Peggy Series

The purpose of this article is to review steatosis and fibrosis of skeletal muscle, focusing on older adults. Although CT, MRI, and ultrasound are commonly used to image skeletal muscle and provide diagnoses for a variety of medical conditions, quantitative assessment of muscle steatosis and fibrosis is uncommon. This review provides radiologists with a broad perspective on muscle steatosis and fibrosis in older adults by considering their public health impact, biologic mechanisms, and evaluation using CT, MRI, and ultrasound...

BACKGROUND: The Pittsburgh Performance Fatigability Index (PPFI) quantifies the percent decline in cadence using accelerometry during standardized walking tasks. Although PPFI has showed strong correlations with physical performance measures, the developmental sample was relatively homogenous and small, necessitating further validation. METHODS: Participants from the Study of Muscle, Mobility and Aging (N=805, age=76.4±5.0 years, 58% women, 85% white) wore an ActiGraph GT9X on non-dominant wrist during usual-paced 400m walk...

BACKGROUND: Vestibular migraine (VM) is a common cause of dizziness that is underrecognized, underdiagnosed, and challenging to effectively treat. The prevalence, appropriate diagnostic workup, and therapies for VM in low- and lower-middle-income countries (LLMICs) remain understudied. The objective of this scoping review is to evaluate the current state of VM research in LLMICs. METHODS: PubMed, Embase, and Web of Science databases were searched to execute a scoping review of VM...

BACKGROUND: The Health, Aging and Body Composition (Health ABC) Study is a longitudinal cohort study started just over 25 years ago. This ground-breaking study tested specific hypotheses about the importance of weight, body composition and weight-related health conditions for incident functional limitation in older adults. METHODS: Narrative review with analysis of ancillary studies, career awards, publications and citations. RESULTS: Key findings of the study demonstrated the importance of body composition as a whole, both fat and lean mass, in the disablement pathway...

BACKGROUND: Recent operational definitions of sarcopenia have not been replicated and compared in Australian and New Zealand (ANZ) populations. We aimed to identify sarcopenia measures that discriminate ANZ adults with slow walking speed (<0.8 m/s) and determine agreement between the Sarcopenia Definitions and Outcomes Consortium (SDOC) and revised European Working Group for Sarcopenia in Older People (EWGSOP2) operational definitions of sarcopenia. METHODS: Eight studies comprising 8,100 ANZ community-dwelling adults (mean age±standard deviation 62...

BACKGROUND: Medical aid in dying (MAID) is legal in a number of countries, including some states in the U.S. While MAID is only permitted for terminal illnesses in the U.S., some other countries allow it for persons with psychiatric illness. Psychiatric MAID, however, raises unique ethical concerns, especially related to its effects on mental illness stigma and on how persons with psychiatric illnesses would come to feel about treatment and suicide. To explore those concerns, we conducted several focus groups with persons with lived experience of mental illness...

BACKGROUND: Several candidate molecules that may have application in treating physical limitations associated with aging and chronic diseases are in development. Challenges in the framing of indications, eligibility criteria, and endpoints and the lack of regulatory guidance have hindered the development of function-promoting therapies. METHODS: Experts from academia, pharmaceutical industry, National Institutes of Health (NIH), and Food and Drug Administration (FDA) discussed optimization of trial design including the framing of indications, eligibility criteria, and endpoints...

INTRODUCTION: Fluvoxamine is widely used to treat depression during pregnancy and lactation. However, limited data are available on its transfer to the fetus or in human milk. This case series provides additional information on the infant exposure to fluvoxamine during pregnancy and lactation. CASE PRESENTATION: Two women, aged 38 and 34 years, diagnosed with depression were treated with 50 mg fluvoxamine during pregnancy and lactation. At delivery a paired maternal and cord blood sample was collected for each woman...

Recently, a number of predictive coding models have been proposed to account for post-traumatic stress disorder (PTSD)'s symptomatology, including intrusions, flashbacks and hallucinations. These models were usually developed to account for traditional/type-1 PTSD. We here discuss whether these models also apply or can be translated to the case of complex/type-2 PTSD and childhood trauma (cPTSD). The distinction between PTSD and cPTSD is important because the disorders differ in terms of symptomatology and potential mechanisms, how they relate to developmental stages, but also in terms of illness trajectory and treatment...

BACKGROUND: Myostatin, a cytokine produced by skeletal muscle, may influence Alzheimer's Disease (AD) pathogenesis, but sparse evidence exists in humans. We assessed the association between circulating levels of myostatin at year 1 and plasma levels of β-amyloid 42/40 at year 2, a marker of AD pathology, in a biracial cohort of older adults. METHODS: We studied 403 community-dwelling older adults enrolled in the Health, Aging and Body Composition Study from Memphis, Tennessee, and Pittsburgh, Pennsylvania...

