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共204条结果
  • 1.

    【2hr】Gait Parameter Adjustments for Walking on a Treadmill at Preferred, Slower, and Faster Speeds in Older Adults with Down Syndrome

    包量

    机译 患有唐氏综合症的成年人以偏好，较慢和较快的速度在跑步机上行走的步态参数调整
    摘要：The combined effects of ligamentous laxity, hypotonia, and decrements associated with aging lead to stability-enhancing foot placement adaptations during routine overground walking at a younger age in adults with Down syndrome (DS) compared to their peers with typical development (TD). Our purpose here was to examine real-time adaptations in older adults with DS by testing their responses to walking on a treadmill at their preferred speed and at speeds slower and faster than preferred. We found that older adults with DS were able to adapt their gait to slower and faster than preferred treadmill speeds; however, they maintained their stability-enhancing foot placements at all speeds compared to their peers with TD. All adults adapted their gait patterns similarly in response to faster and slower than preferred treadmill-walking speeds. They increased stride frequency and stride length, maintained step width, and decreased percent stance as treadmill speed increased. Older adults with DS, however, adjusted their stride frequencies significantly less than their peers with TD. Our results show that older adults with DS have the capacity to adapt their gait parameters in response to different walking speeds while also supporting the need for intervention to increase gait stability.
  • 2.

    【2hr】Sarcopenic Obesity and Cognitive Functioning: The Mediating Roles of Insulin Resistance and Inflammation?

    包量

    机译 少肌症肥胖症和认知功能：胰岛素抵抗和炎症的中介作用？
    摘要：This study examined the influence of insulin resistance and inflammation on the association between body composition and cognitive performance in older adults, aged 60–69 and aged 70 and older. Subjects included 1127 adults from NHANES 1999–2002. Body composition was categorized based on measurements of muscle mass and waist circumference as sarcopenic nonobese, nonsarcopenic obese, sarcopenic obese, and normal. Using OLS regression models, our findings suggest body composition is not associated with cognitive functioning in adults ages 60–69; however, for adults aged 70 and over, sarcopenia and obesity, either independently or concurrently, were associated with worse cognitive functioning relative to non-sarcopenic non-obese older adults. Furthermore, insulin resistance accounted for a significant proportion of the relationship between cognitive performance and obesity, with or without sarcopenia. Additionally, although high CRP was significantly associated with poorer cognitive functioning in adults ages 60–69, it did not influence the association between body composition and cognitive performance. This study provides evidence that age-related physiological maladaptations, such as metabolic deregulation, which are associated with abdominal fat, may simultaneously contribute to lower cognition and muscle mass, reflecting a degradation of multiple physiological systems.
  • 3.

    【2hr】Poor Dissociation of Patient-Evaluated Apathy and Depressive Symptoms

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    机译 患者评估的冷漠和抑郁症状的解离性差
    摘要：Apathy has traditionally been conceptualised as part of depression. The appropriateness of this conceptualisation has now been questioned, with the realization that apathy constitutes a distinct neuropsychiatric condition, with separate rehabilitation and patient-care implications to depression. Research on the relationship between apathy and depression has, however, produced mixed results. One reason for this inconsistency may lie behind who does the apathy evaluation. In this study we investigated whether the relationship between apathy and depression would differ when apathy was evaluated by the patients or an informant. A total of 49 brain damaged patients were assessed on self- and informant-rated Apathy Evaluation Scales. The relationship between the apathy scores and depressive symptoms was then investigated. Patient-rated, and not informant-rated apathy significantly correlated with depression. We discuss the implication of these results on the relationship between the two neuropsychiatric conditions and also in relation to the utility of patient self-evaluations in apathy.
  • 4.

