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1.
Z Gerontol Geriatr ; 55(1): 38-43, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34617144

ABSTRACT

BACKGROUND: The Comprehensive Geriatric Assessment (CGA) provides essential information about older hospitalized patients but is either not systematically adopted or not adopted at all in clinical routine. As a consequence, critical factors influencing patients' trajectories, like personal resources (geriatric resources, GR), geriatric syndromes (GS), health-related quality of life (HRQoL) and multidimensional prognosis often escape routine diagnostics. OBJECTIVE: To investigate the association between HRQoL and GR/GS as well as its prognostic signature. MATERIAL AND METHODS: In this study 165 inpatients older than 65 years admitted to an internal medicine department of a German large metropolitan hospital were assessed by a CGA-based calculation of the multidimensional prognostic index (MPI). Ten different GR and 17 GS, as well as HRQoL were collected. After 3, 6 and 12 months the patients were followed-up by telephone. RESULTS: The HRQoL was associated with MPI (p < 0.001), number of GS (p < 0.001) and survival days after discharge (p = 0.008). Additionally, significant associations were found between HRQoL and number of GR (p < 0.001). GS displaying risk for physical dependence like instability (p < 0.001) and chronic pain (p = 0.007) and single GR/GS that influence patient's confidence like isolation (p < 0.001), depression (p < 0.001) and emotional resources (p = 0.002) were also associated with HRQoL. CONCLUSION: The HRQoL is significantly associated to specific risk and protective factor profiles of GR and GS. To improve quality of life, targeted, patient-centered diagnostics and treatment of GS as well as stabilization of GR should be encouraged in the management of older, multimorbid patients outside geriatric settings.


Subject(s)
Inpatients , Quality of Life , Aged , Geriatric Assessment , Humans , Prognosis , Syndrome
4.
Aging Clin Exp Res ; 31(12): 1839-1842, 2019 Dec.
Article in English | MEDLINE | ID: mdl-30623316

ABSTRACT

The number of older patients admitted to emergency departments (ED) increases continuously. The Identification of Seniors at Risk (ISAR) score is currently recommended to screen patients in German ED, but its appropriateness is being criticized. ISAR scores and clinical characteristics from 98 emergency admissions (EA), 80 from acute geriatrics (AG) and 89 from a geriatric rehabilitation (GR) unit were compared retrospectively. No significant differences were found between groups, being the ISAR score positive in 87.7% of EA, 94.9% of AG and 94.4% of GR cases. None of positively identified geriatric patients in the EA was transferred to the geriatric ward of competence. EA patients showed significantly higher number of functional impairments (p = 0.001) and higher BI score (p < 0.0001) compared to AG and GR groups. A higher ISAR score threshold and additional functional information might be needed to better select patients in need of prompt treatment by a geriatric team.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Geriatric Assessment/methods , Aged , Aged, 80 and over , Female , Geriatric Assessment/statistics & numerical data , Humans , Male , Retrospective Studies , Risk Assessment/methods
5.
Z Gerontol Geriatr ; 51(2): 231-236, 2018 Feb.
Article in English | MEDLINE | ID: mdl-28660533

