Resting metabolic rate in relation to incident disability and mobility decline among older adults: the modifying role of frailty.

BACKGROUND: Alterations in resting metabolic rate (RMR), the largest component of daily total energy expenditure, with aging have been shown in various studies. However, little is known about the associations between RMR and health outcomes in later life. AIMS: To analyze whether RMR is associated with incident disability and mobility decline in a 10-year longitudinal study, as well as the moderating role of frailty in these associations. METHODS: Data from 298 older adults aged 70 and over from the Frailty and Dependence in Albacete (FRADEA) study in Spain were used, including a baseline measurement in 2007-2009 and a follow-up measurement 10 years later. RMR was measured by indirect calorimetry. Outcomes were incident disability in basic activities of daily living (BADL, Barthel Index), incident disability in instrumental ADL (IADL, Lawton index), and mobility decline (Functional Ambulation Categories scores). Fried's frailty phenotype was used as an indicator of frailty. Logistic regression analyses were conducted. RESULTS: Fully adjusted and stratified analyses revealed that only in the pre-frail/frail group, a higher RMR was associated with a lower risk of incident BADL disability (OR = 0.47, 95% CI = 0.23-0.96, p = 0.037), incident IADL disability (OR = 0.39, 95% CI = 0.18-0.84, p = 0.017), and mobility decline (OR = 0.30, 95% CI = 0.14-0.64, p = 0.002). CONCLUSIONS: To our knowledge, this is the first study looking at the associations between RMR and functional health using a longitudinal research design. The results suggest that RMR could be used as an early identifier of a specific resilient group within the pre-frail and frail older population, with a lower risk of further health decline.

[Risk of sarcopenia and malnutrition related to COVID-19 in an institutionalized population of Castilla-La Mancha (Spain): determined by R-MAPP.] / Riesgo de sarcopenia y desnutrición relacionado con COVID-19 en una población institucionalizada de Castilla-La Mancha: determinado por R-MAPP.

OBJECTIVE: Knowing the risk status of malnutrition and sarcopenia in institutionalized patients is essential to understand the current context after the impact of the coronavirus (COVID-19) pandemic. METHODS: This research used a retrospective, observational study. The results of the Remote Malnutrition APP test (R-MAPP) are described: risk factors for malnutrition (including COVID-19), the Malnutrition Universal Screening Tool (MUST) and the SARC-F, in a selected sample of 402 residents of Castilla-La Mancha (Spain) during 2021. An inferential analysis was performed to determine which factors were related to the MUST (≥2 points) and SARC-F (≥4 points) response measures. With the factors that obtained statistical significance, a multivariate regression model was performed, adjusting for each one. of those factors. RESULTS: Mean age was 84.2 years, 70.1% women. Most frequent risk factor for malnutrition was aging (85.1%). The mean body mass index was 26.5 (SD 11.6). MUST≥2 points was obtained in 16.2%, and a SARC-F≥4 in 69.9%. COPD (Chronic obstructive pulmonary disease / OR 0.35; 95% CI 0.13-0.92; p 0.03) was a protective factor against the risk of malnutrition. The risk of sarcopenia was related to aging (OR 8.16; 95% CI 4.13-16.20; p 0.00), COVID-19 (OR 1.96; 95% CI 1.17-3.29; p 0.01) and COPD (OR 2.44; 95% CI 1.21-4.89; p 0.01). CONCLUSIONS: No relationship is found between COVID-19 and high risk of malnutrition. Aging, COVID-19 and COPD are risk factors for sarcopenia.

