Elderly Chinese Males Research Articles

Gender differences in the association between changes in the atherogenic index of plasma and cardiometabolic diseases: a cohort study

ObjectiveThe relationship between changes in Atherogenic Index of Plasma (AIP) and cardiometabolic diseases (CMD) in middle-aged and elderly individuals remains unclear. This study aims to explore the association between changes in AIP and CMD.MethodsThis study included 3,791 individuals aged over 45 years from CHARLS. Participants were divided into four groups using the K-Means clustering method. Cumulative AIP was used as a quantitative indicator reflecting changes in AIP. Differences in baseline data and CMD incidence rates among these four groups were compared. Multifactorial logistic regression models were used to assess the relationship between changes in AIP and CMD, and subgroup analysis and interaction tests were conducted to evaluate potential relationships between changes in AIP and CMD across different subgroups. Restricted cubic splines (RCS) were used to assess the dose-response relationship between cumulative AIP and CMD.ResultsChanges in AIP were independently and positively associated with CMD. In males, the risk significantly increased in class4 compared to class1 (OR 1.75, 95%CI 1.12-2.73). In females, changes in AIP were not significantly associated with CMD. Cumulative AIP was positively correlated with CMD (OR 1.15, 95%CI 1.01-1.30), with significant gender differences in males (OR 1.29, 95%CI 1.07-1.55) and females (OR 1.03, 95%CI 0.87-1.23) (p for interaction = 0.042). In addition, a linear relationship was observed between cumulative AIP and CMD in male.ConclusionSubstantial changes in AIP may increase the risk of CMD in middle-aged and elderly Chinese males. Dynamic monitoring of AIP is of significant importance for the prevention and treatment of CMD.

Research of the best screen interval for middle aged and elderly Chinese males with baseline prostate specific antigen levels <2.0 ng/mL in prostate cancer screening

This study aimed to investigate the optimal screening interval of a prostate specific antigen (PSA) screening program for men aged 40–70 with a baseline PSA <2 ng/mL in China. 8-year period clinical data of Chinese males who underwent physical examination annually in our hospital were retrospectively collected. 397 healthy males were included.Total PSA (tPSA) and free PSA (fPSA) were collected, and the free/total PSA ratio (f/t PSA) was calculated. According to the baseline PSA value, study population was divided into 2 groups: 0–0.99 ng/mL and 1–1.99 ng/mL. Prostate biopsy indicates at tPSA >10 ng/mL, or 4–10 ng/mL (gray area) and f/t PSA <0.16. Kaplan-Meier survival analysis was used to calculate the relevant cumulative incidence rate. Over the eight-year screening period, 27 people (6.8%) had abnormal PSA that met prostate biopsy criteria. 7 cases of prostate cancer were detected (detection rate 25.9%) among the 27 patients who performed a biopsy. In the 0–0.99 ng/mL and 1–1.99 ng/mL group, 4.1% (13/317) and 17.5% (14/80) achieved biopsy criteria within 8 years, with a statistically significant difference (p < 0.001). In both groups, abnormal PSA began appearing in the sixth year. According to stratifying the cohort age and PSA, abnormal PSA levels began to appear in all subgroups by the sixth year, except for men aged <50 years plus baseline PSA <1 ng/mL, where they appeared by the seventh year. Furthermore, in the group of baseline 40–49 years and baseline PSA <2 ng/mL, the probability of meeting biopsy indications during eight years was very low (1.4%, 2/143). Chinese men aged 50–70 with baseline PSA <2 ng/mL should undergo for PSA retest in the sixth year, while aged 40–49 with a baseline PSA <2 ng/mL do not need PSA screening within eight years.

