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Topic Review
Brain Natriuretic Peptide in Geriatric Heart Failure Evaluation
Heart failure is one of the main morbidity and mortality factors in the general population and especially in elderly patients. Natriuretic peptides, in particular B-type natriuretic peptide (BNP) and its fraction NTproBNP, have gained an increasingly important role in the screening, diagnosis and treatment of heart failure.
  • 1.1K
  • 16 May 2023
Topic Review
Ultrasound in Sarcopenia
Sarcopenia is a progressive, systemic musculoskeletal disorder associated with an increased risk of adverse events such as falls and fractures, mobility disorders, cardiac and respiratory disease, cognitive impairment, institutionalization, and death. Physical disability and impaired ability to perform activities of daily living contribute to reducing both patient quality of life and functional independence, adding to the necessity of long-term care services for the patient. Considering this evidence, it would seem clear that early diagnosis of sarcopenia and care optimization would also reduce the economic impact on the health care system and individual social-economic burdens.
  • 1.1K
  • 19 Apr 2022
Topic Review
Physical Exercise on Sleep Quality in Elderly Adults
Aging is directly related to sleep problems. Primary insomnia has a negative impact on the lives of elderly adults, altering cognitive and metabolic functions. Physical activity is positively related to improvement in sleep quality. The systematic and continuous practice of physical exercise significantly improves perceived sleep quality in elderly individuals. Therefore, physical activities can be used as a tool to prevent sleep disorders and improve health in general. 
  • 1.0K
  • 28 Apr 2022
Topic Review
Topical Cellular/Tissue and Molecular Aspects in Alzheimer’s Disease
One of the most complex and challenging developments at the beginning of the third millennium is the alarming increase in demographic aging, mainly—but not exclusively—affecting developed countries. This reality results in one of the harsh medical, social, and economic consequences: the continuously increasing number of people with dementia, including Alzheimer’s disease (AD), which accounts for up to 80% of all such types of pathology. Its large and progressive disabling potential, which eventually leads to death, therefore represents an important public health matter, especially because there is no known cure for this disease. Consequently, periodic reappraisals of different therapeutic possibilities are necessary. 
  • 1.0K
  • 12 Dec 2023
Topic Review
Cannabinoid Systems and the Brain
The use of cannabinoids as therapeutic drugs has increased among aging populations. Age-related changes in the endogenous cannabinoid system could influence the effects of therapies that target the cannabinoid system. At the preclinical level, cannabidiol (CBD) induces anti-amyloidogenic, antioxidative, anti-apoptotic, anti-inflammatory, and neuroprotective effects. These findings suggest a potential therapeutic role of cannabinoids to neurodegenerative disorders such as Parkinson’s disease (PD) and Alzheimer. 
  • 954
  • 16 Dec 2022
Topic Review
Subtle Daily Behavioral Changes and Mild Cognitive Impairment
Short-term memory impairment, disorientation, and visuospatial deficits are the main symptoms in patients with Mild Cognitive Impairment (MCI) and very mild  Alzheimer’s disease (AD). Interestingly, patients with MCI and very mild AD have subtle changes in their daily behavioral patterns alongside these main symptoms. Thus, subtle changes in daily behavioral patterns may be an indicator of early MCI and AD detection.
  • 924
  • 21 Jul 2022
Topic Review
Late-Life Depression
Late-life depression (LLD), compared to depression at a young age, is more likely to have poor prognosis and high risk of progression to dementia. A recent systemic review and meta-analysis of the present antidepressants for LLD showed that the treatment response rate was 48% and the remission rate was only 33.7%, thus implying the need to improve the treatment with other approaches in the future. Recently, agents modulating the glutamatergic system have been tested for mental disorders such as schizophrenia, dementia, and depressive disorder.
  • 885
  • 22 Sep 2021
Topic Review
Aging of Human Hematopoietic Stem and Progenitor Cells
In human blood and immune system, aging is characterized by a decline of innate immunity and regenerative potential of hematopoietic stem cells. This decline is defined at a molecular level in the  hematopoietic stem and progenitor cells (HSPC) compartment. A series of studies have demonstrated that aging of HSPC is induced by an accumulation of senescent cells in the HSPC compartment of the aging human bone marrow. Multi-omics studies have provided evidence that senescent cells are characterized by elevated central carbon metabolism. This property has rendered an enrichment of senescent HSPC for in depth mechanistic studies possible, and in addition has provided novel targets for senolysis therapy strategies. 
