Presbyesophagus presented with chronic intermittent dysphagia

VZV-containing vaccines and hospitalization for herpes zoster: careful optimism

The repeatable battery for the assessment of the neuropsychological status (RBANS): a diagnostic validity study in Greek elderly Abstract Objective There is a broad need for a rapid and efficient neurocognitive battery to detect cognitive decline and differentiate MCI (mild cognitive impairment) and mild dementia from cognitively intact elders. The purpose of this study is to create a version of the repeatable battery for the assessment of neuropsychological status (RBANS) for the Greek population. Method One hundred and sixty-three (163) adults, including healthy controls (HC), MCI and patients with mild dementia, irrespective etiology, were recruited from the day centers of Greek Alzheimer Association after having followed the diagnostic procedure set by the DSM V. The three groups of our sample were matched for age, gender, and education. Results The Greek RBANS had satisfactory internal reliability, as it yielded the satisfactory coefficient of 0.914. According to the criterion validity, the sensitivity of the RBANS Total score to discriminate controls from patients with mild dementia was 0.94, whereas the specificity was 0.97. In addition, RBANS was also able to discriminate HC from MCI population (sensitivity = 0.87, specificity = 0.81) and MCI from patients with mild dementia (sensitivity = 0.91, specificity = 0.97). Conclusions The current data suggest that the Greek version of RBANS is both a valid and reliable psychometric tool, as well as sensitive for detecting cognitive impairment in MCI and early dementia, irrespective etiology. Therefore, taken into account that it revealed coherence in discriminating HC from clinical population, it should be utilized as a neuropsychological screening battery in Greek elders in clinical practice, and also in research protocols.

Resveratrol and 1,25-dihydroxyvitamin D co-administration protects the heart against d -galactose-induced aging in rats: evaluation of serum and cardiac levels of klotho Abstract The current study investigates the cooperative cardioprotective effect of calcitriol (active form of vitamin D) combined with resveratrol in a rat model of d-galactose (d.gal)-induced aging. Male Wistar rats received resveratrol (d.gal + Res), calcitriol (d.gal + Cal), or a combination of them (d.gal + Res + Cal). Intact animals served as control (Ctl). Blood pressure (BP) was recorded by cannulation of the left carotid artery. Fibrosis and cell size were assessed by Masson’s trichrome and hematoxylin–eosin staining, respectively. Cardiac and serum level of antiaging protein, klotho, was measured by ELISA assay method. Gene expression was evaluated by real-time RT-PCR. Biochemical tests were performed according to the standardized method. In d.gal + Res + Cal group, BP, heart weight-to-body weight ratio, and cardiomyocytes size decreased significantly compared with d-gal group. The cardiac transcription levels of catalase and superoxide dismutase 1 and 2 were upregulated in d.gal + Res + Cal compared to the d.gal group (P < 0.001, P < 0.05, P < 0.05, respectively). Increased level of malondialdehyde was observed in d.gal group (P < 0.01 vs. Ctl) which was normalized partially in d.gal + Res + Cal group (P < 0.05). Catalase and superoxide dismutase activity also increased in d.gal + Res + Cal group (P < 0.01 vs. d.gal). Cardiac Klotho, as the antiaging protein, remained unchanged at mRNA and protein levels among the experimental groups. The serum level of Klotho did not change significantly in d.gal group; however, in d.gal + Res + Cal group, serum klotho concentration was increased (P < 0.05 vs. d.gal). It could be concluded that co-administration of resveratrol and vitamin D protects the heart against aging-induced damage by the modulation of hemodynamic parameters and antioxidant status of the heart. Furthermore, increased serum level of klotho could be a novel mechanism for antiaging effects of resveratrol and vitamin D.

