Association between sarcopenia and new-onset chronic kidney disease among middle-aged and elder adults: findings from the China Health and Retirement Longitudinal Study.

BACKGROUND: Sarcopenia is a senile syndrome of age-related muscle loss. It is thought to affect the development of chronic kidney disease and has a serious impact on the quality of life of the elder adults. Little is known about the association between sarcopenia and new-onset chronic kidney disease in middle-aged and elder adults. Using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted a longitudinal analysis to investigate the association between sarcopenia status and new-onset chronic kidney disease in middle-aged and elder adults in China. METHODS: The study population consisted of 3676 participants aged 45 or older selected from 2011 CHARLS database who had no history of chronic kidney disease at the baseline and completed the follow-up in 2015. A multivariate cox regression model was employed to examine the association between sarcopenia and the incidence of new-onset chronic kidney disease. RESULTS: Followed up for 4 years, a total of 873 (22.5%) new cases of chronic kidney disease occurred. Among them, participants diagnosed with sarcopenia (HR1.45; 95% CI 1.15-1.83) were more likely to develop new-onset chronic kidney disease than those without sarcopenia. Similarly, patients with sarcopenia were more likely to develop new-onset chronic kidney disease than those with possible sarcopenia (HR 1.27; 95%CI 1.00-1.60). Subgroup analysis revealed that elder adults aged between 60 and 75 years old (HR 1.666; 95%CI 1.20-22.28), with hypertension (HR 1.57; 95%CI 1.02-2.40), people with sarcopenia had a significantly higher risk of developing new-onset chronic kidney disease than those without sarcopenia (all P < 0.05). CONCLUSION: Middle-aged and elder adults diagnosed with sarcopenia have a higher risk of developing new-onset chronic kidney disease.

Impact of social, familial and personal factors on depressive symptoms in middle-aged and older adults from the national CHARLS cohort.

BACKGROUND: This study aimed to evaluate whether social, familial and personal factors can predict incident and prevalent depressive symptoms in Chinese adults aged ≥ 45 years using data from the China Health and Retirement Longitudinal Study (CHARLS). METHODS: Study subjects without depressive symptoms from CHARLS at baseline were enrolled. Depressive symptoms were defined by the 10-item Center for Epidemiologic Studies Depression Scale. Statistical adjustment, subgroup exploration and unmeasured confounding assessment were undertaken to derive reliable estimates. RESULTS: 1681 (27.04%) of 6215 subjects who had no depressive symptoms in 2011, suffered one or more depressive symptoms in 2018. Multivariate analyses showed that number of grandchildren (odds ratio [95% confidence interval]: 1.06 [1.02, 1.10]), social activity score (0.95 [0.91, 0.98]), instrumental activities of daily living (IADL) (1.35 [1.11, 1.65]) and number of comorbidities (1.16 [1.10, 1.22]) were independently and significantly associated with the presence of incident depressive symptoms. Further categorization revealed significance for social activity score (odds ratio [95% confidence interval]: 0.78 [0.69, 0.89] and 0.71 [0.53, 0.95] for 1-5 and > 5 vs. 0), IADL (1.35 [1.11, 1.65] for yes vs. no) and number of comorbidities (1.38 [1.20, 1.58], 1.44 [1.16, 1.81] and 2.42 [1.54, 3.80] for 1-2, 3-4 and > 4 vs. 0) associated with incident depressive symptoms. Restricting analysis to wave IV data in 2018 observed significant association of number of grandchildren, social activity score, IADL and number of comorbidities with prevalent depressive symptoms. CONCLUSIONS: The present study findings support the marked contribution of social activity score, IADL and number of comorbidities to incident and prevalent depressive symptoms in Chinese middle-aged and older adults.

Association between alcohol use and frailty among elder adults in three Chinese cities.

BACKGROUND: Frailty is often described as a condition of the elderly and alcohol use is associated with frailty. The aim of this study is to examine the associations between alcohol use and frailty in three cities in elder adults. METHODS: A cross-sectional study was conducted in three cities in China from June 2017 to October 2018. In total, 2888 residents aged ≥65 years old were selected by using a multi-level stage sampling procedure. Alcohol use was assessed by Focusing on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers (CAGE) four-item questionnaire. Frailty was measured by a validated Chinese version of the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) scale. Multinomial logistic regressions were used to examine the association of alcohol use with pre-frailty and frailty after controlling for varied covariates. RESULTS: In general, the prevalence of pre-frailty and frailty was 38.64 and 20.26%, respectively. After controlling for covariates and interaction of age and problematic drinking, non-problematic drinkers neither had association with pre-frailty (OR: 1.15, 95%CI:0.86-1.52) nor with frailty (OR:0.90, 95%CI:0.60-1.36), and problematic drinkers neither had association with frailty (OR: 1.21, 95%CI:0.83-1.76), while problematic drinkers had high odd ratios of frailty (OR:3.28, 95%CI:2.02-5.33) compared with zero-drinker. CONCLUSIONS: Our study found a positive association between problematic drinking and frailty, no relationship between non-problematic drinking and (pre-)frailty compared with zero-drinking among Chinese elder adults. Based on previous findings and ours, we conclude it is important for the prevention of frailty to advocate no problematic drinking among elder adults.

