[Animal mediation and social bond: a psychosocial study in Ehpad]. / Médiation animale et lien social : une étude psychosociale en Ehpad.

Ehpad are French establishments intended to elderly people in a situation of physical and/or psychological loss of autonomy. Institutionalization in Ehpad is often synonymous with the disruption of social ties. In this context, different group activities are likely to favour the residents' relationships. Among these activities, animal mediation is an emerging approach that is gradually being introduced in these establishments. The aim of this research is to study the benefits of animal mediation on the social bond of Ehpad residents, according to animal mediation practitioners and professionals working in these establishments. Semi-directive interviews were carried out with nine professionals working in Ehpad in daily contact with the residents and who had attended collective sessions. These professionals were invited to give their views on the interactions between residents and on the benefits of the sessions. At the same time, fifty animal mediation practitioners responded to a questionnaire aimed at determining the place given to the development of social links in their practices. The professionals working in Ehpad described animal mediation as a practice that facilitates interactions during the sessions but also outside. For residents for whom verbalization is difficult or even impossible, animal mediation is presented as facilitating non-verbal communication. These comments converge with the discourse of animal mediation practitioners who place the creation of social links and the development of social skills at the heart of their practices. They highlight the central role of the animal which facilitates interactions and provides an emotional exchange.

Can Nutrition Contribute to a Reduction in Sarcopenia, Frailty, and Comorbidities in a Super-Aged Society?

Many countries are facing the advent of super-aging societies, where sarcopenia and frailty will become pertinent problems. The prevalence of comorbidities is a major problem in countries with aged populations as elderly people suffer from various diseases, such as diabetes, heart failure, chronic kidney disease and dementia. All of these diseases are associated with sarcopenia and frailty, and they frequently cause falls, fractures, and a decline in activities of daily living. Fractures in the elderly people are associated with bone fragility, which is influenced by diabetes and chronic kidney disease. Nutritional support for chronic disease patients and sarcopenic individuals with adequate energy and protein intake, vitamin D supplementation, blood glucose level management for individuals with diabetes, obesity prevention, nutritional education for healthy individuals, and the enlightenment of society could be crucial to solve the health-related problems in super-aging societies.

The association between the essential metal mixture and fasting plasma glucose in Chinese community-dwelling elderly people.

BACKGROUND: Epidemiological studies about the effect of essential metal mixture on fasting plasma glucose (FPG) levels among elderly people are sparse. The object of this study was to examine the associations of single essential metals and essential metal mixture with FPG levels in Chinese community-dwelling elderly people. METHODS: The study recruited 2348 community-dwelling elderly people in total. Inductively coupled plasma-mass spectrometry was adopted to detect the levels of vanadium (V), selenium (Se), magnesium (Mg), cobalt (Co), calcium (Ca), and molybdenum (Mo) in urine. The relationships between single essential metals and essential metal mixture and FPG levels were evaluated by linear regression and Bayesian kernel machine regression (BKMR) models, respectively. RESULTS: In multiple-metal linear regression models, urine V and Mg were negatively related to the FPG levels (ß = - 0.016, 95 % CI: - 0.030 to - 0.003 for V; ß = - 0.021, 95 % CI: - 0.033 to - 0.009 for Mg), and urine Se was positively related to the FPG levels (ß = 0.024, 95 % CI: 0.014-0.034). In BKMR model, the significant relationships of Se and Mg with the FPG levels were also found. The essential metal mixture was negatively associated with FPG levels in a dose-response pattern, and Mg had the maximum posterior inclusion probability (PIP) value (PIP = 1.0000), followed by Se (PIP = 0.9968). Besides, Co showed a significant association with decreased FPG levels in older adults without hyperlipemia and in women. CONCLUSIONS: Both Mg and Se were associated with FPG levels, individually and as a mixture. The essential metal mixture displayed a linear dose-response relationship with reduced FPG levels, with Mg having the largest contribution to FPG levels, followed by Se. Further prospective investigations are necessary to validate these exploratory findings.

The effects of nutritional supplementation on older sarcopenic individuals who engage in resistance training: a meta-analysis.

Objective: Sarcopenia is a typical age-related disorder characterized by loss of muscle mass, strength, and physical function. Resistance training has a noticeable effect on sarcopenia, but there is no consensus on whether nutritional supplements can boost this effect. We conducted a meta-analysis of relevant literature to investigate the therapeutic effect of resistance training combined with nutrition intervention on sarcopenia compared with resistance training alone. Methods: Cochrane Library, PubMed, Web of Science, Embase, Sinomed, CNKI, VIP, and Wanfang Data were searched for relevant studies on resistance training combined with nutritional intervention for aging adults with sarcopenia. The retrieval period ranged from the inception of the databases to May 24, 2022. Literature screening and information extraction were performed by two researchers. The Physiotherapy Evidence Database (PEDro) scale was adopted for literature quality evaluation and Stata 15.0 software for analysis. Results: Twelve clinical trials were included, involving 713 older adults diagnosed with sarcopenia, of whom 361 were assigned to the experimental group and 352 to the control group. Compared with the control group, grip strength of the experimental group was substantially elevated [WMD = 1.87, 95% CI (0.01, 3.74), P = 0.049]. Subgroup analysis demonstrated that vitamin D and protein increased grip strength and gait speed. There were no significant improvement in grip strength and gait speed in the protein and vitamin D free subgroup. Conclusions: This meta-analysis demonstrated that resistance training combined with additional nutritional supplementation, especially compound nutritional supplements that included protein and vitamin D, might further enhance grip strength rather than muscle mass in older adults with sarcopenia. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022346734.

