Healthy Brain Aging: Effect of Head Injury, Alcohol and Environmental Toxins

Preexisting dementia is associated with higher mortality rate in patients with femoral neck fracture

OBJECTIVE

This study aimed to assess the mortality and the influence of age, Abbreviated Mental Test (AMT) scores, and American Society of Anesthesiologists (ASA) grades on patients with dementia and femoral neck fracture (FNF) at 30 days, 4 months, 1 year, and 2 years after undergoing surgery.

METHODS

Of 1296 patients admitted with FNF, 180 had had prefracture dementia. A retrospective study of these 180 patients was carried out. The patient demographics, including age, sex, presence of diabetes mellitus (DM), lipid profile, AMT score, preoperative comorbidities, ASA grade, and incidence of postoperative delirium, were documented.

RESULTS

A total of 113 patients (62.8%) died postoperatively. The mortality rate was 17.7% (20 patients) at 30 days, 54.9% (62 patients) at 4 months, 77.9% (88 patients) at 1 year, and 87.6% (99 patients) at 2 years. The mortally rate in dementia with FNF was three times higher than that in FNF without dementia and was independent of age, ASA grades, DM, lipid profile, AMT scores, and development of postoperative delirium.

CONCLUSIONS

Dementia should be a principal predictive factor in mortality of FNF and should be a key determinant in all frailty scores.

The ageing rate of workers engaged in chrome ore processing

BACKGROUND

According to the modern concept of occupational medicine adopted by the World Health Organization, relationship between health and work is fully established while the levels of physical, chemical and biological harmful production factors can be considered as causative factors of occupational diseases.

OBJECTIVE

The aim of this research is to determine the aging rate of at risk workers engaged in chrome ore processing in order to increase their health status and quality of life.

METHODS

Biological age (BA) of workers was calculated by measuring the blood pressure, static balance (SB), respiratory rate (RR) and by a questionnaire survey on subjective health assessment (SHA).

RESULTS

Based on the workplace certification, we have selected unfavorable professions to assess the rate of aging. We have determined the aging rate, according to which biological age exceeds the official age of workers engaged in chrome ore processing in harmful working conditions.

CONCLUSIONS

In harmful working conditions, the aging rate accelerates manifesting in at risk worker's health status with BA-PBA ratio in the range from 2.6 to 7.9 years. Regulators, crusher attendants and refractory men, who work in unfavorable climate, should be the leading professional occupations in terms of proper biological age (PBA) monitoring.

Dementia and hip fractures: development of a pathogenic framework for understanding and studying risk

Dementia and hip fractures are 2 conditions that are seen primarily in older adults, and both are associated with substantial morbidity and mortality. An individual with dementia is up to 3 times more likely than a cognitively intact older adult to sustain a hip fracture. This may occur via several mechanisms, including (1) risk factors that are common to both outcomes; (2) the presence of dementia increasing hip fracture incidence via intermediate risk factors, such as falls, osteoporosis, and vitamin D; and (3) treatment of dementia causing side effects that increase hip fracture risk. We describe a model that applies these 3 mechanisms to explain the relationship between dementia and hip fractures. Comprehensive understanding of these pathways and their relative influence on the outcome of hip fracture will guide the development of effective interventions and potentially improve prevention efforts.

Bapineuzumab and solanezumab for Alzheimer's disease: is the 'amyloid cascade hypothesis' still alive?

INTRODUCTION

The 'amyloid cascade hypothesis' remains the leading hypothesis to explain the pathophysiology of Alzheimer's disease (AD). Immunotherapeutic agents have been developed to remove the neurotoxic amyloid β42 protein and prevent the hypothesized amyloid β42-induced neurotoxicity and neurodegeneration. The most notable of these immunotherapies are bapineuzumab and solanezumab.

AREAS COVERED

This article briefly reviews the experimental agents in development for treatment of AD and then discusses the results of bapineuzumab and solanezumab in AD patients, as reported in preclinical studies, clinical trials and press releases.

EXPERT OPINION

Phase III trials showed that bapineuzumab failed to improve cognitive and functional performances in AD patients, and was associated with a high incidence of amyloid-related imaging abnormalities (ARIA). Solanezumab's two Phase III trials in AD patients failed to meet endpoints when analyzed independently. However, analysis of pooled data from both trials showed a significant reduction in cognitive decline in mild AD patients. The improvement was associated with an increase in plasma amyloid-β (Aβ) levels and a low incidence of ARIA in solanezumab-treated patients. The marginal benefits of solanezumab are encouraging to support continued evaluation in future studies, and offer small support in favor of the ongoing viability of the 'amyloid cascade hypothesis' of AD.