Association of depressive symptoms with ambient PM2.5 in middle-aged and elderly Chinese adults: A cross-sectional study from the China health and Retirement Longitudinal Study wave 4.

Depressive symptoms have become a serious public health issue worldwide. Several studies showed that air pollution, especially fine particulate matter (PM2.5), may be a risk factor of mental disorders. However, existing studies reported inconsistent results and little evidence is available in developing countries, like China. To fill the gap, in this study, we explored the relationship between ambient PM2.5 exposure and depressive symptoms among middle-aged and elderly Chinese adults in the Chinese Health and Retirement Longitudinal Study (CHARLS). The social and demographic variables and depressive symptoms were obtained from the Wave4 of CHARLS in 2018. PM2.5 concentrations were obtained from the national urban air quality real-time release platform of China Environmental Monitoring Station. We applied generalized linear mixed models to determine the association between PM2.5 exposure and depressive symptoms. A total of 15,105 middle-aged and elderly adults from CHARLS Wave4 were included in the analyses. We found positive impact of ambient PM2.5 on depressive symptoms for the exposure windows of 30-day, 60-day, 120-day, 180-day, 1-year and 2-year. The most significant increase was observed for 180-day moving average. For every 10 µg/m3 increment in PM2.5 exposure, the incidence of depressive symptoms increased by 9% (OR = 1.09; 95%CI: 1.05, 1.14) after adjusting for age, sex and residence. In interaction analyses, we found PM2.5 had weaker effect on depressive symptoms among people who used to drink alcohol (OR = 1.05; 95%CI: 1.00, 1.10) and exercise (OR = 1.10; 95%CI: 1.02, 1.18). People living in western China (OR = 1.09; 95%CI: 1.03, 1.16) were more vulnerable than those living in eastern China (OR = 0.99; 95%CI: 0.94, 1.05). In conclusion, exposure to PM2.5 was significantly associated with depressive symptoms in middle-aged and elder Chinese adults, particularly for people who never drink, with lower physical activity levels, or lived in western China.

Traumatic Brain Injury Profile of an Elderly Population in Puerto Rico.

OBJECTIVE: Describe the types of traumatic brain injury secondary to falls sustained by the members of an elderly population who received services at the Puerto Rico Medical Center and the demographic profile of that population. METHODS: A group of 332 adults (60 years and over) assessed for traumatic brain injury secondary to falls suffered in 2013 were included in the analysis. The cases were retrieved from the computerized database of the Neurosurgery Section. We analyzed information such as age, gender, type of traumatic brain injury, mechanism of injury, and the performance of surgery (if applicable). Descriptive analysis was performed to derive a general profile of elderly adults who presented with traumatic brain injury secondary to falls. RESULTS: The sample consisted of 332 elderly adults: 73% were men and 27% were women. The mean age was 76.74 (SD=9.95) years: 75.67 (SD=9.78) for men and 79.13 (SD=10.02) for women. The most common traumatic brain injury was subdural hematoma (51%) and the mechanism of injury most prevalent was the groundlevel fall (83%). Other traumatic brain injuries included traumatic subarachnoid hemorrhages (14%), cerebral contusions (18%) and epidural hematomas (3%). Of all the cases, 52% had were managed surgically. CONCLUSION: The elderly population is growing and the risk of falls increases with advancing age. Recurrent falls are an important cause of morbidity, and mortality rates oscillate from 6 to 18%. Elderly patients have longer rehabilitation times, incur more expenses, and have greater levels of disability. This study provides a platform for future epidemiological studies to help develop strategies for the prevention of traumatic brain injury in older adults.

Triglyceride-glucose index is associated with the risk of impaired fasting glucose in Chinese elderly individuals.

