View clinical trials related to Aging.
Filter by:The proposed studies will assess 1) the mechanisms for the age-related increase in fatigability during dynamic exercise (Aims 1 and 2) and 2) the effectiveness of high-velocity resistance training coupled with blood flow restriction (BFR) in improving muscle power output and fatigability in older adults (Aim 3). The first two aims are cross-sectional studies comparing young (18-35 years old) and older adults (≥60 yrs old) to test our central hypothesis that the greater accumulation of metabolites and increase in fatigability in older adults is due to either age-related impairments in skeletal muscle bioenergetics (Aim 1) and/or vascular dysfunction (Aim 2). These two aims will integrate techniques to assess whole-muscle bioenergetics (31P-MRS) and in vivo vascular function (near infrared spectroscopy; NIRS and doppler ultrasonography) with in vitro assessment of single fiber bioenergetics (epifluorescence microscopy) and vasoreactivity of isolated skeletal muscle arterioles (video microscopy). We will then determine whether bioenergetics, vascular function and fatigability are altered in older men and women in response to 8 weeks of resistance exercise training of the lower limb both with and without blood flow restriction (Aim 3).
Introduction The promotion of physical activity among older adults is considered to be one of the main actions that can result in more successful aging. Currently, there are few studies focusing on the effects of long-duration physical activity interventions in older adults. Thus, the purpose of the following study was to analyze the effects of an 8-month multicomponent intervention program on cardiorespiratory capacity, body composition, and strength in a group of nonagenarians. A secondary objective was to determine if the impact of the program differed according to the participants' way of life (institutionalized vs. community dwelling). Methods Participants Participants in this research represent a subset from an ongoing study aimed at collecting baseline and follow-up data over three years, to evaluate the health-related changes observed in a cohort of older adults f The present research was carried out on the basis of data obtained from the individuals in this sample who participated in a multicomponent intervention program offered to the inhabitants of the said region and who met the following inclusion criteria: a) being ninety years of age or older; and b) holding a medical certificate confirming their suitability for sport. The exclusion criteria were a) lack of independent ambulation (walking with an assistive device); b) recent upper or lower limb injuries; c) neurological or orthopedic diagnosis in upper or lower-extremities. Intervention A multicomponent intervention program was developed consisting of two 60-minute sessions per week, held on non-consecutive days, for a period of 8 months. The sessions consisted of a warm-up phase (10') in which individuals performed joint mobility exercises and walked at a rate of 3 km/h. Afterwards, muscular strength work was carried out on the upper and lower limbs, including calisthenic exercises, and the use of dumbbells or medicine balls (1-3kg). Generally, the exercises were organized in two sets of 10-15 repetitions, resting for two minutes between sets. Communal ball games and relay games were then practiced (over a distance of 30 meters). Finally, 10 minutes were devoted to relaxation and stretching exercises. multicomponent intervention program was designed and monitored by a specialist in gerontogymnastics. Evaluations Two weeks before the start and after the end of the exercise program, a series of assessments were carried out, which were monitored by specialists in physical exercise and sport, who did not know whether those evaluated were institutionalized or not. Body composition Weight was measured to the nearest 0.1 kg using a Tefal digital scale (type PP1200VO) with the participants wearing light clothing and no shoes. Height was measured to the nearest millimeter with a field stadiometer (Seca 220). The body mass index (BMI) was calculated taking the body weight in kilograms and dividing it by the height in meters squared (BMI: kg/m2). Densitometry Bone mineral density content (BMD) of the femoral neck was measured using a dual energy X-ray absorptiometry (DEXA) machine (Hologic QDR 1000®), which reported BMD in grams per square centimeter (g/cm2). This method was used to ensure better reproducibility, a lower radiation dose and better image resolution (Watts 2004). The minimum significant alteration, with a 95% confidence interval, was 4.7%. Muscular strength Upper limb muscle strength was assessed with the Handgrip Test (HG) on the right hand using a dynamometer (SH5001, SAEHAN Corporation, South Korea). For each measurement, patients were asked to perform their maximum voluntary contraction for 5s. Each measurement was repeated three times with patients resting for 30s between trials. The best performance was recorded for further analysis. Lower limb muscle strength was assessed with the Isometric Knee Extension Test (KNEE), performed three times on the right leg with participants seated on a custom-built chair with a load cell (Vetek VZ101BS, Vaddo, Sweden). For each measurement, participants were asked to perform their maximum voluntary contraction for 5 s. The test was repeated 3 times and participants rested for 2 min between trials. The best performance from the three trials was considered for further analysis. Cardiorespiratory fitness In order to assess the effect of the program on the participants' cardiorespiratory fitness, the six-minute walk test (6MWT), was performed, following standard procedure. The subjects were instructed to walk at their own pace from one end to the other of a 100-foot-long measured distance in an enclosed, level, corridor, and to cover as much ground as possible in 6 min. They were allowed to stop and rest during the test, but were instructed to resume walking as soon as they felt able to do so.
As a consequence of the impending increase in life expectancy, there is urgent need to adopt life-saving interventions, such as hematopoietic stem cell transplantation, (SCT) in groups of patients that have been regarded as unsuitable for such medical procedures owing to their advanced age. However, a growing body of evidence shows that age per se does not account for a reliable estimation of the capability of an individual to cope with the stressful procedure of SCT and to deal with the cognate adverse effects. Recent literature shows that changes in epigenetic markers (i.e. the extent of methylation) at specific loci of genomic DNA marks the rate of aging and allows for the estimation of the so called "biologic aging." In other words, individuals of the same chronologic age may turn out to be older or younger respect when their biologic age is assessed. This latter is expected to be tightly linked to changes in major homeostatic mechanisms and consequently to be in relationship the chance of successful SCT. The primary objective of the study is the study of DNA in patients undergoing allogeneic haematopoietic stem cell transplantation. DNA will be assessed for the extent of methylation, which will be also in relationship with circulating exogenous DNA (i.e the microbiome).
