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Current Gerontology and Geriatrics Research publishes research based on molecular, cellular, organismal aspects of gerontological research and in diagnosis, treatment, evaluation and educational aspects of geriatrics research.
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The Utility of Psoas Muscle Assessment in Predicting Frailty in Patients Undergoing Transcatheter Aortic Valve Replacement
Background. The rise in an ageing population has resulted in an increase in the prevalence of aortic stenosis. With the advent and rapid expansion in the use of transcatheter aortic valve replacements (TAVRs), patients with severe aortic stenosis, traditionally thought too high risk for surgical intervention, are now being treated with generally favourable results. Frailty is an important factor in determining outcome after a TAVR, and an assessment of frailty is fundamental in the identification of appropriate patients to treat. Objective. The objective of the study was to identify if the psoas muscle area is associated with frailty in TAVR patients and outcome after intervention. Method. In this prospective study, we measured outcomes of 62 patients who underwent TAVR procedures against the psoas muscle area and the Reported Edmonton Frail Scale (REFS). Our aim was to assess if psoas muscle assessment can be used as a simple method to predict frailty in our population group. Results. A total of 60 patients met the study criteria. Mean psoas-lumbar vertebral index was 0.61, with a lower value in the frail group. There was not a statistically significant correlation between the psoas measures, REFS score (indicative of frailty), and mortality. However, there was a statistically significant relationship between the psoas size and REFS score (). Conclusion. Psoas assessment can be useful in providing additional information when planning for patients to undergo a TAVR and can be used as a screening tool to help identify frail patients within this high-risk group.
Delayed Disclosure of HIV Status and Lack of Resources Affect Older Persons during Care of Adult Family Members with AIDS-Related Illness in Rural Mpumalanga, South Africa
Purpose. This paper examines the older persons’ knowledge of HIV and AIDS and explores the effect of delayed disclosure of HIV status and lack of resources during care. Methods. The study site was health facilities in Thembisile Hani subdistrict, Mpumalanga Province, South Africa. Older persons aged 60 years and above were selected using purposive sampling for in-depth interviews. Thematic analysis was used to analyse the data. Results. Providing physical care to sick adults is labour intensive for the already weak older persons. They undertake the caring role within constraints arising from lack of resource such as gloves, diapers, and soap with which to perform the caring role. Taking care of the sick needed resources for specialized care and money for transport to the health facilities. This put a strain on the finances and rendered the older persons food insecure. Furthermore, disclosure of HIV status was delayed, and some older persons cared for the sick adult children without knowing that they were HIV-infected and had AIDS-related illnesses. The nondisclosure of their HIV status by the sick prevented them from taking precautionary measures to prevent the risk of infection during the provision of care. This was heightened by the limited knowledge of HIV/AIDS of the older persons. Conclusion. Older persons undertake the caring role with diligence under trying conditions due to lack of resources and the nondisclosure of HIV status of the adult children they take care of. Healthcare workers should educate older persons to take preventive precautionary measures when caring for family members even when there is no suspicion of HIV infection. In addition, access to the incapacity grants provided for individuals sick with AIDS-related illnesses could relieve the older persons from financial constraints.
Carotid Disease and Ageing: A Literature Review on the Pathogenesis of Vascular Senescence in Older Subjects
Aging is a natural process that affects all systems of the human organism, leading to its inability to adapt to environmental changes. Advancing age has been correlated with various pathological conditions, especially cardiovascular and cerebrovascular diseases. Carotid artery (CA) is mainly affected by age-induced functional and morphological alterations causing atheromatous disease. The evolvement of biomedical sciences has allowed the elucidation of many aspects of this condition. Symptomatic carotid disease (CD) derives from critical luminar stenosis or eruption of an atheromatous plaque due to structural modifications of the vessels, such as carotid intima-media thickening. At a histologic level, the aforementioned changes are mediated by elastin fragmentation, collagen deposition, immune cell infiltration, and accumulation of cytokines and vasoconstrictors. Underlying mechanisms include chronic inflammation and oxidative stress, dysregulation of cellular homeostatic systems, and senescence. Thus, there is an imbalance in components of the vessel wall, which fails to counteract exterior stress stimuli. Consequently, arterial relaxation is impaired and atherosclerotic lesions progress. This is a review of current evidence regarding the relationship of aging with vascular senescence and CD. A deeper understanding of these mechanisms can contribute to the production of efficient prevention methods and targeted therapeutic strategies.
