1,721,014 research outputs found
The link between spirituality and longevity
Full text linkWe are facing an inverted demographic pyramid with continuously growing aged populations around the world. However, the advances that prolong physical life not always contemplate its psychological and social dimensions. Longevity is a complex outcome influenced by a wide range of factors, including genetics, lifestyle choices, access to healthcare, socio-economic conditions, and other environmental factors. These factors have been generally considered in the compelling research that seeks the determinants of longevity, particularly those concerning personal lifestyle choices, socioeconomic conditions, and molecular mechanisms proposed to mediate these effects. Nonetheless, fundamental aspects that can affect health and well-being, such as spirituality and religiosity, have been somehow left aside despite numerous epidemiological studies showing that higher levels of spirituality/religiosity are associated with lower risk of mortality, even after adjusting for relevant confounders. Because spirituality/religiosity are dimensions of great value for patients, overlooking them can leave them with feelings of neglect and lack of connection with the health system and with the clinicians in charge of their care. Integrating spirituality and religiosity assessment and intervention programs into clinical care can help each person obtain better and complete well-being and also allowing clinicians to achieve the highest standards of health with holistic, person-centered care. The present narrative review aims to explore the available evidence of a relationship between spirituality/religiosity and longevity and discusses the possible mechanisms that can help explain such relationship
Sarcopenic obesity and health outcomes: An umbrella review of systematic reviews with meta‐analysis
Full text linkMany studies support the idea that sarcopenic obesity (SO) could be considered a potential risk factor for negative health outcomes. These results have been inconsistent, and no umbrella reviews exist regarding this topic. Several databases until November 2023 were searched for systematic reviews with meta-analysis of observational studies (cross-sectional, case–control and prospective). For each association, random-effects summary effect sizes with correspondent 95% confidence intervals (CIs) were evaluated using the GRADE tool. Among the 213 papers initially screened, nine systematic reviews with meta-analysis were included, for a total of 384 710 participants. In cross-sectional and case–control studies, 30 different outcomes were analysed, and 18 were statistically significant. In any population addressed in cross-sectional and case–control studies, compared with non-SO, SO increased the prevalence of cognitive impairment (k = 3; odds ratio [OR] = 3.46; 95% CI: 2.24–5.32; high certainty of evidence), coronary artery disease (k = 2; OR = 2.48; 95% CI: 1.85–3.31) and dyslipidaemia (k = 3; OR = 2.50; 95% CI: 1.51–4.15). When compared with sarcopenia or obesity, the results were conflicting. In prospective studies, the association between SO—compared with non-SO—and other negative outcomes was supported by low/very low certainty of evidence and limited to a few conditions. Besides, no comparison with sarcopenia or obesity was provided. Finally, only a few studies have considered muscle function/physical performance in the diagnostic workup. SO could be considered a risk factor only for a few conditions, with the literature mainly based on cross-sectional and case–control studies. Future studies with clear definitions of SO are needed for quantifying the importance of SO—particularly when compared with the presence of only sarcopenia or obesity—and the weight of muscle function/physical performance in its definition
Dietary fiber intake and the Mediterranean population
No full textDietary fiber encompasses carbohydrates not digested or absorbed in the small intestine, arriving intact to the colon. Its role in human health has been mentioned since the times of Hippocrates but only in the 1970s of the 20th century, and subsequently a myriad of epidemiological and clinical studies has shown that a diet with low content of dietary fiber is associated with several chronic diseases such as diabetes, cardiovascular diseases, certain neoplastic diseases, specially colon cancer, and also obesity. The Western dietary pattern, which is spreading in our current globalized world and in which many components are ultraprocessed, has very low fiber content. Conversely the Mediterranean diet, followed for centuries by the populations living in the Mediterranean basin and a paradigm of healthy eating and lifestyle, has a high fiber content. In this chapter, we will review the relationship of dietary fiber intake and diverse health outcomes in Mediterranean populations
