GeriatricsPub Date : 2025-03-13DOI: 10.3390/geriatrics10020042
Gohar Azhar, Amanda K Pangle, Karen Coker, Shakshi Sharma, Jeanne Y Wei
{"title":"Effect of Protein Supplementation on Orthostatic Hypotension in Older Adult Patients with Heart Failure.","authors":"Gohar Azhar, Amanda K Pangle, Karen Coker, Shakshi Sharma, Jeanne Y Wei","doi":"10.3390/geriatrics10020042","DOIUrl":"10.3390/geriatrics10020042","url":null,"abstract":"<p><p><b>Purpose:</b> Heart failure (HF) impairs physical performance and increases the incidence of orthostatic hypotension (OH). Individuals with OH have a higher risk of falls, which are a major source of morbidity and mortality in older adults. Dietary protein supplementation can improve physical performance in healthy older adult individuals; however, its effect on OH in older adult patients with HF is unknown. <b>Methods:</b> Twenty-one older adult patients with mild-to-moderate HF were randomized to placebo or protein supplementation. Dietary protein was supplemented with whey protein so the total protein intake for each participant was 1.2 g/kg bodyweight/day, plus 1 g/day of the amino acid l-carnitine for 16 weeks. Susceptibility to OH was assessed using a head-up tilt test, blood markers, and a functional test (6 min walk) at baseline and 16 weeks. <b>Results:</b> There were no differences in tilt test responses or 6 min walk test (6MWT) distances. The protein-supplement group had a significant increase in 6MWT pulse pressures post-walk after 16 weeks of treatment as compared to placebo. However, the tachycardia observed at baseline after 6MWT in the protein group was not seen at the end of the study. There was also a trend towards lower levels of brain naturetic peptide (proBNP) in the protein group vs. placebo at 16 weeks. <b>Conclusions:</b> The improved pulse-pressure response to exertion and positive trends in proBNP in this pilot study suggest that dietary supplementation may improve cardiovascular function and general health in individuals with HF and that larger future studies are justifiable.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-03-13DOI: 10.3390/geriatrics10020040
Luciano Maia Alves Ferreira, José Brito, Josie Resende Torres da Silva, Marcelo Lourenço da Silva, Maia E Maia Fischel E Andrade, André Júdice, José João Mendes, Vanessa Machado, João Thiago Botelho, Simone Cecílio Hallak Regalo
{"title":"Assessing Frailty in the Older: The Role of Bite Force as an Independent Indicator.","authors":"Luciano Maia Alves Ferreira, José Brito, Josie Resende Torres da Silva, Marcelo Lourenço da Silva, Maia E Maia Fischel E Andrade, André Júdice, José João Mendes, Vanessa Machado, João Thiago Botelho, Simone Cecílio Hallak Regalo","doi":"10.3390/geriatrics10020040","DOIUrl":"10.3390/geriatrics10020040","url":null,"abstract":"<p><p><b>Background:</b> This study investigates the relationship between bite force and grip strength as indicators of frailty in older adults. Frailty syndrome, characterized by increased vulnerability to adverse health outcomes, poses significant challenges in geriatric care. <b>Objectives:</b> This research builds on previous findings linking oral health to frailty risk, emphasizing the need for targeted interventions. <b>Methods:</b> A total of 59 older participants, aged 60 years and older, were enrolled in this cross-sectional study conducted at the Egas Moniz School of Health and Science. The participants underwent assessments of bite force using an electric dynamometer and grip strength using a specialized device. Body composition was also measured using bioelectrical impedance analysis (BIA). <b>Results:</b> Statistical analysis revealed a significant positive correlation between bite force and grip strength, even after adjusting for age and body mass index (BMI). Age was significantly correlated with bite and grip force (<i>p</i> < 0.05), while BMI was correlated only with handgrip force but not with bite force (coefficient = -0.047, <i>p</i> = 0.737). Notably, bite force was found to be independent of BMI, unlike grip strength, which is generally influenced by body composition. This independence highlights the potential of bite force as a reliable and distinct marker for frailty that is not confounded by BMI-related factors. This study highlights the importance of oral health in maintaining overall well-being in older adults. Reduced bite force may indicate an increased risk of frailty, which can lead to malnutrition and decreased quality of life. These findings suggest that integrating bite force measurements into clinical assessments may improve the assessment of frailty and inform interventions aimed at improving health outcomes in the older population. <b>Conclusions:</b> This research provides new insights into the association between bite force and grip strength, emphasizing the unique value of bite force as an independent marker of frailty. It advocates for further studies to explore its role in geriatric care strategies.