Journal of gerontology & geriatric research最新文献

{"title":"Testosterone Supplementation Improves Carbohydrate and Lipid Metabolism in Some Older Men with Abdominal Obesity.","authors":"Fr Sattler,&nbsp;J He,&nbsp;J Chukwuneke,&nbsp;H Kim,&nbsp;Y Stewart,&nbsp;P Colletti,&nbsp;Ke Yarasheski,&nbsp;Ta Buchanan","doi":"10.4172/2167-7182.1000159","DOIUrl":"https://doi.org/10.4172/2167-7182.1000159","url":null,"abstract":"<p><strong>Background/objectives: </strong>The effects of testosterone supplementation on carbohydrate and lipid metabolism in obese older men are uncertain. We conducted a single-arm open-label prospective pilot study to investigate the effects of testosterone supplementation on central and peripheral insulin sensitivity in older men with upper body obesity and insulin resistance.</p><p><strong>Subjects/methods: </strong>Twenty men (62-78 years-old) with morning testosterone levels <13.9 nmol/L (400 ng/dL), waist circumference ≥ 102 cm, and HOMA-IR ≥ 4.0 or HgbA1C 5.7-6.4% applied transdermal testosterone (10 mg) daily for 20 weeks. Insulin sensitivity (Si) was determined by a 2-stage glucose clamp, liver and intramyocellular lipid by ¹H-MR spectroscopy and body composition by DEXA.</p><p><strong>Results: </strong>Testosterone supplementation significantly reduced total fat (-.9 ± 2.4 kg, p=0.002), trunk fat (-1.3 ± 1.4 kg, p=0.0007) and extremity fat (-0.7 ± 1.1 kg, p=0.01), and increased extremity lean tissue (+1.3 ± 1.4 kg, p=0.0006). Whole body (WB) Si improved by 21% (0.76 ± 1.57 dL/min per µU/mL, p=0.04) and insulin-stimulated glucose uptake (Rd) by 24% (0.91 ± 1.74 dL/min per µU/mL, p=0.03). Improvements in glucose kinetics were limited to men with reductions in trunk and extremity fat greater than median declines for the entire group. Reductions in intramyocellular lipid were associated with improvements in WB Si (p=0.04) and Rd (p=0.03). Change in Rd accounted for 90% of the change in WB Si. Hepatic glucose output and liver lipid/H₂O were unchanged (p>0.05). Multivariable analyses revealed that reductions in extremity fat, trunk fat, and FFA levels during the clamp accounted for 45% (p=0.004), 31% (p=0.002) and 8% (p=0.04) of respective changes in Rd. Triglycerides decreased by -0.40 ± 0.67mmol/L (p=0.02), LDL-C by-0.35 ± 0.57 mmol/L (p=0.02), and HDL-C by -0.14 ± 0.19 mmol/L (p=0.004).</p><p><strong>Conclusions: </strong>Testosterone supplementation that resulted in greater reductions in regional adiposity was associated with improved insulin sensitivity, lower LDL-C and fasting triglycerides, but lower HDL-C. Placebo controlled trials need to further examine the potential cardiometabolic risks/benefits of androgen supplementation for older men with low testosterone levels, central obesity, and insulin resistance.</p>","PeriodicalId":90221,"journal":{"name":"Journal of gerontology & geriatric research","volume":"3 3","pages":"1000159"},"PeriodicalIF":0.0,"publicationDate":"2014-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7182.1000159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32811007","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":"Gender Difference in Falls among Adults Treated in Emergency Departments and Outpatient Clinics.","authors":"Feifei Wei,&nbsp;Amy L Hester","doi":"10.4172/2167-7182.1000152","DOIUrl":"https://doi.org/10.4172/2167-7182.1000152","url":null,"abstract":"<p><strong>Background: </strong>This study examined the impact of gender on age-related increase for falls and injurious falls resulting in head injuries/fractures among adults, using data from both emergency department and clinic visits. We also estimated the percentages of falls treated in points of entry outside of emergency departments.</p><p><strong>Methods: </strong>The study population consisted of 259,611 adults seen at emergency department, inpatient, and/or outpatient facilities between January, 2007 and June, 2012 at a US medical center. Rates of falls and injurious falls with head injuries/fractures were calculated by age and gender.</p><p><strong>Results: </strong>After using both emergency department and clinic visit data, medically consulted falls and injurious falls resulting in head injuries/fractures increased with age for females aged ≥ 18 years. For males, these rates declined, reached the lowest point at age of 65-74, and then increased again. Thirty-nine percent of females and 63% of males treated their falls in clinics, instead of emergency departments.</p><p><strong>Conclusion: </strong>Gender disparity of medically consulted falls and related injuries exits among adults. Age and gender targeted fall injury prevention interventions need further development. Significant numbers of fall-related injuries were treated at clinics; future research is needed to determine whether fall injury surveillance should be expanded to include outpatient clinics.</p>","PeriodicalId":90221,"journal":{"name":"Journal of gerontology & geriatric research","volume":"3 ","pages":"152"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7182.1000152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32742061","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":"Trends in Fall-Related Traumatic Brain Injury among Older Persons in Connecticut from 2000-2007.","authors":"Terrence E Murphy,&nbsp;Dorothy I Baker,&nbsp;Linda S Leo-Summers,&nbsp;Mary E Tinetti","doi":"10.4172/2167-7182.1000168","DOIUrl":"https://doi.org/10.4172/2167-7182.1000168","url":null,"abstract":"<p><strong>Background: </strong>Anecdotal evidence suggests a rising trend in the occurrence of fall-related traumatic brain injuries (FR-TBI) among persons ≥ 70 years. To document this apparent trend on a more substantive basis, this report longitudinally describes overall and age-stratified rates of three outcomes attributed to FR-TBI among persons ≥ 70 years: emergency department visits (ED), hospitalizations, and terminal hospitalizations.