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Introducción: La infección del tracto urinario (ITU) es una de las enfermedades más prevalentes en la práctica clínica y aumenta en pacientes mayores de 65 años en comparación con pacientes de mediana edad. Con el fin de mejorar el tratamiento empírico se ha estudiado la etiología y el perfil de sensibilidad antibiótica de las bacterias más frecuentes productoras de ITU en personas mayores. Material y métodos: Estudio transversal, descriptivo y retrospectivo en el que se incluyeron los microorganismos aislados con recuento significativo en muestras de orina de pacientes con ITU. Se analizó la etiología global y en función del sexo. Se consideró únicamente una muestra de orina por paciente y episodio de ITU. Resultados: Respecto a la procedencia de la muestra, la mayor proporción fue en atención primaria, con 4.853 urocultivos (51,6% de urocultivos positivos), seguido de atención hospitalaria, con 3.565 urocultivos (46,4% de urocultivos positivos) y 94 urocultivos en las residencias de ancianos (2% de urocultivos positivos). Escherichia coli fue el microorganismo más aislado tanto en el conjunto de la población (54%) como en cada uno de los grupos analizados. Se observó que E. coli aislado en mujeres fue significativamente superior que en hombres (χ2, p = 0,044). Su sensibilidad fue: fosfomicina 80% y 75% amoxicilina-ácido clavulánico. Conclusiones: E. coli continúa siendo el microorganismo más frecuentemente aislado en ITU. El tratamiento empírico de las ITU en nuestro medio debería incluir fosfomicina o amoxicilina-ácido clavulánico, independientemente de la unidad de atención sanitaria y del sexo. Introduction: Urinary tract infection (UTI) is one of the most prevalent diseases in clinical practice and increases in patients older than 65 years compared to middle-aged patients. In order to improve empirical treatment, the etiology and antibiotic sensitivity profile of the most frequent bacteria that produce UTIs in older people have been studied. Material and methods: Cross-sectional, descriptive and retrospective study in which isolated micro-organisms with significant counts in urine samples from patients with UTI were included. The global etiology and according to sex were analyzed. Only one urine sample per patient and UTI episode was considered. Results: Regarding the origin of the sample, the highest proportion was in primary care with 4853 urine cultures (51.6% of positive urine cultures), followed by hospital care with 3565 urine cultures (46.4% of positive urine cultures) and 94 urine cultures in nursing homes elderly (2% positive urine cultures). Escherichia coli was the most isolated micro-organism both in the population as a whole (54%) and in each of the analyzed groups. It was observed that E. coli isolated in women was significantly higher than in men (χ2, P = .044). Their sensitivity was: 80% fosfomycin and 75% amoxicillin-clavulanic acid. Conclusions: E. coli continues to be the most frequently isolated micro-organism in UTI. Empirical treatment of UTI in our environment should include fosfomycin or amoxicillin-clavulanic acid, regardless of the health care unit and gender.

Identifying genetic determinants of reproductive success may highlight mechanisms underlying fertility and identify alleles under present-day selection. Using data in 785,604 individuals of European ancestry, we identified 43 genomic loci associated with either number of children ever born (NEB) or childlessness. These loci span diverse aspects of reproductive biology, including puberty timing, age at first birth, sex hormone regulation, endometriosis and age at menopause. Missense variants in ARHGAP27 were associated with higher NEB but shorter reproductive lifespan, suggesting a trade-off at this locus between reproductive ageing and intensity. Other genes implicated by coding variants include PIK3IP1, ZFP82 and LRP4, and our results suggest a new role for the melanocortin 1 receptor (MC1R) in reproductive biology. As NEB is one component of evolutionary fitness, our identified associations indicate loci under present-day natural selection. Integration with data from historical selection scans highlighted an allele in the FADS1/2 gene locus that has been under selection for thousands of years and remains so today. Collectively, our findings demonstrate that a broad range of biological mechanisms contribute to reproductive success.

[Abstract] Senescence is a process characterized by a prolonged irreversible cell-cycle arrest. The accumulation of senescent cells in tissues is related to aging and to the development of age-related diseases. Recently, gene therapy has emerged as a powerful tool for treating age-associated diseases by the transference of specific genes into the target cell population. However, the high sensitivity of senescent cells significantly precludes their genetic modification via classical viral and non-viral systems. Niosomes are self-assembled non-viral nanocarriers that exhibit important advantages due to their elevated cytocompatibility, versatility, and cost-efficiency, arising as a new alternative for genetic modification of senescent cells. In this work, we explore for the first time the use of niosomes for genetic modification of senescent umbilical cord-derived mesenchymal stem cells. We report that niosome composition greatly affected transfection efficiency; those formulations prepared in medium with sucrose and containing cholesterol as helper lipid being the most suitable to transfect senescent cells. Moreover, resulting niosome formulations exhibited a superior transfection efficiency with a markedly less cytotoxicity than the commercial reagent Lipofectamine. These findings highlight the potentiality of niosomes as effective vectors for genetic modification of senescent cells, providing new tools for the prevention and/or treatment of age-related diseases. Ministerio de Ciencia e Innovación (España); RTI2018-099389-A-100 Ministerio de Ciencia e Innovación (España); RYC2018-025617-I Ministerio de Ciencia e Innovación (España); RYC2021-032567-I Xunta de Galicia; ED431F2021/10 Xunta de Galicia; ED481D-2021-020 Instituto de Salud Carlos III; PI20/00497

