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BACKGROUND: Slow gait speed (GS) predicts dementia, but this association might be mediated by body composition parameters like total fat mass (TFM) or total lean mass (TLM). The aim of the study was to evaluate whether GS, TLM, and TFM were associated factors with an increased risk for subsequent dementia in community-dwelling older women. METHODS: A case-control study was nested in the EPIDemiologie de l'OStéoporose cohort. GS (at usual pace more than 6 m), TLM, and TFM (assessed by dual energy x-ray absorptiometry) were measured at baseline. Cognitive performance was evaluated at baseline and at 7 years of follow-up. The presence of dementia was assured by two blinded memory experts based on best practice and validated criteria. Multivariate logistic regression models assessed the association of GS, TLM, and TFM with dementia risk. RESULTS: Of the initial 1,462 women, 75 years old and older, 647 (43.4%) were cognitively intact at baseline and had a full cognitive assessment at 7 years (145 of them developed dementia). Controlled for covariates (demographics, physical activity, self-reported disabilities, and comorbidities), GS was an independent associated factor for subsequent dementia as a continuous variable (odds ratio [OR] 2.28, 95% CI: 1.32-3.94) and as a categorized variable (OR 2.38, 95% CI: 1.28-4.43 highest vs lowest quartile). Neither interaction with GS nor a statistically significant association with dementia risk was found for TLM and TFM. CONCLUSIONS: GS was an independent associated factor for subsequent dementia not mediated by TLM or TFM. [ABSTRACT FROM AUTHOR]

BACKGROUND/AIMS: To assess if cardiovascular disease risk factors (CVDRF) are predictive factors for poorer evolution of Alzheimer's disease (AD) patients in terms of cognitive decline. METHODS: The Réseau de la maladie d'Alzheimer - France (REAL.FR) study is a prospective multicentre cohort which has recruited 686 community-dwelling patients presenting mild to moderate AD. The presence of CVDRF and associated treatments was recorded at baseline. The rate of cognitive decline of AD patients was assessed using the Mini Mental State Examination (MMSE) and the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-Cog), after 2 years of follow-up. RESULTS: Of the 629 patients at baseline, 268 (42.6%) had no CVDRF, 256 (40.7%) reported 1 CVDRF and 105 (16.7%) reported 2-3. At inclusion, hypertension was present in 44.1% of patients, hypercholesterolaemia in 22.6% and diabetes in 9.4%. No statistically significant differences (p values of 0.9 for MMSE and 0.8 for ADAS-Cog) in mean cognitive decline after 2 years of follow-up were found comparing different subgroups of patients with CVDRF to the non-CVDRF group. CONCLUSIONS: Although there is evidence that CVDRF contribute to the onset of AD, these results suggest that CVDRF may not be part of the underlying processes that affect progression of AD. [ABSTRACT FROM AUTHOR]

The proportion of adults over 60 years of age is rapidly increasing and is estimated to reach approximately one‐sixth of the global population by 2030. An ageing population is a real challenge for healthcare resources, including dermatologists and geriatricians, as age‐related changes in skin integrity and barrier function make older adults more susceptible to developing skin pathologies such as pruritus, dermatitis and infections. Fragile skin arises from several interlinked causes, including age‐related changes in skin barrier integrity, previous and current lifestyle choices, skin pathologies and medical interventions. Dermo‐cosmetics can play a key role in enhancing skin care regimens and preventing pathologies in this age group. In vitro studies, clinical, and in‐daily clinical practice studies of dermo‐cosmetics have shown them to be effective in many skin conditions in older adults, like xerosis and pruritus. Incontinence‐associated dermatitis (IAD), a common condition arising from contact with irritants such as urine and faeces which can significantly impact the quality of life of sufferers, can also be improved with a barrier cream in incontinent patients aged 70 years and older. This supplement focuses on the increased fragility of older skin, the development of common skin pathologies and the efficacy and tolerance of dermo‐cosmetic products in older adults. [ABSTRACT FROM AUTHOR]

Abstract: Frailty is a clinical state in which there is an increase in an individual’s vulnerability for developing increased dependency and/or mortality when exposed to a stressor. Frailty can occur as the result of a range of diseases and medical conditions. A consensus group consisting of delegates from 6 major international, European, and US societies created 4 major consensus points on a specific form of frailty: physical frailty. [1.] Physical frailty is an important medical syndrome. The group defined physical frailty as “a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual's vulnerability for developing increased dependency and/or death.” [2.] Physical frailty can potentially be prevented or treated with specific modalities, such as exercise, protein-calorie supplementation, vitamin D, and reduction of polypharmacy. [3.] Simple, rapid screening tests have been developed and validated, such as the simple FRAIL scale, to allow physicians to objectively recognize frail persons. [4.] For the purposes of optimally managing individuals with physical frailty, all persons older than 70 years and all individuals with significant weight loss (≥5%) due to chronic disease should be screened for frailty.

An operational definition of musculoskeletal decline in older people is needed to allow development of interventions for prevention or treatment, as was developed for the treatment of osteoporosis. Frailty and sarcopenia are linked, but distinct, correlates of musculoskeletal aging that have many causes, including age-related changes in body composition, inflammation, and hormonal imbalance. With the emergence of a number of exciting candidate therapies to retard the loss of muscle mass with aging, the derivation of a consensual definition of sarcopenia and physical frailty becomes an urgent priority. Although several consensual definitions have been proposed, these require clinical validation. An operational definition, which might provide a threshold for treatment/trial inclusion, should incorporate a loss of muscle mass as well as evidence of a decrease in muscle strength and/or physical activity. Evidence is required for a link between improvements in the measures of muscle strength and/or physical activity and clinical outcomes to allow development of interventions to improve clinical outcomes in frail older patients. [ABSTRACT FROM AUTHOR]