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The photomodulation of the helical pitch of cholesteric liquid crystals results in dynamic and coloured canvases that can potentially be used in applications ranging from energy-efficient displays to colour filters, anti-counterfeiting tags and liquid crystal (LC) lasers. Here we report on the analysis of a series of photoswitchable chiral dopants that combine the large geometrical change and bistability of hydrazone switches with the efficient helical pitch induction of the chiral motif, triptycene. We elucidate the effects that conformational flexibility, dispersion forces and π-π interactions have on the chirality transfer ability of the dopant. We then use the irradiation time with visible light (442 nm) combined with a simple digital light processing microscope projection set-up to draw numerous stable multi-coloured images on an LC canvas, showcasing the fine control this dopant yields over the LC assembly.
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Pumping ions against a concentration gradient through protein-based transporters is a cornerstone of numerous biological processes. Mimicking this function by using artificial receptors remains a daunting challenge, mainly because of the difficulties in balancing between the requirement for high binding affinities and precise and on-demand ion capture and release properties. We report a trimeric hydrazone photoswitch-based receptor that converts light energy into work by actively transporting chloride anion against a gradient through a dichloromethane liquid membrane, functioning as a molecular pump. The system manifests ease of synthesis, bistability, excellent photoswitching properties, and superb ON-OFF binding properties (difference of up to six orders of magnitude).
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The long-range supramolecular interactions in liquid crystals (LCs) can be used to amplify and subsequently propagate microscopic structural changes into macroscopic events. Here, we report on a systematic structure-property analysis using 16 chiral photoswitchable dopants composed of bistable hydrazones and chiral isosorbide moieties. Our findings showcase the relationship between the dopant's structure and its helical twisting power (ß), and hence, the photophysical properties of the host LC. We show that an increase in the hydrazone CNNH dihedral angle results in an increase in the ß value, while alkoxy chains do not lead to such an increase. These results contradict established rules of thumb, stating that structural rigidity and long alky chains are needed for high ß values. We also found that the position of the substitution, whether at the 2' or 5' positions of the isosorbide unit, or the attachment of the chiral unit to the rotor or stator phenyl units can have negative or positive additive effects that can either increase or decrease the ß values. These results made us hypothesize that unsymmetrically functionalized dopants should result in large Δß values, which we corroborated experimentally. Moreover, a fluorine-functionalized dopant resulted in higher overall ß values, most likely because of π-π interactions. Finally, the dopants were used in modulating and locking in the reflective properties of LC films, yielding multicolor LC canvases that can reflect light from the ultraviolet to the infrared range (i.e., a manipulation of up to ca. 1500 nm of reflected light).
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BACKGROUND: Anorexia of aging (AA) is a condition in older adults that includes loss of appetite and reduced food intake. There is a lack of detailed analysis of the potential influence of educational initiatives in addressing AA. This study aimed to clarify the current state of knowledge and practice regarding AA and its relationship with the availability of continuing education opportunities among Japanese healthcare professionals involved in treating older patients. METHODS: The Japan Geriatrics Society and the Japanese Association on Sarcopenia and Frailty, in collaboration with the Society on Sarcopenia, Cachexia, and Wasting Disorders, conducted an online questionnaire survey on the knowledge and practices in AA detection and management. Questions were asked in the areas of demographics, screening, definition/diagnosis, treatment, referral, and awareness, with those who 'participate' in continuing education and professional development programmes in nutrition for their patients were classified as the 'education group' and those who 'do not participate' were classified as the 'non-education group'. The results for each question were compared. RESULTS: The analysis included 870 participants (physicians, 48%; registered dietitians, 16%; rehabilitation therapists, 14%; pharmacists, 12%; nurses, 6%; and other professionals, 5%). The education group (45%) was more likely than the non-education group (55%) to use the Mini-Nutritional Assessment Short Form (MNA-SF) to screen for AA (49% vs. 27%) and less likely not to use a validated tool (33% vs. 47%). More participants used evidence-based tools and materials for AA care (38% vs. 12%), and fewer used their clinical judgement (23% vs. 35%) or were unaware of the tools and materials (9% vs. 23%). The proportion using a team of professionals experienced in AA care were 47% and 24% of the education and non-education groups, respectively. By profession, few physicians used specific validated tools and resources for AA screening and treatment. More than half of the dietitians used the MNA-SF regardless of training opportunity availability. Regarding professional availability and team use, differences in educational opportunities were particularly large among physicians. CONCLUSIONS: Participation in continuing education programmes on nutrition is associated with responsiveness to AA screening and treatment and the availability of a team of professionals, which may influence the quality of AA treatment. Nutrition education may support the confidence of healthcare professionals working with older adults in AA with complex clinical signs and encourage them to conduct evidence-based practice.