Background Venous ulcers usually present a torpid evolution with a negative impact on patients’ quality of life. In primary care, they account for 2.5% of nursing consultations and their treatment represents high costs for national health systems. These patients usually have a low level of physical activity, with muscle pump dysfunction of the lower limbs, which may improve with increased physical activity. The purpose of this study is to analyse the effectiveness of a structured intervention involving physical activity and exercise (Active Legs) as an adjuvant treatment in improving healing of chronic venous ulcers at 3 months follow-up. Methods A randomized, multicentre clinical trial. A total of 224 individuals receiving primary nursing care with a diagnosis of venous ulcer, with a diameter of 1 cm or greater and an ankle-brachial index between 0.8 and 1.3, able to comply with the study requirements and consenting to participate, will be sequentially included (112 per group). Both groups will receive the standard treatment in primary care, with cleansing, debridement and healing in a moist environment together with multilayer compression therapy. The intervention group will also receive a structured educational intervention involving lower limb physical exercise and daily ambulation guidelines. The primary response variables will be complete healing –understood as complete and sustained epithelialisation for at least 2 weeks– and time to healing. The secondary variables will be degree of healing, ulcer area, quality of life, pain and variables related to the healing process, prognosis, and recurrences. Sociodemographic variables, adherence to treatment and satisfaction variables will also be recorded. Data will be collected at baseline, at 3 months and at 6 months follow-up. Survival analysis (Kaplan-Meier and Cox) will be performed to measure primary effectiveness. Intention-to-treat analysis. Discussion If the intervention is effective, a cost-effectiveness analysis could be conducted and implemented as an additional intervention in the usual venous ulcer treatment in primary care. Trial registration NCT04039789. [https://ClinicalTrials.gov]. 07/11/2019.

Introducción: La gripe es una de las enfermedades de mayor impacto epidemiológico y de máxima relevancia en la gestión de los servicios sanitarios. La vacuna de la gripe puede tener una gran variabilidad cada temporada, por lo que nuestro objetivo fue conocer la efectividad de la vacuna de la gripe de la temporada 2017/2018 para la prevención de casos graves de gripe en mayores de 65 años en un hospital general de agudos de 385 camas. Material y método: Estudio de casos y controles. Se incluyeron todos los pacientes hospitalizados con gripe mayores de 65 años confirmada por el laboratorio durante la temporada 2017/2018. Los que cumplieron criterios de caso grave de gripe se consideraron caso. Los que no cumplían criterios de gravedad se consideraron controles. Se calculó los factores asociados con el desarrollo de la gripe grave. Resultados: La mediana de edad fue de 68 años (DE 91,87). La tasa de ataque fue de 0,23/100 habitantes y la efectividad vacunal de 38%. Los grupos de vacunados y no vacunados fueron diferentes en cuanto a edad (p < 0,0481). El estado de vacunación frente a la gripe grave resultó ser un factor protector independiente (OR = 0,840; 0,746-0,913). Conclusiones: La efectividad de la vacunación antigripal proporcionó una mayor protección contra la infección y redujo la gravedad de la gripe en los pacientes mayores hospitalizados. Estos hallazgos deberían tenerse en cuenta para mejorar las estrategias de vacunación y alcanzar mejores coberturas vacunales en la población de riesgo. Introduction: Influenza is one of the diseases with the greatest epidemiological impact and of maximum relevance in the management of health services. The flu vaccine can have great variability each season, so our objective was to find out the effectiveness of the flu vaccine for the 2017/2018 season for the prevention of severe cases of flu in people over 65 years of age in a 385-bed acute general hospital. Material and method: Study of cases and controls. All hospitalized patients with laboratory-confirmed influenza older than 65 years during the 2017/2018 season were included. Those who met the criteria for a severe case of influenza were considered cases. Those who did not meet the severity criteria were considered controls. Factors associated with the development of severe influenza were calculated. Results: The median age was 68 years (SD 91.87). The attack rate was 0.23 per hundred inhabitants and the vaccine effectiveness was 38%. The vaccinated and unvaccinated groups were different in terms of age (p < 0.0481). Vaccination status against severe influenza was found to be an independent protective factor (OR = 0.840; 0.746-0.913). Conclusions: The effectiveness of influenza vaccination provided greater protection against infection and reduced the severity of influenza in older hospitalized patients. These findings should be taken into account to improve vaccination strategies and achieve better vaccination coverage in the population at risk.

Introduction COVID-19 has been responsible for countless deaths during this time. Objectives The main objective of this study was to determine if the referred fever of elderly patients admitted for COVID-19 was related to their mortality. Material and methods Data were obtained from the 2020 hospital admissions records of the Hospital de San Juan de Alicante, Spain. Results Those patients without fever had a greater age and comorbidity. There was not a significant difference related to fever in in-hospital mortality. Discussion Previous studies seem to indicate that fever in its early stages has a protective effect rather than a harmful one. Our results confirm this trend. No data have been found in the literature that express the differences of elderly patients admitted for COVID-19 who presented fever versus those who did not in the context of hospital admission. Conclusion No significant differences were detected in terms of mortality with respect to the fever variable. However, patients without fever present significantly different laboratory values that could indicate a greater severity in their evolutionary course. For example, patients without fever have significantly higher D-dimer and LDH levels in addition to significantly lower arterial oxygen pressure and PaO2/FiO2 and SpO2/FiO2 ratios.

Background Patients with a dementia diagnosis and COVID-19 sometimes manifest an atypical clinical picture. However, differences between elderly COVID-19 patients having dementia and those not having dementia have not been described yet. The in-hospital mortality and out-of-hospital mortality from both groups has not been reported. Objective The primary aim of this study is to determine if there is a significant difference in-hospital and out-of-hospital mortality in the elderly patients admitted for COVID-19, comparing those with dementia and those without dementia. A secondary aim is to determine whether there are significant clinical and laboratory differences between elderly COVID-19 patients with dementia and without dementia. Methods Data collection of hospitalizations of elderly patients aged 70 years old or older admitted for COVID-19 in 2020 at the Hospital de San Juan de Alicante. Results In-hospital mortality in a context of admission for COVID-19 is significantly higher in patients with out dementia. However, post-discharge out-of-hospital mortality is significantly higher in patients with dementia. Conclusion The out-of-hospital mortality of elderly patients with dementia appears to be significantly higher than those who do not. Therefore, the importance of caring for elderly patients with dementia after being discharged from hospital should be emphasized.