The association between the triglyceride-glucose (TyG) index and impaired fasting glucose (IFG) in elderly individuals remains uncertain. Our study aimed to explore the association between the TyG index and the risk of future IFG in this population. This retrospective cohort study included 17,746 elderly individuals over 60. In this population, Cox regression models proportional to hazards, along with smooth curve fitting and cubic spline functions, were employed to examine the association between the baseline TyG index and the risk of IFG. Subgroup analyses and sensitivity were also performed to ensure the robustness of the study findings. After adjusting for covariates, a positive association between the TyG index and the risk of IFG was found (HR = 1.43, 95% CI 1.27-1.60, P < 0.0001). The likelihood of IFG rose steadily as the TyG index quartiles (from Q1 to Q4) increased, with Q4 demonstrating a 62% elevated risk compared to Q1 (adjusted HR = 1.62, 95% CI 1.37-1.90). Additionally, we found the association between TyG index and risk of IFG was a linear. Sensitivity and subgroup analyses confirmed the stability of the results. Our study observed a linear association between the TyG index and the development of IFG in elderly Chinese individuals. Recognizing this association can help clinicians identify high-risk individuals and implement targeted interventions to reduce their risk of progressing to diabetes.

The influence of social participation and depressive symptoms on cognition among middle-aged and older adults.

Background: The global aging phenomenon has raised concerns about the cognitive abilities of older individuals. This study aimed to explore the relationship between social participation, depressive symptoms, and cognitive function among middle-aged and older adults. Methods: This study utilized data from the China Longitudinal Study of Health and Retirement (CHARLS) from wave 1 to wave 4. We used linear regression and generalized estimation equations to investigate the correlation between social participation, depressive symptoms, and cognitive function. Moreover, three models were constructed by adjusting covariates, and we used the sobel test and bootstrap method to analyze the mediating effects of depressive symptoms on social activities and cognitive function. Results: The results of both linear regression and generalized estimation equation showed that social participation had a positive correlation with cognitive function (P < 0.05), and the impact of social participation on cognition increased with the number of social activity types. Meanwhile, depressive symptoms had a negative association with cognitive function (P < 0.05). Furthermore, there was no interaction between social participation and depressive symptoms on cognitive function. Finally, after adjusting the model, social participation could affect cognitive function by affecting depressive symptoms (P < 0.05). Conclusion: The study emphasizes the mediating role of depressive symptoms in the relationship between social participation and cognitive function. Notably, no interaction was observed between social participation and depressive symptoms. These findings highlight the potential of active social participation in reducing depressive symptoms and enhancing cognitive function in middle-aged and older adults.

Factors influencing the social participation ability of rural older adults in China: A cross-sectional study.

Objective: To investigate the epidemiology and influencing factors of social participation ability of rural older adults in China. Methods: From March to April 2021, 3450 older adults in poverty aged 60 and above registered in Jishishan County (J County) were selected by cluster sampling for a cross-sectional questionnaire survey and their social participation ability was assessed using the Ability Assessment of older adults (MZ/T039-2013). The results were statistically analyzed and an ordered multi-category logistic regression analysis was used to analyze the effect of influencing factors on the social participation ability of rural older adults. Results: 3,346 questionnaires were collected, with an effective recovery rate of 96.99%. Out of all the participants, 1,355 (40.5%) of the 3,346 cases had intact social participation ability, while 1,991 (59.5%) had different degrees of loss of social participation ability, of which 1,393 (41.14%) were mildly impaired, 419 (12.5%) were moderately impaired and 179 (5.3%) were severely impaired. Age, educational level, religious belief, living status, whether suffering from dementia and the occurrence of accidents in recent 30 days were influencing factors on the social participation ability (p < 0.05). Conclusion: The rate of impaired social participation ability among older adults was >50% and age, educational level, religious beliefs, living status, whether suffering from dementia, and the occurrence of accidents in recent 30 days (such as falls, choking, loss) were significant factors influencing the ability of social participation of rural older adults.

Effectiveness of a Telerehabilitative Home Exercise Program on Elder Adults' Physical Performance, Depression and Fear of Falling.