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Anorexia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Japón/epidemiología , Anorexia/terapia , Anorexia/diagnóstico , Encuestas y Cuestionarios , Femenino , Masculino , Anciano , Envejecimiento , Personal de Salud , Persona de Mediana Edad , Manejo de la Enfermedad , Anciano de 80 o más AñosRESUMEN
BACKGROUND: National and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice. METHODS: An anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil. RESULTS: Most of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p < 0.001 for all). Those with fewer years of experience were more likely to evaluate frailty (p = 0.009). Being a doctor increased the chance of using a specific tool; the opposite was true for dietitians (p = 0.03). Those who assisted more older people had a higher likelihood of having a plan (p = 0.011). CONCLUSION: Frailty assessment was heterogeneous among healthcare professions groups, predominantly using non-specific criteria. Training contributed to frailty assessment, use of specific criteria, confidence, and having a management plan. This data informs the need for standardized screening criteria and management plans for frailty, in association with increasing training at the national level for all the HCPs who assist older people.
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Anciano Frágil , Fragilidad , Evaluación Geriátrica , Personal de Salud , Humanos , Brasil/epidemiología , Masculino , Femenino , Anciano , Fragilidad/diagnóstico , Fragilidad/epidemiología , Fragilidad/terapia , Evaluación Geriátrica/métodos , Encuestas y Cuestionarios , Persona de Mediana Edad , Adulto , Anciano de 80 o más Años , Manejo de la EnfermedadRESUMEN
OBJECTIVE: Marincolo et al. showed that older adults without limitations in basic activities of daily living at baseline presented with an 11.7% concomitant presence of functional dependence, slow gait speed, and low muscle strength at follow-up. Slow gait speed remains a predictor of dependence in basic activities of daily living. To determine whether low muscle strength and low gait speed increase the risk of disability related to basic activities of daily living in community-dwelling older adults. METHODS: A longitudinal study (9 years of follow-up) was conducted with 390 older adults who were independent in basic activities of daily living at baseline and answered the Katz Index at follow-up. Associations were determined using Pearson's χ2 test with a 5% significance level and logistic regression analysis. RESULTS: Increases in prevalence between baseline and follow-up were observed for low muscle strength (17.5%-38.2%), slow gait speed (26.0%-81.1%), and functional dependence (10.8%-26.6%). At follow-up, 11.7% of the participants had concomitant functional dependence, slow gait speed, and low muscle strength. Slow gait speed remained a predictor of dependence in basic activities of daily living (odds ratio=1.90; 95% confidence interval=1.06-3.41). CONCLUSION: Slow gait speed is a predictor of functional dependence, constituting an important variable for screening functional decline.