Taurine is an abundant metabolite associated with regulation of cell volume. Several signaling pathways are stimulated at a micromolar concentrations of taurine. However, most of the experimental studies employ this compound at a very high concentration (tens of millimolar). In this study, the role of a chronic treatment with a micromolar dosage of taurine in the physical performance of skeletal muscle of castrated-aged mice was characterized. Taurine was administered in drinking water (800 μM) to 9-months-old castrated (or sham) mice at approximately 20 mg/kg per day for 12 weeks. The weight of the mice, grip strength, food and water intake were monitored. Soleus or EDL muscles were dissected for determinations of force and fatigue. Castrated mice show a slow increase in body mass and a sustained reduction of grip strength. The taurine treatment delays the weigh recovery and generates a decrease in force of castrated and sham mice. No effect of taurine was observed in young mice. The food intake was significantly reduced in castrated mice treated with taurine (with no effect in water intake). The raw force generation or muscle mass in EDL and soleus muscle were similar in treated mice in comparison with control groups. Interestingly, the taurine treatment generated an increased fatigability in both EDL and soleus muscle. We suggest that a submillimolar concentration of taurine chronically administered during aging produce negative effect in physical performance. Caution should be taken when this compound is routinely consumed by old adults.

[cat] Ens trobam davant un escenari de canvi en els serveis, recursos i polítiques públiques destinades a les persones adultes majors. És un repte demogràfic, en què la piràmide poblacional està canviant i els desitjos de les persones s’expressen cada cop més. Moltes vegades, els serveis han estat dissenyats i construïts de manera exclusiva; estan ubicats enfora de la comunitat i duen a terme accions que no sempre compleixen els desitjos ni cobreixen les expectatives de les persones a qui van destinades i que aïllen de la comunitat les persones que en fan ús. La intervenció amb persones adultes majors presenta, molt sovint i al llarg de la història, decisions marcades pel desconeixement de l’evidència científica, que hauria de ser l’objectiu principal a l’hora de planificar. No sempre s’ha tingut en compte l’opinió de persones expertes i molt menys de les destinatàries, les persones adultes majors, les autèntiques protagonistes de les intervencions i de l’acompanyament. Es fa necessària una planificació juntament amb les persones implicades i una avaluació dels resultats. Per tot això i de cada vegada més, s’implementa en els diferents serveis i recursos el model d’atenció integral i centrat en la persona, que és situada a l’eix de l’acompanyament, hi té un rol actiu i n’és protagonista, ja que és l’única que sap què vol i què necessita. Trobam com a antecedent el model de Carl Rogers, que proposà un enfocament psicoterapèutic partint de la premissa que qui més coneixement té d’una persona és un mateix (Rodríguez i Vilà, 2014). La transformació dels serveis ha de seguir, tal com s’ha comentat, criteris d’evidència científica, com són els beneficis derivats d’aplicar enfocaments de normalització i intervenció comunitària en els diferents contextos, per adaptar-los als desitjos i interessos de les persones i oferir-los serveis que els millorin la qualitat de vida. Així doncs, s’ha d’anar cap a una política que creï serveis i recursos de proximitat, que ofereixi igualtat d’oportunitats a totes les persones i també amb criteris d’accessibilitat universal i igualtat. Aquests serveis han de formar i ser part de la comunitat, en la qual la persona ha de continuar exercint els seus drets i deures, i han de reconèixer la dignitat que té tothom. S’han de dissenyar polítiques públiques per fomentar el dret d’envellir en companyia; per eliminar o minimitzar situacions de solitud no desitjada i l’aïllament, i oferir un ventall de serveis que s’adaptin a la individualitat i als desitjos de cadascú., [spa] Actualmente, nos encontramos ante un escenario de cambio en los servicios, recursos y políticas públicas destinadas a las personas adultas mayores. Es un reto demográfico, en el que la pirámide poblacional está cambiando y los deseos de las personas de cada vez se expresan más. Muchas veces, los servicios han sido diseñados y construidos de forma exclusiva; están ubicados afuera de la comunidad y llevan a cabo acciones que no siempre cumplen los deseos y expectativas de las personas a las que van destinadas, y que aíslan de la comunidad a las personas que los utilizan. La intervención con personas adultas mayores presenta, a menudo ya lo largo de la historia, decisiones marcadas por el desconocimiento de la evidencia científica, que debería ser el objetivo principal a la hora de planificar. Asimismo, no siempre se ha tenido en cuenta la opinión de personas expertas y mucho menos de las destinatarias, las personas adultas mayores, las auténticas protagonistas de las intervenciones y del acompañamiento. Es necesaria una planificación junto con las personas implicadas y una evaluación de los resultados. Por todo ello y de cada vez más, se implementa en los diferentes servicios y recursos el modelo de atención integral y centrado en la persona, que está situada en el eje del acompañamiento, tiene un rol activo y es protagonista, ya que es la única que sabe lo que quiere y lo que necesita. Encontramos como antecedente el modelo de Carl Rogers, que propuso un enfoque psicoterapéutico partiendo de la premisa de que quien más conocimiento tiene de una persona es uno mismo (Rodríguez y Vilà, 2014). La transformación de los servicios debe seguir, tal y como se ha comentado, criterios de evidencia científica, como son los beneficios derivados de aplicar enfoques de normalización e intervención comunitaria en los diferentes contextos, para adaptarlos a los deseos e intereses de las mismas personas y ofrecerles servicios que mejoren su calidad de vida. Así pues, debe ir hacia una política que cree servicios y recursos de proximidad, que ofrezca igualdad de oportunidades a todas las personas y también con criterios de accesibilidad universal e igualdad. Estos servicios deben formar y ser parte de la comunidad, en la que la persona debe seguir ejerciendo sus derechos y deberes, y deben reconocer la dignidad que tiene todo el mundo. Deben diseñarse políticas públicas para fomentar el derecho de envejecer en compañía; para eliminar o minimizar situaciones de soledad no deseada y el aislamiento, y ofrecer un abanico de servicios que se adapten a la individualidad y a los deseos de cada uno.