OBJETIVO: Conocer el estado de riesgo de desnutrición y sarcopenia de las personas institucionalizadas es clave para entender el contexto actual tras la repercusión que ha tenido la pandemia por coronavirus (COVID-19). METODOS: Se realizó un estudio observacional retrospectivo. Se describen los resultados de la prueba Remote Malnutrition APP (R-MAPP): factores de riesgo de desnutrición (incluyendo la COVID-19), Malnutrition Universal Screening Tool (MUST) y la SARC-F, en una muestra seleccionada de 402 residentes de Castilla-La Mancha (España) durante 2021. Se llevó a cabo un análisis inferencial para determinar qué factores tenían relación con las medidas de respuesta MUST (≥2 puntos) y SARC-F (≥4 puntos). Con los factores que obtuvieron significación estadística se realizó un modelo de regresión multivariante ajustando por cada uno de esos factores. RESULTADOS: La edad media fue de 84,2 años, con un 70,1% de mujeres. El factor de riesgo de desnutrición más frecuente fue el envejecimiento (85,1%). El Índice de Masa Corporal medio fue 26,5 (DE 11,6). Se obtuvo un MUST mayor o igual a 2 puntos en un 16,2%, y un SARC-F igual o mayor de 4 en el 69,9%. Se observó, como factor protector, la EPOC (enfermedad pulmonar obstructiva crónica / OR 0,35; IC 95% 0,13-0,92; p 0,03) contra el riesgo de desnutrición. El riesgo de sarcopenia se relacionó con envejecimiento (OR 8,16; IC 95% 4,13-16,20; p 0,00), COVID-19 (OR 1,96; IC 95% 1,17-3,29; p 0,01) y EPOC (OR 2,44; IC 95% 1,21- 4,89; p 0,01). CONCLUSIONES: No se halla relación entre COVID-19 y riesgo alto de desnutrición. Envejecimiento, COVID-19 y EPOC son factores de riesgo de sarcopenia.

Riesgo de sarcopenia y desnutrición relacionado con COVID-19 en una población institucionalizada de Castilla-La Mancha: determinado por R-MAPP / Risk of sarcopenia and malnutrition related to COVID-19 in an institutionalized population of Castilla-La Mancha (Spain): determined by R-MAPP

FUNDAMENTOS: Conocer el estado de riesgo de desnutrición y sarcopenia de las personas institucionalizadas es clave para entender el contexto actual tras la repercusión que ha tenido la pandemia por coronavirus (COVID-19). MÉTODOS: Se realizó un estudio observacional retrospectivo. Se describen los resultados de la prueba Remote Malnutrition APP (R-MAPP): factores de riesgo de desnutrición (incluyendo la COVID-19), Malnutrition Universal Screening Tool (MUST) y la SARC-F, en una muestra seleccionada de 402 residentes de Castilla-La Mancha (España) durante 2021. Se llevó a cabo un análisis inferencial para determinar qué factores tenían relación con las medidas de respuesta MUST (≥2 puntos) y SARC-F (≥4 puntos). Con los factores que obtuvieron significación estadística se realizó un modelo de regresión multivariante ajustando por cada uno de esos factores. RESULTADOS: La edad media fue de 84,2 años, con un 70,1% de mujeres. El factor de riesgo de desnutrición más frecuente fue el envejecimiento (85,1%). El Índice de Masa Corporal medio fue 26,5 (DE 11,6). Se obtuvo un MUST mayor o igual a 2 puntos en un 16,2%, y un SARC-F igual o mayor de 4 en el 69,9%. Se observó, como factor protector, la EPOC (enfermedad pulmonar obstructiva crónica / OR 0,35; IC 95% 0,13-0,92; p 0,03) contra el riesgo de desnutrición. El riesgo de sarcopenia se relacionó con envejecimiento (OR 8,16; IC 95% 4,13-16,20; p 0,00), COVID-19 (OR 1,96; IC 95% 1,17-3,29; p 0,01) y EPOC (OR 2,44; IC 95% 1,21- 4,89; p 0,01). CONCLUSIONES: No se halla relación entre COVID-19 y riesgo alto de desnutrición. Envejecimiento, COVID-19 y EPOC son factores de riesgo de sarcopenia.(AU)

