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Middle-aged
Terms modified by Middle-aged Selected AbstractsThe Vulnerability of Middle-Aged and Elderly Patients to Hepatitis C Virus Infection in a High-Prevalence Hospital-Based Hemodialysis SettingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Anil K. Saxena MD Objectives: To determine the relationship between advancing age and the risk of acquiring hepatitis C virus (HCV) infection, through evaluation and statistical comparison of seroprevalence and seroconversion rates in different age groups of patients on long-term hemodialysis (HD). Design: Retrospective cohort study. Setting: Hemodialysis facility of King Fahad Hospital and Tertiary Care Center, Al-Hasa region of the eastern province of Saudi Arabia. Participants: One hundred ninety-eight patients with end-stage renal disease enrolled for long-term HD therapy from September 1995 to September 2000. Measurements: HCV seroprevalence and seroconversion rates. Results: The overall HCV seroprevalence of 43.4% (86/198) and seroconversion rate of 8.6% per year were recorded. Patients aged 55 to 64 had the highest anti-HCV prevalence (55.3% (26/47)) and annual seroconversion rates (11.0%). Those aged 65 to 74 had the next-highest prevalence (48.9% (24/49)) and seroconversion rate (9.7%), and patients aged 15 to 24 had the lowest prevalence (12.5% (1/8)) and seroconversion rate (2.5%) (reference group). Conclusion: Significantly higher annual seroconversion rates in those aged 55 to 64 and 65 to 74 during a shorter dialysis period (35.6 and 32.7 vs 58.0 months), suggest the greater susceptibility of the middle-aged and elderly patients to acquisition of HCV infection than the younger (15,24 years) group. This could be attributed to the combined effect of immunosuppression associated with advancing age, uremia, and undernutrition, but multicenter molecular follow-up studies with larger sample sizes would be needed to corroborate these findings and plan appropriate strategies for these high-risk groups. [source] Respiratory Function as a Marker of Bone Health and Fracture Risk in an Older Population,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2009Alireza Moayyeri Abstract Identification of those at high risk of osteoporosis and fractures using clinically available tests beyond BMD measures is a major clinical challenge. We examined forced expiratory volume in 1 s (FEV1), an easily obtainable measure of respiratory function, as a clinical measure for fracture prediction. In the context of the European Prospective Investigation into Cancer-Norfolk Study, 8304 women and 6496 men 42,81 yr of age underwent a health check including spirometry and heel quantitative ultrasonography between 1997 and 2000 and were followed up for incident hip fractures until 2007. The main outcome measures were broadband ultrasound attenuation (BUA) of the heel (cross-sectional analysis) and hip fracture risk (prospective analysis). In multivariate regression models, a 1-liter increase in FEV1 was associated with a statistically significant 2.2-dB/MHz increase in BUA, independent of age, smoking, height, body mass index, history of fracture, and use of corticosteroids. Mean FEV1 was significantly lower among 84 women and 36 men with hip fracture compared with other participants. In multivariate proportional-hazard regression models, the relative risk (RR) of hip fracture associated with a 1-liter increase in FEV1 was 0.5 (95% CI, 0.3,0.9; p < 0.001) for both men and women. RR of hip fracture for a 1 SD increase in FEV1 was approximately equivalent to a 0.5 SD increase in BUA among women (1 SD among men) and an ,5-yr decrease in age among both men and women. Middle-aged and older people with low respiratory function are at increased risk of osteoporosis and hip fracture. FEV1, an easy, low-cost, and feasible clinical measure, may help improve the identification of high-risk groups. [source] Post-operative pressure lability and cardiac baroreflex in normotensive patients as a function of ageACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2008A. CIVIDJIAN Background: Pressure lability may be linked to the loss of the cardiac baroreflex. The reduction of the sensitivity of the cardiac baroreflex has not been delineated in the post-operative period according to age in normotensive patients. This study addresses pressure lability and slope of the cardiac baroreflex as a function of age. Methods: Patients were allocated to the following three groups: young (20,39 years, n=7), middle aged (40,59 years, n=7) and elderly (60,79 years, n=6), and studied before minor intra-abdominal surgery under CO2 peritoneal insufflation and nitrous oxide,isoflurane,sufentanil anesthesia, up to 24 h after extubation. An electrocardiogram and non-invasive beat-by-beat pressure monitoring (Finapres®) allowed offline calculation of the sensitivity of the cardiac baroreflex (,sequence' technique) and standard deviation (SD) of heart rate (HR; HR variability) and systolic blood pressure (SBP; pressure lability). Results: Before anesthesia, (a) an inverse relationship was observed between the slope of the cardiac baroreflex and age and (b) a trend (P<0.09) existed between the slope of the cardiac baroreflex and pressure lability, irrespective of age. During the early post-operative period, young patients returned to their baseline slope of the cardiac baroreflex; no inverse relationship between increased SD of SBP and decreased SD of RR interval was observed. Middle-aged and elderly patients displayed a depressed slope of the cardiac baroreflex both before and after anesthesia. Conclusion: At variance with the pre-operative period, no simple inverse relationship was observed between increased pressure lability and depressed HR variability in young patients during the early post-operative period. [source] Strategies for improving melanoma education and screening for men age , 50 yearsCANCER, Issue 7 2002Findings from the American Academy of Dermatology National Skin Cancer Screening Program Abstract BACKGROUND Recently, the Institute of Medicine (2000) and the Third United States Preventive Services Task Force (2001) called for studies to help clinicians identify patients, especially elderly patients, who are at high risk for melanoma. In the current study, the authors sought to identify factors associated with a high yield in skin cancer screening and to explore strategies for improving mass screenings for melanoma. METHODS The authors analyzed the data base of the 242,374 skin