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Validation of the Italian Version of the Rapid Geriatric Assessment in Community-Dwelling Older Adults.","authors":"Carlotta Tacchino, Luca Carmisciano, Elena Page, Silvia Ottaviani, Luca Tagliafico, Alda Boccini, Alessio Signori, Chiara Giannotti, Alessio Nencioni, Fiammetta Monacelli","doi":"10.3390/geriatrics10020038","DOIUrl":"10.3390/geriatrics10020038","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The Rapid Geriatric Assessment (RGA) is a tool designed to screen for frailty, sarcopenia, anorexia related to aging, and cognitive impairment. This study aimed to translate and validate the RGA for use among Italian community-dwelling older adults. <b>Methods</b>: This cross-cultural study involved 100 community-dwelling older adults randomly recruited through convenience sampling from general practitioner offices in Genoa (Italy), between January and June 2019. The RGA includes the Simple FRAIL Questionnaire Screening Tool, SARC-F Screening for Sarcopenia, Simplified Nutritional Assessment Questionnaire (SNAQ), and Rapid Cognitive Screening (RCS). These were validated against gold-standard tools: the Abbreviated Comprehensive Geriatric Assessment (aCGA) and Multidimensional Prognostic Index (MPI). Additional assessments included the Timed Up and Go (TUG) and Handgrip test. The validation process included forward-backward translation, synthesis, and consensus by independent reviewers. Psychometric properties, internal consistency (Cronbach alpha), and validity correlations were analyzed. <b>Results</b>: The RGA demonstrated satisfactory psychometric properties, with internal consistency (Cronbach alpha = 0.59) and significant validity correlations (RGA and aCGA, rho = 0.34, <i>p</i> = 0.001; RGA and MPI, rho = 0.49, <i>p</i> < 0.001). Discriminant validity was confirmed by significant correlations between specific subitems and reference measures: FRAIL with TUG (<i>p</i> < 0.05), SARC-F with Handgrip strength (<i>p</i> = 0.013), SNAQ with BMI, and RCS with MMSE (<i>p</i> < 0.001). <b>Conclusions</b>: The Italian version of the RGA is a reliable screening tool for geriatric syndromes in community-dwelling older adults. While it does not replace a CGA, the RGA may identify individuals who may benefit from further evaluation using a complete CGA.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-03-07DOI: 10.3390/geriatrics10020036
Toby O Smith, Susanne Arnold, Mark Baxter
{"title":"Health Professional Support for Friends and Family Members of Older People Discharged from Hospital After a Fracture: A Survey Study.","authors":"Toby O Smith, Susanne Arnold, Mark Baxter","doi":"10.3390/geriatrics10020036","DOIUrl":"10.3390/geriatrics10020036","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Friends and family members of people who are discharged from hospital after a fracture often take on caring roles, since these patients have reduced independence during recovery. Previous literature suggests that these individuals are rarely supported in their adoption of these roles. No studies have previously explored the use of carer training interventions to support friends/family members by health professionals in this setting. This survey study aimed to address this. <b>Methods:</b> A cross-sectional online survey was conducted among health professionals who treat people in hospital following fractures. Respondents were asked about the use of care training for friends/family members of people discharged from hospital after fracture, and whether a clinical trial would be useful to test such carer training interventions. <b>Results:</b> A total of 114 health professionals accessed the survey. Fifty respondents (44%) reported that carer training was not offered in their practice. When it was offered, respondents reported this was not consistently provided. Less than 12% of respondents reported offering carer training to most of their patients following a fracture. What was offered in these instances was largely based on education provision (69%), practical skills in exercise prescription (55%) and manual handling (51%). Ninety-eight percent of respondents reported that a clinical trial would be, or would potentially be, valuable to aid a change in practice to include carer training in routine clinical care. <b>Conclusions:</b> Carer training programmes are not routinely provided in clinical practice for people following a fracture. The results indicate that health professionals see a potential value in these programmes, but further research is recommended to provide an evidence base for these interventions.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-03-07DOI: 10.3390/geriatrics10020037
Alison I C Donaldson, Claire L Fyfe, Jennifer C Martin, Ellen E Smith, Graham W Horgan, Phyo K Myint, Alexandra M Johnstone, Karen P Scott