Aging impairs organismal homeostasis leading to multiple pathologies. Yet, the mechanisms and molecular intermediates involved are largely unknown. Here, we report that aged aryl hydrocarbon receptor-null mice (

Reproductive longevity is essential for fertility and influences healthy ageing in women1,2, but insights into its underlying biological mechanisms and treatments to preserve it are limited. Here we identify 290 genetic determinants of ovarian ageing, assessed using normal variation in age at natural menopause (ANM) in about 200,000 women of European ancestry. These common alleles were associated with clinical extremes of ANM; women in the top 1% of genetic susceptibility have an equivalent risk of premature ovarian insufficiency to those carrying monogenic FMR1 premutations3. The identified loci implicate a broad range of DNA damage response (DDR) processes and include loss-of-function variants in key DDR-associated genes. Integration with experimental models demonstrates that these DDR processes act across the life-course to shape the ovarian reserve and its rate of depletion. Furthermore, we demonstrate that experimental manipulation of DDR pathways highlighted by human genetics increases fertility and extends reproductive life in mice. Causal inference analyses using the identified genetic variants indicate that extending reproductive life in women improves bone health and reduces risk of type 2 diabetes, but increases the risk of hormone-sensitive cancers. These findings provide insight into the mechanisms that govern ovarian ageing, when they act, and how they might be targeted by therapeutic approaches to extend fertility and prevent disease. Hundreds of genetic loci associated with age at menopause, combined with experimental evidence in mice, highlight mechanisms of reproductive ageing across the lifespan.

The Eupatorium plant has been well used in medication and as a decorative plant. Some studies have reported that this herb has biochemical compounds, such as sesquiterpenes, phenolics, polysaccharides, and pyrrolizidine alkaloids. Thus, it has pharmacological effects, including antifungal, antibacterial, cytotoxic, and antinociceptive properties, that can be utilized for cosmetic purposes. However, only a few published works have summarized the active compounds and the application of Eupatorium plants as cosmetic agents. Therefore, this article aims to review the application of Eupatorium plants as a potential cosmetic agent. The active compounds of Eupatorium are contained in the whole plant, as well as the stems, leaves, roots, and aerial parts (flower, fruit, and seeds). In terms of cosmetic applications, the activities of Eupathorium are antioxidant, anti-tyrosinase, anti-melanin/melanogenesis, anti-acne, and anti-inflammatory. This review aims to contribute to a better understanding for expanding the utilization of this plant for cosmetic purposes by using these active compounds.

The consumption of soft drinks has increased considerably in recent decades, mainly cola soft drinks. Excessive consumption of cola-based soft drinks is associated with several diseases and cognitive decline, particularly memory impairment. Furthermore, diets with high sugar can promote insulin resistance, metabolic syndrome, and dyslipidemia.Thus, the present study aimed to evaluate the effect of cola soft drink intake on behavioral alterations and oxidative damage in 2-, 8- and 14- month-old male Wistar rats.The soft drink groups drank soft drink and/or water ad libitum during 67 days, the control groups ingested only water. Radial-arm maze and Y-maze were used to evaluate spatial memory, open-field to evaluate the habituation memory, and inhibitory avoidance to evaluate aversive memory. The behavioral tests started at the day 57 and finished at day 67 of treatment. At 68th day, the rats were killed; frontal cortex and hippocampus were dissected to the analysis of antioxidants enzymes catalase (CAT) and superoxide dismutase (SOD); and the oxidative markers thiobarbituric acid reactive substances (TBARS) and dichloro-dihydro-fluorescein diacetate (DCFH) were measured in the hippocampus.The cola-based soft drink intake caused memory impairment in the radial-arm maze, Y-maze task, and open-field in the 2- and 8-month-old rat, but not in the 14-month-old. There were no difference among groups in the inhibitory avoidance test. In the frontal cortex, soft drink intake reduced CAT activity in the 8-month-old rats and SOD activity in the 8- and 14-month-old rats. In the hippocampus, the soft drink increased CAT activity in 2- and 8-month-old rats, increased DCFH levels at all ages, and increased TBARS levels in 2-month-rats. Therefore, the results show that long-term soft drink intake leads to memory impairment and oxidative stress. The younger seems to be more susceptible to the soft drink alterations on behavior; however, soft drink caused alterations in the oxidative system at all ages evaluated.

Resumen Objetivo Comparar las caracteristicas de la prostatitis aguda (PA) en los pacientes ancianos ≥ 75 anos con los Material y metodos Estudio descriptivo observacional y prospectivo de los pacientes con PA atendidos de forma consecutiva durante un ano en el SU de un hospital terciario. Se incluyen los datos relativos a la comorbilidad, episodios previos, clinica, microbiologia, tratamiento, evolucion a 30 dias y se comparan los pacientes en funcion de la edad. Resultados Se han incluido 241 episodios de PA con una edad media de 62,9 ± 16 anos y 64 (26,5%) con ≥ 75 anos. Fueron positivos 104 de los 215 (48,4%) urocultivos y 25 de los 136 (18,4%) hemocultivos. El aislamiento mas frecuente fue Escherichia coli con resistencias en los pacientes ancianos > 30% para ciprofloxacino, amoxicilina-clavulanico y cotrimoxazol, y 15,4% de cepas productoras de beta-lactamasas de espectro extendido. En el analisis univariante la manipulacion de la via urinaria, los antecedentes de cancer, la antibioterapia previa, la insuficiencia renal, la proporcion de cepas de E. coli resistentes y el ingreso hospitalario resultaron mas frecuentes en los pacientes ≥ 75 anos. A pesar de ello, unicamente el tratamiento antibiotico inadecuado resulto significativamente mas frecuente en los pacientes ancianos en el analisis multivariante (p = 0,004). Conclusiones Al establecer el tratamiento empirico inicial de la PA en el SU, especialmente en los pacientes ancianos, es importante tener en cuenta el patron de resistencias a los antibioticos de uso mas frecuente.