cancer screenings conducted on more than 206,000 Americans who attended the American Academy of Dermatology National Skin Cancer Screening Programs during the period 1992,1994. RESULTS Ninety-six percent of 3476 screenees with a presumptive diagnosis of melanoma or possible melanoma were contacted, and follow-up records were obtained for 73% of screenees. Of these, 363 screenees had histologically proven melanoma. Middle-aged and older men (age , 50 years) comprised only 25% of screenees but comprised 44% of those with a confirmed diagnosis of melanoma. The overall yield of melanoma (the number of confirmed diagnoses per the number of screenees) was 1.5 per 1000 screenings (363 diagnoses of 242,374 screenees) compared with a yield of 2.6 per 1000 screenings among men age , 50 years. The yield was improved further for men age , 50 years who reported either a changing mole (4.6 per 1000 screenings) or skin types I and II (3.8 per 1000 screenings). The predictive value of a screening diagnosis of melanoma was more than twice as high for men age , 50 years with either a changing mole or skin types I and II compared with all other participants. CONCLUSIONS The yield of mass screening for melanoma would be improved by outreach to middle-aged and older men, with particular focus on men with changing moles or with skin types I and II. Primary care physicians should be attuned to the risk factors among all of their patients but should be alerted in particular to the heightened risk of melanoma for men age , 50 years. Formal assessment of the impact of targeted screening on mortality warrants further study. Cancer 2002;95:1554,61. © 2002 American Cancer Society. DOI 10.1002/cncr.10855 [source] Age-related anthropometric remodelling resulting in increased and redistributed adiposity is associated with increases in the prevalence of cardiovascular risk factors in Chinese subjectsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 1 2006G. Neil Thomas Abstract Background Ageing promotes increases in the prevalence of components of the metabolic syndrome, which obesity often underlies. Methods We report the relationship between ageing, obesity and other cardiovascular risk factors in 694 community-based Chinese subjects in gender-specific groups of three age ranges: 20.0,39.9 (young), 40.0,59.9 (middle-aged) and 60.0,79.9 (old-aged) years. Results Body mass index (BMI) values were similar in males in each age group, but waist and percentage body fat increased (6.6, and 39.5%, both p < 0.001, respectively), from young to old-age groups, as did blood pressure and glycated haemoglobin levels (all p < 0.001). In the females, increases (all p < 0.001) in percentage body fat (29.3%) were accompanied by greater increases in BMI (10.3%) and waist (19.2%) than the males. Blood pressure, glycated haemoglobin, total and LDL-cholesterol and triglyceride levels increased linearly with age (all p < 0.001). Conclusion Age-related increases in central adiposity and percentage body fat were associated with increasingly adverse cardiovascular risk factor profiles. Copyright © 2005 John Wiley & Sons, Ltd. [source] A Novel Approach to Assess Aortic Stiffness Related to Changes in Aging Using a Two-Dimensional Strain ImagingECHOCARDIOGRAPHY, Issue 9 2008Yoshifumi Oishi M.D. Background: Recently, it has been demonstrated that aortic stiffness is associated with cardiovascular morbidity and mortality. The objective of the present study was to accurately evaluate the aortic stiffness relative to the changes in aging using two-dimensional (2D) strain imaging in 39 comparatively normal patients (15,85 years). Methods: We obtained short-axis images of the abdominal aorta (Ao) and determined the peak circumferential strain (Ao-S) and strain rate (Ao-SR) and the time from Q-wave of electrocardiogram to peak Ao-S using the 2D strain imaging. The stiffness parameters ,1 and ,2 of the abdominal aorta were measured using M-mode ultrasonography and 2D strain imaging, respectively. Results: The stiffness parameters ,1 and ,2 correlated significantly with age (r=0.51, P < 0.001 and r=0.69, P < 0.0001, respectively), particularly the latter parameter ,2. The peak circumferential Ao-S and Ao-SR correlated strongly with age (r=,0.79, P < 0.0001 and r=,0.87, P < 0.0001, respectively). The stiffness parameter ,1 was significantly greater in the old-aged group (>60 years) than in the young-aged group (<30 years). The peak circumferential Ao-S and Ao-SR were significantly lower in the middle-aged (30,60 years) and old-aged groups than in the young-aged group. Conclusion: The aortic circumferential strain and strain rate measured by 2D strain imaging allow simple and accurate determination of the aortic stiffness. [source] WORKFORCE COMPOSITION AND FIRM PRODUCTIVITY: EVIDENCE FROM TAIWANECONOMIC INQUIRY, Issue 4 2010JIN-TAN LIU We study the relationship between workforce composition and firm productivity based on a new employee-employer-matched data set, using an array of workforce characteristics and three alternative measures of firm productivity. While firm age is not essential for the performance of firms, those of smaller size and those in the steel and transportation industries outperform others. Moreover, labor quality, particularly the middle-aged with higher education, contributes significantly to firms' productivity. Furthermore, economic incentives and market competition both play important roles in the performance of firms. Finally, there is an employer-size premium with larger firms paying higher wages and nonwage benefits. (JEL C33, D20, J30) [source] Weakening of one more alcohol control pillar: a review of the effects of the alcohol tax cuts in Finland in 2004ADDICTION, Issue 4 2009Pia Mäkelä ABSTRACT Aims To review the consequences of the changes in Finnish alcohol policy in 2004, when quotas for travellers' tax-free imports of alcoholic beverages from other European Union (EU) countries were abolished, Estonia joined the EU and excise duties on alcoholic beverages were reduced in Finland by one-third, on average. Design A review of published research and routinely available data. Setting Finland. Measurements Prices of alcoholic beverages, recorded and unrecorded alcohol consumption, data on criminality and other police statistics, alcohol-related deaths and hospitalizations, service use. Findings Alcohol consumption increased 10% in 2004, clearly more than in the early 2000s. With few exceptions, alcohol-related harms increased. Alcohol-induced liver disease deaths increased the most, by 