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Ricardo Taipa, Vitor Ferreira, Paulo Brochado, Andrew Robinson, Inês Reis, Fernanda Marques, David M Mann, Manuel Melo Pires, Nuno Sousa
AIMS: The association between the pathological features of AD and dementia is stronger in younger old persons than in older old persons suggesting that additional factors are involved in the clinical expression of dementia in the oldest old. Cumulative data suggests that neuroinflammation plays a prominent role in Alzheimer's disease (AD) and different studies reported an age-associated dysregulation of the neuroimmune system. Consequently, we sought to characterize the pattern of microglial cell activation and astrogliosis in brain post-mortem tissue of pathologically confirmed cases of early and late onset AD (EOAD and LOAD) and determine their relation to age...
October 17, 2017: Neuropathology and Applied Neurobiology
Bo Abrahamsen
Managing osteoporosis and preventing hip fractures in the oldest old remains a challenge surrounded by controversy and strong opinions. This is understandable given the paucity of randomized controlled trial (RCT) data in patients aged 80 years and above [1], the legitimate concerns that efficacy would disappoint given the multiple comedications and comorbid conditions that are prevalent in many of the oldest osteoporosis patients, and the probability that adverse effects would be more common and more severe in this age group...
October 14, 2017: Journal of Internal Medicine
Bert Vaes, David Depoortere, Gijs Van Pottelbergh, Catharina Matheï, Joana Neto, Jan Degryse
BACKGROUND: To date, there is no consensus regarding cardiovascular risk management in the very old. Studies have shown that the relationship between traditional cardiovascular risk factors and mortality is null or even inverted within this age group. This relationship could be modified by the presence of frailty. This study was performed to examine the effect of frailty on the association between cardiovascular risk factors and mortality in the oldest old. METHODS: The BELFRAIL study is a prospective, observational, population-based cohort study of 567 subjects aged 80 years and older...
October 12, 2017: BMC Geriatrics
Somayeh Rostamian, Mark A van Buchem, J Wouter Jukema, Jacobijn Gussekloo, Rosalinde K E Poortvliet, Anton J M de Cren, Behnam Sabayan
Background: Impairment in orientation to time and place is commonly observed in community-dwelling older individuals. Nevertheless, the clinical significance of this has been not fully explored. In this study, we investigated the link between performance in orientation domains and future risk of cardiovascular events and mortality in a non-hospital setting of the oldest old adults. Methods: We included 528 subjects free of myocardial infarction (Group A), 477 individuals free of stroke/transient ischemic attack (Group B), and 432 subjects free of both myocardial infarction and stroke/transient ischemic attack (Group C) at baseline from the population-based Leiden 85-plus cohort study...
2017: Frontiers in Aging Neuroscience
Louise M Lavrencic, Connor Richardson, Stephanie L Harrison, Graciela Muniz-Terrera, Hannah A D Keage, Katie Brittain, Thomas B L Kirkwood, Carol Jagger, Louise Robinson, Blossom C M Stephan
Background: The oldest-old (aged ≥85 years) are the fastest growing age group, with the highest risk of cognitive impairment and dementia. This study investigated whether cognitive reserve applies to the oldest-old. This has implications for cognitive interventions in this age group. Methods: Baseline and 5-year follow-up data from the Newcastle 85+ Study were used (N = 845, mean age = 85.5, 38% male). A Cognitive Reserve Index (CRI) was created, including: education, social class, marital status, engagement in mental activities, social participation, and physical activity...
July 22, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Manuel Serrano-Alarcón, Julian Perelman
BACKGROUND: In a context of population ageing, it is a priority for planning and prevention to understand the socioeconomic (SE) patterning of functional limitations and its consequences on healthcare needs. This paper aims at measuring the gender and SE inequalities in functional limitations and their age of onset among the Southern European elderly; then, we evaluate how functional status is linked to formal and informal care use. METHODS: We used Portuguese, Italian and Spanish data from the Survey of Health, Ageing and Retirement in Europe (SHARE) of 2011 (n = 9233)...
October 3, 2017: International Journal for Equity in Health
Lucia Tortorella, Giuseppe Vizzielli, Domenico Fusco, William C Cho, Roberto Bernabei, Giovanni Scambia, Giuseppe Colloca
Ovarian cancer is the most common cause of death from gynecological cancers in developed countries. It is a common disease of older women at or above 63 years upon diagnosis. Thanks to advance in new treatments, mortality from ovarian cancer has declined in developed countries in the last decade. This decline in mortality rate is unevenly distributed across the age-spectrum. While mortality in younger women has decreased 21.7%, for elderly women it has declined only 2.2%. Even if ovarian cancer is clearly a disease of the elderly, older women are underrepresented in clinical trials, and scant evidence exists for the treatment of women older than 80 years...
