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1. Development of Continuous Assessment of Muscle Quality and Frailty in Older Patients Using Multiparametric Combinations of Ultrasound and Blood Biomarkers: Protocol for the ECOFRAIL Study

Author

Naiara Virto, Xabier Río, Garazi Angulo-Garay, Rafael García Molina, Almudena Avendaño Céspedes, Elisa Belen Cortés Zamora, Elena Gómez Jiménez, Ruben Alcantud Córcoles, Leocadio Rodriguez Mañas, Alba Costa-Grille, Ander Matheu, Diego Marcos-Pérez, Uxue Lazcano, Itziar Vergara, Laura Arjona, Morelva Saeteros, Diego Lopez-de-Ipiña, Aitor Coca, Pedro Abizanda Soler, and Sergio J Sanabria

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundFrailty resulting from the loss of muscle quality can potentially be delayed through early detection and physical exercise interventions. There is a demand for cost-effective tools for the objective evaluation of muscle quality, in both cross-sectional and longitudinal assessments. Literature suggests that quantitative analysis of ultrasound data captures morphometric, compositional, and microstructural muscle properties, while biological assays derived from blood samples are associated with functional information. ObjectiveThis study aims to assess multiparametric combinations of ultrasound and blood-based biomarkers to offer a cross-sectional evaluation of the patient frailty phenotype and to track changes in muscle quality associated with supervised exercise programs. MethodsThis prospective observational multicenter study will include patients aged 70 years and older who are capable of providing informed consent. We aim to recruit 100 patients from hospital environments and 100 from primary care facilities. Each patient will undergo at least two examinations (baseline and follow-up), totaling a minimum of 400 examinations. In hospital environments, 50 patients will be measured before/after a 16-week individualized and supervised exercise program, while another 50 patients will be followed up after the same period without intervention. Primary care patients will undergo a 1-year follow-up evaluation. The primary objective is to compare cross-sectional evaluations of physical performance, functional capacity, body composition, and derived scales of sarcopenia and frailty with biomarker combinations obtained from muscle ultrasound and blood-based assays. We will analyze ultrasound raw data obtained with a point-of-care device, along with a set of biomarkers previously associated with frailty, using quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Additionally, we will examine the sensitivity of these biomarkers to detect short-term muscle quality changes and functional improvement after a supervised exercise intervention compared with usual care. ResultsAt the time of manuscript submission, the enrollment of volunteers is ongoing. Recruitment started on March 1, 2022, and ends on June 30, 2024. ConclusionsThe outlined study protocol will integrate portable technologies, using quantitative muscle ultrasound and blood biomarkers, to facilitate an objective cross-sectional assessment of muscle quality in both hospital and primary care settings. The primary objective is to generate data that can be used to explore associations between biomarker combinations and the cross-sectional clinical assessment of frailty and sarcopenia. Additionally, the study aims to investigate musculoskeletal changes following multicomponent physical exercise programs. Trial RegistrationClinicalTrials.gov NCT05294757; https://clinicaltrials.gov/ct2/show/NCT05294757 International Registered Report Identifier (IRRID)DERR1-10.2196/50325

Published
2024
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2. Relative sit-to-stand power cut-off points and their association with negatives outcomes in older adults

Author

Ivan Baltasar-Fernandez, Julian Alcazar, Asier Mañas, Luis M. Alegre, Ana Alfaro-Acha, Leocadio Rodriguez-Mañas, Ignacio Ara, Francisco J. García-García, and Jose Losa-Reyna

Subjects
Medicine, Science
Abstract

Abstract The purposes of this study were: (i) to evaluate the association of sit-to-stand (STS) power and body composition parameters [body mass index (BMI) and legs skeletal muscle index (SMI)] with age; (ii) to provide cut-off points for low relative STS power (STSrel), (iii) to provide normative data for well-functioning older adults and (iv) to assess the association of low STSrel with negative outcomes. Cross-sectional design (1369 older adults). STS power parameters assessed by validated equations, BMI and Legs SMI assessed by dual-energy X-ray absorptiometry were recorded. Sex- and age-adjusted segmented and logistic regression analyses and receiver operator characteristic curves were used. Among men, STSrel showed a negative association with age up to the age of 85 years (− 1.2 to − 1.4%year−1; p

Published
2021
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3. Frailty is associated with objectively assessed sedentary behaviour patterns in older adults: Evidence from the Toledo Study for Healthy Aging (TSHA).

Author

Borja Del Pozo-Cruz, Asier Mañas, María Martín-García, Jorge Marín-Puyalto, Francisco J García-García, Leocadio Rodriguez-Mañas, Amelia Guadalupe-Grau, and Ignacio Ara

Subjects
Medicine, Science
Abstract

The aim of this study was to examine the association of sedentary behaviour patterns with frailty in older people.Clinical setting.Cross-sectional, observational study.A triaxial accelerometer was used in a subsample from the Toledo Study for Healthy Aging (519 participants, 67-97 years) to assess several sedentary behaviour patterns including sedentary time per day, the number and duration (min) of breaks in sedentary time per day, and the proportion of the day spent in sedentary bouts of 10 minutes or more. Frailty was assessed using the Frailty Trait Scale (FTS). Regression analysis was used to ascertain the associations between sedentary behaviour patterns and frailty.Sedentary time per day and the proportion of the day spent in sedentary bouts of 10 minutes or more, were positively associated with frailty in the study sample. Conversely, the time spent in breaks in sedentary time was negatively associated with frailty.In summary, breaking up sedentary time and time spent in sedentary behaviour are associated with frailty in older people.

Published
2017
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4. Sex differences in the association between serum levels of testosterone and frailty in an elderly population: the Toledo Study for Healthy Aging.

Author

Laure Carcaillon, Carmen Blanco, Cristina Alonso-Bouzón, Ana Alfaro-Acha, Francisco-José Garcia-García, and Leocadio Rodriguez-Mañas

Subjects
Medicine, Science
Abstract

BACKGROUND: Age-associated decline in testosterone levels represent one of the potential mechanisms involved in the development of frailty. Although this association has been widely reported in older men, very few data are available in women. We studied the association between testosterone and frailty in women and assessed sex differences in this relationship. METHODS: We used cross-sectional data from the Toledo Study for Healthy Aging, a population-based cohort study of Spanish elderly. Frailty was defined according to Fried's approach. Multivariate odds-ratios (OR) and 95% confidence intervals (CI) associated with total (TT) and free testosterone (FT) levels were estimated using polytomous logistic regression. RESULTS: In women, there was a U-shaped relationship between FT levels and frailty (p for FT(2) = 0.03). In addition, very low levels of FT were observed in women with ≥ 4 frailty criteria (age-adjusted geometric means = 0.13 versus 0.37 in subjects with

Published
2012
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5. Urinary tract infections in the elderly: a review of disease characteristics and current treatment options

Author

Leocadio Rodriguez-Mañas

Subjects
0301 basic medicine, medicine.medical_specialty, Medical device, Urinary system, 030106 microbiology, Review, elderly patients, urologic and male genital diseases, Placebo, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, 030212 general & internal medicine, Pharmacology, medical device, business.industry, Hibiscus sabdariffa, lcsh:RM1-950, non-antimicrobial treatment, General Medicine, Immunosenescence, bacterial infections and mycoses, Antimicrobial, female genital diseases and pregnancy complications, lcsh:Therapeutics. Pharmacology, Molecular Medicine, Observational study, urinary tract infections, business
Abstract

Urinary tract infections (UTIs) are common in the elderly, and cover a range of conditions from asymptomatic bacteriuria to urosepsis. Risk factors for developing symptomatic UTIs include immunosenescence, exposure to nosocomial pathogens, multiple comorbidities, and a history of UTIs. European guidelines on urological infections recommend antimicrobial treatment only for symptomatic UTIs. Non-antimicrobial options to treat and prevent UTIs include among others cranberry products, OM-89 Escherichia coli bacterial lysate vaccine, and estrogen therapy in postmenopausal women, although evidence for their efficacy is weak. Another non-antimicrobial option to control and prevent UTIs is a medical device (Utipro Plus®) containing xyloglucan, gelatin, propolis, and extracts of Hibiscus sabdariffa. The device acts in the intestine as a mechanical barrier to protect against invasion by uropathogenic E. coli strains. A randomized controlled trial of Utipro Plus® in patients with uncomplicated UTIs provided good-quality evidence of its efficacy compared with placebo. In an observational study of Utipro Plus® in patients with recurrent UTIs, more than 80% women reported a return to their pre-UTI clinical status and about 30% transitioned from symptomatic UTIs to asymptomatic bacteriuria. New treatment strategies that offer a safe and effective non-antimicrobial means of managing UTIs could have an important role in the elderly.

