Associação entre Alteração da Glicemia de Jejum, Cognição e Capacidade Funcional de Idosos / Association Between Impaired Fasting Glycemia, Cognition and Reduced Functional Capacity of Elderly People

Objetiva-se investigar a possível associação entre a alteração da glicemia de jejum, o déficit cognitivo e a redução da capacidade funcional. Foram selecionados 802 idosos com idade igual ou superior a 60 anos que foram submetidos às questões incluídas na Avaliação Geriatrica Ampla (AGA), no Mini Exame do Estado Mental (MEEM), no teste da Escala de Depressão Geriátrica (GDS) e nos testes de Atividade da Vida Diária (AVD), além do exame laboratorial da glicemia de jejum. A análise dos resultados mostrou que há relação entre alteração da glicemia de jejum, o declínio cognitivo e a redução da capacidade funcional. Os resultados do presente estudo sugerem que a hiperglicemia de jejum é um fator de risco para o desenvolvimento da diminuição do desempenho cognitivo e para a redução da capacidade funcional de idosos

Objective: to investigate the possible association between altered fasting glycemia, cognitive deficit and reduced functional capacity. Methods: 802 elderly individuals aged over 60 years were selected. The elderly were submitted to evaluations that are included in Comprehensive Geriatric Assessment, Mini Mental State Examination and Daily Life Activity and Geriatric Depression Scale tests, as well as the laboratory blood glucose test. Results: The analysis of the results showed that there is a relationship between fasting glycemia, cognitive decline and functional capacity reduction. Conclusions: The results of the present study suggest that fasting hyperglycemia is a risk factor for the development of cognitive impairment and reduced functional capacity of the elderly

Assessment of fructose overload in the metabolic profile and oxidative/nitrosative stress in the kidney of senescent female rats.

The aging process is a complex phenomenon that leads the body to several changes, affecting its integrity and resulting in chronic pathologies, which compromises health and quality of life of elderly people. Animals supplemented with fructose have been used as an experimental model for induction of insulin resistance. The objective of this study was to evaluate the metabolic effects and the levels of oxidative/nitrosative stress in the kidney of senescent rats with a high fructose intake. The animals were allocated into 4 groups: young control (Y), aged control (A), young fructose (YF) and aged fructose (AF). Groups Y and A received water and groups YF and AF received fructose (100g/L) in the water, both ad libitum. After 12weeks of high fructose intake, the animals were sacrificed to collect their kidneys, blood and the thoracic aorta. The results are presented as mean±SE, analyzed by the One-Way ANOVA test with Newman-Keuls post-test; significant at p<0.05. The fructose overload caused metabolic dysfunctions and insulin resistance, confirming the efficacy of the chosen model. In this study, we observed a body weight gain in the studied groups (except in the elderly fructose group), and an increase in general caloric intake, diuresis and adipose tissue; insulin resistance, increased fasting glucose, triglycerides and cholesterol in the fructose groups. We also found a loss of renal function, increased oxidative/nitrosative stress and inflammation, and a reduction of antioxidants and a lower vasodepressor response in the studied groups, especially those who consumed fructose. In summary, our data showed that aging or high fructose intake contributed to the increase of oxidative/nitrosative stress in animals, demonstrating that at the dose and the period of fructose treatment utilized in this study, fructose was not able to aggravate several aspects which were already altered by aging. We believe that the high fructose intake simulates most of the effects of aging, and this understanding would be useful to prevent or minimize many of the alterations caused by this condition.

Corrigendum to "Relationship between perceived sleep and polysomnography in older adult patients" [Sleep Sci. 8 (2015) 75-81].

[This corrects the article DOI: 10.1016/j.slsci.2015.04.002.].

Relationship between perceived sleep and polysomnography in older adult patients.