October 2017: Aging and Disease
Daniela Brandão, Alberto Freitas, Constança Paúl, Oscar Ribeiro
BACKGROUND: Mental health problems have been reported as one of the principal causes of incapacity and morbidity. According to the World Health Organization approximately 15% of adults aged 60+ and over suffer from a mental disorder. In the oldest old population, a higher deterioration in the mental state is expected, which is ought to increase the risk of incidence of mental problems and use of healthcare services. The aim of this study is to examine inpatient episodes with a mental disorder coded as primary discharge diagnosis between 2000 and 2014 by patients aged 80+ in Portugal mainland...
October 2, 2017: International Psychogeriatrics
Eric M Vogelsang
Background and Objectives: Although the majority of individuals in their 80s or 90s do not experience improving health, a significant portion of this age group either (a) subjectively assess their health as improving; or (b) demonstrate self-rated health improvements when comparing consecutive surveys. While there is a body of research that examines self-rated health declines in older ages, much less work has studied possible determinants of self-rated health improvements. This is important, since there is increasing evidence that oldest-old adults have unique health evaluative processes that are not yet well-understood...
September 8, 2017: Gerontologist
Eamon Laird, Aisling M O'Halloran, Daniel Carey, Martin Healy, Deirdre O'Connor, Patrick Moore, Tom Shannon, Anne M Molloy, Rose Anne Kenny
Background: Few data are available examining the determinants of vitamin D status exclusively in older adults. We aimed to investigate the prevalence and determinants of vitamin D deficiency in a representative sample of the older Irish population (aged 50 - 98 y). Methods: The concentration of 25-hydroxyvitamin D (25(OH)D) was measured in 5,356 community-dwelling older Irish adults from The Irish Longitudinal Study on Ageing (TILDA). Detailed demographic, geographic, lifestyle and socio-economic factors were assessed by questionnaire...
September 2, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Bu B Yeap, Laurens Manning, S A Paul Chubb, David J Handelsman, Osvaldo P Almeida, Graeme J Hankey, Leon Flicker
CONTEXT: Sex hormone trajectories in ageing men and their health implications remain unclear. We examined longitudinal trajectories and associations of testosterone (T), dihydrotestosterone (DHT), oestradiol (E2), luteinizing hormone (LH) and sex hormone-binding globulin (SHBG) in oldest old men. DESIGN: Prospective cohort study. PARTICIPANTS: We studied 1025 community-dwelling men median age 75.1 years at baseline with 8.6 years of follow-up...
September 25, 2017: Clinical Endocrinology
Alessandra Regina Silva Araujo Aguiar, Giane Amorim Ribeiro-Samora, Leani Souza Maximo Pereira, Larissa Birro Godinho, Marcella Guimarães Assis
BACKGROUND: The increase in the older adult and oldest old population in Brazil is growing. This phenomenon may be accompanied by an increase in musculoskeletal symptoms such as low back pain. This condition is usually associated with disability. OBJECTIVE: To verify the association between pain intensity and disability in older adults with acute low back pain and assess whether these variables differ depending on the age group and marital status. METHODS: This is a cross-sectional study conducted with 532 older adults with acute low back pain episodes...
September 2017: Brazilian Journal of Physical Therapy
Ching-Chi Lee, Jiun-Ling Wang, Chung-Hsun Lee, Yuan-Pin Hung, Ming-Yuan Hong, Chia-Ming Chang, Wen-Chien Ko
To understand the epidemiological variation in bacteremia characteristics among differently aged populations, adults with community-onset bacteremia during a 6-year period were studied in a retrospective cohort. A total of 2,349 bacteremic patients were stratified into four age categories: young adults (18-44 years old; 196 patients, 8.3%), adults (45-64; 707, 30.1%), the elderly (65-84; 1,098, 46.7%), and the oldest old (≥ 85; 348, 14.8%). Age-related trends in critical illness (a Pitt bacteremia score ≥ 4) at bacteremia onset, antibiotic-resistant pathogens (ESBL-producing Escherichia coli, Klebsiella species, and Proteus mirabilis [EKP]; methicillin-resistant Staphylococcus aureus [MRSA]; and levofloxacin non-susceptible EKP), inappropriate empirical antibiotic therapy (EAT), and 4-week mortality rate were observed...