  • 875
  • 02 Apr 2022
Topic Review
Tumor Necrosis Factor Antagonists in Neuroinflammation for Dementia
Prolonged activation of pro-inflammatory responses in Alzheimer’s disease (AD) alters function of glial cells and in turn, further accelerates neuroinflammation. Subsequent synaptic dysfunction and loss of neurons are responsible for clinical symptoms of the disease. Additionally, factors such as insufficient sleep length and subsequent reduction in amyloid clearance via the glymphatic system lead to amyloid accumulation, while simultaneously aggravating systemic inflammatory response. Inflammation in vascular dementia (VaD) contributes to the three-hit hypothesis, along with hypertension and hypoxia. Vasculitis is responsible for restricted blood circulation in microvessels and leads to decreased oxygen supply and regional glial activation favoring neuroinflammation in the central nervous system (CNS). Peripheral immune response and increased cytokine production, including an early surge in TNF and IL-1β concentrations activate glia, leading to aggravation of neuroinflammation and dysfunction of neurons during COVID-19. Lifestyle factors, such as diet, have a large impact on future cognitive outcomes and should be included as a crucial intervention in dementia prevention.
  • 864
  • 09 Jan 2023
Topic Review
Psychedelics for Treating Alzheimer’s Disease and Related Depression
Alzheimer’s disease (AD), the most common form of senile dementia, is poised to place an even greater societal and healthcare burden as the population ages. Psychedelic drugs target AD-related psychological pathology and symptoms such as depression. Using microdosing, psychedelic drugs may prove to help combat this devastating disease by eliciting psychiatric benefits via acting through various mechanisms of action such as serotonin and dopamine pathways.
  • 838
  • 18 Aug 2023
Topic Review
End-of-Life Care for Patients with Advanced COPD
Exacerbations of chronic obstructive pulmonary disease (COPD) may lead to a rapid decline in health and subsequent death, an unfortunate tyranny of having COPD—an irreversible health condition of 16 million individuals in the USA totaling 60 million in the world. While COPD is the third largest leading cause of death, causing 3.23 million deaths worldwide in 2019 (according to the WHO), most patients with COPD do not receive adequate treatment at the end stages of life. Although death is inevitable, the trajectory towards end-of-life is less predictable in severe COPD. Thus, clinician-patient discussion for end-of-life and palliative care could bring a meaningful life-prospective to patients with advanced COPD. 
  • 833
  • 21 Feb 2022
Topic Review
XBP1 Modulates the Aging Cardiorenal System
X-box binding protein 1 (XBP1) is a unique basic-region leucine zipper (bZIP) transcription factor. Over recent years, the powerful biological functions of XBP1 in oxidative stress have been gradually revealed. When the redox balance remains undisturbed, oxidative stress plays a role in physiological adaptations and signal transduction. However, during the aging process, increased cellular senescence and reduced levels of endogenous antioxidants cause an oxidative imbalance in the cardiorenal system.
  • 805
  • 15 Nov 2023
Topic Review
Improving the Anticholinergic Prescribing Practice in Older Adults
Healthcare practitioner-oriented interventions have the potential to reduce the occurrence of anticholinergic prescribing errors in older people. Interventions were primarily effective in reducing the burden of anticholinergic medications and assisting with deprescribing anticholinergic medications in older adults. 
  • 792
  • 08 Feb 2022
Topic Review
MSCs in Cell and Cell-Free Therapies
The progressive loss of the regenerative potential of tissues is one of the most obvious consequences of aging, driven by altered intercellular communication, cell senescence and niche-specific stem cell exhaustion, among other drivers. Mesenchymal tissues, such as bone, cartilage and fat, which originate from mesenchymal stem cell (MSC) differentiation, are especially affected by aging. Senescent MSCs show limited proliferative capacity and impairment in key defining features: their multipotent differentiation and secretory abilities, leading to diminished function and deleterious consequences for tissue homeostasis. 