BACKGROUND AND AIMS: Aging is a multifactorial process that elicits changes in the duration and quality of sleep. Polysomnography is considered to be the standard examination for the analysis of sleep and consists of the simultaneous recording of selected physiological variables during sleep. OBJECTIVE: The objective of this study was to use polysomnography to compare sleep reported by senior citizens. METHODS: We selected 40 patients, both male and female, with ages ranging from 64 to 89 years from the Center for the Study of Aging at the Federal University of São Paulo. Patients answered questions about sleep on the Comprehensive Geriatric Assessment and underwent polysomnography. RESULTS: The results were compared, and agreement between perceived sleep and polysomnography was found in several areas. There was an association between difficulty sleeping and sleep onset latency (p=0.015), waking up at night with sleep onset latency (p=0.005), total sleep time with daytime sleepiness (0.005) and snoring (0.027), sleep efficiency with sleepiness (0.004), snoring (0.033) and pause in breathing (p=0.024), awakenings with snoring (p=0.012) and sleep apnea with pauses in breathing (p=0.001). CONCLUSION: These results suggest that the older adult population have a good perception of their sleep. The questionnaires aimed at this population should be used as an alternative to polysomnography.

Calcium signaling alterations, oxidative stress, and autophagy in aging.

SIGNIFICANCE: Aging is a multi-factorial process that may be associated with several functional and structural deficits which can evolve into degenerative diseases. In this review, we present data that may depict an expanded view of molecular aging theories, beginning with the idea that reactive oxygen species (ROS) are the major effectors in this process. In addition, we have correlated the importance of autophagy as a neuroprotective mechanism and discussed a link between age-related molecules, Ca(2+) signaling, and oxidative stress. RECENT ADVANCES: There is evidence suggesting that alterations in Ca(2+) homeostasis, including mitochondrial Ca(2+) overload and alterations in electron transport chain (ETC) complexes, which increase cell vulnerability, are linked to oxidative stress in aging. As much as Ca(2+) signaling is altered in aged cells, excess ROS can be produced due to an ineffective coupling of mitochondrial respiration. Damaged mitochondria might not be removed by the macroautophagic system, which is hampered in aging by lipofuscin accumulation, boosting ROS generation, damaging DNA, and, ultimately, leading to apoptosis. CRITICAL ISSUES: This process can lead to altered protein expression (such as p53, Sirt1, and IGF-1) and progress to cell death. This cycle can lead to increased cell vulnerability in aging and contribute to an increased susceptibility to degenerative processes. FUTURE DIRECTIONS: A better understanding of Ca(2+) signaling and molecular aging alterations is important for preventing apoptosis in age-related diseases. In addition, caloric restriction, resveratrol and autophagy modulation appear to be predominantly cytoprotective, and further studies of this process are promising in age-related disease therapeutics.

Effects of Panax ginseng, Turnera diffusa and Heteropterys tomentosa extracts on hippocampal apoptosis of aged rats.

OBJECTIVE: To verify if the medicinal plants Panax ginseng C.A. Mey, Turnera diffusa Willd. ex Schult., and Heteropterys tomentosa O. Mach., which are amply used by the population as tonics and cognition enhancers, could have a protective effect on cell death by apoptosis, since this could be one of the mechanisms of action of these substances. METHODS: Aged male Wistar rats (n = 24) were divided into four groups. Over 30 days, three groups received treatments with hydroalcoholic extracts of the plants, and one group received saline solution. A fifth group with young adult male Wistar rats (n = 4) received saline solution during the same period. Using the TUNEL technique, the percentage of apoptosis in the hippocampus of these animals was evaluated. RESULTS: No differences were observed between the percentage of apoptotic cells in the hippocampus of aged animals and of young control animals. The percentage of apoptosis in the hippocampus of aged animals treated chronically with the extracts from the three plants also did not differ from the percentage of apoptosis in the hippocampus of the control group of aged animals. CONCLUSION: Treatment with the hydroalcoholic extracts of Panax ginseng, Turnera diffusa, and Heteropterys tomentosa did not influence the apoptosis of the hippocampal cells of aged rats.

Efeito dos extratos de Panax ginseng, Turnera diffusa e Heteropterys tomentosa sobre a apoptose no hipocampo de ratos idosos / Effects of Panax ginseng, Turnera diffusa and Heteropterys tomentosa extracts on hippocampal apoptosis of aged rats