Our aim in this study was to analyze the effects of a home exercise program of calisthenic exercises delivered through telerehabilitation on physical performance, depression, and risk of falling in elder adults. Our participants were elder adults aged 65 and over, divided into exercise and control groups. We initiated a 4-week telerehabilitation calisthenic exercise program in the exercise group following initial assessments, while our control group received no formal exercise training. Both groups were evaluated online before and after this 4-week period with the Geriatric Depression Scale (GDS), Modified Falls Efficacy Scale (MFES), and Short Physical Performance Battery (SPPB). In total, 255 elder adults participated, with 132 (males = 72, females = 60) allocated to calisthenic exercise and 123 (males = 66, females = 57) allocated to the control group. While the groups did not differ significantly on any of our parameters before the exercise, there were statistically significant post-exercise group differences in GDS (p ≤ .001) and MFES (p ≤ .001) scores related to remarkable physical improvements achieved in the calisthenic exercise group. The exercise group showed significant increases in their scores on the SPPB Balance Test (p = .049), SPPB Chair Test (p = .009), and SPPB Total (p = .002) while there was no significant increase in any of these scores among control group participants (p > .05). Thus, calisthenic exercises performed via telerehabilitation significantly improved elder adults' physical performance, fear of falling, and depression. Telerehabilitation is a useful remote means of assessing, inducing, and following-up exercise training, particularly during the ongoing COVID-19 pandemic.

Clinical Effectiveness and Safety of Anti-PD-(L)1 Therapy Among Older Adults With Advanced Non-Small Cell Lung Cancer.

INTRODUCTION: As a result of the approval of several immune checkpoint inhibitors (ICIs) for the treatment of non-small cell lung cancer (NSCLC), many older adults are being treated with ICIs. Older adults are underrepresented in most pharmaceutical clinical trials. Therapy outcomes in this population with ICIs is particularly important since, age related factors may have an influence on the immune system. METHODS: We utilized the MD Anderson Cancer Center Gemini Team's Lung Cancer Database to retrospectively study patients ≥70 years of age with advanced NSCLC treated with anti-PD-(L)1 monotherapy to look at the clinical outcomes. RESULTS: 179 patients met the inclusion criteria for this retrospective analysis. There were 106 men and 73 women. The median age of the cohort was 74.9 years, and overall survival was 20.6 months. 27.6% of all patients had an objective response to therapy. In 33 patients who had radiological progression, treatment continued beyond progression due to clinical benefit. In this group, 6 patients had subsequent improvement in radiologic assessment. Age groups were not significantly associated with differences in clinical outcomes. CONCLUSIONS: This study suggests that anti-PD-(L)1 monotherapy is effective and well tolerated among older adults with advanced NSCLC. While pseudoprogression is rare, treatment beyond progression may provide clinical benefit in a subset of patients and warrants further investigation.

Association between cognitive function and ambient particulate matters in middle-aged and elderly Chinese adults: Evidence from the China Health and Retirement Longitudinal Study (CHARLS).

Increasing studies have discussed how ambient air pollution affects cognitive function, however, the results are inconsistent, and such studies are limited in developing countries. To fill the gap, in this study, we aimed to explore the effect of ambient particulate matters (PM1, PM2.5, PM10) on cognitive function of middle-aged and elderly Chinese adults. A total of 7928 participants older than 45 were included from CHARLS collected in 2011, 2013, and 2015. Cognitive function was evaluated with two dimensions, the first one was episodic memory and the second dimension was mental status. The total score of cognitive function was the sum of above two dimensions (0-31 points). Participants' exposure to ambient particulate matters was estimated by using a satellite-based spatiotemporal model. Linear mixed models were applied to analyze the impact of PM1, PM2.5, and PM10 on cognition function. Further interaction analyses were applied to examine the potential effect modifications on the association. After adjusting for confounding factors, we found an IQR increase in all three ambient particulate matters was significantly associated with a decrease in cognitive function score, with the greatest effect in the 90-day exposure window for PM1 (ß = -0.227, 95%CI: -0.376, -0.078) and PM2.5 (ß = -0.220, 95%CI: -0.341, -0.099). For ambient PM10, the most significant exposure window was 60-day (ß = -0.158, 95%CI: -0.274, -0.042). Interaction analyses showed that the PM-cognitive function association could be modified by gender, region, alcohol consumption, smoking, education level, chronic diseases, and depressive symptoms. In conclusion, exposure to ambient particulate matter for a certain period would significantly decrease cognitive function among middle-aged and elderly Chinese. Furthermore, individuals who were female, or lived in the midland of China were more susceptible to the adverse effect of particulate matters.

Effects of Different Assistive Seats on Ability of Elderly in Sit-To-Stand and Back-To-Sit Movements.