Association of symptomatic late-onset hypogonadism and lower urinary tract symptoms in aging males: a community-based study

Objective: Testosterone deficiency may be a risk factor for lower urinary tract symptoms (LUTS), and there may be a causal link between the emergence of LUTS and the incidence of late-onset hypogonadism (LOH). We performed an epidemiologic study to investigate the association between symptomatic late-onset hypogonadism (SLOH) and LUTS in middle-aged and elderly rural Chinese males. Methods: A total of 965 men completed a questionnaire and underwent a detailed physical examination. The Aging Males’ Symptoms (AMS) scale was used to assess SLOH, and the International Prostate Symptom Score (IPSS) questionnaire was used to assess LUTS. Serum reproductive hormone levels of testosterone, sex hormone-binding globulin (SHBG) and luteinizing hormone (LH) were measured. Results: A total of 965 males (mean age: 56.34 ± 8.85, range: 40–80 years) were recruited for the present study. A total of 20.93% (202/965) were diagnosed with SLOH. A total of 93.16% (899/965) had mild LUTS, 5.18% (50/965) had moderate LUTS, and 1.66% (16/965) had severe LUTS. Among SLOH patients, 13.40% (27/202) and 3.90% (8/202) had moderate and severe LUTS, respectively. Patients with severe LUTS had increased SHBG and LH compared with those with mild and moderate LUTS (P <0.01). Correlation analysis revealed that the AMS total score was positively correlated with the IPSS score (P <0.05). The prevalence of SLOH was significantly increased with LUTS severity. In addition to the known effect of age, the results of multiple regression analysis also showed that serum LH or SHBG appeared to have a weak link with SLOH and LUTS that requires etiological and biological clarification in our future study. Conclusion: In this cross-sectional analysis of SLOH and LUTS, LUTS severity was significantly associated with hypogonadism symptoms. Additionally, the prevalence of SLOH advanced with increasing LUTS severity. Serum SHBG or LH showed a positive correlation with SLOH and LUTS.

Prevalence and Reasons for the Absence of Vaginal Intercourse in Chinese Middle-Aged and Elderly Men.

IntroductionAs the global population ages, research on the health of middle-aged and elderly men has intensified.AimTo report a paucity of data on the prevalence, etiology, and risk factors associated with lack of vaginal intercourse in middle-aged and elderly Chinese men.MethodsBetween January, 2018, and May, 2020, 6,096 men aged 40-90 years old who reside in mainland China were included in the community-based study. Validated scales related to erectile dysfunction (EHS and IIEF-5) and late-onset hypogonadism (ADAM and AMS), and in-person interview method were used to collect data. Multivariable analysis was performed to examine the risk factors associated with the absence of intercourse.OutcomesPrevalence estimate of no current vaginal intercourse and its associations with basic factors and medical comorbidities. Reasons for no current vaginal intercourse.ResultsThe prevalence of intercourse absence was 19.8% (95% CI; 18.8–20.8%) in middle-aged and elderly Chinese males, and this proportion was significantly higher in older age groups (8.6%, 11.5%, 24.1%, and 34.2% for men aged 40–49, 50–59, 60–69, and 70–90, respectively; P < .05). Among the men who attributed the lack of intercourse to themselves, 168 (21.4%, 95% CI; 18.7–24.4%) had erectile problems and were apprehensive about erectile failure during intercourse. Strained spousal relationships (35 men, 8.4%, 95% CI; 6.1–11.4%), marital issues (163 men, 39%, 95% CI; 34.4–-43.8%), and poor health of the partner (179 men, 42.8%, 95% CI; 38.2–47.6%) were described as reasons for lack of intercourse with spouses. Same risk factors were also found in the multivariate analysis.Clinical implicationsModifiable factors that are related to lack of intercourse may be beneficial to Chinese middle-aged and elderly men.Strength & limitationsThe main strength of the study is that it involved real-world settings. The limitations are as follows. Firstly, psychological data, data on sexual frequency and data regarding types of sex other than vaginal intercourse were not recorded. Secondly, this is a cross-sectional study, from which definite or causative conclusions can't be drawn. Thirdly, the spouses of the participants were not included in the study, and hence the data represent the perceptions of males only. Finally, objective data are required.ConclusionModifiable factors related to both the patients and their partners were associated with an increased rate of no intercourse in Chinese middle-aged and elderly men. Guidance for sexual life may benefit men with an absence of intercourse. Future studies are warranted to reexamine our findings.Lu Y, Zhang J, Ma C, et al. Prevalence and Reasons for the Absence of Vaginal Intercourse in Chinese Middle-Aged and Elderly Men. Sex Med 2022;10:100511.