BACKGROUND: Knowing the risk status of malnutrition and sarcopenia in institutionalized patients is essential to understand the current context after the impact of the coronavirus (COVID-19) pandemic. METHODS: This research used a retrospective, observational study. The results of the Remote Malnutrition APP test (R-MAPP) are described: risk factors for malnutrition (including COVID-19), the Malnutrition Universal Screening Tool (MUST) and the SARC-F, in a selected sample of 402 residents of Castilla-La Mancha (Spain) during 2021. An inferential analysis was performed to determine which factors were related to the MUST (≥2 points) and SARC-F (≥4 points) response measures. With the factors that obtained statistical significance, a multivariate regression model was performed, adjusting for each one. of those factors. RESULTS: Mean age was 84.2 years, 70.1% women. Most frequent risk factor for malnutrition was aging (85.1%). The mean body mass index was 26.5 (SD 11.6). MUST≥2 points was obtained in 16.2%, and a SARC-F≥4 in 69.9%. COPD (Chronic obstructive pulmonary disease / OR 0.35; 95% CI 0.13-0.92; p 0.03) was a protective factor against the risk of maln utrition. The risk of sarcopenia was related to aging (OR 8.16; 95% CI 4.13-16.20; p 0.00), COVID-19 (OR 1.96; 95% CI 1.17-3.29; p 0.01) and COPD (OR 2.44; 95% CI 1.21-4.89; p 0.01). CONCLUSIONS: No relationship is found between COVID-19 and high risk of malnutrition. Aging, COVID-19 and COPD are risk factors for sarcopenia.(AU)

New titanocene derivative with improved stability and binding ability to albumin exhibits high anticancer activity.

Titanium-based therapies have emerged as a promising alternative for the treatment of cancer patients, particularly those with cisplatin resistant tumors. Unfortunately, some titanium compounds show stability and solubility problems that have hindered their use in clinical practice. Here, we designed and synthesized a new titanium complex containing a titanocene fragment, a tridentate ligand to improve its stability in water, and a long aliphatic chain, designed to facilitate a non-covalent interaction with albumin, the most abundant protein in human serum. The stability and human serum albumin affinity of the resulting titanium complex was investigated by UV-Vis absorption and fluorescence spectroscopy techniques. Complex [TiCp2{(OOC)2py-O-myr}] (3) (myr = C14H29, py = pyridine) and its analogous [TiCp2{(OOC)2py-OH}] (4), lacking the aliphatic chain, showed improved stability in phosphate saline buffer compared with [TiCp2Cl2] (1). 3 showed a strong interaction with human serum albumin in a 1:1 stoichiometry. The cytotoxic effect of 3 was higher compared to [TiCp2Cl2] in tumor cell lines and showed potential tumor selectivity when assayed in non-tumor human epithelial cells. Finally, 3 showed an antiproliferative effect on cancer cells, decreasing the population in the S phase, and increasing apoptotic cells in a significant manner. All this makes the novel Ti(IV) compound 3 a firm candidate to continue further studies of its therapeutic potential in vitro and in vivo.

A nocturnal atmospheric loss of CH2I2 in the remote marine boundary layer.

Ocean emissions of inorganic and organic iodine compounds drive the biogeochemical cycle of iodine and produce reactive ozone-destroying iodine radicals that influence the oxidizing capacity of the atmosphere. Di-iodomethane (CH2I2) and chloro-iodomethane (CH2ICl) are the two most important organic iodine precursors in the marine boundary layer. Ship-borne measurements made during the TORERO (Tropical Ocean tRoposphere Exchange of Reactive halogens and Oxygenated VOC) field campaign in the east tropical Pacific Ocean in January/February 2012 revealed strong diurnal cycles of CH2I2 and CH2ICl in air and of CH2I2 in seawater. Both compounds are known to undergo rapid photolysis during the day, but models assume no night-time atmospheric losses. Surprisingly, the diurnal cycle of CH2I2 was lower in amplitude than that of CH2ICl, despite its faster photolysis rate. We speculate that night-time loss of CH2I2 occurs due to reaction with NO3 radicals. Indirect results from a laboratory study under ambient atmospheric boundary layer conditions indicate a k CH2I2+NO3 of ≤4 × 10-13 cm3 molecule-1 s-1; a previous kinetic study carried out at ≤100 Torr found k CH2I2+NO3 of 4 × 10-13 cm3 molecule-1 s-1. Using the 1-dimensional atmospheric THAMO model driven by sea-air fluxes calculated from the seawater and air measurements (averaging 1.8 +/- 0.8 nmol m-2 d-1 for CH2I2 and 3.7 +/- 0.8 nmol m-2 d-1 for CH2ICl), we show that the model overestimates night-time CH2I2 by >60 % but reaches good agreement with the measurements when the CH2I2 + NO3 reaction is included at 2-4 × 10-13 cm3 molecule-1 s-1. We conclude that the reaction has a significant effect on CH2I2 and helps reconcile observed and modeled concentrations. We recommend further direct measurements of this reaction under atmospheric conditions, including of product branching ratios.

