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  • 1.

    【2hr】Active Ageing: An Empirical Approach to the WHO Model

    包量

    机译 积极老龄化：世卫组织模式的一种经验方法
    摘要：Background. In the beginning of the 21st century, the world summit on population taking place in Madrid approved active ageing, WHO (2002) as the main objective of health and social policies for old people. Few studies have been done on the scientific validity of the construct. This study aims to validate the construct of active ageing and test empirically the WHO (2002) model of Active Ageing in a sample of community-dwelling seniors. Methods. 1322 old people living in the community were interviewed using an extensive assessment protocol to measure WHO's determinants of active ageing and performed an exploratory factor analysis followed by a confirmatory factor analyses. Results. We did not confirm the active ageing model, as most of the groups of determinants are either not independent or not significant. We got to a six-factor model (health, psychological component, cognitive performance, social relationships, biobehavioural component, and personality) explaining 54.6% of total variance. Conclusion. The present paper shows that there are objective as well as subjective variables contributing to active ageing and that psychological variables seem to give a very important contribute to the construct. The profile of active ageing is expected to vary between contexts and cultures and can be used to guide specific community and individually based interventions.
  • 2.

    【2hr】An Exploration of Apathy and Impulsivity in Parkinson Disease

    包量

    机译 帕金森氏病的冷漠与冲动探索
    摘要：Background. Apathy and impulsivity in Parkinson disease (PD) are associated with clinically significant behavioral disorders. Aim. To explore the phenomenology, distribution, and clinical correlates of these two behaviors. Methods. In PD participants (n = 99) without dementia we explored the distribution of measures of motivation and impulsivity using univariate methods. We then undertook factor analysis to define specific underlying dimensions of apathy and impulsivity. Regression models were developed to determine the associated demographic and clinical features of the derived dimensions. Results. The factor analysis of apathy (AES-C) revealed a two-factor solution: “cognitive-behavior” and “social indifference”. The factor analysis of impulsivity (BIS-11) revealed a five-factor solution: “inattention”; “impetuosity”; “personal security”; “planning”; and “future orientation”. Apathy was significantly associated with: age, age of motor symptom onset (positive correlation), disease stage, motor symptom severity, and depression. Impulsivity was significantly associated with: age of motor symptom onset (negative correlation), gambling and anxiety scores, and motor complications. We observed an overlap of apathy and impulsivity in some participants. Conclusion. In PD, apathy and impulsivity have specific phenomenological profiles and are associated with particular clinical phenotypes. In spite of this, there is some overlap of behaviors which may suggests common aspects in the pathology underlying motivation and reward processes.
  • 3.

    【2hr】The Theory and Practice of Active Aging

    包量

    机译 主动衰老的理论与实践
    • 作者：James F. Fries
    • 刊名：Current Gerontology and Geriatrics Research
    • 2012年第-1期
    摘要：“Active aging” connotes a radically nontraditional paradigm of aging which posits possible improvement in health despite increasing longevity. The new paradigm is based upon postponing functional declines more than mortality declines and compressing morbidity into a shorter period later in life. This paradigm (Compression of Morbidity) contrasts with the old, where increasing longevity inevitably leads to increasing morbidity. We have focused our research on controlled longitudinal studies of aging. The Runners and Community Controls study began at age 58 in 1984 and the Health Risk Cohorts study at age 70 in 1986. We noted that disability was postponed by 14 to 16 years in vigorous exercisers compared with controls and postponed by 10 years in low-risk cohorts compared with higher risk. Mortality was also postponed, but too few persons had died for valid comparison of mortality and morbidity. With the new data presented here, age at death at 30% mortality is postponed by 7 years in Runners and age at death at 50% (median) mortality by 3.3 years compared to controls. Postponement of disability is more than double that of mortality in both studies. These differences increase over time, occur in all subgroups, and persist after statistical adjustment.
  • 4.

