http://www.hindawi.comThe latest articles from Hindawi Publishing Corporation© 2012, Hindawi Publishing Corporation. All rights reserved.http://www.hindawi.com/journals/cggr/2012/216185/It is intuitive to think that sarcopenia should be associated with declines in physical function though recent evidence questions this assertion. This study investigated the relationship between absolute and relative sarcopenia, with physical performance in 202 nonobese (mean BMI =26.6 kg/ht2) community-dwelling older (mean age = 73.8±5.9 years) adults. While absolute sarcopenia (appendicular skeletal mass (ASM)/ht2) was either not associated, or weakly associated with physical performance, relative sarcopenia (ASM/kg) demonstrated moderate (r=0.31 to r=0.51, P<0.01) relationships with performance outcomes in both males and females. Knee extension strength (r=0.27) and leg extension power (r=0.41) were both related to absolute sarcopenia (P<0.001) in females and not in males. Strength and power were associated with relative sarcopenia in both sexes (from r=0.47 to r=0.67, P<0.001). The ratio of lean mass to total body mass, that is, relative sarcopenia, is an important consideration relative to physical function in older adults even in the absence of obesity. Stratifying these individuals into equal tertiles of total body fat revealed a trend of diminished regression coefficients across each incrementally higher fat grouping for performance measures, providing further evidence that total body fat modulates the relationship between sarcopenia and physical function.Robin L. Marcus, Diana I. Brixner, Sameer Ghate, and Paul LaStayoCopyright © 2012 Robin L. Marcus et al. All rights reserved.http://www.hindawi.com/journals/cggr/2012/359369/The molecular instructions that govern gene expression regulation are encoded in the genome and ultimately determine the morphology and functional specifications of the human brain. As a consequence, changes in gene expression levels might be directly related to the functional decline associated with brain aging. Small noncoding RNAs, including miRNAs, comprise a group of regulatory molecules that modulate the expression of hundred of genes which play important roles in brain metabolism. Recent comparative studies in humans and nonhuman primates revealed that miRNAs regulate multiple pathways and interconnected signaling cascades that are the basis for the cognitive decline and neurodegenerative disorders during aging. Identifying the roles of miRNAs and their target genes in model organisms combined with system-level studies of the brain would provide more comprehensive understanding of the molecular basis of brain deterioration during the aging process.Stephan P. Persengiev, Ivanela I. Kondova, and Ronald E. BontropCopyright © 2012 Stephan P. Persengiev et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/673012/In the continuum of patients with Alzheimer's disease (AD), mild cognitive impairment (MCI), and normal controls, a possible association of verbal memory and endogenous estradiol (E2) levels was investigated. Verbal episodic memory was measured with a german version of the California verbal memory test (CVLT). Results were controlled for apolipoprotein E (ApoE) phenotype. We studied 37 controls, 32 MCIs and 117 ADs. Groups differed in all trials of the CVLT (P<0.001) and in E2 levels (P<0.001). E2 levels differed significantly between groups only among females (P<0.001). In females correcting for age and ApoE, there was an overall correlation between CVLT delayed recall and level of E2   (P=0.025). Stepwise regression analyses found E2 level to be a significant predictor for CVLT delayed recall (P<0.001). It may be concluded that lower E2 levels occur more in the course of the disease than may be considered as a risk factor per se.D. M. Bittner, V. Bittner, and M. W. RiepeCopyright © 2011 D. M. Bittner et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/826862/Population-based studies have investigated the relation between β-amyloid levels in cerebrospinal fluid or plasma and white matter lesions (WMLs). However, these circulating levels of β-amyloid in cerebrospinal fluid or plasma may not reliably reflect the actual degree of amyloid present in the brain. Therefore, we investigated the relation between WMLs and β-amyloid plaques and amyloid angiopathy in brain tissue. WML on MRI or CT were rated in 28 nondemented patients whose neuroimaging was available prior to death. β-amyloid in plaques and arterioles were immunohistochemically stained and quantified in postmortem brain