46% in 2004,06 compared to 2001,03, which indicates a strong effect on pre-2004 heavy drinkers. Consumption and harms increased most among middle-aged and older segments of the population, and harms in the worst-off parts of the population in particular. Conclusions Alcohol taxation and alcohol prices affect consumption and related harms, and heavy drinkers are responsive to price. In Finland in 2004, the worst-off parts of the population paid the highest price in terms of health for cuts in alcohol prices. The removal of travellers' import quotas, which was an inherent part of creating the single European market, had serious public health consequences in Finland. [source] Why is soluble intercellular adhesion molecule-1 related to cardiovascular mortality?EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2002A. Becker Increased plasma levels of soluble adhesion molecules are associated with an increased risk of atherothrombosis. The pathophysiological mechanisms responsible for these associations are not known. The aim of the present study was to investigate the association of soluble intercellular adhesion molecule-1 (sICAM-1) concentration and risk of cardiovascular and all-cause mortality among individuals with and without type 2 diabetes. In addition, we assessed potential pathophysiological mechanisms by which sICAM-1 may promote mortality. Six hundred and thirty-one subjects taken from a general population of the middle-aged and elderly participated in this prospective cohort study. Baseline data collection was performed from 1989 to 1992; subjects were followed until 1 January 2000. Subjects who died had higher levels of sICAM-1 than those who survived (506(164) vs. 477(162) ng mL,1, respectively). After adjustment for age, gender and glucose tolerance status, subjects with sICAM-1 levels in the upper quartile (,550 ng mL,1) had a relative risk of cardiovascular mortality of 2·05 (95% confidence interval, 1·10,3·81) compared to subjects with sICAM-1 levels in the other quartiles. Further adjustment for classical cardiovascular risk factors or indicators of (sub)clinical atherosclerosis, endothelial dysfunction, inflammation and renal function did not materially alter this relative risk. A high sICAM-1 level was more frequent in subjects with type 2 diabetes than in subjects with a normal glucose tolerance (33·3 vs. 17·8%). Individuals with a plasma concentration of sICAM-1 higher than 550 ng mL,1 had a cardiovascular mortality risk that was twice that of individuals with a lower concentration. Classical cardiovascular risk factors (sub)clinical atherosclerosis, endothelial dysfunction and inflammation do not explain this excess risk. [source] Age-dependent effect of prenatal stress on hippocampal cell proliferation in female ratsEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 3 2009Muriel Koehl Abstract Stressors occurring during pregnancy can alter the developmental trajectory of offspring and lead to, among other deleterious effects, cognitive deficits and hyperactivity of the hypothalamo-pituitary-adrenal axis. A recent feature of the prenatal stress (PS) model is its reported influence on structural plasticity in hippocampal formation, which sustains both cognitive functions and stress responsiveness. Indeed, we and others have previously reported that males exposed to stress in utero are characterized by a decrease in hippocampal cell proliferation, and consequently neurogenesis, from adolescence to senescence. Recent studies in females submitted to PS have reported conflicting results, ranging from no effect to a decrease in cell proliferation. We hypothesized that changes in cell proliferation in PS female rats are age dependent. To address this issue, we examined the impact of PS on hippocampal cell proliferation in juvenile, young, middle-aged and old females. As hypothesized, we found an age-dependent effect of PS in female rats as cell proliferation was significantly decreased only when animals reached senescence, a time when adrenal gland weight also increased. These data suggest that the deleterious effects of PS on hippocampal cell proliferation in females are either specific to senescence or masked during adulthood by protective factors. [source] Is self-reported alcohol consumption associated with osteoporotic mandibular bone loss in women?EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2009Olivia Nackaerts The aim of this study was to determine whether alcohol consumption would predict mandibular bone quality and quantity in a large European female population. In total, 672 middle-aged and elderly women (45,70 yr of age; standard deviation = 6) were recruited in the study. Alcohol consumption was recorded through a self-reported questionnaire. Mandibular cortical width was measured, by five observers, in the mental foramen region on panoramic radiographs. Mandibular bone density, expressed as aluminium thickness, was recorded on intra-oral radiographs. Alcohol consumption was associated with a reduction of mandibular bone density and cortical width. This association was higher in subjects with excessive alcohol consumption, defined in the present study as > 14 units consumed per week. This study showed reduced jaw-bone quality in older individuals and in those with increased alcohol consumption. [source] Hypertrophic cardiomyopathy in the elderlyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2010Toru Kubo Hypertrophic cardiomyopathy (HCM) is a relatively common genetic cardiac disorder with heterogeneous morphological, functional and clinical features. Although the risk of sudden death and incapacitating symptoms in young patients has been focused upon, the disease has been found with increasing frequency in elderly patients. However, there have been few studies on clinical features of HCM in the elderly. We established a cardiomyopathy registration study in Kochi Prefecture, which is one of the most aged communities in Japan, to provide detailed descriptions of the clinical features of HCM in a community-based patient cohort. The unselected regional HCM population consisted largely of elderly patients (70% of the study cohort being ,60 years of age at registration), although HCM has been regarded largely as a disease of the young. Cardiac hypertrophy that becomes clinically apparent late in life can be a genetic disorder, and mutations in the cardiac myosin-binding protein C gene are the most common cause of late-onset or elderly HCM. In the morphological features, sarcomere gene defects seem