1,721,280 research outputs found
Fragilità
No full textLa fragilitá é caratterizzata da un declino accelerato di molteplici sistemi fisiologici che compromette l’efficienza dei meccanismi omeostatici dell’organismo.
Particolarmente importanti appaiono alcune modificazioni ormonali, l’iperattivazione del sistema infiammatorio, un’accentuazione dello stress ossidativo e alcune modificazioni dell’equilibrio funzionale tra sistema nervoso simpatico e parasimatico.
La fragilità può essere innescata attraverso meccanismi multipli. Tuttavia, una volta iniziato, il processo viene automantenuto tramite l’attivazione di altre vie fisiopatologiche e la formazione di circoli viziosi
Muscle dysfunction in type 2 diabetes: a major threat to patient’s mobility and independence
No full textType 2 diabetes, a common metabolic disease in older people, is a major risk factor for functional limitation, impaired mobility, and loss of independence. In older people, the pathogenesis of functional limitation and disability is complex and multifactorial. A number of potential pathways are involved including cardiovascular disease, peripheral neuropathy, overweight, osteoarthritis, visual deficit, and cognitive impairment, conditions that are all more prevalent among patients with diabetes. Sarcopenia, a geriatric condition characterized by a progressive and generalized loss of skeletal muscle mass and strength, is also involved in the pathogenesis of functional limitations and disability. Recent research has shown that older patients with type 2 diabetes are often affected by skeletal muscle impairment, leading to reduced muscle strength and physical function. Insulin resistance, hyperglycemia, muscle fat infiltration, and peripheral neuropathies are hypothesized as the fundamental biological mechanisms leading to muscle impairment in people with diabetes. This review summarizes the current literature on the biological pathways responsible for skeletal muscle dysfunction in type 2 diabetes and analyzes the role of decline in muscle strength and quality on the association between diabetes and mobility disability
Complicanze emergenti del diabete nel soggetto anziano
No full textIl continuo incremento del numero di soggetti anziani affetti da diabete associato all’aumentata sopravvivenza dei pazienti diabetici sta espandendo lo spettro delle complicanze a lungo termine di questa malattia. In aggiunta alle classiche manifestazioni vascolari e neuropatiche sarà necessario quindi considerare anche il declino cognitivo, la demenza, la depressione, la disabilità e le cadute. Queste condizioni hanno un profondo impatto sulla qualità di vita del paziente e dei suoi famigliari e rappresenteranno un nuovo e ulteriore problema per il clinico e per il sistema sanitario. Appare quindi già da ora indispensabile la ricerca di nuove strategie per ridurre il rischio di queste nuove complicanze. In particolare è necessario che i grandi studi clinici randomizzati disegnati per stabilire l’efficacia dei diversi protocolli terapeutici nel paziente diabetico, includano un numero sostanziale di soggetti anziani ed esaminino l’effetto dei vari interventi sulla funzione cognitiva e sul declino funzionale oltre che sulle classiche complicanze micro- e macrovascolari
Physical function and disability in older adults with diabetes
No full textFunctional decline and physical disability are an important clinical and public health problem in older adults because they are associated with loss of independence, nursing home admission, and mortality. Several impairments and comorbidities related to or associated with diabetes are potential disabling conditions that could account for the excess risk of disability. But in most studies, no single condition explains this association. Accelerated loss of muscle strength is a potential mediator in the disabling effect of diabetes. Because some diabetes-related comorbidities are potential modifiable risk factors, preventing and reducing the excess risk of disability associated with diabetes needs further study
Physical Disability in the Elderly with Diabetes: Epidemiology and Mechanisms
No full textDiabetes mellitus is a common chronic condition worldwide, especially in the elderly population. Several epidemiologic studies in the last 2 years have consistently associated diabetes with physical disability, a condition that may profoundly affect the quality of life of older people. Although in older people with diabetes, the pathogenesis of functional limitation and disability has not been completely elucidated, it is certainly complex and involves multiple potential pathways. In this narrative review, we described the most recent epidemiologic and clinical evidence supporting the association between diabetes and impaired physical function in older persons focusing on emerging biological mechanisms explaining the excess risk of disability associated with diabetes
Type 2 diabetes and risk for functional decline and disability in older persons
No full textAs older adults make up an increasingly lager proportion of the diabetic population, the spectrum of chronic diabetes complications will change and expand. Aside from the traditional long-term complications, diabetes has been associated with excess risk of a number of clinical conditions typical of the geriatric population, including functional decline, physical disability, falls, fractures, cognitive impairment, and depression. These conditions are common and profoundly affect the quality of life of older patients with diabetes. The identification of effective ways of preventing and treating these emerging complications, thus improving quality of life among older diabetic patients, is already a major issue in geriatric medicine. In this narrative review, we describe current epidemiological and clinical evidence supporting the association between diabetes and physical disability in older persons. Furthermore, the potential biological mechanisms underlying such an association are analyze
Self-rated health showed a graded association with frequently used biomarkers in a large population sample, but predicted mortality independently of them and other health variables
No full textBACKGROUND AND OBJECTIVES: Self-rated health is a widely used measure of health status, but its biologic foundations are poorly understood. We investigated the association of frequently used biomarkers with self-rated health, and the role of these biomarkers in the association of self-rated health with mortality. METHODS: The relation of self-rated health to blood levels of albumin, white blood cell count, hemoglobin, HDL cholesterol, and creatinine was examined in a population-based sample of 4,065 men and women aged 71 years or older. A Cox proportional hazards model was used to determine the association of self-rated health with mortality during 4.9 years. Sociodemographic factors, diagnosed chronic conditions, and activities of daily living disability were controlled for in these analyses. RESULTS: All the biomarkers showed a graded relationship with self-rated health. After adjusting for other indicators, hemoglobin and white cell count were significantly associated with fair or poor self-rated health. When biomarkers and other indicators were adjusted for, self-rated health still was a significant predictor of mortality. CONCLUSION: Self-rated health has a biologic basis, and it can be a sensitive barometer of physiologic states. Self-rated health is likely to predict mortality because it covers the spectrum of health conditions better than the variables measured in the study
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