necropsies. WMLs were present in 43% of the total population. Both cortex and periventricular region showed no differences for β-amyloid deposition in either plaques or blood vessel walls in patients with WMLs compared to those without WMLs. Thus, our results indicate that there is no relation between the degree of WMLs and β-amyloid deposition in the brain.Loes C. A. Rutten-Jacobs, Frank-Erik de Leeuw, Lenny Geurts-van Bon, Marije C. Gordinou de Gouberville, Annelieke N. Schepens-Franke, P. Jos Dederen, Wim G. M. Spliet, Pieter Wesseling, and Amanda J. KiliaanCopyright © 2011 Loes C. A. Rutten-Jacobs et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/357896/This study examined change over time in five resources assessed by the Duke OARS Multidisciplinary Functional Assessment Questionnaire: social, economic, mental, physical, and functional resources. Two hundred and one participants in the Georgia Centenarian Study provided data for this longitudinal study: 70 sexagenarians, 63 octogenarians, and 68 centenarians. Those in their 60s and 80s were followed up within 60 months; due to mortality attrition, centenarians were followed up within 20 months. Centenarians experienced the lowest levels of resources relative to those in their 80s and 60s. Over time they primarily experienced loss in activities of daily living, highlighting that the ability to maximize gains and mitigate losses over time for older adults is highly associated with various resources essential to well-being. Findings suggest that older adults'—especially the very old—resources should be concurrently assessed in a multidimensional analysis by researchers and practitioners who work with older adults in various settings.G. Kevin Randall, Peter Martin, Alex J. Bishop, Leonard W. Poon, and Mary Ann JohnsonCopyright © 2011 G. Kevin Randall et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/128581/This paper aims to present a broad perspective of health of older Singaporeans spanning 15 health dimensions and study the association between self-rated health (SRH) and other health dimensions. Using data from a survey of 5000 Singaporeans (≥60 years), SRH and health in 14 other dimensions were assessed. Generalized logit model was used to assess contribution of these 14 dimensions to positive and negative SRH, compared to average SRH. About 86% reported their health to be average or higher. Prevalence of positive SRH and “health” in most other dimensions was lower in older age groups. Positive and negative SRH were associated with mobility, hearing, vision, major physical illness, pain, personal mastery, depressive symptoms, and perceived financial adequacy. The findings show that a majority of older Singaporeans report themselves as healthy overall and in a wide range of health dimensions.Chetna Malhotra, Angelique Chan, Rahul Malhotra, and Truls ØstbyeCopyright © 2011 Chetna Malhotra et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/514059/Background. A “dysexecutive” group of patients with Alzheimer disease (AD) has been previously identified, and these patients have been found to present higher frequency of psychiatric symptoms and more pronounced functional impact. This study aimed at evaluating the frequency of neuropsychiatric symptoms in patients with early AD who present with impaired executive functioning. Methods. Thirty patients with early AD diagnosis were divided into a spared (SEF) and an impaired (IEF) executive functioning group according to their performance scores on neuropsychological tests. Their closest relatives or caregivers completed the Cambridge behavioral inventory (CBI), which assesses behavioral symptoms grouped into 13 categories. Results. A significant difference was exclusively found between SEF and IEF in terms of the frequency of stereotypies and repetitive motor behavior (U=60.5, P=.024). Conclusions. The presence of stereotypies could be associated with a dysexecutive profile in AD patients. These results shed light on the role of frontal circuitry in the expression of motor symptoms in AD and prompt for further research that will contribute to the differential diagnosis both of different subtypes of AD and other types of dementia.Ezequiel Gleichgerrcht, Anabel Chade, Teresa Torralva, María Roca, and Facundo ManesCopyright © 2011 Ezequiel Gleichgerrcht et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/708154/Obesity and ageing are both characteristics of the human population that are on the increase across the globe. It has long been established that ageing is the major risk factor for