The journal of nutrition, health & aging
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The aetiology of sarcopenia is multifactorial but still poorly understood while the sequelae of this phenomenon, i.e. loss of independence and metabolic complications, represent a major public health. The most evident metabolic explanation for muscle decline in elderly people is an imbalance between protein synthesis abd breakdown rates but other causes like neurodegenerative processes, reduction in anabolic hormone productions or sensitivity such as insulin, growth and sex hormones, dysregulation of cytokine secretions, modification in the response to inflammatory events, inadequate nutritional intakes and sedentary lifestyle are involved. Consequently, the age-related loss of muscle mass could be counteracted by adequate metabolic interventions including nutritional intakes or exercise training. ⋯ Other strategies including changes in daily protein pattern, the speed of protein digestion or specific amino acids supplementation may be beneficial to improve short term muscle anabolic response in elderly people. The beneficial impact of resistance or endurance training on muscle mass and function is highlighted in many studies suggesting that the potential anabolic response to exercise still remains despite a lesser metabolic response to nutrients. Thus a multimodal approach combining nutrition, exercise, hormones, specific anabolic drugs may an innovative treatment for limiting the development of sarcopenia with aging.
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J Nutr Health Aging · Apr 2009
ReviewSleep disorders and their impacts on healthy, dependent, and frail older adults.
Sleep disorders differ widely in the heterogeneous older adult population. Older adults can be classified into three groups based upon their overall level of disability: healthy, dependent, and frail. Frailty is an emerging concept that denotes older persons at increased risk for poor outcomes. ⋯ Our knowledge in the field of sleep disorders in older adults has increased in recent years, yet some groups within this heterogeneous population, such as frail older adults, remain to be more thoroughly studied and characterized.
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Delirium, a mental disorder that becomes established over a few hours or days, is characterised by fluctuating attention and cognitive states. This article reviews the disorder, which has all the features of an important geriatric syndrome: it appears mainly in persons older than 65 years of age, is closely linked with very prevalent diseases and complications arising in the elderly, and is the mode of presentation of many other diseases in this age group. We discuss diagnostic, clinical preventive and therapeutic aspects and analyse the most common risk and precipitating factors in our hospitalised patients from the viewpoint of clinical practice. Finally, we propose a scheme for the prevention and treatment of delirium.
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J Nutr Health Aging · Mar 2007
ReviewIANA task force on nutrition and cognitive decline with aging.
Cognitive impairment can be influenced by a number of factors. The potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments that nutrients (food and/or supplements) such as vitamins, trace minerals, lipids, can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of deficiencies. ⋯ It is important to stress the need to develop further prospective studies of sufficiently long duration, including subjects whose diet is monitored at a sufficiently early stage or at least before disease or cognitive decline exist. Meta analyses should be developed, and on the basis of their results the most appropriate interventional studies can be planned. These studies must control for the greatest number of known confounding factors and take into account the impact of the standard social determinants of food habits, such as the regional cultures, social status, and educational level.
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J Nutr Health Aging · Nov 2006
ReviewThe Mini Nutritional Assessment (MNA) review of the literature--What does it tell us?
To review the literature on the MNA to Spring 2006, we searched MEDLINE, Web of Science and Scopus, and did a manual search in J Nutr Health Aging, Clin Nutr, Eur J Clin Nutr and free online available publications. ⋯ The MNA is a screening and assessment tool with a reliable scale and clearly defined thresholds, usable by health care professionals. It should be included in the geriatric assessment and is proposed in the minimum data set for nutritional interventions.