Strength training is associated with better functional fitness and perceived healthy aging among physically active older adults: a cross-sectional analysis of the Canadian Longitudinal Study on Aging Abstract Background Regular participation in strength exercise is important to promote healthy aging. However, much of the available evidence on physical activity and older adults has focused on aerobic activity, while there is less research on the benefits of exercise that is performed specifically to strengthen muscles. Aims Using cross-sectional data from the Canadian Longitudinal Study on Aging, the purpose of this study was to determine if strength training is associated with better functional fitness and health among older adults who meet the minimum guidelines for aerobic physical activity. Methods Older adults who met guidelines for aerobic physical activity (≥ 60 years, N = 9100) completed performance-based assessments of physical function and self-reported their physical activity, perceived health, and chronic conditions. Body fat was determined using DEXA. Logistic regression analyses were used to determine whether strength training was associated with better functional fitness, body composition, and health. Results 32.5% of active older adults reported engaging in strength training 1–7 days per week. Participating in any strength training was associated with better scores on measures of balance (OR 1.17, CI 1.04, 1.32), mobility (OR 1.32, CI 1.18, 1.47), body fatness (OR 1.58, CI 1.38, 1.81), and better perceived health (OR 1.34, CI 1.19, 1.51), and healthy aging (OR 1.26, CI 1.12, 1.42). Discussion These results suggest that all older adults, even those who are active and have good mobility, may benefit from strength training. Conclusion Physical activity guidelines should place a greater emphasis on strength training for older adults.

Assistive robots for socialization in elderly people: results pertaining to the needs of the users Abstract Background/aim Technological solutions can support the elderly, improve their quality of life and reduce isolation and loneliness. The Euro-Japan ACCRA (Agile Co-Creation for Robots and Aging) project has the objective of building a reference co-creation methodology for the development of robotic solutions for ageing. The aim of this study is to provide a pilot qualitative analysis of the real needs of elderly people and their caregivers when exposed to conversational activities with robots and to identify priority needs that should be developed from end-user perspectives. Methods A qualitative research design was adopted to define a pre-structured questionnaire that was administered to the elderly taking part in the piloting sessions. Three groups of end-users were included: subjects with an age ≥ 60 years, informal caregivers and formal caregivers. Results The interviews were carried out in Italy and Japan. A total of 17 elderly and 36 caregivers were recruited. Common needs in the two sites were categorized into 3 groups: Communication; Emotion Detection and Safety. General robot acceptance level is good and perception is positive among participants in the pilot sites. Conclusion A positive perception of the elderly on the application of a robotic solution was found and many are the needs that could be addressed by an appropriate and careful robotic development taking into account the real needs and capabilities of the involved subjects.

Aging leads to dysfunctional innate immune responses to TLR2 and TLR4 agonists Abstract Background Sepsis is more common in the elderly. TNF⍺ is recognized as an important mediator in sepsis and Toll-like receptors (TLRs) play an important role in initiating signaling cascades to produce TNF⍺. Little is known about how innate immunity is altered in healthy human aging that predisposes to sepsis. Aims and methods We tested the hypothesis that aging dysregulates the innate immune response to TLR 2 and 4 ligands. We performed whole blood assays on 554 healthy subjects aged 40–80 years. TNFα production was measured at baseline and after stimulation with the TLR2 agonists: peptidoglycan, lipoteichoic acid, Pam3CysK, Zymosan A and the TLR4 agonist lipopolysaccharide (LPS). In a subset of subjects (n = 250), we measured Toll-like receptor (TLR) 2, 4 and MyD88 expression using real-time PCR. Results and discussion We measured a 2.5% increase per year in basal secretion of TNFα with aging (n = 554 p = 0.02). Likewise, TNFα secretion was increased with aging after stimulation with peptidoglycan (1.3% increase/year; p = 0.0005) and zymosan A (1.1% increase/year p = 0.03). We also examined the difference between baseline and stimulated TNFα for each individual. We found that the increase was driven by the elevated baseline levels. In fact, there was a diminished stimulated response to LPS (1.9% decrease/year; p = 0.05), lipoteichoic acid (2.1% decrease/year p = 0.03), and Pam3CysK (2.6% decrease/year p = 0.0007). There were no differences in TLR or MyD88 mRNA expression with aging, however, there was an inverse relationship between TLR expression and stimulated TNFα production. Conclusions With aging, circulating leukocytes produce high levels of TNFα at baseline and have inadequate responses to TLR2 and TLR4 agonists. These defects likely contribute to the increased susceptibility to sepsis in older adults.