to have a predilection for a crescent-shaped left ventricular cavity with reversed septal curvature even in elderly patients, although an ovoid left ventricular shape was frequently seen in elderly patients in previous clinical studies on morphological characteristics of HCM. In middle-aged or elderly patients with HCM, heart failure and embolic events, which were strongly associated with atrial fibrillation, were very important. It is important to manage HCM patients from the standpoint of longitudinal evolution in order to prevent those clinical complications. [source] Aging per se does not influence postprandial glucose levels in type 2 diabetesGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2005Yumiko Magata Background: It is well known that postprandial glucose increases with aging in non-diabetic subjects. The question we addressed is whether elderly type 2 diabetic patients with definite fasting hyperglycemia (, 126 mg/dL) also display increased postprandial hyperglycemia relative to their younger counterparts. Methods: Diurnal plasma glucose profiles were measured in 162 overt type 2 diabetic patients treated by diet alone (diet group) or with sulfonylureas as monotherapy (SU group). Plasma glucose concentrations were measured at 08.00 hours (before breakfast), 10.00, 12.00 (before lunch), 14.00, 18.00 (before dinner), 20.00, 24.00, 03.00, 06.00 and 08.00 hours the next morning. The postprandial glucose area under the curve (AUC) from 08.00 to 24.00 hours was calculated above the baseline level equal to the 08.00-hours plasma glucose value, and the relationships with clinical variables, including age, were assessed. Results: There were no differences in diurnal plasma glucose profiles between the middle-aged (< 65 years) and elderly (, 65 years) groups either the diet group or the SU group. Univariate analysis showed that the postprandial glucose area under the curve was related to the 08:00-hours plasma glucose value (R = 0.583, P < 0.001) in the diet alone group and to the duration of diabetes (R = 0.220, P < 0.05), SU dose (R = 0.330, P = 0.001) and urine CPR (R = ,0.229, P < 0.05) in the SU group. In multivariate analysis, postprandial glucose area under the curve was only related to 08.00 hours plasma glucose value in the diet group (R2 of the model = 0.340, P < 0.001) and to the SU dose in SU group (R2 of the model = 0.145, P < 0.001). Conclusion: These results suggest that aging, per se, does not influence postprandial glucose levels in overt type 2 diabetic patients. [source] Stem/progenitor cell proliferation factors FGF-2, IGF-1, and VEGF exhibit early decline during the course of aging in the hippocampus: Role of astrocytesGLIA, Issue 3 2005Ashok K. Shetty Abstract Dentate neurogenesis, important for learning and memory, declines dramatically by middle age. Although studies have shown that this age-related decrease can be reversed to some extent by exogenous applications of mitogenic factors, it is unclear whether one or more of these factors exhibits decline by middle age. We hypothesize that multiple stem/progenitor cell proliferation factors exhibit early decline during the course of aging in the hippocampus, and some of these declines are linked to age-related alterations in hippocampal astrocytes. We measured the concentrations of fibroblast growth factor-2 (FGF-2), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF) in the hippocampus of young, middle-aged, and aged F344 rats, using enzyme-linked immunosorbent assay (ELISA). In addition, we quantified the total number of FGF-2 immunopositive (FGF-2+) and glial fibrillary acidic protein immunopositive (GFAP+) cells in the dentate gyrus and the entire hippocampus. Our results provide new evidence that the concentrations of FGF-2, IGF-1, and VEGF decline considerably by middle age but remain steady between middle age and old age. Further, decreased concentrations of FGF-2 during aging are associated with decreased numbers of FGF-2+ astrocytes. Quantification of GFAP+ cells, and GFAP and FGF-2 dual immunostaining analyses, reveal that aging does not decrease the total number of astrocytes but fractions of astrocytes that express FGF-2 decline considerably by middle age. Thus, dramatically decreased dentate neurogenesis by middle age is likely linked to reduced concentrations of FGF-2, IGF-1, and VEGF in the hippocampus, as each of these factors can individually influence the proliferation of stem/progenitor cells in the dentate gyrus. Additionally, the results demonstrate that decreased FGF-2 concentration during aging is a consequence of age-related impairment in FGF-2 synthesis by astrocytes. © 2005 Wiley-Liss, Inc. [source] Emerging clinical concerns in the ageing haemophilia patientHAEMOPHILIA, Issue 6 2009B. A. KONKLE Summary., The availability of safe replacement clotting factor concentrates together with effective antiviral drugs to treat human immunodeficiency and hepatitis C viruses and the provision of care at designated haemophilia treatment centres have resulted in a new phenomenon in haemophilia management , the ageing patient. Today, increasing numbers of persons with haemophilia (PWH) are middle-aged and older, and they face the same age-related health issues as the general population. The impact of these risks on PWH is unclear, however, and there is a paucity of information about how to manage comorbidities in this patient population. This review focuses on five comorbidities that uniquely affect older PWH: cardiovascular disease, liver disease, cancer, renal disease and joint disease. Available research is summarized and potential management approaches are suggested. [source] Quantitative two-dimensional analysis of facial wrinkles of Japanese women at various agesINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 2 2002K. Tsukahara Synopsis To evaluate individual differences in the recognition of facial wrinkles, we asked 40 Japanese female observers to identify wrinkles using transparent sheets over frontal facial photos of four females aged 20, 39, 55 or 75 years. We then measured the number and length of those wrinkles by image analysis. Wrinkles identified by those 40 observers showed aged-related increases in the standard deviation (SD) values for number and length but age-related decreases in the coefficient of variation (CV)%. Therefore, to clarify factors affecting the degree of wrinkle detection, wrinkles were identified by two groups of age-matched male and female observers, by two groups that differed by age, and by two other