ABSTRACT

BACKGROUND: Peripheral blood dyscrasias in older patients are repeatedly seen in geriatric clinical practice; however, there is substantial lack of data about the epidemiology, possible causes and treatment options in this patient group. Proton pump inhibitors (PPI) are extensively used in older patients and associated with leukopenia. The primary objective of this study was the assessment of encoded cytopenia prevalence in a geriatric patient cohort and the secondary objective was the assessment of putative causes and the analysis of PPI administration in patients with cytopenia. METHODS: Retrospective evaluation of patients admitted to the geriatric department of a German urban hospital between 2010 and 2012. Electronic patient data were screened for encoded diagnosis of cytopenia according to the International Classification of Diseases (ICD) 10. Inclusion criteria were ICD code D69.0-9 and/or D70.0-7, age ≥60 years and exclusion criteria were no ICD code D69.0-9 and/or D70.0-7 and age <60 years. Out of 9328 screened inpatients 54 patients remained for analysis. Study parameters included hemoglobin (Hb), red blood cell count (RBC), leucocytes, platelets, mean cell volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), presence of leukopenia (<4000/µl), presence of thrombocytopenia (<140,000/µl) and presence of anemia according to the World Health Organization (WHO). Substitution of blood products, medication with PPI and potential causes for dyscrasias were evaluated based on electronic patient records. RESULTS: The mean age was 78.3 ± 6.5 years (27 females, 27 males), anemia was seen in 78%, leukopenia was encoded in13% and thrombocytopenia in 44.4%. In most of the patients no substitution of blood products was documented. In most of the patients (20.4%) cytopenia was attributed to either heparin-induced thrombocytopenia (HIT) or hemato-oncologic (20.4%) diseases, followed by drug association in 18.5%. In 70.8% of the study patients PPIs were administered but the indication for PPI administration remained unclear in 20.4%. CONCLUSION: The results encourage accurate assessment of blood dyscrasias and appropriate documentation as well as indication check for PPI treatment in geriatric inpatients.


Subject(s)
Anemia/epidemiology , Leukopenia/epidemiology , Proton Pump Inhibitors/adverse effects , Thrombocytopenia/epidemiology , Aged , Aged, 80 and over , Anemia/chemically induced , Cohort Studies , Cross-Sectional Studies , Erythrocyte Count , Erythrocyte Indices/drug effects , Female , Hemoglobinometry , Hospitals, Urban , Humans , Leukocyte Count , Leukopenia/chemically induced , Male , Middle Aged , Platelet Count , Proton Pump Inhibitors/therapeutic use , Retrospective Studies , Risk Factors , Thrombocytopenia/chemically induced
6.
Z Gerontol Geriatr ; 49(3): 227-31, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26062963

ABSTRACT

BACKGROUND: The implementation of a computerized physician order entry (CPOE) can help reduce prescription errors in clinical practice. OBJECTIVE: The aim of this study was to evaluate the effects of a CPOE for geriatric patients with the two most common conditions for drug-induced iatrogenic diseases, dysphagia and renal failure. SUBJECTS AND METHODS: A retrospective analysis of actual drug prescriptions versus CPOE recommendations in the geriatric department of the St. Marien Hospital in Cologne, Germany was carried out. Actual drug prescriptions were collected for 26 patients with dysphagia (15 female, 11 male, average age 82.3 ± 8.0 years) and 35 patients with renal failure (23 female, 12 male, average age 80.5 ± 6.7 years) which were compared with recommended prescriptions by means of a CPOE and discrepancies were statistically analyzed. RESULTS: Prescription errors for at least 1 drug were detected in 46 % of patients with renal failure and the administration of at least 1 drug with inadequate crushing was observed in 77 % of dysphagia patients. CONCLUSION: Prescription errors appear to be frequent to highly frequent in the medical routine even in a highly specialized geriatric setting. Inaccuracies might be reduced by the implementation of a CPOE and even more if coupled to a decision support system. Drug-drug or drug-disease interactions, which are particularly high risks in patients with multimorbidities, multidrug therapy, renal failure or malnutrition, might be kept under control through careful verification of medication indications, organ function status as well as drug administration and preparation in cases of tube feeding.


Subject(s)
Deglutition Disorders/drug therapy , Drug Prescriptions/statistics & numerical data , Medical Order Entry Systems/statistics & numerical data , Medication Errors/prevention & control , Medication Errors/statistics & numerical data , Renal Insufficiency/drug therapy , Aged , Aged, 80 and over , Deglutition Disorders/epidemiology , Germany/epidemiology , Humans , Male , Renal Insufficiency/epidemiology , Retrospective Studies
7.
Curr Alzheimer Res ; 12(6): 585-91, 2015.
Article in English | MEDLINE | ID: mdl-26238813