Effects of Tai Chi on insomnia in elderly people with chronic non-specific low back pain: A study protocol for a randomized controlled trial.

Introduction: Chronic non-specific low back pain (CNLBP) is a complex condition characterized by pain, dysfunction, disturbed sleep, anxiety, and depression, all of which impair the quality of life. Previous studies showed that practicing Tai Chi had effects on chronic low back pain. However, there is a lack of evidence on its impact on sleep. The trial will evaluate the use of Tai Chi as a treatment for insomnia in elderly people with CNLBP. Methods: The study design will be a randomized, controlled, open-label trial. Participants (n = 106) will be recruited from the Hospital of Chengdu University of Traditional Chinese Medicine, Qing Yang District University for the Elderly, and Ci Tang Street Community. Participants will be randomly assigned to the Tai Chi group (n = 53) and the control group (n = 53). The Tai Chi group will undergo a Yang-style 24-form Tai Chi program for 8 weeks. The control group will have a waiting period of 8 weeks, followed by 8 weeks of Tai Chi practice. The primary outcomes of this study will be changes in sleep quality and pain intensity. Secondary outcomes of interest will include changes in the quality of pain, range of motion, physical performance, social support, and overall quality of life. Any adverse events and attendance rates will also be reported in this study. Clinical trial registration: ChiCTR2200064977.

Cross-sectional study of depression tendency and sleep quality in 1352 people practicing Tai Chi.

This cross-sectional study aimed to analyse the relationship between Tai Chi exercise habits and depression tendency and sleep quality in people practicing Tai Chi in Chengdu, China. A total of 1352 Tai Chi practitioners aged 50-79 years old were divided into six groups according to age and gender for Tai Chi exercise habits, depression tendency and sleep quality. The frequency of weekly Tai Chi practice and duration of single Tai Chi practice have a significant positive correlation with the exercise years. For female subjects who had long-term Tai Chi exercise, depression decreased with the duration and weekly frequency of a single exercise. Tai Chi exercise habits reduced sleep disturbance scores (in the male group aged 60-69 years old, exercise years, r = -0.242, p = 0.004) and sleep duration (in the male and female group aged 70-79 years old, duration of single Tai Chi practice, r = -0.334, p = 0.035; r = -0.235, p = 0.029), suggesting that long-term Tai Chi exercise may reduce the trend of poor sleep quality due to increased ageing.

The influence of tai chi on the death anxiety of elderly people living alone: the chain mediating effect of social support and psychological capital.

Background: Population aging is a global trend, and the number of older adults living alone is increasing. Tai chi, a traditional Chinese exercise, has been shown to improve the physical and mental health of older adults. Aim: To investigate the effects of tai chi on death anxiety in older adults living alone and the role of social support and psychological capital in this relationship. Method: A cross-sectional study of 493 older adults living alone in four cities in southwestern China. Participants were assessed using questionnaires on tai chi practice, social support, psychological capital, and death anxiety. Results: Tai chi practice significantly reduced death anxiety in older adults living alone. It also positively correlated with social support and psychological capital, both of which negatively correlated with death anxiety. Social support and psychological capital mediated the relationship between tai chi practice and death anxiety, suggesting that tai chi may reduce death anxiety through these factors. These findings encourage older adults living alone to practice tai chi, as it may improve their mental and physical health and reduce their risk of death anxiety. Conclusion: Tai chi practice may reduce death anxiety in older adults living alone through the chain-mediated effects of social support and psychological capital. This suggests that tai chi may be a beneficial intervention for older adults living alone.

The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review.

Background: Increasing lines of evidence indicate that traditional Chinese exercise (TCE) has potential benefits in improving chronic low back pain (CLBP) symptoms. To assess the clinical efficacy of TCE in the treatment of CLBP, we performed a systematic review of existing randomized controlled trials (RCTs) of CLBP and summarized the neural mechanisms underlying TCE in the treatment of CLBP. Methods: A systematic search was conducted in four electronic databases: PubMed, Embase, the Cochrane Library, and EBSCO from January 1991 to March 2022. The quality of all included RCTs was evaluated by the Physiotherapy Evidence Database Scale (PEDro). The primary outcomes included pain severity and pain-related disability. Results: A total of 11 RCTs with 1,256 middle-aged and elderly patients with CLBP were included. The quality of all 11 included RCTs ranged from moderate to high according to PEDro. Results suggested that TCE could considerably reduce pain intensity in patients with CLBP. Overall, most studies did not find any difference in secondary outcomes (quality of life, depression, and sleep quality). Conclusion: The neurophysiological mechanism of TCE for treating CLBP could be linked to meditation and breathing, posture control, strength and flexibility training, and regulation of pain-related brain networks. Our systematic review showed that TCE appears to be effective in alleviating pain in patients with CLBP.

