Social support is associated with technology use in old age.

BACKGROUND: The use of technological innovations can play a significant role in healthy aging and social participation in old age; however, it is not well understood how social contexts can influence or support older adults' use of technology. This study explored the associations between technology use, perceived technology-related support and actual technology-related social support. It was expected that older adults who perceived having more supportive resources available would be more likely to receive actual support in technology-related issues, which, in turn would explain a greater use of technology in everyday life. MATERIAL AND METHODS: The data are based on a sample of 107 community-dwelling older adults between 60 and 93 years of age (mean age = 73.66 years, 40% male). Measures included self-reports of actual technology-related support, perceived technology-related support, the use of different devices related to digital information and communication technology and personal characteristics (e.g. chronological age, gender, education and functional limitations). A path model was used to explore the research hypotheses. RESULTS: Actual technology-related support received was positively associated with a greater number of devices used. Participants received more support with technology when they perceived a greater availability of supportive resources. The actual support received mediated the influence of perceived support and functional limitations on technology use. CONCLUSION: The results of this study show that the provision of supportive behavior is associated with the actual use of technology. Moreover, the findings shed light on the individual and contextual factors that explain differences in actual support received.

Validity of microscopy for diagnosing urinary tract infection in general practice - a systematic review.

Objective: To investigate the validity of microscopy as a diagnostic tool for urinary tract infection in general practice. Methods: (Design/setting) A systematic review was conducted by searching Medline for clinical studies made in general practice, outpatient clinics or similar settings in which the accuracy/validity of microscopy was evaluated with urine culture as the reference standard. Results: Our search resulted in 108 titles. 28 potentially eligible studies were retrieved for full-text reading. We included eight studies involving 4582 patients in this review. The quality of the studies was moderate to high. Specificity ranged from 27% to 100%, sensitivity from 47% to 97%. The variation between studies did not allow for meta-analysis. Conclusion: We did not find substantial evidence to determine the clinical validity of microscopy performed in general practice on urine samples from patients with symptoms of UTI. Key points Urinary tract infection is common in general practice. Methods for precise diagnosis are needed in order to avoid inappropriate treatment. Currently no evidence-based consensus exists regarding the use of urinary microscopy in general practice. We did not find substantial evidence to determine the overall clinical validity of microscopy performed in general practice on urine samples from patients with symptoms of UTI. Light microscopy with oil immersion had high sensitivity and specificity but is time-consuming. Phase-contrast microscopy is quick and had high specificity but lower sensitivity.

Subjective Technology Adaptivity Predicts Technology Use in Old Age.

BACKGROUND: To date, not much is known about the psychological and motivational factors underlying technology use in late life. What are the interindividual determinants that lead older adults to invest in using technological innovations despite the age-related physiological changes that impose challenges on behavioral plasticity in everyday life? OBJECTIVE: This research explores interindividual differences in subjective technology adaptivity - a general technology-related motivational resource that accounts for technology use in late life. More specifically, we investigate the influence of this factor relative to demographic characteristics, personality traits, and functional limitations in a longitudinal sample of community-dwelling older adults. METHODS: We report results from a paper-and-pencil survey with 136 older adults between 59 and 92 years of age (mean = 71.4, SD = 7.4). Of those participants, 77 participated in a 2-year follow-up. We assessed self-reports of technology use, subjective technology adaptivity, functional limitations, and the personality traits openness to new experiences and neuroticism. RESULTS: Higher levels of subjective technology adaptivity were associated with technology use at the first measurement as well as increased use over the course of 2 years. CONCLUSIONS: Subjective technology adaptivity is a significant predictor of technology use in old age. Our findings contribute to improving the understanding of interindividual differences when using technological innovation in late life. Moreover, our findings have implications in the context of user involvement and may contribute to the successful development of innovative technology for older adults.

[Subjective time left in life and precautionary relocation planning in the last half of life]. / Subjektive Restlebenszeit und vorsorgende Umzugsplanung in der zweiten Lebenshälfte.