groups, one of which who felt that there was an improvement in their wrinkles after application of an antiwrinkle agent and another group who did not feel that there was any improvement after the same treatment. Improvement was observed by replica image analysis in all groups. The degree of wrinkles identified was not affected by the age or by the sex of the observer group. However, the group who felt that there was an improvement in their wrinkles after treatment with the antiwrinkle agent identified a significantly higher number of wrinkles than did the group who did not feel that there was an improvement. These results suggest marked individual differences in the recognition of wrinkles. Fine wrinkles in relatively young subjects are difficult to detect, but moderate to marked wrinkles in middle-aged and in aged subjects can easily be detected. Concerning the cause of individual differences in the extent of wrinkle detection, observers who identified a large number of wrinkles tended to recognize not only pronounced wrinkles but also recognized fine wrinkles as ,wrinkles'. This seems to have also affected their feelings about the success of treatment with the antiwrinkle agent. Résumé Pour pouvoir évaluer les différences individuelles dans la l'identification des rides faciale, nous avons demandéà 40 femmes japonaises d'identifier des rides en utilisant des feuilles transparentes sur des photos faciales frontales de quatre femmes, âgées respectivement de 20, 39, 55 et 75 ans. Nous avons alors mesuré le nombre et la longueur de ces rides par analyse d'images. Les rides identifiées par ces 40 femmes montraient que le vieillissement qui s'y rattachait augmentait selon les valeurs d'un écart standard (ES) pour le nombre et la longueur, mais que le vieillissement qui s'y rattachait diminuait dans le pourcentage du coefficient de variation. Par conséquent, pour clarifier les facteurs affectant le degré de détection des rides, ces dernières furent identifiées par deux groupes d'hommes et de femmes dont l'âge coïncidait, âgés de 26,6 ans et de 44,5 ans, et par deux autres groupes. Un groupe qui a estimé qu'il y avait eu une amélioration dans les rides après une application de 6 semaines d'un agent antirides aux coins des yeux et un autre groupe qui a considéré qu'après le même traitement il n'y avait pas eu d'amélioration. Une amélioration fut remarquée par la copie d'une analyse d'images dans tous les groupes. Le degré d'importance des rides identifiées n'était pas affecté par l'âge ou le sexe des groupes étudiés. Cependant, le groupe qui a estimé qu'il y avait eu une amélioration concernant leurs rides après un traitement avec un agent antirides a identifié un nombre significativement plus élevé de rides que le groupe qui estimait qu'il n'y avait pas eu d'amélioration. Ces résultats suggèrent des différences individuelles notoires dans l'identification de rides. De minces rides dans les groupes relativement jeunes sont difficiles à déceler. Mais des rides modérées remarquées dans les groupes de personnes d'un,ge moyen et, âgées peuvent être facilement localisées. Concernant la cause de ces différences individuelles dans l'importance d'un décèlement des rides, les sujets qui identifièrent un grand nombre de rides avaient tendance à ne pas prononcer le mot ,rides', mais trouvaient que de fines rides n'étaient que des ,rides'. Cela semblait aussi affecter leurs sentiments après le succès du traitement avec des agents antirides. [source] Prevalence and longitudinal stability of negative symptoms in healthy participantsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2009Lindsay C. Emmerson Abstract Objective Although negative symptoms are prominent in older patients with schizophrenia, it is unknown whether this pattern is prevalent in healthy participants. The objective of this study was to evaluate whether negative symptoms are present in healthy populations and to determine whether they are linked to illness-related processes or normal aging. Methods A systemic review of 26 studies that have administered negative symptom assessments to healthy participants was conducted. In addition, 213 (age,>,40,years old) healthy participants completed PANSS and SANS ratings at both baseline and 1-year follow-up. One-hundred participants also completed ratings after 3 years. Results Across all reviewed studies, negative symptoms were absent in the majority of participants. Comparable results were found in the current study's large longitudinal evaluation with middle-aged to older adults. Conclusions Taken together, the data suggest that healthy volunteers do not suffer from prominent negative symptoms. This finding is consistent with the hypothesis that the greater prevalence and severity of negative symptoms in older patients is not related to normal aging but to illness-related processes. Copyright © 2009 John Wiley & Sons, Ltd. [source] Insight, quality of life, and functional capacity in middle-aged and older adults with schizophreniaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2008Ashley S. Roseman Abstract Objective The quality of life (QOL) for individuals with schizophrenia is determined by a number of factors, not limited to symptomatology. The current study examined lack of insight as one such factor that may influence subjective QOL or functional capacity. It was hypothesized that insight would significantly interact with symptom severity to influence subjective QOL. Insight was not expected to influence the relation between symptom severity and functional capacity. Methods Participants were middle-aged and older outpatients who met diagnostic criteria for schizophrenia or schizoaffective disorder, and subsyndromal depression. Insight, psychopathology, and subjective QOL were assessed via semi-structured interviews and functional capacity was assessed via performance-based measures. Results Insight interacts with negative symptom severity to predict subjective QOL. Severity of negative symptoms and insight contribute directly to functional capacity. Conclusions Individuals with intact insight may be better able to manage their symptoms, resulting in improved QOL. Treatment implications for improving the QOL of middle age and older adults with schizophrenia are discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Measurement-specific bioavailable testosterone using concanavalin A precipitation: Comparison of calculated and assayed bioavailable testosteroneINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2009Kenrou Yamamoto Objective: To assess the value of calculated bioavailable testosterone (cBT) and assayed BT (aBT) for the diagnosis of late-onset hypogonadism (LOH) in middle-aged and elderly subjects. Methods: In order to assay serum BT, sex hormone-binding globulin was precipitated with concanavalin-A and then testosterone was measured using liquid chromatography-tandem mass spectrometry. To validate the non-sex-hormone-binding-globulin-bound testosterone, gel filtration chromatography and concanavalin-A sepharose were used. Following this validation, the usefulness between aBT and cBT was evaluated in clinical samples. Results: Eighty-eight healthy male volunteers (mean age 65.6 years, range: 50,86) were recruited for this study. A significant correlation was found between cBT and aBT (R2 = 0.53, P < 0.01). Mean value ratio (cBT/aBT) was 2.48. Both cBT (R2 = 0.122) and aBT (R2 = 0.251) decreased with age. Variations in aBT were less marked than those for cBT, suggesting that aBT can be used to determine age-related reduced testosterone levels. Conclusion: aBT levels are more reliable than cBT levels for the diagnosis of LOH in middle-aged and elderly subjects. [source] Determinants of perceived barriers to condom use among HIV-infected middle-aged and older African-American menJOURNAL OF ADVANCED NURSING, Issue 4 2007Christopher Lance Coleman Abstract Title.,Determinants of perceived barriers to condom use among HIV-infected middle-aged and older African-American men Aim., This paper is a report of a study to describe which determinants best predict perceived barriers to condom use during sexual encounters among human immunodeficiency virus human immunodeficiency virus-infected African-American men, middle-aged and older, living in the United States of America. Background., While the global epidemic of acquired immunodeficiency syndrome infection is a well-documented phenomenon with national and international implications, prevalence statistics indicate that middle-aged and older African-American (non-Hispanic) men have not benefited from the prevention efforts implemented during the past two decades. Method., A cross-sectional design using a survey and convenience sampling was adopted between September 2003 and July 2004 to recruit n = 130 middle-aged human immunodeficiency virus-infected African-American men from infectious disease clinics from the Mid-Atlantic region in the United States of America. The survey covered demographics, perceived health beliefs, spiritual well-being and symptoms related to human immunodeficiency virus. Findings., Stepwise multiple regression showed having fewer human immunodeficiency virus-related symptoms associated with the human immunodeficiency virus (P = 0·004) and being single (P = 0·05) were perceived as barriers to condom use during sexual encounters (R2 = 0·029, P = 0·046). Conclusion., Tailored interventions are needed for African-American men, middle-aged and older, infected with human immunodeficiency virus nationally and worldwide that are designed to decrease perceived barriers in order to increase condom use. [source] The Vulnerability of Middle-Aged and Elderly Patients to Hepatitis C Virus Infection in a High-Prevalence Hospital-Based Hemodialysis SettingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Anil K. Saxena MD Objectives: To determine the relationship between advancing age and the risk of acquiring hepatitis C virus (HCV) infection, through evaluation and statistical comparison of seroprevalence and seroconversion rates in different age groups of patients on long-term hemodialysis (HD). Design: Retrospective cohort study. Setting: Hemodialysis facility of King Fahad Hospital and Tertiary Care Center, Al-Hasa region of the eastern province of Saudi Arabia. Participants: One hundred ninety-eight patients with end-stage renal disease enrolled for long-term HD therapy from September 1995 to September 2000. Measurements: HCV seroprevalence and seroconversion rates. Results: The overall HCV seroprevalence of 43.4% (86/198) and seroconversion rate of 8.6% per year were recorded. Patients aged 55 to 64 had the highest anti-HCV prevalence (55.3% (26/47)) and annual seroconversion rates (11.0%). Those aged 65 to 74 had the next-highest prevalence (48.9% (24/49)) and seroconversion rate (9.7%), and patients aged 15 to 24 had the lowest prevalence (12.5% (1/8)) and seroconversion rate (2.5%) (reference group). Conclusion: Significantly higher annual seroconversion rates in those aged 55 to 64 and 65 to 74 during a shorter dialysis period (35.6 and 32.7 vs 58.0 months), suggest the greater susceptibility of the middle-aged and elderly patients to acquisition of HCV infection than the younger (15,24 years) group. This could be attributed to the combined effect of immunosuppression associated with advancing age, uremia, and undernutrition, but multicenter molecular follow-up studies with larger sample sizes would be needed to corroborate these findings and plan appropriate strategies for these high-risk groups. [source] Abdominal aortic calcification on vertebral morphometry images predicts incident myocardial infarctionJOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2010Mark J Bolland Abstract Abdominal aortic calcification (AAC) measured on spine X-rays is an established risk factor for cardiovascular disease. We investigated whether AAC assessed using vertebral morphometry and a recently developed scoring system (AAC-8) is reliable and associated with cardiovascular risk factors or events. A total of 1471 healthy postmenopausal women and 323 healthy middle-aged and older men participated in 5 and 2,year trials of calcium supplements, respectively. AAC-8 was assessed on vertebral morphometry images at baseline and follow-up. In addition, 163 men also had coronary artery calcification measured using computed tomography. Cardiovascular events during the trials were independently adjudicated. We found strong inter- and intrameasurer agreement for AAC-8 (,,>,0.87). The prevalence of AAC increased with age (p,<,.01) in women and in men. AAC was associated with many established cardiovascular risk factors, with serum calcium in women (p,=,.002) and with higher coronary calcium scores in men (p,=,.03). Estimated 5,year cardiovascular risk increased with increasing AAC-8 score (p,<,.001) in women and in men. The presence of AAC independently predicted myocardial infarction (MI) in women [hazards ratio (HR),=,2.30, p,=,.007] and men (HR,=,5.32, p,=,.04), even after adjustment for estimated cardiovascular risk in women. In