{"title":"Aging Gut-Brain Interactions: Pro-Inflammatory Gut Bacteria Are Elevated in Fecal Samples from Individuals Living with Alzheimer's Dementia.","authors":"Alison I C Donaldson, Claire L Fyfe, Jennifer C Martin, Ellen E Smith, Graham W Horgan, Phyo K Myint, Alexandra M Johnstone, Karen P Scott","doi":"10.3390/geriatrics10020037","DOIUrl":"10.3390/geriatrics10020037","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Alzheimer's disease (AD) is the most common form of dementia, characterized by an irreversible decline in cognitive function. The pathogenesis of several neurodegenerative disorders has been linked to changes in the gut microbiota, transmitted through the gut-brain axis. <b>Methods</b>: We set out to establish by case-control study methodology whether there were any differences in the composition and/or function of the gut microbiota between older resident adults in care homes with or without an AD diagnosis via analysis of the microbial composition from fecal samples. <b>Results</b>: The microbial composition, determined by 16S rRNA gene profiling, indicated that AD sufferers had significantly increased proportions of <i>Escherichia/Shigella</i> and <i>Clostridium_sensu_stricto_1</i>, and significantly decreased proportions of <i>Bacteroides</i>, <i>Faecalibacterium</i>, <i>Blautia</i>, and <i>Roseburia</i> species. The increase in potentially pro-inflammatory bacteria was consistent with slightly higher concentrations of calprotectin, a biomarker of gut inflammation. Fecal concentrations of most microbial metabolites measured were similar across groups, although participants with AD had significantly increased proportions of the branched-chain fatty acid, iso-butyrate, and lower overall concentrations of total short chain fatty acids. <b>Conclusions</b>: Participants with Alzheimer's disease have several key differences within their gut microbiota profile, in contrast to care home residents without Alzheimer's disease. The altered microbiome included both compositional and functional changes linked to poorer health and gut inflammation.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-03-05DOI: 10.3390/geriatrics10020035
Carrie Stewart, Nicole Thomas, Robert Witton, Ewen McColl, Patricia Schofield
{"title":"Involving Family Caregivers in Developing an Intervention for Assessing Risk of Dental Pain in Individuals Living with Dementia.","authors":"Carrie Stewart, Nicole Thomas, Robert Witton, Ewen McColl, Patricia Schofield","doi":"10.3390/geriatrics10020035","DOIUrl":"10.3390/geriatrics10020035","url":null,"abstract":"<p><p><b>Background</b>: Experiences of dental pain among older people living with dementia, particularly those residing in care homes, have been identified as an under-researched area. There is an urgent need for initiatives, co-developed with experts according to their experience, to address key challenges for oral health improvement among older people living with dementia. This paper reports the findings from a participatory activity which informed the development of an intervention. <b>Methods</b>: Informed by discussions with a prominent PPI representative in the field of caring for persons with dementia and a prior multi-disciplinary stakeholder event, a discussion involving ten caregivers of individuals with dementia was conducted. Caregivers were invited from different regions of the UK, with seven joining an online group discussion and three engaging in one-on-one conversations. Transcripts of the conversations based on three topics of discussion (dental experiences, dental challenges and thoughts on a dental pain risk assessment tool) were analysed using thematic analysis to inform a proposed co-developed model of an intervention which can improve dental care for those living with dementia. <b>Results</b>: Areas which informed the next phase of discussions and intervention development were access to dental services, lack of alignment between dental care services and health and social care, and low support for carers in how to carry out mouthcare, specific to the type of dementia lived with. Carers felt that preventing, monitoring and managing dental pain should form part of the care package and that it should not be the responsibility of the carer to conduct a dental pain risk assessment. The key recommendation made by carers was the need for a multi-component intervention. This should be flexible according to individual needs and provide education and support to carers to assist with mouthcare, with responsibility for assessing dental pain risk sitting firmly with a nominated professional. <b>Conclusions</b>: Our findings from this discussion group with carers of persons living with dementia identified which areas of mouthcare responsibility should be part of the unpaid caring role and which should form part of a healthcare professional role. This shaped a final stakeholder event and facilitated the development of a grant proposal (which includes one of the caregivers as a co-investigator) to test a co-developed intervention for the prevention of dental pain in persons living with dementia.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-03-01DOI: 10.3390/geriatrics10020034
Julian Andrés Mateus Rodríguez, Patricia Rodríguez Sanz, Edgar Kostandyan, Rubén Palacios Sanchez, María Luz Pino Roque, Patricia Chaves Vasquez, Pedro Roy Millán
