41,656 research outputs found
Special Issue—“Multimorbidity Development and Evolution: Clinical Implications”
No full text: Multimorbidity, the co-existence of multiple chronic diseases in the same individual, is not only extremely common in older persons but is also strongly associated with several poor health outcomes [...]
Comparing the prognostic value of geriatric health indicators: a population-based study
No full textThe identification of individuals at increased risk of poor health-related outcomes is a priority. Geriatric research has proposed several indicators shown to be associated with these outcomes, but a head-to-head comparison of their predictive accuracy is still lacking. We therefore aimed to compare the accuracy of five geriatric health indicators in predicting different outcomes among older persons: frailty index (FI), frailty phenotype (FP), walking speed (WS), multimorbidity, and a summary score including clinical diagnoses, functioning, and disability (the Health Assessment Tool; HAT)
Social engagement in late life may attenuate the burden of depressive symptoms due to financial strain in childhood
No full textBackground: It remains poorly understood if childhood financial strain is associated with old-age depression and if active social life may mitigate this relationship. Aims: To investigate the association between childhood financial strain and depressive symptoms during aging; to examine whether late-life social engagement modifies this association. Method: 2884 dementia-free individuals (aged 60+) from the Swedish National study of Aging and Care-Kungsholmen were clinically examined over a 15-year follow-up. Presence of childhood financial strain was ascertained at baseline. Depressive symptoms were repeatedly assessed with the Montgomery–Åsberg Depression Rating Scale. Social engagement comprised information on baseline social network and leisure activities. Linear, logistic and mixed-effect models estimated baseline and longitudinal associations accounting for sociodemographic, clinical, and lifestyle factors. Results: Childhood financial strain was independently associated with a higher baseline level of depressive symptoms (β = 0.37, 95%CI 0.10–0.65), but not with symptom change over time. Relative to those without financial strain and with active social engagement, depressive burden was increased in those without financial strain but with inactive social engagement (β = 0.43, 95%CI: 0.15–0.71), and in those with both financial strain and inactive engagement (β = 0.99, 95%CI: 0.59–1.40). Individuals with financial strain and active social engagement exhibited similar depressive burden as those without financial strain and with active social engagement. Limitations: Recall bias and reverse causality may affect study results, although sensitivity analyses suggest their limited effect. Conclusions: Early-life financial strain may be of lasting importance for old-age depressive symptoms. Active social engagement in late-life may mitigate this association
Impact of cardiovascular and neuropsychiatric multimorbidity on older adults' health
No full textMultimorbidity, the presence of two or more chronic diseases in one person, is common in older people, and associates with a number of negative outcomes. In this thesis, we propose a methodology to assess and measure multimorbidity in older individuals. We use it to describe the longitudinal evolution and prognosis of multimorbidity clusters, and to investigate the extent to which clusters of cardiovascular and neuropsychiatric multimorbidity impact and interact with physical function. Data are from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), a population-based study including 3,363 community-dwelling and institutionalized individuals aged ≥60 years.Study I. We provided a clinically driven list of 60 chronic diseases for the assessment of multimorbidity in older adults. After applying this methodology to the 3,363 SNAC-K participants, we found that 88.6% of them had two or more diseases, 73.2% had three or more diseases, and only 11.4% had zero or one single disease. Given the ceiling effect associated with the use of a cutoff, multimorbidity should be rather be considered as a continuous metric, which better reflects the progressive accumulation of diseases starting in early aging and continuing up to very late life. Study II. We identified and traced the evolution of