Published
2020
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6. Factors associated with poor balance ability in older adults of nine high-altitude communities

Author

Leocadio Rodriguez-Mañas, Diego Urrunaga-Pastor, José F. Parodi, Enrique Moncada-Mapelli, Zaira Bailón-Valdez, Fernando M. Runzer-Colmenares, and Rafael Samper-Ternent

Subjects
Male, Aging, Health (social science), Alcohol Drinking, Cross-sectional study, Psychological intervention, Comorbidity, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Peru, medicine, Postural Balance, Humans, 030212 general & internal medicine, Poisson regression, Fatigue, Aged, Balance (ability), Aged, 80 and over, business.industry, Altitude, Middle Aged, medicine.disease, Confidence interval, Walking Speed, Preferred walking speed, Cross-Sectional Studies, symbols, Accidental Falls, Female, Geriatrics and Gerontology, business, Gerontology, 030217 neurology & neurosurgery, Demography
Abstract

Introduction Poor balance ability in older adults result in multiple complications. Poor balance ability has not been studied among older adults living at high altitudes. In this study, we analysed factors associated with poor balance ability by using the Functional Reach (FR) among older adults living in nine high-altitude communities. Material and methods Analytical cross-sectional study, carried out in inhabitants aged 60 or over from nine high-altitude Andean communities of Peru during 2013–2016. FR was divided according to the cut-off point of 8 inches (20.32 cm) and two groups were generated: poor balance ability (FR less or equal than 20.32 cm) and good balance ability (greater than 20.32 cm). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor balance ability. Prevalence ratio (PR) with 95% confidence intervals (95CI%) are presented. Results A total of 365 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60–91 years), and 180 (49.3%) participants had poor balance ability. In the adjusted Poisson regression analysis, the factors associated with poor balance ability were: alcohol consumption (PR = 1.35; 95%CI: 1.05–1.73), exhaustion (PR = 2.22; 95%CI: 1.49–3.31), gait speed (PR = 0.67; 95%CI: 0.50–0.90), having had at least one fall in the last year (PR = 2.03; 95%CI: 1.19–3.46), having at least one comorbidity (PR = 1.60; 95%CI: 1.10–2.35) and having two or more comorbidities (PR = 1.61; 95%CI: 1.07–2.42) compared to none. Conclusions Approximately a half of the older adults from these high-altitude communities had poor balance ability. Interventions need to be designed to target these balance issues and prevent adverse events from concurring to these individuals.

Published
2018
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7. A Therapeutic Insole Device for Postural Stability in Older People With Type 2 Diabetes. A Feasibility Study (SENSOLE Part I)

Author

Sophie C. Regueme, Charles Cowtan, Mohamed Y. Sedgelmaci, Mark Kelson, Joël Poustis, Leocadio Rodriguez-Mañas, Alan J. Sinclair, Benjamin Dallaudière, and Isabelle Bourdel-Marchasson

Subjects
030506 rehabilitation, medicine.medical_specialty, Diabetic neuropathy, Side effect, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Sensation, medicine, Postural Balance, Lead (electronics), postural balance, Balance (ability), lcsh:R5-920, business.industry, Work (physics), General Medicine, medicine.disease, Gait, Clinical Trial, vibrating insole, 3. Good health, type 2, diabetes mellitus, Medicine, neuropathy, lcsh:Medicine (General), 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract

The application of a stochastic mechanical noise has been shown to improve plantar touch sensitivity in patients with diabetic neuropathy and balance control. The present work aimed to test the feasibility of a specially designed vibrating device on gait and posture in older patients with type 2 diabetes with special interest on potential side effect (sensation of needles or tingling, dizziness or falls) before further investigations. For this, gait and balance tests were performed in 29 older out and in-patients (mean age 84 years, Barthel index ≥ 60/100) immediately before and after a 19 min plantar vibrating sequence, as well as 15 min after. These tests included posturographic measurements under eyes closed and static conditions and clinical gait tests (Short Physical Performance Battery and Timed-Up and Go tests). The results showed that no side effect was measured immediately, 15 min and up to 30 days after the vibration sequence. Besides, postural and clinical gait tests showed global positive effects at immediate and 15 min follow-up. Further investigation are now necessary to determine whether a daily stimulation sequence for a given time would lead to long-term positive effects on daily living (NCT01654341; https://clinicaltrials.gov/ct2/show/NCT01654341).

Published
2019

8. FRAILTOOLS study protocol : a comprehensive validation of frailty assessment tools to screen and diagnose frailty in different clinical and social settings and to provide instruments for integrated care in older adults

Author

Marta Checa-López, Myriam Oviedo-Briones, Armando Pardo-Gómez, Jimmy Gonzales-Turín, Tania Guevara-Guevara, José Antonio Carnicero, Shirley Alamo-Ascencio, Francesco Landi, Matteo Cesari, Tomasz Grodzicki, Leocadio Rodriguez-Mañas, and on behalf of FRAILTOOLS consortium

Subjects
Male, Gerontology, Health Services for the Aged, Frail Elderly, medicine.medical_treatment, lcsh:Geriatrics, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Ambulatory Care, Humans, Medicine, Outpatient clinic, Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Geriatric Assessment, Aged, Aged, 80 and over, Protocol (science), Rehabilitation, Primary Health Care, Frailty, Delivery of Health Care, Integrated, business.industry, Reproducibility of Results, medicine.disease, Comorbidity, Nursing Homes, Integrated care, Assessment tools, lcsh:RC952-954.6, Sample size determination, FRAILTOOLS project, Older adults, Accidental Falls, Female, Observational study, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Dozens of scales and questionnaires have been used in the detection of frailty; however, a generalized method for its screening and diagnosis is still lacking in clinical settings. FRAILTOOLS´ main objective is to evaluate the usefulness of frailty scales in the detection of frailty in different clinical and social settings, and its integration in management algorithms for the frail older patient. FRAILTOOLS is an observational, longitudinal and prospective study with a follow-up of 6, 12 and 18 months. People older than 75 years old will be recruited from three separate clinical settings (acute geriatric wards, geriatric outpatient clinics and primary care) and one social setting (nursing homes). Exclusion criteria include Mini-mental State Examination

Published
2019

9. The Concept of Frailty and Functional Decline

Author

María Ángeles Caballero Mora and Leocadio Rodriguez Mañas

Subjects
Gerontology, 03 medical and health sciences, 0302 clinical medicine, 030502 gerontology, business.industry, Stressor, Vulnerability, Medicine, 030212 general & internal medicine, Functional decline, 0305 other medical science, business
Abstract

Frailty is a condition characterized by a high vulnerability to low-power stressors affecting around 10% of people older than 65 years.

