Serum vitamin D and functional impairment in octogenarian women.

PURPOSE: Serum vitamin D deficiency has been associated with frailty in people aged 65 and over, however its relationship with functional impairment has not been investigated in octogenerian (aged 80-90 years) institutionalized women. METHODS: We assessed functional impairment in this latter group by measuring frailty syndrome and other geriatric and psychological assessment scales: the Tinetti gait and balance index to determine the risk for falls, the Barthel index to measure the basic activities of daily living, the Lawton index for instrumental activities, the mini-mental score examination test for cognitive impairment, the Yesavage scale for geriatric depression, and the Norton scale for the risk of ulceration. RESULTS: Frail individuals had significantly reduced serum vitamin D concentrations (measured as total 25-hydroxyvitamin D; 25(OH)D) compared to robust individuals, but reduced 25(OH)D concentration did not significantly correlate with frailty syndrome severity, and mean 25(OH)D concentrations were within the recommended levels in all groups. The 25(OH)D concentration did not correlate with any of the blood analytical parameters measured and with the geriatric assessment scales used, suggesting a selective relationship with frailty. CONCLUSION: These results highlight the need to individualize treatment such as vitamin D supplementation in order to treat frailty syndrome.

Beneficial Effect of Foot Plantar Stimulation in Gait Parameters in Individuals with Parkinson's Disease.

New treatments based on peripheral stimulation of the sensory-motor system have shown to be promising in rehabilitation strategies for patients with neurological disorders, including Parkinson's disease (PD), especially in regards to reducing gait impairment, and hence, the incidence of falls. The aim of this study was to evaluate the change in several gait parameters measured by sensor inertial measurement in PD patients after acute plantar stimulation, under the distal phalanx of the big toe, and underneath the head of the first metatarsal joint of both feet, using a 3D printing insole. In order to assess whether the effects are selective for PD patients, we compared the effect of the treatment in a control group (age-matched) consisting of patients with other neurological disorders which also displayed gait and balance impairment, and a similar cognitive function, depressive symptoms, body mass index, and comorbidity burden observed in the PD group. Plantar foot stimulation in PD patients eliminated the significant (p < 0.05) alterations existing in stride asymmetry and in stride variability. When comparing the effects of post-plantar stimulation with the respective basal level, considered as 100% in both groups, we observed a significant (p = 0.019, Mann-Whitney test) increase in stride length compared to basal in the PD group and control group. No significant effects of foot plantar stimulation were observed in any of the gait parameters in the control group. Plantar foot stimulation has a positive effect on the step and stride length, and has a positive effect on walking stability, measured by the increase in stride length. No significant effect was observed on bradykinesia because it did not improve walking velocity. These findings indicate that foot plantar stimulation using a 3D printing insole seems to generate a more stable walking pattern in PD patients, with an interesting applicability, and a low-cost, for reducing gait impairment in PD patients.

Blood zinc levels and cognitive and functional evaluation in non-demented older patients.

A complete battery of geriatric and psychometric tests was used to determine whether plasma-borne zinc (Zn), a key ion in neuroplasticity, can be associated with the severity of functional, psychological and cognitive impairment in non-demented older individuals. There was a significant positive correlation between plasma Zn levels and the concentration subcategory measured with the Mini-Mental State Examination (MMSE) test (p < 0.001), but not the total MMSE score, and the levels were significantly reduced in polymedicated patients (defined as concurrent administration of >5 drugs). No correlations were found between plasma Zn levels and depressive symptoms measured with the Yesavage scale for geriatric depression or the Barthel Index - a measurement of the ability of individuals to perform the activities of daily living. Depressive symptoms were associated with poor sleep quality and polymedication (p < 0.001 and p < 0.05, respectively). Our results suggest that peripheral Zn concentration may play a role in the physiopathology of some domain of cognitive function. No correlation to depressive symptoms in the geriatric population under antidepressant drug treatment was observed. However, further studies are needed to understand the relationship between circulating Zn and concentration deficits in order to determine whether Zn represents a candidate early biomarker for cognitive impairment.