Determinants of bone health in elderly Japanese men: study design and key findings of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) cohort study

BACKGROUND@#The Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study was launched to investigate risk factors for osteoporotic fractures, interactions of osteoporosis with other non-communicable chronic diseases, and effects of fracture on QOL and mortality.@*METHODS@#FORMEN baseline study participants (in 2007 and 2008) included 2012 community-dwelling men (aged 65-93 years) in Nara prefecture, Japan. Clinical follow-up surveys were conducted 5 and 10 years after the baseline survey, and 1539 and 906 men completed them, respectively. Supplemental mail, telephone, and visit surveys were conducted with non-participants to obtain outcome information. Survival and fracture outcomes were determined for 2006 men, with 566 deaths identified and 1233 men remaining in the cohort at 10-year follow-up.@*COMMENTS@#The baseline survey covered a wide range of bone health-related indices including bone mineral density, trabecular microarchitecture assessment, vertebral imaging for detecting vertebral fractures, and biochemical markers of bone turnover, as well as comprehensive geriatric assessment items. Follow-up surveys were conducted to obtain outcomes including osteoporotic fracture, cardiovascular diseases, initiation of long-term care, and mortality. A complete list of publications relating to the FORMEN study can be found at https://www.med.kindai.ac.jp/pubheal/FORMEN/Publications.html .

Praxiologia do cuidado de saúde homens que convivem com a Diabetes e a Hipertensão Arterial / Health care praxiology men living with diabetes and hypertension / Hombres de praxiología de la salud que viven con diabetes e hipertensión

Objetivo: Aprender as práticas de cuidado de saúde exercitadas por homens em situação de adoecimento crônico. Método: Estudo qualitativo realizado com 38 homens idosos que conviviam com a Diabetes e a Hipertensão Arterial Sistêmica em um município da Bahia, Brasil. Realizamos entrevista individual submetida à análise pelo método do Discurso do Sujeito Coletivo, suportado pela Teoria das Transições. Resultados: A praxiologia do cuidado de saúde dos homens esteve configurada pelo desenvolvimento de aprendizados e aquisições de habilidades específicas sobre a doença crônica; reeducação familiar; adesão às terapêuticas tradicionais face a utilização dos fitoterápicos, de saberes ancestrais e populares; a promoção de atividade física e repouso; o controle de modificações nos órgãos e no corpo e a promoção do bem-estar psicológico e a superação do sofrimento. Conclusão: As práticas de cuidado estão constituídas a partir das vivências masculinas na experiência do adoecimento crônico pela Diabetes Mellitus e a Hipertensão Arterial, que ao seu modo, implicam em mobilizações das masculinidades ao encontro de atos, atitudes, ações direcionadas à convivência com a doença, o seu enfrentamento e a significação a partir das oportunidades e dos acessos que estão disponíveis no território.

Objective: Objective: To learn the health care practices exercised by men in a situation of chronic illness. Method: Qualitative study carried out with 38 elderly men who lived with Diabetes and Systemic Arterial Hypertension in a city in Bahia, Brazil. We conducted an individual interview submitted to analysis using the Collective Subject Discourse method, supported by the Transition Theory. Results: The praxiology of men's health care was shaped by the development of learning and the acquisition of specific skills about chronic disease; family reeducation; adherence to traditional therapies in view of the use of herbal medicines, ancestral and popular knowledge; the promotion of physical activity and rest; the control of changes in organs and body and the promotion of psychological well-being and the overcoming of suffering. Conclusion: Care practices are constituted from male experiences in the experience of chronic illness due to Diabetes Mellitus and Arterial Hypertension, which, in their own way, imply mobilizations of masculinities to meet acts, attitudes, actions directed to living with the disease, its confrontation and the significance from the opportunities and accesses that are available in the territory.

Objetivo: Conocer las prácticas asistenciales que ejercen los hombres en situación de enfermedad crónica. Método: Estudio cualitativo realizado con 38 hombres mayores que vivían con Diabetes e Hipertensión Arterial Sistémica en una ciudad de Bahía, Brasil. Realizamos una entrevista individual sometida a análisis utilizando el método del Discurso Colectivo del Sujeto, apoyado en la Teoría de la Transición. Resultados: La praxiología del cuidado de la salud de los hombres fue moldeada por el desarrollo del aprendizaje y la adquisición de habilidades específicas sobre enfermedades crónicas; reeducación familiar; adherencia a las terapias tradicionales en vista del uso de hierbas medicinales, conocimientos ancestrales y populares; la promoción de la actividad física y el descanso; el control de los cambios en los órganos y el cuerpo y la promoción del bienestar psicológico y la superación del sufrimiento. Conclusión: Las prácticas de cuidado se constituyen a partir de vivencias masculinas en la vivencia de enfermedad crónica por Diabetes Mellitus e Hipertensión Arterial, que, a su manera, implican movilizaciones de masculinidades para enfrentar actos, actitudes, acciones encaminadas a convivir con la enfermedad. , su enfrentamiento y la trascendencia de las oportunidades y accesos que se encuentran disponibles en el territorio.

