Advances in Geriatrics http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. CSF Biomarkers of Alzheimer’s Disease: Impact on Disease Concept, Diagnosis, and Clinical Trial Design Thu, 14 Aug 2014 07:21:39 +0000 http://www.hindawi.com/journals/ager/2014/302712/ Data from clinicopathologic and biomarker studies have converged to support the view of Alzheimer’s disease (AD) as a continuum, with pathology developing decades prior to the onset of cognitive symptoms which culminate as dementia at the end stage of the disease. This concept is impacting disease nomenclature, diagnostic criteria, prognostic potential, and clinical trial design. Revisions to diagnostic criteria to incorporate biomarker results have recently been proposed in order to increase the confidence of AD as the underlying etiology of a clinical impairment and to permit a diagnosis of AD across the disease continuum, eventually perhaps in the asymptomatic period. Individuals in this preclinical stage are receiving intense focus as a targeted population for secondary prevention trials aimed at identifying disease-modifying therapies that have the best chance of preserving normal cognitive function. The goal is to bring validated biomarkers to clinical practice for the purpose of disease diagnosis, prognosis, and evaluation of therapeutic efficacy once disease-modifying treatments become available. Realization of this goal requires worldwide biomarker standardization efforts, consensus among researchers and clinicians regarding the clinical utility of assessing biomarkers in patient care settings, and eventually the endorsement and adoption of such procedures and practices into global health care systems. Anne M. Fagan Copyright © 2014 Anne M. Fagan. All rights reserved. Biodemographic Analyses of Longitudinal Data on Aging, Health, and Longevity: Recent Advances and Future Perspectives Thu, 24 Jul 2014 00:00:00 +0000 http://www.hindawi.com/journals/ager/2014/957073/ Biodemography became one of the most innovative and fastest growing areas in demography. This progress is fueled by the growing variability and amount of relevant data available for analyses as well as by methodological developments allowing for addressing new research questions using new approaches that can better utilize the potential of these data. In this review paper, we summarize recent methodological advances in biodemography and their diverse practical applications. Three major topics are covered: (1) computational approaches to reconstruction of age patterns of incidence of geriatric diseases and other characteristics such as recovery rates at the population level using Medicare claims data; (2) methodological advances in genetic and genomic biodemography and applications to research on genetic determinants of longevity and health; and (3) biodemographic models for joint analyses of time-to-event data and longitudinal measurements of biomarkers collected in longitudinal studies on aging. We discuss how such data and methodology can be used in a comprehensive prediction model for joint analyses of incomplete datasets that take into account the wide spectrum of factors affecting health and mortality transitions including genetic factors and hidden mechanisms of aging-related changes in physiological variables in their dynamic connection with health and survival. Konstantin G. Arbeev, Igor Akushevich, Alexander M. Kulminski, Svetlana V. Ukraintseva, and Anatoliy I. Yashin Copyright © 2014 Konstantin G. Arbeev et al. All rights reserved. Application of Traditional Medical Ideas to Geriatric Syndrome Tue, 15 Jul 2014 08:39:39 +0000 http://www.hindawi.com/journals/ager/2014/528042/ Background. Japan is a superaging society, with the percentage of persons aged >65 years increasing year after year. Traditional medicine (TM) for elderly has been practiced worldwide for thousands of years. Treatment methods for aspiration pneumonia, gait disorder, glaucoma, and bowel symptoms have been developed. The ideas of acupuncture, moxibustion, and herbal medicine have been implemented in modern medical settings, and medical devices using heat transfer engineering and nanotechnology have been developed. An ultrasound scanner can be used for the evaluation of effects and indications for these therapeutic measures. Objectives. To review published literature and our studies that evaluated medical treatments for the elderly on the basis of ideas of TM. Search Methods. We searched Pubmed, Scopus, and reference lists of relevant clinical trials. Authors’ Conclusions. Many studies were found. But there are insufficient data on the effects of traditional medical therapies and further research is needed. TM therapies vary widely and studies of these therapies that ascertain practical application are essential for the utilization of ideas of TM in modern medicine. Moreover, to verify practical application, a quantitative evaluation index is necessary. Nonetheless, modalities using ideas of TM may be