Association between dietary riboflavin intake and cognitive decline in older adults: a cross-sectional analysis.

BACKGROUND: Research exploring the link between dietary riboflavin intake and cognitive decline in this demographic is limited. Our aim was to examine the association between riboflavin intake levels and cognitive decline. METHODS: The National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2014 were utilized in this cross-sectional analysis. The Consortium to Establish a Registry for Alzheimer's Disease test Word Learning delayed recall trial (DR), Digit Symbol Substitution Test (DSST), Animal Fluency Test(AFT) and Z test were used to evaluate cognitive performance. Multivariate logistic regression, restricted cubic spline and subgroup analysis were performed to evaluate the associations between riboflavin intake and cognitive decline. RESULTS: The study included a total of 2255 patients, with 47.9% being male. The incidence of cognitive decline was 23.8%. After adjusting for all selected covariates, we found that high riboflavin intake was associated with a lower risk of cognitive impairment in adults in the United States. When riboflavin intake was used as a Categorical variable, compared to those with the lowest intake, the odds ratio (OR) of individuals with the highest riboflavin intake for DR test, AFT test, DSST test and Z test were 0.73 (95% CI: 0.53~1), 0.68(95% CI: 0.49-0.96),0.53(95% CI: 0.37-0.77) and 0.56(95% CI: 0.39-0.8). The study also found an L-shaped association between riboflavin intake and cognitive decline, with an inflection point at approximately 2.984 mg/d. CONCLUSIONS: Our cross-sectional study in a nationwide sample of American old adults suggests that dietary riboflavin intake was negative associated with cognitive decline.

Plasma BDNF/Irisin Ratio Associates with Cognitive Function in Older People.

Background: Reliable blood biomarkers are crucial for early detection and treatment evaluation of cognitive impairment, including Alzheimer's disease and other dementias. Objective: To examine whether plasma biomarkers and their combination are different between older people with mild cognitive impairment (MCI) and cognitively normal individuals, and to explore their relations with cognitive performance. Methods: This cross-sectional study included 250 older adults, including 124 participants with MCI, and 126 cognitively normal participants. Plasma brain-derived neurotrophic factor (BDNF), irisin and clusterin were measured, and BDNF/irisin ratio was calculated. Global cognition was evaluated by the Montreal Cognitive Assessment. Results: Plasma irisin levels, but not BDNF, were significantly different between MCI group and cognitively normal group. Higher irisin concentration was associated with an increased probability for MCI both before and after controlling covariates. By contrast, plasma BDNF concentration, but not irisin, was linearly correlated with cognitive performance after adjusting for covariates. Higher BDNF/irisin ratios were not only correlated with better cognitive performance, but also associated with lower risks of MCI, no matter whether we adjusted for covariates. Plasma BDNF and irisin concentrations increased with aging, whereas BDNF/irisin ratios remained stable. No significant results of clusterin were observed. Conclusions: Plasma BDNF/irisin ratio may be a reliable indicator which not only reflects the odds of the presence of MCI but also directly associates with cognitive performance.

What exercise strategies are best for people with cognitive impairment and dementia? A systematic review and meta-analysis.

OBJECTIVE: Explore the types of exercise that are appropriate for people with dementia, as well as the intensity and frequency of exercise training that is appropriate for older patients to carry out. METHODS: Cochrane Library, PubMed, Embase, Web of Science, Scopus databases were searched by computer to collect RCT studies that met the inclusion criteria of this article. The search time limit was until January 2024. Two reviewers independently screened literature, extracted data, and assessed the quality and risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.4 and Stata 15.1 software. RESULTS: The results of our study showed that physical exercise improved patients' cognitive ability and walking ability, with aerobic and multicomponent training showing the best improvement, and that the number of training sessions should not be too high, with the experimental group showing the best results when the total number of interventions was less than 30. CONCLUSION: We recommend long-term exercise training for middle-aged and elderly patients with dementia or those who are predisposed to dementia. The type of training we recommend is multi-component training and aerobic training, and we recommend 2-3 sessions of exercise per week for about 60 min each.

"Like another human being in the room": a community case study of smart speakers to reduce loneliness in the oldest-old.

