Relation between frailty and common geriatric problems in elderly

There is a high prevalence of common geriatric problems [falls, urinary incontinence, visual and hearing impairment] among frail elderly leading to more disability and functional impairment. The aim of this study is to compare the prevalence of common geriatric problems between frail and non-frail elderly. A Case control study. 90 participants aged 60 years and above. They were selected from Ain Shams University Hospital from inpatient wards and outpatient clinics. The studied sample was divided into 2 groups: Group A [30 frail elderly females and 30 frail elderly males] and Group B [30 healthy elderly subjects; 15 males and 15 females]. Comprehensive geriatric assessment, including detailed history of common geriatric problems as mentioned above, physical examination, and also assessment of frailty using modified Fried criteria]. Hearing impairment, incontinence and falls were more prevalent in frail elderly with a highly difference between the two groups, with p values< [0.001,0.009,0.006] consequently, visual impairment was statistically significant in cases more than controls with p value [0.012]. There is a significant positive relationship and high prevalence of common geriatric problems especially falls, urinary incontinence, visual and hearing impairment among frail elderly

Blood levels of iron, copper, zinc, nitric oxide, and APOE [epsilon]4 allele frequency in patients with Alzheimer's disease

Alzheimer's disease [AD] is the most common form of dementia, characterized by slow, progressive memory loss. As the disease progresses other symptoms such as visuospatial disorientation, language impairment, and executive dysfunction or frontal lobe signs develop. The current study was performed to investigate the role of iron, copper, zinc, nitric oxide [NO] in relation to ApoE epsilon 4 allele frequencies in patients with AD. This study was carried out on sixty elderly subjects aged >/= 60 years. The subjects were classified into two groups matched for age and gender: Group I: included 30 elderly patients [74.3 +/- 7.2 years] diagnosed as probable Alzheimer's disease according to the DSM-IV-TR and the NINCDS-ADRDA. Group II: included 30 cognitively normal elderly subjects [71.7 +/- 3.6 years] with no evidence of any neurological or psychiatric diseases, or any medical illness that affects cognition. Laboratory investigations were done for patients. The following plasma parameters were measured: iron, copper, zinc and nitric oxide together with ApoE genotyping by PCR - RFLP. The current study revealed that plasma copper, zinc and nitric oxide levels were higher in AD group than control group. But, no statistically significant difference could be found between the two groups in plasma iron level. The frequency of ApoE 4 allele was higher among AD patients than control subjects. In comparison between ApoE4 +ve and ApoE4 -ve patients, no statistical significant difference in the neuropsychological assessment and biochemical assays was observed. Plasma copper level had statistically significant negative correlation with constructional praxis, ward list recognition, recall of constructional praxis, and stage of AD. While, iron, zinc, and NO plasma levels were not significantly correlated with any of the tested neuropsychological tests. We have demonstrated that, NO level had the highest sensitivity and specificity for predicting AD, followed by copper level. It can be concluded that, the ApoE4 gene is a strong risk factor for the AD but it is neither necessary, nor enough for the disease occurrence. Trace metals and NO abnormalities would influence ApoE, leading to development AD. Also, Copper blood levels are related to the abnormal cognition in AD patients