Dietary Zinc Is Associated with Cardiac Function in the Older Adult Population.

The elderly is a group at particularly high cardiovascular risk. The coexistence of chronic diseases and use of multiple medications creates the need to look for non-pharmacological agents to improve cardiovascular health in that population. In view of reports on the potential role of zinc in enhancing pathways of myocardial tissue repair, the aim of this study was to evaluate the association between dietary zinc intake and cardiac structure and function in individuals of advanced age. The study group included 251 community-dwelling patients, with a median age of 80 years. Dieta 6.0 software was used for calculation of zinc consumption. Percentage of Recommended Dietary Allowance (RDA) for zinc correlated with left ventricular ejection fraction (LVEF) (r = 0.196, p < 0.05), left ventricular mass index (r = -0.137, p < 0.05) and tricuspid annular plane systolic excursion (TAPSE) (r = 0.153, p < 0.05), while zinc density did so with E/E' ratio (r = -0.127, p < 0.05). In a multiple stepwise regression analysis, the best determinants of LVEF were %RDA for zinc (p = 0.014; ß = 0.143), presence of coronary artery disease (p < 0.001; ß = -0.39) and age (p = 0.036; ß = -0.12). Furthermore, %RDA for zinc (p = 0.009; ß = 0.16), female sex (p = 0.005; ß = -0.171), beta-blocker use (p = 0.024; ß = -0.136), body mass index (p = 0.008; ß = 0.16) and heart rate (p = 0.0006; ß = -0.209) had an independent effect on TAPSE. In conclusion, in individuals of very advanced age, lower zinc intake is associated with poorer cardiac function. Therefore, increasing the recommended zinc intake in this group deserves consideration.

Comparison of Nutrition Risk Screening 2002 and Subjective Global Assessment Form as Short Nutrition Assessment Tools in Older Hospitalized Adults.

The aim of the present study was to compare two widely recommended short nutrition assessment tools-Nutrition Risk Screening 2002 (NRS-2002) and Subjective Global Assessment Form (SGA)-with other Comprehensive Geriatric Assessment (CGA) measurements. The study included 622 consecutively hospitalized older subjects, aged 81.7 ± 7.8 years. The criteria to participate were the ability to communicate and given consent. Both NRS-2002 and SGA were inversely related to anthropometric measurements, functional assessment tests, Mini-Mental State Examination (MMSE) and positively associated with the Vulnerable Elders Survey-13 (VES-13) score. Results of SGA and NRS-2002 were not related to sex and 15-item Geriatric Depression Scale (GDS) score. Comparison of well-nourished subjects and patients with suggested problems with nutrition according to NRS-2002 (0-2 vs. 3-7) and SGA (A vs. B + C) gave comparable results. Both nutritional scales at given cut-off points similarly discriminated anthropometric data and other CGA tools in the populations of well-nourished vs. malnourished hospitalized older subjects. In conclusion, we can recommend using both NRS-2002 and SGA to detect malnutrition or risk of malnutrition in a routine clinical practice of the geriatric department ward.

Gonadotropins and steroid hormones in older people: their mutual connections and relations to body mass indices.

INTRODUCTION: Aging in mammals, including man, is accompanied by deep changes in hormone secretion. In the majority of cases, hormone secretion (mostly of gonadal steroids and adrenocortical hormone dehydroepiandrosterone - DHEA) undergoes pronounced decrease. This decrease is thought to contribute to the progression of aging. In contrast, the secretion of gonadotropins is sharply increased in older adults, as a result of gonadal deficiency. Recent data indicate that gonadotropin excess may also, by itself, influence the aging process. The aim of the present study was to investigate the mutual relation between steroid hormones and gonadotropins and their effect on body mass indices in older people. MATERIAL AND METHODS: In a group of 100 patients (61 women and 39 men) aged over 75 years, blood serum concentrations of folliclestimulating hormone (FSH), luteinising hormone (LH), oestradiol (E2), testosterone, dehydroepiandrosterone sulphate (DHEAs), and cortisol were measured. All the patients were measured for the following: body weight (kg), body mass index (BMI) (kg/m²), and waist-to-height ratio (WtHR). The differences of the numerical data were evaluated by Student's t-test and the correlations between them by means of Pearson's test. RESULTS AND CONCLUSIONS: The most interesting finding of this study was to show that FSH and LH are negatively correlated with body mass and indices such as BMI and WtHR in older women. Because in older women the mediation of ovary is unlikely, we conclude that gonadotropins may influence the body mass by their direct extra-gonadal action.