multimorbidity clusters over 12 years of 2,931 SNAC-K participants with two or more diseases. At baseline, 51.3% of participants were included in one of five clusters; the rest were part of an unspecified group, given that no disease patterns could cluster them. Cardiometabolic risk factors, the evolution of several diseases, and death may have steered most of the longitudinal transitions among the multimorbidity clusters we described over a period of 12 years. Study III. We investigated the association of cardiovascular and neuropsychiatric multimorbidity with 9 years of change in walking speed and intact basic activities of daily living in 2,385 SNAC-K participants. Neuropsychiatric disease, alone or combined with cardiovascular disease, showed the strongest detrimental impact on functional decline. Cardiovascular multimorbidity showed an association solely with decline in walking speed. Study IV. We studied the interplay between cardiovascular multimorbidity and functional impairment, as well as between neuropsychiatric multimorbidity and functional impairment, on all-cause and causespecific mortality in 3,241 SNAC-K participants. Slow walking speed provided additional prognostic information in terms of all-cause and cause-specific mortality beyond the number of both cardiovascular and/or neuropsychiatric diseases.Conclusions. The use of a standardized methodology to assess chronic disease and multimorbidity may enhance comparability across studies, settings, and geographical regions. Studying the natural evolution of multimorbidity in older individuals may help to better hypothesize about underlying mechanisms and provide important prognostic information. In this regard, multimorbidity clusters including cardiovascular and neuropsychiatric disease emerge as major determinants of functional decline and higher mortality rate. Finally, the adoption of a simple and easy-to-use measure of functional impairment such as walking speed may help health-care professionals identify older people affected by specific groups of chronic disease with similar needs, health trajectories, and prognoses.List of scientific papersI. Calderón-Larrañaga A, Vetrano DL (co-first author), Onder G, Gimeno-Feliu LA, Coscollar-Santaliestra C, Carfí A, Pisciotta MS, Angleman S, Melis RJF, Santoni G, Mangialasche F, Rizzuto D, Welmer AK, Bernabei R, Prados-Torres A, Marengoni A, Fratiglioni L. Assessing and measuring chronic multimorbidity in the older population: A proposal for its operationalization. J Gerontol A Biol Sci Med Sci. 2017 Oct 1;72(10):1417–1423. https://doi.org/10.1093/gerona/glw233 II. Vetrano DL, Roso-Llorach A (co-first author), Fernández S, Guisado-Clavero M, Violán C, Onder G, Fratiglioni L, Calderón-Larrañaga A, Marengoni A. Twelve-year clinical trajectories of multimorbidity in older adults: A population-based study. [Submitted]III. Vetrano DL, Rizzuto D, Calderón-Larrañaga A, Onder G, Welmer AK, Bernabei R, Marengoni A, Fratiglioni L. Trajectories of functional decline in older adults with neuropsychiatric and cardiovascular multimorbidity: A Swedish cohort study. PLoS Med. 2018 Mar 6;15(3):e1002503. https://doi.org/10.1371/journal.pmed.1002503 IV. Vetrano DL, Rizzuto D, Calderón-Larrañaga A, Onder G, Welmer AK, Qiu C, Bernabei R, Marengoni A, Fratiglioni L. Walking speed drives the prognosis of older adults with cardiovascular and neuropsychiatric multimorbidity. [Submitted]</p
Peak expiratory flow, walking speed and survival in older adults: An 18-year longitudinal population-based study
No full textBackground: Peak expiratory flow (PEF) and walking speed (WS) have been proposed as indicators of robustness and are independent predictors of health-related outcomes. We aimed to investigate how the co-occurrence of respiratory and physical impairments changes as a function of age, and to quantify the association of the combination of low PEF and slow WS on survival in older people. Methods: This prospective study analyzes data from 2656 community-dwelling participants (age ≥ 60 years) from the SNAC-K study. At baseline, we assessed: (1) sociodemographic, lifestyle and medical data; (2) respiratory function, estimated through PEF and expressed as standardized residual (SR) percentile; and (3) WS at usual pace, categorized as no (>1.2 m/s), mild (0.8–1.2 m/s) and moderate-to-severe (<0.8 m/s) walking impairment. Participants' vital status over an 18-year follow-up