This community case study examined the potential benefits of smart speakers to tackle loneliness in the oldest old adults living in supported accommodation. The program was established as a collaboration between the supported accommodation provider and a technology company to explore the feasibility of smart speakers to alleviate resident loneliness. Loneliness in later life often accompanies a shrinking social circle, loss of a spouse or increased disability. People aged 85 years of age and over are increasingly likely to experience these life events, leading to an increased risk of social isolation and loneliness. Five older people, mean age 90 years of age, who resided in supported accommodation, were given a smart speaker for 8 weeks to examine their experience with the voice assistant. The experiences of the five older adults are explored as case studies, with each person interviewed both before and after receiving the smart speaker. All five valued their smart speaker, recognised its potential for tackling loneliness, and wanted to keep it. The three most lonely individuals reported that their smart speaker made them feel less lonely and isolated through two mechanisms: (i) creating a presence and (ii) having some control over their situation. Although only a small study, these experiences suggest providing smart speakers for lonely and isolated oldest-old people, could be one way to help combat loneliness in community settings.

Carboxymethylcellulose-induced depletion attraction to stabilize high internal phase Pickering emulsions for the elderly: 3D printing and ß-carotene delivery.

In this study, a carboxymethylcellulose (CMC) induced depletion attraction was developed to stabilize high internal phase Pickering emulsions (HIPPEs) as age-friendly 3D printing inks. The results demonstrated that depletion force induced the adsorption of yolk particles at the droplet interface and the formation of osmotic droplet clusters, thereby increasing the stability of HIPPEs. In addition, the rheological properties and nutrient delivery properties of HIPPEs could be adjusted by the mass ratio of yolk/CMC. The HIPPEs stabilized at yolk/CMC mass ratio 20:7.5 showed optimal printability, viscoelastic, structural recovery, and swallowability. HIPPEs have been applied to 3D printing, International Dysphagia Dietary Standardization Initiative (IDDSI) test, and in vitro digestive simulation in the elderly, indicating their attractive appearance, safe swallowability, and enhanced bioaccessibility of ß-carotene. Our work provides new ideas for developing age-friendly foods with plasticity and nutrient delivery capacity by depletion attraction stabilizing HIPPEs.

The relationship between blood pressure and functional fitness of older adults in Korea.

Hypertension, also known as high blood pressure (BP), is a critical health issue that can cause cardiovascular disease. It is observed more frequently in older adults. Thus, this study aimed to identify the functional fitness and body composition factors that significantly influence both systolic and diastolic BPs in older adults. Data from 155,266 older adults (51,751 men [33.3%] and 103,505 women [66.7%]) who underwent functional fitness tests between 2013 and 2018 were analyzed. The following seven functional fitness tests were conducted: (a) aerobic endurance (2-min step), (b) upper body muscle strength (hand grip strength), (c) lower body muscle endurance (chair sit-and-stand), (d) flexibility (sit-and-reach), (e) agility (Timed Up and Go), and (f) body composition (body mass index [BMI] and body fat percentage). Systolic and diastolic BPs were used as outcome variables. In examining the proposed relationships, the regression analysis revealed that BMI, body fat percentage, sit-and-reach, 2-min step, hand grip, chair sit-and-stand, and Timed Up and Go were significantly associated with reduced systolic and diastolic body pressures.

Alzheimer's Disease and Suicide: An Integrative Literature Review.

INTRODUCTION: Suicide has been described in patients with Alzheimer's disease. Some promising medications for treating Alzheimer's disease have had their studies suspended because they increase the risk of suicide. Understanding the correlations between suicide and Alzheimer's disease is essential in an aging world. METHODS: A search was carried out on electronic websites (PubMed and Scielo) using the MeSH Terms "suicide" and "Alzheimer" (1986-2023). Of a total of 115 articles, 26 were included in this review. RESULTS: Depression and the allele ε4 of Apolipoprotein (APOE4) were demonstrated to be the main risk factors for suicide in patients with Alzheimer's disease. CONCLUSION: Adequately delineating which elderly people are vulnerable to suicide is important so that new treatments for Alzheimer's disease can be successful. This review showed a need for new studies to investigate the interface between Alzheimer's disease and suicide.

Ambient PM2.5 and cardiopulmonary mortality in the oldest-old people in China: A national time-stratified case-crossover study.