BACKGROUND: Many people wish to remain in current residence for as long as possible. Nonetheless, they do think about their residential future. For older people the question of where to live must be considered with respect to age-related changes and continuity. So far only little research has been focused on the influence of the subjective perception of remaining lifetime until death on plans for the future, for example regarding relocation. OBJECTIVE: This study investigated the influence of the subjective perception of time left to live on relocation planning and its timing in the further course of life. MATERIAL AND METHODS: The data were obtained from a paper-pencil questionnaire including 2156 persons aged 50 years and older (average age 65.5 years, SD = 9.7 years, range 50-94 years, 51.1 % female) who were asked about their wishes and plans for the future, particularly about their relocation considerations and the subjective perception of remaining time until death. RESULTS: Approximately 39 % of the subjects considered relocation in the further course of life. Besides social demographics, current housing and the state of health, the subjective time left in life had a significant influence on the consideration of relocation and its timing in the further course of life. Persons who perceived their time horizon as limited considered relocation later in life (temporizing relocation planning) than persons who perceived themselves to have more time left in life. Their temporal occurrence of precautionary relocation planning is embedded earlier in the course of life. CONCLUSION: Thoughts about the residential future of older people should be considered not only in connection with the content of these wishes but also related to the future time perspective and the timing in the further course of life. This can be of assistance in consultation and decision-making situations.

Outdoor motivation moderates the effects of accessibility on mobility in old age.

BACKGROUND: Mobility plays a major role in healthy aging and social participation. This study explored whether accessibility problems in the housing environment are negatively associated with mobility in old age and whether this association is moderated by differences in an individual's preference for spending time outside the home (outdoor motivation). MATERIAL AND METHODS: This article reports the results of a research project on mobility in old age. The project included a survey study of 120 community-dwelling older adults between 59 and 92 years of age (mean = 71.7 years, SD = 7.3 years) living in the metropolitan region of Nuremberg, Germany. Objective assessments were conducted in the participants' housing environment to evaluate the magnitude of accessibility problems. RESULTS: Accessibility problems were negatively associated with mobility. Interaction analyses suggested a buffering effect of outdoor motivation on this association, i.e. participants who reported a preference for spending time outside the home had a higher mobility in the face of accessibility problems as compared with those who preferred staying at home. CONCLUSION: Outdoor motivation may have protective effects for older adults when accessibility problems challenge mobility. These findings contribute to improving the understanding of how and under what circumstances older adults stay mobile and active in everyday life. Considering interindividual differences in outdoor motivation may binterventions and public health programs that are aimed at enhancing mobility and social participation in old age.

Engulfment adaptor phosphotyrosine-binding-domain-containing 1 (GULP1) is a nucleocytoplasmic shuttling protein and is transactivationally active together with low-density lipoprotein receptor-related protein 1 (LRP1).

APP (amyloid precursor protein) and LRP1 (low-density lipoprotein receptor-related protein 1) have been implicated in the pathogenesis of AD (Alzheimer's disease). They are functionally linked by Fe65, a PTB (phosphotyrosine-binding)-domain-containing adaptor protein that binds to intracellular NPxY-motifs of APP and LRP1, thereby influencing expression levels, cellular trafficking and processing. Additionally, Fe65 has been reported to mediate nuclear signalling in combination with intracellular domains of APP and LRP1. We have previously identified another adaptor protein, GULP1 (engulfment adaptor PTB-domain-containing 1). In the present study we characterize and compare nuclear trafficking and transactivation of GULP1 and Fe65 together with APP and LRP1 and report differential nuclear trafficking of adaptors when APP or LRP1 are co-expressed. The observed effects were additionally supported by a reporter-plasmid-based transactivation assay. The results from the present study indicate that Fe65 might have signalling properties together with APP and LRP1, whereas GULP1 only mediates LRP1 transactivation.

Engulfment adapter PTB domain containing 1 interacts with and affects processing of the amyloid-ß precursor protein.

