Current Aging Science - Volume 15, Issue 3, 2022

Objectives: This review outlines the normal heart rate and blood pressure response to active standing, the physiological mechanisms governing these, and the effect of ageing on the responses. Methods: A literature search was conducted to identify articles investigating the normal heart rate and/or blood pressure response to standing. Results: Heart rate when standing increases and then decreases and recovers to baseline. Blood pressure responses are inverse. Skeletal muscle contraction and the baroreceptor reflex drive this. With ageing, heart rate response attenuates and the initial blood pressure response increases. Discussion: Normal heart rate and blood pressure responses are attributed to the baroreceptor reflex and skeletal muscle contraction. Decreased muscle strength and baroreceptor sensitivity are associated with ageing, suggesting a possible benefit in improving skeletal muscle strength to maintain an efficient response. Understanding these responses and their variation with ageing is clinically relevant and may be beneficial in improving rehabilitation outcomes.

Sarcopenia is a disease characterized by a gradual decline in skeletal muscle mass and strength that accompanies the normal aging process. The disease is associated with various adverse health outcomes in the geriatric population, such as prolonged hospital admission, disability, poor quality of life, frailty, and mortality. Factors involved in the development of age-related sarcopenia include anorexia, hormone level alterations, decreased neural innervation, low muscular blood flow, cytokine dysregulation, altered mitochondrial activity, genomic instability, intracellular proteolysis, and insulin resistance. Understanding the underlying mechanisms may facilitate the development of efficient prophylactic and therapeutic strategies to improve the quality of life in elderly individuals. Thus, the present review highlights literature regarding the mechanism of sarcopenia development in elderly patients.

Oxytocin facilitates reproduction both by physiological and behavioral mechanisms. Oxytocinergic neurons emerging from the hypothalamus release oxytocin from the pituitary gland to the blood by axonal discharge to regulate reproductive organs. However, at the same time, oxytocin is secreted into neighboring areas of the hypothalamus from the dendrites of these neurons. Here, the peptide acts by autocrine and paracrine mechanisms to influence other neuroendocrine systems. Furthermore, oxytocinergic neurons project to many different locations in the brain, where they affect sensory processing, affective functions, and reward. Additional to its regulatory role, significant anti-inflammatory and restoring effects of oxytocin have been reported from many invivo and in-vitro studies. The pervasive property of the oxytocin system may enable it generally to dampen stress reactions both peripherally and centrally, and protect neurons and supportive cells from inadequate inflammation and malfunctioning. Animal experiments have documented the importance of preserving immune- and stem cell functions in the hypothalamus to impede age-related destructive processes of the body. Sexual reward has a profound stimulating impact on the oxytocinergic activity, and the present article therefore presents the hypothesis that frequent sexual activity and gratigying social experiance may postpone the onset of frailty and age-associated diseases by neural protection from the bursts of oxytocin. Furthermore, suggestions are given how the neuroplastic properties of oxytocin may be utilized to enhance sexual reward by learning processes in order to further reinforce the release of this peptide.

Background: The aging population is growing faster than any other age group worldwide. Associated with aging, the prevalence of overweight and obesity is a potential risk factor for the development and aggravation of numerous pathologies. A genetic factor often associated with obesity is the fat mass and obesity-associated (FTO) (rs9939609) gene polymorphism, which has been extensively investigated in children, young, and adults. However, few studies have been carried out on the older population. This review aimed to verify the influence of the FTO (rs9939609) gene polymorphism on the body composition of the older population. Methods: We conducted a systematic review and meta-analysis on PubMed, Scielo, and LILACS databases. Statistical analysis for meta-analysis was performed using mean values of Body Mass Index (BMI) and standard deviations. Results: The results did not show significant differences between FTO genotypes and BMI values (-0.32, 95% CI -0.45 to -0.19, I2 = 0%, p = 0.52). However, 59% of the studies identified some influence on body composition, obesity, or comorbidities. Conclusion: Few publications verify FTO polymorphism effects on specific groups of the older population, suggesting a reduction in the influence of this gene on the BMI with advancing age. However, we believe that more controlled studies in older populations should be performed.