BACKGROUND: Evidence on the associations of fine particulate matter (PM2.5) with cardiopulmonary mortality in the oldest-old (aged 80+ years) people remains limited. METHODS: We conducted a time-stratified case-crossover study of 1,475,459 deaths from cardiopulmonary diseases in China to estimate the associations between short-term exposure to ambient PM2.5 and cardiopulmonary mortality among the oldest-old people. FINDINGS: Each 10 µg/m3 increase in PM2.5 concentration (6-day moving average [lag05]) was associated with higher mortality from cardiopulmonary diseases (excess risks [ERs] = 1.69%, 95% confidence interval [CI]: 1.54%, 1.84%), cardiovascular diseases (ER = 1.72%, 95% CI: 1.54%, 1.90%), and respiratory diseases (ER = 1.62%, 95% CI: 1.33%, 1.91%). Compared to the other groups, females (ER = 1.94%, 95% CI: 1.73%, 2.15%) (p for difference test = 0.043) and those aged 95-99 years (ER = 2.31%, 95% CI: 1.61%, 3.02%) (aged 80-85 years old was the reference, p for difference test = 0.770) presented greater mortality risks. We found 14 specific cardiopulmonary causes associated with PM2.5, out of which emphysema (ER = 3.20%, 95% CI: 1.57%, 4.86%) had the largest association. Out of the total deaths, 6.27% (attributable fraction [AF], 95% CI: 5.72%, 6.82%) were ascribed to short-term PM2.5 exposure. CONCLUSIONS: This study provides evidence of PM2.5-induced cardiopulmonary mortality and calls for targeted prevention actions for the oldest-old people. FUNDING: This work was supported by the National Key Research and Development Program of China, the National Natural Science Foundation of China, the Foreign Expert Program of the Ministry of Science and Technology, the Natural Science Foundation of Guangdong, China, and the Science and Technology Program of Guangzhou.

[ICOPE Evaluations and Promoting Health in Older Adults: A Chinese Medicine Perspective].

The Integrated Care for Old People (ICOPE) guidelines were developed by the World Health Organization. These guidelines address functional abilities in older adults in six intrinsic capacity domains, including cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms with the goal of improving their assessment and management. In this article, aging is interpreted from the perspective of Chinese medicine and guided by the theory of Yin Yang, the five elements, the six ICOPE domains, and the five organs (liver, heart, spleen, lungs, and kidneys). Huang Di Nei Jing's concept of disease prevention is proposed in a manner that corresponds to the three-stage preventive public health strategy for promoting health, delaying the effects of aging, and improving quality of life in older adults.

World trends in publication for maxillofacial and dental trauma in the elderly.

Aging may increase the risk of maxillofacial and dentoalveolar trauma (MDT). This review assessed global trends in scientific publications on MDT in the elderly. Six databases were searched. Studies about MDT in the elderly (≥60 years old) were included in two text mining stages (S1 and S2). In S1, all studies with elderly subjects were included, while in S2 only studies in which the elderly were assessed in a separate set of data or in a subanalysis by age groups were included. In S1, relevant data were mined using VantagePoint™ software. In S2, data were descriptively analyzed. There were 2265 studies at S1 and 110 at S2. The publication dates spanned from 1963 to 2023. In S1, the most cited keywords and terms were aged (n = 1872), male (n = 1839), female (n = 1777), "mandible fracture" (n = 460), "orbit fracture" (n = 362), and "maxilla fracture" (n = 118). Thirty authors published 10 or more articles with visible collaboration networks. There was a progressive increase in publications, especially in Europe (n = 150). In S2, most studies were case reports/case series (n = 62). The primary etiology was accidental falls (n = 84), the most affected region was the middle third of the face (n = 65), and dental trauma was rarely reported (n = 15). Cone Beam computed tomography was the most used diagnostic tool (n = 67). Of the 81 articles that addressed therapy, 52 opted for surgical treatment. Although there has been an increase in the number of articles on MDT over the years, studies with the elderly population as a specific study group are still needed. Accidental falls were the most reported etiology, while the middle third of the face and the mandible were the anatomic region and bone most affected, respectively. The high number of case reports indicates the need for improvement in the available scientific evidence about MDT in the elderly.

Network analysis of illness perception, stigma, and resilience with cognition in old people living with HIV.