Prevalence of mental disorders among elderly men: a systematic review and meta-analysis

ABSTRACT BACKGROUND: Elderly men have been characterized as a group vulnerable to suicide, motivated by loneliness, loss of loved ones and feelings of uselessness to family members. OBJECTIVES: To ascertain the prevalence of different mental disorders among elderly men who attempted suicide. DESIGN AND SETTING: Systematic review of observational studies developed as a result of a partnership between two postgraduate schools (Lagarto and Uberlândia). METHODS: An electronic search was performed in eight electronic databases, including "grey literature", in January 2019. Observational studies that assessed mental disorders among men older than 60 years who attempted suicide were eligible for inclusion. RESULTS: Among the disorders evaluated, mood disorders had the highest prevalence (42.0%; 95% confidence interval, CI: 31.0-74.0%; I2: 0.0%; P = 0.763), followed by substance use-related disorders (41.0%; 95% CI: 8.0-74.0%; I2: 96.4; P < 0.001) and, lastly, schizophrenic disorders (5.0%; 95% CI: 0.0%-14.0%; I2: 80.3%; P = 0.024). CONCLUSIONS: It seems that mood disorders and substance use-related disorders are quite prevalent among elderly men with mental disorders who attempted suicide. It is important to consider the role of healthcare services in making early diagnoses of mental disorders among elderly men, in order to diminish the chances of suicide attempts among them. SYSTEMATIC REVIEW REGISTRATION: CRD42018105981.

Clarification of psychosocial factors required for continuance of life of elderly men living alone in heavy snowfall and underpopulated areas / Journal of Rural Medicine

Purpose: The aim of this study was to clarify psychosocial factors supporting elderly men who were living alone in a heavy snowfall area where the population aging rate exceeded 40%.Methods: The authors conducted semi-structured interviews with six elderly men living alone. As the method of analysis, we conducted a hierarchical cluster analysis of the contents of the interviews via text mining.Results: As a result, we found the psychosocial factors supporting the elderly men living alone. We divided the factors into six categories: “well-planned roof snow removal”, “interaction with young people”, “realization of the meaning of life via driving”, “engagement in leisure and recreational activities”, “living a life aligned with personal preference” and “insistence on living alone”.Conclusion: Formal and informal networking that avoids debasing these psychosocial factors required for the continuance of living life alone is necessary.

Hepatocyte growth factor and carotid intima-media thickness in relation to circulating CD34-positive cell levels

BACKGROUND@#Hepatocyte growth factor (HGF) may act as a possible biochemical index for vascular damage, although evidence for the association between HGF and carotid intima-media thickness (CIMT) is limited. Since both HGF and circulating CD34-positive cells play an important role in endothelial repair, circulating CD34-positive cell levels may influence the association between HGF and CIMT.@*METHODS@#We conducted a cross-sectional study of 269 elderly Japanese men aged 60-69 years who had undertaken an annual medical checkup from 2014 to 2015.@*RESULTS@#The median value for circulating CD34-positive cells was 0.93 cells/μL. Among the study population, 135 men showed low circulating CD34-positive cell levels (≤ 0.93 cells/μL). By multivariable linear regression analysis, HGF was found to be significantly positively associated with CIMT only to participants with low circulating CD34-positive cell levels, with a multi-adjusted β of 0.26 (p = 0.005) and 0.002 (0.986) for low and high circulating CD34-positive cell levels, respectively. In addition, a significant interaction was observed between HGF and circulating CD34-positive cell levels (low and high) on CIMT (multivariable p value of 0.049). A positive association exists between HGF and CIMT in elderly Japanese men, limited to participants with low circulating CD34-positive cell levels.@*CONCLUSION@#A positive association exists between HGF and CIMT in community-dwelling elderly Japanese men, which is limited to participants with low numbers of circulating CD34-positive cells. Our findings indicate that circulating CD34-positive cell levels could determine the influence of HGF on CIMT in elderly Japanese men.