was derived from registers. The association of different combinations of PEF and WS on median survival time was estimated through Laplace regression adjusted for potential confounders. Results: Respiratory and walking impairments co-occurred more frequently with increasing age. Among individuals with PEF SR-percentiles < 10th, the percentage of moderate-to-severe walking impairment was 12.1% in sexagenarians, 35.7% in septuagenarians, and 75–80% in the oldest old. The greatest reduction in median survival time (−5.4 [95%CI: −6.4; −4.4] years, p < 0.001) was observed among people with combined respiratory and moderate-to-severe walking impairments, compared with those with no dysfunctions, who had a median survival time of 17.4 (95%CI: 17.0; 17.8) years. Conclusions: Impaired PEF and WS co-occur more frequently with advancing age, and their co-occurrence is associated with shorter survival
Efficacy of a potent and safe vitamin D receptor agonist for the treatment of inflammatory bowel disease
No full textDeficiency in 1 alpha,25-dihydroxyvitamin D(3) (1,25D(3)) has been suggested as an important environmental factor for immuno-mediated disorders including inflammatory bowel diseases (IBD), comprising Crohn's disease and ulcerative colitis, both characterized by chronic intestinal inflammation. Administration of vitamin D receptor (VDR) agonists can ameliorate spontaneous and induced animal models of colitis, but hypercalcemia is a dose-limiting adverse event. Previous work in our laboratory has identified 1 alpha,25(OH)(2)-16-ene-20-cyclopropyl-vitamin D(3) (BXL-62) as a potent anti-inflammatory VDR agonist with a low calcemic activity. In the present study, we confirm the marked anti-inflammatory properties of BXL-62 and show its capacity to induce VDR primary response genes, like CYP24A1 and CAMP, at lower concentrations than 1,25D(3), in PBMCs from IBD patients. Its higher anti-inflammatory potency compared to 1,25D(3) was demonstrated by the significantly more potent inhibition in PBMCs and in lymphocyte-enriched lamina propria mononuclear cells of the pro-inflammatory cytokines TNF-alpha, IL-12/23p40, IL-6 and IFN-gamma, both at mRNA and protein level. The therapeutic efficacy of intra-rectal administration of BXL-62 in experimental IBD is shown by its beneficial effects, significantly higher than 1,25D(3), to induce recovery of clinical symptoms of colitis at normocalcemic doses in mice undergoing dextran sodium sulfate-induced colitis. These results confirm the therapeutic efficacy of VDR agonists in experimental colitis, and suggest BXL-62 as a promising compound for IBD treatment. (C) 2010 Elsevier B.V. All rights reserved
Influence of preharvest gibberellic acid treatments on postharvest quality of minimally processed leaf lettuce and rocket
No full textPlant growth regulators are used in high-value vegetable crops during cultivation and after harvest to increase yield, enhance crop management, and improve or retain the produce quality. The aim of this work was to evaluate the quality characteristics during cold storage of minimally processed leaf lettuce and rocket, obtained from plants grown in a hydroponic floating system with mineral nutrient solutions (MNS) containing different levels of gibberellic acid (GA(3)). Plants were grown in greenhouse conditions on nutrient solutions containing 0,10(-8), and 10(-6) M GA(3). At harvest, lettuce and rocket were immediately processed as fresh-cut vegetables and stored for 21 d at 4 degrees C. After processing, weight loss, total soluble solids, titratable acidity, ascorbic acid and nitrate content, leaf color characteristics, and overall quality were evaluated. Adding 10(-6) M GA(3) to the MNS of a floating system significantly increased the yield of leaf lettuce and rocket plants and of minimally-processed leaves. In addition, preharvest GA(3) treatments had positive effects on delaying senescence and enhancing shelf-life of minimally processed lettuce and rocket. The slowed senescence of GA(3)-treated samples maintained an overall quality over the threshold of marketability in both lettuce and rocket for up to 21 d of cold storage
Nuova mutazione di CYP24A1 in un caso di ipercalcemia idiopatica infantile diagnosticata nell’adulto
