Associations of Omega-3 fatty acids with brain morphology and volume in cognitively healthy older adults: A narrative review.

INTRODUCTION: Human neurodevelopment is complete by the 4th decade of life at which point brain atrophy ensues with variable rate and regionality into old age. Literally all regions of the brain experience atrophy with older age, however the pattern and rate of atrophy can dictate the behavioral consequences (i.e., cognitive impairment, Alzheimer's disease). Substantial research has aimed to discover the reasons why some people experience greater morphologic changes that produce undesirable consequences with aging and how it may be prevented. One possible explanation is diet, particularly fish consumption and the intake of omega-3 polyunsaturated fatty acids (omega 3) concentrated in fish oil. This narrative review examines the available evidence on the association between omega-3 and brain volume in non-demented older adults. METHODS: A PubMed search of the literature was conducted in search of studies that investigated the associations of omega-3 on brain morphology and volume in cognitively intact older adults. Inclusion criteria were: populations of adults aged 45 years or over, who were cognitively intact, free of any central nervous system disease, and free of advanced structural brain atrophy. Study participants had to have DHA and EPA levels measured either by blood testing or scoring of dietary intake. There were no restrictions to dates of publication. Studies including demented participants, or participants with substantial white or grey matter atrophy visible on magnetic resonance imaging were excluded. RESULTS AND CONCLUSION: The search identified only 12 studies, 8 of which were cross-sectional observational studies, 3 longitudinal observational studies, and 1 randomized controlled trial published between 2007 and 2019. The largest amount of evidence indicated that the hippocampus was most frequently involved in this association, with a higher volume associated with higher omega-3 levels. Larger total grey matter, total brain volume, and lower white matter lesion volume were also associated with higher omega-3 among four of the reviewed studies. However, most studies reviewed provided mixed findings regarding the presence or absence of the association of interest, and the findings were observed to be brain region-dependent. Current evidence is still insufficient to formulate recommendations for omega-3 intake to support brain health specifically.

Urinary incontinence in older adults.

Urinary incontinence is a common problem in the elderly which is under-reported and under-treated.It can have profound effects on the quality-of-life of affected persons and their companion or caregiver. Though common, incontinence is not an inevitable consequence of aging, but multiple anatomic and physiologic age-related changes increase the risk of UI with advancing age. Many treatment modalities are available for managing UI, some more effective than others. Patient education, and careful selection of treatment modalities can significantly improve urinary incontinence, and in some cases cure it, but treatment complications and side effects are common and must be closely monitored for successful long-term management. Surgical management of stress incontinence is a safe and effective intervention that is underutilized.

Versatile use of hindered oxalates for the stereoselective preparation of novel 11-modified androst-5-ene derivatives.

The 11alpha- and 11beta-modified androst-5-ene derivatives 3a,b as well as the exo- and endocyclic dehydrated compounds 4a-c and 5b-c were produced using the oxalate derivatives of the highly hindered 11beta-hydroxyandrost-5-enes 1a-c. The 11-tetrahydrofuran derivative 6 was produced for the first time with good diastereoselectivity by an intramolecular 5-exo cyclization under radical conditions from the corresponding oxalate as precursor.

Are the 11-oxo-steroids really so hindered towards organometallic compounds?

Allylation of an 11-oxo-steroid, the protected adrenosterone, was studied to examine more closely the steric hindrance of such a ketosteroid. While the beta face exhibits, as well known, a strong steric hindrance, the alpha side appears to be only relatively hindered. A high diastereoselectivity was observed in the addition of crotyl magnesium bromide.

Synthesis, receptor binding, molecular modeling, and proliferative assays of a series of 17alpha-arylestradiols.

A series of new derivatives of estradiol substituted at position 17alpha by various aryls has been synthesized. This was made possible by efficient activation methods for the addition of aryllithiums to the carbonyl group at position 17 of estrone by using tetramethylethylenediamine (TMEDA) or BF3 x OEt2. Their relative binding affinity (RBA) for the alpha and the beta forms of the estrogen receptor (ER) have been measured. All except one of the compounds synthesized had an RBA value of around 10 % which indicates a level of tolerance towards the bulky substituent at position 17. The lipophilicity values measured for these compounds are higher than that found for estradiol (E2). A study of their proliferative/antiproliferative effects was carried out on hormone-dependent (MCF7) and hormone-independent (MDA-MB231) breast cancer cell lines. It is interesting to note that all the compounds are estrogenic. The possibility of easily attaching an iodine at the end of a phenyl spacer opens up a route to new radiopharmaceuticals for use in radioimaging.