Aims To investigate potential age, period and birth cohort effects in the prevalence of suicide ideation in European ageing population. Methods A total of 50 782 community-dwelling adults (aged + 50) from 20 different European countries were collected in the Survey Health Ageing and Retirement study. A multilevel logistic regression model of repeated measures was modelled to assess the effects of age and other variables, including the variability of observations over three levels: birth cohort groups, time period assessment and individual differences. Results The larger effect of variability was attributed to individual-level factors (57.8%). Youngest-old people (65-79 years) showed lower suicide ideation than middle-Aged people (50-64 years). No significative differences were found for suicide ideation between middle-Aged people and oldest-old (80 + years). Only 0.85% and 0.13% of the total variability of suicide ideation accounted for birth cohort and period effects, respectively. Cohorts born between 1941 and 1944 possessed the lowest estimates of suicide ideation. Conversely, suicide ideation started to rise with post-War generations and reached a significant level for people born from 1953-1957 to 1961-1964. Regarding the time period, participants assessed in 2006-2007 showed a lower likelihood of suicide ideation. The rest of the cohorts and period groups did not show any significant effect on the prevalence of suicide ideation. Conclusions Our results suggest that age and suicide ideation relationship is not linear in middle and older age. The European Baby boomers born from 50s to mid-60s might report higher suicide ideation than their ancestors. This scenario would imply a greater need for mental healthcare services for older people in the future., This work was supported by the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project which was funded by the European Union’s Horizon 2020 (No. 635316). The present work also received support from the Instituto Carlos III-FIS (project PI16/ 00218) and by The European Union Regional Development Fund (ERDF) ‘A Way to Build Europe’ (project PI16/00218). The first four Waves of the SHARE study have been mainly funded by the European Commission by the 5th framework programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life)), the 6th framework programme (projects SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5-CT-2005-028857, and SHARE-LIFE (CIT4-CT-2006-028812)) and by the 7th framework programme, projects SHARE-PREP (No 211909), SHARE-LEAP (No 227822) and M4 (No 261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged (see www.share-project.org).

Introduction Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. Objective Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes following hospitalization. Setting and subjects Data came from the Sarcopenia 9+ EAMA Project, a European prospective multi-centre study. For this study, 227 hospitalised older people were included from four different hospitals in Belgium, Spain and Poland, between 18 February 2019 and 5 September 2020. Methods Sarcopenia status at admission and discharge were calculated using a combined score (desirability value) based on muscle mass (calf circumference), strength (grip) and function (walking speed). Ratio of admission to discharge status was the outcome (desirability ratio; 1.00 meaning no difference). Predictor variable was the pre-admission care dependency level, classified into three groups: independent older people living at home, dependent older people living at home and older people living in a care home. Linear regression models were applied, considering potential confounders. Results Mean desirability ratio for dependent older people living at home (‘middle dependent group’) was lower (0.89) compared to independent older people (0.98; regression coefficient −0.09 [95% CI −0.16, −0.02]) and care home patients (1.05; −0.16 [95% CI −0.01, −0.31]). Adjusting for potential confounders or using another statistical approach did not affect the main results. Conclusion Dependent older people living at home were at higher risk of deterioration in sarcopenia status following hospitalization. In-depth studies investigating causes and potential interventions of these findings are needed.

In this review several characteristics of the aging process are described and some theories that try to explain it are briefly mentioned. Although none of them fully explains this phenomenon, they can interact between each other in a complex way, out of which cellular senescence is the common outcome. Molecular changes take place on both genetic and epigenetic levels, and several studies have associated senescence with changes in the epigenetic-mediated chromatin condensation, while others consider that free radicals represent a useful mechanism to explain aging and age-related disorders that, along with the alteration of mitochondrial homeostasis, promote the aging process through the accumulation of damage along time.En esta revisión se describen varias características del proceso de envejecimiento y de manera resumida algunas de las teorías que intentan explicarlo y, si bien ninguna es totalmente satisfactoria, pueden actuar entre sí de una manera compleja; en ellas, la senescencia celular es el factor común. Las alteraciones moleculares se llevan a cabo tanto a nivel genético como epigenético y varios estudios asocian la senescencia con cambios en la condensación de la cromatina, los cuales están regulados por factores epigenéticos y otros; en esos estudios se considera que los radicales libres representan un mecanismo útil para explicar el envejecimiento y los trastornos relacionados con la edad y que en forma conjunta, con las alteraciones en la homeostasis de la mitocondria, promueven el envejecimiento por daño acumulado a través del tiempo.

The hippocampus is central for higher cognition and emotions. In patients suffering from neuropsychiatric or neurodegenerative diseases, hippocampal signaling is altered causing cognitive defects. Thus, therapeutic approaches aim at improving cognition by targeting the hippocampus. Enhanced physical activity (EPA) improves cognition in rodents and humans. A systematic screen, however, for expression changes in the hippocampus along the dorso-ventral axis is missing, which is a prerequisite for understanding molecular mechanisms. Here, we exploited label free mass spectrometry to detect proteomic changes in the hippocampus of male mice upon voluntary wheel running. To identify regional differences, we examined dorsal and ventral CA1, CA3 and dentate gyrus hippocampal subregions. We found metabolic enzymes and actin binding proteins, such as RhoA, being upregulated in the hippocampus upon EPA suggesting a coordination between metabolism and cytoskeleton remodeling, two pathways essential for synaptic plasticity. Strikingly, dorsal and ventral hippocampal subregions respond differentially to EPA. Together, our results provide new insight into proteomic adaptations driven by physical activity in mice. In addition, our results suggest that dorsal and ventral hippocampus, as well as hippocampal subregions themselves, contribute differently to this process. Our study therefore provides an important resource for studying hippocampal subregion diversity in response to EPA.

