Abstract
Objective: The aim of this study was to investigate self-reported hearing difficulties, uptake, and hearing-aid outcomes and their relationships to demographic, cognitive, psychosocial, and ...health variables in 85 year olds. Design and study sample: Three hundred and forty-six elderly adults participated in a survey that included questionnaires and home visits. Fifty-five percent of participants admitted to having hearing difficulties, and 59% of these owned hearing aids. The participants' most frequently cited reason for not acquiring hearing aids was that they did not think their hearing problem was perceived as severe enough. Participants with hearing difficulties who did not own hearing aids showed worse general and mental health. Many of the elderly participants were successful in their rehabilitation, and their hearing-aid outcomes were similar to those of a younger group, with the exception of a greater proportion of non-users among the elderly. Conclusion: Many older people with self-reported hearing difficulties do not acquire hearing aids, despite this study's findings that older people are likely to have success with hearing rehabilitation. It is important to make greater efforts to try to increase elderly adults' awareness of hearing loss and the benefits of hearing rehabilitation.
Summary
Background Patients with psoriasis who had raised IgG and/or IgA antigliadin antibodies showed clinical improvement in a trial with a gluten‐free diet. The selection of patients for the diet ...treatment was based on the presence of specific antibodies, i.e. the result of humoral immunity.
Objectives As psoriasis is now considered to be a T cell‐mediated disease we decided to challenge peripheral blood mononuclear cells (PBMCs) in vitro from randomly selected patients with well‐defined wheat proteins/peptides to explore the possibility of identifying a specific antigen with T cell activating properties in a subgroup of patients.
Methods PBMCs from 37 patients (20 female and 17 male; mean age 49 years) and 37 healthy controls (12 female and 25 male; mean age 57 years) were included. Not all patients participated in all experiments. The PBMCs were exposed in vitro with the following wheat proteins/peptides in various concentrations: total albumins, 0·28 α‐amylase inhibitor and the synthetic peptides, p31–43, p57–68 and p62–75, based on coeliac‐active sequences of α‐gliadin. The proliferative response was measured as counts per minute after the cells had been pulsed with methyl‐3H‐thymidine.
Results Albumin, α‐amylase inhibitor, p31–43 and p57–68 elicited a significant response in both patients and controls but showed no differences between the groups. The response induced by the α‐amylase inhibitor was higher than that induced by the albumin fraction and the p31–43 and p57–68 peptides. At a concentration of 25 μg mL−1, five of 36 patients with psoriasis responded positively to the p62–75 peptide and none of the 33 controls, using a stimulation index of 2·4 as the cut‐off level (P < 0·05). These five patients did not show clinical features that differed from the remaining patients. Among the responding patients the relative number of CD4+ cells increased in some but not all after in vitro challenge with the albumins, 0·28 α‐amylase inhibitor, and p62–75. These antigens could also induce in vitro the expression of the homing antigen cutaneous lymphocyte antigen (CLA) in a few patients and controls.
Conclusions The wheat protein antigens, especially the p62–75 peptide, might be of interest in a subgroup of patients with psoriasis.
OBJECTIVES: To investigate whether anthropometric and body composition variables and handgrip strength (HS) were associated with physical function and independent daily living in 88-year-old Swedish ...women. PARTICIPANTS: A cross-sectional analysis of 83 community-dwelling women aged 88 years who were of normal weight (n=30), overweight (n=29), and obese (n=24) was performed. MEASUREMENTS: Body weight (Wt), height, waist circumference (WC), and arm circumference were assessed using an electronic scale and a measuring tape. Tricep skinfold thickness was measured using a skinfold calliper. Fat mass (FM) and fat-free mass (FFM) were measured using bioelectrical impedance analysis, and HS was recorded with an electronic grip force instrument. Linear regression was used to determine the contributions of parameters as a single predictor or as a ratio of HS to physical function (Short Form-36, SF-36PF) and instrumental activities of daily living (IADL). RESULTS: Obese women had greater absolute FM and FFM and lower HS corrected for FFM and HS-based ratios (i.e., HS/Wt, HS/body mass index BMI) than their normal weight and overweight counterparts. After adjusting for physical activity levels and the number of chronic diseases, HS-based ratios explained more variance in SF-36PFscoring (R², 0.52–0.54) than single anthropometric and body composition variables (R², 0.45–0.51). WC, HS, and HS-based ratios (HS/Wt and HS/FFM) were also associated with independence in IADL. CONCLUSION: Obese very old women have a high WC but their HS is relatively low in relation to their Wt and FFM. These parameters are better than BMI for predicting physical function and independent daily living.
Abstract
Objectives Hot flushes and night sweats often cause discomfort and may negatively affect sleep and quality of life. Studies have shown that menopausal symptoms, like hot flushes, may persist ...for up to 20 years after the menopausal transition, but there are no published studies regarding the occurrence of hot flushes among women older than 80 years. The aim of this study is to determine the prevalence of hot flushes in 85-year-old women.
