CONCLUSION: There was a low utilization rate of palliative care in patients with COVID-19. Conscious utilization of palliative care is needed at the time of COVID-19.
Fighting the current COVID-19 pandemic, we must not forget to prepare for the next. Since elderly and frail people are at high risk, we wish to predict their vulnerability, and intervene if possible. For example, it would take little effort to take additional swabs or dried blood spots. Such minimally-invasive sampling, exemplified here during screening for potential COVID-19 infection, can yield the data to discover biomarkers to better handle this and the next respiratory disease pandemic....
The current pandemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2 has created an unparalleled health crisis. Besides the acute respiratory infection, CoVs are neuroinvasive causing additional inflammation and neurodegeneration. This is likely also true of SARS-CoV-2 given reports of neurological manifestations in coronavirus disease 2019 (COVID-19) positive patients. Older adults > 65 years of age constitute a high-risk group prone to severe infection and death. Despite...
COVID-19 can affect the hematopoietic system. Thrombocytopenia at admission was prevalent, while late-phase or delayed-phase thrombocytopenia (occurred 14 days after symptom onset) is obscure. This retrospective single-center study screened 450 COVID-19 patients and enrolled 271 patients at the Union Hospital, Wuhan, China, from January 25th to March 9th, 2020. COVID-19 associated delayed-phase thrombocytopenia occurred in 11.8% percent of enrolling patients. The delayed-phase thrombocytopenia...
CONCLUSIONS: Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.
This article reviews recent federal and state policy changes in response to the COVID-19 pandemic that affect health care and quality of life for older adults. Specific regulations and guidelines issued at the state and federal level have increased access and provided additional funding for essential services and supports. Many of these changes are temporary and have the potential to improve care beyond the immediate crisis. This period of greater flexibility offers the opportunity to accrue...
CONCLUSIONS: Dyspnoea was the only symptom predictive for severe COVID-19 and ICU admission. Patients with COPD, cardiovascular disease and hypertension were at higher risk of severe illness and ICU admission.
Loneliness and social isolation are associated with adverse physical and psychological consequences which are particularly prevalent in older persons. During this unprecedented time of the COVID-19 pandemic, we must follow social distancing guidelines to protect ourselves and to reduce the spread of coronavirus. At the same time, it is crucial to maintain social connections with each other, especially with older persons, to help cope and reduce the negative consequences of loneliness and social...
Objective: To analyze the clinical characteristics of 34 COVID-19 cases and to provide the basis for the prevention and control of the epidemic disease. Methods: Thirty-four COVID-19 patients diagnosed with RT-PCR in the isolation ward of the Fourth People's Hospital of Ningxia Hui autonomous region (infectious diseases hospital) from the January 22 to February 4, 2020 were selected as the research subjects. The clinical data were collected. Excel was used to describe the relationship between...
Throughout the world, the outbreak of the novel Coronavirus disease (COVID-19) has exposed the older population to health, social and financial risks. With the effects of COVID-19 pandemic on social security schemes and individuals' income, dependent older people's needs are critically at stake. Like other developing countries, older people in Ghana need to rely on their social networks through family ties, friends and social organisations for support. Also, there is the need for social security...
Introduction: Muscle and bone metabolism are both important for the healing of fractures and the regeneration of injured muscle tissue. The aim of this investigation was to evaluate myostatin and other regulating factors in patients with hip fractures who underwent hemi-arthroplasty. Methods: Serum levels of myostatin (MSTN), follistatin (FSTN), dickkopf-1 (Dkk1), and periostin (PSTN) as well as markers of bone turnover were evaluated in patients with hip fractures before surgery and twice in the 2 weeks after surgery. These parameters were also evaluated in age- and gender-matched subjects without major musculoskeletal injury. Results: MSTN was transiently reduced; its opponent FSTN was transiently increased. Dkk1, the negative regulator of bone mass, and PSTN, a marker of subperiosteal bone formation, increased after surgery. With regard to markers of bone turnover, resorption was elevated during the entire period of observation whereas the early bone formation marker N-terminal propeptide of type I collagen was elevated 12 days after surgery. Conclusions: Unexpectedly, MSTN, a negative regulator of muscle growth, was reduced after surgery compared with before surgery. As musculoskeletal markers are altered during bone healing, they do not reflect general bone metabolism after fracture or joint arthroplasty. This is important because many elderly patients receive treatment for osteoporosis.