  • 751
  • 26 Oct 2021
Topic Review
Biomarkers for Early Detection of Cognitive Impairment
Dementia is a major cause of poor quality of life, disability, and mortality in old age. According to the geroscience paradigm, the mechanisms that drive the aging process are also involved in the pathogenesis of chronic degenerative diseases, including dementia. The dissection of such mechanisms is therefore instrumental in providing biological targets for interventions and new sources for biomarkers. Within the geroscience paradigm, several biomarkers have been discovered that can be measured in blood and allow early identification of individuals at risk of cognitive impairment. Examples of such markers include inflammatory biomolecules, markers of neuroaxonal damage, extracellular vesicles, and DNA methylation. Furthermore, gait speed, measured at usual and fast pace and as dual task, has shown to detect individuals at risk of future dementia.
  • 742
  • 18 Feb 2024
Topic Review
Influencing Factors of Antibiotics Prescribing in the Elderly
Infections are important factors contributing to the morbidity and mortality among elderly patients. High rates of consumption of antimicrobial agents by the elderly may result in increased risk of toxic reactions, deteriorating functions of various organs and systems and leading to the prolongation of hospital stay, admission to the intensive care unit, disability, and lethal outcome. Both safety and efficacy of antibiotics are determined by the values of their plasma concentrations, widely affected by physiologic and pathologic age-related changes specific for the elderly population. Drug absorption, distribution, metabolism, and excretion are altered in different extents depending on functional and morphological changes in the cardiovascular system, gastrointestinal tract, liver, and kidneys. Water and fat content, skeletal muscle mass, nutritional status, use of concomitant drugs are other determinants of pharmacokinetics changes observed in the elderly. The choice of a proper dosing regimen is essential to provide effective and safe antibiotic therapy in terms of attainment of certain pharmacodynamic targets.
  • 729
  • 09 Jun 2023
Topic Review
DXA-Derived Indices in the Characterisation of Sarcopenia
Sarcopenia is linked with increased risk of falls, osteoporosis and mortality. No consensus exists about a gold standard “dual-energy X-ray absorptiometry (DXA) index for muscle mass determination” in sarcopenia diagnosis. Thus, many indices exist, but data on sarcopenia diagnosis agreement are scarce. Regarding sarcopenia diagnosis reliability, the impact of influencing factors on sarcopenia prevalence, diagnosis agreement and reliability are almost completely missing. 
  • 724
  • 10 Jan 2022
Topic Review
CDGSH Iron-Sulfur Domain 2 Mediates Lifespan and Healthspan
An age-dependent decrease in CDGSH (Cys-Asp-Gly-Ser-His) iron-sulfur domain 2 (CISD2) expression during the natural aging of mice has been reported in a range of tissues, including the brain, spinal cord, skeletal muscle, heart, and skin. However, the rate of CISD2 downregulation varies from tissue to tissue.
  • 706
  • 22 Nov 2022
Topic Review
Strategies for the Appropriateness of Medication Use
The evidence on the effectiveness of strategies and tools to promote and improve medication appropriateness and their sustainability largely derives from local and heterogeneous experiences with contrasting results. As a general framework, three main steps should be considered in implementing measures to improve the appropriateness of medications: prescription, acceptance by the patient, and continuous monitoring of adherence and the risk-benefit profile. Each step needs efforts from specific actors (physicians, patients, caregivers, healthcare professionals) and dedicated supporting tools. Moreover, how to support the appropriateness also strictly depends on the particular care setting (hospital, ambulatory or primary care, nursing home, long-term care) and available economic resources. 
  • 686
  • 23 Sep 2022
Topic Review
Geriatric Assessment-Driven Interventions in Older Adults with Cancer
Comprehensive geriatric assessment is defined as a multi-dimensional, multi-disciplinary diagnostic and therapeutic process that is conducted to determine the medical, mental, and functional problems that older people with frailty have so that a coordinated and integrated plan for treatment and follow-up can be developed. Progress has been made in the definition of the best way to detect problems, but the benefits are mostly based on prognosis stratification and on the adaptation of cancer treatment.
  • 675
  • 06 Apr 2022
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