Background Sarcopenia, the age-related loss of muscle mass, may not be an isolated process but is associated with an increase in fat mass. The aim of this study was to estimate the mortality risk of ...sarcopenia in the presence or absence of obesity. Methods Data are from 934 participants aged 65 years or older, enrolled in the “Invecchiare in Chianti” study, and followed for 6 years. At baseline, a peripheral quantitative computerized tomography (pQCT) scan was performed on all participants to evaluate the muscle density, and the muscular and fat cross-sectional areas of the calf. Walking speed was measured on a 7-m track. Cox proportional hazard models were performed to estimate the association of pQCT measures (per 1 standard deviation increase) with mortality. Results Unadjusted analyses showed significant associations of muscle density (hazard ratio HR 0.78, 95% confidence interval CI 0.69–0.88), muscle area (HR 0.75, 95% CI 0.66–0.86), and fat area (HR 0.82, 95% CI 0.73–0.92) with mortality. After adjustment for potential confounders, no body composition parameter was significantly associated with mortality. Walking speed (used as a reference measure to verify whether the negative results were due to peculiarities of the study sample) confirmed its well-established association with mortality risk (HR 0.73, 95% CI 0.60–0.88). These results did not change after the analyses were stratified according to sarcopenia and body mass index groups, and restricted to participants with frailty or a high inflammatory profile. Conclusions Calf skeletal muscle and fat mass are not significant risk factors for mortality in community-dwelling older adults. Walking speed confirmed to be a powerful predictor of health-related events.
The first model independent results obtained by the DAMA/LIBRA-phase2 experiment are presented. The data have been collected over 6 annual cycles corresponding to a total exposure of 1.13 t yr, ...deep underground at the Gran Sasso National Laboratory (LNGS) of the I.N.F.N. The DAMA/LIBRA-phase2 apparatus, ≃ 250 kg highly radio-pure NaI(Tl), profits from a second generation high quantum efficiency photomultipliers and of new electronics with respect to DAMA/LIBRA-phase1. The improved experimental configuration has also allowed to lower the software energy threshold. New data analysis strategies are presented. The DAMA/LIBRA-phase2 data confirm the evidence of a signal that meets all the requirements of the model independent Dark Matter (DM) annual modulation signature, at 9.5 C.L. in the energy region (1 - 6) keV. In the energy region between 2 and 6 keV, where data are also available from DAMA/NaI and DAMA/LIBRA-phase1 (exposure 1.33 t yr, collected over 14 annual cycles), the achieved C.L. for the full exposure (2.46 t yr) is 12.9 ; the modulation amplitude of the single-hit scintillation events is: (0.0103 ± ± 0.0008) cpd/kg/keV, the measured phase is (145 ± 5) d and the measured period is (0.999 ± 0.001) yr, all these values are well in agreement with those expected for DM particles. No systematics or side reaction able to mimic the exploited DM signature (i.e. to account for the whole measured modulation amplitude and to simultaneously satisfy all the requirements of the signature), has been found or suggested by anyone throughout some decades thus far.
Summary
This study analyzed data of bone mineral density (BMD) from a large cohort of adults with Down syndrome (DS). BMD was found to decrease with age more rapidly in these subjects than in the ...general population, exposing adults with DS to an increased risk of osteoporosis and bone fracture.
Introduction
Down syndrome (DS) in adulthood presents with a high prevalence of osteoporosis. However, in DS, bone mineral density (BMD) can be underestimated due to short stature. Furthermore, the rate of age-related decline in BMD and its association with gender in DS has been rarely evaluated or compared with the general population. The present study is aimed at assessing the variation of BMD with age and gender in a sample of adults with DS and to compare these data with those of the general population, after adjusting for anthropometric differences.
Methods
Adults with DS, aged 18 or older, were assessed dual-energy-X-ray-absorptiometry (DXA) at the femoral neck and at the lumbar spine. They were compared with the general population enrolled in the National Health and Nutrition Examination Survey (NHANES) 2009–2010 dataset. Bone mineral apparent density (BMAD) was calculated for each individual.
Results
DXA was evaluated in 234 subjects with DS (mean age 36.93 ± 11.83 years, ranging from 20 to 69 years; 50.4% females). In the lumbar spine both mean BMD (DS 0.880 ± 0.141 vs. NHANES 1.062 ± 0.167,
p
< 0.001) and BMAD (DS 0.138 ± 0.020 vs. NHANES 0.152 ± 0.020,
p
< 0.001) were significantly lower in the DS sample than in the NAHNES cohort. The same trend was observed at the femoral neck in both BMD (DS 0.658 ± 0.128 vs. NHANES 0.835 ± 0.137,
p
< 0.001) and BMAD (DS 0.151 ± 0.030 vs. NHANES 0.159 ± 0.028,
p
<0.001). Age was associated with lower femoral neck BMAD in both samples; importantly, this association was significantly stronger in the DS sample. In the lumbar spine region, no significant association between BMAD and age could be observed in both samples.
Conclusions
Adults with DS have lower bone mineral density compared to the general population and they experience a steeper decline with age. Early screening programs are needed in DS population.
The channeling effect of low energy ions along the crystallographic axes and planes of NaI(Tl) crystals is discussed in the framework of corollary investigations on WIMP dark matter candidates. In ...fact, the modeling of this existing effect implies a more complex evaluation of the luminosity yield for low energy recoiling Na and I ions. In the present paper related phenomenological arguments are developed and possible implications are discussed at some extent.