Application of bone turnover markers and DXA and QCT in an elderly Chinese male population.

To investigate the clinical values and relationships of bone turnover markers (BTMs), dual-energy X-ray absorptiometry (DXA), and quantitative computed tomodensitometry (QCT) in the screening of osteoporosis (OP) in elderly Chinese males. General data, including age, height, and weight, the results of BTM measurements, and the findings of DXA and QCT in 357 male patients aged ≥50 years who visited the outpatient or inpatient Department of Geriatrics, Beijing Jishuitan Hospital from June 2017 to May 2019 were retrospectively analyzed. The OP detection rates based on T-scores of DXA L1-4, DXA total hip, and spine QCT were 3.4% (12/357), 13.2% (47/357), and 40.3% (144/357), respectively. QCT had a significantly higher OP detection rate than did DXA (P<0.001). There were 24 cases of fragility fractures, which were significantly correlated with the DXA total hip BMD and its T-score, with risk cut-off values of 0.607 g/cm2 and -2.950, respectively. The measured levels of the 5 BTMs were as follows: total procollagen type I amino-terminal propeptide (tPINP), 39.23±20.82 ng/mL; β-isomerized C-terminal telopeptides (β-CTX), 0.38±0.21 ng/mL; osteocalcin (OC), 13.50±8.80 ng/mL; 25-hydroxycholecalciferol (25(OH)D3), 12.90±7.46 ng/mL; and parathormone (PTH), 54.50±25.35 pg/mL. The elevation of tPINP, β-CTX, and OC were negatively correlated with aging and positively correlated with decreased BMD (all P<0.05). OC and 25(OH)D3 values were significantly lower than their normal range. Among the 43 patients with normal bone mass on both DXA and QCT examinations, 34 presented with abnormal BTMs, including elevated tPINP in 2 cases, elevated β-CTX in 2 cases, and OC decreased in 31 cases. In the Chinese elderly male population, spine QCT has a higher detection rate of OP than DXA, whereas hip DXA is more advantageous in predicting the risk of fragility fracture. tPINP, β-CTX, and OC can be used as reliable indicators for the dynamic observation of bone content changes and may screen for early bone metabolism abnormalities when BMD examinations still show negative results.

Association of gonadal hormones and sex hormone binding globulin with risk of diabetes: A cohort study in middle-aged and elderly Chinese males.

Late-onset hypogonadism in men is related to the development of diabetes. The association of gonadal hormones, sex hormone binding globulin with diabetes has been studied in various studies. However, there is no cohort study on the relationship between gonadal hormone, sex hormone binding globulin and diabetes in Chinese. We aimed to provide an insight into the possible association in middle-aged and elderly Chinese males. We included a population sample of 673 subjects aged 40years or older. Total testosterone (TT), sex hormone binding globulin (SHBG), follicle-stimulating hormone (FSH) and luteinising hormone (LH) were detected. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated to estimate insulin sensitivity. Diabetes was diagnosed according to the 2010 American Diabetes Association criteria. With an average follow-up time of 3.2±0.5years, 9.8% of participants had developed diabetes. The prevalence of diabetes was decreased according to increasing SHBG quartiles (Q1:13.1%, Q2: 12.0%, Q3: 11.2%, Q4: 3.0%, P for trend<.0001) and TT (Q1:16.0%, Q2: 7.9%, Q3: 9.0%, Q4: 6.4%, P for trend<.0001). The ORs of diabetes for increasing SHBG quartiles were 4.52 (95% CI 1.40-14.57), 4.32 (95% CI 1.33-14.06), 3.89 (95% CI 1.21-12.50) and 1.00 (reference) respectively. But the odds of prevalent diabetes were not increased in different quartiles of TT, FSH and LH. In subgroup analyses, the relationship between SHBG and risk of incident diabetes was significantly increased in the population aged over 60, without insulin resistance and with eGFR<90mL/min per 1.73m2 . Compared with gonadal hormones, a lower level of SHBG is independently associated with the risk of diabetes in middle-aged and elderly Chinese males.