Fragilidad como predictor de mortalidad, discapacidad incidente y hospitalización a largo plazo en ancianos españoles. Estudio FRADEA / Frailty and long term mortality, disability and hospitalisation in Spanish older adults. The FRADEA Study

Introducción. El objetivo de nuestro trabajo fue analizar si la fragilidad se asocia a largo plazo con mortalidad, discapacidad incidente en actividades básicas de la vida diaria (ABVD) y hospitalización. Material y métodos. Estudio de cohortes concurrente sobre 993 mayores de 70 años incluidos en el estudio FRADEA. La fragilidad se midió mediante el fenotipo de Fried. Durante el seguimiento se registraron mortalidad, hospitalización y discapacidad incidente en ABVD (baño, aseo, vestido, retrete, transferencias y comer). El riesgo de presentar dichos eventos adversos se determinó mediante regresión logística, Kaplan-Meier y análisis de riesgos proporcionales de Cox ajustado por edad, sexo, Barthel basal, comorbilidad e institucionalización. Resultados. El tiempo medio de seguimiento fue de 952 días (DE 408) durante los cuales fallecieron 182 sujetos (18,4%). Los participantes frágiles tuvieron mayor riesgo ajustado de mortalidad (HR 4,5; IC 95%: 1,8-11,1), discapacidad incidente en ABVD (OR 2,7; IC 95%: 1,3-5,9) y del evento combinado mortalidad o discapacidad incidente (OR 3,0; IC 95%: 1,5-6,1). Los prefrágiles tuvieron mayor riesgo ajustado de mortalidad (HR 2,9; IC 95%: 1,2-6,5), discapacidad incidente (OR 2,1; IC 95%: 1,2-3,6) y del evento combinado mortalidad o discapacidad incidente (OR 2,2; IC 95%: 1,3-3,6). Se observó una asociación positiva entre fragilidad y hospitalización que quedó al borde de la significación (OR 1,7; IC 95%: 1,0-3,0). Conclusiones. El estado de fragilidad se asocia a largo plazo con mortalidad y discapacidad incidente en ABVD en una cohorte de ancianos españoles (AU)

Introduction. The objective of this study was to analyse whether frailty is related to long-term mortality, incident disability in basic activities of daily living (BADL), and hospitalisation. Material and methods. A concurrent cohort study conducted on 993 participants over age 70 from the FRADEA Study. Frailty was determined with Fried frailty phenotype. Data was collected on mortality, hospitalisation and incident disability in BADL (bathing, grooming, dressing, toileting, eating or transferring) during the follow-up period. The risk of adverse events was determined by logistic regression, Kaplan-Meier analysis, and Cox proportional hazard analysis adjusted for age, sex, Barthel index, comorbidity and institutionalization. Results. Mean follow-up was 952 days (SD 408), during which 182 participants (18.4%) died. Frail participants had an increased adjusted risk of death (HR 4.5, 95%CI: 1.8-11.1), incident disability in BADL (OR 2.7, 95%CI: 1.3-5.9) and the combined event mortality or incident disability (OR 3.0, 95%CI: 1.5-6.1). Pre-frail subjects had an increased adjusted risk of death (HR 2.9, 95%CI: 1.2-6.5), incident disability in BADL (OR 2.1, 95%CI: 1.2-3.6), and the combined event mortality or incident disability (OR 2.2, 95%CI: 1.3-3.6). There was a positive association between frailty and hospitalisation, which almost reached statistical significance (OR 1.7, 95%CI: 1.0-3.0). Conclusions. Frailty is long-term associated with mortality and incident disability in BADL in a Spanish cohort of older adults (AU)

