Suchergebnisse

This study analyzes the incidence of falls for older adults who transitioned from institutions to the community through the Connecticut Money Follows the Person demonstration program, identifying intrinsic and extrinsic fall risk factors for this population. This prospective cohort study analyzed data from 648 Money Follows the Person participants aged 65 years and older, using 6- and 12-month posttransition surveys. Of the 648 participants, 161 (25.2%) fell in the first 6 months after transition, while 156 (24.5%) fell between 6 and 12 months after transition. Unmet medical care needs, depressive symptoms, mistreatment, and previous falls significantly predicted falls. Given the vulnerability of this population and increased use of fall-related health services, fall prevention represents a critical element in posttransition care. Beyond previously identified risk factors, care providers should consider issues such as unmet medical care needs, depressive symptoms, and mistreatment in assessing fall risk.

Abstract

Background
Biomarkers for sarcopenia are lacking. We examined the diagnostic power of serum creatinine to cystatin C ratio for identifying low magnetic resonance imaging-muscle volume and low grip strength in a large observational study of UK Biobank older adults.


Methods
Serum creatinine and cystatin C were measured via immunoassays (Beckman Coulter AU5800 and Siemens Advia 1800, respectively) and grip strength by hydraulic hand dynamometer at baseline visit (2008–2010). magnetic resonance imaging-thigh fat-free muscle volume and DXA-derived appendicular lean mass were measured at imaging visit (2014–2018). Extreme outliers were removed, and covariates (demographic, lifestyle, and clinical factors, as well as time elapsed between baseline-imaging visit) were adjusted for in statistical models.


Results
12 873 older adults (mean age: 63.5 ± 2.7 years, 44.2% women) were included for fat-free muscle volume and appendicular lean mass/body mass index; 149 707 older adults (mean age: 64.0 ± 2.9 years, 50.5% women) for grip strength. Despite significant associations (p < .05), in fully adjusted models, creatinine to cystatin C showed poor to acceptable diagnostic power for identifying low fat-free muscle volume when using cutpoints of 20th percentile (area under the curve: 0.577 men; 0.622 women) and T scores of −2 (area under the curve: 0.596 men; 0.659 women) and −2.5 (area under the curve: 0.609 men; 0.722 women). In fully adjusted model, creatinine to cystatin C showed poor diagnostic power (area under the curves: <0.70) for identifying low appendicular lean mass/body mass index or low grip strength, irrespective of the cutpoint used.


Conclusions
Creatinine to cystatin C may not be a suitable biomarker for identifying low muscle volume or low strength in older adults. This finding, drawn from a large sample size and the use of advanced medical imaging, marks an important contribution to the sarcopenia field.

AbstractBackgroundLower urinary tract syndrome (LUTS) is a group of urinary tract symptoms and signs that can include urinary incontinence. Advancing age is a major risk factor for LUTS; however, the underlying biochemical mechanisms of age-related LUTS remain unknown. Hypoxanthine (HX) is a purine metabolite associated with generation of tissue-damaging reactive oxygen species (ROS). This study tested the hypothesis that exposure of the adult bladder to HX–ROS over time damages key LUT elements, mimicking qualitatively some of the changes observed with aging.MethodsAdult 3-month-old female Fischer 344 rats were treated with vehicle or HX (10 mg/kg/day; 3 weeks) administered in drinking water. Targeted purine metabolomics and molecular approaches were used to assess purine metabolites and biomarkers for oxidative stress and cellular damage. Biomechanical approaches assessed LUT structure and measurements of LUT function (using custom-metabolic cages and cystometry) were also employed.ResultsHX exposure increased biomarkers indicative of oxidative stress, pathophysiological ROS production, and depletion of cellular energy with declines in NAD+ levels. Moreover, HX treatment caused bladder remodeling and decreased the intercontraction interval and leak point pressure (surrogate measure to assess stress urinary incontinence).ConclusionsThese studies provide evidence that in adult rats chronic exposure to HX causes changes in voiding behavior and in bladder structure resembling alterations observed with aging. These results suggest that increased levels of uro-damaging HX were associated with ROS/oxidative stress-associated cellular damage, which may be central to age-associated development of LUTS, opening up potential opportunities for geroscience-guided interventions.

Abstract
The inaugural Canadian Conferences on Translational Geroscience were held as 2 complementary sessions in October and November 2023. The conferences explored the profound interplay between the biology of aging, social determinants of health, the potential societal impact of geroscience, and the maintenance of health in aging individuals. Although topics such as cellular senescence, molecular and genetic determinants of aging, and prevention of chronic disease were addressed, the conferences went on to emphasize practical applications for enhancing older people's quality of life. This article summarizes the proceeding and underscores the synergy between clinical and fundamental studies. Future directions highlight national and global collaborations and the crucial integration of early-career investigators. This work charts a course for a national framework for continued innovation and advancement in translational geroscience in Canada.