women, AAC independently predicted cardiovascular events (MI, stroke, or sudden death) (HR,=,1.74, p,=,.007), and changes in AAC-8 score over time were associated with MI and cardiovascular events, even after adjustment for estimated cardiovascular risk. In summary, scoring AAC on vertebral morphometric scans is a reproducible method of assessing cardiovascular risk that independently predicts incident MI and cardiovascular events, even after taking into account traditional cardiovascular risk factors. © 2010 American Society for Bone and Mineral Research [source] Long-Term Leisure Time Physical Activity and Properties of Bone: A Twin Study,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 8 2009Hongqiang Ma Abstract Effects of physical activity on bone properties, when controlled for genetic effects, are not fully understood. We aimed to study the association between long-term leisure time physical activity (LTPA) and bone properties using twin pairs known to be discordant for leisure time physical activity for at least 30 yr. Volumetric BMD and geometric properties were measured at the tibia shaft and distal end using pQCT in 16 middle-aged (50,74 yr) same-sex twin pairs (seven monozygotic [MZ] and nine dizygotic [DZ] pairs) selected from a population-based cohort. Paired differences between active and inactive co-twins were studied. Active members of MZ twin pairs had larger cortical bone cross-sectional area (intrapair difference: 8%, p = 0.006), thicker cortex (12%, p = 0.003), and greater moment of inertia (Imax, 20%, p = 0.024) at the tibia shaft than their inactive co-twins. At the distal tibia, trabecular BMD (12%, p = 0.050) and compressive strength index (18%, p = 0.038) were also higher in physically active MZ pair members than their inactive co-twins. The trends were similar, but less consistently so, in DZ pairs as in MZ pairs. Our genetically controlled study design shows that LTPA during adulthood strengthens bones in a site-specific manner, that is, the long bone shaft has a thicker cortex, and thus higher bending strength, whereas the distal bone has higher trabecular density and compressive strength. These results suggest that LTPA has a potential causal role in decreasing the long-term risk of osteoporosis and thus preventing osteoporotic fractures. [source] Age-Related Changes in the Osteogenic Differentiation Potential of Mouse Bone Marrow Stromal Cells,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 7 2008Weixi Zhang Abstract Age-dependent bone loss has been well documented in both human and animal models. Although the underlying causal mechanisms are probably multifactorial, it has been hypothesized that alterations in progenitor cell number or function are important. Little is known regarding the properties of bone marrow stromal cells (BMSCs) or bone progenitor cells during the aging process, so the question of whether aging alters BMSC/progenitor osteogenic differentiation remains unanswered. In this study, we examined age-dependent changes in bone marrow progenitor cell number and differentiation potential between mature (3 and 6 mo old), middle-aged (12 and 18 mo old), and aged (24 mo old) C57BL/6 mice. BMSCs or progenitors were isolated from five age groups of C57BL/6 mice using negative immunodepletion and positive immunoselection approaches. The osteogenic differentiation potential of multipotent BMSCs was determined using standard osteogenic differentiation procedures. Our results show that both BMSC/progenitor number and differentiation potential increase between the ages of 3 and 18 mo and decrease rapidly thereafter with advancing age. These results are consistent with the changes of the mRNA levels of osteoblast lineage-associated genes. Our data suggest that the decline in BMSC number and osteogenic differentiation capacity are important factors contributing to age-related bone loss. [source] Age-Related Increase in Atrial Fibrillation Induced by Transvenous Catheter-Based Atrial Burst Pacing: An In Vivo Rat Model of Inducible Atrial FibrillationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2010DONGZHU XU M.D. AF Rat Model Induced by Transvenous Catheter Pacing.,Introduction: Large animal models of atrial fibrillation (AF) are well established, but limited experimental reports exist on small animal models. We sought to develop an in vivo rat model of AF using a transvenous catheter and to evaluate the model's underlying characteristics. Methods and Results: Echocardiogram, surface electrocardiogram (ECG), and atrial effective refractory period (AERP) were recorded at baseline in young (3 months) and middle-aged (9 months) Wistar rats. AF inducibility and duration were measured through transvenous electrode catheter in young (n = 11) and middle-aged rats (n = 11) and middle-aged rats treated with either pilsicainide (1 mg/kg iv, n = 7) or amiodarone (10 mg/kg iv, n = 9). Degrees of interstitial fibrosis and cellular hypertrophy in the atria were assessed histologically. The P-wave duration and AERP were significantly longer and echocardiographic left atrial dimension significantly larger in middle-aged versus young rats. AF was inducible in >90% of all procedures in both untreated rat groups, whereas AF inducibility was reduced by the antiarrhythmic drugs. The AF duration was significantly longer in middle-aged than in young rats and was significantly shortened by treatment with either pilsicainide or amiodarone. Histologic analysis revealed significant increases in atrial interstitial fibrosis and cellular diameter in middle-aged versus young rats. Conclusions: Transvenous catheter-based AF is significantly longer in middle-aged than in young rats and is markedly reduced by treatment with antiarrhythmic drugs. This rat model of AF is simple, reproducible, and reliable for examining pharmacologic effects on AF and studying the process of atrial remodeling.