Background
There is increasing evidence that frailty may play a role in chronic diseases, but the associations with specific chronic disorders are still unclear.
Objectives
To conduct a systematic ...review and meta-analysis assessing the association of anaemia and frailty in observational studies.
Methods
The review was performed according to PRISMA guidelines. We searched PubMed, Web of Science, and Embase from 01/01/2002-10/09/2017. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Homogeneity was assessed with the I2 statistic. Publication bias was assessed with Egger’s and Begg’s tests.
Results
Nineteen studies were included; two longitudinal, seventeen cross-sectional. All studies except three reported an association between anaemia and frailty. The pooled prevalence of prefrailty in individuals with anaemia was 49% (95% CI=38-59%; I2=89.96%) and 24% (95% CI=17-31%; I2= 94.78%) for frailty. Persons with anaemia had more than a twofold odds of frailty (pooled OR=2.24 95% CI=1.53-3.30; I2=91.8%). Only two studies longitudinally examined the association between anaemia and frailty, producing conflicting results.
Conclusions
Frailty and prefrailty are common in anaemic persons. Older persons with anaemia have more than a two-fold increased odds of frailty. These results may have clinical implications, as they identify the need to assess frailty in anaemic people and investigate any potential negative effects associated with the co-occurrence of both conditions. Longitudinal research that examines temporal changes in anaemia and effect of treatment are needed to further clarify the relationship between anaemia and frailty.
A general consensus about the need to manage geriatric conditions in their early phase has emerged following the disappointing results of several therapeutic trials, and as a consequence of ...accumulating research demonstrating that pathological processes begin years before the appearance of clinical symptoms. Several lessons have been learned from previous prevention trials. The targeted populations were too diverse, the interventions were probably not well-fitted and strong enough, and the time of exposure too short. In this paper, we focus on a new approach (Precision Medicine) that incorporates several components: 1. multi-pronged primary prevention at the population level (vascular and metabolic risk factors, physical activity, cognitive stimulation, and diet), 2. targeting persons at risk identified by specific criteria including biomarkers with the help of primary care health professionals (e.g., weight loss, subjective memory impairment, frailty, sarcopenia), 3. robust and specific interventions for the targeted population (e.g., a multi-domain interventions for a large heterogeneous population vs. interventions that target specific mechanisms of action in at risk populations). This new approach towards the therapy of geriatric conditions requires new concepts that integrate the specialist geriatric and primary care settings and that implements new health technologies. To achieve these goals, efforts must be made by healthcare authorities to maximize change in this field, taking into account the need to balance priorities, needs, and resources.
Background. Injuries due to falls are one of the most important public health concerns for all ages, but especially for frail elderly people. Although a small number of falls have a single cause, the ...majority have many different causes resulting from the interactions between intrinsic or extrinsic risk factors. Methods. We conducted an observational study on data from a large population of community-dwelling elderly people to tests the hypothesis that the current use of different classes of psychotropic medications, including antipsychotic agents, benzodiazepines, nonbenzodiazepine sedative-hypnotics, and antidepressants, increases the risk for falls. We analyzed data from a large collaborative observational study group, the Italian Silver Network Home Care project, that collected data on patients admitted to home care programs (n = 2854). Results. After adjusting for all potential confounders, users of any psychotropic drugs had an increased risk of fall of nearly 47% (adjusted odds ratio OR, 1.47; 95% confidence interval CI, 1.24–1.74). Similarly, compared with nonusers, users of atypical antipsychotic drugs also had an increased risk of falling at least once (OR, 1.45; 95% CI, 1.00–2.11). Among benzodiazepine users, patients taking agents with long elimination half-life (OR, 1.45; 95% CI, 1.00–2.19) and patients taking benzodiazepines with short elimination half-life (OR, 1.32; 95% CI, 1.02–1.72) had an increased risk of falls. Patients taking antidepressants did not show a higher risk of falling compared to nonusers (OR, 0.92; 95% CI, 0.83–1.41). Conclusions. Our data suggest that, among psychotropic medications, antipsychotic agents and benzodiazepines are associated with an increased risk of falls. Our findings do not support the hypothesis that preferential prescribing of short-acting benzodiazepines instead of long-acting agents or atypical antipsychotic medications instead of typical agents will substantially decrease fall risk associated with the use of these classes of drugs.
Background
Selenium has a wide range of pleiotropic effects, influencing redox homeostasis, thyroid hormone metabolism, and protecting from oxidative stress and inflammation. Serum selenium levels ...are reduced in the older population.
Objectives
to investigate the association of serum selenium levels with all-cause mortality in a sample of community-dwelling older adults.
Design and Setting
Data are from the ‘Invecchiamento e Longevità nel Sirente’ (Aging and Longevity in the Sirente geographic area, ilSIRENTE) study, a prospective cohort study that collected information on individuals aged 80 years and older living in an Italian mountain community (n=347). The main outcome was risk of death after ten years of follow-up.
Participants and measurements
Participants were classified according to the median value of selenium (105.3 μg/L) in two groups: high selenium and low selenium.
Results
A total of 248 deaths occurred during a 10-year follow-up. In the unadjusted model, low levels of selenium was associated with increased mortality (HR, 0.66; 95% CI 0.51-0.85). After adjusting for potential confounders the relationship remained significant (HR, 0.71; 95% CI 0.54-0.92).
Conclusions
Low serum levels of selenium are associated with reduced survival in elderly, independently of age and other clinical and functional variables.
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