Background: Diet can affect the body's acid-base balance due to its content of acid or base precursors. There is conflicting evidence for the role of metabolic acidosis in the development of cardiometabolic disorders, hypertension (HT), and insulin resistance (IR). Objective: We hypothesized that dietary acid load (DAL) is associated with adverse metabolic risk factors and aimed to investigate this in the elderly. Methods: A total of 114 elderly participants were included in the study. The participants were divided into four groups, such as HT, diabetes (DM), both HT and DM, and healthy controls. Anthropometric, biochemical, and clinical findings were recorded. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) results were obtained for three days, 24-hour dietary records via a nutrient database program (BeBiS software program). Results: The groups were matched for age, gender, and BMI. There was a statistically significant difference between the groups regarding NEAP (p =0.01) and no significant difference for PRAL ( p = 0.086). The lowest NEAP and PRAL levels were seen in the control group while the highest in the HT group. Both NEAP and PRAL were correlated with waist circumference (r = 0,325, p = 0.001; r=0,231, p =0,016, respectively). Conclusion: Our data confirmed that subjects with HT and DM had diets with greater acid-forming potential. High NEAP may be a risk factor for chronic metabolic diseases, particularly HT. PRAL could not be shown as a significantly different marker in all participants. Dietary content has a significant contribution to the reduction of cardiovascular risk factors, such as HT, DM, and obesity.

Background: Aging with diabetic neuropathy is likely to predispose people to falls. Despite being a high-risk population, estimates of falls and their associated factors are poorly documented in elderly diabetic neuropathy patients living in coastal Karnataka, India. Objective: To investigate fear of falling and functional mobility, as an approximate measure of clinical fall risk, and explore the associated risk factors in elderly diabetic neuropathy patients living in coastal Karnataka, India. Methods: A hospital-based cross-sectional study was conducted on 316 elders aged 60 to 80 with diabetic neuropathy. A detailed diabetic foot evaluation was done. Self-reported fear of fall and functional mobility was measured using the Falls Efficacy Scale- International and Timed Up and Go test, respectively, with published cut-points. Additionally, a recall of 12 months of fall history was recorded. Results: Descriptive analysis showed that self-reported fear of fall and below-average functional mobility was present in 39% and 49% of the elders with diabetic neuropathy, respectively. Spearman's correlational analysis revealed that self-reported fall concerns and functional mobility are significantly interdependent. Regression analysis suggested female gender, the severity of neuropathy, and previous falls as significant modifiers for fear of falls and poor functional mobility. Conclusion: Half of the elders (49%) with diabetic neuropathy have poor functional mobility and 39% have a fear of falling. Improving physical function and addressing fall concerns of elders with diabetic neuropathy can result in greater confidence to participate in everyday activities and contribute to their better health. Hence, early fall risk identification is recommended for providing better health care to these individuals.

Aims: The attitudes toward older patients are considered the main factor in providing health services. Background: There is a lack of proper short scale to measure attitudes toward older patients among healthcare professionals. Objective: The present study was to assess the psychometric properties of the UCLA Geriatric Attitude scale (UCLA-GAS) among a sample of Iranian healthcare professionals. Methods: The method of this study was cross-sectional for psychometric evaluation. The sample included 232 healthcare professionals in Mazandaran city. Study participants were selected by cluster random sampling technique. Psychometric evaluation of the UCLA-GAS assessed through content and construct validity. Content validity was evaluated based on the content validity index (CVI) and construct validity was investigated using exploratory and confirmatory factor analysis. Also, convergent validity was assessed using the Kogan’s Attitudes Toward Older People Scale (KAOPS) questionnaire. Cronbach's alpha was used to evaluate internal consistency reliability and stability was assessed using test-retest. Results: Regarding the content validity, CVI and modified Kappa statistic for all items were >0.79 and showed all items relevant to the UCLA-GAS in the Iranian context. The three dimensions of the UCLA-GAS extracted from factor analysis were labeled: 1- medical/economic burden (6 items) 2- appreciate attitude (5 items), 3- resource allocation (3 items). CFA revealed that the UCLA-GAS structure model was a validated model (CMIN = 2.312, GFI = 0.913, CFI = 0.902, RMSEA = 0.075). The scale had a significant and positive correlation with KAOPS questionnaire. Also, The Cronbach's alpha of the scale was 0.78 and intra-class correlation coefficient (ICC) for total instrument was reported as 0.93 (95% CI: 0.87-0.98) and demonstrated good reliability of the instrument. Conclusion: The result shows the UCLA-GAS is a valid and reliable scale for measuring attitudes toward older patients among healthcare professionals. This study recommends using Iranian UCLA-GAS in future research and policy-making.

