Vol 17, No 2 (2024)

Medicine

The Relationship Between Sarcopenia And Proteinuria, What Do We Know?

Gungor O., Ulu S., Inci A., Topal K., Kalantar-Zadeh K.

Abstract

Sarcopenia is one of the most common geriatric syndromes in the elderly. It is defined as a decrease in muscle mass and function, and it can lead to physical disability, falls, poor quality of life, impaired immune system, and death. It is known that, the frequency of sarcopenia increases in the kidney patient population compared to healthy individuals. Although it is known that kidney disease can lead to sarcopenia; our knowledge of whether sarcopenia causes kidney disease is limited. Prior studies have suggested that protein energy wasting may be a risk of de novo CKD. Proteinuria is an important manifestation of kidney disease and there is a relationship between sarcopenia and proteinuria in diabetes, geriatric population, kidney transplant, and nephrotic syndrome. Does proteinuria cause sarcopenia or vice versa? Are they both the results of common mechanisms? This issue is not clearly known. In this review, we examined the relationship between sarcopenia and proteinuria in the light of other studies.

Current Aging Science. 2024;17(2):93-102
pages 93-102 views

Nicotinamide Mononucleotide in the Context of Myocardiocyte Longevity

Marzoog B.

Abstract

Cellular and subcellular metabolic activities are crucial processes involved in the regulation of intracellular homeostasis, including cellular and subcellular signaling pathways. Dysregulation of intracellular regulation mechanisms is catastrophic and cumulates into cell death. To overcome the issue of dysregulation of intracellular regulation mechanisms, the preservation of subcellular and extracellular components is essential to maintain healthy cells with increased longevity. Several physiopathological changes occur during cell ageing, one of which is the dysregulation of intracellular physiology of the oxidative phosphorylation process. Nicotinamide mononucleotide (NMN) remains in the debut of anti-aging therapeutic effect. Aged myocardiocyte characterized by disrupted NMN and or its precursors or signaling pathways. Simultaneously, several other pathophysiological occur that collectively impair intracellular homeostasis. The NMN role in the antiaging effect remains unclear and several hypotheses have been introduced into describing the mechanism and the potential outcomes from NMN exogenous supply. Correction of the impaired intracellular homeostasis includes correction to the NMN metabolism. Additionally, autophagy correction, which is the key element in the regulation of intracellular intoxication, including oxidative stress, unfolding protein response, and other degradation of intracellular metabolites. Several signaling pathways are involved in the regulation mechanism of NMN effects on myocardiocyte health and further longevity. NMN protects myocardiocytes from ischemic injury by reducing anabolism and, increasing catabolism and further passing the myocardiocytes into dormant status. NMN applications include ischemic heart, disease, and failed heart, as well as dilated cardiomyopathies. Cytosolic and mitochondrial NADPH are independently functioning and regulating. Each of these plays a role in the determination of the longevity of the myocardiocytes. NMN has a cornerstone in the functionality of Sirtuins, which are an essential anti-senescent intrinsic molecule. The study aims to assess the role of NMN in the longevity and antisenescent of myocardiocytes.

Current Aging Science. 2024;17(2):103-108
pages 103-108 views

Prevalence of COVID-19 Among 8000 Patients at a Hospitalized and Mortality in Old Age

de Godoy M., Salomão M., Queiroz F., de Godoy J.

Abstract

Background:COVID-19 created a general challenge to healthcare systems throughout the world and was an important cause of mortality.

Aim:The aim of the present study was to report the general evolution of patients with COVID-19 at a teaching hospital and analyze differences by age group and sex considering mortality rates in the years 2020 and 2021 among patients older than 60 years of age.

Methods:A cross-sectional study was conducted with patients hospitalized with a diagnosis of COVID-19 confirmed by RT-PCR at the São Jose do Rio Preto university hospital between March 2020 and March 2022. The patients were male and female patients, of varying ages belonging to the region of Sao Jose do Rio Preto, were accommodated in the wards or intensive care units (ICUs). Overall mortality was analyzed for the hospital as well as in the ICUs and wards. This analysis was performed separately in two years considering age group, sex, and main comorbidities in patients older than 60 years of age.

