[Chronic kidney disease and accelerated aging: the role of comprehensive geriatric assessment.]

This review presents data from the literature on the characteristics of the course of chronic kidney disease from the perspective of the geriatric patient. Chronic kidney disease and progression of renal failure is a prototype model of premature and accelerated aging. Many authors have stated that a better mechanistic understanding of the phenomenon of premature aging, early diagnosis of chronic kidney disease, and a geriatric approach to the patient can improve the effectiveness of management and prolongation of life in this category of patients. Comprehensive geriatric assessment is one of the most important tools used by geriatricians and their teams to globally assess elderly patients and plan effective interventions. It is concluded that the use of comprehensive geriatric assessment in patients with chronic kidney disease may improve the clinical status of patients and allow selection of patients who may benefit most from renal replacement therapy compared to a conservative approach. And even in the early stages of chronic kidney disease, a comprehensive geriatric assessment may be useful in formulating a complete intervention plan and optimizing quality of life, autonomy, and prognosis. However, despite recognition of the importance of comprehensive geriatric assessment, the means to implement this tool in nephrology departments have not been developed and require special training programs and appropriate skills. It is concluded that much more needs to be done to realize the continuity of nephrologists and geriatricians in the provision of meaningful skilled care to older patients with chronic kidney disease.

Regional brain aging: premature aging of the domain general system predicts aphasia severity.

Premature brain aging is associated with poorer cognitive reserve and lower resilience to injury. When there are focal brain lesions, brain regions may age at different rates within the same individual. Therefore, we hypothesize that reduced gray matter volume within specific brain systems commonly associated with language recovery may be important for long-term aphasia severity. Here we show that individuals with stroke aphasia have a premature brain aging in intact regions of the lesioned hemisphere. In left domain-general regions, premature brain aging, gray matter volume, lesion volume and age were all significant predictors of aphasia severity. Increased brain age following a stroke is driven by the lesioned hemisphere. The relationship between brain age in left domain-general regions and aphasia severity suggests that degradation is possible to specific brain regions and isolated aging matters for behavior.

Mitochondrial Dysfunction, Oxidative Stress and Premature Aging in Children With Nutritional Rickets.

OBJECTIVES: To assess the mitochondrial dysfunction, oxidative stress and premature aging in children with nutritional rickets. METHODS: This cross-sectional study enrolled children aged 6 months - 5 years with nutritional rickets attending a tertiary care hospital between January 2021 and August 2022. Mitochondrial dysfunction, oxidative stress and premature aging were assessed by measuring the mitochondrial DNA (mtDNA) content, total antioxidant status (TAOS) and telomere length (TL) in 40 children with nutritional rickets and 40 age- and sex- matched healthy children without rickets (controls). RESULTS: The median (IQR) mtDNA content was significantly higher in children with rickets as compared to controls [152.27 (111.83, 218.66) vs 93.7 (72.5, 134.14); P < 0.001], implying mitochondrial dysfunction attributed to increased mitochondrial biogenesis in children with rickets. The median (IQR) TAOS ( mM Trolox equiv.) was significantly lower in children with rickets than controls [4.54 (3.93, 5.73) vs 7.86 (5.09, 9.58); P < 0.001)]. The median (IQR) TL in cases was significantly longer in children with rickets compared to controls [417.31 (111.83,218.66) vs 93.7 (72.5,134.14); P < 0.001] implying that children with rickets do not have premature aging. CONCLUSIONS: Children with rickets have high oxidative stress and mitochondrial dysfunction but no evidence of premature aging.

The Detrimental Effects of Bedrest: Premature Cardiovascular Aging and Dysfunction.

Bedrest as an experimental paradigm or as an in-patient stay for medical reasons has negative consequences for cardiovascular health. The effects of severe inactivity parallel many of the changes experienced with natural aging but over a much shorter duration. Cardiac function is reduced, arteries stiffen, neural reflex responses are impaired, and metabolic and oxidative stress responses impose burden on the heart and vascular systems. The effect of these changes is revealed in studies of integrative function. Aerobic fitness progressively deteriorates with bedrest and tolerance of upright posture is rapidly impaired. In this review we consider the similarities of aging and bedrest-induced cardiovascular deconditioning. We concur with many recent clinical recommendations that early and regular mobility with upright posture will reduce likelihood of hospital-associated disability related to bedrest.

Características da marcha de mulheres com fibromialgia: um padrão prematuro de envelhecimento / Gait characteristics of women with fibromyalgia: a premature aging pattern

Introdução: Fibromialgia é uma condição que envolve dor crônica generalizada. Além disso, mulheres de meia idade com fibromialgia apresentam alterações no padrão de marcha, expondo-se prematuramente a um padrão de marcha semelhante ao encontrado na população idosa. Objetivo: Determinar os parâmetros espaciais (linear e angular) da marcha de mulheres com fibromialgia e compará-los com idosas sem essa condição. Métodos: 25 mulheres (10 no grupo com fibromialgia e 15 no grupo de idosas) se qualificaram como voluntárias para participar do estudo. A análise cinemática foi realizada por meio de um sistema optoeletrônico, e as variáveis lineares e angulares foram determinadas. Resultados: Ambos os grupos apresentaram similaridades na velocidade da marcha, tamanho da passada, cadência e amplitude de movimento do quadril, joelho e tornozelo (p > 0,05), exceto para a rotação da pelve, na qual o grupo com fibromialgia apresentou maior rotação de quadril (p < 0,05) quando comparado ao grupo de idosas. Além disso, houve correlação negativa no grupo com fibromialgia entre rotação do quadril e dor no glúteo (r = -0,69; p < 0,05), e entre obliquidade da pelve e dor na região do trocanter maior (r = -0,69; p < 0,05). Conclusão: Mulheres de meia idade com fibromialgia apresentaram um padrão de marcha similar ao de idosas, o qual é caracterizado por amplitude de movimento, tamanho da passada e velocidade da marcha reduzidos. .

Background: Fibromyalgia is a condition which involves chronic pain. Middle-aged individuals with fibromyalgia seem to exhibit changes in gait pattern, which may prematurely expose them to a gait pattern which resembles that found in the elderly population. Objective: To determine the 3 D spatial (linear and angular) gait parameters of middle-aged women with fibromyalgia and compare to elderly women without this condition. Methods: 25 women (10 in the fibromyalgia group and 15 in the elderly group) volunteered to participate in the study. Kinematics was performed using an optoelectronic system, and linear and angular kinematic variables were determined. Results: There was no difference in walking speed, stride length, cadence, hip, knee and ankle joints range of motion between groups, except the pelvic rotation, in which the fibromyalgia group showed greater rotation (P < 0.05) compared to the elderly group. Also, there was a negative correlation with pelvic rotation and gluteus pain (r = - 0.69; P < 0.05), and between pelvic obliquity and greater trochanter pain (r = - 0.69; P < 0.05) in the fibromyalgia group. Conclusion: Middle-aged women with fibromyalgia showed gait pattern resemblances to elderly, women, which is characterized by reduced lower limb ROM, stride length and walking speed. .