Correlation of serum androgen levels with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou / 中华男科学杂志

<p><b>Objective</b>To investigate the relationship of the levels of serum androgens with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou.</p><p><b>METHODS</b>Using the stratified cluster sampling method, we conducted a questionnaire investigation and physical examinations among 437 men in Zunyi City. We divided the subjects into a middle-aged (40－64 ［53.20 ± 7.41］ years, n = 269) and an elderly group (=≥65 ［70.63 ± 4.66］ years, n = 168) and collected fasting elbow venous blood samples from them for measuring the levels of total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), total cholesterol (TCH), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), calculated free testosterone (cFT), free testosterone index (FTI), and testosterone secretion index (TSI).</p><p><b>RESULTS</b>Compared with the elderly group, the middle-aged males showed significantly lower SHBG, LH, HDL and LDL, and higher cFT, FTI, TSI, TG and TCH (all P < 0.05). TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, while cFT was positively correlated with TCH, and so was FTI with TG, TCH with LDL, and TSI with TCH, HDL and LDL (all P < 0.05), but LH was negatively correlated with TG, TCH and LDL (all P < 0.05). Multivariate linear regression analysis showed that TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, and so was LH with TCH, HDL and LDL (all P < 0.05).</p><p><b>CONCLUSIONS</b>In the middle-aged and elderly men in Zunyi, low concentrations of TT, SHBG and LH were associated with the increased risk of high-TCH and -LDL dyslipidemia, low concentrations of TT and SHBG with that of high-TG dyslipidemia, while high concentrations of TT, SHBG and LH with that of low-HDL dyslipidemia.</p>

Effects and safeties of desmopressin on nocturia in medium-elderly men / 中华泌尿外科杂志

Objective To explore the effects and safeties of desmopressin on nocturia in elderly men.Methods We used random number table to divide patients into 2 groups.The patient in treatment group took desmopressin acetate tablets 0.2 mg orally and the patient in control group took tamsulosin hydmchloride sustained release capsule 0.2 mg orally before sleep for 4 weeks.The patient recorded 24 hours voiding diaries for 3 days and worked out mean number of nocturnal voids,hours of undisturbed sleep (HUS) before treatment and before subsequent visit weekly.Before treatment and 1 to 4 weeks after treatment,mean number of nocturnal voids,HUS,night quality of life (NQOL),quality of life (QOL),adverse event were recorded.Before treatment,1 week and 4 weeks after treatment,blood serum sodium was checked in treatment group.Results 42 men had been diagnosed with nocturia in outpatient department of investigator from December 2014 to March 2016,34 of them were recruited in our study and randomly enter the treatment group or control group.Each group consisted of 17 cases.There was no statistical difference in the baseline data between two groups (all P ＞ 0.05).The average ages of treatment group and the control group were (65.1 ± 11.2) and (63.9 ± 9.3) years old,the courses of disease were (3.0 ± 5.0) and (2.3 ± 2.6) years,respectively.Before treatment mean numbers of nocturnal voids were (3.8 ± 1.2) and (3.2 ± 1.4) times,HUS were (1.8 ± 1.7) and (1.8 ± 0.6) h,NQOL were (51.8 ± 13.8) and (41.2 ± 13.6),QOL were (4.0 ± 1.0) and (3.9 ± 0.9),respectively.Four weeks after treatment,mean numbers of nocturnal voids decreased to (1.6 ± 1.0) and (2.0 ± 0.9) times,HUS increased to (4.0 ± 0.7) and (2.6 ± 0.7) h,NQOL decreased to (20.9 ± 12.0) and (30.6 ± 12.4),QOL decreased to (1.4 ± 1.1) and (2.9 ± 1.0) in treatment group and control group,respectively.Every index of the two groups were statistically significant differences compared with that before treatment (P ＜ 0.05).There were statistically significant differences in the degree of improvement between treatment group and control group from 2 weeks to 4 weeks after treatment (P ＜ 0.05).Therefore,the degree of improvement of treatment group was superiored to the control group.Before treatment and both 1 week and 4 weeks after treatment,the blood serum sodium of patients in treatment group were (140.3 ± 3.9),(139.2 ± 4.3) and (140.6 ± 3.1) mmol/ L,respectively.Two patients of treatment group appeared dizzy during the follow-up period.In one of both,the symptom disappeared after the dose decreased from 0.2 mg to 0.1 mg per night.The symptom sustained and the dose was not changed in the other one.In treatment group,two other patients suffered from dyspepsia,one palpitation and one thirst.Those symptoms could be tolerated and the dose was not changed.In control group,2 patients suffered from thirst,one nasal congestion,one dizzy and one short of breath.All of those symptoms could be tolerated and the dose was not changed.There was not statistical differencebetween the occurrence rate of adverse events in the 2 groups (P =0.714).Conclusions Desmopressin can improve the symptoms of nocturia in elderly men,improve the quality of life of patients,and has goodsafety.