neurodegenerative conditions such as Alzheimer's disease, and it is becoming increasingly evident that obesity is another such factor. Leptin resistance or insensitivity has been uncovered as a cause of obesity, and in addition the leptin signalling system is less potent in the elderly. Taken together, these findings reveal that this molecule may be a link between neurodegeneration and obesity or ageing. It is now known that leptin has beneficial effects on both the survival and neurophysiology of the neurons that are lost in Alzheimer's disease suggesting that it may be an important research target in the quest for strategies to prevent, halt, or cure this condition.G. H. DohertyCopyright © 2011 G. H. Doherty. All rights reserved.http://www.hindawi.com/journals/cggr/2011/137492/Background. Relatively little is known about patient characteristics associated with doctor-patient interaction style and satisfaction with the medical visit. Objective. The primary study objectives are to assess: whether doctors interact in a more or less patient-centered style with elderly patients and whether patient age moderates the relationship between interaction style and satisfaction, that is, whether elderly patients are more or less satisfied with patient-centered medical encounters. Methods. We collected pre- and post-visit questionnaire data from 177 patients at a large family medicine clinic. We audiotaped the encounters between doctors and patients. Patient-centered interaction style was measured from coding from the audiotapes of the doctor-patient interactions. Patient satisfaction was measured using the Patient Satisfaction Questionnaire. Results. We found physicians were more likely to have patient-centered encounters with patients over age 65. We also found patient age moderated the association between interaction style and patient satisfaction: older patients were more satisfied with patient-centered encounters. Conclusion. Patient age is associated with style of interaction, which is, in turn, associated with patient satisfaction. Understanding the factors and processes by which doctors and patients interact has the potential to improve many facets of health care delivery.B. Mitchell PeckCopyright © 2011 B. Mitchell Peck. All rights reserved.http://www.hindawi.com/journals/cggr/2011/747094/Though popular, there is little agreement on what whole-body vibration (WBV) parameters will optimize performance. This study aimed to clarify the effects of age, sex, hertz and time on four physical function indicators in community-dwelling older adults (N=32). Participants were exposed to 2 min WBV per session at either 2 Hz or 26 Hz and outcome measures were recorded at 2, 20 and 40 min post-WBV. Timed get up-and-go and chair sit-and-reach performances improved post-WBV for both sexes, were significantly different between 2 Hz and 26 Hz treatments (P≤0.05) and showed statistically significant interactions between age and gender (P≤0.01). Counter movement jump and timed one-legged stance performances showed a similar but non-significant response to 2 Hz and 26 Hz treatments, though male subjects showed a distinct trended response. Age and gender should be statistically controlled and both 2 Hz and 26 Hz exert a treatment effect.Harold L. Merriman, C. Jayne Brahler, and Kurt JacksonCopyright © 2011 Harold L. Merriman et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/154246/Current US public policy decisions will have impact on national plans to care for the aging American baby boomer population over the next several decades. The recent health care legislative debate has been largely about the structure of health care for those still too young to be covered by Medicare, but the legislation may have important implications for the average rates of accumulating chronic illness and disability in midlife and influence the care needs for that cohort of individuals even after they become elderly.Neil J. NusbaumCopyright © 2011 Neil J. Nusbaum. All rights reserved.http://www.hindawi.com/journals/cggr/2011/673181/Studies of the psychological well-being of elderly living alone have yielded inconsistent results. Few investigators have distinguished living alone from loneliness in the same study. Thus, the present study examined the independent and interactive effects of living alone and loneliness on depressive symptoms (GDS score) and quality of life (SF-12 MCS score) in a prospective 2-year follow-up cohort study of 2808 community-dwelling older adults (aged ≥55 years) in Singapore, controlling for baseline covariates. In