ABSTRACT

BACKGROUND: Cognitive and motor performance can be supported, especially in older subjects, by different types of brain activations, which can be accurately studied by functional magnetic resonance imaging (fMRI). Vascular risk factors (VRFs) are extremely important in the development of cognitive impairment, but few studies have focused on the fMRI cortical activation characteristics of healthy subjects with and without silent cerebrovascular disease including white matter hyperintensities (WMH) and carotid stenosis (CS) performing cognitive tasks. METHODS: Thirty-five volunteers with and without asymptomatic unilateral carotid stenosis above 70% and variable degrees of WMH underwent performance of a simple motor and cognitive task during an fMRI session. RESULTS: While the performance of the motor task resulted in a cortical activation dependent of age but not of WMH and carotid stenosis, performance of the cognitive task was accompanied by a significantly increased activation independently correlated with age, presence of WMH as well as of carotid stenosis. CONCLUSIONS: in this study, cognitive domains regulating attention and working memory appear to be activated with a pattern influenced by the presence of carotid stenosis as well as by white matter hyperintensities. The impairment of these cognitive abilities is of high relevance in Alzheimer's disease pathology. The fMRI pattern shown in patients with asymptomatic but significant carotid stenosis might be related to chronic cerebrovascular hypoperfusion, a critical pathophysiological mechanisms in AD. In these patients, carotid endoarterectomy should be considered also for AD prevention and might be recommended.


Subject(s)
Brain/pathology , Carotid Stenosis/complications , Cognition Disorders/etiology , Leukoencephalopathies/complications , Movement Disorders/etiology , Adult , Aged , Aged, 80 and over , Brain/blood supply , Brain Mapping , Carotid Intima-Media Thickness , Cognition Disorders/diagnosis , Female , Functional Laterality , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Middle Aged , Movement Disorders/diagnosis , Neuropsychological Tests , Oxygen/blood
8.
Z Gerontol Geriatr ; 48(7): 619-24, 2015 Oct.
Article in English | MEDLINE | ID: mdl-25877770

ABSTRACT

BACKGROUND: Anemia and hypoalbuminemia (HA) are acknowledged independent risk factors for morbidity and mortality in geriatric patients and are associated with nutritional status and frailty. Data exist regarding the association between albumin and frailty, anemia and frailty as well as frailty and nutritional status; however, there is a lack of information on the association between HA, anemia and nutritional status in older people. PATIENTS AND METHODS: This study retrospectively analyzed 626 patients admitted to a German geriatrics department (average age 81.1 years, 68.2% female and 31.8% male) for anemia and HA. Data from the comprehensive geriatric assessment (CGA) and from the mini-nutritional assessment (MNA) were available in all patients. RESULTS: Patients with anemia suffered significantly more often from HA (p<0.001) than patients without anemia, with an odds ratio (OR) of 1.99 (95% confidence interval CI: 1.2-3.2) and of 5.41 (CI 95%: 2.3-12.6) in patients at risk for malnutrition and in malnourished patients, respectively. A moderately significant association was seen between hemoglobin (Hb) and albumin values (Pearson's correlation r=0.330; p<0.001) as well as between albumin values and the Barthel index (Spearman's correlation r=0.210; p<0.001). CONCLUSION: Anemia appears to be a risk factor for HA in inpatients with malnutrition and the observed association between albumin and Hb warrants further research. Geriatric inpatients with anemia should be evaluated in terms of the presence of malnutrition risk and HA.


Subject(s)
Anemia/diagnosis , Anemia/epidemiology , Geriatric Assessment/statistics & numerical data , Hypoalbuminemia/diagnosis , Hypoalbuminemia/epidemiology , Nutritional Status , Aged, 80 and over , Anemia/blood , Comorbidity , Female , Frail Elderly/statistics & numerical data , Geriatric Assessment/methods , Germany/epidemiology , Hemoglobins/analysis , Hospitalization/statistics & numerical data , Humans , Hypoalbuminemia/blood , Male , Prevalence , Risk Factors , Serum Albumin/analysis
9.
J Neural Transm (Vienna) ; 122(4): 523-30, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25585970