Presbyphagia and dysphagia in old age
Full text linkAlthough presbyphagia is a clinically relevant problem among elderly population, possibly leading to dysphagia in old age, it remains a still underestimated health condi-tion. The present review analyzes swallow-ing related anatomical and functional changes during aging, both in healthy peo-ple and in those affected by dysphagia. First of all, dysphagia in old people must not be confused with presbyphagia. To distinguish these two different conditions, a correct def-inition of both should be considered. Subsequently, a comprehensive evaluation including instrumental analysis should be carried out. The aim of this narrative review is to analyze the current knowledge of this clinical condition and to provide the state of art to clinicians. A systematic PubMed research on dysphagia in the elderly was conducted and most relevant and most recent references were manually screened and selected. The aim of a correct diagnosis is to enable the choice of a correct interven-tion in order to prevent and treat complica-tions of dysphagia, such as ab ingestis pneumonia and malnutrition. Moreover, the assessment, diagnosis and therapy of dys-phagia/presbyphagia should include the intervention of different specialists
Magnesium and the Hallmarks of Aging
Full text linkMagnesium is an essential ion in the human body that regulates numerous physiological and pathological processes. Magnesium deficiency is very common in old age. Age-related chronic diseases and the aging process itself are frequently associated with low-grade chronic inflammation, called 'inflammaging'. Because chronic magnesium insufficiency has been linked to excessive generation of inflammatory markers and free radicals, inducing a chronic inflammatory state, we formerly hypothesized that magnesium inadequacy may be considered among the intermediaries helping us explain the link between inflammaging and aging-associated diseases. We show in this review evidence of the relationship of magnesium with all the hallmarks of aging (genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, disabled autophagy, dysbiosis, and chronic inflammation), which may positively affect the human healthspan. It is feasible to hypothesize that maintaining an optimal balance of magnesium during one's life course may turn out to be a safe and economical strategy contributing to the promotion of healthy aging. Future well-designed studies are necessary to further explore this hypothesis
The place of frailty and vulnerability in the surgical risk assessment: should we move from complexity to simplicity?
Full text linkDue to aging of the world population, older patients accessing health services are becoming continuously more frequent. This has increased the interest in assessing frailty and vulnerability in all specialties and general medicine. Although the term frailty has been recognized for over 30 years, there is not yet a universally recognized definition, and different care providers assess frailty and vulnerability with dissimilar tools, from very complex to very simple validated scales. Being treated with respect and dignity at the right time and place is the key message, as well as after undergoing a global evaluation both in urgency/emergency and in programmed surgery for all older surgical patients. Filling the gap will improve the results of any clinical intervention, both medical and surgical. Anesthesiologists, surgeons, hospitalists, and any member of the team of care providers must be trained into geriatric syndromes
Magnesium in Aging, Health and Diseases
Full text linkSeveral changes of magnesium (Mg) metabolism have been reported with aging, including diminished Mg intake, impaired intestinal Mg absorption and renal Mg wasting. Mild Mg deficits are generally asymptomatic and clinical signs are usually non-specific or absent. Asthenia, sleep disorders, hyperemotionality, and cognitive disorders are common in the elderly with mild Mg deficit, and may be often confused with age-related symptoms. Chronic Mg deficits increase the production of free radicals which have been implicated in the development of several chronic age-related disorders. Numerous human diseases have been associated with Mg deficits, including cardiovascular diseases, hypertension and stroke, cardio-metabolic syndrome and type 2 diabetes mellitus, airways constrictive syndromes and asthma, depression, stress-related conditions and psychiatric disorders, Alzheimer's disease (AD) and other dementia syndromes, muscular diseases (muscle pain, chronic fatigue, and fibromyalgia), bone fragility, and cancer. Dietary Mg and/or Mg consumed in drinking water (generally more bioavailable than Mg contained in food) or in alternative Mg supplements should be taken into consideration in the correction of Mg deficits. Maintaining an optimal Mg balance all through life may help in the prevention of oxidative stress and chronic conditions associated with aging. This needs to be demonstrated by future studies