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Actividades Cotidianas , Evaluación Geriátrica , Fuerza de la Mano , Velocidad al Caminar , Humanos , Velocidad al Caminar/fisiología , Anciano , Masculino , Femenino , Fuerza de la Mano/fisiología , Estudios Longitudinales , Evaluación Geriátrica/métodos , Anciano de 80 o más Años , Vida Independiente , Estudios de Seguimiento , Evaluación de la Discapacidad , Fuerza Muscular/fisiologíaRESUMEN
Adaptive materials that exhibit a multichromatic response as a function of applied stimulus are highly desirable, as they can result in applications ranging from smart surfaces to anticounterfeit devices. Here we report on such a system based on an intriguing thermal 1,2-BF2 shift that transforms a visible-light-activated azo-BF2 photoswitch into a BF2-hydrazone fluorophore (BODIHY) in both solution and the solid-state. Structure-property analysis, in conjunction with DFT calculations, reveals that the shift is catalyzed by the spatial proximity of an oxygen atom next to the BF2 group and that the activation originates from an electronic and not steric effect. Theoretical calculations also show that while the energy barrier for the trans â BODIHY transformation is accessible at room temperature (thermal half-life of 30 h), the cis â BODIHY transformation has a much higher barrier, which is why the 1,2-BF2 shift is not observed for the cis form. The photoswitching of the azo-BF2, in conjunction with the 1,2-BF2 shift, was then used in the multicolor modulation of a switch-containing cross-linked polydimethylsiloxane film using light and/or heat stimuli, elaborating the usefulness of the sophisticated reaction cascade that can be accessed from this simple system.
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OBJECTIVE: Malnutrition is one of the most threatening conditions in geriatric populations. The gut microbiota has an important role in the host's metabolic and muscular health: however, its interplay with disease-related malnutrition is not well understood. We aimed to identify the association of malnutrition with the gut microbiota and predict clinical outcomes in hospitalized acutely ill older adults. METHODS: We performed a secondary longitudinal analysis in 108 geriatric patients from a prospective cohort evaluated at admission and 72 h of hospitalization. We collected clinical, demographic, nutritional, and 16S rRNA gene-sequenced gut microbiota data. Microbiota diversity, overall composition, and differential abundance were calculated and compared between patients with and without malnutrition. Microbiota features associated with malnutrition were used to predict clinical outcomes. RESULTS: Patients with malnutrition (51%) had a different microbiota composition compared to those who were well-nourished during hospitalization (ANOSIM R = 0.079, P = 0.003). Patients with severe malnutrition showed poorer α-diversity at admission (Shannon P = 0.012, Simpson P = 0.018) and follow-up (Shannon P = 0.023, Chao1 P = 0.008). Differential abundance of Lachnospiraceae NK4A136 group, Subdoligranulum, and Faecalibacterium prausnitzii were significantly lower and inversely associated with malnutrition, while Corynebacterium, Ruminococcaceae Incertae Sedis, and Fusobacterium were significantly increased and positively associated with malnutrition. Corynebacterium, Ruminococcaceae Incertae Sedis, and the overall composition were important predictors of critical care in patients with malnutrition during hospitalization. CONCLUSION: Older adults with malnutrition, especially in a severe stage, may be subject to substantial gut microbial disturbances during hospitalization. The gut microbiota profile of patients with malnutrition might help us to predict worse clinical outcomes.
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Microbioma Gastrointestinal , Desnutrición , Desnutrición Proteico-Calórica , Humanos , Anciano , Microbioma Gastrointestinal/genética , Estudios Prospectivos , ARN Ribosómico 16S/genética , Desnutrición/complicacionesRESUMEN
ABSTRACT Objective To determine whether low muscle strength and low gait speed increase the risk of disability related to basic activities of daily living in community-dwelling older adults. Methods A longitudinal study (9 years of follow-up) was conducted with 390 older adults who were independent in basic activities of daily living at baseline and answered the Katz Index at follow-up. Associations were determined using Pearson's χ2 test with a 5% significance level and logistic regression analysis. Results Increases in prevalence between baseline and follow-up were observed for low muscle strength (17.5%-38.2%), slow gait speed (26.0%-81.1%), and functional dependence (10.8%-26.6%). At follow-up, 11.7% of the participants had concomitant functional dependence, slow gait speed, and low muscle strength. Slow gait speed remained a predictor of dependence in basic activities of daily living (odds ratio=1.90; 95% confidence interval=1.06-3.41). Conclusion Slow gait speed is a predictor of functional dependence, constituting an important variable for screening functional decline.
