Obesity Paradox in Caucasian Seniors: Results of the PolSenior Study.

OBJECTIVES: To investigate the influence of overweight and obesity on general performance and mortality in seniors. DESIGN: Cross-sectional multidisciplinary study on ageing of the Polish population. SETTING: Community-dwelling individuals aged 65 years or older, selected using three-stage stratified, proportional draw. PARTICIPANTS: 4944 Polish Caucasian seniors, aged 65 years or older recruited between October 2007 and October 2010. MEASUREMENTS: All study subjects underwent measurement of body mass index (BMI), waist circumference (WC), and arm circumference (AC). The physical and cognitive performance was evaluated using the Katz Activities of Daily Living (ADL) score and Mini-Mental State Examination (MMSE), respectively. Morbidity data were obtained from a medical questionnaire. Mortality data were obtained from the Population Register of Poland between October 2015 and October 2018. RESULTS: Increasing age was associated with a decreased prevalence of obesity (all p<0.001). Higher BMI, WC and AC values were associated with higher ADL and MMSE scores (all p<0.001). On multivariate analysis, all three body measurements in women remained independent predictors of the ADL score (BMI p=0.002, WC p=0.005, AC p<0.001) and MMSE score (p<0.001, p=0.003, p<0.001). In men, physical functioning was associated with AC (p=0.003), and cognitive status was associated with AC (p<0.001) and BMI (p=0.013). There was no association between general obesity, abdominal obesity, or AC with several aging-related adverse conditions. Kaplan-Meier survival curves showed that overweight and obesity were associated with the lowest mortality. On multivariate analysis, BMI and AC values remained independent predictors of mortality. In successfully aging individuals, neither BMI, WC, nor AC remained such predictors. CONCLUSIONS: Overweight and obesity in Caucasian seniors are not associated with deterioration of physical and cognitive function or with increased mortality.

Influence of Sociodemographic, Behavioral and Other Health-Related Factors on Healthy Ageing Based on Three Operative Definitions.

OBJECTIVES: Healthy ageing (HA) is a key concept and highly desirable phenomenon in every ageing and already old societies. The aim of our study was to evaluate the influence of socio-economic conditions as well as life-style and other health-related factors on the WHO definition of HA. DESIGN, SETTING, PARTICIPANTS: The study used cross-sectional data of the PolSenior Project - nationwide research evaluating different aspects of ageing in Poland - which included 4'653 respondents aged 65 years and over. MEASUREMENTS: Data were collected by trained interviewers in respondents' homes. Three definitions of HA including or not the participants' chronic conditions were analyzed. RESULTS: The prevalence of HA appeared as high as 17.6% if none or 1 chronic disease was present and 42.8% if no information about chronic diseases was taken into account. The association between known health predictors (age, marital status, education, income) and HA was observed. Moreover, HA appeared in relation with indicators of physical functioning and lifestyle. There was a strong concordance between HA and the fair self-rated health (OR = 1.87; 1.99, and 2.74 for the 1st, 2nd and 3rd definitions, respectively) and opposite relation with self-reported need for help (OR = 0.15; 0.15; and 0.13, respectively). CONCLUSIONS: The HA definition based on no functional activity limitations, no cognitive impairment, no depressive symptoms, no more than one disease and being socially active seems to be a useful approach of HA.

Proton conductivity of imidazole entrapped in microporous molecular sieves.

Imidazole embedded in molecular sieves shows remarkable and steady proton conductivity (>1 × 10-5 S cm-1 above 360 K). It can be considered to be a promising solid high proton conducting electrolyte for fuel cells. The conductivity depends on imidazole loading and mobility, which result from the pore geometry, the chemical nature of matrices and the preparation method.

Social and economic correlates of malnutrition in Polish elderly population: the results of PolSenior study.