Accuracy of 24-hour Diet Recalls for Estimating Energy Intake in Elderly Men using the Doubly Labeled Water Method / 대한지역사회영양학회지

OBJECTIVES: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. METHODS: Seventeen subjects (mean age 72.5 ± 3.9 years), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. RESULTS: The total energy intake from the 24-hour diet recalls method was 2536.7 ± 350.6 kcal/day, and the total energy expenditure from the doubly labeled water method was 2659.8 ± 306.8 kcal/day. The total energy intake was slightly under-reported by −123.2 ± 260.8 kcal/day (−4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p < 0.005). CONCLUSIONS: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.

Accuracy of 24-hour Diet Recalls for Estimating Energy Intake in Elderly Men using the Doubly Labeled Water Method / 대한지역사회영양학회지

OBJECTIVES: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. METHODS: Seventeen subjects (mean age 72.5 ± 3.9 years), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. RESULTS: The total energy intake from the 24-hour diet recalls method was 2536.7 ± 350.6 kcal/day, and the total energy expenditure from the doubly labeled water method was 2659.8 ± 306.8 kcal/day. The total energy intake was slightly under-reported by −123.2 ± 260.8 kcal/day (−4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p < 0.005). CONCLUSIONS: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.

Association of alcohol use and incidence of type 2 diabetes mellitus in the middle-aged and elderly male population: a prospective cohort study / 中华预防医学杂志

Objective@#To investigate the association between alcohol use and incidence of type 2 diabetes mellitus (T2DM) in the middle-aged and elderly male population.@*Methods@#All participants were from Dongfeng-Tongji cohort, 27 009 retired employees from Dongfeng Motor Corporation in Hubei Province were enrolled in the Dongfeng-Tongji cohort baseline survey in 2008. In baseline study, information of alcohol use and other covariates were collected by semi-structured questionnaire and all participants completed physical examination including the test of fasting glucose and blood lipid levels. A total of 6 784 male participants from Dongfeng-Tongji cohort who were without diagnosis of diabetes, coronary heart disease, stroke, or cancer in baseline study were enrolled in this study. We completed the first follow-up in 2013 and the outcome of disease or death was retrieved based on health-care medical records according to the unique medical insurance ID. Cox proportional hazard regression model was used to estimate the association between alcohol use and incidence of type 2 diabetes mellitus (T2DM), by drinking features and patterns.@*Results@#Out of the 6 784 participants, 3 541 participant were defined as non-alcohol drinkers and there were 15 852.2 person-years of follow-up; among which 270 new cases of T2DM were diagnosed withthe crude incidence density of non-alcohol drinkers at 1 703.2/100 000 person-years. The other 3 243 subjects were classified as alcohol drinkers and there were 14 509.8 person-years of follow-up; and among which 258 new cases of T2DM were diagnosed, with the crude incidence density of T2DM at 1 778.1/100 000 person-years. Multivariate COX proportional hazard regression model indicated that there was no significantly increased risk of T2DM incidence between alcohol drinkers and non-alcohol drinkers(HR(95% CI): 1.09 (0.91- 1.30)). However, participants who averagely consumed >20 g/d or>7 times/week had a significantly increased risk of T2DM compared with non-alcohol drinkers, and the value of HR(95%CI) was 1.27 (1.02- 1.58) and 1.35 (1.00- 1.83), respectively. Among men who consumed alcoholic beverages more than 7 times/week, HR (95%CI) for T2DM incidence in the subjects who consumed 0.01 to 40 g and > 40 g once a time were 1.48 (1.05- 2.09) and 1.27 (0.80- 2.10), respectively.@*Conclusion@#Although we found no relationship between alcohol use and T2DM incidence overall, alcohol use more than 20 g/d or more than 7 times/week would increase the risk of T2DM.

A Study on the Body Composition, Physical Activity Level, Basal Metabolic Rate, and Daily Energy Expenditure of Elderly in Busan / 대한지역사회영양학회지

