[The relationship between aortic pulse wave velocity and atherogenic index in centenarians].

It is considered that the atherogenic index (AI), calculated from cholesterol fraction levels, is biochemically acceptable but cannot completely express the degree of physiological development of individual arteriosclerotic changes in extremely elderly persons. The purpose of this study is to search for another form of the atherosclerotic index which is more reliable in terms of physiological aspects, and to clarify the relationship between aortic pulse wave velocity (PWV) and AI in centenarians. We have measured the PWV in 40 healthy centenarians (7 males and 33 females; age 100 to 105, average age 101.1) and 92 ordinary elderly people (45 males and 47 females; age 70 to 89, average age 75.8) in Okinawa, Japan. The conventional AI was calculated by the Fridewald Method. A statistically significant difference in the AI value was observed between centenarians (1.91), and controls (2.59, p < 0.0001). Higher levels of PWV in centenarians (10.15 m/sec), were recognized than in the controls (8.45 m/sec, p < 0.0001). However, no significant correlations were noticed between PWV and AI in centenarians (r = 0.0049) and in controls (r = 0.094). These results suggested that pathological findings in centenarians are produced mainly by physiological fibrotic changes of the arterial wall instead of pathological atherosclerotic changes.

[Red blood cell parameters of healthy centenarians].

Since the number of centenarians is increasing rapidly in recent years, the establishment of normal ranges in red blood cell (RBC) parameters for healthy centenarians is necessary for diagnostic criteria of anemia. The subjects were 129 centenarians consisting of 27 men (17; healthy, 69; low ADL) and 102 women (33; healthy, 69; low ADL) after excluding centenarians with diseases affecting RBC parameters. The t test was used for statistical evaluation. The mean RBC count for healthy centenarian men was 403 +/- 54.7 x 10(4)/microliters; hemoglobin (Hb) level, 12.4 +/- 1.3 g/dl; hematocrit (Hct), 38.2 +/- 3.9%; MVC, 95.3 +/- 5.3 fl; MCH, 31.4 +/- 2.2 pg; and MCHC, 32.1 +/- 1.1%. Comparable results for healthy centenarian women were as follows: 375 +/- 43.9 x 10(4)/microliters, 11.6 +/- 1.2 g/dl, 36.3 +/- 3.6%, 97.1 +/- 5.3 fl, 31.0 +/- 2.3 pg, and 32.0 +/- 1.3%, respectively. The mean Hb for healthy centenarian women was significantly lower than that for healthy centenarian men. The mean RBC, Hb and hematocrit values for low ADL-centenarian men were lower than the comparable values for healthy centenarian men. Conversely, the mean MCV value for low ADL-centenarian men was higher than that for healthy centenarian men. There was no difference in any RBC parameter between healthy centenarian women and low ADL-centenarian women. In addition, there was no difference in any RBC parameter between centenarian women living in their own homes and those living in old-aged homes. This study demonstrated the normal ranges of RBC parameters for healthy centenarians, and lower RBC, Hb, and Hct values for low ADL-centenarian men.

[Chronological study concerning ADL among Okinawan centenarians].

Since 1976 medicobiological and sociological surveys have been carried out upon centenarians in Okinawa. Recently dementia and disability have increased among centenarians. In order to determine the statistical significance, ADL (Activities of Daily Living) scores among Okinawan centenarians were compared; 43 subjects were studied from the 1970's (1976-1980), 99 subjects from the 1980's (1986-1988), and 109 subjects from the 1990's (1992-1994). ADL scores of each centenarian were recorded by the same researchers at the University of the Ryukyus Hospital, based on observation and examination of the centenarians where they lived. Five categories of self sufficiency were defined; completely independent, independent but slow, independent with difficulty, partially dependent, and completely dependent. There were seven physical tasks scored; taking meals, bowel and bladder continence, ability to rise from a toilet, ability to stand, extent of general activities, ability to bathe, and ability to dress oneself. Their sensory functions (auditory acuity and eyesight) and cognitive abilities (comprehension and self-expression) were also scored. Declining rates of total ADL scores were more marked between the 1970's and the 1980's than between the 1980's and the early 1990's. It was also more remarkable in institutionalized centenarians than in centenarians living at home. Decline in physical activities was more distinct in institutionalized than in home-living centenarians. On the other hand, cognitive abilities declined more among centenarian living at home than among institutionalized centenarians. The population of centenarians has increased 23 times over the past 22 years in Okinawa. Human life span has been remarkably extended by advanced medical technology, physically easier life style, and improvement in overall social welfare.(ABSTRACT TRUNCATED AT 250 WORDS)