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BACKGROUND: Borim et al. showed that older adults with chronic pain exhibited more depressive symptoms and frailty components. Depressive symptoms were associated with more frailty components, and those with more depressive symptoms and frailty faced greater limitations in IADL performance. Frailty appears to mediate the pathway from chronic pain to functional impairment Chronic pain is directly associated with depressive symptoms and frailty. Chronic pain is not directly associated with functional disability. Depression and frailty are both directly associated with functional disabilities. Frailty mediates the association between chronic pain and functional disability. Depression; Disability evaluation; Frailty; Frail elderly. OBJECTIVE: To evaluate the direct and indirect effects of chronic pain, depressive symptoms, frailty components, and functional disability through a pathway analysis approach in a sample of community-dwelling older adults. METHODS: Data of 419 participants were cross-sectionally evaluated for the presence of depressive symptoms (Geriatric Depression Scale [15 items]), physical frailty components (phenotype criteria), chronic pain, and limitations in performing instrumental activities of daily living (functional disability scale by Lawton and Brody). Structural equation modeling via path analysis was used to explore the direct and indirect effects among these four variables. Statistical significance was set at p<0.05. RESULTS: Of the total participants, 69.8% were women and 59.3% had low education (1-4 years); the mean age was 80.3±4.6 years. Chronic pain and depressive symptoms were directly related and were associated to frailty. The number of frailty components and depressive symptoms were directly associated with functional disability. Frailty had an indirect effect on the association between chronic pain, depressive symptoms, and functional disabilities. CONCLUSION: The pathway from chronic pain and depressive symptoms to functional disability is potentially mediated by the number of frailty components.
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Dolor Crónico , Fragilidad , Humanos , Femenino , Anciano , Anciano de 80 o más Años , Masculino , Vida Independiente , Actividades Cotidianas , Depresión , Evaluación GeriátricaRESUMEN
The number of COVID-19 disease cases and deaths reached the scale of millions worldwide. Determining risk and prognosis factors are fundamental to allow the development of personalized management strategies. The aim of this study was to correlate lung computed tomographic (CT) findings in patients affected by COVID-19 with the clinical staging of the disease and laboratory findings, and to evaluate whether these findings were effective in predicting disease evolution. Then, laboratory findings and chest CT scans of 309/616 COVID-19 positive patients were analyzed and classified according to the degree of extension of pulmonary involvement. Ground glass opacities predominated in earlyphase, while crazy-paving pattern, consolidation, and fibrosis characterized late-phase disease. CT findings were significantly higher among late than early stages (p<0,05), although the indeterminate patterns were significantly associated with early-phase disease(p=0.00216). The groundglass pattern was significantly associated with TTPA (p=0,0234), and elevated leukocyte counting (p=0,008) and D-dimer levels(p=0.001). ROC curve analysis showed an area of 0.57(95% CI 0·8900.0623) to early disease stage, 0.764(95%CI 0.8170.764) to the progressive stage, and 0.816(0.7170.915) to later stages, suggesting a relevance role of chest CT findings to this disease diagnosis. The data strongly suggested the potential role of chest CT as a technique for enhancing qPCR COVID-19 positiveness capacity by speeding-up diagnosis in symptomatic cases, and predicting the outcome of SARS CoV2 infected patients. The CT findings were also correlated with laboratory findings and disease severity, and may be of great prognostic value for stratifying the evolution of this infectious disease in hospitalized patients. (AU)