OBJECTIVES: The objectives of the study were to assess body composition, physical activity level (PAL), basal metabolic rate (BMR), and daily energy expenditure (DEE) and to examine associations between PAL and body composition, BMR, and DEE of elderly in Busan. METHODS: A cross-sectional study was conducted among 226 elderly aged 65-93 years. Body composition was measured by Inbody 720. PAL was calculated by daily activity diary. BMR was calculated by Harris-Benedict (H-B) formula, Dietary Reference Intakes (DRI) formula, and Inbody 720 measurement. DEE was calculated by H-B formula, DRI formula, Inbody 720 measurement, and estimated energy requirements (EER) formula. RESULTS: The mean fat free mass (FFM) in elderly men was significantly higher than that in elderly women (p<0.001). The mean percent body fat and fat mass (FM) in elderly women were significantly greater than those in elderly men (p<0.001, p<0.001). The mean PAL in elderly men (1.59) was significantly higher than that in elderly women (1.53) (p<0.001). The mean DEEs calculated by 3 methods except for H-B formula in elderly men were higher than EER for elderly men (2000kcal). The mean DEEs calculated by 4 different methods in elderly women were higher than EER for elderly women (1600kcal). Age showed significantly negative correlations with height (p<0.001, p<0.001), FFM (p<0.001, p<0.001), BMRs calculated by H-B formula (p<0.001, p<0.001), DRI formula (p<0.001, p<0.001) and Inbody 720 measurement (p<0.05 p<0.01) and DEEs calculated by H-B formula (p<0.001, p<0.001), DRI formula (p<0.001, p<0.001), Inbody 720 measurement (p<0.05, p<0.05), and EER formula (p<0.001, p<0.001) in elderly men and elderly women. PAL showed significantly positive correlations with FFM (p<0.05), BMR by Inbody 720 measurement (p<0.05) in elderly men and negative correlations with FM (p<0.05) in elderly women. CONCLUSIONS: Based on the results, PAL was associated with greater FFM in elderly men and lesser FM in elderly women. Therefore, nutritional education to increase physical activity for health promotion in late life is needed in the elderly.

Lazer e participação de homens em grupos de convivência para idosos de Florianópolis (SC): motivações e significados / Leisure and men's participation in elderly groups of Florianópolis (SC): reasons and meanings

Objetivando analisar o lazer e a participação de homens em cinco Grupos de Convivência para Idosos (GCI) de Florianópolis (SC), quanto aos motivos de ingresso e permanência, às relações interpessoais que estabelecem, e aos significados que eles atribuem a sua participação, realizou-se uma pesquisa descritiva exploratória e qualitativa. Participaram 38 homens. Utilizaram-se entrevistas e observações. Os homens buscam os GCI para preencher o tempo com atividades de lazer e relações sociais. Os motivos de permanência centraram-se nas amizades. Múltiplos significados foram atribuídos à participação nos GCI.

This survey was carried out in order to analyze leisure and participation of older men in five Elderly Groups of Florianópolis (SC). Issues of Elderly men entrance, remain, established relationships with other group members, and the meaning they give to their participation were evaluated. Thirty eight men participated in the study. Interviews and remaining were focused on friendships. Multiple meanings were attributed to participation in the groups.

Why Japanese frail elderly men refuse social network? : a qualitative study / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : Japanese elderly men tend to refuse social network even if they need to use them. The objective is to explore Japanese elderly men's perceptions of social network including daycare services.<br><b>Methods</b> : Qualitative studies using focused group and semi-structured interviews for elderly men more than seventy-five years old who live in Nagi-cho, Okayama, Japan were conducted.. All interviews were recorded and transcribed. Data analysis was done with modified grounded theory approach.<br><b>Results</b> : Three categories were made as internal factors (role seeking, adapt aging), relationship factor (female attendance, staff communication), and external factor (transportation, economy).<br><b>Conclusion</b> : By conducting intervention focusing on causes of relationships and external factors inclusive of day care services , it may be possible to improve social involvement of elderly men. 10 proposals were made to government.

Clinic application of serum low-density lipoprotein cholesterol level in predicting expansion hematoma in elderly male patients with acute hypertensive intracerebral hemorrhage / 天津医药

Objective To investigate whether serum level of low-density lipoprotein cholesterol can predict the expan?sion of hemorrhage growth in elderly male patients with acute hypertensive intracerebral hemorrhage. Methods Patients (n=108) who visited our hospital with from June 2012 until May 2014 spontaneous hypertensive intracerebral hemorrhage with?in 6 hours of onset which is confirmed by initial computed tomography (CT) were sent to repeated CT within 24 hours of on?set. All selected patients were divided into the LDL-C≥2.49 mmol/L group and LDL-C<2.49 mmol/L group. Clinical data of these 2 groups were compared and the relationships of hematoma growth and its risk factors were analyzed. Results Baseline blood pressure, the level of blood glucose, PT, APTT, FIB, PLT and hemorrhage volume did not differ significantly between the LDL-C≥2.49 mmol/L group and LDL-C<2.49 mmol/L group. The ratio of hemorrhage growth in LDL-C<2.49 mmol/L group was significantly higher than that in LDL-C≥2.49 mmol/L group (34.21%vs 11.43%). Multiple logistic regres?sion analysis showed that LDL-C<2.49 mmol/L was the only risk factor contribute to hemorrhage growth. Conclusion Pa?tients with LDL-C<2.49 mmol/L in acute intracerebral hemorrhage are of high risk of hemorrhage growth so early attention and appropriate procedure are needed to prevent or slow its growth.