Published
2018
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10. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others

Author

Katarzyna Szczerbińska, Tischa J. M. van der Cammen, Joost G. Daams, Tahir Masud, Hubert Blain, Lotta Seppälä, Patrik Eklund, Jean Bousquet, Heinrich W. Thaler, Kimberley J. Ploegmakers, Lotta J. Seppala, Marielle H. Emmelot-Vonk, Rose Anne Kenny, Maria Angeles Caballero-Mora, Francesco Landi, Olle Svensson, Sirpa Hartikainen, Yngve Gustafson, Esther M.M. van de Glind, Lucie Laflamme, Mirko Petrovic, Anne M.A.T. Wermelink, Leocadio Rodriguez, Max de Vries, Nathalie van der Velde, Gösta Bucht, Irene O'Byrne-Maguire, APH - Aging & Later Life, Other departments, Graduate School, Geriatrics, AMS - Amsterdam Movement Sciences, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Male, medicine.medical_specialty, Population, MEDLINE, Nursing(all), Poison control, Risk Assessment, law.invention, antiepileptic, 03 medical and health sciences, Benzodiazepines, 0302 clinical medicine, Sex Factors, Randomized controlled trial, law, Internal medicine, Medicine, Humans, medication classification system, 030212 general & internal medicine, polypharmacy, education, General Nursing, Aged, Netherlands, Polypharmacy, Aged, 80 and over, education.field_of_study, Psychotropic Drugs, business.industry, Health Policy, Incidence, Age Factors, General Medicine, Odds ratio, Middle Aged, Confidence interval, Antidepressive Agents, Analgesics, Opioid, Meta-analysis, opioid, Accidental Falls, Female, Public Health, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract

Background and objective The use of psychotropic medication and cardiovascular medication has been associated with an increased risk of falling. However, other frequently prescribed medication classes are still under debate as potential risk factors for falls in the older population. The aim of this systematic review and meta-analysis is to evaluate the associations between fall risk and nonpsychotropic and noncardiovascular medications. Methods and design A systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase. Key search concepts were “falls,” “aged,” “medication,” and “causality.” Studies were included that investigated nonpsychotropic and noncardiovascular medications as risk factors for falls in participants ≥60 years or participants with a mean age ≥70 years. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratio (OR) estimates separately. Results In a qualitative synthesis, 281 studies were included. The results of meta-analysis using adjusted data were as follows (a pooled OR [95% confidence interval]): analgesics, 1.42 (0.91-2.23); nonsteroidal anti-inflammatory drugs (NSAIDs), 1.09 (0.96-1.23); opioids, 1.60 (1.35-1.91); anti-Parkinson drugs, 1.54 (0.99-2.39); antiepileptics, 1.55 (1.25-1.92); and polypharmacy, 1.75 (1.27-2.41). Most of the meta-analyses resulted in substantial heterogeneity that did not disappear after stratification for population and setting in most cases. In a descriptive synthesis, consistent associations with falls were observed for long-term proton pump inhibitor use and opioid initiation. Laxatives showed inconsistent associations with falls (7/20 studies showing a positive association). Conclusion Opioid and antiepileptic use and polypharmacy were significantly associated with increased risk of falling in the meta-analyses. Long-term use of proton pump inhibitors and opioid initiation might increase the fall risk. Future research is necessary because the causal role of some medication classes as fall-risk-increasing drugs remains unclear, and the existing literature contains significant limitations.

Published
2017

12. Secondary Prevention of Cancer in the Older Individual

Author

Miguel Manzano García, Pablo L. Ortiz Romero, Lodovico Balducci, Manuel Ramirez Orellana, Alfredo Carrato, Leocadio Rodriguez Mañas, and María Vallet Regí

Subjects
Gerontology, Biologic marker, education.field_of_study, medicine.medical_specialty, business.industry, Colorectal cancer, Population, Cancer, medicine.disease, Química inorgánica, Surgery, Cancer screening, Life expectancy, Risk of mortality, Medicine, education, business, Preventive healthcare
Abstract

The incidence and the mortality of cancer increase with age. This article explores the possibility of decreasing cancerrelated mortality in the aged with secondary prevention of cancer deaths that entails early diagnosis of cancer through the screening of asymptomatic older individuals. We establish that screening of asymptomatic individuals should be based on physiologic rather than chronologic age that may be estimated from a comprehensive geriatric assessment and possibly with the utilization of biologic markers of aging. It is reasonable to offer some form of screening for lung and colorectal cancer to individuals with a life expectancy of at least five years and screening for breast and prostate cancer to women and men respectively with a life expectancy of at least ten years. The ideal number of screening sessions and the ideal interval between screening sessions is unestablished. The aging of the population, the diversity of the older population, the development of new and more sensitive screening interventions, the discovery of new biologic markers of cancer and age represent the main challenges in studying the value of cancer screening in the aged. Probably the most reliable information may be obtained from rapid-learning databases in which information related to each person's physiologic age is included. Worldwide, the incidence and prevalence of cancer increase with age [1]. In the meantime the risk of cancer-related mortality increases with age at diagnosis [2-4]. As the world population is aging, cancer in the older person is an ever more common problem, and the reduction of cancer deaths in older individuals represents the most urgent goal of cancer control. In this article we explore secondary cancer prevention as representing a strategy to reduce the risk of mortality in the aged.This hypothesis is based on four considerations: i. Several studies showed that the practice of screening asymptomatic individuals for cancer becomes less common with the aging of the population [5]. ii. The average life expectancy of the Western population is rapidly increasing1. Consequently the benefits of early detection of cancer that emerges several years after diagnosis may be present even for those undergoing screening at an advanced age. iii. New forms of cancer treatment, including minimally invasive surgery [6], stereotactic radio surgery [7], and targeted systemic therapy [8], are associated with decreased risk of complications. They may be safely utilized in individuals with limited tolerance of stress who might be hurt by more aggressive treatments. It is now possible to personalize cancer screening according to individual life expectancy and tolerance of stress, as the estimate of a person's physiologic age is becoming more precise [1,9]. After reviewing the principles and the effectiveness of cancer screening and early detection, this article will explore the benefits and risks of secondary cancer prevention in older individuals. In particular we will review the current evidence and the limitations of previous clinical trials. At the end we will propose a conceptual framework to guide the screening of older individuals for cancer, and we will propose a research agenda.

Published
2017

13. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs

Author

Tischa J. M. van der Cammen, Irene O'Byrne-Maguire, Joost G. Daams, Max de Vries, Olle Svensson, Maria Angeles Caballero-Mora, Katarzyna Szczerbińska, Hubert Blain, Patrik Eklund, Sirpa Hartikainen, Gösta Bucht, Mirko Petrovic, Francesco Landi, Lotta J. Seppala, Lotta Seppälä, Tahir Masud, Heinrich W. Thaler, Rose Anne Kenny, Lucie Laflamme, Yngve Gustafson, Leocadio Rodriguez, Esther M.M. van de Glind, Marielle H. Emmelot-Vonk, Nathalie van der Velde, Jean Bousquet, APH - Aging & Later Life, Other departments, Geriatrics, AMS - Amsterdam Movement Sciences, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Male, Drug, medicine.medical_specialty, media_common.quotation_subject, Population, Nursing(all), MEDLINE, PsycINFO, Risk Assessment, statins, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Internal medicine, Prevalence, Humans, Medicine, 030212 general & internal medicine, Risk factor, education, General Nursing, Netherlands, Aged, media_common, Aged, 80 and over, education.field_of_study, business.industry, Health Policy, Age Factors, Cardiovascular Agents, digoxin, General Medicine, Odds ratio, Middle Aged, United Kingdom, diuretics, Confidence interval, cardiovascular medication, Meta-analysis, Female, accidental falls, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract

Background and objective Use of certain medications is recognized as a major and modifiable risk factor for falls. Although the literature on psychotropic drugs is compelling, the literature on cardiovascular drugs as potential fall-risk-increasing drugs is conflicting. The aim of this systematic review and meta-analysis is to provide a comprehensive overview of the associations between cardiovascular medications and fall risk in older adults. Methods Design: A systematic review and meta-analysis. Data sources: Medline, Embase, and PsycINFO. Key search concepts were “fall,” “aged,” “causality,” and “medication.” Studies that investigated cardiovascular medications as risk factors for falls in participants ≥60 years old or participants with a mean age of 70 or older were included. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratios (ORs) separately. Results In total, 131 studies were included in the qualitative synthesis. Meta-analysis using adjusted ORs showed significant results (pooled OR [95% confidence interval]) for loop diuretics, OR 1.36 (1.17, 1.57), and beta-blocking agents, OR 0.88 (0.80, 0.97). Meta-analysis using unadjusted ORs showed significant results for digitalis, OR 1.60 (1.08, 2.36); digoxin, OR 2.06 (1.56, 2.74); and statins, OR 0.80 (0.65, 0.98). Most of the meta-analyses resulted in substantial heterogeneity that mostly did not disappear after stratification for population and setting. In a descriptive synthesis, consistent associations were not observed. Conclusion Loop diuretics were significantly associated with increased fall risk, whereas beta-blockers were significantly associated with decreased fall risk. Digitalis and digoxin may increase the risk of falling, and statins may reduce it. For the majority of cardiovascular medication groups, outcomes were inconsistent. Furthermore, recent studies indicate that specific drug properties, such as selectivity of beta-blockers, may affect fall risk, and drug-disease interaction also may play a role. Thus, studies addressing these issues are warranted to obtain a better understanding of drug-related falls.