Thyroid hormones, metabolic syndrome and Vitamin D in middle-aged and older euthyroid subjects: a preliminary study Abstract Aim To explore the relationship between thyroid hormones, Vitamin D (Vit.D) serum concentrations and metabolic syndrome (MetS) in euthyroid subjects. Methods 123 community-dwelling subjects were enrolled. According to thyroid-stimulating hormone (TSH) values the sample was divided into: (1) group 1 (TSH ≤ 2 mU/L); (2) group 2 (TSH > 2 mU/L). Results Group 2 showed higher percentage of subjects with MetS (p = 0.003) and hypertension (p = 0.031), higher values of waist circumference (WC) (p = 0.007), parathyroid hormone (p = 0.016), glycaemia (p = 0.045), triglycerides (p = 0.034) and free T4 (fT4) (p = 0.013). Correlation analysis showed several weak significant correlations: MetS with TSH (r = 0.202, p = 0.031) and fT3 (r = − 0.206, p = 0.028); THS with body mass index (r = 0.187, p = 0.047) and hypertension (r = 0.199, p = 0.034); Vit.D with WC (r = − 0.185, p = 0.04). Conclusions Our results showed a possible association between thyroid hormones and MetS. Visceral fat and insulin resistance may be an interesting link between Vit.D and TSH levels.

Cut-off for the Life-Space Assessment in persons with cognitive impairment Abstract Background A version of the Life-Space Assessment in persons with cognitive impairment (LSA-CI) has recently been developed. Aims To establish a cut-off value for the newly developed Life-Space Assessment in persons with cognitive impairment (LSA-CI). Methods In a cross-sectional study including 118 multimorbid, older persons with cognitive impairment, life-space mobility (LSM) was documented by the LSA-CI. The analysis was rationalized by Global Positioning System (GPS)-based measures of spatial distance from home. A receiver-operating characteristic (ROC) curve was created and the cut-off point for the LSA-CI was identified with the Youden’s Index. Results ROC curve analysis indicated a critical value of 26.75 (within a range of 0–90) to differentiate between low and high LSM with a sensitivity of 78.1% and specificity of 84.2%. Discussion Diagnostic interpretation of the ROC curves revealed that low and high LSM groups can be differentiated with the proposed cut-off. Conclusions The proposed LSA-CI cut-off score can be recommended to tailor clinical interventions and evaluate change over time.

Cognitive task modality influences postural control during quiet standing in healthy older adults Abstract Background The interstimulus interval of a cognitive task was found to have a limited effect on postural control in young adults, while visual cognitive tasks were found to improve stability compared to auditory tasks. It is of interest to investigate whether postural control in healthy older adults is sensitive to these types of cognitive task manipulations. Aims The objectives of the present experiment were to evaluate the impact of interstimulus interval and modality of a continuous cognitive task on postural control in healthy older adults. Methods Fifteen healthy older adults (70 ± 3.2 years, 3 male) were asked to stand with feet together on a force platform while performing auditory and visual cognitive tasks performed with interstimulus intervals of 2 and 5 s. Results Visual tasks led to reductions in sway area and sway variability in the anterior–posterior direction compared to auditory tasks (ps ≤ 0.05). The interstimulus interval did not lead to a change in sway, except for a small change in the medial–lateral direction for the 2-s interval compared to the 5-s interval (p = 0.05). Discussion and conclusions Results suggest that the interstimulus interval had a very limited effect on postural sway. The modality of the cognitive task had a greater effect on postural sway, as visual cognitive tasks yielded smaller sway area and anterior–posterior sway variability than auditory conditions. Visual stimuli may have acted as an anchor, yielding reduced sway.