COPD in non-smoking elderly men at sea level and high altitude: comparing anthropometric characteristics and physiological responses / EPOC en hombres de edad avanzada no fumadores a nivel del mar y en altura: comparación de las características antropométricas y respuestas fisiológicas

The World Health Organization considers cigarette smoke as a major risk factor and causal agent of chronic obstructive pulmonary disease (COPD); however, smoke from biomass in poorly ventilated environments may be the major causative agent in developing countries. There is little epidemiological evidence of COPD in relation to the use of biomass fuels and altitude of the place of residence, and there is no record of the morphological and physiological characteristics of patients with COPD living at different altitudes. The objective of this research was to compare a) morphological characteristics: weight, height and body mass index (BMI) and b) physiological responses: spirometric record, heart rate, oxygen saturation and hemoglobin concentration in a sample (n=30) of adults aged between 60-75 years, non smokers, exposed to smoke from biomass fuels, diagnosed with COPD, living at sea level (San Miguel de Azapa, 580 m.a.s.l, n = 10) and high altitude (Putre, 3500 meters, n = 20). The results among residents from sea level versus high altitude showed no significant differences in morpho-anthropometric variables such as weight (70.5 +/- 6.8/69.7 +/- 6.1), height (1.58 +/- 0.08/1.56 +/- 0.05) and BMI (29.1 +/- 2.5 / 28.5 +/- 1.9). Similar behavior was observed in the spirometric records of FVC (2.66 +/- 0.54 / 2.48 +/- 0.40) and FEV1 (1.86 +/- 0.72 / 1.84 +/- 0.55). Significant differences were observed for physiological variables such as heart rate (65 +/- 5/90 +/- 3), oxygen saturation (93 +/- 2.7 / 79 +/- 4) and hemoglobin concentration (14 +/- 2/19 +/- 2), respectively. These results manifest the greater physiological effort made by individuals from high altitude to cope both environmental and related from COPD hypoxia. We conclude that there are distinct physiological responses among patients with COPD living at high altitude and sea level.

La Organización Mundial de la Salud señala al humo del cigarrillo como principal factor de riesgo y agente causal de la enfermedad pulmonar obstructiva crónica (EPOC), sin embargo, el humo de biomasas en ambientes mal ventilados sería el mayor agente causal en regiones en vías de desarrollo. Existe escasa evidencia epidemiológica de la EPOC en relación al uso de combustibles de biomasas y la altitud del lugar de residencia y no se dispone de antecedentes de las características morfológicas y fisiológicas de pacientes con EPOC viviendo en diferentes altitudes. El objetivo de esta investigación fue comparar a) características morfológicas: peso, talla e índice de masa corporal (IMC) y b) respuestas fisiológicas: registro espirométrico, frecuencia cardiaca, saturación parcial de oxígeno y concentración de hemoglobina, en una muestra (n=30) de adultos mayores de entre 60 - 75 años, no fumadores, expuestos al humo de biomasas, diagnosticados con EPOC, residentes a nivel del mar (San Miguel de Azapa, 580 msnm, n=10) y en altura (Putre, 3.500 msnm, n=20). Los resultados entre residentes de nivel del mar versus altura, no muestran diferencias significativas en las variables morfo-antropométricas de peso (70.5 +/- 6.8/69.7 +/- 6.1), talla (1.58 +/- 0.08/1.56 +/- 0.05) e IMC (29,1 +/- 2,5/28,5 +/- 1,9). Igual comportamiento se observa en los registros espirométricos de CVF (2.66 +/- 0.54 / 2.48 +/- 0.40), VEF1 (1.86 +/- 0.72 / 1.84 +/- 0.55). Si se observan diferencias significativas en las variables fisiológicas de frecuencia cardiaca (65 +/- 5/90 +/- 3); saturación parcial del oxígeno (93 +/- 2,7/79 +/- 4) y de concentración de la hemoglobina (14 +/- 2/19 +/- 2) respectivamente. Estos resultados, expresan el mayor esfuerzo fisiológico realizan los individuos de altura para enfrentar la hipoxia ambiental y aquella derivada de la EPOC. Se concluye que existen respuestas fisiológicas diferenciadas entre pacientes con EPOC viviendo en altura y a nivel del mar.