ABSTRACT

In light of the recent advances regarding the role of vascularity in Alzheimer's disease (AD) pathophysiology, the relationship between plasma levels and activities of the major antioxidant molecules and the carotid intima-media thickness (C-IMT) of older persons with no or very mild cognitive impairment was evaluated. The underlying hypothesis is that the IMT may be an indirect index of vascular damage in persons with low levels of plasma antioxidants. Plasma levels of vitamins A, C, E, of uric acid as well as activities of the plasma antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) were measured. Plasma levels of vitamins C and E significantly decreased among participants from the first to the fourth IMT quartile, with a linear slope only for vitamin C. Compared to participants in the lowest vitamin C quartile, the probability to have IMT >1.2 mm significantly decreased among persons from the second to the fourth quartile independent of confounders. In conclusion, only vitamin C plasma levels appear to be selectively associated with the risk of increasing C-IMT. An adequate vitamin C status might be particularly important for protection against AD and other clinical manifestations of vascular and cognitive ageing.


Subject(s)
Aging/blood , Aging/pathology , Ascorbic Acid/blood , Carotid Intima-Media Thickness , Vitamin E/blood , Aged , Aged, 80 and over , Alzheimer Disease , Female , Glutathione Peroxidase/blood , Humans , Linear Models , Male , Superoxide Dismutase/blood , Uric Acid/blood , Vitamin A/blood
10.
Front Pharmacol ; 5: 147, 2014.
Article in English | MEDLINE | ID: mdl-25002849

ABSTRACT

Several chemical substances belonging to classes of natural dietary origin display protective properties against some age-related diseases including neurodegenerative ones, particularly Alzheimer's disease (AD). These compounds, known as nutraceuticals, differ structurally, act therefore at different biochemical and metabolic levels and have shown different types of neuroprotective properties. The aim of this review is to summarize data from observational studies, clinical trials, and randomized clinical trials (RCTs) in humans on the effects of selected nutraceuticals against age-related cognitive impairment and dementia. We report results from studies on flavonoids, some vitamins and other natural substances that have been studied in AD and that might be beneficial for the maintenance of a good cognitive performance. Due to the substantial lack of high-level evidence studies there is no possibility for recommendation of nutraceuticals in dementia-related therapeutic guidelines. Nevertheless, the strong potential for their neuroprotective action warrants further studies in the field.

11.
Dtsch Med Wochenschr ; 137(7): 305-8, 2012 Feb.
Article in German | MEDLINE | ID: mdl-22318842

ABSTRACT

BACKGROUND AND AIM: Oxidative stress is a critical factor in the pathophysiology of dementia, but the role of oxidant/antioxidant imbalance in relation to vascular pathology in the onset and progression of Alzheimer's disease (AD) is poorly understood. The aim of this study was the identification of an association between vascular comorbidities/vascular risk factors and plasma levels of antioxidant micronutrients in patients with AD. PATIENTS AND METHODS: 41 patients with AD  and 34 controls were included in the study. Atherosclerosis (increased intima-media thickness of the common carotid artery) and/or type 2 diabetes mellitus were diagnosed in 21 AD  patients (AD  Plus group). 20 patients with AD were free of vascular comorbidities and risk factors (AD group). A neuropsychological assessment (Mini-Mental State Examination, MMSE; Clock drawing test; DemTect) and the measurement of plasma levels of lipophilic micronutrients including retinol (vitamin A), α-tocopherol (vitamin E), lutein, zeaxanthin, ß-cryptoxanthin, lycopene, α-carotene and ß-carotene by HPLC were performed in all study subjects. RESULTS: Plasma levels of retinol, vitamin E, lutein, zeaxanthin, lycopene and ß-carotene were significantly lower in the AD  Plus group than in controls. Furthermore, vitamin A levels were correlated with MMSE scores and the levels of vitamin E, lutein, zeaxanthin and lycopene were correlated with all neuropsychological tests. CONCLUSION: The depletion of circulating antioxidant micronutrients observed in AD  patients is associated with vascular comorbidities and risk factors. The vascular comorbidities of patients with AD should also be identified in light of the presence and degree of depletion of the antioxidant defense system of the organism. This might lead to a better lifestyle-related counselling of patients with AD  and their caregivers, with possible positive preventive effects on worsening in the long run. Further studies with a larger patient sample are needed to verify the negative effect of vascular pathology in AD-related oxidative stress.


