Relationship between frailty and cognitive decline in older Mexican Americans

OBJECTIVES

To examine the association between frailty status and change in cognitive function over time in older Mexican Americans.

DESIGN

Data used were from the Hispanic Established Population for the Epidemiological Study of the Elderly.

SETTING

Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California.

PARTICIPANTS

One thousand three hundred seventy noninstitutionalized Mexican-American men and women aged 65 and older with a Mini-Mental State Examination (MMSE) score of 21 or higher at baseline (1995/96).

MEASUREMENTS

Frailty, defined as three or more of the following components: unintentional weight loss of more than 10 pounds, weakness (lowest 20% in grip strength), self-reported exhaustion, slow walking speed (lowest 20% in 16-foot walk time in seconds), and low physical activity level (lowest 20% on Physical Activity Scale for the Elderly score). Information about sociodemographic factors, MMSE score, medical conditions (stroke, heart attack, diabetes mellitus, arthritis, cancer, and hypertension), depressive symptoms, and visual impairment was obtained.

RESULTS

Of the 1,370 subjects, 684 (49.9%) were not frail, 626 (45.7%) were prefrail (1-2 components), and 60 (4.4%) were frail (>/=3 components) in 1995/96. Using general linear mixed models, it was found that frail subjects had greater cognitive decline over 10 years than not frail subjects (estimate=-0.67, standard error=0.13; P<.001). This association remained statistically significant after controlling for potential confounding factors.

CONCLUSION

Frail status in older Mexican Americans with MMSE scores of 21 or higher at baseline is an independent predictor of MMSE score decline over a 10-year period. Future research is needed to establish pathophysiological components that can clarify the relationship between frailty and cognitive decline.

The activity of N-(hydroxymethyl) melamines in fresh human ovarian tumour cells and xenografts

Trimelamol (TM) was developed as a water soluble analogue of the oral chemotherapeutic agent hexamethyl-melamine (HMM), to be administered i.v., in an effort to avoid dose limiting emesis. Because of formulation difficulties due to its inherent instability the development of TM was halted. In vivo studies using a human ovarian cancer xenograft model PXN/65 showed TM to be curative in the dose range of 15-60 mg/kg i.p. daily x 5, for 4 weeks. Conversely, HMM given at the highest dose (60 mg/kg i.p., or 90 mg/kg p.o.) indicated only very modest tumour growth delays. In vitro chemosensitivity testing using primary ovarian tumour cultures showed that in 12/23 cases indicating reduced sensitivity to cisplatin or carboplatin, sensitivity to TM was increased. TM was curative in the carboplatin-resistant HX 110P human ovarian cancer xenograft and promising activity was seen in the MX-1 human breast cancer xenograft. In spite of enhanced stability in aqueous solution and good in vitro cytotoxicity, the TM analogues CB 7669 (triscyanomethyl) and CB 7639 (tristrifluoroethyl) showed disappointing in vivo antitumour activity which may be explained by the need for prolonged exposure. TM analogues with intermediate stability are currently under development in an effort to further the clinical development of this promising group of antitumour agents.

Isoelectric focusing of membrane proteins: high resolution separation of myelin proteins

A mixture of the nonionic detergent Triton X-100, the zwitterionic detergent 3-[(cholamidopropyl)dimethylammonio]-1-propanesulphonate (CHAPS), 9M urea and carrier ampholytes was found comparable to media containing sodium dodecyl sulfate in the capacity for solubilization of myelin proteins, including the highly hydrophobic proteolipid protein. The solubilized sample was incorporated into the polymerization mixture before moulding an ultrathin gel, with heat convection characteristics allowing a high wattage to be applied, thus allowing fast separation with high resolving power. Since the most basic protein in myelin focuses at a pH greater than 10, fast separation is essential in order to minimize decay of the cathodic end of the pH gradient.