The ability to perform sit-to-stand (STS) and back-to-sit (BTS) movements is important for the elderly to live independently and maintain a reasonable quality of life. Accordingly, this study investigated the STS and BTS motions of 28 healthy older adults (16 male and 12 female) under three different seat conditions, namely nonassisted, self-designed lifting seat, and UpLift seat. The biomechanical data were acquired using a three-dimensional (3D) motion analysis system and force plates, and were examined by one-way repeated-measures ANOVA to investigate the effects of the different seat conditions on the joint angle, joint moments, and movement duration time (α = 0.05). No significant difference was observed in the STS duration among the three test conditions. However, the BTS duration was significantly increased in the UpLift seat condition. Moreover, the peak flexion angle of the hip during STS motion was also significantly higher in the UpLift condition. For both motions (STS and BTS), the lifting seats significantly decreased the knee and hip joint moments, but significantly increased the ankle joint moment. Moreover, compared to the nonassistive seat, both assistive lifting seats required a greater ankle joint strength to complete the STS and BTS motions.

Estado nutricional, fuerza de prensión manual y condición funcional en adultos mayores institucionalizados

Los cambios propios de la edad podrían indirectamente afectar al estado nutricional en los adultos mayores, siendo la dependencia funcional un episodio desalentador. El objetivo de la investigación fue evaluar el estado nutricional, el nivel de prensión manual y la condición funcional en adultos mayores institucionalizados en el Centro Especializado para adultos mayores dependiente del Instituto de Previsión Social de la ciudad de San Bernardino en el periodo septiembre y octubre del 2018. Para ello se diseñó un estudio descriptivo de corte transversal con datos primarios, se incluyeron a adultos mayores albergados en el Centro Especializado para adultos mayores de San Bernardino. Se midieron datos demográficos, estado nutricional por MNA, fuerza de prensión manual por dinamometría y condición funcional a través de la EFAM. Se utilizó estadística descriptiva. El trabajo fue presentado al Comité de ética de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción. Se analizaron datos de 26 adultos mayores, cuya edad media fue 76±5 años. El 61,5% eran mujeres, prevaleció un estado nutricional normal en el 84,6%, y se encontró una mayor tendencia a presentar muy mala fuerza de prensión manual en mujeres, 22,2%. Mayor frecuencia de adultos mayores sin riesgo de dependencia, 80,8%. Hombres con mayor dependencia que las mujeres, 60%. En la muestra de estudio se observó estado nutricional normal, y fuerza de prensión muy mala en mujeres. Los adultos mayores del Centro Especializado para adultos mayores del Instituto de Previsión Social presentan condición funcional autovalente sin riesgo.

Age-specific changes could indirectly affect nutritional status in older adults, with functional dependence being a discouraging episode. To evaluate the nutritional status, the level of manual grasping and the functional condition in institutionalized older adults in the Specialized Center for the elderly dependent on the Social Pressure Institute from the city of San Bernardino in the period of September to October, 2018. Transversal descriptive study with primary data, in which older adults housed in the Specialized Center for Older Adults of San Bernardino were included. Demographic data, nutritional status by MNA, hand grip strength by dynamometry and functional condition through EFAM were measured. Descriptive statistics was used. The work was presented to the Ethics Committee of the Faculty of Medical Sciences of the National University of Asunción. Data from 26 older adults were analyzed, the average age was 76±5 years, and 61.5% were women. A normal nutritional status prevailed in 84.6%, there was a greater tendency to present very bad hand grip strength in women, 22.2% and greater frequency of older adults without risk of dependence, 80.8%. Men had greater dependence than women, 60%. In the study, a normal nutritional status was observed in the sample as well as a very bad grip strength in women. Older adults of the Specialized Center for the elderly of the Social Security Institute present a self-sustaining functional condition without risk.

Estilo de vida del adulto mayor de acuerdo con el nivel socioeconómico, ocupación y vecindario / Elder adult´s lifestyle according to socioeconomic status, occupation and neighborhood

Resumen Objetivo: Conocer si el estilo de vida es determinado por el nivel socioeconómico, ocupación y vecindario de adultos mayores. Materiales y métodos: El estudio fue transversal, correlacional, con muestreo no probabilístico por conveniencia usando medios digitales de grupos conocidos. Se contactaron 101 adultos mayores por correo electrónico, WhatsApp o a través de conocidos. Los datos fueron recolectados mediante la herramienta digital QuestionPro. Se usaron las subescalas del instrumento FANTASTIC: actividad física, nutrición, toxicidad (tabaco), alcohol, sueño, estrés y control de la salud; Neighborhood Environment Walkability Survey; el AMAI para valorar estilos de vida, caminabilidad del vecindario y nivel socioeconómico, respectivamente. así como preguntas abiertas sobre ocupación. Las medidas de tendencia central, dispersión, frecuencias y porcentajes describen las variables continuas y nominales, el Alpha de Cronbach la consistencia interna de los instrumentos y prueba de Kolmogorov Smirnov con corrección de Lilliefors para la distribución de variables. Se usaron coeficientes de correlación de Spearman y modelos de regresión lineal múltiple para responder los objetivos. Resultados: A medida que el nivel socioeconómico mejora las medias de caminabilidad del vecindario aumentan (p < 0.001). El modelo de regresión lineal múltiple fue significativo (p < 0.001), el nivel socioeconómico (p = 0.006) y vecindario (p = 0.005), explican el 28% de la variación de estilos de vida. Conclusiones. El estudio permitió confirmar las teorizaciones en el sentido de que el estatus social y las oportunidades de vida, entendidas como el entorno inmediato juegan un papel importante en la elección del estilo de vida, en este caso representado por nivel socioeconómico y la caminabilidad del vecindario de los adultos mayores. Sin embargo, ello evidencia la desigualdad de oportunidades para mantener un estilo de vida saludable por parte de los adultos mayores, y es a la vez un reto para los profesionales de la salud.