The Relationship between Smoking, Socioeconomic Status and Grip Strength among Community-dwelling Elderly Men in Korea: Hallym Aging Study / 한국역학회지

OBJECTIVES: Low grip strength is associated with decline in bone mineral density (BMD) and increased risk of spine fracture among the elderly. Smoking, a major factor determining BMD, is also known to have an indirect effect on bone loss. This study investigated whether smoking is associated with grip strength in the community-dwelling elderly in Korea. METHODS: This study was an outcome of the second of three waves of the Hallym Aging Study from January to May 2007, a population-based study of Koreans aged 45 years and upwards dwelling in Chuncheon. Its 218 subjects comprised men aged 65 years or over. They were evaluated at a general hospital for socioeconomic status, smoking history, and various clinical measures including grip strength. RESULTS: Grip strength was higher in non-, ex-, and current smokers (33.7 kg, 30.6 kg, and 29.3 kg, respectively). Current smoking was found to increase the risk of decreased grip strength (adjusted odds ratio [aOR], 4.58; 95% confidence interval [CI],1.31 to 16.04) compared with non-smoking, after adjustment for potential covariates including socioeconomic status. After adjustment for smoking effect, education of fewer than six years and monthly income of fewer than 500,000 Korean won increased the risk of decreased grip strength compared with education of more than six years (aOR, 2.88; 95% CI, 1.08 to 7.66) and monthly income of more than 1,500,000 Korean won (aOR, 2.86; 95% CI, 1.08 to 7.54). CONCLUSIONS: These results showed that current smoking, low education and low income were independent risk factors for decreased grip strength among elderly men in Korea.

Suicídio de homens idosos no Brasil / Suicide of elderly men in Brazil

Discute-se o suicídio de homens idosos no Brasil. O texto se fundamenta em estudos de gênero e masculinidades e dá ênfase ao sentido de "masculinidade hegemônica" dentro da lógica do patriarcalismo que, no caso dos suicídios, se expressa na perda do trabalho como referência existencial e no sentido de honra como escudo. O estudo contempla casos de 40 homens que faleceram por suicídio no período entre 2006 a 2009 em dez municípios do país e tinham idade acima de 60 anos. Pela técnica de autópsia psicossocial foram coletados e analisados dados da história e modo de vida; avaliação dos antecedentes; impacto na família; letalidade do método; proximidade de fontes de apoio; tentativas anteriores; estado mental que antecedeu o ato; reações da família e da comunidade. Embora sejam vários os fatores que se associam à morte autoinfligida nesse grupo social, é inegável a importância da cultura masculina hegemônica na preeminência do número de suicídios de homens idosos em relação com as mulheres idosas. É fundamental dar atenção especial aos homens nos momentos de passagem da vida laboral para a aposentadoria, nas situações de perdas de familiares referenciais e quando são diagnosticados com enfermidades crônicas degenerativas que provoquem deficiências, perda de autonomia ou impotência sexual.

This paper assesses the suicide of elderly men in Brazil. The text is based on studies of gender and masculinity and emphasizes the sense of "hegemonic masculinity" within the logic of patriarchalism that, in the case of suicide, is expressed in the loss of employment as an existential reference and as a loss of honor. The study includes 40 cases of men over 60 who committed suicide between 2007 and 2010 in ten districts of the country. Using the psychosocial autopsy technique, data were collected and analyzed from their history and lifestyle; evaluation of the background to the act; the impact on their families; lethality of the method; proximity to sources of support; previous attempts; mental status which preceded the act; reaction of families and communities. Although many factors are associated with self-inflicted death in this social group, the influence of a hegemonic masculinity culture in the predominance of suicides among elderly men compared with elderly women is undeniable. It is essential to give special attention to men at the moment of transition from working life to retirement, loss or important family members, and when they are diagnosed with chronic and degenerative diseases that cause disabilities, loss of autonomy or sexual impotence.

The relationship between serum testosterone and metabolic syndrome in middle-aged and elderly men / 中国综合临床