{"title":"Mitigating Diarrhoea-Related Inflammation in Frail Older Adults with Postbiotic-Enhanced Oral Rehydration Solution: Insights from a Randomised, Double-Blind, Placebo-Controlled Study.","authors":"Julian Andrés Mateus Rodríguez, Patricia Rodríguez Sanz, Edgar Kostandyan, Rubén Palacios Sanchez, María Luz Pino Roque, Patricia Chaves Vasquez, Pedro Roy Millán","doi":"10.3390/geriatrics10020034","DOIUrl":"10.3390/geriatrics10020034","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Diarrhoea in older adults can lead to dehydration and malnutrition, impaired gut barrier function, and reduced quality of life. Unresolved inflammation during diarrhoea episodes contributes to relapse and complications. This randomised study evaluated the effects of a novel oral rehydration solution (ORS) with the postbiotic ABB C22<sup>®</sup>, known for its anti-inflammatory properties, on diarrhoea-associated inflammation in an elderly population. <b>Methods</b>: A randomised, double-blind, placebo-controlled, parallel-group trial was conducted at two hospital centres in Barcelona, Spain. Forty-seven participants aged ≥65 years with diarrhoea (<i>n</i> = 47) were randomised (1:1) to receive either ABB C22<sup>®</sup>-enriched ORS or placebo ORS for up to 14 days. Randomization was stratified by centre using a computer-generated sequence. Participants, caregivers, and outcome assessors were blinded. Primary endpoints were changes in faecal inflammatory biomarkers (calprotectin and lactoferrin) and blood immunoglobulin A. Secondary endpoints included changes in stool consistency (Bristol Stool Scale) and treatment tolerability. <b>Results</b>: Of the 47 participants, 42 completed the trial (21 per group). At day 14, the ORS + ABB C22<sup>®</sup> group showed greater reductions in faecal calprotectin and lactoferrin levels compared to the placebo group. Lactoferrin-positive cases were halved by day 3 in the intervention group. Stool consistency improved in both groups. No adverse events were reported in either group. <b>Conclusions</b>: ABB C22<sup>®</sup>-enriched ORS exhibited superior anti-inflammatory effects compared to standard ORS while achieving similar improvements in stool consistency. These findings suggest that postbiotic-enriched formulations represent a promising approach to better address the management of diarrhoea which is often accompanied by gut inflammation. The study protocol was registered in ClinicalTrials.gov (NCT06738420; date: 16 December 2024).</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-02-24DOI: 10.3390/geriatrics10020033
Guido Gembillo, Luca Soraci, Luigi Peritore, Rossella Siligato, Vincenzo Labbozzetta, Alfio Edoardo Giuffrida, Felicia Cuzzola, Claudia Spinella, Adolfo Romeo, Vincenzo Calabrese, Alberto Montesanto, Andrea Corsonello, Domenico Santoro
{"title":"Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients.","authors":"Guido Gembillo, Luca Soraci, Luigi Peritore, Rossella Siligato, Vincenzo Labbozzetta, Alfio Edoardo Giuffrida, Felicia Cuzzola, Claudia Spinella, Adolfo Romeo, Vincenzo Calabrese, Alberto Montesanto, Andrea Corsonello, Domenico Santoro","doi":"10.3390/geriatrics10020033","DOIUrl":"10.3390/geriatrics10020033","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated by COVID-19-related inflammation. To this aim, in this small-scale retrospective study, we investigated trends in the erythropoietin resistance index (ERI) over time in patients with and without SARS-CoV-2 infection. <b>Methods:</b> This single-center retrospective study included 25 HD patients, divided into two groups: 15 with a history of SARS-CoV-2 infection (CoV2 group) and 10 without (nonCoV2 group). The ERI was assessed over four visits, with 70-100-day intervals between them. Linear mixed models were used to evaluate factors associated with ERI changes. <b>Results:</b> Patients in the CoV2 group exhibited significantly higher ERI increases between T1 (baseline) and T2 (post-infection) compared to the nonCoV2 group (median ΔERI: +4.65 vs. -0.27, <i>p</i> < 0.001). During the T2-T4 recovery period, CoV2 patients demonstrated a delayed but substantial decline in the ERI, converging to baseline levels by T4. Male sex and hemoglobin levels were negatively associated with the ERI. <b>Conclusions:</b> SARS-CoV-2 infection induces transient but significant erythropoietin resistance in HD patients, likely due to inflammation and disrupted erythropoiesis. Tailored anemia management strategies, including the potential use of hypoxia-inducible factor stabilizers, are warranted. Larger, multicenter studies are needed to validate these findings and improve treatment protocols.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-02-20DOI: 10.3390/geriatrics10020032
Nicolò Granata, Marco Vercesi, Annamaria Bonfanti, Claudio Mencacci, Ilaria Coco, Mario Mangrella, Roberto Piazza, Giancarlo Cerveri