cross-sectional analysis, loneliness was a more robust predictor of GDS score than living arrangements; living alone, when controlled for loneliness, was not associated with GDS score. GDS score associated with living alone was worse for those who felt lonely than for those who did not feel lonely. Similar patterns of association were found in longitudinal analyses and for SF-12 MCS score, although not all were significant. Thus, though living alone predicted lower psychological well-being, its predictive ability was reduced when loneliness was taken into account and loneliness, a stronger predictor, worsened the psychological effects of living alone.Lena L. Lim and Ee-Heok KuaCopyright © 2011 Lena L. Lim and Ee-Heok Kua. All rights reserved.http://www.hindawi.com/journals/cggr/2011/316386/Effects of aging on memory and brain morphology were examined in aged, 21-month-old, and young, 4-month-old, Fischer 344 female rats. Spatial memory was assessed using the object placement task, and dendritic spine density was determined on pyramidal neurons in the hippocampus following Golgi impregnation. Consistent with previous studies, aged females showed poorer object placement performance than young subjects. Young subjects significantly discriminated the location of objects with a 1.5-hour intertrial delay while aged subjects did not. Spine density of basal dendrites on CA1 pyramidal cells was 16% lower in the aged subjects as compared to the young subjects. No differences in spine density were found between young and aged subjects in basal dendrites of CA1 or in either dendritic field of CA3 pyramidal neurons. Thus, decreased hippocampal CA1 dendritic spine density in aged rats may contribute to poorer spatial memory as compared to young rats. The possibility that the neuroplastic changes observed in this study may pertain only to female subjects having had a specific set of life experiences is discussed. Different factors, such as reproductive status, diet, and handling may contribute to neuroplasticity of the brain during aging; however, this view requires further examination.Victoria N. Luine, Maureen E. Wallace, and Maya FrankfurtCopyright © 2011 Victoria N. Luine et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/101276/Context. Little is known about the number and types of moves made in the last year of life to obtain healthcare and end-of-life support, with older adults more vulnerable to care setting transition issues. Research Objective. Compare care setting transitions across older (65+ years) and younger individuals. Design. Secondary analyses of provincial hospital and ambulatory database data. Every individual who lived in the province for one year prior to death from April 1, 2005 through March 31, 2007 was retained (N=19,397). Results. Transitions averaged 3.5, with 3.9 and 3.4 for younger and older persons, respectively. Older persons also had fewer ER and ambulatory visits, fewer procedures performed in the last year of life, but longer inpatient stays (42.7 days versus 36.2 for younger persons). Conclusion. Younger and older persons differ somewhat in the number and type of end-of-life care setting transitions, a matter for continuing research and healthcare policy.Donna M. Wilson, Jessica A. Hewitt, Roger Thomas, Deepthi Mohankumar, and Katharina Kovacs BurnsCopyright © 2011 Donna M. Wilson et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/979270/Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N=5641; 42.0% men; 15.5% black; 72.8±5.6 years) were followed 10.9 ± 4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG) ≥126 mg/dL. Peripheral artery disease (PAD) was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years) were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9) and BMI ≥25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7), but similar for BMI ≥30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78). PAD (HR = 1.25 (95% CI: 0.92–1.57)) and longer walk time (HR = 1.07 (95% CI: 1.04–1.10)) modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57)). Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.Elsa S. Strotmeyer, Aruna Kamineni, Jane A. Cauley, John A. Robbins, Linda F. Fried, David S. Siscovick, Tamara B. Harris, and Anne B. NewmanCopyright © 2011 Elsa S. Strotmeyer et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/651718/Seniors show deficits of dual-task walking when the second task has high visual-processing requirements. Here, we evaluate whether similar deficits emerge when the second task is discrete rather than continuous, as is often the case in everyday life. Subjects walked in a hallway, while foot proprioception was either perturbed by vibration or unperturbed. At unpredictable intervals, they were prompted to turn their head and perform a mental-rotation task. We found that locomotion of young subjects was not affected by this distracter task with or without vibration. In contrast, seniors moved their legs after the distraction at a slower pace through smaller angles and with a higher spatiotemporal variability; the magnitude of these changes was vibration independent. We conclude that the visual distracter task degraded the gait of elderly subjects but completely spared young ones, that this effect is not due to degraded proprioception, and that it rather might reflect the known decline of executive functions in the elderly.Otmar Bock and Rainer BeurskensCopyright © 2011 Otmar Bock and Rainer Beurskens. All rights reserved.http://www.hindawi.com/journals/cggr/2011/791765/Background. The low serum level of testosterone in the elderly subjects may contribute to coronary artery disease (CAD). Our aim is to study serum levels of free testosterone in elderly men with CAD. Subjects and Methods. This study was conducted on 100 elderly males with CAD, one half of them was presented with ACS (with mean age 69.6±2.44 year), and the other half was presented with stable CAD (with mean age 69.42±2.14 year), in addition to 50 apparently healthy elderly males (with mean age 69.06±1.64 year) as a control group. We detected the levels of serum free testosterone, cortisol, fibrinogen, plasminogen activator inhibitor-1(PAI-1), high sensitive C-reactive protein(hsCRP), interleukin-6(IL-6). Results. Cases with CAD had significant lower values of free testosterone and HDL-c, but they had significant higher values of cortisol, fibrinogen, PAI-1, IL-6, hsCRP, in comparison to control group. Cases with ACS had significant higher values of cortisol, hsCRP, IL-6, fibrinogen, PAI-1, total cholesterol and BMI more than those with stable CAD. The free testosterone had significant negative correlation with fibrinogen, PAI-1, hsCRP and IL-6 in both groups of patients. Conclusion. The lower value of serum free testosterone in elderly male subjects may contribute to CAD.Mohamed A. Helaly, Eid Daoud, and Noha El-MashadCopyright © 2011 Mohamed A. Helaly et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/175763/Men and women exhibit different gait patterns during customary walking and may respond differently to joint diseases. The present paper aims to identify gait patterns associated with knee-OA separately in men and women. Participants included 144 men and 124 women aged 60 years and older enrolled in the Baltimore Longitudinal Study of Aging (BLSA) who underwent gait testing at a self-selected speed. Both men and women with knee-OA had lower ankle propulsion mechanical work expenditure (MWE; P<.001 for both) and higher hip generative MWE (P<.001) compared to non-OA controls. Women with knee-OA had a higher BMI (P=.008), slower gait speed (P=.049), and higher knee frontal-plane absorbing MWE (P=.007) than women without knee-OA. These differences were not observed in men. Understanding sex-specific differences in gait adaptation to knee-OA may inform the development of appropriate strategies for early detection and intervention for knee-OA in men and women.Seung-uk Ko, Eleanor M. Simonsick, Liz M. Husson, and Luigi FerrucciCopyright © 2011 Seung-uk Ko et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/484713/The fragile X-associated tremor/ataxia syndrome (FXTAS) is a relatively common cause of balance problems leading to gait disturbances in older males (40%) with the premutation. FXTAS is less common in females. We utilized the CATSYS system, a quantitative measure of movement, in 23 women with FXTAS (mean age 62.7; SD 12.3), 90 women with the premutation without FXTAS (mean age 52.9; SD 9.4), and 37 controls (mean age 56.53; SD 7.8). CATSYS distinguished differences between carriers with and without FXTAS in postural tremor, postural sway, hand coordination, and reaction time tasks. Differences were also seen between carriers without FXTAS and controls in finger tapping, reaction time, and one postural sway task. However, these differences did not persist after statistical correction for multiple comparisons. Notably, there were no differences across groups in intention tremor. This is likely due to the milder symptoms in females compared to males with FXTAS.Vivien Narcisa, Dalila Aguilar, Danh V. Nguyen, Luis Campos, Jeffrey Brodovsky, Shana White, Patrick