ObjectiveTo explore the causes for descending of the serum testosterone (T) in middle-aged and elderly men with metabolic syndrome (MS).MethodsFifty-six male patients aged between 45 and 83 years old were investigated.Blood pressure,height and weight were measured,and body mass index (BMI) was calculated.Biochemical indice in fasting state [ fasting blood sugar (FBG),total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol (HDL-C) ],fasting insulin (FIN),and the level of serum testosterone) were detected.An insulin resistance index (IR) was calculated using homeostasis model assessment (HOMA).Participants were divided into the MS group and the non-MS group according to CDS diagnostic standard.The relationships between the level of serum Testosterone and each index were analyzed.ResultsThe level of serum Testosterone was significantly lower in the MS group than that in the non-MS group [ (9.97 ± 3.87 ) nmol/L vs.( 13.73 ± 3.93 ) nmol/L,t =3.337,P ＜ 0.01 ].Multiple regression analysis showed that the level of serum testooterone was negatively correlated with age,waist circumference and HOMA-IR ( regression coefficients:- 0.214,- 0.329,- 0.317; standardized regression coefficients:- 0.730,- 0.597,- 0.313 ; t =- 5.833,- 4.681,- 2.686 respctively; P ＜ 0.01 ).ConclusionThe level of serum testosterone descends in middle-aged and elderly men with MS.The level of serum testosterone is closely related to age,waist circumference and insulin resistance

Association of blood pressure variability and cerebral infarction in elderly men with atherosclerosis / 中国综合临床

Objective , To investigate the influence of blood pressure variability on cerebral infarction in older men. Methods Ambulatory blood pressure was measured in 1527 elderly men ( older than 65 yrs) with atherosclerosis. All cases were divided into 2 groups: Six hundred and seven patients with cerebral infarction ( group A)and 920 patients without cerebral infarction ( group B). Smooth curve method was used to analyze each patient's ambulatory blood pressure data and the trend of each patient's blood pressure curve was portrayed. The differences between the actual blood pressure and the blood pressure on the curve was defined as blood pressure variability,and the blood pressure variability between the 2 groups was compared. Results The systolic blood pressure variability in 24 hours in group A was significantly higher than that in group B( [8.4'±2. 2]mm Hg vs [ 8.0 ± 2. 0 ] mm Hg, P ＜ 0. 01 ), especially for the systolic blood pressure variability in daytime( [ 8. 2 ± 2. 2 ] mm Hg vs [ 7. 8 ± 2. 1 ] mm Hg, P ＜ 0. 01 ). However, the systolic blood pressure variability at night was not significantly different between the 2 groups( [ 8.9 ± 3. 9 ] mm Hg vs [ 8. 7 ± 3.7 ] mm Hg,P ＞ 0. 05 ). There were no significant difference between the diastolic blood pressure of 24 hours( [5. 5 ± 3.8 ] mm Hg vs [5.5 ± 1.5 ]mm Hg,P ＞0. 05),during daytime([5.4 ± 1.5]mm Hg vs [5.3 ± 1.4] mm Hg,P ＞0.05)and nighttime ( [ 6. 1 ± 2.7 ] mm Hg vs [ 6. 1 ± 2. 6 ] mm Hg, P ＞ 0. 05 ). Conclusion In elderly men with atherosclerosis,cerebral infarction was closely related to systolic blood pressure variability,but independent of nighttime systolic blood pressure and diastolic blood pressure variability.

AMOUNT AND INTENSITY OF PHYSICAL ACTIVITY IN RELATION TO CARDIORESPIRATORY FITNESS IN JAPANESE MIDDLE-AGED AND ELDERLY MEN / 体力科学

PORPOSE: This study aimed to investigate the relation between cardiorespiratory fitness(CRF) and physical activity, especially vigorous physical activity, in Japanese middle-aged and elderly men.METHODS: Eighty-five men aged 30-69 years participated in this study. CRF was assessed by measuring the maximal oxygen uptake based on weight (VO₂max/wt) in an incremental test on a bicycle ergometer. METs·h/week was measured as the parameter of physical activity by using accelerometers. We defined the amount of physical activity higher than 3 METs as “Physical activity ; PA”in this study. Then, PA was divided into “Moderate physical activity ; MPA”(higher than 3 METs and below 6 METs)and “Vigorous physical activity ; VPA”(higher than 6 METs).RESULTS : CRF was positively correlated with PA(r=0.318, P<0.01), MPA(r=0.230, P<0.05), and VPA(r=0.301, P<0.01) and negatively correlated with age(r=-0.607, P<0.001), BMI(r=-0.369, P<0.01), and waist circumference(WC)(r=-0.486, P<0.001). After adjusting for age and WC, the multiple regression analysis revealed that PA was positively correlated with CRF(P<0.01). VPA was positively correlated with CRF(P<0.05) after adjusting for age, WC, and MPA. MPA was not correlated with CRF in the case of adjusting for age and WC.CONCLUSION : This study suggested that physical activity higher than 3 METs was positively associated with cardiorespiratory fitness independently of age and waist circumference, and particularly vigorous physical activity may contribute to increased cardiorespiratory fitness in middle-aged and elderly men. Thus physically active life with maintenance of adequate waist circumference may help to prevent age-related decline in cardiorespiratory fitness.