[Serum globulin levels and activities of daily living in centenarians].

Serum globulin levels in 101 centenarians (77 women, 24 men) were analyzed by zonal electrophoresis and immunoglobulin assays. Six subjects showed an M band in electrophoretograms. Five M bands were immunoglobulin G (IgG) type and one was IgA. One subject was suspected to suffer from IgG-type multiple myeloma, and the others were thought to have essential (benign) monoclonal gammopathy. The relationship between serum globulin levels and activities of daily living (ADL) was studied in remaining 95 subjects. There were 21 rank-J (free-living), 25 rank-A (unable to go outside without help), 23 rank-B (bedridden but able to sit on the bed), and 26 rank-C (completely bedridden) centenarians. The mean serum alpha 1-, alpha 2-, and beta-globulin level in the rank-J centenarians was at the upper limit of the normal adult range. The mean alpha 1-globulin levels in rank-B (3.3 +/- 0.4%) and C (3.4 +/- 0.5%) subjects were significantly higher than those in rank-J (2.9 +/- 0.3%) centenarians. The mean serum gamma-globulin level of rank-J centenarians (16.9 +/- 3.7%) was within the normal range. The mean gamma-globulin levels in rank-B (21.0 +/- 2.7%) and C (22.8 +/- 4.9%) subjects were significantly higher than that in rank-J centenarians. The mean immunoglobulin G concentrations in rank-B (1.620 +/- 304 mg/dl) and C (1.720 +/- 392 mg/dl) subjects were significantly higher than those in rank-J centenarians (1.320 +/- 361 mg/dl) and in normal adults (1.150 +/- 235 mg/dl). IgA concentrations in all centenarians were higher than in normal controls. There was no significant difference in IgA or IgM concentration between rank-J subjects and those in other ranks. Serum globulin levels measured with electrophoresis, and the immunoglobulin concentrations, can be valuable indicators of the ability to perform activities of daily living, and may be useful predictors of subclinical diseases or morbidity in centenarians.

[Serum albumin level and activities of daily living in centenarians].

The relationship between serum albumin level and activities of daily living was studied in 95 centenarians. There were 73 women (12 rank J: free-living, 18 rank A: unable to go outside without help, 20 rank B: bedridden but able to sit on the bed, 23 rank C: completely bedridden) and 22 men (9 rank J, 7 rank A, 6 rank B or C). The serum albumin level (mean +/- S.D. 4.0 +/- 0.4 g/dl) of the rank J women was at the lower limit of normal for young adults. The albumin levels of rank A, rank B, and rank C were 3.7 +/- 0.4 g/dl, 3.5 +/- 0.3 g/dl, and 3.4 +/- 0.4 g/dl, respectively. The levels of rank B and rank C women were significantly lower than that of rank J women. The albumin level of rank J men (3.9 +/- 0.3 g/dl) was lower than that of young adults. The albumin level of ranks B and C men (3.1 +/- 0.3 g/dl) was significantly lower than that of rank J men. The A/G ratio or albumin fraction (%) measured by serum electrophoresis was similar to that of the serum albumin level of centenarians of both sexes. There were no significant differences in the serum protein level or in the peripheral hemoglobin level between rank J centenarians and those of other ranks, for both sexes. The serum albumin level is a valuable indicator of the ability to perform activities of daily living and may be a useful prognostic index in centenarians.