OBJECTIVES: Old people living with HIV (PLWH) are highly susceptible to HIV-related psychological and neurocognitive disorders, which are multidimensional and inseparably intertwined. Despite this, few studies have investigated the interrelationship between these disorders. We aimed to estimate the detailed associations and identify potential intervention points between HIV-related psychological factors and cognitive function in old PLWH. METHODS: This cross-sectional study drew on the Older People with HIV Infections Cohort from 65 communities in Sichuan, China. Three HIV-related psychological factors, including illness perception, HIV stigma perception and resilience, were collected using a self-reported questionnaire. Cognitive function was measured using the MoCA-B scale. Network analysis was used to estimate the interrelationships between HIV-related psychological factors and cognitive function dimensions in old PLWH, and to identify factors that act as bridges in connecting these factors in the network. RESULTS: Of the 1587 old PLWH, 47.0% had mild or severe cognitive function impairment. Network analysis revealed that better visual perception was directly connected with poorer negative self-image (edge weight: 0.13), and poorer illness comprehensibility was connected with poor visual perception (-0.09) and executive functioning (-0.13). The cognitive illness perceptions (bridge strength: 0.41), illness comprehensibility (0.36) and negative self-image (0.39) were identified as bridges connecting HIV-related psychological and cognitive function. CONCLUSIONS: The interconnection of HIV-related illness perception, stigma perception, and resilience with cognition may be achieved through the links of negative self-image, illness comprehensibility and cognitive illness perceptions. These factors may serve as potential non-pharmaceutical action points to improve psychological and cognitive health among old PLWH.

Concepções e vivências da sexualidade e seus efeitos nas vidas de mulheres idosas / Conceptions and experiences of sexuality and the efects on the lives of elderly women / Concepciones y vivencias de la sexualidade y sus efectos em la vida de las mujeres mayores

Objetivo: desvelar os conceitos e percepções da sexualidade de mulheres idosas e os impactos em suas vidas. Método: trata-se de um estudo qualitativo exploratório-descritivo, com onze entrevistadas, mulheres entre 60 e 80 anos de idade, usuárias de uma Unidade Básica de Saúde, localizada no noroeste do Paraná. Resultados: observou-se que as mulheres idosas, em sua maioria, relacionam a sexualidade ao ato sexual e, consequentemente, depende de seu parceiro e percebem o ato como algo exclusivo do casamento e que depende do marido para acontecer. Conclusão: conclui-se que a sexualidade, apesar do conceito ter relação direta com o ato sexual, podem produzir influência em sua autoestima, na dinâmica familiar e busca pela assistência de saúde.

Objective: to reveal the concepts and perceptions of elderly women's sexuality and the impacts on their lives. Method: this is an exploratory-descriptive qualitative study, with eleven interviewees, women between 60 and 80 years of age, users of a Basic Health Unit, located in the northwest of Paraná. Results: it was observed that the majority of elderly women relate sexuality to the sexual act and, consequently, depend on their partner and perceive the act as something exclusive to marriage and that it depends on the husband to happen. Conclusion: It is concluded that sexuality, despite the concept having a direct relationship with the sexual act, can influence self-esteem, family dynamics and the search for health care.

Objetivos: revelar los conceptos y percepciones sobre la sexualidad de las mujeres mayores y los impactos en sus vidas. Método: Se trata de un estudio cualitativo exploratorio-descriptivo, con once entrevistadas, mujeres entre 60 y 80 años, usuarias de una Unidad Básica de Salud, ubicada en el noroeste de Paraná. Resultados: se observó que la mayoría de las mujeres mayores relacionan la sexualidad con el acto sexual y, en consecuencia, dependen de su pareja y perciben el acto como algo exclusivo del matrimonio y que depende del marido para realizarse. Conclusión: se concluye que la sexualidad, apesar de que el concepto tiene relación directa con el acto sexual, puede influir en la autoestima, la dinámica familiar y la búsqueda de atención de salud.

Effects of climate and environment on migratory old people with allergic diseases in China: Protocol for a Sanya cohort study.