Results:A total of 8032 patients with COVID-19 were hospitalized between March 2020 and March 2022: 2866 patients with 658 deaths (22.92%) in 2020; 4324 patients with 1168 deaths (27.01%) in 2021; and 842 patients with 205 deaths (24.35 %) in 2022 up to the month of March. More than half (53.60%) of the patients were hospitalized in the ICUs and 46.39% were hospitalized in the wards. Differences in the mortality rate were found for the different age groups in the comparison of the years, with more deaths occurring among individuals up to 90 years of age in the second year (p (<0.05). Men were affected more and had a higher mortality rate (p (<0.0001). The main comorbidities were cardiovascular disease (70.93%), diabetes (37.76%), and obesity (23.68%).

Conclusions:The mortality rate of older people hospitalized with COVID-19 was higher than the average, it was higher in 2021 compared to 2020 and increased with age. Cardiovascular disease, diabetes, and obesity were the main comorbidities.

Current Aging Science. 2024;17(2):109-112
pages 109-112 views

Evaluating the Balancing Ability of Older Adults with Diabetes Mellitus Using the Multi-directional Reach Test

Amput P., Wongphon S., Phrompao P.

Abstract

Background:The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity, disability, and bone fractures, especially hip fractures. This study aimed to investigate balancing ability using a multi-directional reach test (MDRT) in older adults with and without diabetes mellitus.

Methods:72 older adults with and without diabetes mellitus were recruited, and divided into two groups, including older adults without diabetes mellitus (n= 36) and older adults with diabetes mellitus (n= 36). All subjects completed all directions of the MDRT.

Results:There were no significant differences in MDRT scores in all directions between the two groups (p>0.05). Both groups achieved the highest MDRT scores in the forward direction. In contrast, the two groups had the lowest scores of MDRT in a backward direction. Furthermore, older adults with diabetes mellitus had lower MDRT scores in all directions than older adults without diabetes mellitus.

Conclusion:The current study indicated that MDRT could be used to investigate the ability of balance in individuals with diabetes mellitus.

Current Aging Science. 2024;17(2):113-117
pages 113-117 views

Mesenchymal Stromal Cells Nanovesicles Carry microRNA with Nephroprotective Proprieties Regardless of Aging

Convento M., de Oliveira A., Boim M., Borges F.

Abstract

Containing information molecules from their parent cells and inclining to fuse with targeted cells, bone marrow mesenchymal stromal cells-derived extracellular vesicles (MSCs- EV) are valuable in nanomedicine.

Background:The effects of aging on the paracrine mechanism and in the production and action of MSCs-EV and their cargos of miR-26a and siRNA-26a for the treatment of tubular renal cells under nephrotoxicity injury remain unelucidated.

Objective:The purpose of this study was to evaluate MSCs-EV of different ages and their ability to deliver the cargos of miR-26a and siRNA-26ª to target renal tubular cells affected by nephrotoxicity injury.

Methods:In a model of gentamicin-induced nephrotoxicity, renal tubular cells treated with MSCs-EV expressing or not expressing microRNA-26a were analyzed. Western blotting was utilized to evaluate cell cycle markers, and MTT assay was utilized to evaluate auto-renovation capacity.

Results:Tubular cells under nephrotoxicity injury showed decreased proliferative capacity, but the treatment in the tubular renal cells under nephrotoxicity injury with MSCs-EV expressing microRNA-26a showed nephroprotective effects, regardless of EV age. While the treatment with EV-mediated siRNA-26a failed to preserve the nephroprotective effects equally, regardless of age.

Conclusion:Mesenchymal stromal cell nanovesicles carry microRNA with nephroprotective proprieties regardless of aging.

Current Aging Science. 2024;17(2):118-126
pages 118-126 views

Relationship of Self-Reported Physical Activity with Cognition in Middle- Aged Adults

Pachava S., Shenoy S.

Abstract

Objective:The increasing prevalence of age-related cognitive decline highlights the importance of physical activity for cognitive health. Regular exercise has been associated with improved mental health and reduced risk of cognitive decline. This study investigated the connection between self-reported physical activity and cognitive function in middle-aged adults.

Methods:This cross-sectional study included 56 Indian adults aged 30-55, selected based on a health screening questionnaire. Participants reported their physical activity using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), which categorized them into low, moderate, and high activity levels. Cognitive functions, including visual memory, executive function, and attention, were assessed using the Cambridge Neuropsychological Automated Testing Battery (CANTAB). Results were statistically analyzed for relationships between cognitive domains and physical activity parameters using Pearson’s correlation and linear regression analysis.