    【2hr】Prevalence of Successful Aging in the Elderly in Western Mexico

    包量

    机译 在西墨西哥老年人中成功衰老的患病率
    摘要：Objectives. The aim of this paper is to estimate the prevalence of successful aging in the elderly in Western Mexico and to analyze its variability by age, sex, education, marital status, and pension. Methods. This study employs data from the Health, Wellbeing, and Aging Study (SABE) in Jalisco and Colima, Mexico. Successful aging was operationalized in accordance with no important disease, no disability, physical functioning, cognitive functioning, and being actively. There were a total of 3116 elderly. Results. 12.6% of older adults were “successful” aging. The old-old is a lower proportion of successful aging people; it ranges from 18.9% among people aged 60–69 years to 3.9% in the 80–89 years and up to 1% in people 90 and older. There were also differences according to sex (P = .000), with a higher proportion of successful aging men (18.4% compared with 9.2% of women). There were differences in educational level (P = .000); those higher with education were found to be more successful aging, and also there were differences in marital status for married people (P = .000). Discussion. A small number of older adults meet the criteria definition of successful aging, suggesting the need to analyze in depth the concept and the indicators.
  • 5.

    【2hr】Social Determinants of Active Aging: Differences in Mortality and the Loss of Healthy Life between Different Income Levels among Older Japanese in the AGES Cohort Study

    包量

    机译 积极衰老的社会决定因素：AGES队列研究中年龄较大的日本人的死亡率和健康生活损失之间的差异
    摘要：We examined the relationship between income, mortality, and loss of years of healthy life in a sample of older persons in Japan. We analyzed 22,829 persons aged 65 or older who were functionally independent at baseline as a part of the Aichi Gerontological Evaluation Study (AGES). Two outcome measures were adopted, mortality and loss of healthy life. Independent variables were income level and age. The occurrence of mortality and need for care during these 1,461 days were tracked. Cox regressions were used to calculate the hazard ratio for mortality and loss of healthy life by income level. We found that people with lower incomes were more likely than those with higher incomes to report worse health. For the overall sample, using the governmental administrative data, the hazard ratios of mortality and loss of healthy life-years comparing the lowest to the highest income level were 3.50 for men and 2.48 for women for mortality and 3.71 for men and 2.27 for women for loss of healthy life. When only those who responded to questions about income on the mail survey were included in the analysis, the relationships became weaker and lost statistical significance.
  • 6.

    【2hr】Different Apathy Profile in Behavioral Variant of Frontotemporal Dementia and Alzheimers Disease: A Preliminary Investigation

    包量

    机译 额颞痴呆和阿尔茨海默氏病的行为变异中的不同冷漠概况：初步调查。
    摘要：Apathy is one of the most common behavioral symptoms of dementia; it is one of the salient features of behavioral variant of frontotemporal dementia (bvFTD) but is also very frequent in Alzheimer's disease. This preliminary investigation was aimed at assessing the type of apathy-related symptoms in a population of bvFTD and AD subjects showing comparable apathy severity. Each patient underwent a comprehensive neuropsychological assessment; behavioral changes were investigated by the neuropsychiatric inventory (NPI), using the NPI-apathy subscale to detect apathetic symptoms. At univariate analysis, bvFTD subjects showed lack of initiation (χ 2 = 4.602, p = 0.032), reduced emotional output (χ 2 = 6.493, p = 0.008), and reduced interest toward friends and family members (χ 2 = 4.898, p = 0.027), more frequently than AD subjects. BvFTD displayed higher scores than AD on NPI total score (p = 0.005) and on subscales assessing agitation (p = 0.004), disinhibition (p = 0.007) and sleep disturbances (p = 0.025); conversely, AD subjects were more impaired on memory, constructional abilities, and attention. On multivariate logistic regression, reduced emotional output was highly predictive of bvFTD (OR = 18.266; p = 0.008). Our preliminary findings support the hypothesis that apathy is a complex phenomenon, whose clinical expression is conditioned by the site of anatomical damage. Furthermore, apathy profile may help in differentiating bvFTD from AD.
  • 7.

    【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.
  • 8.

    【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.
  • 9.

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

    包量

    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.
  • 10.

    【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.
  • 11.

    【2hr】Are Dementia Patients 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.
  • 12.

    【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.
  • 13.

    【2hr】Neuroinflammation in the Aging Down Syndrome Brain; Lessons from Alzheimers 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-1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.
  • 14.

    【2hr】Pain Management in the Elderly: An FDA Safe Use Initiative Expert Panels 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.
  • 15.

    【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.
  • 16.

    【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.
  • 17.

    【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.
  • 18.

    【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.
  • 19.

    【2hr】β-Secretases Alzheimers 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.
  • 20.

    【2hr】Oxidative Stress and Mitochondrial Dysfunction in Downs 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.
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