The Evolutionary Stage of Cognitive Frailty and Its Changing Characteristics in Old Adults.

OBJECTIVES: This study aimed to explore the evolutionary stage of the elderly from the normal to the cognitive frailty, and to identify the important factors which influenced the changes of the cognitive frailty stage from the «physiological-psychological-social¼ perspective. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: A random cluster sampling was used to recruit 4,010 old adults living in community from Shanxi province in China. MEASUREMENTS: Data were collected by face-to-face questionnaire survey. Multinomial logistic regression was used to screen the factors contributing to the 6 population groups with various cognitive functions and frailty status. Principal component analysis was used to redefine the evolutionary stages of cognitive frailty, while the orthogonal partial least squares discrimination analysis and binary logistic regression were used to identify the important factors and distinguish different stages and influence directions. RESULTS: The factors contributing to the population with various cognitive functions and frailty status were involved in all aspects of «physical-psychological-social¼. Apart from normal group, other 5 groups were clustered into «stage of frailty change¼ and « stage of cognitive frailty change¼. Aging, early onset of chronic diseases, high pain intensity, and poor nutritional status might deteriorate the individual's evolution from "normal stage" to "stage of frailty change", while the increasing social activity might promote the individual's health. Simultaneously, early onset of chronic diseases, high pain intensity and poor nutritional status also played important roles in the evolution of individual from "stage of frailty change" to "stage of cognitive frailty change". CONCLUSION: The formation of cognitive frailty might experience the «normal-frailty-cognitive frailty¼ stages change, and both the prevention and intervention of frailty might delay the occurrence of cognitive frailty. Therefore, the strategies for both prevention and intervention among old adults should be throughout centered on the parts of preventing the premature onset of chronic diseases, carrying out stage-tailored nutrition intervention, and establishing standardized pain management, especially the part of increasing the social activities among older adults.

Inhibition of hepatic fibrosis with artificial microRNA using ultrasound and cationic liposome-bearing microbubbles.

We sought to investigate the antifibrotic effects of an artificial microRNA (miRNA) targeting connective tissue growth factor (CTGF) using the ultrasound-targeted cationic liposome-bearing microbubble destruction gene delivery system. Cationic liposomes were conjugated with microbubbles using a biotin-avidin system. Plasmids carrying the most effective artificial miRNA sequences were delivered by ultrasound-targeted cationic liposome-bearing microbubble destruction gene delivery system to rats with hepatic fibrosis. The results show that this method of gene delivery effectively transported the plasmids to the rat liver. The artificial miRNA reduced hepatic fibrosis pathological alterations as well as the protein and mRNA expressions of CTGF and transforming growth factor ß1. Furthermore, the CTGF gene silencing decreased the levels of type I collagen and α-smooth muscle actin (P<0.01). These data suggest that delivery of an artificial miRNA targeted against CTGF using ultrasound-targeted cationic liposome-bearing microbubble destruction may be an efficacious therapeutic method to ameliorate hepatic fibrosis.