Published
2018
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14. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics

Author

Joost G. Daams, Nathalie van der Velde, Kimberley J. Ploegmakers, Lucie Laflamme, Jean Bousquet, Katarzyna Szczerbińska, Gösta Bucht, Tischa J. M. van der Cammen, Leocadio Rodriguez, Rose Anne Kenny, Max de Vries, Olle Svensson, Irene O'Byrne-Maguire, Hubert Blain, Mirko Petrovic, Anne M.A.T. Wermelink, Lotta Seppälä, Sirpa Hartikainen, Yngve Gustafson, Esther M.M. van de Glind, Lotta J. Seppala, Maria Angeles Caballero-Mora, Marielle H. Emmelot-Vonk, Tahir Masud, Heinrich W. Thaler, Patrik Eklund, Francesco Landi, APH - Aging & Later Life, Graduate School, Other departments, Geriatrics, AMS - Amsterdam Movement Sciences, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Male, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Population, Nursing(all), Poison control, Falls in older adults, Risk Assessment, 03 medical and health sciences, Benzodiazepines, 0302 clinical medicine, Sex Factors, Internal medicine, Prevalence, Medicine, Humans, 030212 general & internal medicine, Antipsychotic, education, Geriatric Assessment, General Nursing, Accidental falls, Aged, Netherlands, Aged, 80 and over, Benzodiazepine, education.field_of_study, Psychotropic Drugs, psychotropic: antidepressant, business.industry, Health Policy, Age Factors, General Medicine, Odds ratio, Middle Aged, Confidence interval, Antidepressive Agents, antipsychotic, psychotropic: antidepressant, benzodiazepine, Meta-analysis, Female, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Antipsychotic Agents
Abstract

Background and objective Falls are a major public health problem in older adults. Earlier studies showed that psychotropic medication use increases the risk of falls. The aim of this study is to update the current knowledge by providing a comprehensive systematic review and meta-analysis on psychotropic medication use and falls in older adults. Methods and design This study is a systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase. Key search concepts were “falls,” “aged,” “medication,” and “causality.” Studies were included that investigated psychotropics (antipsychotics, antidepressants, anxiolytics, sedatives, and hypnotics) as risk factors for falls in participants ≥60 years of age or participants with a mean age of ≥70 years. Meta-analyses were performed using generic inverse variance method pooling unadjusted and adjusted odds ratio (OR) estimates separately. Results In total, 248 studies met the inclusion criteria for qualitative synthesis. Meta-analyses using adjusted data showed the following pooled ORs: antipsychotics 1.54 [95% confidence interval (CI) 1.28–1.85], antidepressants 1.57 (95% Cl 1.43–1.74), tricyclic antidepressants 1.41 (95% CI 1.07–1.86), selective serotonin reuptake inhibitors 2.02 (95% CI 1.85–2.20), benzodiazepines 1.42 (95%, CI 1.22–1.65), long-acting benzodiazepines 1.81 (95%, CI 1.05–3.16), and short-acting benzodiazepines 1.27 (95%, CI 1.04–1.56) Most of the meta-analyses resulted in substantial heterogeneity that did not disappear after stratification for population and healthcare setting. Conclusions Antipsychotics, antidepressants, and benzodiazepines are consistently associated with a higher risk of falls. It is unclear whether specific subgroups such as short-acting benzodiazepines and selective serotonin reuptake inhibitors are safer in terms of fall risk. Prescription bias could not be accounted for. Future studies need to address pharmacologic subgroups as fall risk may differ depending on specific medication properties. Precise and uniform classification of target medication (Anatomical Therapeutic Chemical Classification) is essential for valid comparisons between studies.

Published
2018
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15. Laboratory biomarkers and frailty: presentation of the FRAILOMIC initiative

Author

Giuseppe Lippi, Pidder Jansen-Duerr, Jose Viña, Anna Durrance-Bagale, Imad Abugessaisa, David Gomez-Cabrero, Jesper Tegnér, Johannes Grillari, Jorge Erusalimsky, Alan Sinclair, Leocadio Rodriguez-Manãs, and null on behalf of the FRAILOMIC consorti

Subjects
Gerontology, business.industry, Frail Elderly, media_common.quotation_subject, Biochemistry (medical), Clinical Biochemistry, Medical laboratory, Laboratory, biomarkers, frailty, Geriatric assessment, frailty, General Medicine, medicine.disease, Laboratory, Presentation, Sarcopenia, Humans, Medicine, Frail elderly, business, Geriatric Assessment, Biomarkers, Aged, media_common
Abstract

This article was published in Clinical Chemistry and Laboratory Medicine on 14 March 2015 (online), available at http://dx.doi.org/10.1515/cclm-2015-0147

Published
2015
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16. Metabolic syndrome across Europe: different clusters of risk factors

Author

Leocadio Rodriguez Mañas, Francesco Mattace Raso, Angelo Scuteri, Edward G. Lakatta, Peter M. Nilsson, Stéphane Laurent, Henry Völzke, James B. Strait, Ernst Rietzschel, Charalambos Vlachopoulos, Francesco Cucca, Pedro Cunha, Maria Lorenza Muiesan, Ligita Ryliškytė, John R. Cockcroft, and Internal Medicine

Subjects
Blood Glucose, Male, Pediatrics, Epidemiology, Blood Pressure, HDL cholesterol, Risk Factors, 80 and over, Prevalence, Cluster Analysis, glucose, triglycerides, Abdominal obesity, Metabolic Syndrome, Aged, 80 and over, education.field_of_study, Metabolic Syndrome X, Age Factors, Middle Aged, waist circumference, Europe, Cholesterol, Cardiovascular Diseases, Obesity, Abdominal, Cohort, Hypertension, epidemiology, Female, Waist Circumference, medicine.symptom, Cardiology and Cardiovascular Medicine, Blood pressure, metabolic syndrome, Adult, Age Distribution, Aged, Biomarkers, Cross-Cultural Comparison, Diabetes Mellitus, Dyslipidemias, Humans, Sex Distribution, Sex Factors, Triglycerides, United States, Young Adult, medicine.medical_specialty, Waist, Population, Article, Diabetes mellitus, medicine, Abdominal, Obesity, education, business.industry, Hypertriglyceridemia, medicine.disease, Metabolic syndrome, business, Demography
Abstract