Adams, Flora Tassone, Paul J. Hagerman, and Randi J. HagermanCopyright © 2011 Vivien Narcisa et al. All rights reserved.http://www.hindawi.com/journals/cggr/2011/263507/Subcortical vascular dementia is a clinical entity, widespread, even challenging to diagnose and correctly treat. Patients with this diagnosis are old, frail, often with concomitant pathologies, and therefore, with many drugs in therapy. We tried to diagnose and follow up for three years more than 600 patients. Study subjects were men and women, not bedridden, aged 68–94 years, outpatients, recruited from June, 1st 2007 to June, 1st 2010. We examined them clinically, neurologically, with specific consideration on drug therapies. Our aim has been to define gait and imbalance problem, if eventually coexistent with the pathology of white matter and/or with the worsening of the deterioration. Drug intake interference has been detected and considered.Rita Moretti, Paola Torre, Rodolfo M. Antonello, Francesca Esposito, and Giuseppe BelliniCopyright © 2011 Rita Moretti et al. All rights reserved.http://www.hindawi.com/journals/cggr/2010/614814/The prevalence of excess body mass (XBM), poor oral health (POH), and stress in a secluded population of aged (≥60 years) Hmong immigrants was surveyed. The findings were related to the prevalence of diabetes in the same population. Diabetes was associated separately with POH (OR 2.4; CL 1.3, 4.2) or with XBM (OR 2.5; CL 1.4, 4.8). The association of diabetes with the combination of XBM and POH was striking (OR 5.1; CL 3.4, 7.5); that apparent synergism has not been fully appreciated. We describe a mechanism that explains the synergism. The concept of “thrifty genotype” is a plausible explanation of XBM in the elderly Hmong immigrants and possibly the current older Laotian population. POH is common among elderly Laotians as it is in most developing countries. We conclude that synergism of XBM and POH significantly elevates the prevalence of diabetes among aging populations and probably other age groups as well.Julia W. AlbrightCopyright © 2010 Julia W. Albright. All rights reserved.http://www.hindawi.com/journals/cggr/2010/340161/Many studies have demonstrated that social relationships confer mental health benefits. This paper aims to identify whether and how reciprocity in social relationships predicts or is associated with mental health benefits as well as with continuity in elderly people's social relationships. The studies reviewed in this paper show that, among elders, being in a balanced or underbenefited reciprocal position predicts better mental health and life quality than being in an overbenefited position. Throughout the course of life, reciprocity evens out present and earlier reciprocal imbalances, securing continuity in close relationships—particularly between spouses and between elderly parents and adult children. In friendships, securing continuity seems to be based on the maintenance of independence based on balanced reciprocal relations, making these relationships more vulnerable. Due to the problems of conceptualization and measurement in the reviewed studies, one should be cautious in stating a final conclusion that the reciprocity norm has a universal positive effect on mental health and continuity in elderly people's relationships.Live FyrandCopyright © 2010 Live Fyrand. All rights reserved.http://www.hindawi.com/journals/cggr/2010/127605/Background. Identifying the risk factors peculiar to each population has a great relevance, because it enables health policy formulators to analyze information accurately and by doing so, define objectives and action programs aimed at a qualitative and economically feasible solution to the problem. Thus, this study aimed at identifying the risk factors for survival in elderly in a city in the state of Rio Grande do Norte (RN), Brazil. Methods. A prospective study was carried out, where 310 elderly persons were selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. Statistical analysis was performed using bivariate analysis, survival analysis, followed by Cox regression in the multivariate analysis. Results. A total of 60 (19.3%) elderly individuals died during the follow-up. The survival mean was 24.8 months. In the Cox analysis, dependence in basic activities of daily living (HR = 3.55), cognitive deficit (HR = 4.22) and stroke (HR = 3.35) continued as independent risk factors for death. Discussion. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community.