{"title":"Choline Alphoscerate: A Therapeutic Option for the Management of Subthreshold Depression in the Older Population.","authors":"Nicolò Granata, Marco Vercesi, Annamaria Bonfanti, Claudio Mencacci, Ilaria Coco, Mario Mangrella, Roberto Piazza, Giancarlo Cerveri","doi":"10.3390/geriatrics10020032","DOIUrl":"10.3390/geriatrics10020032","url":null,"abstract":"<p><p><b>Background and Objectives:</b> Subthreshold depression (StD) presents with depressive symptoms similar to major depressive disorder (MDD) but of lower intensity. Despite its milder form, StD is significantly prevalent in the older population, affecting up to 12.9%. StD is associated with adverse outcomes, such as an increased risk of MDD and mild cognitive impairment (MCI). Treating StD in older adults is challenging due to the limited efficacy and side effects of traditional antidepressants. As a result, clinicians often adopt a \"watchful waiting\" strategy, which increases the risk of StD progressing into MDD or MCI. Choline alphoscerate (α-GPC), a cholinergic drug, is indicated in the treatment of pseudodepression in the elderly, a condition that corresponds to the actual definition of StD. This review highlights the role of α-GPC in the treatment of StD in older subjects. <b>Methods:</b> A comprehensive review of preclinical and clinical studies was conducted, focusing on the efficacy of α-GPC in improving cognitive and behavioral functions in mental conditions and in modulating neurotransmitter systems involved in depression, such as dopamine and serotonin. <b>Results:</b> Evidence points to the therapeutic benefits of using α-GPC in StD as it acts on cholinergic dysfunction and cognitive impairment. Additionally, it may improve mood regulation and motivation, key factors in StD and in depressive disorders. These findings suggest that α-GPC may reduce the risk of progression from StD to MDD or MCI. <b>Conclusions:</b> α-GPC represents an effective and safe therapeutic option for the treatment of StD in the older population, improving clinical outcomes and enhancing the quality of life in this high-risk group.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GeriatricsPub Date : 2025-02-18DOI: 10.3390/geriatrics10010030
Ridwan Hashi, Rahma Thamer, Ahmed Hassan, Khalid Canna, Musaab Ahmed, Mohamed T Hassan, Safaa Badi, Mohamed H Ahmed
{"title":"A Contemporary Multifaceted Insight into the Association Between Diabetes Mellitus and Diverticular Disease: An Update About Geriatric Syndrome.","authors":"Ridwan Hashi, Rahma Thamer, Ahmed Hassan, Khalid Canna, Musaab Ahmed, Mohamed T Hassan, Safaa Badi, Mohamed H Ahmed","doi":"10.3390/geriatrics10010030","DOIUrl":"10.3390/geriatrics10010030","url":null,"abstract":"<p><p><b>Introduction:</b> Diverticular disease, once considered a rare geriatric gastrointestinal condition, has now become a prevalent disorder associated with increased morbidity and healthcare costs. The spectrum of complications from diverticular disease ranges from incidental findings to more serious issues such as bleeding and diverticulitis. Symptomatic diverticular disease represents a significant economic burden in the western world. Diabetes mellitus is a major global health issue. As global aging accelerates, geriatric syndromes such as diabetes mellitus (DM) and diverticular disease (DD) are becoming increasingly prevalent. Understanding their interplay is critical, particularly within the geriatric population. Both conditions are linked to lifestyle, dietary habits, and changes in gut physiology. Additionally, age-related alterations in the gut microbiome and immune system make this association more complex, contributing to morbidity and healthcare burdens in older adults. The primary aim of this review is to provide an update on the association between diabetes mellitus and diverticular disease. <b>Methods:</b> This narrative review explores the association between diabetes mellitus and diverticular disease. Relevant articles were identified by searching major databases. <b>Results:</b> Risk factors for diverticular disease include insulin resistance, diabetes mellitus, smoking, non-alcoholic fatty liver disease, lack of physical activity, a low-fibre diet, and a high-carbohydrate diet. These risk factors are also associated with the development of diabetes mellitus. Major population studies indicate that diabetes can either increase the risk of diverticular disease or have a neutral impact. A complication of diabetes mellitus includes impaired intestinal peristalsis and enteric nervous system dysfunction, which can ultimately lead to the formation of intestinal diverticula. High-calorie foods low in fibre are a staple in the diets of many type 2 diabetes mellitus patients, contributing to gut dysbiosis. A detrimental consequence of dysbiosis is a breach in the protective intestinal barrier, which promotes the development of diverticulosis. <b>Conclusions:</b> Diabetes mellitus may be associated with diverticular disease, and the risk factors that contribute to diabetes mellitus can also be linked to diverticular disease. Further studies are needed to explore the complex relationship between diabetes mellitus and diverticular disease.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}