Subject(s)
Alzheimer Disease/blood , Alzheimer Disease/complications , Antioxidants/analysis , Micronutrients/blood , Vascular Diseases/blood , Vascular Diseases/complications , Aged , Aged, 80 and over , Alzheimer Disease/physiopathology , Diabetes Mellitus, Type 2/complications , Female , Humans , Male , Neuropsychological Tests , Oxidative Stress/physiology , Risk Factors , Vitamin A/blood
13.
Z Gerontol Geriatr ; 45(1): 7-10, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22278000

ABSTRACT

A large number of published overview and original articles provide evidence and declare the need for immediate, appropriate preventive lifestyle measures to prevent the development of dementia and Alzheimer's disease (AD). However, despite this, there are great difficulties in drafting effective guidelines in this field. This is mainly due to a lack of not only (comparable) randomized controlled trials but also a lack of homogeneous measures of type and degree of managed risk. Several risk factors for dementia are non-modifiable, such as genes and age. Factors related to lifestyle habits and vascular risk factors are classified as modifiable risk factors. While waiting for effective drug therapies and first-level evidence data, geriatricians, general practitioners, neurologists, and health professionals should be encouraged to improve early diagnosis of cognitive impairment and activate control strategies against vascular disease and unhealthy lifestyle habits.


Subject(s)
Cognition Disorders/prevention & control , Cognition Disorders/therapy , Dementia/prevention & control , Dementia/therapy , Evidence-Based Medicine , Geriatric Assessment , Aged , Aged, 80 and over , Cognition Disorders/complications , Dementia/complications , Germany , Humans
14.
Cerebrovasc Dis ; 30(3): 244-51, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20664257

ABSTRACT

BACKGROUND: It is still a matter of debate if and to what extent carotid endarterectomy (CEA) and carotid artery stenting (CAS) impair cognitive functioning in the elderly. METHODS: We conducted a nonrandomized clinical trial on subjects with asymptomatic carotid artery stenosis comparing CEA (n = 28; 24 males and 4 females; 72.6 +/- 5.8 years old) with CAS (n = 29; 17 males and 12 females; 75.1 +/- 5.7 years old). Cognition, mood and functional status were evaluated by a broad spectrum of tests performed on the day prior to carotid reopening as well as 3 and 12 months after. RESULTS: No significant differences in scores on cognitive tests including the Babcock story recall test and Rey's auditory verbal learning test (memory), category naming test (verbal fluency), trail-making test parts A and B (attention and executive function) and controlled oral word association test (executive functioning) were observed 3 and 12 months after carotid reopening independent of the technique used. Only scores on the copy drawing test (visuospatial and constructional abilities) slightly but significantly (p < 0.05) worsened in the CAS group 12 months after the intervention. No significant differences between the CEA and CAS groups were detected regarding mood and functional status after 3 and 12 months. CONCLUSIONS: CEA and CAS seem to be safe procedures in elderly patients in terms of cognitive, mood and functional status in the short and long term. CAS might be preferred for the shorter hospital stay, but further studies with a larger number of old and oldest old subjects with a longer follow-up are needed to better understand the cost-effectiveness of both treatments.


Subject(s)
Carotid Stenosis/surgery , Cognition/physiology , Endarterectomy, Carotid , Stents , Affect/physiology , Aged , Attention/physiology , Carotid Stenosis/physiopathology , Carotid Stenosis/psychology , Female , Follow-Up Studies , Humans , Male , Memory/physiology , Neuropsychological Tests
15.
Free Radic Res ; 44(3): 241-8, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20166891