OBJECTIVES: The aim of this study was to evaluate the prevalence of malnutrition in Polish elderly population and analyse its social and economic correlates based on the data from the PolSenior project, the first large-scale study of a representative group of Polish seniors. DESIGN: A cross-sectional population-based study. SETTING: All territorial provinces in Poland. PARTICIPANTS: 4482 community-dwelling respondents aged 65 years or above (women: n=2142, age=79.0±8.4 years; men: n=2340, age= 78.3±8.6 years). MEASUREMENTS: The nutritional status of participants was assessed through the Mini Nutritional Assessment Short Form (the revised MNA-SF). Out of social and economic correlates we evaluated age, sex, level of education, marital status, place of residence, living conditions and economic status. Economic status of the respondents was determined on the basis of questions on how well they could manage their own budgets. Those who could afford only the cheapest food or clothes were considered the group of self-reported poverty. RESULTS: Frequency of malnutrition in the PolSenior population accounted for 7.5% (in 5.0% men and 9.0% women; p<0.001). The risk of malnutrition was present in 38.9% (33.3% men and 42.4% women; p<0.001). In our study female sex, older age, unmarried status, living in a rural area and self-reported poverty were independent correlates of malnutrition. CONCLUSIONS: Our data showed high prevalence of malnutrition and the risk of its development among the community-dwelling elderly people in Poland. Screening with MNA-SF should focus in particular on unmarried, poorly educated individuals, in late old age, living in rural areas and self-reporting a poor financial state, especially women.

Carotid atherosclerosis in elderly hypertensive patients: potential role of endothelin and plasma antioxidant capacity.

Endothelin-1 (ET-1) and oxidative stress are involved in the development of hypertension-induced cardiovascular complications. The aim of this study was to evaluate the relationship between plasma ET-1 level and plasma antioxidant capacity and carotid atherosclerosis. In 61 treated patients with hypertension (44 women, 35 diabetics, mean age 72.4+/-7.2 years) medical histories, ambulatory blood pressure, blood tests (glucose, creatinine, cholesterol, haemoglobin A1c (HbA1c), ET-1) and common carotid artery intima-media thickness (CCA-IMT) measurement were carried out. Plasma antioxidant capacity was assessed by the ferric-reducing ability of plasma (FRAP). Subjects with diabetes presented with higher concentrations of glucose (7.01+/-2.3 vs 5.14+/-0.6 mmol l(-1), P<0.001), HbA1c (7.75+/-2.1 vs 6.1+/-1.2%, P<0.001) and ET-1 (1.36+/-0.53 vs 1.01+/-0.4 pg ml(-1), P<0.01), and lower cholesterol level (5.02+/-0.8 vs 5.86+/-1.3 mmol l(-1), P<0.01). A significant positive correlation between CCA-IMT and ET-1 plasma concentration (r=0.40, P<0.001) and reverse relationship between CCA-IMT and FRAP (r=-0.36, P<0.01) was observed. In a stepwise regression analysis, after adjustment for all confounders, CCA-IMT was independently influenced by age, systolic blood pressure (SBP), HbA1c and ET-1. When FRAP was included in the regression model, CCA-IMT was significantly influenced by age, FRAP, HbA1c and SBP. ET-1 promotes the increase in CCA-IMT contributing to the development of end-organ damage. Plasma antioxidant capacity may modulate this deleterious effect, but whether better antioxidant defence may prevent against the development of atherosclerosis remains to be elucidated.

Kidney function and thickness of carotid intima-media complex in patients with treated arterial hypertension.

The aim of the study was to evaluate of the association between renal function and the intima-media thickness of common carotid artery (CCA-IMT) in treated hypertensive patients. Eighty-seven hypertensives (51.7% diabetic), aged >45 years, were examined. Renal function was evaluated by plasma concentration of creatinine, cystatin C (in 64 patients) and creatinine clearance, calculated according to the Cockcroft-Gault formula. HbA1c measurement and blood pressure monitoring were performed. CCA-IMT was measured at near and far wall of the CCA and of the bulb on both sides and averaged. In 63 hypertensives (72.4%) IMT was over 0.9 mm. These subjects were older (71.17+/-9.72 vs 57.75+/-7.76 years; p<0.0001), had higher pulse pressure (57.45+/-11.73 vs 49.35+/-8.35, p = 0.004), cystatin C concentration (1.25+/-0.34 vs 0.99+/-0.17 mg/l; p = 0.002), higher HbA1c (7.24+/-1.59 vs 6.25+/-1.28, p = 0.01), and lower creatinine clearance (71.28+/-28.32 vs 93.86+/-25.04; p<0.0001) in comparison to patients with IMT <0.9 mm. Groups did not differ with respect to creatinine concentration. The logistic regression analysis showed that CCA-IMT was independently influenced only by age, and the effect of age was stronger in older patients. After exclusion of age, 0.1 mg/l higher concentrations of cystatin C or 10 ml/min lower estimated creatinine clearance were significantly associated with 56% and 34%, respectively, higher probability of CCA-IMT of more than 0.9 mm. Cystatin C concentration seems to be a useful indicator of renal function impairment associated with carotid intima-media thickening. Similar information is obtained when estimated creatinine clearance is used.