Posted: May 26, 2020, 9:10 am
Throughout the life course, individuals are confronted with adversities that challenge their ability to live the life they imagined. Adversities that are the most prominently studied and shown to bring about the most serious consequences for adjustment across the adult lifespan include job loss, disease and disability onset, and spousal and child bereavement. However, not all individuals show sustained declines to adversity; some are able to bounce back. The resilience literature is built on the premise that individuals are able to bounce back, or adapt to adversity. The past 15–20 years have seen an abundance of resilience research examining resilience to diverse types of adversity across the adult lifespan. The overarching goal of this paper is to evaluate psychological concepts of resilience in adulthood and old age and recommend avenues for future research. To do so, I first evaluate and discuss definitions of resilience and their overlap across literatures with an emphasis on sociological approaches to studying adversity across the adult lifespan. Second, I discuss promising conceptual and methodological approaches to advance the resilience literature in adulthood and old age. Conceptual approaches to furthering the resilience literature include incorporating an anticipation component into the definition of resilience. Methodological approaches to furthering the resilience literature include prospective longitudinal designs that incorporate quantitative and qualitative approaches, multidimensional assessments, and the need to examine repeated adversities or multiple adversities that transpire in relatively close proximity to one another.
Posted: May 14, 2020, 4:18 pm
Posted: April 24, 2020, 6:28 am
This study investigated the dissimilarity in midlife adults’ reports of support they and their spouse provide to their parents-in-law, gender differences in these dissimilarity patterns, and implications of this dissimilarity for marital quality. Middle-aged married participants (n = 164, mean age = 53.96 years) from Wave 2 of the Family Exchanges Study reported on the support they and their spouse provided to at least 1 living parent-in-law. Regression models examined associations of marital satisfaction with support for parents-in-law, evaluations of support for parents-in-law, and spousal dissimilarity in support. Gender differences in own and spousal support for parents-in-law revealed matrilineal focused support among married adults. Spousal dissimilarity in support was negatively associated with marital satisfaction for middle-aged adults. This pattern suggests the importance of a perceived balance in supporting one’s spouse’s parents for marital quality.
Posted: April 2, 2020, 9:13 am
Background: Wearable camera photographs have been shown to be an effective memory aid in people with and without memory impairment. Most studies using wearable cameras as a memory aid have presented photographs on a computer monitor and used a written diary or no review as a comparison. In this pioneering study, we took a new and innovative approach to wearable camera photograph review that embeds the photographs within a virtual landscape. This approach may enhance these benefits by reinstating the original environmental context to increase participants’ sense of re-experiencing the event. Objective: We compare the traditional computer monitor presentation of wearable camera photographs and actively taken digital photographs with the presentation of wearable camera photographs in a new immersive interface that reinstates the spatiotemporal context. Methods: Healthy older adults wore wearable or took digital photographs during a staged event. The next day and 2 weeks later, they viewed wearable camera photographs on a computer monitor or in context on an immersive interface, or digital photographs. Results: Participants who viewed wearable camera photographs in either format recalled more details during photo viewing and subsequent free recall than participants who viewed digital photographs they had taken themselves. Conclusion: Wearable camera photographs are an effective support for event memory, regardless of whether they are presented in context in an experience-near format.
Posted: March 27, 2020, 12:20 pm
Over the past century, the life expectancy in industrialized countries has rapidly risen by over 30 years due to improvements in standards of medical care, sanitation, and lifestyle. Estimation of life expectancy has traditionally been viewed through a lens of epidemiology and public health. However, this data, while considered the “gold standard” of measuring healthy life expectancy, may soon find itself redundant in the face of advancing medical technology. Even as average life expectancy has increased, there has not been an equivalent increase in healthy life expectancy, or “healthspan”; furthermore, there is a current trend of stagnation in life expectancy, as the supposed increases are estimated to be drastically slowing down, in part due to exhaustion of our current ability to extend the human lifespan. In this viewpoint, we will examine the developing fields of medicine and life sciences which will reshape our current approach to life expectancy prediction.
Posted: February 26, 2020, 12:48 pm
Introduction: Pathogenesis in a subgroup of sarcopenic patients seems to be based on a reduced number of motor neurons. This study aimed at investigating the overlap between sarcopenia and neurodegeneration, as reflected by a low number of motor neurons in patients with Parkinsonian syndromes (PS). Methods: The motor unit number index (MUNIX) of the hypothenar muscle was used to assess the number and size (MUSIX) of motor units (MUs) in patients with idiopathic Parkinson disease (iPD, n = 53), patients with atypical Parkinsonian syndrome (aPS, n = 21), and a control group (n = 30). Mean age of participants was 70.3 years and 54.1% were female. Skeletal muscle mass by bioelectrical impedance analysis, hand-grip strength and gait speed were measured. Based on these assessments, sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People. Results: Sarcopenia criteria were met by 10 patients with PS (13.5%). The study group had significantly lower MUNIX values than the control group (109 [SD ±39.1] vs. 129 [SD ±45.1]; p = 0.020) even after adjustment for age and sex. Three of the 5 sarcopenic iPD patients (75%) had pathological low MUNIX values (#x3c;80). Discussion/Conclusion: Sarcopenia is a frequent comorbidity in PS. The pathologically low MUNIX values found in 75% of our sarcopenic iPD patients provides further support for the existence of a neurodegenerative overlap syndrome with a reduced number of MUs potentially leading to sarcopenia. This finding warrants further evaluation.