ABSTRACT

It is not known whether the association between increased plasma homocysteine (Hcy) associated with LDL modification and propensity for LDL uptake by macrophages in cardiovascular disease patients holds true in vascular dementia (VaD). Plasma from 83 subjects diagnosed with Alzheimer's disease (AD), VaD, mild cognitive impairment (MCI) and from controls was analysed to examine (1) whether LDL isolated from the plasma of VaD is biochemically and functionally distinct from that isolated from AD, MCI or controls; and (2) whether such biomarkers of LDL phenotype are related to plasma folate levels, Hcy levels and/or to disease severity. Folate and vitamin B6 levels were significantly lower in VaD subjects than in controls. VaD-LDL showed increased protein carbonyl content (p < 0.05) and was more susceptible to scavenging by macrophages (p < 0.05) than AD- or control-LDL. Patients from the VaD cohort were more prevalent in the lowest tertile for HDL:LDL and the upper tertile for LDL oxidation; the combined parameters of HDL cholesterol, LDL oxidation and scavenging by macrophages show 87% sensitivity towards VaD detection. The association between folate deficiency, LDL modification and dysfunction in VaD but not in AD may provide a novel biomarker assessment to discriminate between the diseases.


Subject(s)
Biomarkers/blood , Cholesterol, LDL/metabolism , Cognition Disorders/metabolism , Dementia, Vascular/metabolism , Aged , Aged, 80 and over , Alzheimer Disease/metabolism , Cholesterol, HDL/metabolism , Cognition Disorders/etiology , Dementia, Vascular/complications , Female , Folic Acid/blood , Homocysteine/blood , Humans , Male , Oxidation-Reduction
16.
Amino Acids ; 32(4): 553-9, 2007.
Article in English | MEDLINE | ID: mdl-17273806

ABSTRACT

The pathogenesis of several neurodegenerative diseases, including Alzheimer's disease, has been linked to a condition of oxidative and nitrosative stress, arising from the imbalance between increased reactive oxygen species (ROS) and reactive nitrogen species (RNS) production and antioxidant defences or efficiency of repair or removal systems. The effects of free radicals are expressed by the accumulation of oxidative damage to biomolecules: nucleic acids, lipids and proteins. In this review we focused our attention on the large body of evidence of oxidative damage to protein in Alzheimer's disease brain and peripheral cells as well as in their role in signalling pathways. The progress in the understanding of the molecular alterations underlying Alzheimer's disease will be useful in developing successful preventive and therapeutic strategies, since available drugs can only temporarily stabilize the disease, but are not able to block the neurodegenerative process.


Subject(s)
Alzheimer Disease/metabolism , Antioxidants/metabolism , Free Radicals/metabolism , Proteins/metabolism , Reactive Nitrogen Species/metabolism , Reactive Oxygen Species/metabolism , Aging , Alzheimer Disease/physiopathology , Animals , Brain , Humans , Neurodegenerative Diseases/metabolism , Oxidative Stress/physiology , Proteomics/methods , Signal Transduction
17.
Eur J Clin Nutr ; 61(7): 922-4, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17228351

ABSTRACT

In this study, 153 Italian centenarians from four different geographical areas, including Modena (northern Italy), Ancona (central Italy), Perugia (central Italy) and Sardinia island (AKEA Project) were enrolled. Plasma levels of vitamin C, uric acid, vitamin A and vitamin E as well as the activities of superoxide dismutase and glutathione peroxidase were measured. Subjects were compared to a younger control population of the same areas, divided into three age groups:

Subject(s)
Aging/blood , Antioxidants/metabolism , Longevity , Vitamins/blood , Aged , Aged, 80 and over , Aging/metabolism , Antioxidants/analysis , Ascorbic Acid/blood , Female , Glutathione Peroxidase/metabolism , Humans , Italy , Male , Oxidative Stress , Superoxide Dismutase/metabolism , Uric Acid/blood , Vitamin A/blood , Vitamin E/blood , Vitamins/metabolism
18.
Biogerontology ; 7(5-6): 391-8, 2006.
Article in English | MEDLINE | ID: mdl-16967205

