Alzheimer's Disease Association with Metals and Metalloids Concentration in Blood and Urine.

As there is some evidence that the risk for Alzheimer's disease (AD) is partially attributable to environmental exposure to some metals and metalloids, we examined an association between AD and arsenic, chromium, and selenium in 53 AD patients and 217 controls. Urinary arsenic, blood chromium, and selenium were determined by inductively coupled plasma mass spectrometry. Logistic regression models calculating odds ratios (ORs) and 95% confidence intervals (CI) were used to estimate AD association with arsenic, chromium, and selenium. In AD patients, urinary arsenic and blood chromium were significantly higher, while blood selenium was significantly lower compared to controls. Increased blood selenium was related to a significant decrease in the odds of AD after adjustment for risk factors. Blood selenium per 1 kg × 10-9/m3 × 10-4 increment was associated with 1.4 times lower risk of AD (OR = 0.71; 95% CI 0.58-0.87). A significant increase in the odds of AD associated with increased blood chromium was also seen in the adjusted model: the OR per 1 kg × 10-9/m3 × 10-3 chromium increment was 2.39 (95% CI 1.32-4.31). The association of urinary arsenic with the risk of AD was not significant. The data obtained provide evidence that selenium reduces the risk of Alzheimer's disease, while chromium increases it.

[Assessment of cognitive functions of the elderly in a hospital and long-term care institutions]. / Pagyvenusio amziaus zmoniu pazinimo funkciju ivertinimas stacionare ir ilgalaikes globos institucijose.

UNLABELLED: The aim of this study was to assess cognitive functions of the elderly in an acute care department and long-term care institutions. MATERIAL AND METHODS: A total of 151 hospitalized patients and 111 residents in long-term care facilities participated in the study; in total, 262 respondents. The general items of the inter RAI Questionnaires (Acute Care and Long-Term Care Facilities) were used to evaluate and compare cognitive functions. Hospitalized patients were examined on admission (during 24 hours) evaluating the patient's status before hospitalization (three days before admission to hospital) and 24 hours before planned discharge. The residents in long-term care institutions were examined once. RESULTS: The assessment of skills for daily decision-making showed that more patients made decisions independently at discharge (68.6%) comparing with admission day (53.0%). Impaired decision-making was more common on admission than at discharge, while the residents in long-term care institutions were more dependent than the hospitalized elderly. Procedural memory problems were more frequent among the residents in long-term care institutions (67.6%) than among the hospitalized elderly both on admission (34.7%) and discharge (21.9%) (P<0.001). The patients were able to express themselves clearly and understood others well at discharge more frequently (81.0% and 82.5%, respectively) than on admission (72.7% and 75.3%, respectively), while only 14.4% of the residents in long-term care institutions were able to express themselves clearly and understood others well (P<0.001). CONCLUSIONS: The residents in long-term care institutions had worse cognitive functions than the hospitalized patients. Cognitive functions of the hospitalized elderly were significantly more impaired on admission as compared to discharge, possibly due to impaired somatic and functional status on admission.

[Assessment of urinary incontinence in the elderly using the InterRAI-AC instrument]. / Pagyvenusio amziaus zmoniu slapimo nelaikymo tyrimas naudojant InterRAI-AC klausimyna.

UNLABELLED: The aim of this study was to identify and evaluate the prevalence of urinary incontinence and risk factors that influenced it among inpatients treated in the departments of internal medicine. MATERIAL AND METHODS: A total of 151 inpatients were questioned using a standardized geriatric questionnaire (InterRAI-Acute Care). Inpatients aged 65 years and more and who gave written informed consent were enrolled into the study. The mean age of the inpatients was 78+/-0.6 years. There were 58.9% of women and 41.06% of men. RESULTS: Urinary incontinence was significantly influenced by the age of the inpatients. Inpatients with urinary incontinence were 3 years older on the average as compared to those without urinary continence (P<0.025). Women were more frequently affected than men (74.2% vs. 48.4%). A significant association between urinary and fecal incontinence and memory problems, movement disorders, delirium, dependence in daily activities, falls was established. The odds of having double incontinence were increased by dementia (OR=20.9; 95%, CI 2.3-186) and residual effects of a stroke (OR=3.5; 95%, CI 1.2-9.6). The prevalence of urinary incontinence decreased from 63.6% before hospitalization to 39.7% after hospitalization. According to standard medical documentation, urinary incontinence was diagnosed in 3.3% of cases, while using the interRAI-AC questionnaire, it was documented in 63.6% of cases. CONCLUSIONS: The prevalence of urinary incontinence increases in the elderly; therefore, it has to be investigated and treated. Memory problems, delirium, dependence in daily activities, movement disorders, and falls are directly related to the risk of urinary, fecal, and double incontinence among elderly inpatients. Double incontinence was significantly influenced by dementia (20.9 times) and residual effects of a stroke (3.5 times). Underdiagnosis of urinary and fecal incontinence in inpatients burdens the possibility of providing aid for elderly patients with this disorder.