OBJECTIVE: To verify if the medicinal plants Panax ginseng C.A. Mey, Turnera diffusa Willd. ex Schult., and Heteropterys tomentosa O. Mach., which are amply used by the population as tonics and cognition enhancers, could have a protective effect on cell death by apoptosis, since this could be one of the mechanisms of action of these substances. METHODS: Aged male Wistar rats (n=24) were divided into four groups. Over 30 days, three groups received treatments with hydroalcoholic extracts of the plants, and one group received saline solution. A fifth group with young adult male Wistar rats (n=4) received saline solution during the same period. Using the TUNEL technique, the percentage of apoptosis in the hippocampus of these animals was evaluated. RESULTS: No differences were observed between the percentage of apoptotic cells in the hippocampus of aged animals and of young control animals. The percentage of apoptosis in the hippocampus of aged animals treated chronically with the extracts from the three plants also did not differ from the percentage of apoptosis in the hippocampus of the control group of aged animals. CONCLUSION: Treatment with the hydroalcoholic extracts of Panax ginseng, Turnera diffusa, and Heteropterys tomentosa did not influence the apoptosis of the hippocampal cells of aged rats.

OBJETIVO: Plantas medicinais, como Panax ginseng C.A. Mey, Turnera diffusa Willd. Ex Schult. e Heteropterys tomentosa O. Mach. são amplamente utilizadas pela população como tônicas e para melhora da cognição. O presente estudo verificou se essas plantas poderiam ter algum efeito protetor na morte celular por apoptose, podendo este ser um dos mecanismos de ação dessas substâncias. MÉTODOS: Ratos machos Wistar idosos (n=24) foram divididos em quatro grupos. Durante 30 dias, três grupos receberam tratamento com extratos hidroalcoólicos das plantas e um grupo recebeu solução salina. Um quinto grupo com ratos machos Wistar adultos jovens (n=4) recebeu solução salina durante o mesmo período. Utilizando-se a técnica de TUNEL, avaliou-se a porcentagem de apoptose no hipocampo desses animais. RESULTADOS: Não foram observadas diferenças entre a porcentagem de células apoptóticas no hipocampo de animais idosos e de animais jovens controles. A porcentagem de apoptose no hipocampo dos animais idosos tratados cronicamente com os extratos das três plantas também não diferiu da porcentagem de apoptose do hipocampo dos animais idosos do grupo controle. CONCLUSÃO: O tratamento com os extratos hidroalcoólicos de Panax ginseng, Turnera diffusa e Heteropterys tomentosa não influenciou a apoptose das células hipocampais de ratos idosos.

A plant Kunitz-type inhibitor mimics bradykinin-induced cytosolic calcium increase and intestinal smooth muscle contraction.

BbKI is a kallikrein inhibitor with a reactive site sequence similar to that of kinins, the vasoactive peptides inserted in kininogen moieties. This structural similarity probably contributes to the strong interaction with plasma kallikrein, the enzyme that releases, from high-molecular weight kininogen (HMWK), the proinflammatory peptide bradykinin, which acts on B(2) receptors (B(2)R). BbKI was examined on smooth muscle contraction and Ca(2+) mobilization, in which the kallikrein-kinin system is involved. Contrary to expectations, BbKI (1.8 µm) increased [Ca(2+)](c) and contraction, as observed with BK (2.0 µm). Not blocked by B(1) receptors (B(1)R), the BbKI agonistic effect was blocked by the B(2)R antagonist, HOE-140 (6 µm), and the involvement of B(2)R was confirmed in B(2)R-knockout mice intestine. The same tissue response was obtained using a synthetic peptide derived from the BbKI reactive site structure, more resistant than BK to angiotensin I-converting enzyme (ACE) hydrolysis. Depending on the concentration, BbKI has a dual effect. At a low concentration, BbKI acts as a potent kallikrein inhibitor; however, due to the similarity to BK, in high concentrations, BbKI greatly increases Ca(2+) release from internal storages, as a consequence of its interaction with B(2)R. Therefore, the antagonistic and agonistic effects of BbKI may be considered in conditions of B(2)R involvement.

Decreased ß-cell insulin secretory function in aged rats due to impaired Ca(2+) handling.