The relationship between pulse wave velocity and indexes of collagen synthesis in hypertensive patients, according to the level of systolic blood pressure.

Vascular stiffening, a process responsible for the development of isolated systolic hypertension, depends on dysregulation of collagen-elastine production and arrangement, yet it is not known whether the effect is uniform throughout wide blood pressure (BP) range. To check whether arterial stiffness is similarly related to increased fibrotic remodelling, in patients with systolic blood pressure (SBP) above and below 160 mmHg. Consecutive peri- and postmenopausal female outpatients treated for hypertension and free from other disorders interfering with fibrotic processes, had their BP, pulse wave velocity (PWV), and collagen (N-terminal procollagen type III propeptide (PIIINP); C-terminal procollagen type I propeptide-(PICP)) measured. The average age of 100 women was 71.8+/-10.5 years, BP was 145/83+/-25/15 mmHg, pulse pressure 63+/-17 mmHg, and mean blood pressure (MBP) 104+/-17 mmHg. PWV was 12.9+/-3.6 m/s and was significantly higher among 30 patients with SBP of > or =160 mmHg. PIIINP averaged 4.6+/-1.6 ng/ml and PICP 142.2+/-47.0 ng/ml. In the low SBP (<160 mmHg) group there was no relationship between PWV and collagen concentrations. However, in the > or =160 mmHg group there was significant correlation between PWV and PIIINP concentration. The relationship held significant after adjustment for age, and BP components. Our result can help explaining the results of recent intervention trials where older patients tended to benefit more from potentially antifibrotic drugs (ACE-I), whereas those with compliant arteries tend to benefit from diuretics.

[Involutional osteoporosis--etiopathogenesis and treatment]. / Osteoporoza inwolucyjna--etiopatogeneza i leczenie.

Osteoporosis is a unique disease of old people. It is progressing from 5-th decade of life. The following factors are increasing progress of the disease: estrogen (and androgen) deficiency, low calcium diet, small physical activity, low body weight (body mass index). Disease mainly affects women in whom normal with age loss of bone tissue (average 0.3% of bone mass per year) increases up to 1-2% in postmenopausal period and in every third woman the loss may reach several percent a year. All these factors results in osteoporosis, systemic disease of the skeleton, characterized by low bone mass, damaged microarchitectonics and increase probability of spontaneous fracture of bones. The treatment of this disease is directed towards stimulating osteogenesis and inhibition the resorption of the bone tissue by more active lifestyle, diet rich in calcium (milk and its products), hormone replacement therapy supplemented with calcium and vitamin D3. The most effective drug in osteoporosis with increase bone turnover seems to be calcitonin, which is especially effective in treatment of senile osteoporosis (type II) and in all cases complicated by bone fractures.

Influence of long-term treatment with nifedipine on blood pressure, left ventricular mass and cardiac arrhythmias in elderly hypertensive patients.

To determine the benefits of the long-term monotherapy with nifedipine in the elderly hypertensive patients, 100 subjects > 60 years old were included to the trial. Therapeutic efficacy of nifedipine was confirmed in 69% of the patients and resulted in reduction of SBP by 20.9% and DBP by 19.0% of their initial values, from 179.7/101.3 to 142.1/82.9 mmHg (p < 0.001). On the other hand, the range of circadian changes in systolic and diastolic BM did not decrease (67.1 and 37.0 mmHg before treatment and 65.0 and 36.2 mmHg at the end of the trial). Although cardiac output and ejection fraction significantly improved, the patients showed neither a significant reduction of left ventricular mass (313.6 g before and 282.4 g after therapy) nor a decrease in cardiac arrhythmias. Usefulness of long-term monotherapy with nifedipine in elderly patients is diminished by side-effects (11%), as well as a preserved high circadian BP variability and the unchanged left ventricular morphology that may result in persistent cardiac arrhythmias despite of the significant fall in BP.