Results:The study showed a significant positive correlation of attention with moderate and vigorous physical activity, while sedentary behavior negatively impacted attention. Linear regression showed that attention is affected by moderate-intensity activity whereas executive function and visual memory are affected by age.

Conclusion:This study supports the view that moderate and vigorous intensity activities may positively affect attention in middle-aged adults highlighting the benefits of physical activity.

Current Aging Science. 2024;17(2):127-134
pages 127-134 views

STOPP-START Criteria Used to Identify the Elderly Population Prone to Potentially Inadequate Prescribing in a Colombian Cohort

Zambrano L., Bustos R., Beltran E., Gomez D., Arias S., Briceño W.

Abstract

Background:Elderly people have multiple comorbidities that often require treatment with multiple medications. Having strategies to lessen the risks associated with pharmacological interactions and potentially inadequate prescribing (PIP) is of major importance. The STOPP– START criteria are useful in identifying PIP along with other tools, such as LASA (look alike/sound alike) drugs and high-risk medications (HRM).

Objective:We aimed to clinically and sociodemographically characterize the population with PIP according to the STOPP–START criteria in hospitalized elderly patients over 6 months in a third-level hospital in Colombia, South America. We also aimed to calculate the prevalence of PIP, LASA drugs and HRM and to identify other problems related with medication. Finally, we proposed an algorithm for the identification of PIP in this population.

Methods and Materials:This was a descriptive, cross-sectional study in hospitalized patients older than 60 years during the first semester of 2021 to identify PIP according to STOPP– START criteria. An analysis of clinical and sociodemographic variables was conducted, as well as the construction of an algorithm to identify PIP in the elderly in a semiautomated way. Data were collected and analyzed using the software SPSS 2021, using descriptive statistics and measures of central tendency.

Results:The prevalence of PIP in the study population was 25%. Furthermore, 60% of patients had one problem related to medication, and 27% used at least one LASA drug or HRM.

Conclusion:This study allows one to characterize, for the first time, the Colombian population prone to PIP, as well as the construction of an algorithm that identifies PIP in a semiautomated way.

Current Aging Science. 2024;17(2):135-143
pages 135-143 views

N-Stearoylethanolamine Exerts Cardioprotective Effects in Old Rats

Kosiakova H., Berdyshev A., Horid’ko T., Meged O., Klimashevsky V., Matsokha R., Tkachenko O., Asmolkova V., Kvitnitskaya-Ryzhova T., Luhovskyi S., Klymenko P., Hula N.

Abstract

Background:Aging is associated with the slowing down of metabolic processes, diminished physiological processes, changes in hormonal activity and increasing exposure to oxidative stress factors and chronic inflammation. The endocannabinoid system (ECS) is a major signaling network that plays a pro-homeostatic role in the central and peripheral organs of the human body. A class of minor lipids, N-acylethanolamines (NAEs), which do not activate cannabinoid receptors, except for anandamide, but can potentiate the action of endocannabinoids and have a wide spectrum of biological activity and significant adaptogenic potential, belongs to ECS. The results of different studies over the past decades have established the protective effect of NAE on many pathological conditions.

Objective:This study aimed to investigate the cardioprotective effects of C18:0 NAE— N-stearoylethanolamine (NSE) in aged rats. In this study, we focused on investigating the effects of C18:0 NAE— N-stearoylethanolamine (NSE) on the intensity of oxidative/ nitrosative stress, antioxidant potential, lipoprotein profile and inflammation markers of blood plasma, phospholipid composition and age-related morphological changes of old rat heart tissues.

Methods:The study was conducted on Sprague Dawley male laboratory rats. The three groups of rats were involved in the study design. The first group consisted of young rats aged 4 months (n=10). The second (n=10) and third (n=10) groups included old rats aged of 18 months. Rats from the third group were administered a per os aqueous suspension of NSE at a dose of 50 mg/kg of body weight daily for 10 days. All groups of rats were kept on a standard vivarium diet. The blood plasma, serum, and heart of rats were used for biochemical and histological analysis.

Results:The cardioprotective effect of N-stearoylethanolamine in old rats was established, which was expressed in the normalization of the antioxidant system condition and the level of proinflammatory cytokines, positive modulation of blood plasma and lipoprotein profile, normalization of heart tissue lipid composition, and significant reduction in age-related myocardium morphological changes.