The Atlas of Retinal Imaging in Alzheimer's (ARIAS) study is a 5-year study examining the natural history of retinal imaging biomarkers associated with disease risk, disease burden, and disease progression in Alzheimer's disease (AD). The objective of this project is to create a 'gold standard' reference database of structural anatomic and functional imaging of the retina, in order to enable the identification and development of both sensitive and reliable markers of AD risk and/or progression. Our ultimate goal is to develop a new screening protocol that identifies changes related to AD 10-20 years before AD is clinically visible.
During middle-age, humans begin to lose muscle mass and strength. With increasing age the deterioration of muscle health is associated with a decline in quality of life and the loss of independence. β-hydroxy β-methylbutyrate (HMB) plus Vitamin D (VitD) have been proposed to increase skeletal muscle mass, contractile function and improve body composition but has yet to be evaluated in middle-aged women. The overall goal of this study is to determine the effects of HMB +VitD supplementation during 12 weeks of resistance exercise training or a non-exercise control on body composition, skeletal muscle size, and skeletal muscle function in middle-aged women.
To assess the acceptability of a personalised ICT tool that facilitates coordinated care planning, treatment optimisation and patient self-management for patients with multiple long term conditions and their team of health professionals.
Aging is the primary risk factor for cardiovascular diseases (CVD), the number one cause of death in developed societies. Systolic blood pressure (SBP) increase with age and is a key intermediary factor linking aging to increased CVD risk. The primary mechanisms underlying the age-associated increase in SBP is stiffening of the large elastic arteries, which is mediated by increases in oxidative stress, inflammation, and vascular smooth muscle tone. Regular caloric restriction is effective at lowering SBP in middle-aged and older adults; however, adherence to caloric restriction is poor and may be detrimental to normal weight older adults due to reduced skeletal muscle mass and bone mineral density. Therefore, identification of more practical alternative interventions that mimic the beneficial effects of caloric restriction, with stronger adherence and less risk of adverse consequences, is of significant biomedical importance. Nicotinamide riboside is a naturally occurring precursor of nicotinamide adenine dinucleotide (NAD+), a critical mediator of the beneficial effects of caloric restriction, and therefore a novel caloric restriction mimetic compound. We recently completed the first pilot study of nicotinamide riboside supplementation in healthy middle-aged and older adults and demonstrated that 6 weeks of supplementation decreased systolic blood pressure (SBP) by 8 mmHg in individuals with baseline SBP of 120-139 mmHg (elevated SBP/stage 1 hypertension) compared with placebo, and lowered arterial stiffness, a strong independent predictor of CVD and related morbidity and mortality. As a next translational step, we will conduct a randomized, placebo-controlled, double-blind clinical trial to further assess the safety and efficacy of oral nicotinamide riboside (3 months vs placebo) for decreasing SBP and arterial stiffness in middle-aged and older men and women with SBP between 120 and 139 mmHg at baseline.
The objective of this study is to determine if a four-week, 20-session intervention of personalized transcranial direct current stimulation (tDCS), as compared to sham intervention, improves dual task standing and walking performance (Aim 1), as well as other physical (Aim 2) and cognitive (Aim 3) factors on the causal pathway to falls, in older adults who report two or more falls within the past year and fear of falling again in the future, yet who do not have any acute or over neurological or musculoskeletal condition. Primary endpoints will include the "dual task" costs to gait speed when walking and postural sway speed when standing, as induced by performing a serial subtraction cognitive task (i.e., [(speeddual task - speedsingle task) / speedsingle task) X 100] (Aim 1), the Short Physical Performance Battery (Aim 2), and the Trail Making Test (Part B minus Part A) (AIM 3). Secondary endpoints will include the dual task cost to serial subtraction performance, additional gait and balance outcomes derived from the dual task paradigm, the Timed Up-and-Go, fear of falling, habitual physical activity, and performance within a battery of neuropsychological tests focused on global cognitive function, attention, verbal fluency and memory.
Older adults often experience substantial deficits in walking ability, especially for walking tasks that are more complex such as obstacle crossing. This is due in part to changes in the brain that make performance of physical and cognitive tasks more difficult. Rehabilitation can help to improve walking ability, but effective rehabilitation is time consuming and expensive. New approaches are needed to improve the efficiency of rehabilitation so that gains in walking ability are widely attainable. A promising strategy is to focus on enhancing motor learning, which is defined as improved ability to perform a motor task due to practice or experience. The investigators will investigate the use of non-invasive brain stimulation to increase motor learning and retention of the newly learned walking skills. The investigators will also use neuroimaging to assess brain characteristics that explain how motor learning works. The knowledge gained from this study is expected to contribute to better understanding of mechanistic targets and intervention approaches to improve rehabilitation of walking.
Purpose Frailty and multi-morbidity have been associated with increased pressure on Emergency Departments (ED), higher hospital admissions and more risks for patients arising from the ED stay. The advantages of developing specific attention to frailty in ED have been highlighted. The benefits of these approaches are related to patients but also to organizations. The aim is to present how a Program of Care for Frailty (PCF) in an ED impacts on patient health and flows. Objective is to analyze the clinical impact of Comprehensive Geriatric Care (CGA) in the Emergency Department (ED) and on patient flows Setting: A tertiary, teaching, 550-bed urban hospital, with 80,000 adult patients/year ED attendances (43%≥65 years). Two periods are compared: First period (before CGA implantation) del 01/04/2016 - 15/04/2016 and second period (after) 01/04/2017 - 15/04/2017