Background: Metabolic syndrome (MetS) remains a controversial entity. Specific clusters of MetS components - rather than MetS per se - are associated with accelerated arterial ageing and with cardiovascular (CV) events. To investigate whether the distribution of clusters of MetS components differed cross-culturally, we studied 34,821 subjects from 12 cohorts from 10 European countries and one cohort from the USA in the MARE (Metabolic syndrome and Arteries REsearch) Consortium. Methods: In accordance with the ATP III criteria, MetS was defined as an alteration three or more of the following five components: elevated glucose (G), fasting glucose >= 110 mg/dl; low HDL cholesterol, = 150 mg/dl; elevated blood pressure (B), >= 130/ >= 85 mmHg; abdominal obesity (W), waist circumference >102 cm for men or >88 cm for women. Results: MetS had a 24.3% prevalence (8468 subjects: 23.9% in men vs. 24.6% in women, p < 0.001) with an age-associated increase in its prevalence in all the cohorts. The age-adjusted prevalence of the clusters of MetS components previously associated with greater arterial and CV burden differed across countries (p < 0.0001) and in men and women (p < 0.0001). In details, the cluster TBW was observed in 12% of the subjects with MetS, but was far more common in the cohorts from the UK (32.3%), Sardinia in Italy (19.6%), and Germany (18.5%) and less prevalent in the cohorts from Sweden (1.2%), Spain (2.6%), and the USA (2.5%). The cluster GBW accounted for 12.7% of subjects with MetS with higher occurrence in Southern Europe (Italy, Spain, and Portugal: 31.4, 18.4, and 17.1% respectively) and in Belgium (20.4%), than in Northern Europe (Germany, Sweden, and Lithuania: 7.6, 9.4, and 9.6% respectively). Conclusions: The analysis of the distribution of MetS suggested that what follows under the common definition of MetS is not a unique entity rather a constellation of cluster of MetS components, likely selectively risky for CV disease, whose occurrence differs across countries. (Less)

Published
2015

17. Antinociceptive/Anti-Edema Effects of Liposomal Morphine during Acute Inflammation of the Rat Paw

Author

Olga Pol, Silvia Sánchez, Leocadio Rodriguez, Eulalia Planas, and Margarita M. Puig

Subjects
Male, Narcotic Antagonists, Inflammation, Pharmacology, Carrageenan, Rats, Sprague-Dawley, Edema, Animals, Medicine, Pain Measurement, Drug Carriers, Liposome, Morphine, Naloxone, business.industry, General Medicine, Rats, Analgesics, Opioid, Nociception, Anesthesia, Liposomes, medicine.symptom, business, medicine.drug
Abstract

We evaluated the anti-edema/antinociceptive effects of subcutaneous free and liposomal morphine in rats with carrageenan-induced inflammation of the paw. We assessed antinociception by the paw pressure test and edema by plethysmography. Unilamellar liposomes (150–200 nm) with 0.3% morphine hydrochloride were used; encapsulation signifcantly reduced the rate for release of morphine in vitro. During inflammation, the antinociceptive potency of free, but not liposomal morphine increased 2.5 times; moreover, duration of the effects was prolonged by encapsulation (p < 0.001). The anti-edema effects of liposomal morphine were more pronounced (p < 0.001) and of longer duration (p < 0.05). All the effects were reversed by naloxone. The results show that morphine encapsulation enhances the anti-edema effects and prolongs antinociception.

Published
2000
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18. Bisphosphonate-Related Osteonecrosis of the Jaw in an 80-Year-Old Woman with Diabetes Mellitus: Case Report

Author

Leocadio Rodriguez Mañas, Cristina Alonso-Bouzón, and Lizette Valenzuela

Subjects
medicine.medical_specialty, Bisphosphonate-associated osteonecrosis of the jaw, business.industry, medicine.medical_treatment, Treatment outcome, Bisphosphonate, Risk adjustment, medicine.disease, Surgery, Diabetes mellitus, medicine, Geriatrics and Gerontology, Osteonecrosis of the jaw, business
Published
2015
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19. La experiencia europea ADVANTAGE para el manejo de la fragilidad: claves sobre su aplicabilidad en América Latina

Author

Cristina Alonso Bouzón and Leocadio Rodríguez Mañas

Subjects
fragilidad, personas con discapacidad, envejecimiento saludable, dinámica poblacional, prevención de enfermedades, Medicine, Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

La Comisión Europea y 22 de sus Estados Miembros cofinanciaron durante 2017-2019 la primera acción conjunta para abordar la fragilidad en las personas mayores, denominada ADVANTAGE Joint Action. En el marco de esta iniciativa, se definió una estrategia común, basada en la mejor evidencia científica, para posicionar el envejecimiento saludable y la fragilidad como temas prioritarios de salud pública en los países participantes y contribuir así a un abordaje homogéneo de la fragilidad en toda Europa. En este artículo se detalla la metodología del trabajo realizado y los principales logros de ADVANTAGE y se incluye un análisis de las claves que contribuyeron a su éxito. En los tres años de funcionamiento se formaron y desarrollaron potentes redes de trabajo multisectoriales, tanto a nivel nacional como internacional. ADVANTAGE logró marcar rutas prácticas para abordar de manera global la fragilidad y la prevención de la dependencia en 22 países con realidades políticas, económicas, sociales y organizativas muy heterogéneas. ADVANTAGE ha demostrado que acciones de este tipo son factibles y eficaces, y que si se toman en cuenta y aplican los puntos clave de éxito identificados, debidamente ajustados a cada realidad, esta acción puede ser reproducible en cualquier país decidido a promover el envejecimiento saludable de su población, incluidos los de América Latina y el Caribe.

Published
2021
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20. La vejez y la nueva CIE-11: posición de la Academia Latinoamericana de Medicina del Adulto Mayor

Author

Carlos Cano-Gutierrez, Luis Miguel Gutiérrez-Robledo, Roberto Lourenço, Pedro Paulo Marín, Fernando Morales Martínez, José Parodi, Leocadio Rodríguez Mañas, and Clemente Humberto Zúñiga Gil

Subjects
clasificación internacional de enfermedades, envejecimiento, envejecimiento saludable, Medicine, Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

Desde 1948, la Organización Mundial de la Salud ha venido publicando un sistema codificado de causas de enfermedad y muerte bajo el nombre genérico de Clasificación Estadística Internacional de Enfermedades (CIE), con revisiones en profundidad cada 10-15 años. En su última versión, CIE-11, se utiliza una terminología para caracterizar la vejez como “períodos geriátricos inicial y final”, lo que implica una medicalización de esta etapa de la vida que ha generado confusión y polémica. En este trabajo se discute la nueva terminología propuesta a la luz del conocimiento actual en torno a la vejez y el proceso de envejecimiento, y su definición más aceptada. La CIE no solo clasifica las enfermedades sino también los períodos de la vida y los “problemas relacionados con la salud”, y la vejez por sí sola no representa un problema relacionado con la salud para muchos de quienes se encuentran en esta etapa de la vida. Desde esta perspectiva, es imprescindible cambiar o matizar el epígrafe “vejez” de la CIE-11 para que no se perciba como síntoma, signo o resultado clínico anómalo, e introducir términos que reflejen mucho mejor el estado de envejecimiento patológico. Entre los términos que gozan de un creciente soporte experimental y bibliográfico están “fragilidad” y “pérdida de la capacidad intrínseca”, que aportan mucha mayor precisión a la hora de definir la condición de la persona que no goza de un envejecimiento saludable.

