Detecting a valid screening method for sarcopenia in acute care setting.

OBJECTIVES: Sarcopenia is prevalent among geriatric patients and it has a high rate of negative health related outcomes. Diagnostic and assessment approaches are not always feasible. The aim of the study was to detect a valid screening tool for sarcopenia that could be used easily in acute care setting. METHODS: A cross sectional study was conducted in Geriatrics department, Ain Shams University Hospital. 127 inpatient elderly participants were recruited. Sarcopenia was defined according to the European Working Groups on Sarcopenia in Older People (EWGSOP) criteria as low skeletal muscle mass with either low handgrip strength or slow gait speed. Muscle mass was measured by bioelectrical impedance analysis (BIA). Two screening methods for sarcopenia were investigated, namely SARC-F questionnaire and Ishii equation including age, handgrip, and calf circumference (CC). RESULTS: Both SARC-F questionnaire and Ishii equation can detect sarcopenia in both genders and both showed good agreement with the standard diagnostic method. Combining SARC-F to Ishii equation improved the diagnostic accuracy, with a higher sensitivity and specificity. CONCLUSIONS: SARC-F and Ishii equation could be used as a valid simple screening tool in acute hospital setting. Combing these two screening tools resulted in better diagnostic accuracy with higher sensitivity and specificity.

Interferon- Gamma- Inducible Guanosine Triphosphate Cyclohydrolase 1 (GTP-CH1) Pathway Is Associated with Frailty in Egyptian Elderly.

BACKGROUND: Chronic low-grade inflammation may be a cardinal pathophysiologic feature in the pathogenesis of frailty. Interferon-gamma (INF-γ) is an understudied proinflammatory cytokine in frailty that induces many inflammatory pathways including the guanosine triphosphate cyclohydrolase 1 (GTP-CH1) pathway. Our aim was to evaluate the GTP-CH1 pathway in Egyptian frail elderly subjects. METHODS: INF-γ, neopterin, and nitric oxide (NO) levels were measured in 80 participants. RESULTS: Both pre-frail and frail subjects had significantly higher levels of INF-γ, neopterin and lower levels of NO than the control group. These biomarkers were associated with the risk of frailty with significant odds ratio. CONCLUSION: Elevated INF-γ levels in frail subjects may activate the GTP-CH1 pathway. Elevated neopterin and reduced NO levels correlated with an active GTP-CH1 pathway. The risk of frailty increased with elevated INF-γ and neopterin and decreased with elevated NO levels.

Quality of life in elderly diabetic patients with peripheral arterial disease.

AIM: To study the impact of peripheral arterial disease (PAD) on quality of life and functional status in Egyptian elderly diabetic patients. METHODS: This case-control study included 90 non-demented patients aged 60 years and older. Quality of life assessment was carried out using the Short Form 36 health survey (SF-36), Arterial duplex for diagnosis of peripheral arterial disease; Mini-Mental State Examination, Geriatric Depression Scale, Activity of Daily Living and Instrumental Activity of Daily Living were used. RESULTS: SF-36 domains (except emotional well-being) were significantly affected in diabetic patients with PAD compared with the diabetic patients without PAD. Most of functional assessment items were significantly affected in diabetic patients with PAD compared with diabetic patients without PAD. Increasing PAD severity and presence of PAD symptoms had a significant negative impact on SF-36 scores. Among diabetic complications in PAD patients, cardiovascular disease or stroke significantly affected quality of life. CONCLUSION: PAD significantly affects quality of life and functional status in elderly diabetic patients.

Histone deacetylases enzyme, copper, and IL-8 levels in patients with Alzheimer's disease.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive loss of cognitive abilities. Epigenetic modification, oxidative stress, and inflammation play an important role in the pathogenesis of the disease. We aimed to detect noninvasive peripheral biomarkers with a high degree of sensitivity and specificity in diagnosis and progression of AD. METHODS: A total of 25 elderly patients with AD and 25 healthy control participants were selected and subjected to cognitive assessment and laboratory measures including histone deacetylases (HDACs), copper, and interleukin 8 (IL-8) levels. RESULTS: The levels of HDACs, copper, and IL-8 were significantly higher in patients with AD (P < .001) and had a significant negative effect on all cognitive assessment tests. Receiver-operating curve (ROC) analysis revealed that HDACs and copper levels had higher sensitivity and specificity. CONCLUSIONS: Plasma levels of HDACs and copper may be used as peripheral biomarkers in diagnosis of AD, while IL-8 level could be a useful biomarker in following AD progression.