    【2hr】Association between Physical Functionality and Falls Risk in Community-Living Older Adults

    包量

    机译 社区生活的老年人身体机能与跌倒风险之间的关联
    摘要：Ageing-related declines in physiological attributes, such as muscle strength, can bring with them an increased risk of falls and subsequently greater risk of losing independence. These declines have substantial impact on an individual's functional ability. However, the precise relationship between falls risk and physical functionality has not been evaluated. The aims of this study were to determine the association between falls risk and physical functionality using objective measures and to create an appropriate model to explain variance in falls risk. Thirty-two independently living adults aged 65–92 years completed the FallScreen, the Continuous-Scale Physical Functional Performance 10 (CS-PFP10) tests, and the 12-Item Short-Form Health Survey (SF-12). The relationships between falls risk, physical functionality, and age were investigated using correlational and multiple hierarchical regression analyses. Overall, total physical functionality accounted for 24% of variance in an individual's falls risk while age explained a further 13%. The oldest-old age group had significantly greater falls risk and significantly lower physical functional performance. Mean scores for all measures showed that there were substantial (but not significant) differences between males and females. While increasing age is the strongest single predictor of increasing falls risk, poorer physical functionality was strongly, independently related to greater falls risk.
  • 5.

    【2hr】Are Dementia Patient's Engagement Using Tailored Stimuli the Same? The Apathy Dilemma in Nursing Home Residents

    包量

    机译 痴呆患者使用量身定制的刺激方式是否相同？疗养院居民的冷漠困境
    摘要：Background. Apathy is the most frequent behavioural disturbance understanding how apathy drives engagement in resident's activities of interests is a milestone to better understanding and tailored challenging interventions targeting engagement enhancement. Method. Residents aged 60 and older with dementia according to the ICD 10 from four nursing homes in the south east of France. A set of 25 stimuli were used and categorized by participant into Work, Leisure, Family, or Personal categories, an additional “not interested” category was used for comparison of engagement. The participants stimuli allocation was randomized in guided and unguided situations over a two-week period with 15minute interaction for each stimulus (n = 2) of each category (5×(15 min×2)). Clinical trial identifier: . Results. The mean age, 95% confidence interval (CI) of the 40 participants was 85.4 (83.8–87) with a mean MMSE score, CI95% of 17.7 (16.5–19). Analyses revealed a significant superiority effect of guidance over unguided interaction in duration of engagement in all categories of interest except for the stimulus category “family” and all P < .05. Apathetic participants when guided had longer engagement duration in stimulus Leisure and Personal (all P < .01). Conclusion. Guidance and better activities of interest can lead to enhanced engagement time in participants with dementia.
  • 6.

    【2hr】Ophthalmic Disorders in Adults with Down Syndrome

    包量

    机译 成人唐氏综合症的眼科疾病
    摘要：A myriad of ophthalmic disorders is associated with the phenotype of Down syndrome including strabismus, cataracts, and refractive errors potentially resulting in significant visual impairment. Ophthalmic sequelae have been extensively studied in children and adolescents with Down syndrome but less often in older adults. In-depth review of medical records of older adults with Down syndrome indicated that ophthalmic disorders were common. Cataracts were the most frequent ophthalmic disorder reported, followed by refractive errors, strabismus, and presbyopia. Severity of intellectual disability was unrelated to the presence of ophthalmic disorders. Also, ophthalmic disorders were associated with lower vision-dependent functional and cognitive abilities, although not to the extent that was expected. The high prevalence of ophthalmic disorders highlights the need for periodic evaluations and individualized treatment plans for adults with Down syndrome, in general, but especially when concerns are identified.
  • 7.