Ageing is associated with an increased impairment in glucose homeostasis and an increased incidence of type 2 diabetes. In this study, we evaluated ß-cell function and its implications for glucose homeostasis in 24-month-old female Wistar rats. Aged rats showed lower plasma glucose levels in the fed and fasting states compared with control rats. In addition, insulinaemia in the fed state was reduced in the older rats. Insulin receptor ß (IRß) expression was lower in the livers of the aged animals, whereas IRß and Akt(1/2/3) protein expressions were higher in the muscles. These effects may contribute to the normal glucose tolerance observed in older rodents. Isolated islets from aged rats secreted less insulin in response to 8.3 and 16.7 mm glucose. Accordingly, this group presented a lower [Ca(2+)](i) in the presence of glucose and a depolarizing stimulus (30 mm K(+)). In addition, islets from aged rats showed reduced insulin secretion in response to 100 µm carbachol (CCh), 10 nm phorbol 12-myristate 13-acetate and 10 µm forskolin. The expressions of protein kinase C, protein kinase A and exocytotic proteins, such as syntaxin 1 and synaptosomal-associated protein 25 kDa (SNAP-25), were similar in islets from aged and control rats. In conclusion, our evidence suggests that the increased incidence of type 2 diabetes with age may be due to a progressive decline in ß-cell secretory capacity due to disruption of Ca(2+) handling. Furthermore, the expression of proteins of the insulin transduction cascade showed an adaptive profile, with a compensatory increase in IRß and Akt(1/2/3) in gastrocnemius muscles, which may maintain normal glucose homeostasis in 24-month-old rats.

Association between levels of physical activity and use of medication among older women.

The aim of this study was to determine the association between levels of physical activity and usage of medication in older women. The level of physical activity was assessed using a pedometer. Use of medication was assessed through medical records supplied in reports kept by the Family Health Program, City Health Department, São Caetano do Sul, São Paulo State, Brazil. Regular use of pharmaceuticals, regardless of type of illness or treatment, was listed. Data analysis was performed using Poisson regression to estimate the prevalence ratio. The results of the study indicated that, amongst the 271 eligible women, 84.9% had been classified as active. Only 23.2% did not use any type of medication while 29.8% used three or more medications. The level of physical activity was inversely associated with the number of medications used, under both crude analysis and after adjustment. The study concluded that higher volumes of physical activity were significantly associated with lower usage of pharmaceuticals in women who are involved in a physical activity program.

Association between levels of physical activity and use of medication among older women / Associação entre nível de atividade física e uso de medicamentos entre mulheres idosas

The aim of this study was to determine the association between levels of physical activity and usage of medication in older women. The level of physical activity was assessed using a pedometer. Use of medication was assessed through medical records supplied in reports kept by the Family Health Program, City Health Department, São Caetano do Sul, São Paulo State, Brazil. Regular use of pharmaceuticals, regardless of type of illness or treatment, was listed. Data analysis was performed using Poisson regression to estimate the prevalence ratio. The results of the study indicated that, amongst the 271 eligible women, 84.9 percent had been classified as active. Only 23.2 percent did not use any type of medication while 29.8 percent used three or more medications. The level of physical activity was inversely associated with the number of medications used, under both crude analysis and after adjustment. The study concluded that higher volumes of physical activity were significantly associated with lower usage of pharmaceuticals in women who are involved in a physical activity program.

O objetivo deste estudo foi avaliar a associação entre o nível de atividade física e uso de medicamentos em mulheres com 60 anos de idade ou mais. O nível de atividade física foi avaliado utilizando pedômetro. O consumo de medicamento foi avaliado mediante o prontuário de cadastro da Estratégia Saúde da Família em São Caetano do Sul, São Paulo, Brasil. Foram registrados os medicamentos de uso regular independente do tipo da doença ou do tratamento. Foi realizada análise de regressão de Poisson para estimar a razão de prevalências. Das 271 mulheres elegíveis, 84,9 por cento foram classificadas como ativas. Apenas 23,2 por cento não utilizam nenhum tipo de medicamento, enquanto 29,8 por cento utilizaram três ou mais medicamentos. O nível de atividade física foi inversamente associado com o número de medicamentos utilizados tanto na análise bruta como na ajustada. Maiores volumes de atividade física associaram-se significativamente com menor consumo de medicamentos em mulheres envolvidas em um programa de atividade física.

Inspiratory training increases insulin sensitivity in elderly patients.