Conclusion:The revealed effects of N-stearoylethanolamine can become the basis for developing a new drug for use in complex therapy to improve the quality of life of older people.

Current Aging Science. 2024;17(2):144-155
pages 144-155 views

Perturbation-based Balance Training in Adults Aged Above 55 Years with Chronic Low Back Pain: A Comparison of Effects of Water versus Land Medium - A Preliminary Randomized Trial

Muthukrishan R., Badr Ul Islam F., Shanmugam S., Arulsingh W., Gopal K., Kandakurti P., Rajasekar S., Malik G., S.G. G.

Abstract

Background:‘Rapid balance reaction’ or ‘perturbation’ training is an emerging paradigm in elderly back pain rehabilitation due to its connection to postural stability.

Objective:This study aimed to inform the feasibility and practicality of perturbation-based balance training (PBT) using a stratification approach and to determine the effectiveness of land versus water-based PBT in elderly individuals with chronic low back pain (CLBP)

Methods:Elderly CLBP participants (n=24) received exercise interventions as per treatmentbased classification (TBC) and were randomly allotted into water-based perturbation exercises (WBPE, Mean age=63.0±2.6years, n=12) and land-based perturbation exercise group (LBPE, 62.3±2.6 years, n=12). Pain intensity, disability, scores of fear-avoidance beliefs, fall efficacy, and rate of perceived exertion (RPE) were assessed before and at the end of 6 weeks.

Results:WBPE group reported a significant reduction in pain score (median difference(MD)):2, p(<0.03), fear avoidance behaviour for work (MD:9, p(<0.01) and fear avoidance behaviour for physical activity (MD:10, P< 0.05), improved straight leg raise right (SLR) (MD:37.5°, p(<0.05), and improved modified fall efficacy scores (MFES, MD:25, p(<0.05) compared to the LBPE group at post-intervention. Within-group analysis in both groups revealed significant improvement in clinical outcomes except for fear-avoidance beliefs related to physical activity in the LBPE group. Subgroup analysis revealed that the high BMI elderly CLBP group of LBPE had significant improvements similar to the WBPE group except for scores of FABQ physical activity scores and SLR.

Conclusion:Possible key factors for future research are discussed in the realms of perturbation exercise in the elderly with CLBP.

Current Aging Science. 2024;17(2):156-168
pages 156-168 views

A Novel Mutation (Lys31Arg) in the DMD Gene Impacts on Neuromuscular Dysfunctions Found by Whole Exome Sequencing and In Silico Analyses in an Iranian Family

Omarmeli V., Lewandrowski K., Assefi M., Faizmahdavi H., Sharafshah A., Mansouri N.

Abstract

Background:Duchene Muscular Disorder (DMD) is a severe X-linked recessive neuromuscular disease. Previous reports predicted that one-third of cases with a fatal X-linked recessive disease will be caused by a novel mutation, and the mutation rate for DMD seems to be higher in males.

Objective:A novel mutation in the DMD gene DMD (NM_004006.3):c.92A>G (p.Lys31Arg) is suggested for males because of their heterozygous mothers carrying the mutant alleles

Method:Whole Exome Sequencing (WES) was done for a 25-year-old female followed by the screening of the novel mutation in her parents and her brother by the Sanger sequencing technique. Some in silico analyses were run to find the putative alterations in wild-type and mutant structures by PolyPhen-2 and Mupro. Notably, SWISS-MODEL was performed to build a reliable model for the mutant allele based on the PDB ID: 1DXX structure. Also, superimposition was done by PyMol.

Results:WES analysis revealed three novel mutations including DLD (exon13:c.G1382A:p. G461E), ABCA3 (exon12:c.G1404C:p.W468C), and DMD (exon2:c.A92G:p.K31R) in the case. Focusing on DMD mutation, Sanger sequencing of the patient’s parents and brother indicated no mutant allele in her mother and brother but a mutant allele in her father as a hemizygous pattern. In silico analyses showed no considerable change regarding pathogenic impact.

Conclusion:In conclusion, our findings revealed no pathogenic effect of the new mutation (K31R) of the DMD gene in an Iranian 25-year-old woman. Because of the DMD importance in preclinical diagnosis, these data may shed a light on the diagnosis of this mutation in future pregnancies.

Current Aging Science. 2024;17(2):169-174
pages 169-174 views