Abstract Objective: To learn if elder adults lifestyle is determined by socioeconomic status, occupation, and neighborhood. Materials and methods: The design was cross sectional, correlational and a convenience non probabilistic sampling through digital social networks of known groups was used. One hundred and one older adults were contacted through e-mail, WhatsApp or by known groups (friends, classmates, professors). Data were collected through the QuestionPro digital tool. Lifestyle was measure using the following subscales: physical activity, nutrition, toxicity (tobacco), alcohol, sleep, stress and health control of the FANTASTIC instrument. Neighborhood's walkability was measured by short version of the Neighborhood Environment Walkability Survey, the AMAI index was used to determine the socioeconomic status, and the type of past or present occupation, activities performed and number of people under their command. Descriptive statistics, Cronbach's Alpha, Kolmogorov Smirnov test with Lilliefors correction, and nonparametric statistics were used. Results: As socioeconomic status went up medians of neighborhood walkability increased (p < 0.001). The linear multiple regression model was significant (p < 0.001); socioeconomic status (p = 0.006), and neighborhood (p = 0.005), explained 28% of the lifestyle variance. Conclusions. The study allowed some theoretical confirmation, in that social status, and life opportunities like environment, play an important role on lifestyle choices, in this study represented by socioeconomic status and neighborhood's walkability of elder adults. But results evidence social inequalities of opportunities to keep a healthy lifestyle by elder adults and at the same time it is a challenge for health professionals.

Exploring Willingness of Elder Chinese in Houston to Participate in Clinical Research.

BACKGROUND AND OBJECTIVES: Inadequate minority participation in clinical research can threaten the applicability and strength of scientific findings. Previous research suggests that trial participation rates are lowest among Asian Americans, compared to other groups. This study explored barriers to clinical research participation among elder Chinese living in Houston, Texas. Additionally we administered the Trust in Medical Researchers Scale (TIMRS), used previously in researching trust in medical researchers as related to research participation. DESIGN: In this mixed methods study, a semi-structured interview, including the TIMRS were administered to 30 adults of Chinese ancestry aged 50 years or older recruited from a Chinese community center. Interviews were conducted in English, Mandarin and Cantonese and independently coded and analyzed using thematic content analysis. TIMRS scores were calculated for participants. RESULTS: Participants were 70% female, 70% were 60 or elder, all were foreign born and on average lived in the US for 21.8 years. Participants perceived risks to research participation and preferred language concordant research staff. Interviewees were more willing to participate if they perceived personal and community health-related benefits. The overall TIMRS score was 23.9 (±5.0), lower than the overall TIMRS for Whites in a previous study (P<0.001). CONCLUSIONS: The barriers and facilitators to research participation confirmed previous research among Asians. Our participant TIMRS scores were consistent with decreased levels of trust observed in the original TIMRS study for African Americans as compared and lower than Whites. Employing strategies that utilize language concordant staff who build trust with participants may aid in recruiting elder Chinese, especially if the research is personally relevant to those being recruited.

History of cigarette smoking in cognitively-normal elders is associated with elevated cerebrospinal fluid biomarkers of oxidative stress.