Published
2021
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23. The medium-term consequences of a COVID-19 lockdown on lifestyle among Spanish older people with hypertension, pulmonary disease, cardiovascular disease, musculoskeletal disease, depression, and cancer

Author

Irene Rodríguez-Gómez, Coral Sánchez-Martín, Francisco J. García-García, Esther García-Esquinas, Marta Miret, Germán Vicente-Rodriguez, Narcís Gusi, Asier Mañas, José A. Carnicero, Marcela Gonzalez-Gross, José L. Ayuso-Mateos, Fernando Rodríguez-Artalejo, Leocadio Rodríguez-Mañas, and Ignacio Ara

Subjects
chronic diseases, ageing, sedentary time, anxiety, quality of life, Medicine
Abstract

OBJECTIVES This study investigated the associations of chronic diseases with changes in lifestyle and health behaviours in older people following the coronavirus disease 2019 (COVID-19) lockdown in Spain and compared the differences in changes over time. METHODS 1,092 participants (80.3±5.6 years; 66.5% female) from 2 Spanish cohorts were included. Telephone-based questionnaires were conducted to evaluate lifestyle and health risk behaviours at the end of lockdown and 7 months post-lockdown. Participants were classified as having physician-diagnosed chronic diseases based on self-reported data. Cox proportional models adjusted for major confounders were used. RESULTS Compared to those without the corresponding chronic diseases, older people with hypertension were less likely to report increased alcohol consumption (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55 to 0.99). Pulmonary diseases were associated with lower risks of increased sedentary time (HR, 0.58; 95% CI, 0.39 to 0.86) and worsened sleep quality (HR, 0.56; 95% CI, 0.36 to 0.87), while cardiovascular diseases were associated with a lower risk of decreased sedentary time (HR, 0.58; 95% CI, 0.38 to 0.88). Depression was linked to a higher likelihood of improved diet quality (HR, 1.53; 95% CI, 1.00 to 2.36). Cancer pacients were less likely to have worsened sleep quality (HR, 0.44; 95% CI, 0.22 to 0.89) but more likely to have reduced their frequency of social contact (HR, 2.05; 95% CI, 1.05 to 3.99). CONCLUSIONS Older people with chronic diseases showed beneficial changes in lifestyle and health risk behaviours after the COVID-19 lockdown. In particular, older people with hypertension, pulmonary disease, and cancer tended to make beneficial lifestyle and health behaviour changes. However, older people with cardiovascular disease and depression engaged in more health risk behaviours.

Published
2022
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24. Home Monitoring System for Comprehensive Geriatric Assessment in Patient's Dwelling: System Design and UX Evaluation

Author

Elena Villalba-Mora, Xavier Ferre, Rodrigo Pérez-Rodríguez, Cristian Moral, Myriam Valdés-Aragonés, Alberto Sánchez-Sánchez, and Leocadio Rodríguez-Mañas

Subjects
older population, home monitoring, frailty, user experience, usability, acceptability, Medicine, Public aspects of medicine, RA1-1270, Electronic computers. Computer science, QA75.5-76.95
Abstract

Population aging threatens the sustainability of welfare systems since it is not accompanied by an extended healthy and independent period in the last years of life. The Comprehensive Geriatric Assessment (CGA) has been shown to be efficient in maintaining the healthy period at the end of the life. Frailty monitoring is typically carried out for an average period of 6 months in clinical settings, while more regular monitoring could prevent the transition to disability. We present the design process of a system for frailty home monitoring based on an adapted CGA and the rationale behind its User eXperience (UX) design. The resulting home monitoring system consists of two devices based on ultrasound sensors, a weight scale, and a mobile application for managing the devices, administering CGA-related questionnaires, and providing alerts. Older users may encounter barriers in their usage of technology. For this reason, usability and acceptability are critical for health monitoring systems addressed to geriatric patients. In the design of our system, we have followed a user-centered process, involving geriatricians and older frail patients by means of co-creation methods. In the iterative process of design and usability testing, we have identified the most effective way of conducting the home-based CGA, not just by replicating the dialogue between the physician and the patient, but by adapting the design to the possibilities and limitations of mobile health for this segment of users. The usability evaluation, carried out with 14 older adults, has proved the feasibility of users older than 70 effectively using our monitoring system, additionally showing an intention over 80% for using the system. It has also provided some insights and recommendations for the design of mobile health systems for older users.

Published
2021
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25. Prevalence of renal impairment in type 2 diabetes: a primary care-based study

Author

Manuel Gorostidi, Rafael Marín, Salvador Tranche, Jose Abellan, and Leocadio Rodriguez-Mañas

Subjects
medicine.medical_specialty, Proteinuria, business.industry, Primary health care, Type 2 diabetes, Urine, Primary care, medicine.disease, Blood pressure, Internal medicine, Diabetes mellitus, Epidemiology, Internal Medicine, medicine, medicine.symptom, Intensive care medicine, business
Published
2002
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26. Hypertension prevalence and control in type 2 diabetes: a primary care-based study

Author

Manuel Gorostidi, Rafael Marín, Jose Abellan, Salvador Tranche, and Leocadio Rodriguez-Mañas

Subjects
medicine.medical_specialty, Proteinuria, Hypertension control, business.industry, Primary health care, Primary care, Type 2 diabetes, medicine.disease, Urate level, Endocrinology, Diabetes mellitus, Hypertension prevalence, Internal medicine, Internal Medicine, Medicine, medicine.symptom, business
Published
2002
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27. Associations between sedentary time, physical activity and bone health among older people using compositional data analysis.

Author

Irene Rodríguez-Gómez, Asier Mañas, José Losa-Reyna, Leocadio Rodríguez-Mañas, Sebastien F M Chastin, Luis M Alegre, Francisco J García-García, and Ignacio Ara

Subjects
Medicine, Science
Abstract

INTRODUCTION:Aging is associated with a progressive decrease in bone mass (BM), and being physical active is one of the main strategies to combat this continuous loss. Nonetheless, because daily time is limited, time spent on each movement behavior is co-dependent. The aim of this study was to determine the relationship between BM and movement behaviors in elderly people using compositional data analysis. METHODS:We analyzed 871 older people [395 men (76.9±5.3y) and 476 women (76.7±4.7y)]. Time spent in sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA), was assessed using accelerometry. BM was determined by bone densitometry (DXA). The sample was divided according to sex and bone health indicators. RESULTS:The combined effect of all movement behaviors (PA and SB) was significantly associated with whole body, leg and femoral region BM in the whole sample (p≤0.05), with leg and pelvic BM (p

Published
2018
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30. Differential effect of amylin on endothelial-dependent vasodilation in mesenteric arteries from control and insulin resistant rats.

Author

Mariam El Assar, Javier Angulo, Marta Santos-Ruiz, Paola Moreno, Anna Novials, María Luisa Villanueva-Peñacarrillo, and Leocadio Rodríguez-Mañas

Subjects
Medicine, Science
Abstract

Insulin resistance (IR) is frequently associated with endothelial dysfunction and has been proposed to play a major role in cardiovascular disease (CVD). On the other hand, amylin has long been related to IR. However the role of amylin in the vascular dysfunction associated to IR is not well addressed. Therefore, the aim of the study was to assess the effect of acute treatment with amylin on endothelium-dependent vasodilation of isolated mesenteric arteries from control (CR) and insulin resistant (IRR) rats and to evaluate the possible mechanisms involved. Five week-old male Wistar rats received 20% D-fructose dissolved in drinking water for 8 weeks and were compared with age-matched CR. Plasmatic levels of glucose, insulin and amylin were measured. Mesenteric microvessels were dissected and mounted in wire myographs to evaluate endothelium-dependent vasodilation to acetylcholine. IRR displayed a significant increase in plasmatic levels of glucose, insulin and amylin and reduced endothelium-dependent relaxation when compared to CR. Acute treatment of mesenteric arteries with r-amylin (40 pM) deteriorated endothelium-dependent responses in CR. Amylin-induced reduction of endothelial responses was unaffected by the H2O2 scavenger, catalase, but was prevented by the extracellular superoxide scavenger, superoxide dismutase (SOD) or the NADPH oxidase inhibitor (VAS2870). By opposite, amylin failed to further inhibit the impaired relaxation in mesenteric arteries of IRR. SOD, or VAS2870, but not catalase, ameliorated the impairment of endothelium-dependent relaxation in IRR. At concentrations present in insulin resistance conditions, amylin impairs endothelium-dependent vasodilation in mircrovessels from rats with preserved vascular function and low levels of endogenous amylin. In IRR with established endothelial dysfunction and elevated levels of amylin, additional exposure to this peptide has no effect on endothelial vasodilation. Increased superoxide generation through NADPH oxidase activity may be a common link involved in the endothelial dysfunction associated to insulin resistance and to amylin exposure in CR.

Published
2015
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31. Inflammation determines the pro-adhesive properties of high extracellular d-glucose in human endothelial cells in vitro and rat microvessels in vivo.