O número de casos e mortes pela COVID-19 atingiu a escala de milhões em todo o mundo. A determinação de fatores de risco e prognóstico ainda são de fundamental importância para permitir o desenvolvimento de estratégias de manejo personalizadas. O objetivo foi correlacionar achados tomográficos (TC) pulmonares em pacientes acometidos por COVID-19 com o estadiamento clínico da doença e os achados laboratoriais, e avaliar se os mesmos são efetivos para a predição da evolução da doença. Então, os achados laboratoriais e resultados de TC de tórax de 309/616 pacientes positivos para COVID-19 foram analisados e associados, e classificados de acordo com o grau de extensão do acometimento pulmonar. Opacidades em vidro fosco predominaram na fase inicial da doença, enquanto o padrão de pavimentação em mosaico, consolidação e fibrose caracterizaram a doença na fase tardia. Os achados tomográficos foram significativamente maiores para os estágios tardios em relação aos iniciais (p<0,05), embora os padrões indeterminados tenham sido significativamente associados com a doença em estágio inicial (p=0,00216). O padrão em vidro fosco estava significativamente associado com o TTPA (p=0,0234), a contagem elevada de leucócitos (p=0,008) e os níveis elevados de dímero D (p=0,001). A análise da curva ROC mostrou uma área de 0,57 (95% CI 0,8900,0623) para o estágio inicial da doença, 0,764 (95% CI 0,8170,764) para o estágio progressivo e 0,816 (0,7170,915) para os estágios tardios, sugerindo uma relevância dos achados da TC de tórax para o diagnóstico efetivo dessa doença. Os dados fortemente sugerem o papel potencial da TC de tórax como uma técnica a ser associada ao teste de qPCR positivo para a COVID-19, a fim de acelerar o diagnóstico em casos sintomáticos e prever o desfecho de pacientes infectados. Os achados tomográficos também foram correlacionados com os achados laboratoriais e a gravidade da doença, se mostrando de importante valor prognóstico para estratificar a evolução dessa doença infecciosa em pacientes hospitalizados. (AU)
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The forthcoming generation of materials, including artificial muscles, recyclable and healable systems, photochromic heterogeneous catalysts, or tailorable supercapacitors, relies on the fundamental concept of rapid switching between two or more discrete forms in the solid state. Herein, we report a breakthrough in the "speed limit" of photochromic molecules on the example of sterically-demanding spiropyran derivatives through their integration within solvent-free confined space, allowing for engineering of the photoresponsive moiety environment and tailoring their photoisomerization rates. The presented conceptual approach realized through construction of the spiropyran environment results in ~1000 times switching enhancement even in the solid state compared to its behavior in solution, setting a record in the field of photochromic compounds. Moreover, integration of two distinct photochromic moieties in the same framework provided access to a dynamic range of rates as well as complementary switching in the material's optical profile, uncovering a previously inaccessible pathway for interstate rapid photoisomerization.
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We present here a group of Azo-BF2 photoswitches that store and release energy in response to visible light irradiation. Unmodified Azo-BF2 switches have a planar structure with a large π-conjugation system, which hinders E-Z isomerization when in a compacted state. To address this challenge, we modified the switches with one or two aliphatic groups, which altered the intermolecular interactions and arrangement of the photochromes in the solid state. The derivative with two substituents exhibited a non-planar configuration that provided particularly large conformational freedom, allowing for efficient isomerization in the solid phase. Our discovery highlights the potential of using double aliphatic functionalization as a promising approach to facilitate solid-state switching of large aromatic photoswitches. This finding opens up new possibilities for exploring various photoswitch candidates for molecular solar thermal energy storage applications.