Summary Introduction Malnutrition and nutrition-related diseases are associated with hospital admissions, disability, institutionalization, and mortality in older people. Specialists in Geriatric Medicine and nutrition evaluate nutritional status as part of the comprehensive geriatric assessment; however, malnutrition still remains under-recognized and under-managed. Our survey explored nutrition assessment approaches used in daily clinical practice by geriatricians across Europe. Methods A 19-item survey on methods and instruments for malnutrition assessment in geriatric settings, and details of any national guidelines, was sent to 40 postgraduate fellows of the European Academy of Medicine of Aging (EAMA, 2017–2019 class). Results Thirty-six of the 40 eligible EAMA participants, representing 14 European countries, responded. In clinical practice, MNA and MNA-SF were most frequently used for screening (44.1%, 52.9%, respectively) and diagnosing (45.7%, 40.0%) malnutrition. Weight loss (n = 36, 100%), body mass index (n = 30, 85.7%), and low energy/food intake (n = 27, 77.1%) were the most frequent clinical variables considered. The absolute and relative amount of weight loss, and over what time period, varied widely. These routinely considered clinical factors contribute to validated GLIM, ASPEN-AND and ESPEN criteria for diagnosis of malnutrition, but these criteria were seldom used (GLIM = 0%, ASPEN = 0%; n = 9, ESPEN = 25.7%). National guidelines were available in 9 of the 14 countries, and generally recommended MNA and MNA-SF for community-dwelling and hospitalized older patients. Albumin was often suggested as a nutritional marker. Conclusions Nutritional assessment is systematically performed in geriatrics; but differs widely among geriatricians and countries. Harmonizing guidelines with the new international consensus might provide best-evidence care for older people across Europe.

The recently developed non-equilibrium self-consistent generalized Langevin equation theory of the dynamics of liquids of non-spherically interacting particles [2016 J. Phys. Chem. B 120 7975] is applied to the description of the irreversible relaxation of a thermally and mechanically quenched dipolar fluid. Specifically, we consider a dipolar hard-sphere liquid quenched (at t w = 0) from full equilibrium conditions towards different ergodic–non-ergodic transitions. Qualitatively different scenarios are predicted by the theory for the time evolution of the system after the quench (t w > 0), that depend on both the kind of transition approached and the specific features of the protocol of preparation. Each of these scenarios is characterized by the kinetics displayed by a set of structural correlations, and also by the development of two characteristic times describing the relaxation of the translational and rotational dynamics, allowing us to highlight the crossover from equilibration to aging in the system and leading to the prediction of different underlying mechanisms and relaxation laws for the dynamics at each of the glass transitions explored.

The telomere protects against genomic instability by minimizing the accelerated end resection of the genetic material, a phenomenon that results in severe chromosome instability that could favor the transformation of a cell by enabling the emergence of tumor-promoting mutations. Some mechanisms that avoid this fate, such as capping and loop formation, have been very well characterized; however, telomeric non-coding transcripts, such as long non-coding RNAs (lncRNAs), should also be considered in this context because they play roles in the organization of telomere dynamics, involving processes such as replication, degradation, extension, and heterochromatin stabilization. Although the mechanism through which the expression of telomeric transcripts regulates telomere dynamics is not yet clear, a non-coding RNA component opens the research options in telomere biology and the impact that it can have on telomere-associated diseases such as cancer.

Senescence is an irreversible process by which cells enter to a permanent cell cycle arrest with generalized molecular changes. Senescent cells remain metabolically active and most of them show a secretory phenotype; through its secretion may induce senescence or cancer in other cells. The secretory cells in the so-called transient senescence may participate in embryogenesis, tissue regeneration and immune response. The deleterious changes associated with age affect the immune system members and the immune senescence cause poor response to vaccines and susceptibility to cancer and infections. These latter are a frequent cause of asthma mostly in the elderly, the incidence is increasing in old people, and it may be related with those anatomical, physiological and immune changes caused by age, asthma chronicity and external agents. Comorbidity in the elderly worsens the ailment and hinders diagnosis, therefore, knowledge and handling of these clinical entities must be in control by the physicians responsible of the first level attention to old patients.La senescencia, proceso por el cual la célula entra en un estado de parálisis per-manente del ciclo celular, implica cambios moleculares generalizados. Las células senescentes permanecen metabólicamente activas y la mayoría expresa el fenotipo secretor; mediante su secreción inciden en otras células y pueden inducir senes-cencia o cáncer. Por el contrario, en la llamada senescencia transitoria, las células secretoras pueden participar en la embriogénesis, la regeneración tisular y la res-puesta inmune normal. Los cambios deletéreos asociados con la edad afectan a los integrantes del sistema inmune y la inmunosenescencia ocasiona pobre respuesta a vacunas y susceptibilidad a cáncer e infecciones. Estas últimas son causa fre-cuente de asma, sobre todo en ancianos, en quienes al parecer su incidencia va en aumento, lo que puede estar en relación con los cambios anatómicos, fisiológicos e inmunes ocasionados por la edad, la cronicidad del asma y los factores externos. La comorbilidad en los ancianos agrava el padecimiento y dificulta el diagnóstico, por lo que el conocimiento y manejo de estas entidades clínicas, deben ser del do-minio de los médicos responsables de la atención primaria de los adultos mayores.

Objectives To assess the association between cognitive reserve (CR) and quality of life (QoL), as well as the role of depression, cognitive functioning, and disability in this association. Methods Nationally-representative cross-sectional population-based data on 1973 individuals aged ≥ 50 years from the Spanish sample of the Collaborative Research on Ageing in Europe (COURAGE) study were analysed. CR was a composite score ranging from 0 to 25 obtained from the Cognitive Reserve Questionnaire, which is composed of items on training courses, occupation, musical training, languages, reading activities, intellectual games, and level of education of the participants and their parents. QoL, ranging from 0 to 100, was assessed with the WHOQOL-AGE. Multiple linear regression and mediation analyses were performed. Results Higher levels of CR were associated with higher QoL, after controlling for potential confounders (Coef. 0.53; 95% CI = 0.36, 0.70). The strongest mediator in this association was disability, which explained about half of the association, while depression and cognition explained 6–10% of this association. Discussion CR is associated with higher QoL in older adults. Interventions targeting determinants of CR that can be modified or trained across the lifespan may lead to successful ageing by prolonging autonomous functioning and enhancing QoL.

Staufen2 (Stau2) is an RNA-binding protein that is involved in dendritic spine morphogenesis and function. Several studies have recently investigated the role of Stau2 in the regulation of its neuronal target mRNAs, with particular focus on the hippocampus. Here, we provide evidence for Stau2 expression and function in cerebellar Purkinje cells. We show that Stau2 downregulation (Stau2GT) led to an increase of glutamate receptor ionotropic delta subunit 2 (GluD2) in Purkinje cells when animals performed physical activity by voluntary wheel running compared with the age-matched wildtype (WT) mice (C57Bl/6J). Furthermore, Stau2GT mice showed lower performance in motor coordination assays but enhanced motor learning abilities than did WT mice, concomitantly with an increase in dendritic GluD2 expression. Together, our results suggest the novel role of Stau2 in Purkinje cell synaptogenesis in the mouse cerebellum.