Author

Verónica Azcutia, May Abu-Taha, Tania Romacho, Marta Vázquez-Bella, Nuria Matesanz, Francis W Luscinskas, Leocadio Rodríguez-Mañas, María Jesús Sanz, Carlos F Sánchez-Ferrer, and Concepción Peiró

Subjects
Medicine, Science
Abstract

BACKGROUND: Hyperglycemia is acknowledged as an independent risk factor for developing diabetes-associated atherosclerosis. At present, most therapeutic approaches are targeted at a tight glycemic control in diabetic patients, although this fails to prevent macrovascular complications of the disease. Indeed, it remains highly controversial whether or not the mere elevation of extracellular D-glucose can directly promote vascular inflammation, which favors early pro-atherosclerotic events. METHODS AND FINDINGS: In the present work, increasing extracellular D-glucose from 5.5 to 22 mmol/L was neither sufficient to induce intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression, analyzed by flow cytometry, nor to promote leukocyte adhesion to human umbilical vein endothelial cells (HUVEC) in vitro, measured by flow chamber assays. Interestingly, the elevation of D-glucose levels potentiated ICAM-1 and VCAM-1 expression and leukocyte adhesion induced by a pro-inflammatory stimulus, such as interleukin (IL)-1beta (5 ng/mL). In HUVEC, high D-glucose augmented the activation of extracellular signal-regulated kinase 1/2 (ERK 1/2) and nuclear transcription factor-kappaB (NF-kappaB) elicited by IL-1beta, measured by Western blot and electromobility shift assay (EMSA), respectively, but had no effect by itself. Both ERK 1/2 and NF-kappaB were necessary for VCAM-1 expression, but not for ICAM-1 expression. In vivo, leukocyte trafficking was evaluated in the rat mesenteric microcirculation by intravital microscopy. In accordance with the in vitro data, the acute intraperitoneal injection of D-glucose increased leukocyte rolling flux, adhesion and migration, but only when IL-1beta was co-administered. CONCLUSIONS: These results indicate that the elevation of extracellular D-glucose levels is not sufficient to promote vascular inflammation, and they highlight the pivotal role of a pro-inflammatory environment in diabetes, as a critical factor conditioning the early pro-atherosclerotic actions of hyperglycemia.

Published
2010
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32. Prevention of Functional Decline by Reframing the Role of Nursing Homes?

Author

Joseph G. Ouslander, Mikel Izquierdo, Philipe de Souto Barreto, Bruno Vellas, Clarisse Laffon de Mazières, Mario Barbagallo, Finbarr C. Martin, John E. Morley, Leocadio Rodríguez Mañas, Graziano Onder, Debra Saliba, Lorenzo M. Donini, Yves Rolland, A. Franco, Rosalie A. Kane, Cari Levy, Kaisu H. Pitkälä, Matteo Cesari, Alan J. Sinclair, Fabien Agenes, Jaime Fitten, Laffon de Mazières, Clarisse, Morley, John E., Levy, Cari, Agenes, Fabien, Barbagallo, Mario, Cesari, Matteo, De Souto Barreto, Philipe, Donini, Lorenzo Maria, Fitten, Jaime, Franco, Alain, Izquierdo, Mikel, Kane, Rosalie A., Martin, Finbarr C., Onder, Graziano, Ouslander, Joseph, Pitkälä, Kaisu, Saliba, Debra, Sinclair, Alan, Manas, Leocadio Rodriguez, Vellas, Bruno, and Rolland, Yves

Subjects
United State, Gerontology, medicine.medical_specialty, Activities of daily living, Institutionalisation, Frail Elderly, Calidad de vida, Gerontología, frailty, 03 medical and health sciences, Medicina preventiva, 0302 clinical medicine, Quality of life (healthcare), prevention, Nursing, Intervention (counseling), Activities of Daily Living, Humans, Medicine, Cognitive Dysfunction, 030212 general & internal medicine, Nursing (all)2901 Nursing (miscellaneous), General Nursing, Health policy, Aged, Geriatrics, Nursing home, business.industry, Medicine (all), Health Policy, Cognition, General Medicine, Cognitive reframing, United States, Nursing Homes, 3. Good health, Geriatría, functional decline, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Human
Abstract

Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of these challenges: how to prevent or slow functional decline and disabilities for NH residents and how NHs may promote the prevention of functional decline in community-dwelling frail elderly. The present article reports the main results of the Task Force discussions to generate a new paradigm. Sin financiación 5.325 JCR (2017) Q1, 4/53 Geriatrics & Gerontology UEM

Published
2017
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33. Operational Definition of Active and Healthy Aging (AHA): The European Innovation Partnership (EIP) on AHA Reference Site Questionnaire: Montpellier October 20-21, 2014, Lisbon July 2, 2015

