Factors Associated with Improvement in Activities of Daily Living during Hospitalization: A Retrospective Study of Older Patients with Hip Fractures.

BACKGROUND: In this study, we aimed to examine the changes in delirium during hospitalization of patients and its association with behavioral and psychological symptoms of dementia (BPSD), as well as improvements in activities of daily living (ADL). METHODS: A longitudinal, retrospective cohort study was conducted involving 83 older adults (≥65 years) with hip fractures. We collected Mini-Mental State Examination (MMSE) and Functional Independence Measure-motor domain (m-FIM) assessment results from the medical charts at two time points: baseline (first week of hospitalization) and pre-discharge (final week before discharge). Additionally, we collected data on delirium and BPSD at three points: baseline, week 2 post-admission, and pre-discharge. We performed univariate logistic regression analysis using changes in m-FIM scores as the dependent variable and MMSE and m-FIM scores at baseline and pre-discharge, along with delirium and BPSD subtypes at baseline, week 2 post-admission, and pre-discharge, as the explanatory variables. Finally, we performed a multivariate logistic regression analysis incorporating the significant variables from the univariate analysis to identify factors associated with ADL improvement during hospitalization. RESULTS: We observed significant correlations between ADL improvement during hospitalization and baseline m-FIM and MMSE scores, hypoactive delirium state, and BPSD subtype pre-discharge. Notably, all participants with hypoactive symptoms before discharge exhibited some subtype of delirium and BPSD at baseline. CONCLUSION: Besides ADL ability and cognitive function at admission, the presence of hypoactive delirium and BPSD subtype before discharge may hinder ADL improvement during hospitalization.

Differences in the effect of exercise interventions between prefrail older adults and older adults without frailty: A pilot study.

AIM: We aimed to clarify whether there are differences in the effect of exercise interventions between prefrail older adults and older adults without frailty. METHODS: The participants were community-dwelling older adults (mean age 75.1 ± 5.1 years). The participants were instructed to use a training method at home to prevent frailty. The effects of the intervention were evaluated at 4 months. Outcome measures were the Timed Up and Go test, grip strength, one leg balance, knee extension strength and the fall risk index. The present study used the criteria for frailty status of the National Center for Geriatrics and Gerontology in Japan. The studied sample included prefrail participants (n = 17) and robust participants (n = 24). We compared the value of outcome measures before and after the intervention in each group using two-way repeated measures analysis of variance. RESULTS: There were significant differences for the group effect for one leg balance (P < 0.01), and there were significant differences for the time effect for Timed Up and Go, one leg balance and knee extension strength (P < 0.01). In these outcomes, there were no significant interactions between frailty status and intervention. Four prefrail participants (mean age 78.0 ± 3.8 years) returned to the robust status after the intervention. No participants became frail. CONCLUSIONS: These results suggest that we can expect similar interventional effects for prefrail older adults and robust older adults. It is important that a frail status be prevented in prefrail older adults by using an exercise intervention. Further studies are required to determine the different effects of exercise intervention on prefrail status compared with frailty status in community-dwelling older adults. Geriatr Gerontol Int 2017; 17: 1265-1269.

Oral administration of lactic acid bacteria isolated from traditional South Asian fermented milk 'dahi' inhibits the development of atopic dermatitis in NC/Nga mice.

We investigated the suppressive effect of lactic acid bacteria (LAB) isolated from traditional South Asian fermented milk 'dahi' on the development of atopic dermatitis (AD) using NC/Nga AD model mice. In the initial evaluation, we confirmed the effect of LAB on serum total IgE using ovalbumin (OVA)-induced type 1 allergy model mice. Forty-one bacterial strains isolated from dahi were evaluated for their ability to induce interleukin (IL)-12 production and suppress IL-4 production in splenocytes obtained from OVA-sensitized mice. Of the 41 strains tested, Lactobacillus delbrueckii subsp. lactis R-037 exhibited the greatest IL-12 induction, suggesting that it is a potent Th1 inducer. Oral administration of heat-treated R-037 significantly suppressed the elevation of serum total IgE in OVA-induced type 1 allergy model mice. In NC/Nga AD model mice, oral administration of heat-treated R-037 reduced inflammatory auricular thickness and alleviated the AD clinical score although the effect on serum total IgE level was unclear. Histopathological findings showed a tendency toward improvement of inflammation. Hyperkeratosis in particular showed improvement in dermatitis skin lesions. These results suggest that oral administration of R-037 may alleviate AD.

Insulin stimulates expression of the pyruvate kinase M gene in 3T3-L1 adipocytes.

M2-type pyruvate kinase (M2-PK) mRNA is produced from the PKM gene by an alternative RNA splicing in adipocytes. We found that insulin increased the level of M2-PK mRNA in 3T3-L1 adipocytes in both time- and dose-dependent manners. This induction did not require the presence of glucose or glucosamine in the medium. The insulin effect was blocked by pharmacological inhibitors of insulin signaling pathways such as wortmannin, an inhibitor of phosphatidylinositol 3-kinase (PI3K), and PD98059, an inhibitor of mitogen-activated protein kinase (MAPK) kinase. A stable reporter expression assay showed that the promoter activity of an about 2.2-kb 5'-flanking region of the rat PKM gene was stimulated by insulin, but the extents of these stimulations were lower than those of the mRNA stimulation. Thus, we suggest that insulin increases the level of M2-PK mRNA in adipocytes by acting at transcriptional and post-transcriptional levels through signaling pathways involving both PI3K and MAPK kinase.