Aging

Atrial fibrillation in aging adults

Atrial fibrillation in aging adults

This is an important study evaluating the associative factors and natural history of atrial fibrillation. Until age 90, men are at higher risk of developing A.Fib compared to women. Tall women, and overweight and dyslipidemic men are more likely to experience it than their counterparts. Lifetime risk for Atrial fibrillation high, more than 30%. It increases the mortality rate by 3.5 fold in both genders. Subjects were followed for about 13 years.

GT

Elderly should consume more protein

Elderly should consume more protein

The Recommended Daily Allowance (RDA) for protein intake in the adult population is widely promoted as 0.8 grams/kg/day. Aging may increase protein requirements, particularly to maintain muscle mass. 

Authors investigated whether controlled protein consumption at the current RDA or twice the RDA (2 x RDA) affects skeletal muscle mass and physical function in elderly men. 

Study found that consumption of a diet providing 2 x RDA for protein compared with the current guidelines was found to have beneficial effects on lean body mass and leg power in elderly men.

AJCN

Frailty and exercise in aging population

Frailty and exercise in aging population

A structured exercise program was not associated with a decreased risk for frailty among older adults. However, the beneficial effect of the exercise program on reducing major mobility disability was not affected by whether the participants were frail at baseline.

AIM

Protein intake in aging adults

Protein intake in aging adults

The anorexia of aging, which affects 20% of older adults, has been well documented within the current body of evidence as a primary cause of reduced daily intake in this population. This condition is characterized by reductions in appetite in combination with early satiation and sustained increases in satiety.

Circulating concentrations of the hunger-stimulating hormone ghrelin are lower, whereas the satiety hormones cholecystokinin, peptide YY, and GLP-1 are elevated in older adults compared with their younger counterparts. Gastric emptying also tends to be slower in older adults than in younger adults, which leads to early satiation. These responses occur concomitantly with an increase in perceived fullness and decreased hunger, desire to eat, and prospective food consumption.

Am J Clin Nutr

Insulin Resistance and Memory

Insulin Resistance and Memory

Higher fasting insulin levels and increased insulin resistance predict future memory decline as measured by verbal fluency. About 4,000 individuals, average age 50, were followed for 11 years. These findings imply the need of addressing insulin resistance early rather then later, when prediabetes or diabetes emerge.

GT

Exercise effect in older sedentary adults

Exercise effect in older sedentary adults

Combined aerobic and resistance activity increased physical performance more than aerobic or resistance training alone. A group of 160 sedentary individuals with average age 70 and BMI 35 were followed and evaluated at 6 months.

Results could be confounded by the fact that participants in the combined training group spent overall more time exercising than those who utilized only aerobic or resistance activities.

GT

Aging, Diabetes and Cognition

Aging, Diabetes and Cognition

One of the challenges of managing older adults with diabetes is the individualization of care in people with multiple comorbid conditions. Although macrovascular and microvascular complications of diabetes are well recognized, there is a lack of awareness regarding other conditions such as cognitive dysfunction, depression, and physical disabilities.

Cognitive dysfunction is of particular importance because of its impact on self-care and quality of life. In this Perspective, I discuss common and practical questions faced by clinicians managing diabetes in older adults who also have cognitive dysfunction.

Diabetes Care

Aging, Diabetes and Cardiovascular Illness

Aging, Diabetes and Cardiovascular Illness

Older adults with diabetes are at higher risk for atherosclerotic cardiovascular disease (ASCVD) than younger adults with diabetes and older adults without diabetes. The rationale to implement ASCVD risk–lowering therapies in older adults with diabetes is compelling.

The variability in health status among older adults is pertinent. Those with robust health are more likely to tolerate and derive benefit from many therapies when compared with those who have more complex health including frailty.

Diabetes Care

SPRINT Trial: Systolic Blood Pressure in Older Adults >75

SPRINT Trial: Systolic Blood Pressure in Older Adults >75

Both, February 2014 JNC8 and January 2017 ACP/AAFP guidelines recommend a target systolic blood pressure <150 mmHg for adults older then age 60.

SPRINT trial paints a different picture: older individuals with tight systolic blood pressure control <120 mmHg experienced less cardiovascular events and all-cause mortality compared to those with sBP<140 mmHg.

A group of 2,500 participants with average age 80 and without diabetes were followed for 3 years. Side effects were overall similar between patients with sBP<120 and sBP<140 mmHg.

GT