    【2hr】Neuroinflammation in the Aging Down Syndrome Brain; Lessons from Alzheimer's Disease

    包量

    机译 衰老综合症大脑中的神经炎症；阿尔茨海默氏病的教训
    • 作者：Donna M. Wilcock
    • 刊名：Current Gerontology and Geriatrics Research
    • 2012年第期
    摘要：Down syndrome (DS) is the most genetic cause of mental retardation and is caused by the triplication of chromosome 21. In addition to the disabilities caused early in life, DS is also noted as causing Alzheimer's-disease-like pathological changes in the brain, leading to 50–70% of DS patients showing dementia by 60–70 years of age. Inflammation is a complex process that has a key role to play in the pathogenesis of Alzheimer's disease. There is relatively little understood about inflammation in the DS brain and how the genetics of DS may alter this inflammatory response and change the course of disease in the DS brain. The goal of this review is to highlight our current understanding of inflammation in Alzheimer's disease and predict how inflammation may affect the pathology of the DS brain based on this information and the known genetic changes that occur due to triplication of chromosome 21.
  • 8.

    【2hr】Pain Management in the Elderly: An FDA Safe Use Initiative Expert Panel's View on Preventable Harm Associated with NSAID Therapy

    包量

    机译 老年人疼痛管理：FDA安全使用计划专家小组对与NSAID治疗相关的可预防伤害的观点
    摘要：Optimization of current pain management strategies is necessary in order to reduce medication risks. Promoting patient and healthcare provider education on pain and pain medications is an essential step in reducing inadequate prescribing behaviors and adverse events. In an effort to raise awareness on medication safety, the FDA has launched the Safe Use Initiative program. The program seeks to identify areas with the greatest amount of preventable harm and help promote new methods and practices to reduce medication risks. Since the establishment of the program, FDA's Safe Use initiative staff convened a panel of key opinion leaders throughout the medical community to address pain management in older adults (≥65 years of age). The aim of the expert panel was to focus on areas where significant risk occurs and where potential interventions will be feasible, implementable, and lead to substantial impact. The panel suggested one focus could be the use of NSAIDs for pain management in the elderly.
  • 9.

    【2hr】Eye Diseases and Impaired Vision as Possible Risk Factors for Recurrent Falls in the Aged: A Systematic Review

    包量

    机译 眼病和视力障碍是老年人反复跌倒的可能危险因素：系统评价
    摘要：Background. Recurrent falls are common among the aged. Vision is needed in maintaining balance, and impaired vision may be an intrinsic risk factor of recurrent falls. The aim was to perform a systematic review about the relationships between eye diseases or impaired vision and the risk of recurrent falls in the aged. Material and Methods. MEDLINE and CINAHL databases were searched in order to find longitudinal epidemiological studies about the associations between eye diseases or impaired vision and the risk of recurrent falls. Altogether 19 studies were found. A qualitative systematic analysis of these studies was performed. Results and Conclusions. The evidence about poor depth perception/stereoacuity and poor low-contrast visual acuity as risk factors of recurrent falls is quite convincing. Discrepant vision, a decrease in visual acuity, and loss of visual field may be risk factors, but more studies are needed. The results concerning the relationships between poor visual acuity and poor contrast sensitivity and the risk of recurrent falls are controversial. More studies about the relationships between different measures of vision and the risk of recurrent falls are needed before final conclusions about poor vision as a risk factor for recurrent falling can be done.
  • 10.

    【2hr】Nicotinamide, NAD(P)(H), and Methyl-Group Homeostasis Evolved and Became a Determinant of Ageing Diseases: Hypotheses and Lessons from Pellagra

    包量

    机译 烟酰胺，NAD（P）（H）和甲基稳态逐渐发展并成为衰老疾病的决定因素：糙皮病的假说和教训
    摘要：Compartmentalized redox faults are common to ageing diseases. Dietary constituents are catabolized to NAD(H) donating electrons producing proton-based bioenergy in coevolved, cross-species and cross-organ networks. Nicotinamide and NAD deficiency from poor diet or high expenditure causes pellagra, an ageing and dementing disorder with lost robustness to infection and stress. Nicotinamide and stress induce Nicotinamide-N-methyltransferase (NNMT) improving choline retention but consume methyl groups. High NNMT activity is linked to Parkinson's, cancers, and diseases of affluence. Optimising nicotinamide and choline/methyl group availability is important for brain development and increased during our evolution raising metabolic and methylome ceilings through dietary/metabolic symbiotic means but strict energy constraints remain and life-history tradeoffs are the rule. An optimal energy, NAD and methyl group supply, avoiding hypo and hyper-vitaminoses nicotinamide and choline, is important to healthy ageing and avoids utilising double-edged symbionts or uncontrolled autophagy or reversions to fermentation reactions in inflammatory and cancerous tissue that all redistribute NAD(P)(H), but incur high allostatic costs.
  • 11.