Antiageing strategies
No full textThe certainty of ageing and death has been a major concern of humans since the beginnings of time, with a consequent never-ending search for methods to combat the consequences of the ageing process and delay the final moment as long as possible. This chapter explores the topic of antiageing therapies from different perspectives. It discusses the rationale behind the possible delay of death, disease, and disability. Then, some of the advances in biogerontological research in animal models and possible translations into humans are explored. The chapter examines the results of epidemiological studies on lifestyle modification proven to be effective in promoting healthy ageing. Disability and functional dependence associated with ageing may be reversible to some extent; however, when the functional reserve becomes extremely depleted, the restoration of normal function is no longer possible
The role of the World Guidelines for Falls Prevention and Management’s risk stratification algorithm in predicting falls: a retrospective analysis of the Osteoarthritis Initiative
No full textIntroduction: Recurrent falls are observed frequently among older people, and they are responsible for significant morbidity and mortality. The aim of the present study was to verify sensitivity, specificity and accuracy of World Guidelines for Falls Prevention and Management (WGFPM) falls risk stratification algorithm using data from the Osteoarthritis Initiative (OAI). Methods: Participants aged between 40 and 80 years were stratified as ‘low risk’, ‘intermediate risk’ or ‘high risk’ as per WGFPM stratification. Data from the OAI cohort study were used, a multi-centre, longitudinal, observational study focusing primarily on knee osteoarthritis. The assessment of the outcome was carried out at baseline and during the follow-up visit at 24 months. Data about sensitivity, specificity and accuracy were reported. Results: Totally, 4796 participants were initially included. Participants were aged a mean of 61.4 years (SD = 9.1) and were predominantly women (58.0%). The population was divided into three groups: low risk (n = 3266; 82%), intermediate risk (n = 25; 0.6%) and high risk (n = 690; 17.3%). WGFPM algorithm applied to OAI, excluding the intermediate-risk group, produced a sensitivity score of 33.7% and specificity of 89.9% for predicting one or more falls, with an accuracy of 72.4%. Conclusion: In our study, WGFPM risk assessment algorithm successfully distinguished older people at greater risk of falling using the opportunistic case finding method with a good specificity, but limited sensitivity, of WGFPM falls risk stratification algorithm
Association Between Pollution and Frailty in Older People: A Cross-Sectional Analysis of the UK Biobank
No full textObjectives: Frailty is a relevant issue in older people, being associated with several negative outcomes. Increasing literature is reporting that pollution (particularly air pollution) can increase the risk of frailty, but the research is still limited. We aimed to investigate the potential association of pollution (air, noise) with frailty and prefrailty among participants 60 years and older of the UK Biobank study. Design: Cross-sectional. Settings and participants: Older participants (age ≥ 60 years) participating to the UK Biobank. Methods: Frailty and prefrailty presence were ascertained using a model including 5 indicators (weakness, slowness, weight loss, low physical activity, and exhaustion). Air pollution was measured through residential exposures to nitrogen oxides (NOx) and particulate matter (PM2.5, PM2.5-10, PM10). The average residential sound level during the daytime, the evening, and night was used as an index for noise pollution. Results: A total of 220,079 subjects, aged 60 years and older, was included. The partial proportional odds model, adjusted for several confounders, showed that the increment in the exposure to NOx was associated with a higher probability of being in both the prefrail and frail category [odds ratio (OR) 1.003; 95% CI 1.001-1.004]. Similarly, the increase in the exposure to PM2.5-10 was associated with a higher probability of being prefrail and frail (OR 1.014; 95% CI 1.001-1.036), such as the increment in the exposure to PM2.5 that was associated with a higher probability of being frail (OR 1.018; 95% CI 1.001-1.037). Conclusions and implications: Our study indicates that the exposure to air pollutants as PM2.5, PM2.5-10, or NOx might be associated with frailty and prefrailty, suggesting that air pollution can contribute to frailty and indicating that the frailty prevention and intervention strategies should take into account the dangerous impact of air pollutants
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