Diabetes mellitus and angina pectoris are important conditions in older persons. The utility of pre-diabetes mellitus, diabetes mellitus and other risk factors as predictors of incident angina pectoris among older adults has not been characterized. We examined incident angina pectoris rates by sex and diabetes mellitus status in 4511 adults aged ⩾65 years without coronary heart disease at baseline from the Cardiovascular Health Study. Cox regression examined predictors of incident angina pectoris, including pre-diabetes mellitus or diabetes mellitus adjusted for sociodemographic characteristics and other risk factors, over 12.2 ± 6.9 years of follow-up. Overall, 39.1% of participants had pre-diabetes mellitus, 14.0% had diabetes mellitus and 532 (11.8%) had incident angina pectoris. Incident angina pectoris rates per 1000 person-years in those with neither condition, pre-diabetes mellitus, and diabetes mellitus were 7.9, 9.0 and 12.3 in women and 10.3, 11.2 and 14.5 in men, respectively. Pre-diabetes mellitus and diabetes mellitus were not independently associated with incident AP; however, key predictors of AP were male sex, low-density lipoprotein-cholesterol, triglycerides, systolic blood pressure, antihypertensive medication and difficulty performing at least one instrumental activity of daily living (all p

Objective:Successful aging (SA) refers to maintaining well-being in old age. Several definitions or models of SA exist (biomedical, psychosocial, and mixed). We examined the longitudinal association between various SA models and sociodemographic factors, and analyzed the patterns of change within these models. Method: This was a nationally representative follow-up in Spain including 3,625 individuals aged ≥50 years. Some 1,970 individuals were interviewed after 3 years. Linear regression models were used to analyze the survey data. Results: Age, sex, and occupation predicted SA in the biomedical model, while marital status, educational level, and urbanicity predicted SA in the psychosocial model. The remaining models included different sets of these predictors as significant. In the psychosocial model, individuals tended to improve over time but this was not the case in the biomedical model. Conclusion: The biomedical and psychosocial components of SA need to be addressed specifically to achieve the best aging trajectories.

To determine whether the effect of multimorbidity on time to mortality is modified by level of social support and loneliness in a representative sample of 2113 participants aged 60+.Vital status was ascertained through national registers or by asking participants' relatives. Baseline variables included number of illnesses, self-perceived social support (Oslo social support scale) and loneliness (UCLA loneliness scale). Kaplan-Meier survival curves were used to estimate the time to death by multimorbidity, social support and loneliness. Adjusted cox proportional hazards regression models were conducted to explore interactions between multimorbidity and social support and loneliness.Multimorbidity was associated with low probability of survival, whereas high loneliness and low social support were not related with time to death. Only the interaction multimorbidity∗social support was significant. Participants with low social support and 2 chronic diseases, compared with none, presented lower probability of survival (HR=2.43, 95%CI=1.14-5.18, p0.05), whereas the effect of multimorbidity, in comparison with not having chronic conditions, did not affect mortality if participants had high social support. For participants with low social support, there were no differences between having one, two or more than two diseases. When there is high social support, the probability of death is significantly lower if one or two chronic diseases are present, compared with more than two.These findings indicate that having a supportive social environment increases the survival of people with physical illnesses, especially those with one or two. For those with more than two illnesses, survival remains unchanged regardless of the level of social support and other protective factors should be explored in future research. Geriatric health professionals are encouraged to evaluate social relationships and stimulate support given by relatives, friends or neighbors.

This study (1) analyzes the differences between non-participating and participating older women in terms of clinical characteristics, pain coping strategies, health-related quality of life and physical activity (PA), (2) studies the associations between non-participants and participants, clinical characteristics, pain coping strategies, HRQoL and bodily pain and PA, and (3) determines whether catastrophizing, physical role, behavioural coping, social functioning and emotional role are significant mediators in the link between participating in a Pilates-aerobic program (or not) and bodily pain. The sample comprised 340 older women over 60 years old. Participants of the present cross-sectional study completed measures of clinical characteristics: HRQoL using the SF-36 Health Survey, pain-coping strategies using the Vanderbilt Pain Management Inventory (VPMI) and PA using the International Physical Activity Questionnaire (IPAQ). Significant differences between non-participants and participants, were found in clinical characteristics, pain-coping strategies (both, p &lt, 0.05), HRQoL (p &lt, 0.01), and PA (p &lt, 0.001). Moreover, catastrophizing support mediated the link between non-participants and participants and bodily pain by 95.9% of the total effect, 42.9% was mediated by PA and 39.6% was mediated by behavioural coping. These results contribute to a better understanding of the link between PA and bodily pain.

Birth weight (BW) has been shown to be influenced by both fetal and maternal factors and in observational studies is reproducibly associated with future risk of adult metabolic diseases including type 2 diabetes (T2D) and cardiovascular disease. These life-course associations have often been attributed to the impact of an adverse early life environment. Here, we performed a multi-ancestry genome-wide association study (GWAS) meta-analysis of BW in 153,781 individuals, identifying 60 loci where fetal genotype was associated with BW (P&thinsp

PURPOSE: Loneliness and depression are associated, in particular in older adults. Less is known about the role of social networks in this relationship. The present study analyzes the influence of social networks in the relationship between loneliness and depression in the older adult population in Spain. METHODS: A population-representative sample of 3535 adults aged 50 years and over from Spain was analyzed. Loneliness was assessed by means of the three-item UCLA Loneliness Scale. Social network characteristics were measured using the Berkman-Syme Social Network Index. Major depression in the previous 12 months was assessed with the Composite International Diagnostic Interview (CIDI). Logistic regression models were used to analyze the survey data. RESULTS: Feelings of loneliness were more prevalent in women, those who were younger (50-65), single, separated, divorced or widowed, living in a rural setting, with a lower frequency of social interactions and smaller social network, and with major depression. Among people feeling lonely, those with depression were more frequently married and had a small social network. Among those not feeling lonely, depression was associated with being previously married. In depressed people, feelings of loneliness were associated with having a small social network; while among those without depression, feelings of loneliness were associated with being married. CONCLUSION: The type and size of social networks have a role in the relationship between loneliness and depression. Increasing social interaction may be more beneficial than strategies based on improving maladaptive social cognition in loneliness to reduce the prevalence of depression among Spanish older adults.