    【2hr】Acquired Inhibitors: A Special Case of Bleeding in Older Adults

    包量

    机译 获得性抑制剂：老年人出血的特例
    摘要：This literature review is intended to familiarize physicians and healthcare providers of older adults with the potential causes of acute bleeding in older adults and to review diagnostic approaches that can produce prompt identification of acute bleeding and facilitate timely treatment. Adverse events from anticoagulant treatment and nonsteroidal anti-inflammatory drug (NSAID) and aspirin use and abuse are among the most common causes of bleeding in older adults. Diagnoses infrequently considered—mild congenital hemophilia, acquired hemophilia, von Willebrand disease, and platelet dysfunction—can contribute to acute bleeding in older adults. The approach to management of bleeding varies. Management of acute bleeding in older adults can be challenging because these patients often have chronic comorbidity and have been prescribed long-term concomitant medications that can complicate diagnosis and treatment. Prompt recognition of acquired hemophilia, referral to an expert hematologist, and timely initiation of treatment could improve outcome in older patients who experience bleeding episodes resulting from this condition.
  • 12.

    【2hr】The Impact of MicroRNAs on Brain Aging and Neurodegeneration

    包量

    机译 MicroRNA对大脑衰老和神经变性的影响
    摘要：The molecular instructions that govern gene expression regulation are encoded in the genome and ultimately determine the morphology and functional specifications of the human brain. As a consequence, changes in gene expression levels might be directly related to the functional decline associated with brain aging. Small noncoding RNAs, including miRNAs, comprise a group of regulatory molecules that modulate the expression of hundred of genes which play important roles in brain metabolism. Recent comparative studies in humans and nonhuman primates revealed that miRNAs regulate multiple pathways and interconnected signaling cascades that are the basis for the cognitive decline and neurodegenerative disorders during aging. Identifying the roles of miRNAs and their target genes in model organisms combined with system-level studies of the brain would provide more comprehensive understanding of the molecular basis of brain deterioration during the aging process.
  • 13.

    【2hr】β-Secretases, Alzheimer's Disease, and Down Syndrome

    包量

    机译 β-保密酶，阿尔茨海默氏病和唐氏综合症
    摘要：Individuals with Down Syndrome (DS), or trisomy 21, develop Alzheimer's disease (AD) pathology by approximately 40 years of age. Chromosome 21 harbors several genes implicated in AD, including the amyloid precursor protein and one homologue of the β-site APP cleaving enzyme, BACE2. Processing of the amyloid precursor protein by β-secretase (BACE) is the rate-limiting step in the production of the pathogenic Aβ peptide. Increased amounts of APP in the DS brain result in increased amounts of Aβ and extracellular plaque formation beginning early in life. BACE dysregulation potentially represents an overlapping biological mechanism with sporadic AD and a common therapeutic target. As the lifespan for those with DS continues to increase, age-related concerns such as obesity, depression, and AD are of growing concern. The ability to prevent or delay the progression of neurodegenerative diseases will promote healthy aging and improve quality of life for those with DS.
  • 14.