The urinary β2 microglobulin-creatinine ratio is inversely associated with lumbar spine bone mineral density in the elderly Chinese males.

To study the association of UBCR levels with BMD and the predictive value of UBCR for osteoporosis in elderly Chinese male adults. A cross-sectional study of 149 (65 to 85years, 69.7 ± 4.6) Chinese male adults who underwent health checkups in Huadong Hospital in Shanghai China was conducted. BMD was measured by dual-energy X-ray absorptiometry. The clinical variables and BMD of the participants in the low UBCR group (B1, UBCR < 300μg/g) and the high UBCR group (B2, UBCR ≥ 300μg/g) were compared. Associations between UBCR with clinical variables and BMD were analyzed by Pearson's correlation coefficient and multiple regression analysis. BMD and T and Z values were compared between the B1 and B2 groups. The odds ratios (ORs) for dose-dependent increases in osteoporosis between B1 and B2 were analyzed by binary logistic regression analysis. The area under the receiver operating characteristic (ROC) curve was used to analyze the capacity of UBCR to predict osteoporosis. UBCR was significantly higher in the osteoporosis group. After adjusting for multiple confounders, UBCR levels correlated negatively with BMD and T and Z values of the lumbar spine. Lumbar spine BMD and T and Z values were significantly lower in the B2 UBCR group than in the B1 UBCR group. Compared with the B1 participants, the ORs for "osteoporosis" were 12.401 times higher in B2 participants (P = 0.005) by binary logistic regression analysis after adjusting for potential confounders. The UBCR index (cutoff = 362.48μg/g) had a sensitivity of 78.6% and a specificity of 68.7% for identifying osteoporosis, with an area under the ROC curve of 0.760. These results suggest that UBCR levels correlate negatively with lumbar spine BMD and T and Z values and may serve as a marker for osteoporosis in Chinese elderly male adults.

P1456PREVALENCE OF HEPATITIS B CORE ANTIBODY AND OCCULT INFECTION AMONG HAEMODIALYSIS PATIENTS

Abstract Background and Aims Haemodialysis (HD) patients are highly susceptible to blood borne virus infections and prevention strategies include surveillance, segregation, vaccination and strict implementation of standard precautions. As per new guidelines it is mandatory for all HD patients to be tested for hepatitis B core antibody at the beginning of renal replacement therapy. In the present study we sought to determine the prevalence of core antibody positivity and occult HBV infection as evidenced by viraemia in hepatitis B surface antigen (HBsAg) negative patients on maintenance haemodialysis. Method All HD patients (aged≥ 18 years) who were dialyzing in 2019 were included in this cross-sectional study. Retrospective data based on one-off screening for hepatitis B core antibody total (anti-HBc) for all HBsAg negative patients (study population) carried out between May and Oct 2019 was used for analysis. Information was gathered on HBsAg, anti-HBc antibody, surface antibody (anti-HBs) and Hepatitis B virus (HBV) DNA. All anti-HBc antibody positive patients were tested for HBV DNA using quantitative PCR assay. Patients were classified as immune (anti-HBs &amp;gt;10 IU/L) and non-immune (anti-HBs ≤10 IU/L) based on surface antibody levels. Demographic data were compared using Chi square test for categorical variables and Independent T test/Mann Whitney U test for continuous variables between the patients with and without HBV core antibody. Baseline characteristics were compared between the immune and non-immune groups using Chi square test and Independent T test/Mann Whitney U test as appropriate. Results A total of 3704 HBsAg negative HD patients (mean age 63.5±11.3 years, 56.1% male, 57.7% Chinese, 65.4% diabetic and mean vintage of 5.8±5.4 years) were included in the study after exclusion of 147 patients (3.8%) who had chronic HBV infection from the entire HD cohort of 3851 patients. 895 (24.2%) showed evidence of past HBV infection (anti-HBc positive but HBsAg negative) with only 3 (0.1%) patients having detectable HBV DNA. The HBV core antibody positive patients were predominantly elderly, Chinese, males and with high medical dependency compared to the patients without HBV core antibodies (p&amp;lt;0.001). There were no statistically significant differences in diabetic status and dialysis vintage between the patients with and without HBV core antibody. 3202 (86.4%) patients were immune following vaccination (anti-HBs &amp;gt;10 IU/L). The non-immune patients (13.5%) were more likely to be diabetic, with high medical dependency and lower vintage compared to immune patients (p&amp;lt;0.001). Age, race and gender did not differ significantly between the immune and non-immune patients. Conclusion The prevalence of hepatitis B core antibody positivity was 24.2% in our large racially diverse haemodialysis cohort but the presence of occult HBV was low (0.1%). Elderly Chinese males with high comorbidity and poor functional status were more likely to have evidence of past HBV infection. Occult HBV infection has implications in policy development for the prevention of HBV infection in dialysis centres.