Background: Age-related impairments in macrophage functions have important consequences for the health of the elderly population. The aging process is also accompanied by a reduction in several hormones, including growth hormone (GH). Previous studies have shown that this hormone can affect macrophage activity in young individuals; however, the biological effects of GH stimulation on macrophages during aging have not yet been elucidated. Objective: The aim of this work was to investigate the in vitro effects of GH on peritoneal macrophages from aged mice. Methods: Peritoneal macrophages isolated from young (4 months-old) and old (12-15 months-old) mice were treated in vitro with 100 ng/mL of GH for 24 hours. After treatment, cells were analysed for cell morphology, reactive oxygen species (ROS) production, expression of integrins, cell adhesion to extracellular matrix molecules, and migration in transwell chambers. Results: Although GH-treated cells from old mice exhibited decreased ROS production, we did not observe the effects of GH on macrophage morphology or macrophage phagocytic activity in young and old mice-derived cell cultures. Macrophages from old mice had increased adhesion to laminin and fibronectin substrates, as did cells obtained from young mice treated with GH, but no change was observed in the expression of integrin receptors. Furthermore, cells from old mice exhibited increased migration compared to young mice and a significant increase in macrophage migration was observed under GH stimulation. Conclusion: Our results showed that GH can interfere with the motility of macrophages from old mice, advancing our understanding of the interactions between the immune and neuroendocrine systems during aging.

Background: Sarcopenia is linked to the loss of muscle mass in older adults, leading to impaired functional capacity and quality of life. In addition, this finding was recognized as an agerelated chronic inflammatory process. We aimed to determine the relationship between sarcopenia, functional capacity, and inflammatory biomarkers and subsequent prediction of inflammatory biomarkers in older adults. Methods: A total of 126 women and men aged ≥ 60 years were enrolled. Participants were required to complete a handgrip dynamometer, 6-meter walk test, and bioimpedance analysis. Diagnosis was based on the definition of sarcopenia from the Asian Working Group for Sarcopenia 2019. Prior to performing a 6-minute walking test (i.e., functional capacity testing), blood samples were drawn for a C-reactive protein (CRP) test. Results: A total of 12.70% were categorized as having sarcopenia. Significant differences in CRP and functional capacity between the sarcopenia and non-sarcopenia groups were found (p <.05). Older people with high CRP levels had significantly reduced functional capacity and slow gait speed. Conclusions: Poor functional capacity was associated with increased CRP levels, which might be due to the development of age-related inflammation. Older patients with sarcopenia may be at higher risk for functional decline.

Background: Oxidative stress is one of the risk components in the development of coronary artery diseases (CAD). Genetic polymorphism in major antioxidant genes like Glutathione- S-Transferases (GST) has been associated with increased CAD susceptibility and severity. Objective: To get a precise evaluation and to update the association, a meta-analysis on GST (GSTM1, GSTT1, and GSTP1) polymorphism with CAD was performed. Moreover, the combined effect of GSTM1/GSTT1 null genotypes on CAD risk has not yet been studied, but it has the highest risk of developing diseases. Materials and Methods: PubMed, Embase, and Web of Science were systematically searched for eligible studies. Case-control studies in the English language and with genotypic frequency were selected in order to provide data and calculate the odds ratio (OR). OR with 95% CI was calculated, and a random effect model was used. NOS scale was used to assess the quality of the included studies. Results: Meta-analysis indicated that the GSTM1 null genotype and GSTP1 (Ile105Val) polymorphism is significantly associated with CAD risk with a pooled OR-1.38, p=0.01 for GSTM1 and OR-1.19, p=0.04 for GSTP1. The dual null genotype of GSTM1-GSTT1 has the highest risk for CAD development (OR-1.59, p=0.003), and there is no significant association between GSTT1 null genotype with CAD. In the subgroup analysis, GSTM1 showed an increased risk for Asians (OR- 1.68, p=<0.01) and smokers (OR-1.98, p=<0.01). Publication bias was not observed. Conclusion: The findings suggest that the GSTM1 and GSTP1 polymorphism can be a predictive factor for CAD risk, and a larger sample size is required further to confirm the association.

There is considerable empirical evidence that unequivocally points to loneliness as a modifiable risk factor for the development of Alzheimer's disease and other related dementias. With the emergence of the COVID-19 pandemic and the resulting lockdown and social distancing, there has been a renewed interest in studying this topic. The present review examines the links between loneliness and Alzheimer's disease, with particular emphasis on the mechanisms common to both conditions.