    【2hr】Oxidative Stress and Mitochondrial Dysfunction in Down's Syndrome:Relevance to Aging and Dementia

    包量

    机译 唐氏综合症中的氧化应激和线粒体功能障碍：与衰老和痴呆症的关系
    摘要：Genome-wide gene deregulation and oxidative stress appear to be critical factors determining the high variability of phenotypes in Down's syndrome (DS). Even though individuals with trisomy 21 exhibit a higher survival rate compared to other aneuploidies, most of them die in utero or early during postnatal life. While the survivors are currently predicted to live past 60 years, they suffer higher incidence of age-related conditions including Alzheimer's disease (AD). This paper is centered on the mechanisms by which mitochondrial factors and oxidative stress may orchestrate an adaptive response directed to maintain basic cellular functions and survival in DS. In this context, the timing of therapeutic interventions should be carefully considered for the successful treatment of chronic disorders in the DS population.
  • 15.

    【2hr】The Role of Insulin and Insulin-Like Growth Factor-1/FoxO-Mediated Transcription for the Pathogenesis of Obesity-Associated Dementia

    包量

    机译 胰岛素和胰岛素样生长因子-1 / FoxO介导的转录在肥胖相关性痴呆发病机理中的作用
    摘要：Epidemiological studies suggest that being obese in midlife is a risk factor for cognitive decline and dementia in later life. Hyperinsulinemia is one of the most frequent endocrine features in overweight people which results in insulin desensitization. Thus, chronically high insulin levels have been identified as risk factor for dementia. Accordingly, chronically high insulin levels might be harmful for brain function. Furthermore, insulin and IGF-1-induced signaling is reduced in the brains of patients suffering from Alzheimer's disease (AD). Interestingly, studies in rodents suggest that reduced insulin receptor (IR) and insulin-like growth factor-1 receptor (IGF-1R) signaling decrease AD pathology, that is, β-amyloid toxicity. Data obtained in C. elegans indicate that the beneficial effect mediated via reduced IR/IGF-1R signaling might partially be induced via the forkhead-box O transcription factors (FoxO). In the mammalian brain, there are FoxO1, FoxO3a, and FoxO6 expressed. Surprisingly, high-fat diet specifically reduces the expression of FoxO3a and FoxO6 suggesting that IR/IGF-1 → FoxO-mediated transcription is involved in the pathogenesis of obesity-associated cognitive impairment. Therefore, the function of FoxO1 and FoxO3a has been investigated in animal models of Alzheimer's disease in detail. The current paper focuses on the role of IR/IGF-1 signaling and IR/IGF-1 → FoxO-mediated transcription for the pathogenesis of obesity-associated dementia.
  • 16.

    【2hr】Age-Related Neurodegeneration and Memory Loss in Down Syndrome

    包量

    机译 唐氏综合症与年龄有关的神经变性和记忆丧失
    摘要：Down syndrome (DS) is a condition where a complete or segmental chromosome 21 trisomy causes variable intellectual disability, and progressive memory loss and neurodegeneration with age. Many research groups have examined development of the brain in DS individuals, but studies on age-related changes should also be considered, with the increased lifespan observed in DS. DS leads to pathological hallmarks of Alzheimer's disease (AD) by 40 or 50 years of age. Progressive age-related memory deficits occurring in both AD and in DS have been connected to degeneration of several neuronal populations, but mechanisms are not fully elucidated. Inflammation and oxidative stress are early events in DS pathology, and focusing on these pathways may lead to development of successful intervention strategies for AD associated with DS. Here we discuss recent findings and potential treatment avenues regarding development of AD neuropathology and memory loss in DS.
  • 17.