(J Cardiovasc Electrophysiol, Vol. 21, pp. 88,93, January 2010) [source] Elastofibromatous change of the oral mucosa: case report and literature reviewJOURNAL OF CUTANEOUS PATHOLOGY, Issue 10 2010Cassiano Francisco Weege Nonaka Elastofibroma is an uncommon fibrous pseudotumor that usually occurs in the subscapular region of middle-aged and older adults. Since its seminal description, cases of elastofibroma or elastofibroma-like proliferations have been identified at several anatomic locations, including the foot, hand, thigh, olecranon, gastrointestinal tract, trachea, dorsal spine and eye. Involvement of the oral cavity is rare, with only four cases reported to date. Herein, we report a case of elastofibromatous change in the soft palate of a 55-year-old man and review the literature regarding pathogenesis, clinicopathologic features, differential diagnosis and management. Nonaka CFW, Rêgo DM, Miguel MCC, de Souza LB, Pinto LP. Elastofibromatous change of the oral mucosa: case report and literature review. [source] Human NK cells display major phenotypic and functional changes over the life spanAGING CELL, Issue 4 2010Magali Le Garff-Tavernier Summary Aging is generally associated with an increased predisposition to infectious diseases and cancers, related in part to the development of immune senescence, a process that affects all cell compartments of the immune system. Although many studies have investigated the effects of age on natural killer (NK) cells, their conclusions remain controversial because the diverse health status of study subjects resulted in discordant findings. To clarify this situation, we conducted the first extensive phenotypic and functional analysis of NK cells from healthy subjects, comparing NK cells derived from newborn (cord blood), middle-aged (18,60 years), old (60,80 years), and very old (80,100 years) subjects. We found that NK cells in cord blood displayed specific features associated with immaturity, including poor expression of KIR and LIR-1/ILT-2 and high expression of both NKG2A and IFN-,. NK cells from older subjects, on the other hand, preserved their major phenotypic and functional characteristics, but with their mature features accentuated. These include a profound decline of the CD56bright subset, a specific increase in LIR-1/ILT-2, and a perfect recovering of NK-cell function following IL2-activation in very old subjects. We conclude that the preservation of NK cell features until very advanced age may contribute to longevity and successful aging. [source] Plasticity of hippocampal stem/progenitor cells to enhance neurogenesis in response to kainate-induced injury is lost by middle ageAGING CELL, Issue 2 2008Bharathi Hattiangady Summary A remarkable up-regulation of neurogenesis through increased proliferation of neural stem/progenitor cells (NSCs) is a well-known plasticity displayed by the young dentate gyrus (DG) following brain injury. To ascertain whether this plasticity is preserved during aging, we quantified DG neurogenesis in the young adult, middle-aged and aged F344 rats after kainic acid induced hippocampal injury. Measurement of new cells that are added to the dentate granule cell layer (GCL) between post-injury days 4 and 15 using 5,-bromodeoxyuridine labeling revealed an increased addition of new cells in the young DG but not in the middle-aged and aged DG. Quantification of newly born neurons using doublecortin immunostaining also demonstrated a similar trend. Furthermore, the extent of ectopic migration of new neurons into the dentate hilus was dramatically increased in the young DG but was unaltered in the middle-aged and aged DG. However, there was no change in neuronal fate-choice decision of newly born cells following injury in all age groups. Similarly, comparable fractions of new cells that are added to the GCL after injury exhibited 5-month survival and expressed the mature neuronal marker NeuN, regardless of age or injury at the time of their birth. Thus, hippocampal injury does not adequately stimulate NSCs in the middle-aged and aged DG, resulting in no changes in neurogenesis after injury. Interestingly, rates of both neuronal fate-choice decision and long-term survival of newly born cells remain stable with injury in all age groups. These results underscore that the ability of the DG to increase neurogenesis after injury is lost as early as middle age. [source] Beyond Parental Status: Psychological Well-Being in Middle and Old AgeJOURNAL OF MARRIAGE AND FAMILY, Issue 4 2002Tanya Koropeckyj-Cox Surveys show little evidence of psychosocial disadvantage among childless middle-aged and older adults, but less is known about the diverse experiences that influence subjective well-being among parents and childless adults. In this article, the author uses the National Survey of Families and Households to test a parental-status typology on the basis of attitudes among childless adults and parent-child relationship quality and the connection of these factors with loneliness and depression. Poorer parent-child relationships are linked to worse outcomes for both mothers and fathers, net of other factors. For childless adults, negative attitudes about childlessness are associated with greater distress for women than for men. [source] Alteration in Hypothalamic Neuropeptide Y (NPY) Secretion May Underlie Female Reproductive Ageing: Induction of Steroid-Induced Luteinising Hormone Surge by NPY in Ovariectomised Aged RatsJOURNAL OF NEUROENDOCRINOLOGY, Issue 8 2006A. Sahu A large body of evidence suggests that a defect in the hypothalamic function may be the primary cause of reproductive ageing in female rats. We have previously shown that luteinising hormone (LH)-surge associated changes in hypothalamic neuropeptide Y (NPY) gene expression and median eminence (ME) NPY levels seen in young rats do not occur in middle-aged (MA) rats. The present study examined whether hypothalamic NPY release is altered during the steroid-induced LH surge in ovariectomised (OVX) MA rats, and whether exogenous NPY initiates steroid-induced LH surge in OVX old rats. In the first study, NPY release from the ME-arcuate nucleus, as assessed by the push,pull cannula technique, was significantly increased before and during the progesterone-induced LH surge in oestrogen (E2)-primed ovariectomised young rats (2,3 months old). This antecedent increase in NPY release seen in young rats was not apparent in MA rats (11,13 months old) in association with a delayed and attenuated LH surge. In the second study, whereas progesterone failed to induce LH surges in E2 -primed ovariectomised old rats (23,25 months old), intracerebroventricular NPY (0.1,0.5 µg) injections at 1100, 1200 and 13.00 h resulted in LH surge induction in E2 + progesterone-primed ovariectomised old rats. Because increased hypothalamic NPY synthesis and release is obligatory for the preovulatory LH discharge in young rats, the present findings suggest that alteration in NPY release from the ME-arcuate nucleus contributes to the delayed and reduced LH surges in MA rats and may be involved in the subsequent loss of the LH surges in old rats. [source] | |||||||||||||||||||||||||||||||||||||||||||