Tratamiento farmacológico de la epilepsia en el adulto mayor, revisión de la literatura / Pharmacological treatment of epilepsy in elderly people, a literature review

RESUMEN Los adultos mayores tienen mayor riesgo de desarrollar epilepsia. Con un aumento progresivo de la expectativa de vida, este grupo muestra el más rápido incremento entre los pacientes con epilepsia. El tratamiento en sí se complica debido a los cambios fisiológicos relacionados con el envejecimiento, las comorbilidades, los problemas cognitivos concomitantes, las interacciones farmacológicas complejas y las dificultades en la adherencia a regímenes medicamentosos. Las crisis epilépticas se pueden controlar en la mayoría de los pacientes adultos mayores con dosis bajas de un solo fármaco anticrisis epiléptica de efecto específico. La tolerabilidad es un factor importante en la selección del fármaco, ya que los pacientes adultos mayores tienden a ser muy sensibles a los efectos secundarios. Para los fármacos anticrisis epiléptica que operan como inductores enzimáticos se debe valorar su retiro del arsenal terapéutico en favor de nuevos agentes que han demostrado similar eficacia y mejor tolerabilidad. Lamotrigina y levetiracetam son los fármacos anticrisis epiléptica más recomendados actualmente para el manejo de este cuadro en los adultos mayores. Aun cuando puede tratarse de una epilepsia fácilmente controlable, es recomendable mantener el tratamiento de forma indefinida en los adultos mayores dada la tendencia recurrente de las crisis. Se requieren más estudios que aborden los mecanismos fisiopatológicos de la epilepsia en este grupo etario y una mayor inclusión de los adultos mayores en ensayos clínicos, así como el desarrollo de modelos de atención integral que optimice el cuidado de estos pacientes.

SUMMARY Elderly people are at a higher risk of developing epilepsy. With a progressive increase in life expectancy, this is the fastest growing group of epilepsy patients. Their treatment is complicated by the presence of physiological changes related to aging, comorbidities, concomitant cognitive problems, complex drug interactions, and difficulties in the adherence to medication regimes. Seizures can be controlled in elderly people patients with low doses of a single epileptic seizure drug. Tolerability is an important factor in drug selection, as elderly people patients tend to be very sensitive to side effects. Enzyme-inducing anti-seizure drugs should gradually be left out of the therapeutic arsenal in favor of new anti-seizure drugs that have shown similar efficacy and better tolerability. Levetiracetam and lamotrigine are the most recommended anti-seizure drugs for older adults with epilepsy nowadays. Although it could be easily controlled, it is recommended that older adults continue their treatment indefinitely, due to the recurrent seizures' proclivity. More studies are needed to address the pathophysiological mechanisms of epilepsy in this age group, and greater inclusion of elderly people in clinical trials is needed, as is the development of comprehensive care models to provide optimal patient care.

RISK OF HYPERCALCEMIA IN ELDERLY PATIENTS WITH HYPERVITAMINOSIS D AND INTOXICATION.

OBJECTIVE: We aimed to determine the risk of hypercalcemia in a geriatric population with very high dose levels of 25-hydroxy-vitamin D (25(OH)D). PATIENTS AND METHOD: This study was designed as a retrospective, cross-sectional two-center study for examining the elderly patients with very high 25(OH)D levels (>88ng/mL) between January 2014 and December 2019. After recruitment, subgroup analyses of the patients were performed based on their calcium and vitamin D levels. RESULTS: A total of 81.101 elderly patients, who had been evaluated for their vitamin D levels, were screened. Of the 458 (0.6%) elderly patients with 25(OH)D>88 ng/mL according to our criteria, 217 patients with complete data were accepted into our study. The median 25(OH)D level was 103.7ng/mL (min-max:88.2-275.9). Most of the elderly patients (86.6%) with very high 25(OH)D levels were normocalcemic. When patients with hypercalcemia were compared with normocalcemic group, no difference was observed in the levels of 25(OH)D, intact parathormone (iPTH), phosphorus, alkaline phosphatase (ALP), and their age. However, the PTH suppression rate was significantly higher in hypercalcemic group (p=0.005). CONCLUSION: The elderly patients with very high 25(OH)D levels would appear to be mostly normocalcemic whereas life-threatening hypercalcemia would also occur. Treatment and follow-up planning should be done according to the clinical guideline recommendations.