Previous studies identified engulfment adapter phosphotyrosine binding (PTB) domain containing 1 (GULP1) as an NPXY-motif interactor of low-density lipoprotein receptor-related protein 1 (LRP1) and suggested a potential relevance in Alzheimer's disease (AD). Since AD associated proteins amyloid-ß A4 precursor protein (APP) and LRP1 were shown to interact with the PTB domain of Fe65 and several other adapters via their intracellular NPXY-motifs, we examined a possible interaction of GULP1 PTB domain with the YENPTY-motif of APP. Here we demonstrate that GULP1 is present in human hippocampal and neocortical neurons. Confocal live cell imaging revealed that coexpressed and endogenous GULP1 colocalizes with APP in the Golgi and endoplasmic reticulum. Analysis of the interacting domains by co-immunoprecipitation of point and deletion mutants revealed that the interaction depends on the PTB domain of GULP1 and the YENPTY-motif of APP. Coexpression of GULP1 affected APP cell surface localization and suppressed generation of Aß40/42 and sAPPα. Taken together, these data identify GULP1 as a novel neuronal APP interacting protein that alters trafficking and processing of APP.

The role of low-density receptor-related protein 1 (LRP1) as a competitive substrate of the amyloid precursor protein (APP) for BACE1.

Cleavage of APP by BACE1 is the first proteolytic step in the production of amyloid-beta (Abeta), which accumulates in senile plaques in Alzheimer's disease. Through its interaction with APP, the low-density receptor-related protein 1 (LRP1) enhances APP internalization. Recently, BACE1 has been shown to interact with and cleave the light chain (lc) of LRP1. Since LRP1 is known to compete with APP for cleavage by gamma-secretase, we tested the hypothesis that LRP1 also acts as a competitive substrate for beta-secretase. We found that the increase in secreted APP (sAPP) mediated by over-expression of BACE1 in APP-transfected cells could be decreased by simultaneous LRP1 over-expression. Analysis by multi-spot ELISA revealed that this is due to a decrease in sAPPbeta, but not sAPPalpha. Interaction between APP and BACE1, as measured by immunoprecipitation and fluorescence lifetime assays, was impaired by LRP1 over-expression. We also demonstrate that APP over-expression leads to decreased LRP1 association with and cleavage by BACE1. In conclusion, our data suggest that--in addition to its role in APP trafficking--LRP1 affects APP processing by competing for cleavage by BACE1.

Neuromyelitis optica in a patient with an early onset demyelinating episode: clinical and autoantibody findings.

Recent clinical and laboratory findings have substantially advanced our understanding of neuromyelitis optica (NMO) as a humorally mediated, autoimmune disorder. We report on a patient who suffered a first episode of transverse myelitis at the age of 6 months following diphtheria-pertussis-tetanus (DPT) vaccination which had therefore been considered suggestive of acute disseminated encephalomyelitis (ADEM). Fifteen years later, the further disease course revealed typical NMO meeting all diagnostic criteria. This development points to a broad clinical and temporal heterogeneity of NMO, with ADEM probably occurring in the context of a shared autoimmune diathesis. Despite therapy response following B-cell depletion by rituximab, positive NMO-IgG autoantibody status remained unchanged, whereas direct testing for anti-aquaporin-4 (AQP-4)-antibodies was negative throughout. Our findings challenge the pathogenic relevance of NMO-IgG and indicate a varying diagnostic value of testing for NMO-IgG and AQP-4-autoantibodies.

K+-ATP-channel-related protein complexes: potential transducers in the regulation of epithelial tight junction permeability.

K(+)-ATP channels are composed of an inwardly rectifying Kir6 subunit and an auxiliary sulfonylurea receptor (SUR) protein. The SUR subunits of Kir6 channels have been recognized as an ATPase, which appears to work as a mechanochemical device like other members of the ABC protein family. Thus, in spite of just gating ions, Kir6/Sur might, in addition, regulate completely different cellular systems. However, so far no model system was available to directly investigate this possibility. Using highly specific antibodies against Kir6.1-SUR2A and an in vitro model system of the rat small intestine, we describe a new function of the Kir6.1-SUR2A complex, namely the regulation of paracellular permeability. The Kir6.1-SUR2A complex localizes to regulated tight junctions in a variety of gastrointestinal, renal and liver tissues of rat, pig and human, whereas it is absent in the urothelium. Changes in paracellular permeability following food intake was investigated by incubating the lumen of morphological well-defined segments of rat small intestine with various amounts of glucose. Variations in the lumenal glucose concentrations and regulators of Kir6.1/SUR2A activity, such as tolbutamide or diazoxide, specifically modulate paracellular permeability. The data presented here shed new light on the physiological and pathophysiological role K(+)-ATP channels might have for the regulation of tight junctions.