promising treatments for some diseases in the elderly. Takashi Seki, Shin Takayama, Masashi Watanabe, Noriko Tsuruoka, Tadao Matsunaga, Yoichi Haga, Junnosuke Okajima, Atsuki Komiya, Shigenao Maruyama, and Kenichi Meguro Copyright © 2014 Takashi Seki et al. All rights reserved. Oxidative Stress and Proteostasis Network: Culprit and Casualty of Alzheimer’s-Like Neurodegeneration Tue, 08 Jul 2014 08:42:10 +0000 http://www.hindawi.com/journals/ager/2014/527518/ Free radical-mediated damage to proteins is particularly important in aging and age-related neurodegenerative diseases, because in the majority of cases it is a non-reversible phenomenon that requires clearance systems for removal. Major consequences of protein oxidation are loss of protein function and the formation of large protein aggregates, which are often toxic to cells if allowed to accumulate. Deposition of aggregated, misfolded, and oxidized proteins may also result from the impairment of protein quality control (PQC) system, including protein unfolded response, proteasome, and autophagy. Perturbations of such components of the proteostasis network that provides a critical protective role against stress conditions are emerging as relevant factor in triggering neuronal death. In this outlook paper, we discuss the role of protein oxidation as a major contributing factor for the impairment of the PQC regulating protein folding, surveillance, and degradation. Recent studies from our group and from others aim to better understand the link between Down syndrome and Alzheimer’s disease neuropathology. We propose oxidative stress and alteration of proteostasis network as a possible unifying mechanism triggering neurodegeneration. Fabio Di Domenico, Elizabeth Head, D. Allan Butterfield, and Marzia Perluigi Copyright © 2014 Fabio Di Domenico et al. All rights reserved. Psychoeducational Interventions for Family Caregivers of Seniors across Their Life Trajectory: An Evidence-Based Research Program to Inform Clinical Practice Thu, 19 Jun 2014 06:00:50 +0000 http://www.hindawi.com/journals/ager/2014/316203/ Family caregivers of the elderly are growing in number and the care they are called upon to deliver in industrialized countries is becoming increasingly demanding and complex. Empirical research shows that the caregiving situation can have a significant impact on the health of these caregivers often on account of stress, physical and psychological exhaustion, and a sense of being overwhelmed. In this context, the quality of life of these caregivers depends in large part on professional educational and support interventions. The purpose of this paper is to present three innovative psychoeducational intervention programs developed and empirically tested by the research team of the Université de Montréal’s (Québec, Canada) Chair in Nursing Care for Seniors and Their Families over the past fifteen years. These interventions have been developed together with family caregivers experiencing different stressful situations across their care trajectory. The results of evaluative studies of these programs provide evidence to inform professional clinical practice. Future directions for caregiving research are discussed. Francine Ducharme Copyright © 2014 Francine Ducharme. All rights reserved. Currently Available Biomarkers and Strategies for the Validation of Novel Candidates for Neurochemical Dementia Diagnostics in Alzheimer’s Disease and Mild Cognitive Impairment Wed, 18 Jun 2014 10:55:19 +0000 http://www.hindawi.com/journals/ager/2014/891780/ The number of people afflicted with Alzheimer’s disease (AD) and other types of dementing conditions has grown exponentially in the last decades. This review focuses on the diagnostic role of the classic cerebrospinal fluid (CSF) biomarkers of neurochemical dementia diagnostics (NDD) and critically discusses potential strategies for the development and validation of novel potential candidates. In some countries, NDD is already established as a routine diagnostic tool, used for the evaluation of patients with cognitive impairments. On the other hand, preanalytical and technical issues, partly discussed in this paper, prevent NDD from the general acceptance worldwide. Currently, two groups of biomarkers in the CSF are considered in NDD: amyloid β (Aβ) peptides and Tau proteins, including the hyperphosphorylated forms of the latter (pTau). The analyses of these two groups of biomarkers can reveal pathologic alterations as early as twenty years before the onset of clinical symptoms. In mild cognitive impairment (MCI), NDD can reliably predict which individuals are at risk of converting to AD. The roles of biomarkers of amyloid β deposition in the brain tissue (including the CSF concentration of Aβ42) and biomarkers of neurodegeneration (including the CSF concentrations of Tau/pTau proteins) are reflected in the currently proposed diagnostic criteria for AD and MCI. Piotr Lewczuk Copyright © 2014 Piotr Lewczuk. All rights reserved.