September 18, 2017: Antimicrobial Agents and Chemotherapy
David C Currow, Jane Phillips, Meera Agar
PURPOSE OF REVIEW: Health service planning requires demographic, clinical, and health systems data and is unique to each health system. Planning for palliative care in older people must include patients and their carers. This review explores literature from the last 24 months. RECENT FINDINGS: The proportion of people living in skilled nursing facilities is increasing and many residents require quality palliative care. Simultaneously, the complexity of care for older people is also increasing...
September 16, 2017: Current Opinion in Supportive and Palliative Care
Y He, F X Luan, Y Yao, S S Yang, H G Xie, J Li, M Liu, J H Wang, L Wu, Q Zhu, X P Chen, C X Ning, L N Wang, X Y Li, S B Zhang, F Zhang, Y L Zhao
Objective: To investigate the health status, functional ability, mental psychology, health care and other longevity-related characteristics of individuals aged ≥100 years as well as risk factors in Hainan province, China. Methods: China Hainan Centenarian Cohort Study (CHCCS) is a community-based, prospective cohort study to establish multi-dimensional database consisting of questionnaire findings, anthropometric parameters and biological specimens as well as imaging features. With the household registration information provided by the Department of Civil Affairs of Hainan province, a baseline survey was conducted in centenarians in 18 counties in Hainan with the oldest old in 5 counties as controls between 2014 and 2017...
September 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Daniela Brandão, Óscar Ribeiro, Constança Paúl
INTRODUCTION: The ageing of populations is evident in most developed countries, and the oldest old group is one of the segments with the fastest growing. The aim of this paper is to examine sociodemographic and health related characteristics of the portuguese oldest old, using a census-based approach. MATERIAL AND METHODS: A descriptive study considering all residents aged 80 years and older at the time of the 2011 Census (n = 532 219) was conducted. Information on sociodemographic characteristics, sensory functions (seeing, hearing), functional status (walking/climbing stairs, bathing/dressing alone), cognition (memory/concentration), and communication (understanding others/being understood) as assessed by the Portuguese census official questionnaires were analyzed...
June 30, 2017: Acta Médica Portuguesa
Paola Forti, Fabiola Maioli, Elisabetta Magni, Letizia Regazzoni, Roberto Piperno, Marco Zoli, Maura Coveri, Gaetano Procaccianti
OBJECTIVE: To investigate whether oldest-old age (≥85 yr) is an independent predictor of exclusion from stroke rehabilitation. DESIGN: Retrospective cohort study. SETTING: Stroke Unit (SU) of an Italian tertiary hospital. PARTICIPANTS: 1055 elderly patients (age 65-74 yr, n=230; age, 75-84 yr, n=432; age ≥ 85 yr, n=393), who, between 2009 and 2012, were admitted to SU with acute stroke and evaluated by a multiprofessional team for access to rehabilitation...
September 7, 2017: Archives of Physical Medicine and Rehabilitation
Elena Dragioti, Britt Larsson, Lars Bernfort, Lars-Åke Levin, Björn Gerdle
BACKGROUND: Several studies have illustrated that multisite pain is more frequent than single pain site, and it is associated with an array of negative consequences. However, there is limited knowledge available about the potential factors associated with multisite pain in the elderly general population. OBJECTIVE: This cross-sectional study examines whether the number of anatomical pain sites (APSs) is related to sociodemographic and health-related factors in older adults including oldest-old ages using a new method (APSs) to assess the location of pain on the body...
2017: Journal of Pain Research
Meira Dandaba, Philippe Couratier, Anaïs Labrunie, Marie Nicol, Bello Hamidou, Marie Raymondeau, Giancarlo Logroscino, Pierre Marie Preux, Benoît Marin
BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) is an age-related neurodegenerative disease with unclear characteristics and prognosis in the oldest old (80 years and over). The aim of this study was to compare the oldest old and younger ALS patients in terms of clinical and socio-demographic characteristics, and prognosis. METHODS: ALS incident cases from the register of ALS in Limousin (FRALim), diagnosed between January 2000 and July 2013, were included. Descriptive and comparative analyses by age group were carried out...
2017: Neuroepidemiology
K F Axelsson, M Wallander, H Johansson, D Lundh, M Lorentzon
BACKGROUND: There is high evidence for secondary prevention of fractures, including hip fracture, with alendronate treatment, but alendronate's efficacy to prevent hip fractures in the oldest-old (≥80 years old), the population with the highest fracture risk, has not been studied. OBJECTIVE: To investigate if alendronate treatment among the oldest old with prior fracture was related to decreased hip fracture rate and sustained safety. METHODS: Using a national database of men and women undergoing a fall risk assessment at a Swedish healthcare facility, we identified 90 795 patients who were 80 years or older and had a prior fracture...
August 30, 2017: Journal of Internal Medicine
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