BACKGROUND: Cigarette smoking in adults is associated with abnormalities in brain neurobiology. Smoking-induced central nervous system oxidative stress (OxS) is a potential mechanism associated with these abnormalities. The goal of this study was to compare cognitively-normal elders on cerebrospinal fluid (CSF) levels of F2-isoprostane biomarkers of OxS. METHODS: Elders with a lifetime history of smoking (smokers; n=50; 75±5 years of age; 34±28 pack-years; approximately 12% were actively smoking at the time of study) were compared to never-smokers (n=61; 76±6 years of age) on CSF iPF2α-III and 8,12, iso-iPF2α-VI F2-isoprostanes levels. F2-isoprostanes levels were quantitated with HPLC-atmospheric pressure chemical ionization-tandem mass spectrometry. Associations between F2-isoprostanes levels, hippocampal volumes, and cigarette exposure measures were also evaluated. RESULTS: Smokers showed higher iPF2α-III level than never-smokers. An age×smoking status interaction was observed for 8,12, iso-iPF2α-VI, where smokers demonstrate a significantly greater concentration with increasing age than never-smokers. In smokers only, higher 8,12, iso-iPF2α-VI concentration was associated with smaller hippocampal volume, and greater iPF2α-III level was related to greater pack years. CONCLUSIONS: This is the first study to demonstrate that a history of cigarette smoking in cognitively-normal elders was associated with significantly elevated CSF F2-isoprostane levels and greater age-related increases in F2-isoprostanes, and that higher F2-isoprostane levels in smokers were related to smaller hippocampal volume. These findings provide additional novel evidence that a history of chronic smoking during adulthood is associated with adverse effects on the human brain that are potentially enduring even with extended smoking cessation.

Superación del profesor de Educación Física para la rehabilitación del adulto mayor, desde una visión de ciencia, tecnología y sociedad / Self-improvement of the teacher of Physical Education for the aquatic rehabilitation of the elderly, from a vision of science, technology and society

RESUMEN El artículo constituye una propuesta encaminada a dar respuesta a la necesidad social de la superación del profesor de Educación Física del Centro de Experiencia del Adulto Mayor. Se propone como objetivo fundamentar la estrategia para la superación del profesor de Educación Física dirigida a la rehabilitación acuática de los adultos mayores con limitaciones articulares, desde una visión de ciencia, tecnología y sociedad. Se reconoce la oportunidad que representa el empleo de las nuevas tecnologías como elemento que contribuye a la mejora de la calidad de vida de las personas mayores. La magnitud del reto exige la puesta en acción de todos los resortes con los que la sociedad cuenta, para la atención al envejecimiento, mediante diversos programas, cuya significación contribuye a fortalecer la identidad nacional, y a elevar la cultura general integral de los profesores hacia los adultos mayores lo cual repercutirá en la formación de una conciencia social, política y cultural.

ABSTRACT The article constitutes a proposal directed to give answer to the social need for the self-improvement of the teacher of Physical Education of the Center of Experience of the Elder Adult. It proposes as objective: to base the strategy for the self-improvement of the teacher of Physical Education directed to the aquatic rehabilitation of the elderly with articular limitations, from a vision of science, technology and society. It is recognized the opportunity that represents the employment of the new technologies as element that contributes to the progress of the quality of life of the elderly. The magnitude of the challenge demands the putting in action of all the springs with which the society is provided, for the attention to the aging, by means of diverse programs, which significance helps to strengthen the national identity, and to raise the integral general culture of the teachers towards the elderly which will reverberate in the formation of a social, political and cultural conscience.

Evaluación del proceso de atención al adulto mayor con afecciones respiratorias tratado con fitofármacos. Municipio Colón / Evaluation of the health care process of elder people with respiratory diseases treated with herbal medical products. Municipality of Colon

Introducción: actualmente muchas personas sobrepasan las barreras cronológicas situadas como etapa de vejez, y esto puede transformarse en un problema si no se es capaz de brindar soluciones adecuadas a las consecuencias que del mismo se derivan. Objetivo: evaluar el proceso de atención a los adultos mayores con afecciones respiratorias tratados con fitofármacos. Materiales y métodos: se realizó un estudio observacional descriptivo de corte transversal en los 861 adultos mayores con diagnóstico de infección respiratoria aguda tratados con fitofármacos en los consultorios pertenecientes al Policlínico Dr. "Francisco Figueroa Véliz", del municipio Colón, provincia Matanzas, en el período comprendido entre julio y diciembre del 2015. Se analizaron los indicadores: adultos mayores con infección respiratoria aguda tratados con fitofármacos registrados en el consultorio, seguimiento médico a dichos pacientes, indicaciones correctas de fitofármacos, indicación de complementarios, inter-consultas realizadas y comportamiento de la certificación de calidad emitida a las producciones realizadas. Para la recolección de información se utilizó un instrumento que fue validado en su funcionamiento. Resultados: de los seis indicadores evaluados no alcanzaron los estándares establecidos el seguimiento médico a los adultos mayores con infección respiratoria aguda tratados con fitofármacos pues solo en el 95 % de las historias clínicas había constancia y la certificación de calidad ya que de los 220 lotes elaborados solo fueron analizados por control de la calidad el 81 % de ellos, por lo tanto el componente Proceso no es adecuado. Conclusiones: todas las unidades organizativas del área de salud presentan problemas con el proceso que se desarrolla (AU).

