Search

Maryam Pourhassan,1 Hans Konrad Biesalski,2 Bjoern Angersbach,1 Gero Lueg,1 Christiane Klimek,1 Rainer Wirth1 1Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany; 2Institute of Biological Chemistry and Nutritional Science, University of Hohenheim, Stuttgart, Germany Purpose: Despite some reports of high prevalence of thiamine deficiency in elderly people, the reported prevalence is controversial mainly due to the methods used in assessing thiamin concentrations. In this study, we sought to investigate the prevalence of vitamin B1 deficiency, using the high-performance liquid chromatography (HPLC) method, among older hospitalized patients.Patients and methods: This cross-sectional study retrospectively analyzed the results of routine measurements of vitamin B1 of 238 older patients who were consecutively hospitalized to a geriatric acute care ward. Whole blood vitamin B1 concentrations were measured using the HPLC method at hospital admission, and the whole blood vitamin B1 level of <20 ng/mL was considered as deficiency.Results: Of 238 patients, with a mean age of 82.1±7.1 years, 63% of patients were women. In total, the mean whole blood vitamin B1 level was 66.1±24.8 ng/mL (range 29.5–215 ng/mL), indicating no vitamin B1 deficiency in the entire population. In addition, no significant differences in the mean whole blood vitamin B1 concentrations between sexes were observed (P=0.356).Conclusion: This study indicates that the mean whole blood vitamin B1 concentrations using the HPLC method were within the normal range in older hospitalized patients suggesting that thiamine deficiency appears to be rather uncommon among these patients. Keywords: vitamin B1, thiamine deficiency, older people

High animal and plant richness in tropical rainforest communities has long intrigued naturalists. It is unknown if similar hyperdiversity patterns are reflected at the microbial scale with unicellular eukaryotes (protists). Here we show, using environmental metabarcoding of soil samples and a phylogeny-aware cleaning step, that protist communities in Neotropical rainforests are hyperdiverse and dominated by the parasitic Apicomplexa, which infect arthropods and other animals. These host-specific parasites potentially contribute to the high animal diversity in the forests by reducing population growth in a density-dependent manner. By contrast, too few operational taxonomic units (OTUs) of Oomycota were found to broadly drive high tropical tree diversity in a host-specific manner under the Janzen-Connell model. Extremely high OTU diversity and high heterogeneity between samples within the same forests suggest that protists, not arthropods, are the most diverse eukaryotes in tropical rainforests. Our data show that protists play a large role in tropical terrestrial ecosystems long viewed as being dominated by macroorganisms.

Objectives. Anemia and malnutrition are risk factors for frailty in older people but data from multicenter studies among German geriatric inpatients are lacking. This analysis evaluated data from the multicenter study GerAnaemie2013 commissioned by the German Geriatric Society. Patients and methods. The study involved an analysis of the 579 geriatric inpatients recruited in the context of the German multicenter study GeriAnaemie2013. Study parameters: Barthel index (BI), handgrip strength, nutritional data (e.g. loss of appetite, loss of weight and decreased food intake). Inclusion criteria: in-patient age >= 70 years, exclusion criteria: current cancer disease or cancer-associated treatment. Anemia was defined according to the World Health Organization (WHO) criteria. Results. The mean age of patients was 81.9 years, overall prevalence of anemia 55.1 %, mean hemoglobin (Hb) level 11.9 g/dl, average BI 50.8 points and 30.3 % of all patients were at risk of malnutrition. While univariate analysis revealed a significantly lower BI in anemic patients, this association was no longer seen in multivariate analysis. Regression analysis revealed that a drug intake of > 5 drugs/day doubles the chance of suffering from anemia with an adjusted odds ratio (OR) of 2.17 (confidence interval (CI) 1.28-3.68, p = 0.004) as well as a serum albumin level below 3.5 g/dl with an adjusted OR of 2.11 (range 1.40-3.19, p < 0.001). Conclusion. Polymedication and low serum albumin were independent risk factors for anemia in geriatric patients, probably reflecting disease severity.

Objectives: Objective of this study was to analyse the association between impairment of Barthel Index items and hematologic parameters in geriatric inpatients. Methods: Patient recruitment of the GeriPravalenz2013 study has been described before. Inclusion criteria: in-patient aged >= 70 years; exclusion criteria: actual cancer disease or cancer associated treatment. Anemia was defined according to WHO criteria. Physical impairment was assessed by Barthel Index (BI). Association between all 10 items of the BI and hematologic parameters was statistically evaluated. Results: Anemia prevalence was 55.1% (319/579) with BI impairment in 96.2% patients. T-test revealed significant lower BI in anemic patients (47.9 vs 54.3; p = 0.004). Binary logistic regression revealed that growing age, reduced MCV, reduced iron levels and reduced Hb levels were associated with increased impairment of several items of the Barthel-Index. Interestingly, increased levels of albumin and folic acid (FA) were associated with increased impairment of BI items. Conclusion: Anemia and lower levels of anemia related parameters showed a negative impact on ADL and physical performance based on BI items. An impaired total BI should result in an analysis of BI subitems, particularly if anemia related laboratory parameters are deviant. Reasons for the negative impact of elevated FA and albumin levels on BI remain speculative. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Rainer Wirth,1,2 Rainer Dziewas,3 Anne Marie Beck,4 Pere Clavé,5 Shaheen Hamdy,6 Hans Juergen Heppner,7,8 Susan Langmore,9 Andreas Herbert Leischker,10 Rosemary Martino,11 Petra Pluschinski,12 Alexander Rösler,13 Reza Shaker,14 Tobias Warnecke,3 Cornel Christian Sieber,2,15 Dorothee Volkert2 1Department for Internal Medicine and Geriatrics, St Marien-Hospital Borken, Borken, Germany; 2Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany; 3Department of Neurology, University Hospital Münster, Münster, Germany; 4Department of Nutrition and Health, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark; 5Centro de Investigación Biomédica en Red de enfermadades Hepáticas y Digestivas (CIBERehd), Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain; 6Centre for Gastrointestinal Sciences, Institute of Inflammation and Repair, University of Manchester, Salford Royal Hospital, Salford, UK; 7Department of Geriatrics, Witten- Herdecke University, 8Helios Clinic Schwelm, Schwelm, Germany; 9Department of Speech, Language and Hearing Sciences, Boston University School of Medicine, Boston, MA, USA; 10Department of Geriatrics, Alexianer Hospital Krefeld, Krefeld, Germany; 11Department of Speech-Language Pathology, University of Toronto, Toronto, Canada; 12Department of Phoniatrics and Pediatric Audiology, University of Marburg, Marburg, Germany; 13Department of Geriatrics, Marien Hospital Hamburg, Hamburg, Germany; 14Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA; 15Department of General Internal Medicine and Geriatrics, St John of God Hospital Regensburg, Regensburg, Germany Abstract: Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very