on the need for a nosological framework of age-related skeletal muscle decline. The International Conference on Frailty and Sarcopenia Research Task Force met in April 2017 to discuss the meaning, significance, and barriers to the implementation of the new code as well as strategies to accelerate development of new therapies. Analyses by the Sarcopenia Definitions and Outcomes Consortium...

Reference Values for Knee Extension Strength Obtained by Hand-held Dynamometry from Apparently Healthy Older Adults: A Meta-analysis

Normative reference values for knee extension strength obtained by hand-held dynamometry from adults 60 to 79 years were derived using summary data from 3 studies. The studies, which were identified through PubMed and a hand-search, contributed data from between 3 and 29 individuals for each age, gender, and side stratum. Meta-analysis was employed to consolidate knee extension strength data. Strength, normalized against body weight, ranged 35.6% for the nondominant side of 70 to 79 year...

An International Position Statement on the Management of Frailty in Diabetes Mellitus: Summary of Recommendations 2017

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Aim: the the International Position Statement provides the opportunity to summarise all existing clinical trial and best practice evidence for older people with frailty and diabetes. It is the first document of its kind and is intended to support clinical decisions that will enhance safety in management and promote high quality care. Methods: the Review Group sought evidence from a wide range of studies that provide sufficient confidence (in the absence of grading) for the...

Measuring frailty among older people: further evaluation of the Brody frailty index

Background & Objective: The study aimed to evaluate the predictive validity of the Brody self-report frailty index among older people. Design, setting & measurements: A longitudinal cohort study (2-years) conducted in Sweden, which included 1141 respondents, aged 65–103 years. Data were collected during 2011-2013 through a postal questionnaire with questions about demographic data, living conditions, self-reported health, ADL dependency (ADL-staircase) and frailty (the Brody frailty index). Results: The total sample was comprised of 53 percent...

Identifying published studies of care home research: an international survey of researchers

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Collating the published research around institutional, long term care is confounded by the differing terminologies used to describe this health-care setting. We aimed to collate the descriptors used by researchers to inform the future development of a ‘search filter’ (a collection of search terms to help identify relevant records from electronic literature databases). We surveyed international researchers via the Nursing Home Research International Working Group, European Geriatric Medicine Society and published reviewers, achieving at 38%...

Associations between Resident, Facility and Community Characteristics and Use of Antipsychotic Medications in Rhode Island Nursing Homes

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Background: Antipsychotic medications (APMs) have been used to treat mood and behavior dysregulation associated with dementia. However, APMs are associated with several adverse health outcomes. Federal initiatives have successfully reduced the use of APMs in nursing homes nationally; however, from 2014 to 2017, the use of APMs in Rhode Island (RI) has increased. Objective: Delineate resident, facility and community characteristics associated with APM use in RI. Design: Cross-sectional. Setting: RI, USA. Participants: RI nursing homes...

The Relationship between Arthritis and Muscular Strength in Older Women with Symptoms of Sarcopenia

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Background: Sarcopenia classification is important for prevention or intervention of sarcopenia in the elderly. However, measures used for the current sarcopenia criteria, including muscular strength, could be impacted by forms of arthritis. Thus, it is crucial to understand the impact arthritis has on sarcopenia status. Objectives: The aim was to investigate if arthritis relates to sarcopenia classification via grip strength or single chair stand in older women. A secondary aim was to assess the relationship...

Development Review of the BACE1 Inhibitor Lanabecestat (AZD3293/LY3314814)

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Several ongoing clinical development programs are investigating potential disease-modifying treatments for Alzheimer’s disease (AD), including lanabecestat (AZD3293/LY3314814). Lanabecestat is a brain-permeable oral inhibitor of human beta-site amyloid (Aβ) precursor protein-cleaving enzyme 1 (BACE1) that reduces Aβ production. As a potent BACE1 inhibitor, lanabecestat significantly reduced soluble Aβ species and soluble amyloid precursor proteins (sAPPβ) in mouse, guinea pig, and dog in a time- and dose-dependent manner. Significant reductions in plasma and cerebrospinal fluid (CSF) Aβ1-40...

The Value of Pre-screening in the Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease Trial

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The Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease (ADAD) trial evaluates the anti-amyloid-β antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial...

Diversified analysis of nutritional status in community-dwelling older adults in Japan

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Objectives: This study aimed to comprehensively analyze the nutritional status of community-dwelling older adults in Japan. Design and Participant: Participants included 48 outpatients (13 males and 35 females) aged ≧65 years who visited a private clinic in an urban city. Body height, body weight, and blood variables, including albumin, lymphocyte counts and total cholesterol, and pre-albumin, were obtained from the patient charts. The MNA-SF and nutritional intakes, using an established semiquantitative questionnaire, were conducted by...

Care Services Workforce Development Special Topic Section

The emerging state of knowledge on the early diagnosis, intervention, and treatment of chronic diseases remains extremely fluid. One of the fundamental aims for Care Weekly is the rapid and frequent information exchange among multiple stakeholders. This is a critical step in accelerating the pace of major discoveries. One topic of strong interest particularly as the aging global population continues to place strains on labor markets is stable supply of qualified care workers to handle...

Weight Loss is a Major Cause of Frailty

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The concept of frailty as a centrally important geriatric syndrome is now well established. Frailty is defined as a syndrome where an older person is vulnerable to becoming functionally impaired or dying when exposed to a stressor. A popular approach to identifying frailty is the physical frailty phenotype as first described by Fried et al. (6). This was developed out of data from the Cardiovascular Health Study and defined frailty as having 3 or more...

Accuracy of Body Mass Index versus Lean Mass Index for Prediction of Sarcopenia in Older Women

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We compared accuracy of body mass index (BMI) versus lean mass index (LMI) to predict sarcopenia in 58 community-dwelling women (74.1±0.9 years). Lean mass was measured with multi-frequency bioelectrical impedance analysis, and strength was measured with Arm Curl test, Chair Stand test, and handgrip dynamometry. Sarcopenia was defined as low LMI. When categorized by BMI, normal women had less absolute lean mass (37.6±1.0 vs. 42.6±0.9 kg; P<0.001) and less relative lean mass (14.1±0.2 vs. 16.1±0.2...

Detecting Treatment Group Differences in Alzheimer’s Disease Clinical Trials: A Comparison of Alzheimer’s Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) and the Clinical Dementia Rating - Sum of Boxes (CDR-SB)

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The Alzheimer’s Disease Assessment Scale’s cognitive subscale (ADAS-Cog) has been widely used as an outcome measure in Alzheimer’s Disease (AD) clinical trials. In its original form (ADAS-Cog11), the scale has been used successfully in mild-to-moderate AD dementia populations, but its use is more limited in the study of earlier disease (mild cognitive impairment [MCI] or mild dementia due to AD) owing to lack of appropriate sensitivity of some items. With recent focus on earlier treatment,...

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