AIM: Physiological degeneration in the aging process can cause a notable decline in carbohydrate metabolism. Respiratory training has been recommended to elderly patients in an attempt to prevent or minimize the alterations to the cardiorespiratory, metabolic and cognitive systems and to improve their quality of life. The objective of this work was to investigate the influence of inspiratory muscular training, with Threshold, on insulin resistance in elderly people. METHODS: This study included 14 insulin resistant elderly volunteers, ranging in age from 61 to 82 years old. Insulin resistance was confirmed using the homeostatic model assessment. The patients were divided into two groups: experimental and control. The program lasted 12 weeks, with 30-min training daily using Threshold to train the inspiratory muscles. RESULTS: The experimental group had improved insulin resistance, with decreased glycemia and insulin requirements, a lower homeostatic model assessment of insulin resistance, and increased respiratory force and performance. CONCLUSION: The small sample does not allow for conclusions, but we can suggest that inspiratory muscular training improves insulin sensitivity in elderly patients with insulin resistance.

Aging-induced decrease of cholinergic response and calcium sensitivity on rat jejunum contractions.

The role of aging on contraction or relaxation through muscarinic or alpha-adrenergic receptors, respectively, was studied in isolated rat jejunum. Furthermore, the influence of extracellular calcium was analyzed, through functional and radioligand binding assays. The rank order of potency for selective muscarinic antagonists for M(1), M(2), and M(3) receptor subtypes, measured from affinity (pA(2)) values, was p-fluorohexahydrosiladifenidol (pFHHSiD) (M(3)) > pirenzepine (M(1)) > methoctramine (M(2)), indicating a predominance of M(3) subtype. This order was unchanged with age. Contractions by muscarinic agonist methacholine (MCh) were diminished in aged rats, resulting in lower apparent affinity (pD(2)) values, compared with adult controls. A larger decrease of MCh contractions occurred in aged rats after Ca(2+) withdrawal or after the calcium channel blocker isradipine. Changes were not detected for relaxation by adrenergic agonists. In conclusion, aging caused a decrease of MCh potency, which is probably related to the reduction of calcium sensitivity in jejunum.

Os estoques intracelulares de cálcio e a apoptose na musculatura lisa do cólon de ratos senescentes / Ca2+ of stocks intracellulares and apoptosis in the smooth musculature of colon in senescents rats

Com o objetivo de detectar alteraçoes na musculatura lisa intestinal pelo envelhecimento, estudamos simultaneamente a contraçao e a mobilizaçao de Ca2+, com o indicador fura-2 no colon de rato, em varias condiçoes experimentais. Alem disso, estudamos as mudanças de potencial de membrana e abertura do poro de transiçao de permeabilidade (PTP) mitocondrial, usando o indicador TMRE em microscopia confocal. Estudamos também a ultra-estrutura das mitocôndrias e quantificamos células apoptóticas. Verificamos que: 1-o agonista muscarínico MeCh produziu nos animais velhos, em liquido normal (LN), maior contraçao fásica do que nos animais adultos. Entretanto, a contraçao sustentada e o aumento transiente do Ca 2+ foram semelhantes em velhos e adultos. Alem disso, o efeito máximo foi atingido mais rapidamente para a fluorescência do que para a contraçao, sem diferenças significantes entre velhos e adultos. 2- a Tapsigargina (Tap), que bloqueia a captaçao de Ca2+ pelo retículo sarcoplasmatico, produziu oscilaçoes de Ca2+, que corresponderam a contraçoes espontâneas, com grandes variaçoes individuais, mas sem diferenças detectáveis entre velhos e adultos. Por outro lado, observamos que a contraçao produzida pelo MeCh na presença da Tap, nao se alterou, continuando maior em animais velhos. 3- a cafeína, utilizada para avaliaçao do estoque de Ca 21 sensível à rianodina, produziu aumento transiente de Ca 2+ e contraçao nos dois grupos de animais (adultos e velhos). Por outro lado, reduziu a contraçao e o aumento transiente de Ca 2+ produzido pelo MeCh, tanto nos animais adultos como nos velhos. Após a reduçao, nao foi possível detectar diferenças entre velhos e adultos, possivelmente devido a grande variaçao individual. 4- O protonóforo FCCP promoveu aumento do transiente de Ca2+ e da contraçao, que foram maiores nos animais velhos que nos adultos. Por outro lado, nao foi possível detectar alteraçoes significativas no efeito do MeCh, tanto em relaçao ao controle, quanto entre velhos e adultos, possivelmente devido a grande variaçao individual. 4- Como esperado, tanto a contraçao como a fluorescência por MeCh nao foram reduzidas significantemente em LOCa. Pelo contrario, houve um aumentos das...(au)