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BACKGROUND: Anorexia of aging is a common geriatric syndrome that includes loss of appetite and/or reduced food intake, with associated undernutrition, unintended weight loss, sarcopenia, functional decline, loss of independence and other adverse health outcomes. Anorexia of aging can have multiple and severe consequences and is often overlooked by healthcare professionals (HCPs). Even more concerningly, clinicians commonly accept anorexia of aging as an inevitable part of 'normal' aging. The aim of this assessment was to identify current gaps in professional knowledge and practice in identifying and managing older persons with anorexia. Results may guide educational programmes to fill the gaps identified and therefore improve patient outcomes. METHODS: This international assessment was conducted using a mixed-methods approach, including focus group interviews with subject matter experts and an electronic survey of practicing HCPs. The assessment was led by the Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD) and was supported by in-country collaborating organizations. RESULTS: A quantitative survey of 26 multiple-choice questions was completed by physicians, dietitians and other HCPs (n = 1545). Most HCPs (56.8%) recognize a consistent definition of anorexia of aging as a loss of appetite and/or low food intake. Cognitive changes/dementia (91%) and dysphagia (87%) are seen as the biggest risk factors. Most respondents were confident to give nutritional (62%) and physical activity (59.4%) recommendations and engaged caregivers such as family members in supporting older adults with anorexia (80.6%). Most clinicians assessed appetite at each visit (66.7%), although weight is not measured at every visit (41.5%). Apart from the Mini-Nutritional Assessment Short Form (39%), other tools to screen for appetite loss are not frequently used or no tools are used at all (29.4%). A high number of respondents (38.7%) believe that anorexia is a normal part of aging. Results show that treatment is focused on swallowing disorders (78%), dentition issues (76%) and increasing oral intake (fortified foods [75%] and oral nutritional supplements [74%]). Nevertheless, the lack of high-quality evidence is perceived as a barrier to optimal treatment (49.2%). CONCLUSIONS: Findings from this international assessment highlight the challenges in the care of older adults with or at risk for anorexia of aging. Identifying professional practice gaps between individual HCPs and team-based gaps can provide a basis for healthcare education that is addressed at root causes, targeted to specific audiences and developed to improve individual and team practices that contribute to improving patient outcomes.
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Envejecimiento , Anorexia , Anciano , Anciano de 80 o más Años , Humanos , Anorexia/diagnóstico , Personal de Salud , Brechas de la Práctica Profesional , Sarcopenia/complicacionesRESUMEN
Transition metals play an important role in many biological processes including cellular regulation and signal transduction. Emulating such processes on the molecular level, while challenging, can help us learn how to manipulate intermolecular communication, an important requirement for the development of solution-based molecular machines. In this work, we demonstrate a transition metal-based artificial multistep switching cascade that exhibits intrinsic hierarchical level control. The process starts with Zn(II), which initiates a transition metal relay by displacing a macrocycle-encapsulated Pd(II). The latter then binds to a hydrazone switch leading to coordination-coupled deprotonation (CCD). Finally, the proton generated through CCD activates the E/Z isomerization of a second noncoordinating pH-sensitive hydrazone switch. This whole multistep process can be reset to the original state by removing the Pd(II) from the system.
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A significant percentage of people with bipolar disorder (BD) exhibit suboptimal functional adjustment, even when appropriately treated and after symptomatic recovery is achieved. Given that cognitive impairment is one of the strongest correlates of socio-occupational outcomes and quality of life in BD, cognitive remediation (CR) is currently acknowledged as a promising treatment that could help bridge the gap between symptomatic and full functional recovery. The aim of this review was to explore the efficacy of CR approaches in improving cognitive and functional outcomes in BD patients. PubMed, PsycINFO, and CENTRAL were searched from inception to November 2022. Randomized controlled trials exploring the effects of CR on cognition and/or functional adjustment in adult BD patients were eligible. Ten studies based on seven independent trials (n = 586) were included. Change-score effect sizes (Hedges' g) were obtained for efficacy outcome measures and combined by means of meta-analytic procedures. Small but significant overall effects were observed for working memory (g = 0.32, 95% CI 0.11-0.52), planning (g = 0.30, 95% CI 0.03-0.56), and verbal learning (g = 0.40, 95% CI 0.15-0.66). However, CR was not found to exert any significant effects on functional outcomes at treatment completion or at follow-up assessment. Although CR may modestly enhance the cognitive performance of BD patients, this effect does not translate into an improvement at the functional level. The current data do not support the inclusion of CR as a treatment recommendation in clinical practice guidelines for the management of BD.