The association between platelet indices, cognitive screening tests and functional dependence screening questionnaires in hospitalized older people.

PURPOSE: Activated platelets have been suggested to play an important role in the pathogenesis of dementia. Recent studies have shown contradictory results concerning the relationship between blood platelet indices and cognitive performance. METHODS: This cross-sectional study evaluates the relationship between basic platelet indices and cognitive and functional performance of 754 men and women, aged 60-105 years old, admitted to the geriatric hospital unit. Assessment of global cognitive function and functional ability were performed using Mini-Mental State Examination, the seven-point Clock Drawing Test, the Katz Activities of Daily Living, the Lawton Instrumental Activities of Daily Living Scale and the Vulnerable Elders Survey Questionnaire. As platelet indices, platelet count, mean platelet volume, plateletcrit and platelet distribution width were measured. RESULTS: There was no significant correlation between cognitive performance and platelet indices. Out of the functional dependence questionnaires, only the Katz Activities of Daily Living and the Vulnerable Elders Survey Questionnaire were weakly correlated with platelet count (r = - 0.080 and r = 0.096) and plateletcrit (r = - 0.075 and 0.082, respectively), but these associations diminished in sex-specific analyses. CONCLUSIONS: Cognitive and functional status are not systematically related to platelet indices in multimorbid hospitalized older adults.

Relationship of muscle function to circulating myostatin, follistatin and GDF11 in older women and men.

BACKGROUND: Myostatin, its inhibitor follistatin, and growth/differentiation factor 11 (GDF11) have been proposed as factors that could potentially modify biological aging. The study aimed to test whether there is a relationship between these plasma circulating proteins and muscle strength, power and optimal shortening velocity (υopt) of older adults. METHODS: The cross-sectional study included 56 women and 45 men aged 60 years and older. Every participant underwent examination which included anthropometric and bioimpedance analysis measurements, functional and cognitive performance tests, muscle strength of upper and lower extremities, muscle power testing with two different methods and blood analyses. RESULTS: Women had higher plasma levels of myostatin and GDF11 than men. Men had higher plasma level of follistatin than women. In women, plasma level of myostatin was negatively correlated with left handgrip strength and υopt. Follistatin was negatively correlated with maximum power output (Pmax), power relative to kg of body mass (Pmax∙kg- 1) (friction-loaded cycle ergometer) and power at 70% of the 1-repetition maximum (1RM) strength value (P70%) of leg press (Keiser pneumatic resistance training equipment), and positively correlated with the Timed Up & Go (TUG) test. GDF11 was negatively correlated with body mass, body mass index, waist circumference, fat mass and the percentage of body fat. In men, there were no significant correlations observed between circulating plasma proteins and muscle function measures. CONCLUSIONS: The circulating plasma myostatin and follistatin are negatively associated with muscle function in older women. There is stronger relationship between these proteins and muscle power than muscle strength. GDF11 has a higher association with the body mass and composition than muscle function in older women.

Atherogenic Indices Are Increased in Elderly Patients with Unipolar Depression-Case-Control Analysis.