</p><p><strong>Methods: </strong>Eight years (2000-2007) of observational data from emergency departments and acute care hospitals serving a non-randomly selected, densely populated region in southern Connecticut, U.S.</p><p><strong>Results: </strong>From 2000-2007 among persons 70 years and older, overall rates of FR-TBI visits to emergency departments more than doubled while corresponding rates of hospitalization and terminal hospitalization rose 58% each. The point estimate of growth in the rate of ED in the oldest stratum was nearly triple that of the younger stratum whereas point estimates of growth in rates of hospitalization and terminal hospitalization were nearly four times higher. Total Medicare costs for ED visits increased nearly four-fold while corresponding costs for hospitalizations and terminal hospitalizations rose by 64% and 76%. The most common discharge diagnoses for ED and hospitalization were unspecified head injury and intracranial hemorrhage.</p><p><strong>Conclusions: </strong>The rapid rise in rates of FR-TBI and associated Medicare costs underscore the urgent need to prevent this burgeoning source of human suffering and health care utilization. We believe the rise in rates is at least partially due to a greater public awareness of the outcome that has been facilitated by increasing use of diagnostic imaging in the ED and hospital.</p>","PeriodicalId":90221,"journal":{"name":"Journal of gerontology & geriatric research","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7182.1000168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32949568","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":"Age-Related Treatment Disparities among Medicaid Beneficiaries with Metastatic Colorectal Cancer.","authors":"Heidi D Klepin,&nbsp;Janet A Tooze,&nbsp;Eun-Young Song,&nbsp;Ann M Geiger,&nbsp;Kristie L Foley","doi":"10.4172/2167-7182.1000134","DOIUrl":"https://doi.org/10.4172/2167-7182.1000134","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of age on receipt of chemotherapy among low-income individuals with metastatic colorectal cancer.</p><p><strong>Data sources/study setting: </strong>North Carolina Medicaid enrollees with metastatic colorectal cancer diagnosed from 1999 to 2002 with colorectal as their only cancer (N=326).</p><p><strong>Study design: </strong>Retrospective analysis using linked data from the North Carolina Cancer Registry and Medicaid claims.</p><p><strong>Data collection/extraction methods: </strong>Outcomes were chemotherapy use within one year of diagnosis and time to initiation of chemotherapy. Cox regression models were fit to evaluate the association between chemotherapy use and age, stratifying for comorbidity, and adjusting for patient, community, and health services characteristics.</p><p><strong>Principal findings: </strong>Compared to 67.4% of patients aged <70 years, only 26.2% of patients ≥70 years received chemotherapy. After adjustment, younger patients with and without comorbidity were more likely to receive chemotherapy than older patients (hazard ratio (HR)=2.27, 95% confidence interval (CI) 1.41-3.66 and HR=6.33, 95% CI 2.87-13.96, respectively). Among those who received chemotherapy, the median time to receipt was 53 days, and did not differ significantly by age or comorbidity.</p><p><strong>Conclusion: </strong>In this low-income cohort, older age was consistently associated with non-receipt of chemotherapy but not longer time to initiation of chemotherapy regardless of comorbidity status.</p>","PeriodicalId":90221,"journal":{"name":"Journal of gerontology & geriatric research","volume":"2 4","pages":"134"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7182.1000134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32095650","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":"The Relationship between Health-Related Behaviors and Quality of Life in the Retired Elderly People in Shiraz, Iran in 2014","authors":"T. Rakhshani, F. Bahadori, A. Asadollahi, F. Ebtekar, Z. Motlagh","doi":"10.4172/2167-7182.1000497","DOIUrl":"https://doi.org/10.4172/2167-7182.1000497","url":null,"abstract":"Background: Aging phenomenon is one of the most important economic, social, and health challenges in the twenty-first century. Regarding the growth of the elderly population and the importance of their life quality, this study was designed to assess the relationship between health-related behaviors and quality of life in the retired elderly people in Shiraz, Iran 2014 \u0000Materials and Methods: This cross-sectional study conducted in Shiraz, Iran 2014 on 500 retired elderly people in the state retirement centers. The sampling method was stratified random sampling. Data gathering instrument was Iranian version of the SF-36 questionnaire. Data were analyzed by T- test, ANOVA and the multiple regressions using SPSS 21. \u0000Results: 268 men (53.6%) and 232 women (46.4%) with the mean age 73.9 ± 8.0 entered in the study. The mean ± SD of the total score of the life quality was 50.88 ± 17.01, the mean ± SD of the physical and mental dimension was 49.12 ± 20.22, 52.71 ± 17.81 respectively. There was a significant difference between quality of life and Variables of sex, age, education, marital status, income and life style (p<0.05). \u0000Conclusion: According to the results, the overall quality of life in the elderly is relatively good. However, teaching the elderly people how to live healthy might help prevent many of their problems and take steps to improve their quality of life.","PeriodicalId":90221,"journal":{"name":"Journal of gerontology & geriatric research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7182.1000497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70829188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}