Prevention, Rehabilitation, and Mitigation Strategies of Cognitive Deficits in Aging with HIV: Implications for Practice and Research

Highly active antiretroviral therapy has given the chance to those living with HIV to keep on living, allowing them the opportunity to age and perhaps age successfully. Yet, there are severe challenges to successful aging with HIV, one of which is cognitive deficits. Nearly half of those with HIV experience cognitive deficits that can interfere with everyday functioning, medical decision making, and quality of life. Given that cognitive deficits develop with more frequency and intensity with increasing age, concerns mount that as people age with HIV, they may experience more severe cognitive deficits. These concerns become especially germane given that by 2015, 50% of those with HIV will be 50 and older, and this older cohort of adults is expected to grow. As such, this paper focuses on the etiologies of such cognitive deficits within the context of cognitive reserve and neuroplasticity. From this, evidence-based and hypothetical prevention (i.e., cognitive prescriptions), rehabilitation (i.e., speed of processing training), and mitigation (i.e., spaced retrieval method) strategies are reviewed. Implications for nursing practice and research are posited.

Neuroplasticity and successful cognitive aging: a brief overview for nursing

The brain remains dynamic even in older age and can benefit from mental exercises. Thus, it is important to understand the concepts of positive and negative neuroplasticity and how these mechanisms either support or detract from cognitive reserve. This article provides a brief review of these key concepts using four exemplary studies that clearly show the effects that these neurological mechanisms exert on cognitive reserve and cognitive functioning. From this review, a working knowledge of how neuroplasticity and cognitive reserve are expressed in patients will be provided along with how this information can be incorporated into nursing practice and research.

Protection by an antioxidant of rotenone-induced neuromotor decline, reactive oxygen species generation and cellular stress in mouse brain

Exposure to environmental toxins, including rotenone, results in central nervous system and systemic toxicity. Rotenone is a widely used pesticide and a mitochondrial complex I (CI) inhibitor. This study reports effectiveness of a synthetic lipoylcarnitine antioxidant compound, lipoylcarnitine methyl ester iodide (PMX-500F), for treatment of chronic rotenone induced neurological deficits in mice. Mice (C57BL/6NTac; two months of age) received oral administration of rotenone (30 mg/kg/day) or vehicle, preceded by intraperitoneal injection of PMX-500F (19 mg/kg) or vehicle for four weeks. In the Rota-rod test, rotenone treatment had no effect (P>0.05); however, PMX-500F treatment improved locomotor coordination and endurance (latency to fall time; P<0.05). For neuromuscular strength (wire hang test), rotenone treated mice showed reduced latency to fall compared to control mice (P<0.05). PMX-500F treatment improved the outcome in both control and rotenone exposed mice (P<0.05). Rotenone administration increased ROS generation in the forebrain and midbrain regions, but not in the cerebellum (P<0.05). Co-treatment with PMX-500F normalized the ROS in forebrain and midbrain regions to that of the control concentrations. In rotenone administered mice, activated stress-activated protein kinase/c-Jun NH2-terminal kinase (pSAPK/JNK) was higher in forebrain and midbrain lysates than in control mice (P<0.05) and treatment with PMX-500F reduced pSAPK/JNK to control levels. The pSAPK/JNK levels in the cerebellum were similar in all four groups (P>0.05). Total SAPK/JNK was not altered by either rotenone or PMX-500F treatment (P>0.05). These results illustrate that an antioxidant, here PMX-500F, provides protection against rotenone induced decline in neuromotor function, reactive oxygen species (ROS) generation and cellular stress.

Revitalizing the aged brain

Optimal cognitive and emotional function is vital to independence, productivity, and quality of life. Cognitive impairment without dementia may be seen in 16% to 33% of adults older than 65 years, and is associated with significant emotional distress. Cognitive and emotional well-being are inextricably linked. This article qualifies revitalizing the aged brain, discusses neuroplasticity, and suggests practical neuroplasticity-based strategies to improve the cognitive and emotional well-being of older adults.