ABSTRACT

Enzymatic activities of plasma superoxide dismutase (pSOD), catalase (CAT) and glutathione peroxidase (GPx) and erythrocyte superoxide dismutase (eSOD) were assayed in 981 healthy community dwelling old subjects participating in the Zincage Project. The relationship between antioxidant enzyme activities and, respectively, gender, age and zinc status were assessed. eSOD activity was higher in nonagenarians than in 80 year old subjects. Plasma Zn was lower in nonagenarians compared with younger subjects. The prevalence of Zn deficiency increased with age, with normal Zn levels observed in about 80% of adult subjects and only in 37% of the nonagenarians. Women showed higher eSOD and CAT activities compared to men, whereas plasma Zn was higher in men than in women. There was a positive correlation between eSOD activity and age and a negative correlation between eSOD activity and plasma Zn concentrations. An inverse correlation was also found between plasma Zn concentration and age. Further studies on different aspects of Zn metabolism--intake, plasma concentration, peripheral cell concentration, activity and amount of Zn-dependent enzymes--are warranted.


Subject(s)
Aging/blood , Antioxidants/metabolism , Catalase/blood , Erythrocytes/enzymology , Glutathione Peroxidase/blood , Superoxide Dismutase/blood , Zinc/blood , Age Distribution , Age Factors , Aged , Aged, 80 and over , Europe , Female , Geriatric Assessment , Humans , Male , Middle Aged , Population Surveillance , Reference Values , Sex Factors , Surveys and Questionnaires , Zinc/deficiency
19.
Article in English | MEDLINE | ID: mdl-16183338

ABSTRACT

According to the free radical theory, aging can be considered as a progressive, inevitable process partially related to the accumulation of oxidative damage into biomolecules -- nucleic acids, lipids, proteins or carbohydrates -- due to an imbalance between prooxidants and antioxidants in favor of the former. More recently also the pathogenesis of several diseases has been linked to a condition of oxidative stress. In this review we focus our attention on the evidence of oxidative stress in aging brain, some of the most important neurodegenerative diseases -- Alzheimer's disease (AD), mild cognitive impairment (MCI), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD) -- and in two common and highly disabling vascular pathologies--stroke and cardiac failure. Particular attention will be given to the current knowledge about the biomarkers of oxidative stress that can be possibly used to monitor their severity and outcome.


Subject(s)
Aging/physiology , Brain/physiopathology , Heart Failure/physiopathology , Neurodegenerative Diseases/physiopathology , Oxidative Stress/physiology , Stroke/physiopathology , Alzheimer Disease/physiopathology , Amyotrophic Lateral Sclerosis/physiopathology , Biomarkers/analysis , Humans , Huntington Disease/physiopathology , Parkinson Disease/physiopathology
20.
Int J Geriatr Psychiatry ; 20(2): 168-74, 2005 Feb.
Article in English | MEDLINE | ID: mdl-15660409

ABSTRACT

BACKGROUND: Considerable suffering is experienced by carers of patients with dementia. Most existing studies do not consider the coexistence of subjective and objective aspects that cause, interacting to each other, this suffering. OBJECTIVES: In this study we: (1) define the high-risk group of caregivers on the bases of the scores obtained on the four scales evaluating burden, distress, depression and anxiety (BDDA) taken into account simultaneously and (2) evaluate risk factors related to the high level of BDDA. SUBJECTS AND METHODS: 419 elderly outpatients with dementia and their caregivers were enrolled. Patients were evaluated for their cognitive, neuropsychological and functional impairment and for comorbidity. Caregivers were evaluated with four scales for the assessment of burden, distress related to neuropsychological disturbances, depression and anxiety. Cluster analysis was used to identify the group with the High level of BDDA (HBDDA). RESULTS: By multiple logistic analysis, disability, specific behavioural disturbances of the patients as well as caregiver's age, type of relationship and living in the south of Italy were observed to be a major risk factor for HBDDA. CONCLUSION: The targeted use of scales specifically assessing BDDA of the caregiver and the identification of particular patient and caregiver characteristics are able to allow a precise and early definition of caregivers at high risk of burden and distress. This might be helpful in planning the correct social/clinical/rehabilitative approach.


Subject(s)
Alzheimer Disease , Caregivers/psychology , Stress, Psychological , Adolescent , Adult , Aged , Aged, 80 and over , Alzheimer Disease/psychology , Cluster Analysis , Female , Humans , Italy , Logistic Models , Male , Middle Aged
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