Álvaro Campos Cavalcanti Maciel and Ricardo Oliveira GuerraCopyright © 2010 Álvaro Campos Cavalcanti Maciel and Ricardo Oliveira Guerra. All rights reserved.http://www.hindawi.com/journals/cggr/2010/503817/Information about recent visual decline (RVD) and its consequences is limited. The aim was to investigate this in an observational, prospective study. Participants were recipients of community home services, ≥65 years, from Ontario (Canada, n=101618), Finland (the-RAI-database, STAKES, n=1103), and 10 other European countries (the-Aged-in-HOmeCarestudy (AdHOC), n=3793). The instrument RAI-HC version 2.0 was used in all sites. RVD was assessed by the item “Worsening of vision compared to status 90 days ago” and was present in 6–49% in various sites, more common among persons living alone, and in females. In the AdHOC sample, RVD was independently associated with declining social activity and limited outdoors activities due to fear of falling. The combination of stable vision impairment (SVI) and RVD was independently associated with IADL loss. RVD is common and has greater impact than SVI on social life and function. Caregivers should be particularly aware of RVD, its consequences, and help patients to seek assessments, treatment, and rehabilitation.Else Vengnes Grue, Harriet Finne-Soveri, Paul Stolee, Jeff Poss, Liv Wergeland Sörbye, Anja Noro, John P. Hirdes, and Anette Hylen RanhoffCopyright © 2010 Else Vengnes Grue et al. All rights reserved.http://www.hindawi.com/journals/cggr/2010/348174/Lung cancer is the leading cause of cancer-related mortality in both men and women and approximately 219,440 new cases of nonsmall cell lung cancer (NSCLC) were estimated to occur in the USA in 2009, which caused 159,390 NSCLC-related deaths. More than 50% of cases of advanced NSCLC are diagnosed in patients older than age 65, and recent Surveillance Epidemiology and End Results (SEERs) data suggest that the median age at diagnosis is 70 years. Until recently, the disease has been undertreated in this patient population, with a perception among many clinicians that elderly patients do not tolerate chemotherapy or radiotherapy. So, single agent chemotherapy is the recommended approach by the ASCO and International Expert Panels in unselected patients. The introduction of novel targeted therapies, such as Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitors (TKIs) which improved survival versus placebo in patients who had previously failed on chemotherapy, gives clinicians new, effective, and better tolerated options to consider when treating NSCLC in elderly patients. This paper describes the advances of EGFR TKIs for elderly patients with advanced NSCLC.F. Meriggi and A. ZaniboniCopyright © 2010 F. Meriggi and A. Zaniboni. All rights reserved.http://www.hindawi.com/journals/cggr/2010/915296/Background. Cardiovascular disease is the principal cause of mortality in older individuals, and more than 80% of deaths due to coronary heart disease or stroke occur in patients over 65 years of age. Hyperlipidemia is one of the main modifiable risk factors for cardiovascular disease. Current guidelines recommend the use of statins to reduce low-density lipoprotein cholesterol to appropriate targets based on an individual's cardiovascular risk, and clearly state that older age should not be a barrier to treatment. Despite extensive evidence demonstrating clear benefit with statin therapy in older individuals, this population remains chronically undertreated. Scope. This paper provides an overview of the current evidence available regarding the efficacy and safety of statin therapy to reduce cardiovascular risk in older patients. We use hypothetical case studies to address some of the questions frequently posed by physicians responsible for the cardiovascular health of older patients. Conclusions. Various factors may account for the failure to provide appropriate treatment, including a lack of awareness of clinical benefits and perceived safety issues. However, if current guidelines are followed and older patients treated to appropriate LDL-C goals, the likelihood of cardiovascular events will be reduced in this high-risk population. Employing an evidence-based approach to the management of cardiovascular risk in older patients is likely to yield benefits in terms of overall cardiovascular burden.N. K. Wenger and S. J. LewisCopyright © 2010 N. K. Wenger and S. J. Lewis. All rights reserved.http://www.hindawi.com/journals/cggr/2010/701897/The purpose of this study was to investigate whether age-related differences in stepping response influence postural control when stepping onto a known soft surface