[Frailty and long term mortality, disability and hospitalisation in Spanish older adults. The FRADEA Study]. / Fragilidad como predictor de mortalidad, discapacidad incidente y hospitalización a largo plazo en ancianos españoles. Estudio FRADEA.

INTRODUCTION: The objective of this study was to analyse whether frailty is related to long-term mortality, incident disability in basic activities of daily living (BADL), and hospitalisation. MATERIAL AND METHODS: A concurrent cohort study conducted on 993 participants over age 70 from the FRADEA Study. Frailty was determined with Fried frailty phenotype. Data was collected on mortality, hospitalisation and incident disability in BADL (bathing, grooming, dressing, toileting, eating or transferring) during the follow-up period. The risk of adverse events was determined by logistic regression, Kaplan-Meier analysis, and Cox proportional hazard analysis adjusted for age, sex, Barthel index, comorbidity and institutionalization. RESULTS: Mean follow-up was 952 days (SD 408), during which 182 participants (18.4%) died. Frail participants had an increased adjusted risk of death (HR 4.5, 95%CI: 1.8-11.1), incident disability in BADL (OR 2.7, 95%CI: 1.3-5.9) and the combined event mortality or incident disability (OR 3.0, 95%CI: 1.5-6.1). Pre-frail subjects had an increased adjusted risk of death (HR 2.9, 95%CI: 1.2-6.5), incident disability in BADL (OR 2.1, 95%CI: 1.2-3.6), and the combined event mortality or incident disability (OR 2.2, 95%CI: 1.3-3.6). There was a positive association between frailty and hospitalisation, which almost reached statistical significance (OR 1.7, 95%CI: 1.0-3.0). CONCLUSIONS: Frailty is long-term associated with mortality and incident disability in BADL in a Spanish cohort of older adults.

Validation of the Spanish version of the Baylor Profound Mental Status Examination.

BACKGROUND: There are no short valid instruments to evaluate cognitive status in severe Alzheimer's disease (AD) patients in the Spanish language. OBJECTIVE: To validate the Spanish version of the Baylor Profound Mental Status Examination (BPMSE-Sp). METHODS: The Baylor Profound Mental Status Examination (BPMSE) was translated to Spanish and back translated. Validation was conducted in 100 patients with severe probable AD with a Mini-Mental State Examination (MMSE) <12. We assessed internal consistency (Cronbach's alpha), concurrent validity (Pearson's correlations) with the MMSE, Severe Impairment Battery (SIB), Neuropsychiatric Inventory Short Form (NPI-Q) and the Functional Assessment Staging and reliability. RESULTS: The mean age of patients was 84.9; 74% were female; 64% were institutionalized. The mean MMSE was 5.6; the mean BPMSE-Sp was 13.6; the mean BPMSE-Sp behavior was 1.2; the mean SIB was 42.2; and the mean NPI-Q was 4.7. BPMSE-Sp presented good internal consistency (Cronbach α= 0.84). There were significant correlations between the BPMSE-Sp and MMSE (r = 0.86, p <  0.001), and between the BPMSE-Sp and SIB (r = 0.92, p <  0.001). Inter-rater and test-retest reliability were in both cases excellent, ranging between 0.96 and 0.99 (p <  0.001). BPMSE-Sp had fewer floor and ceiling effects than the MMSE. CONCLUSIONS: The BPMSE-Sp is a valid tool for use in daily practice and research in the evaluation of cognitive function of patients with severe AD.