Background: Several studies have reported that the mountain climate can alleviate asthma, however, the effect of tropical climate on migratory elderly, especially in people with respiratory or allergic diseases is unknown. Objectives: This cohort study aims to explore impact of climate and environmental changes on allergic diseases in migratory old people. Methods: In this prospective cohort study, we recruited 750 older migratory people, the majority of whom were homeowners to minimize the risk of loss to follow up. The study's inclusion criteria were elderly individuals had moved from northern China to Sanya and suffered from either asthma or allergic diseases. Prior to participation, these individuals provided informed consent and underwent baseline assessment. Subsequently, they will be followed for three years. A face-to-face interview was conducted to gather information regarding their living environment and habits. Trained investigators administered the questionnaires and performed physical examinations including height, weight, and blood pressure, while a professional respiratory doctor conducted pulmonary function tests. Blood samples were promptly tested routine blood test, liver function, kidney function, glucose, triglyceride, allergens, and inflammatory factors. Climate and environmental data were obtained from Sanya Meteorological Bureau and Ecological Environment Bureau, respectively. We primarily compared the differences of participants with asthma or allergic diseases between northern China and Sanya in southern China by Chi-square test, t-test or Wilcoxon rank-sum test. Findings: A total of 750 participants were recruited in this cohort from fourteen communities. All participants were surveyed questionnaires about health and family environment, underwent physical examinations, and collected biological samples for laboratory examinations. Novelty: This is the first study to evaluate the effects of tropical climate and environment on elderly migrants from cold regions. This study has important implication for the health tourism and aging health, especially for the elderly migrants who suffered the respiratory and allergic diseases. Furthermore, this cohort study establishes a solid foundation for investigating the influence of environmental changes on elderly migrants with allergic diseases.

Development of an Elliptical Perturbation System that provides unexpected perturbations during elliptical walking (the EPES system).

BACKGROUND: 'Perturbation-based balance training' (PBBT) is a training method that was developed to improve balance reactive responses to unexpected balance loss. This training method is more effective in reducing fall rates than traditional balance training methods. Many PBBTs are performed during standing or treadmill walking which targeted specifically step reactive responses, we however, aimed to develop and build a mechatronic system that can provide unexpected perturbation during elliptical walking the Elliptical Perturbation System (the EPES system), with the aim of improving specifically the trunk and upper limbs balance reactive control. METHODS: This paper describes the development, and building of the EPES system, using a stationary Elliptical Exercise device, which allows training of trunk and upper limbs balance reactive responses in older adults. RESULTS: The EPES system provides 3-dimensional small, controlled, and unpredictable sudden perturbations during stationary elliptical walking. We developed software that can identify a trainee's trunk and arms reactive balance responses using a stereo camera. After identifying an effective trunk and arms reactive balance response, the software controls the EPES system motors to return the system to its horizontal baseline position after the perturbation. The system thus provides closed-loop feedback for a person's counterbalancing trunk and arm responses, helping to implement implicit motor learning for the trainee. The pilot results show that the EPES software can successfully identify balance reactive responses among participants who are exposed to a sudden unexpected perturbation during elliptical walking on the EPES system. CONCLUSIONS: EPES trigger reactive balance responses involving counter-rotation action of body segments and simultaneously evoke arms, and trunk reactive response, thus reactive training effects should be expected.

Association between Frailty Assessed Using Two Electronic Medical Record-Based Frailty Assessment Tools and Long-Term Adverse Prognosis in Older Critically Ill Survivors.

OBJECTIVES: Frailty has become an independent risk factor for adverse outcomes in critically ill patients. This study aimed to explore the predictive ability of two electronic medical record-based frailty assessment tools, the Hospital Frailty Risk Score (HFRS) and Frailty Index based on physiological and laboratory tests (FI-lab), for long-term adverse prognosis in older critically ill survivors. DESIGN: Retrospective observational study. SETTING AND PARTICIPANTS: 9,082 critically ill survivors aged ≥ 65 years. MEASUREMENTS: The HFRS and the 33-item FI-lab were constructed based on the published literature. Cox and logistic regression models assessed the association between frailty and 1-year mortality and post-discharge care needs. RESULTS: 2,586 patients died within 1 year of follow-up. In fully adjusted models, frailty assessed using both the HFRS (per point, hazard ratio [HR] 1.06, 95% confidential interval [CI] 1.05-1.06; intermediate frailty risk, HR 2.00, 95% CI 1.78-2.25; high frailty risk, HR 3.06, 95% CI 2.68-3.50) and FI-lab (per 0.01 points, HR 1.03, 95% CI 1.03-1.03; intermediate frailty risk, HR 1.59, 95% CI 1.44-1.76; high frailty risk, HR 2.30, 95% CI 2.06-2.57) was associated with mortality. Addition of frailty indicators improved the predictive validity of the Sequential Organ Failure Assessment score for mortality (HFRS alone ∆ C-index 0.034; FI-lab alone ∆ C-index 0.016; HFRS and FI-lab combined ∆ C-index 0.042). The HFRS but not the FI-lab was associated with higher probability of post-discharge care needs. CONCLUSION: Both the HFRS and FI-lab could independently predict 1-year mortality in older critically ill survivors. Adding the HFRS to the SOFA score model improved it more than adding the FI-lab. The greatest improvement was achieved when both frailty indicators were used together. These findings suggest that electronic medical record-based frailty assessment methods can be useful tools for predicting long-term outcomes in older critically ill patients.