INTRODUCTION/AIMS: In amyotrophic lateral sclerosis (ALS) caused by superoxide dismutase 1 (SOD1) gene mutations (SOD1-ALS), the antisense oligonucleotide tofersen had been investigated in a phase 3 study (VALOR) and subsequently introduced in an expanded access program. This study assesses neurofilament light chain (NfL) before and during tofersen treatment. METHODS: In six SOD1-ALS patients treated with tofersen at three specialized ALS centers in Germany, NfL in cerebrospinal fluid (CSF-NfL) and/or serum (sNfL), the ALS Functional Rating Scale-Revised (ALSFRS-R), and ALS progression rate (ALS-PR), defined by monthly decline of ALSFRS-R, were investigated...

BACKGROUND: Mechanisms underlying the associations between changes in the urban environment and changes in health-related outcomes are complex and their study requires specific approaches. We describe the protocol of the interdisciplinary UrbASanté study, which aims to explore how urban interventions can modify environmental exposures (built, social, and food environments; air quality; noise), health-related behaviors, and self-reported health using a natural experiment approach...

By combining advantages of two series of lanthanide(III)/zinc(II) metallacrowns (MCs) assembled using pyrazine- (pyzHA2-) and quinoxaline- (quinoHA2-) hydroximate building blocks ligands, we created here water-soluble mixed-ligand MCs with extended absorption to the visible range. The YbIII analogue demonstrated improved photophysical properties in the near-infrared (NIR) range in cell culture media, facilitating its application for NIR optical imaging in living HeLa cells.

BACKGROUND: Parkinson's disease (PD) increases risk for dementia and cascading adverse outcomes. The eight-item Montreal Parkinson Risk of Dementia Scale (MoPaRDS) is a rapid, in-office dementia screening tool. We examine predictive validity and other characteristics of the MoPaRDS in a geriatric PD cohort by testing a series of alternative versions and modelling risk score change trajectories. METHODS: Participants were 48 initially non-demented PD patients (Mage = 71...

BACKGROUND: Converging evidence suggests that a subgroup of bipolar disorder (BD) with an early age at onset (AAO) may develop from aberrant neurodevelopment. However, the definition of early AAO remains unprecise. We thus tested which age cut-off for early AAO best corresponds to distinguishable neurodevelopmental pathways. METHODS: We analyzed data from the FondaMental Advanced Center of Expertise-Bipolar Disorder cohort, a naturalistic sample of 4421 patients...

BACKGROUND: Falls occur annually in 25% of adults aged ≥65 years. Fall-related injuries are increasing, highlighting the need to identify modifiable risk factors. METHODS: Role of fatigability on prospective, recurrent, and injurious fall risk was examined in 1,740 men aged 77-101 years in the MrOS Study. The 10-item Pittsburgh Fatigability Scale (PFS) measured perceived physical and mental fatigability (0-50/subscale) at Year 14 (2014-2016); established cut-points identified men with more severe perceived physical (≥15, 55...

INTRODUCTION: This study aimed to identify how perinatal health workers, especially midwives, explained US Black maternal mortality and morbidity and what ameliorative measures they suggested across categories of primary social determinants, health care access, and provider practices. METHODS: Using a mixed closed-ended and open-ended researcher-designed exploratory survey, 227 perinatal health workers responded to a series of questions probing views of causation and strategies for improvement...

BACKGROUND: The Study of Muscle, Mobility and Aging (SOMMA) aims to understand the biological basis of many facets of human aging, with a focus on mobility decline, by creating a unique platform of data, tissues, and images. METHODS: The multidisciplinary SOMMA team includes two clinical centers (University of Pittsburgh and Wake Forest University), a biorepository (Translational Research Institute at Advent Health), and the San Francisco Coordinating Center (California Pacific Medical Center Research Institute)...

BACKGROUND: In contrast to dual X-ray absorptiometry (DXA), the D3-creatine (D3Cr) dilution method provides a direct measure of skeletal muscle mass and in a cohort of older men has been strongly associated with health-related outcomes. However, sensitivity to detect changes in D3Cr derived muscle mass due to an intervention is limited. METHODS: Twenty-one older adults (≥70 yrs.) with low-to-moderate physical function were randomized to a 15-week high-intensity strength training (ST) or a health education (HE) group...

BACKGROUND: Based on studies from animal models, growth differentiation factor-11 (GDF-11) may have rejuvenating effects in humans. GDF-11 has high sequence homology with GDF-8 (also known as myostatin); follistatin, and follistatin like 3 protein (FSTL3) are inhibitory proteins of both GDF-8 and GDF-11. METHODS: Using highly specific LC-MS/MS assays for GDF-11 and GDF-8 and immunoassays for follistatin and FSTL3, we quantified the association of these factors with muscle size, strength and physical performance in two prospective cohort studies of community-dwelling older adults (Health ABC and CHS)...