Pain catastrophizing is one of the most powerful predictors of poor outcomes in youth and adults with pain; however, little is known about differential effects of pain catastrophizing on outcomes as a function of age. The current study examined the predictive value of pain catastrophizing on pain interference and pain intensity across children, adolescents, and 2 age groups of young adults with chronic pain. Cross-sectional data are presented from the adult and pediatric Collaborative Health Outcomes Information Registry (CHOIR), including measures of pain catastrophizing, pain intensity, pain interference, and emotional distress from 1,028 individuals with chronic pain. Results revealed that age moderated the relation between pain catastrophizing and pain interference, with the strength of these effects declining with age. The effect of pain catastrophizing on pain interference was strongest in adolescents and relatively weak in all 3 other groups. Emotional distress was the strongest predictor of pain interference for children, whereas pain intensity was the strongest predictor for both adult groups. Pain catastrophizing was found to predict pain intensity and, although age was a significant moderator, statistical findings were weak. Developmental considerations and clinical implications regarding the utility of the construct of pain catastrophizing across age groups are discussed. Perspective This article explores differences in pain catastrophizing as predictors of pain interference and pain intensity across cohorts of children, adolescents, and 2 age groups of young adults. This work may stimulate further research on chronic pain from a developmental perceptive and inform developmentally tailored treatment interventions that target catastrophizing, emotional distress, and pain intensity.

Heart rate variability (HRV) analysis is an established method to characterize the autonomic regulation and is based mostly on 24h Holter recordings. The importance of short-term HRV (less than 30 min) for various applications is growing consistently. Major reasons for this are the suitability for ambulatory care and patient monitoring and the ability to provide an almost immediate test result. So far, there have been only a few studies that provided statistically relevant reference values for short-term HRV. In our study, 5 min short-term HRV indices were determined from 1906 healthy subjects. From these records, linear and nonlinear indices were extracted. To determine general age-related influences, HRV indices were compared from subjects aged 25-49 years with subjects aged 50-74 years. In a second approach, we examined the development of HRV indices by age in terms of age decades (25-34, 35-44, 45-54, 55-64 and 65-74 years). Our results showed significant variations of HRV indices by age in almost all domains. While marked dynamics in terms of parameter change (variability reduction) were observed in the first age decades, in particular the last two age decades showed certain constancy with respect to the HRV indices examined.

The impact of dietary patterns rather than single foods or nutrients on health outcomes is increasingly recognized. This cross-sectional study examines the dietary patterns of 527 non-institutionalized functionally independent older people aged ≥70 years from Gipuzkoa (Spain). Sociodemographic characteristics, health status, anthropometric measures and dietary data are collected. Multiple correspondence analysis (MCA) and cluster analysis are performed to identify dietary patterns and groups of individuals. Frequency of selected food items and compliance with food recommendations are included in the MCA. A high proportion of the sample population are overweight or obese, whereas only 3.3% are at risk of malnutrition (determined with the Mini Nutritional Assessment). Frail individuals (n = 130), measured with the Timed-Up and Go test are older, have a lower educational level, are more obese, present a poorer health status (more depressive symptoms, polypharmacy and falls, among others) and worse compliance with food recommendations than robust individuals (n = 392). Three groups of individuals are identified: cluster one (n = 285), cluster two (n = 194) and cluster three (n = 48). A gradient of increasing frailty and poorer health status is observed from cluster one to cluster three. The latter also shows the poorest dietary pattern, regarding dietary recommendations. The use of an easy-to-use tool to assess diet allows detection of differences among the three clusters. There is a need to increase awareness on the implementation of nutritional screening and a subsequent dietary assessment in primary care settings to provide nutritional care to elder, and moreover, frail individuals.

Aims: Testing the effect of the experimental robot-based therapeutic sessions for patients with dementia in: a controlled study of parallel groups of nursing home patients comparing the effects of therapy sessions utilizing a humanoid robot (NAO), an animal-shaped robot (PARO), or a trained dog (DOG), with conventional therapy (CONTROL) on symptoms of dementia; and an experience for patients who attend a day care center, comparing symptom prevalence and severity before and after sessions utilizing NAO and PARO. Methods: In the nursing home, patients were randomly assigned by blocks, based on dementia severity, to one of the 3 therapeutic groups to compare: CONTROL, PARO and NAO (phase 1) and CONTROL, PARO and DOG (phase 2). In the day care center, all patients received therapy with NAO (phase 1) and PARO (phase 2). Therapy sessions were held 2 days/week for 3 months. Evaluation at baseline and follow-up was carried out by blind raters using: the Global Deterioration Scale (GDS), the Severe Mini Mental State Examination (sMMSE), the Mini Mental State Examination (MMSE), the Neuropsychiatric Inventory (NPI), the Apathy Scale for Institutionalized Patients with Dementia Nursing Home version (APADEM-NH), the Apathy Inventory (AI) and the Quality of Life Scale (QUALID). Statistical analysis included descriptive statistics and non parametric tests performed by a blinded investigator. Results: In the nursing home, 101 patients (phase 1) and 110 patients (phase 2) were included. There were no significant differences at baseline. The relevant changes at follow-up were: (phase 1) patients in the robot groups showed an improvement in apathy; patients in NAO group showed a decline in cognition as measured by the MMSE scores, but not the sMMSE; the robot groups showed no significant changes between them; (phase 2) QUALID scores increased in the PARO group. In the day care center, 20 patients (phase 1) and 17 patients (phase 2) were included. The main findings were: (phase 1) imp