Posted: February 21, 2020, 9:23 am
Historically, family ties have been understood as the primary source of support for aging adults, and past empirical and theoretical work has highlighted the tendency of older adults to focus on close family. However, in line with demographic changes and historical increases in the diversity of social structures, friendships are increasing in importance in recent generations of older adults. Given the powerful role of context in shaping these changes, this paper offers a conceptual analysis linking individual agency to sociohistorical context as a way to understand this increasing diversity of social ties. More specifically, we propose that the individual invests time and energy to form and maintain social ties, and that each individual has a specific social opportunity structure (all potential ties that are available to invest in, as well as the costs of those investments). Furthermore, this investment of time and energy is determined in part by individual differences in capacities and motivations. We argue that sociohistorical context influences this process in three important ways: (1) in its effect on the social opportunity structure; (2) in its direct effect on time and energy; and (3) in its effect on individuals’ capacities and motivations. We believe that these mechanisms can account for the increasing diversity of social ties across adulthood, as well as the potential for future historical changes.
Posted: February 21, 2020, 9:23 am
Background:Telomeres are crucial parts of chromosomes that protect the genome. They shorten every time the cell replicates, and shorter telomeres have been associated with increasing age and with many health behaviours. There is inconclusive evidence on the association between physical activity (PA) and telomere length. Objectives: To examine how leisure-time PA (LTPA) is associated with telomere length and telomere attrition during 10 years of follow-up in elderly people. Design: This study is a 10-year prospective follow-up study. Method: For this prospective study, we examined 1,014 subjects (mean age at baseline 60.8 years) from the Helsinki Birth Cohort Study (HBCS). Relative leukocyte telomere length (LTL) was measured with a quantitative real-time PCR and LTPA with a validated questionnaire. Multiple linear regression analyses were used to assess the association between sex-specific LTPA quartiles and LTL at baseline and change in LTL over 10 years. The analyses were adjusted for age, educational attainment, smoking, body fat percentage, oestrogen exposure in women and for follow-up time when applicable. Results: At baseline, volume of LTPA was not associated with LTL in men (p = 0.66) or in women (p = 0.33). Among women, however, higher volume of LTPA at baseline was associated with greater shortening of LTL (p for linearity 0.040) during the 10-year follow-up. No association was found among men (p for linearity 0.75). Conclusions: Our findings suggest that PA has a sex-specific role in regulation of telomere length in the aging process as in our study a high volume of LTPA in elderly women, but not in men, was associated with more rapid telomere attrition.
Posted: February 21, 2020, 9:22 am
Introduction: Many falls in older adults occur during walking and result in lateral falls. The ability to perform a recovery step after balance perturbation determines whether a fall will occur. Aim: To investigate age-related changes in first recovery step kinematics and kinematic adaptations over a wide range of lateral perturbation magnitudes while walking. Methods: Thirty-five old (78.5 ± 5 years) and 19 young adults (26.0 ± 0.8 years) walked at their preferred walking speed on a treadmill. While walking, the subjects were exposed to announced right/left perturbations in different phases of the gait cycle that were gradually increased in order to trigger a recovery stepping response. The subjects were instructed to react naturally and try to avoid falling. Kinematic analysis was performed to analyze the first recovery step parameters (e.g., step initiation, swing duration, step length, and the estimated distance of the center of mass from the base of support [dBoS]). Results: Compared with younger adults, older adults displayed a significantly lower step threshold and at lower perturbation magnitudes during the experiment. Also, they showed slower compensatory step initiation, shorter step length, and dBoS with similar step recovery times. As the perturbation magnitudes increased, older adults showed very small, yet significant, decreases in the timing of the step response, and increased their step length. Younger adults did not show changes in the timing of stepping, with a tendency toward a significant increase in step length. Conclusions: First compensatory step performance is impaired in older adults. In terms of the dynamic approach, older adults were more flexible, i.e., less automatic, while younger adults displayed more automatic behavior.
Posted: February 18, 2020, 3:13 pm