Background: currently many people surpass the chronological barriers limiting the old age stage, and this can become a problem if adequate solutions are not given to the consequences derived from it. Objective: to evaluate the health care processes of elder people treated with herbal medical products. Materials and methods: a cross-sectional, observational, descriptive study was carried out in 861 elder people with acute respiratory infection (ARI) treated with herbal medical products in the medical consultations belonging to the Policlinic "Dr. Francisco Figueroa Véliz" of the municipality of Colon, province of Matanzas, in the period July-December 2015. The indicators analyzed were elder people with acute respiratory infection treated with herbal medical products registered in the consultations, their medical follow-up, correct indication of herbal medical products, indication of complementary tests, inter- consultations and behavior of the quality certifications emitted for the elaborated production. For collecting information, it was used an instrument validated in its functioning. Results: of the six indicators evaluated, the follow-up to elder people with ARI treated with herbal medical products did not reach the average standards because in only 95 % of the clinical records it was registered; the quality certification was also deficient, because only the 81 % of the 220 lots elaborated was analyzed by quality control, therefore the component Process is not suitable. Conclusions: all the organizational units of the health area have problems with the developed process (AU).

Escala de Apoyo Social para cuidadores familiares de adultos mayores mexicanos / Social Support Scale for Family Caregivers of Elder Mexicans

Mediante análisis factoriales exploratorios y confirmatorios, se validó la Escala de Apoyo Social para Cuidadores Familiares de Adultos Mayores. 23 ítems con cargas factoriales > 0.51, agrupados en cuatro factores explican 63% de la varianza del constructo, con valores de Alfa de Cronbach ≥ 0.85; se demostró que el apoyo social tiene una relación causal positiva y significativa con apoyo material (β = 0.66), apoyo práctico (β = 0.69), apoyo emocional (β = 0.6) y apoyo de orientación (β = 0.81); los valores de ajuste del modelo son ≥ 0.97. La escala validada puede ser aplicada junto con otras medidas que permitan valorar las necesidades que enfrentan las familias para generar acciones de apoyo dirigidas al adulto-mayor y a quien lo cuida.

Using exploratory and confirmatory analysis factor, was validated the Social Support Scale for Family Caregivers of Older Adults. 23 items with factor loadings ≥ 0.51, grouped into four factors it explain 63% of the variance of the construct, with Cronbach's alpha values ≥ 0.85; was shown that social support has a positive and significant causal relationship with material support (β = 0.66), practical support (β = 0.69), emotional support (β = 0.6), and counseling support (β = 0.81), the model fit values was ≥ 0.97. The validated scale can be applied together with other measures to assess needs faced by families to generate support actions aimed at adult-senior and caregiver.

Caracterización clínica y genética de los adultos mayores centenarios del municipio Morón / Clinical and genetic characterization of centenarian greater adults from Morón municipality

Se realizó un estudio observacional descriptivo en el municipio Morón con el objetivo de caracterizar los adultos mayores centenarios desde el punto de vista clínico; se trabajó con el universo que fue de 10 pacientes donde predominó la edad de 100 a 104 años, sexo femenino, color de la piel blanca; entre los hábitos tóxicos sobresalió el consumo del café; la enfermedad crónica que prevaleció fue la hipertensión arterial; la mayoría de los longevos realizaron actividad física durante toda su vida y su alimentación fue buena; un mayor por ciento no tuvo riesgo de reacciones a drogas; en la evaluación funcional se analizaron las alteraciones en actividades básicas de la vida diaria, así como en las actividades instrumentadas. Todos los centenarios tenían antecedentes familiares de longevidad. Se realizó el árbol genealógico más representativo, que coincidió con el centenario más longevo del municipio Morón.

A descriptive observational study was carried out in Morón with the aim to characterize the centenarian greater adults from the clinical point of view; the universe was constituted by 10 patients predominating from 100 to 104 years, feminine sex, white skin, within the toxic habits of the coffee consumption; the chronic disease that prevailed was the arterial hypertension; most of the longevous made physical activity during their life and their feeding was good, a greater percent did not have risk of reactions to drugs. In the functional assessment prevailed instrumented alterations on daily life; in the affective sphere a great number of centenarians didn´t have alterations; all of them had longevity familiar antecedents. The genealogical tree more representative was carried out that agreed with the most longevous centenary from Morón municipality.