Acute and long-term treatment of hypertension with nifedipine in the elderly.

The acute hypotensive effect of nifedipine was evaluated, and the possibility of its long-term use in hypertensives over 60 years of age was studied. Sublingual nifedipine in a dose of 20 mg was given to 28 patients, mean age 73.1 yrs, and blood pressure, heart rate, and plasma drug concentration were monitored at 15 min, and every 30 min thereafter for 3 hrs. Systolic and diastolic blood pressure decreased at 15 min by 22.1 and 7.0 mmHg, respectively, reaching a maximal decrease two hours after drug administration. The decrease in blood pressure level did not correlate with nifedipine plasma concentration, but only with the initial systolic blood pressure. Long-term treatment with nifedipine was initiated in 60 patients, with 45 patients completing the study. Mean age was 66.2 years. An initial dose of 30 mg daily had to be increased to 60-80 mg in one-third of the patients. Monotherapy was not satisfactory in some patients. Blood pressure gradually decreased from 173/99 to 148/85 mmHg at three months, and to 141/84 mmHg at six months. Drug tolerance was fairly good. Nifedipine was withdrawn due to a considerable increase in heart rate in three patients and skin allergy in one. The most frequent adverse symptoms were: rash, headache, and leg oedema. Laboratory tests revealed no changes in urea and creatinine, and an increase in fasting glycaemia. Lipid parameters did not change significantly. These data proved that a single dose of 20 mg of nifedipine produced therapeutic plasma concentration of the drug and good hypotensive effect, positively correlating with initial systolic blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Ventricular arrhythmias and echocardiographic parameters of the left ventricular morphology in elderly patients with arterial hypertension.

An analysis of cardiac arrhythmias in relation to left ventricular morphology and function was performed in 68 hypertensive patients 60 to 83 years of age. The study comprised Holter monitoring and echocardiography. Our results suggest that in elderly patients with primary arterial hypertension a correlation exists between left ventricular mass and the incidence of ventricular arrhythmias but not between left ventricular mass and supraventricular arrhythmias.

[Quality of marginal sealing of Evicrol fillings when using dental adhesives in vitro]. / Kvalita okrajového uzáveru výplní z evicrolu pri pouzití dentálních adheziv in vitro.

The quality of the marginal sealing of fillings made from Evicrol in vitro was investigated by means of a couloured indicator. The close adherence of the composite filing to the surface of the tooth was ensured by the by micro retention treatment of the marginal enamel and different dentin adhesives. The thermal strain of filling materials and their combination with the tooth, corresponding roughly to conditions in the oral cavity, was modelled by cyclic temperature changes using a special apparatus designed by the authors.

[Nutritive value of the diet of infants and small children at home and Homes for Small Children in comparison with the current dietary recommendations]. / Wartosc odzywcza rzeczywiscie spozytych racji pokarmowych niemowlat i malych dzieci w warunkach domowych i w Domach Malego Dziecka w zestawieniu z aktualnymi zaleceniami w tym zakresie.

Energy and nutrients intake was evaluated in the groups of artificially fed infants, brought up in families and in "Homes for Small Children". The method of dietary survey and infants groups are described in previous paper (Dluzniewska et al. 1980). For the purpose of accurate estimation of intakes by 24-hour recall method, the models od spoons, and food items as well as photographs of dishes are used. The individual inventory-weighing method in dietary observations in "Homes for Small Children" is regarded as giving the most accurate assessment of food intake. Mean daily energy intake expressed either as kcal (kJ) per child or per kg body weight is in families feeding higher than the recommended intakes (National Research Institute of Mother and Child), the difference beeing the greatest in infants aged 1-3 months. In the "Homes for Small Children" mean daily energy intakes if infants below 9 months is lower than recommended. A twofold variation is observed in intakes between individuals in the same age-group. Mean protein intake is in "Homes for Small Children" similar to recommended allowances, but higher in infants brought up in families; higher is also carbohydrate intake in this group of infants especially at 1 and 2 months. These date are confirmed by the finding of higher nutrient concentration and higher energy content of milk formulas, as prepared by mothers. The further observations of development and body composition of infants in groups, receiving milk formulas of low or high energy concentration may help in the evaluation of the effects of formulas concentration for present and future health of the surveyed children.