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Motoric cognitive risk syndrome (MCR) is defined by the presence of slow gait and subjective cognitive decline. It is well recognized as a prodrome for dementia, but the biological mechanism and trajectory for MCR are still lacking. The objective of this study was to explore the association of MCR with body composition, including sarcopenia and systemic inflammation, in pre-frail older adults in a cross-sectional study of 397 pre-frail community-dwelling older adults. Data on demographics, physical function, frailty, cognition (Montreal Cognitive Assessment (MoCA)), perceived health and depression were collected. Body composition was measured using a bioelectrical impedance analyzer. Systemic inflammatory biomarkers, such as progranulin, growth differentiation factor-15 (GDF-15), interleukin-10 (IL-10), interleukin-6 and tumor necrosis factor-α (TNF-α), were collected. Univariate and multivariate logistic regression were used to analyze the association between MCR, body composition, sarcopenia and systemic inflammatory biomarkers. The prevalence of MCR was 14.9%. They were significantly older and there were more females, depression, functional impairment, lower education, physical activity and MoCA scores. Body fat percentage (BF%), fat mass index, fat to fat free mass ratio (FM/FFM) and sarcopenia prevalence were significantly higher in MCR. Serum GDF-15 and TNF-α levels were highest with progranulin/TNF-α and IL-10/TNF-α ratio lowest in MCR. Compared to healthy patients, MCR was significantly associated with sarcopenia (aOR 2.62; 95% CI 1.46-3.17), BF% (aOR 1.06; 95% CI 1.01-1.12), FMI (aOR 1.16; 95% CI 1.02-1.30) and FM/FFM (aOR 6.38; 95% CI 1.20-33.98). The association of IL-10 to TNF-α ratio (aOR 0.98, 95% CI 0.97-0.99) and IL-10 (aOR 2.22, 95% CI 0.05-0.98) with MCR were independent of sarcopenia and BF%. Longitudinal population studies are needed to understand the role of body fat indices and IL-10 in pre-frail older adults with MCR and trajectory to dementia.
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OBJECTIVE: To assess the longitudinal association between cognitive impairment and sarcopenia in a sample of Brazilian community-dwelling older adults. DESIGN: Nine-year observational prospective study. SETTING AND PARTICIPANTS: A total of 521 community-dwelling older adults from 2 Brazilian sites of the Frailty in Brazilian Older Adults (FIBRA in Portuguese) study. METHODS: Sarcopenia was defined as low hand-grip strength and low muscle mass. Cognitive impairment was determined at baseline using the Mini-Mental State Examination, with education-adjusted cutoff scores. The logistic regression model was used to assess the association between cognitive impairment and incident sarcopenia after adjusting for gender, age, education, morbidities, physical activity, and body mass index. Inverse probability weighting was applied to correct for sample loss at follow-up. RESULTS: The mean age of the study population was 72.7 (±5.6) years, and 365 were women (70.1%). Being 80 years and older [odds ratio (OR), 4.62; 95% CI, 1.38-15.48; P = .013], being under- and overweight (OR, 0.29; 95% CI, 0.11-0.76; P = .012, and OR, 5.12; 95% CI, 2.18-12.01; P < .001, respectively) and having cognitive impairment (OR, 2.44; 95% CI, 1.18-5.04; P = .016) at baseline predicted sarcopenia after 9 years. CONCLUSION AND IMPLICATIONS: Cognitive impairment may predict sarcopenia in Brazilian older adults. More studies are necessary to identify the main mechanisms shared by sarcopenia and cognitive decline, which could support the development of prevention interventions.
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Disfunción Cognitiva , Fragilidad , Sarcopenia , Humanos , Femenino , Anciano , Masculino , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Sarcopenia/psicología , Estudios Prospectivos , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/epidemiología , Fuerza de la Mano/fisiología , Fragilidad/diagnóstico , Fragilidad/epidemiología , Vida IndependienteRESUMEN
All chemists are familiar with the idea that, at equilibrium steady state, the relative concentrations of species present in a system are predicted by the corresponding equilibrium constants, which are related to the free energy differences between the system components. There is also no net flux between species, no matter how complicated the reaction network. Achieving and harnessing non-equilibrium steady states, by coupling a reaction network to a second spontaneous chemical process, has been the subject of work in several disciplines, including the operation of molecular motors, the assembly of supramolecular materials, and strategies in enantioselective catalysis. We juxtapose these linked fields to highlight their common features and challenges as well as some common misconceptions that may be serving to stymie progress.