The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Mar 2005
Comparative StudyApolipoprotein epsilon4 allele and problems with orientation are associated with a persistent decline in cognition in community-dwelling elderly persons.
A decline in cognitive test scores in elderly persons can signal the beginning of a descent into dementia or may indicate only a short-term cognitive disturbance. It would be clinically useful to distinguish between the two outcomes and to identify characteristics of each. ⋯ Persistent cognitive decline is an infrequent occurrence in community-dwelling elderly persons. Presence of the epsilon4 allele and errors made by the subject on questions of orientation may be useful in determining whether a cognitive decline is likely to be persistent.
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J. Gerontol. A Biol. Sci. Med. Sci. · Mar 2005
Comparative StudyPhysical disability contributes to caregiver stress in dementia caregivers.
Previous findings of studies on the impact of physical illness on caregiver health have been inconsistent. The authors wanted to determine whether physical disability, as determined by the SF-12 survey that provides information on both physical and mental health problems, contributes to caregiver stress. ⋯ Chronic disability as assessed by SF-12 PCS scores is independently associated with caregiver stress. These data suggest that caregivers of persons with dementia should be assessed for disabling physical conditions and mental health problems. In addition, reducing the impact of physical disability could ameliorate caregiver stress.
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J. Gerontol. A Biol. Sci. Med. Sci. · Feb 2005
Randomized Controlled Trial Clinical TrialTai Chi and fall reductions in older adults: a randomized controlled trial.
The authors' objective was to evaluate the efficacy of a 6-month Tai Chi intervention for decreasing the number of falls and the risk for falling in older persons. ⋯ A three-times-per-week, 6-month Tai Chi program is effective in decreasing the number of falls, the risk for falling, and the fear of falling, and it improves functional balance and physical performance in physically inactive persons aged 70 years or older.
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J. Gerontol. A Biol. Sci. Med. Sci. · Feb 2005
Comparative StudyAge-related changes in microvascular blood flow and transcutaneous oxygen tension under Basal and stimulated conditions.
Adequate cutaneous microvascular blood flow and tissue oxygen tension are important prerequisites for successful tissue repair. The efficacy of tissue repair decreases with age and is linked to the age-related functional decline of unmyelinated sensory neurons that are important for inflammation and tissue repair. However, available information on the effect of these neuronal changes on microvascular blood flow and tissue oxygen tension is limited, particularly under control and injury conditions. The authors had two aims in this study: (a) to assess age-related changes in the relationship between microvascular blood flow and tissue oxygen perfusion under basal and two different stimulated conditions (sensory dependent and sensory independent), and (b) to clarify the biological meaning of transcutaneous partial pressure of oxygen (tcPO2) measurements. ⋯ The age-associated changes in basal and stimulated microvascular blood flow and tcPO2 could be attributed in part to altered neuronal function. Measuring tcPO2 at 39 degrees C showed a trend toward an increase with age. In contrast, a decrease with age was observed when tcPO2 was measured at 44 degrees C, a temperature sufficient to activate sensory nerve endings. The results may reflect a decline in sensory nerve function with age rather than a decrease in oxygen delivery for vascular reasons. This is supported by the complementary data showing a significant age-related decrease in stimulated blood flow in response to capsaicin, with no change in the response to the sensory-independent vasodilator acetylcholine. Thus, for clinical purposes, data obtained using the tcPO2 monitor should be interpreted with full knowledge of the conditions under which the measurements were made. Furthermore, for scientific purposes, the tcPO2 monitor could be used to assess sensory nerve function when sensors are heated to 44 degrees C.
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J. Gerontol. A Biol. Sci. Med. Sci. · Jan 2005
Comparative StudyPatients aged 90 years or older in the intensive care unit.
Age is an important prognostic factor in patients admitted to intensive care units (ICUs), but it is not as important as illness severity. However, age seems to remain an important independent triage criterion for ICU admission, and 90 years of age seems to represent a psychological barrier for many ICU physicians. The aim of this preliminary study is to compare the management and outcome of patients aged 90 years or older admitted to a respiratory ICU with those of patients aged 70 years or younger. ⋯ Our results reinforce the idea that age alone is not a relevant criterion for ICU admission.