Author

Karen Ritchie, Daniel Harman, Philippe-Jean Bousquet, Erik Melén, Pierre Senesse, Govert Joan Buijs, Antonio Cano, Claude Jeandel, Timo E. Strandberg, Marieke Van Beurden, Pascal Demoly, G. Moda, Raquel Santiago, Sylvie Arnavielhe, Marie-Eve Joel, Nicola Wilson, Eveline Wouters, Jacques Touchon, Martina O'Neill, Isabelle Momas, Karen Andersen Ranberg, D. Heve, Maddalena Illario, Christina Tischer, Jean Bousquet, Marcel Goldberg, Paola Bertone, Guido Iaccarino, Antoine Avignon, Rodolphe Bourret, Valeria Romano, Laura Calzà, Henriet A. Smit, Mirca Barbolini, David Kula, Jacques-Yves Pelissier, Mario Barbagallo, Bruno Vellas, Ann Scott, C. Robalo-Cordeiro, Gregoire Mercier, Mike Bewick, Bernard Combe, Holger Schulz, Sergio Bonini, P. Viriot-Durandal, Itziar Vergara, M. Nogues, Carol Brayne, João Apóstolo, Jacques Mercier, Vicente Traver-Salcedo, François Puisieux, Julia Coletta, Alessandro Blasimme, Olivier Krys, Niels H. Chavannes, John Farrell, Joël Ankri, Ana Maria Carriazo, Rafaelle Varraso, Marie Zins, Zdenec Gutter, José António Pereira da Silva, Bertrand Fougère, Frédéric Cuisinier, Bolesław Samoliński, Jacques Bringer, Theodore D. Cosco, Jordi Alonso, Ana Todo-Bom, Claudine Berr, Daniel Laune, Esteban De Manuel Keenoy, Judith Garcia-Aymerich, Anna Bedbrook, Anne Hendry, Richard Pengelly, Dagmar Poethig, João O. Malva, Thomas Keil, Sandra N. Slagter, Nick A. Guldemond, Pierre Matignon, Hubert Blain, Leocadio Rodríguez Mañas, Marek L. Kowalski, Susana Fernandez-Nocelo, Alfredo Cesario, Sandra Rebello, Federico Alonso, Catarina R. Oliveira, Dieter Maier, Jean-Pierre Michel, David Somekh, T. Camuzat, Julien Venne, Marc Criton, Jaime Correia de Sousa, Hassan Arshad, Anabella Mota Pinto, Valentina A. Andreeva, François Roubille, Yoav Ben-Shlomo, Asghar Zaidi, Elena Villalba-Mora, Emmanuelle Kesse-Guyot, Dirkje S. Postma, Carel Thijs, Jean-Marie Robine, Danielle Porta, George Crooks, Adrianna Nizinska, Jorge Suanzes, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Bone and Joint Research Group, University of Southampton Medical School, CHU Toulouse [Toulouse], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Department of Social Medicine, University of Bristol [Bristol], Pathologies du système nerveux : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Electrical Engineering, Mathematics and Computer Science [Delft], Delft University of Technology (TU Delft), Unité de Recherche en Epidémiologie Nutritionnelle (UREN), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), F2ME, PSA Peugeot - Citroën (PSA), PSA Peugeot Citroën (PSA)-PSA Peugeot Citroën (PSA)-Laboratoire Pluridisciplinaire de Recherche en Ingénierie des Systèmes, Mécanique et Energétique (PRISME), Université d'Orléans (UO)-Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges)-Université d'Orléans (UO)-Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges), Department of Epidemiology and Public Health, Imperial College London, CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-École des hautes études en sciences sociales (EHESS), Département Ecologie, Physiologie et Ethologie (DEPE-IPHC), Institut Pluridisciplinaire Hubert Curien (IPHC), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS)-Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw - Poland, Department of Epidemiology, Maastricht University [Maastricht]-School for Public Health and Primary Care (CAPHRI), Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Kyomed, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Geriatrics - Efficiency and Deficiency Laboratory, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Consiglio Nazionale delle Ricerche (CNR), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Service d'endocrinologie, Departamento de Sistemas Informáticos y Computación [Valencia], Universitat Politècnica de València (UPV), Deputy Scientific Director, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana, Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Laboratoire de chimie biomoléculaire (LCB), Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-MAYOLI SPINDLER SA-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Bioingénierie et NanoSciences (LBN), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Laboratoire de Gérontechnologie [Hôpital La Grave-CHU de Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Gérontopôle, IMIM-Hospital del Mar, Generalitat de Catalunya, Département de Biostatistiques, Agence Régionale de Santé Languedoc Roussillon (ARS), Department of Medicine and Surgery, Università degli Studi di Salerno (UNISA)-RCCS 'Multimedia', Centre de gérontologie clinique, Institute of Social Medicine, Epidemiology and Health Economics-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Institut de Recherche en Infectiologie de Montpellier (IRIM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institute of Environmental Medicine, Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm]-Astrid Lindgren Children's Hospital, Lab-STICC_TB_CID_TOMS, Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS), Epidémiologie Environnementale : Impact Sanitaire des Pollutions (EA 4064), Université Paris Descartes - Paris 5 (UPD5), Universidad Pública de Navarra [Espagne] = Public University of Navarra (UPNA), Unité de Virologie clinique et fondamentale (UVCF), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Mécanismes adaptatifs : des organismes aux communautés (MAOAC), Muséum national d'Histoire naturelle (MNHN)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Department of Pulmonary Medicine and Tuberculosis, University of Groningen [Groningen], Service de gériatrie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Département de nutrition et d'oncologie digestive, CRLCC Val d'Aurelle - Paul Lamarque, Institute of Epidemiology [Neuherberg] (EPI), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Bousquet, Jean, Malva, Joao, Nogues, Michel, Mañas, Leocadio Rodriguez, Vellas, Bruno, Farrell, J, Bewick, M, Kowalski, Ml, Strandberg, T, Alonso, J, Ranberg, Ka, Ankri, J, Barbagallo, M, Ben Shlomo, Y, Berr, C, Crooks, G, de Manuel Keenoy, E, Goldberg, M, Guldemond, N, Illario, Maddalena, Joel, Me, Kesse Guyot, E, Michel, Jp, Pengelly, R, Ritchie, K, Robine, Jm, Romano, V, Samolinski, B, Schulz, H, Thijs, C, Touchon, J, Zaidi, A, Apostolo, J, Alonso, F, Andreeva, V, Arnavielhe, S, Arshad, H, Avignon, A, Barbolini, M, Bedbrook, A, Bertone, P, Blain, H, Blasimme, A, Bonini, S, Bourret, R, Bousquet, Pj, Brayne, C, Bringer, J, Buijs, Gj, Calza, L, Camuzat, T, Cano, A, Carriazo, A, Cesario, A, Chavannes, N, Combe, B, Coletta, J, de Sousa, Jc, Cosco, T, Criton, M, Cuisinier, F, Demoly, P, Fernandez Nocelo, S, Fougère, B, Garcia Aymerich, J, Gutter, Z, Harman, D, Hendry, A, Hève, D, Iaccarino, G, Jeandel, C, Keil, T, Krys, O, Kula, D, Laune, D, Maier, D, Matignon, P, Melen, E, Mercier, G, Moda, G, Momas, I, Pinto, Am, Nizinska, A, Oliveira, C, O'Neill, M, Pelissier, Jy, Pereira da Silva, Ja, Poethig, D, Porta, D, Postma, D, Puisieux, F, Rebello, S, Robalo Cordeiro, C, Roubille, F, Santiago, R, Scott, A, Senesse, P, Slagter, S, Smit, Ha, Somekh, D, Suanzes, J, Tischer, C, Todo Bom, A, Traver Salcedo, V, Van Beurden, M, Varraso, R, Venne, J, Vergara, I, Villalba Mora, E, Viriot Durandal, P, Wilson, N, Wouters, E, Zins, M, Mercier, J., Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Cité (USPC)-Université Paris 13 (UP13)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut National de la Recherche Agronomique (INRA), Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges)-Université d'Orléans (UO)-Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges)-Université d'Orléans (UO), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Montpellier, Universidad Politécnica de Valencia, Centre National de la Recherche Scientifique (CNRS)-MAYOLI SPINDLER SA-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Université Montpellier 2 - Sciences et Techniques (UM2), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Gérontopôle-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse], University of Salerno (UNISA)-RCCS 'Multimedia', Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin -Epidemiology and Health Economics, Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Universidad Pública de Navarra [Espagne] (UPNA), Unité de Virologie clinique et fondamentale EA 4294, Centre National de la Recherche Scientifique (CNRS)-Collège de France (CdF)-Muséum national d'Histoire naturelle (MNHN), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Bousquet J, Malva J, Nogues M, Mañas LR, Vellas B, Farrell J, MACVIA Research Group [.., L. Calzà, ], Farrell, John, Bonini, Sergio, Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Muséum national d'Histoire naturelle (MNHN)-Collège de France (CdF)-Centre National de la Recherche Scientifique (CNRS), Epidemiologie, RS: CAPHRI School for Public Health and Primary Care, and RS: CAPHRI - R5 - Optimising Patient Care

Subjects
Gerontology, Concept Formation, [SDV]Life Sciences [q-bio], Disability Evaluation, 0302 clinical medicine, SF-12, QUALITY-OF-LIFE, Surveys and Questionnaires, WHODAS 2.0, Medicine, 030212 general & internal medicine, VERSION, POPULATION, PSYCHOLOGICAL DISTRESS, SCALE, General Nursing, Nursing (all)2901 Nursing (miscellaneous), health care economics and organizations, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, education.field_of_study, Operational definition, Medicine (all), Health Policy, PHYSICAL-ACTIVITY QUESTIONNAIRE, PRIMARY-CARE, General Medicine, 3. Good health, Europe, General partnership, Scale (social sciences), Population, SELF-REPORT, VALIDATION, 03 medical and health sciences, Quality of life (healthcare), EQ-5D, Journal Article, Humans, OLDER-ADULTS, education, Geriatric Assessment, Health policy, Aged, business.industry, questionnaire, Active and healthy ageing, United States, Questionnaire, Quality of Life, The Conceptual Framework, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

A core operational definition of active and healthy aging (AHA) is needed to conduct comparisons. A conceptual AHA framework proposed by the European Innovation Partnership on Active and Healthy Ageing Reference Site Network includes several items such as functioning (individual capability and underlying body systems), well-being, activities and participation, and diseases (including non-communicable diseases, frailty, mental and oral health disorders). The instruments proposed to assess the conceptual framework of AHA have common applicability and availability attributes. The approach includes core and optional domains/instruments depending on the needs and the questions. A major common domain is function, as measured by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). WHODAS 2.0 can be used across all diseases and healthy individuals. It covers many of the AHA dimensions proposed by the Reference Site network. However, WHODAS 2.0 does not include all dimensions proposed for AHA assessment. The second common domain is health-related quality of life (HRQoL). A report of the AHA questionnaire in the form of a spider net has been proposed to facilitate usual comparisons across individuals and groups of interest. (C) 2015 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Published
2015
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