Sarcopenia: Influence of Regional Skeletal Muscle Cutoff Points and Fat-Free Mass in Older Mexican People—A Pilot Study
Background. Variation in the prevalence of sarcopenia is related to the skeletal muscle index cutoff points applied. The objective of this pilot study was to examine the recruitment process for testing different sarcopenia definitions (ASMI cutoffs) in older Mexican adults. It explored whether the prevalence of sarcopenia decreased by applying ethnic- and gender-specific, DXA-derived appendicular skeletal muscle index (ASMI)-cutoff points in the definitions, as well as some associated factors in a sample of community-dwelling older Mexican people. Methods. This is a pilot feasibility study that included a convenience sample of 217 community-dwelling older adults. Volunteers underwent DXA measurements and an assessment of functional status based on hand grip strength and physical performance. Six definitions were formed based on the 2010 EWGSOP criteria, but using different cutoff points for each of the three components, including regional cutoff points for ASMI derived from young Mexican adults. Several risk factors for sarcopenia were also assessed. Results. The prevalence of sarcopenia varied according to the different definitions applied. The lowest level was found with the definition that applied regional ASMI-cutoff points (). The sarcopenic older adults had significant lower body weight, fat mass, and fat-free mass (FFM) than the nonsarcopenic subjects. The risk of sarcopenia increased with age and low FFM (). Conclusion. The present study demonstrates the feasibility of the main study, and our data support the notion that using regional ASMI cutoff points resulted in a low prevalence of sarcopenia. Therefore, it is preferable to estimate the prevalence of this condition using ethnic- and gender-specific cutoff points and to explore associated factors such as low FFM.
Serum Levels of Matrix Metalloproteinase-1 in Brazilian Patients with Benign Prostatic Hyperplasia or Prostate Cancer
Metalloproteinases (MMPs) are involved in metastatic tumor processes, with changes in circulating levels detected in several cancer types. Here, we compare serum concentrations of metalloproteinase-1 (MMP-1) across individuals clinically diagnosed with prostate cancer (PCa) or benign prostatic hyperplasia (BPH), correcting results for the rs495366 single nucleotide polymorphism (SNP) that predisposes to differential MMP-1 levels. 196 men aged ≥50 years were followed at a university hospital urology outpatient clinic, with clinical, anthropometric, and rectal examinations performed by one urologist. Blood samples obtained prior to any clinical intervention provided baseline MMP-1 and total/free PSA levels as well as metabolic, hormonal, and inflammatory markers. The SNP was genotyped by real-time PCR. Participants with medical and/or laboratory profile compatible with malignancy composed the PCa group when confirmed by the Gleason scale. As expected, A-allele homozygotes showed reduced levels of MMP-1. Genotype-adjusted analyses revealed the mean MMP-1 level as 2-fold higher in PCa carriers compared to BPH patients. No other differences were found according to the prostatic condition or genotypic distribution, except for the expected raise in total and free PSA levels in PCa. In conclusion, increased serum levels of MMP-1 were observed in this context of prostatic malignancy compared to a benign phenotype, regardless of a genetic influence.
Prevalence of Geriatric Syndromes in Elderly Cancer Patients Receiving Chemotherapy
The number of elderly patients with cancer is growing. Our study goals were to determine the prevalence of geriatric syndromes in elderly cancer patients receiving chemotherapy and its related factors using a basic geriatric screening tool. A cross-sectional study using the basic geriatric screening tool was conducted to survey geriatric problems in a population of elderly cancer patients receiving chemotherapy. There were 85 participants who were ≥60 years old. Descriptive statistics and regression analyses were used. The prevalence of having at least one geriatric syndrome was 58.8% (50 out of 85 cases). Depression was the most common component both in male and female patients. Age ≥65 years old was significantly associated with the geriatric syndrome (AOR 4.23, ), and a factor associated with depression was underweight (BMI<18.5 kg/m2) (AOR 13.2, ). In summary, geriatric syndromes are common in elderly cancer patients. Screening for geriatric syndrome adds substantial data on the assessment of elderly cancer patients, even those with a good performance status.