BACKGROUND: Blood lipids are widely used in monitoring the risk of cardiovascular diseases; however, atherogenic indices are more precise markers. The aim of the study was to determine differences in atherogenic indices in elderly patients with unipolar depression (DEP) compared with nondepressed elderly patients (nonDEP) using case-control analysis. METHODS: Fasting serum lipid profiles were measured in 564 (depressed: n = 282, nondepressed: n = 282, 83.7% (n = 236) women in both groups) Caucasian inpatients aged ≥60, with mean age 76.9 years. Patients from both groups were matched for age and sex. Atherogenic index of plasma (AIP) was calculated as log10(triglycerides/HDL cholesterol). Castelli atherogenic indices were calculated as follows: AILDL/HDL is the ratio of low-density lipoprotein (LDL) cholesterol to high-density lipoprotein (HDL) cholesterol and AITC/HDL is the ratio of total cholesterol to HDL cholesterol. RESULTS: HDL levels were significantly decreased in depressed patients (48.2 ± 14.4 mg/dL vs. 54.5 ± 17.7 mg/dL). No other differences in lipid profile were found. We found that all three analyzed atherogenic indices were increased in depressed patients (AIP: 0.41 ± 0.28 vs. 0.33 ± 0.27, AILDL/HDL: 2.90 ± 1.41 vs. 2.42 ± 1.07, AITC/HDL: 4.51 ± 1.84 vs. 3.79 ± 1.21). We found associations between depression severity and reduced level of HDL (ß = -0.02) or increased AIP (ß = 1.66). CONCLUSIONS: All three atherogenic indices were increased in elderly patients with depression. Since depression and age are associated with elevated risk of cardiovascular events, elderly patients with depression should be carefully monitored for abnormal lipid status to reduce their cardiovascular risk. The role of lipid abnormalities in the pathogenesis of depression requires further studies.

An Evaluation of the Work and Life Conditions and the Quality of Life in 60 to 65 Year-Old White-Collar Employees, Manual Workers, and Unemployed Controls.

OBJECTIVES: Assessment of the work and life conditions of 60 to 65-year-old seniors with regard to type of work and quality of life (QoL). METHODS: The European Foundation for Improvement of Living and Working Conditions Questionnaire and the EuroQol 5D were used to evaluate work and life conditions and QoL in the three age- and sex-matched 60 to 65-year-old groups (white-collar, manual workers, and unemployed subjects, 100 each group, 50% of women). RESULTS: Manual workers and unemployed subjects had lower QoL score (0 to 100 point scale) than white-collar workers (accordingly 72.2; 71.2; 76.2; P < 0.05). In working subjects (n = 200), QoL was inversely associated with reported health problems (P < 0.01) and directly related to quality of work (P < 0.001). In the group of manual workers (n = 100), QoL indices were influenced by health factors and quality of work, while in the intellectual group (n = 100) mainly by health factors. CONCLUSIONS: Quality of work and health assessment are the main domains that influence older workers' QoL and may contribute to the shortening of the work period and accelerated transfer to retirement. Quality of work assessment seems especially important in older manual workers.

Inappropriate nutrients intake is associated with lower functional status and inferior quality of life in older adults with depression.

OBJECTIVES: The study is a case-control analysis of whether depression impairs physical and cognitive functioning and quality of life, and whether there is a relationship between nutrient deficiencies and these adverse changes. PATIENTS AND METHODS: A total of 130 older subjects participated in the study: 65 with diagnosed depression (16 men and 49 women) and 65 age- and sex-matched controls without depression. All patients underwent comprehensive geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment, cognitive performance was evaluated by the Mini-Mental State Examination and physical functioning by the Timed "Up & Go" test and handgrip strength. The pattern of consumption of various nutrients was analyzed in detail. RESULTS: The differences in cognitive functioning observed between the groups were related to specific nutrient intake, as was handgrip strength to some extent. The differences in nutritional status, several functional tests and muscle strength were related to both the presence of depression and inappropriate consumption of certain nutrients. CONCLUSION: The incidence of falls and poor quality of life may be partially associated with the presence of depression. The inappropriate intake of selected nutrients may impair the functioning and quality of life of older adults with depression, such as the excess consumption of sucrose and insufficient consumption of protein, fiber, eicosapentaenoic acid, niacin and vitamin B6. Particular nutrients should be translated into dietary patterns which allow the individual patient to address these nutrient deficiencies.