No full textMutazioni nel gene 24-idrossilasi CYP24A1 sono state riconosciute quali cause di ipercalcemia idiopatica infantile (IIH), una malattia rara (incidenza <1:1.000.000 nati vivi) [1] caratterizzata da aumento della sensibilità alla vitamina D [2], con ipercalcemia severa sintomatica. IIH è stata descritta per la prima volta in Gran Bretagna a distanza di due anni dall’inizio di un programma di supplementazione di vitamina D nel latte per la prevenzione del rachitismo, manifestandosi in circa 200 bambini con severa ipercalcemia, disidratazione, difetto di accrescimento, perdita di peso, ipotonia muscolare e nefrocalcinosi [3]. L’associazione tra la comparsa epidemica di IIH e la somministrazione di vitamina D è stata rapidamente attribuita a ipersensibilità intrinseca alla vitamina D [4], e il meccanismo patogenetico è stato riconosciuto nell’inattivazione del Citocromo P450 famiglia 24 sottofamiglia A membro 1 (CYP24A1), che è stata identificata come base molecolare della patologia [5]. Lo spettro fenotipico della mutazione di CYP24A1 può essere variabile, manifestandosi prevalentemente con esordio infantile e sintomatologia severa (ipercalcemia severa, ritardo di crescita, letargia, ipotonia muscolare, disidratazione), ma anche con forme a insorgenza in età giovanile-adulta con nefrolitiasi, nefrocalcinosi e alterazioni dell’omeostasi fosfocalcica [6]. Descriviamo il caso di un paziente in cui la diagnosi di IIH è stata posta in età adulta, presentandosi con riscontro di nefrocalcinosi in età infantile, e con comparsa successiva di ipercalcemia severa con ipercalciuria, ipoparatiroidismo, ipervitaminosi D e litiasi renale ricorrente. L’indagine genetica ha rilevato la presenza in omozigosi della variante c_428_430delAAG_p.Glu143del nel gene CYP24A1 a trasmissione autosomica recessiva, mutazione non segnalata in letteratura
Measurement of the branching fractions for B--> D(*)+pi(-)l(-)(nu)over-bar(l) and (B)over-bar(0)-> D-(*)0 pi(+)l(-)(nu)over-bar(l)
No full textWe report on a measurement of the branching fractions for B- --> D(*)+ pi(-)l(-)(nu) over bar (l) and (B) over bar (0) --> D-(*)0 pi(+)l(-)(nu) over bar (l) with 275 x 10(6) B (B) over bar events collected at the Y(4S) resonance with the Belle detector at KEKB. Events are tagged by fully reconstructing one of the B mesons in hadronic modes. We obtain B(B- --> D(+)pi(-)l(-)(nu) over bar (l)) = (0.54 +/- 0.07 (stat) +/- 0.07(syst) +/- 0.06(BR)) x 10(-2), B(B- --> D*+pi(-) l(-) (nu) over bar (l)) (0.67 +/- 0.11 (stat) +/- 0.09(syst) +/- 0.03(BR)) x 10(-2), B((B) over bar (0) --> D(0)pi(+)l(-) (nu) over bar (l)) = (0.33 +/- 0.06(stat) +/- 0.06(syst) +/- 0.03(BR)) x 10(-2), B((B) over bar (0) -->D(*0)pi(+)l(-)(nu) over bar (l)) = (0.65 +/- 0.12(stat) +/- 0.08(syst) +/- 0.05(BR)) x 10(-2), where the third error comes from the error on (B) over bar --> D((*))l(-)(nu) over bar (l) decays. Contributions from B-0 --> D(*+)l(-)(nu) over bar (l) decays are excluded in the measurement of (B) over bar (0) --> D(0)pi(+)l-(nu) over bar (l).Astronomy & AstrophysicsPhysics, Particles & FieldsSCI(E)0ARTICLE5null7
Influence of Ecklonia maxima extracts on growth, yield, and postharvest quality of hydroponic leaf lettuce
No full textEcklonia maxima is a brown algae seaweed largely harvested over the last years and used to produce alginate, animal feed, fertilizers, and plant biostimulants. Their extracts are commercially available in various forms and have been applied to many crops for their growth-promoting effects which may vary according to the treated species and doses applied. The aim of the study was to characterize the effect of adding an Ecklonia maxima commercial extract (Basfoliar Kelp; 0, 1, 2, and 4 mL L−1) to the nutrient solution of a hydroponic floating system on growth, yield, and quality of leaf lettuce at harvest and during cold storage (21 days at 4◦ C). The supplementation of the E. maxima extract through the mineral nutrient solutions, especially between 2 and 4 mL L−1, enhanced plant growth and improved the yield and many morphological and physiological traits (biomass accumulation, leaf expansion, stomatal conductance, water use efficiency, nitrogen use efficiency, etc.). Preharvest treatments with E. maxima extract were effective in delaying leaf senescence and extending the shelf-life of fresh-cut leaf lettuce. The delay in leaf decay of treated samples allowed to retain an overall quality over the threshold of marketability for up to 21 d of cold storage, especially using 2 mL L−1 of extract
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