Methods All 85-year old women living in Linköping municipality in 2007 (n = 415) received a postal questionnaire. The majority, 74% (n = 307), answered the questionnaire and 47% (n = 194) agreed to visit the Department of Geriatric Medicine; during this visit questions regarding hot flushes and use of hormone therapy were asked.
Results About 16% (n = 29) of the women experienced hot flushes during the day and/or during the night and 6.5% (n = 12) of the women were currently using hormone therapy. Almost 10% (n = 17) of all responding women were very to moderately distressed by their hot flushes.
Conclusion Our results confirm and extend previous knowledge based on studies of younger postmenopausal women in showing that menopausal symptoms still occur in elderly women. We found that, while the prevalence of menopausal symptoms decreases with age, these symptoms are still experienced by some 85-year-old women.
Alzheimer's disease (AD) is the major cause of dementia. During the development of AD, neurofibrillary tangles progress in a fixed pattern, starting in the transentorhinal cortex followed by the ...hippocampus and cortical areas. In contrast, the deposition of β-amyloid (Aβ) plaques, which are the other histological hallmark of AD, does not follow the same strict spatiotemporal pattern, and it correlates poorly with cognitive decline. Instead, soluble Aβ oligomers have received increasing attention as probable inducers of pathogenesis. In this study, we use microinjections into electrophysiologically defined primary hippocampal rat neurons to demonstrate the direct neuron-to-neuron transfer of soluble oligomeric Aβ. Additional studies conducted in a human donor-acceptor cell model show that this Aβ transfer depends on direct cellular connections. As the transferred oligomers accumulate, acceptor cells gradually show beading of tubulin, a sign of neurite damage, and gradual endosomal leakage, a sign of cytotoxicity. These observations support that intracellular Aβ oligomers play a role in neurodegeneration, and they explain the manner in which Aβ can drive disease progression, even if the extracellular plaque load is poorly correlated with the degree of cognitive decline. Understanding this phenomenon sheds light on the pathophysiological mechanism of AD progression. Additional elucidation will help uncover the detailed mechanisms responsible for the manner in which AD progresses via anatomical connections and will facilitate the development of new strategies for stopping the progression of this incapacitating disease.
Abstract Introduction The study aimed to investigate different aspects of cognition using the Cognitive Assessment Battery (CAB) in community-dwelling older adults aged 85 years. We also investigated ...the eventual influence of sex on the results and aimed to identify predictors for further cognitive decline after 1 year. Methods CAB consists of 10 subtests covering the cognitive domains of speed and attention, learning and episodic memory, visuospatial abilities, language, and executive functions. Cognitive tests were performed at baseline ( n = 335) and follow-up after 1 year ( n = 270). Results Univariate statistics revealed that men performed better than women on episodic memory ( P < 0.05) and on the naming test ( P < 0.001). However, floor effects in the paragraph memory test were revealed. There was a high rate of abnormal results on Token Test (67%), PaSMO (50%), Clox (48%), and the cube copying (40%) tests in participants with normal cognition. Logistic regression showed that impaired results on the Stroop III test (odds ratio, 2.38; P < 0.05) was independently associated with an increased risk of cognitive decline. Conclusion Men performed better than women on the memory and on the naming test. However, due to floor effects in the paragraph memory test in 85 year olds, these results can be disputed. The high rate of abnormal results on the Token Test, PaSMO, Clox, and the cube copying tests in cases with normal cognition indicate that these tests are less suitable for screening in the age group. Impaired result on the Stroop test increased the risk more than two-fold for cognitive decline after 1 year.
There is an increasing interest in how oxidative stress can cause cells to go into apoptosis in both normal ageing and in neurodegenerative disorders. Previous research has implicated insulin-like ...growth factor-1 (IGF-1) as being involved in the pathogenesis in Alzheimer’s disease (AD) by protecting the neurons through reducing neuronal susceptibility to oxidative stress. IGF-1 receptor (IGF-1R) polymorphisms alter cerebral and systemic levels of IGF-1 and may alter the function of the receptor. We genotyped the IGF-1R gene by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) to assess whether this gene polymorphism can be linked to dementia. We used leukocyte DNA from 72 patients with AD, 75 patients with vascular dementia (VaD), 14 patients with mixed dementia (AD+VaD), and a control group consisting of 209 individuals without a history of progressive neurological disorders. Analysis of gene frequency for gender revealed a significant difference between female VaD patients and female controls carrying at least one A allele (OR = 1.8, CI 95% 1.1–2.9, p = 0.02), but not for male patients. In addition, we found a strong tendency to a difference between all cases of female dementia patients and controls carrying the A allele (OR = 1.5, CI 95% 0.99–2.2, p = 0.054). Our results suggest that the A allele of IGF-1R may be involved in the pathogenesis of VaD in females.
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