    【2hr】Generativity as a Route to Active Ageing

    包量

    机译 生殖力是积极衰老的途径
    摘要：We elucidate the significance of active ageing from an individual as well as from a societal perspective. Taking an individual perspective, maintaining activity in later years is linked to successful ageing because of empirical relationships to positive self-perception, satisfaction with life, and development of competences, whereas from a societal perspective, active ageing implies usage of older people's life competences as a human capital of society—a societal imperative, particularly in times of demographic change but also more basically substantiated in an ethics of responsibility, intergenerational solidarity, and generation equity. We focus on the psychological construct of generativity which is interpreted as an aspect of the philosophical-anthropological category of joint responsibility. Our own research in Mexico and the Baltic States supports the notion that maintaining access to the public sphere and active engagement for others is a more basic individual concern than a life-stages specific developmental task. We report background and results of a Dialogue Forum Project Funding, a research cooperation between our institute and the Foundation Remembrance, Responsibility, and Future aimed to improve generativity in Belarus, Russia, and Ukraine by implementing and supporting local initiatives offering opportunities for intergenerational dialogue.
  • 18.

    【2hr】The Use of Mouse Models for Understanding the Biology of Down Syndrome and Aging

    包量

    机译 使用小鼠模型了解唐氏综合症和衰老生物学
    摘要：Down syndrome is a complex condition caused by trisomy of human chromosome 21. The biology of aging may be different in individuals with Down syndrome; this is not well understood in any organism. Because of its complexity, many aspects of Down syndrome must be studied either in humans or in animal models. Studies in humans are essential but are limited for ethical and practical reasons. Fortunately, genetically altered mice can serve as extremely useful models of Down syndrome, and progress in their production and analysis has been remarkable. Here, we describe various mouse models that have been used to study Down syndrome. We focus on segmental trisomies of mouse chromosome regions syntenic to human chromosome 21, mice in which individual genes have been introduced, or mice in which genes have been silenced by targeted mutagenesis. We selected a limited number of genes for which considerable evidence links them to aspects of Down syndrome, and about which much is known regarding their function. We focused on genes important for brain and cognitive function, and for the altered cancer spectrum seen in individuals with Down syndrome. We conclude with observations on the usefulness of mouse models and speculation on future directions.
  • 19.

    【2hr】Oxidative Stress and Down Syndrome: A Route toward Alzheimer-Like Dementia

    包量

    机译 氧化应激和唐氏综合症：迈向痴呆症的途径
    摘要：Down syndrome (DS) is one of the most frequent genetic abnormalities characterized by multiple pathological phenotypes. Indeed, currently life expectancy and quality of life for DS patients have improved, although with increasing age pathological dysfunctions are exacerbated and intellectual disability may lead to the development of Alzheimer's type dementia (AD). The neuropathology of DS is complex and includes the development of AD by middle age, altered free radical metabolism, and impaired mitochondrial function, both of which contribute to neuronal degeneration. Understanding the molecular basis that drives the development of AD is an intense field of research. Our laboratories are interested in understanding the role of oxidative stress as link between DS and AD. This review examines the current literature that showed oxidative damage in DS by identifying putative molecular pathways that play a central role in the neurodegenerative processes. In addition, considering the role of mitochondrial dysfunction in neurodegenerative phenomena, results demonstrating the involvement of impaired mitochondria in DS pathology could contribute a direct link between normal aging and development of AD-like dementia in DS patients.
  • 20.

    【2hr】On the Dynamics of Active Aging

    包量

    机译 主动衰老动力学
    摘要：The conceptual basis of active aging is extended with a dynamic systems model, called Janus. The Janus model accounts for the life-course dynamics of simple and more complex growth and decline functions, on the strength of three principles. The first principle of transition states that the unitary lifespan trajectory of development and aging is the product of two complementary forces, growth and senescence, which are effective from conception until death. The first principle solves the traditional problem of the age at which development ends and the process of aging starts. The second and third principles of peak capacity and peak time refer, respectively, to the impact of growth rate (peak capacity) and rate of senescence (peak time) on the life-course of dynamic systems. The validity of the Janus model is demonstrated by simulating the empirical lifespan trajectories of functional capacity, intelligence, and mortality. The Janus model contributes to the concept of active aging by underlining the dynamic limits of human nature, by stimulating effective policies for promoting active aging in the first half of life, and by emphasizing the growth potential of older people in the second half.
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