How Does the Frequency of Eating-Alone among Older People in Korea Affect Their Health and Dietary Behavior?

This study examined the relationship between general population characteristics and diet-related factors pertaining to eating alone for older adults (65 years and older) in Korea. This study used the Korea National Health and Nutrition Examination Survey (KNHANES), 2016-2020, and the target population was 7037 Koreans aged 65 years or older who participated in the nutritional survey and health interview. Eating alone variables were classified as follows. Eating together all day means "eating together", eating only one meal a day means "1/day", eating two meals a day alone means "2/day", and "3/day" means eating three meals a day alone. The main results are as follows. The rate of moderate or severe food insecurity was 3.41% in the "eating together" group to 7.86% in the "3/day" group, which was 4.45% higher in the "3/day" group. Fruit + vegetable intake among food intake lowered by about 35 g from 301.2 g in the "eating together" group to 266.2 g in the "3 day" group. In addition, as a result of analyzing the prevalence of depression using the PHQ-9 score, the "3/day" group had a 1.775 to 2.464 times higher risk of depression than the "eating together" group. Finally, EQ-5D variables and quality of life scores were significantly lowered from the "eating together" group to the "3/day" group. Overall, higher frequency of eating alone was associated with food safety, essential food intake, and quality of life. Based on these results, it is thought that a dietary life support program such as the eating together program is necessary to improve the quality of life of the older people who eat alone.

Catastrophic health expenditure and the risk of depression among middle-aged and old people in China: a national population-based longitudinal study.

AIMS: To estimate the association of catastrophic health expenditure (CHE) with the risk of depression in middle-aged and old people in China. METHODS: We used data of 2011, 2013, 2015 and 2018 from the China Health and Retirement Longitudinal Study, which covered 150 counties of 28 provinces in China. CHE was calculated as out-of-pocket health expenditure exceeding 40% of a household's capacity to pay. Depression was measured by a 10-item Centre for Epidemiological Studies Depression Scale. We evaluated CHE prevalence and applied Cox proportional hazard models to estimate adjusted hazard ratios (aHRs) and 95% confident intervals (CIs) for the risk of depression among participants with CHE after controlling potential confounders, compared with those without CHE. RESULTS: Among 5765 households included in this study, CHE prevalence at baseline was 19.24%. The depression incidence of participants with CHE (8.00 per 1000 person-month) was higher than that of those without CHE (6.81 per 1000 person-month). After controlling confounders, participants with CHE had a 13% higher risk (aHR = 1.13, 95% CI: 1.02-1.26) of depression than those without CHE. In subgroup analysis, the association of CHE with depression was significant in males and in people with chronic diseases, of younger age, living in rural areas and of lowest family economic level (all P < 0.05). CONCLUSIONS: Nearly one of five middle-aged and old people in China incurred CHE, and CHE was associated with the risk of depression. Concerted efforts should be made to monitor CHE and related depression episode. Moreover, timely interventions about CHE and depression need to be implemented and strengthened among middle-aged and old people.

Projetos de extensão universitária e experiências de lazer para pessoas idosas nas universidades públicas brasileiras: um panorama atual / Leisure practices for the elderly in brazilian public universities: a current panorama

O objetivo foi investigar as experiências de lazer ofertadas às pessoas idosas nos projetos e programas existentes nas universidades públicas brasileiras. Realizou-se uma pesquisa exploratória e descritiva. O universo do estudo foi composto por 113 universidades públicas brasileiras, os dados foram coletados por meio de instrumento online com uma amostra de 54 coordenadores. Os programas e projetos ofertam atividades de lazer de acordo com as condições de espaço, material e pessoal. Nem todas as regiões possuem programas bem estruturados. Há carência de recursos, materiais em boa parte deles; faltam estruturas construídas e locais para a realização das atividades. A oferta de atividades de lazer para pessoas idosas nas universidades públicas brasileiras ainda é um campo em expansão. A maior parte dos programas surge por meio da extensão universitária e tem sido ela, uma das mantenedoras da continuidade dos mesmos.