under dual task conditions. Nine young and eleven older female adults participated. First, they stepped on a flat surface while grasping an empty cup (single task), and then they repeated the task while grasping a cup filled with water (dual task). For the second experiment, they stepped on a soft surface placed in front of them while performing the above tasks. The main result was that %DIP (initiation phase as a percentage of the total stepping task time) was significantly higher for older than for young adults during the dual task on the soft surface. In conclusion, caution due to previous experience may increase attentional demand during dual tasks and lengthen the time required for central nervous processing in order to avoid losing postural stability in older adults, resulting in reductions in step velocity and step length compared to those in young adults.Nobuko Harada, Shuichi Okada, and Shinya NegoroCopyright © 2010 Nobuko Harada et al. All rights reserved.http://www.hindawi.com/journals/cggr/2010/510614/Executive function (EF) is believed to control or influence the integration and application of cognitive functions such as attention and memory and is an important area of research in cognitive aging. Recent studies and reviews have concluded that there is no single test for EF. Results from first-order latent variable modeling have suggested that little, if any, variability in cognitive performance can be directly (and uniquely) attributed to EF; so instead, we modeled EF, as it is conceptualized, as a higher-order function, using elements of the CERAD neuropsychological battery. Responses to subtests from two large, independent cohorts of nondemented elderly persons were modeled with three theoretically plausible structural models using confirmatory factor analysis. Robust fit statistics, generated for the two cohorts separately, were consistent and support the conceptualization of EF as a higher-order cognitive faculty. Although not specifically designed to assess EF, subtests of the CERAD battery provide theoretically and empirically robust evidence about the nature of EF in elderly adults.Rochelle E. Tractenberg, Gerda Fillenbaum, Paul S. Aisen, David E. Liebke, Futoshi Yumoto, and Maragatha N. KuchibhatlaCopyright © 2010 Rochelle E. Tractenberg et al. All rights reserved.http://www.hindawi.com/journals/cggr/2010/420139/Although cardiovascular diseases are less prevalent in premenopausal women than in men, their occurrence in women increases at the onset of menopause, and the loss of female sex hormones contributes to the striking increase in cardiovascular morbidity and mortality in postmenopausal women. We present here a description of age-related disruption of lipid homeostasis, which particularly affects 3-hydroxy 3-methylglutaryl Coenzyme A reductase, the key rate-limiting enzyme in the cholesterol biosynthetic pathway. We further discuss the age- and gender-related dysregulation of this enzyme, providing new evidence for the different mechanisms driving dyslipidemia in elderly men and women. In addition, we introduce pharmacological methods of regulating HMGR and maintaining cholesterol homeostasis.Laura Trapani and Valentina PallottiniCopyright © 2010 Laura Trapani and Valentina Pallottini. All rights reserved.http://www.hindawi.com/journals/cggr/2010/219683/Cholesterol is an essential molecule for brain homeostasis; yet, hypercholesterolemia and its numerous complications are believed to play a role in promoting multiple aspects of brain pathogenesis. An ever increasing number of individuals in modern Western Society are regularly consuming diets high in fat which promote the development of hypercholesterolemia. Additionally, modern societies are becoming increasingly aged, causing a collision between increased hypercholesterolemia and increased aging, which will likely lead to the development of increased pathological conditions due to hypercholesterolemia, thereby promoting deleterious neurochemical and behavioral changes in the brain. Lastly, while beneficial in controlling cholesterol levels, the long-term use of statins itself may potentially promote adverse effects on brain homeostasis, although specifics on this remain largely unknown. This review will focus on linking the current understanding of diet-induced hypercholesterolemia (as well as statin use) to the development of oxidative stress, neurochemical alterations, and cognitive disturbances in the aging brain.Romina M. Uranga and Jeffrey N. KellerCopyright © 2010 Romina M. Uranga and Jeffrey N. Keller. All rights reserved.