The objective was to investigate the experienses of leisure practices offered to the elderly in existing projects and programs in Brazilian public universities. An exploratory and descriptive research was carried out. The study universe consisted of 113 Brazilian public universities, data were collected through an online instrument with a sample of 54 coordinators. The programs and projects offer leisure activities according to the conditions of space, material and personnel. Not all regions have wellstructured programs. There is a lack of resources, materials in most of them; there is a lack of built structures and places to carry out activities. The provision of leisure activities for the elderly in Brazilian public universities is still an expanding field. Most of the programs arise through university extension and it has been one of the maintainers of their continuity.

Cardiovascular disease onset in old people with severe hypercholesterolemia.

BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) variants are associated with higher atherosclerotic cardiovascular disease risk (ASCVD) even when compared with other forms of severe hypercholesterolemia, especially in young people. Lipid lowering therapies (LLT) may change hypercholesterolemia natural history. This study aimed at evaluating factors associated with occurrence of ASCVD in old severe hypercholesterolemics diagnosed or not with FH and undergoing LLT. METHODS: Hypercholesterolemic individuals ≥60 years participating on a genetic cascade screening for FH were divided in 4 groups (2 × 2) according to the presence (variant+) or not (variant-) of FH genetic variants and previous ASCVD (ASCVD+ and ASCVD-). Biomarkers associated with new incident ASCVD events were tested using Cox models. Continuous data shown as medians (%25; %75). RESULTS: From 4,111 genotyped individuals, 377 (9.1%) were elderly [age 66 (63; 71) years], 28.9% males, 42.7% variant+, 32.1% with previous ASCVD, LLT duration 9 (5; 16) years, and on treatment LDL-cholesterol 144 (109; 200) mg/dL. After 4.8 (7; 3) years of follow up there were 47 incident events (12.4%, 2.7% patient/year). The annualized event rates were 0.8% (95% CI 0.36%; 1.70%), 2.3% (95% CI 1.3%; 4.1%), 5.2% (95% CI 2.8%; 9.7%) and 6.3% (95% CI 4.0%; 10.0%) respectively for groups variant-/ASCVD-, variant+/ASCVD-, variant-/ASCVD+ and, variant+/ASCVD+ (p log rank p < 0.001). Only presence of previous ASCVD was independently associated with incident ASCVD [hazard ratio 3.236 (95%CI 1.497-6.993, p = 0.003)]. No interaction was found for previous ASCVD and variants. CONCLUSIONS: In old severe hypercholesterolemic individuals undergoing long-term LLT previous ASCVD was associated with incident events while FH causing variants were not.

Osteoporosis and sarcopenia are associated with each other and reduced IGF1 levels are a risk for both diseases in the very old elderly.

It is mandatory to manage musculoskeletal disorders in the elderly to prevent their becoming bed-ridden or requiring long-term care. However, the prevalence of musculoskeletal disorders such as osteoporosis and sarcopenia in otherwise healthy people over 85 years old is not completely known. Here we enrolled 1026 healthy subjects between 85 and 89 years old and evaluated them for the presence of osteoporosis, sarcopenia and fragility fracture(s), and how those conditions were related. We also evaluated biomarkers such as serum levels of insulin-like growth factor 1 (IGF1) and vitamin D status. The prevalence of osteoporosis, sarcopenia or fragility fracture(s) in these subjects was 22.4, 10.2 or 15.0 %, respectively. Serum IGF1 and 25(OH)D were significantly and negatively correlated with osteoporosis or sarcopenia. Osteoporosis and either sarcopenia or fragility fracture(s) were significantly related and shown to be risk factors for each other, even after adjustment for gender and BMI, while sarcopenia and fragility fracture(s) were not associated. Our data may provide a health platform for the very elderly and suggest strategies to prevent musculoskeletal disorders in this population.