Application of CSHA Frailty Index and Clinical Frailty Scale in Geriatric Assessment of Elderly Males in China

People at an advanced age often live with multiple chronic diseases as well as disabilities. To access the health condition of elderly persons, various models have been used in developed countries in the West. However, it is not known how these models apply to the elderly in Asian developing countries. This study investigated the application of the Clinical Frailty Scale-09, a widely used method in patient assessment in Western countries, to older adults living in mainland China. Two hundred and ten elderly males were assessed for their health conditions using a list of variables by the Canadian Study of Health and Aging to construct the 70-item CSHA Frailty Index. The obtained Frailty Indices were compared with the scores of The Clinical Frailty Scale-09 for the same sample group. The assessment revealed the changing pattern in the health condition of the sampled population. Compared to the group aged 65-74 years old, the Frailty Index and the Clinical Frailty Scale increased in the groups aged 75-84 and 85-89 years old. The greatest increase was in the group aged ≥90 years old. The scores of the Frailty Index and the Clinical Frailty Scale-09 correlate with each other. These findings suggest that the Frailty Index and Clinical Frailty Scale-09 provide reliable assessment of the health condition of elderly Chinese males.

Prevalence of cervical spine degenerative changes in elderly population and its weak association with aging, neck pain, and osteoporosis.

To investigate the prevalence of MRI degenerative findings of cervical spine in elderly Chinese males and females. From a general population sample, cervical spine T2 weighted sagittal MR images were acquired in 272 males (mean age: 82.9±3.83) and 150 females (mean age: 81.5±4.27). Images were interpreted and degenerative changes were classified. Study subjects were divided into younger group (group A, ≤81 years) and older group (group B, >81 years). For neck pain, question was structured as 'during the past 12 months, have you had any neck pain?'. Two hundred and fifty-two males and 134 females also had hip bone mineral density (BMD) measured. 98.1% subjects exhibited at least one degenerative change at one or more vertebral levels. The C5/6 level had the highest overall frequency for degenerative changes. Most of the degenerative changes were more common in females. The older female group had higher prevalence or higher severity of degenerative findings than the younger group. Eleven point four percent of the males and 20.6% of the females reported neck pain, and male subjects with neck pain tended to have slightly higher prevalence of cervical degenerative changes. There was a weak trend that osteoporosis was associated with a higher prevalence of spinal cord high signal and a higher prevalence of spinal canal stenosis. The age-dependence of cervical spine degenerative changes was more notable in females. Subjects with neck pain and subjects with osteoporosis were weakly associated with higher prevalence of cervical degenerative changes.

BFH-OSTM, a new predictive screening tool for identifying osteoporosis in elderly Han Chinese males.

PurposeTo develop and validate a new clinical screening tool to identify primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in two elderly Han Chinese male populations.MethodsA cross-sectional study was conducted, enrolling 1,870 community-dwelling and 574 hospital-checkup elderly Han Chinese males aged ≥50 years. All subjects completed a structured questionnaire and had their bone mineral density (BMD) measured using DXA. Using logistic regression analysis in the 1,870 community-dwelling males, we assessed the ability of numerous potential clinical risk factors to identify male with osteoporosis. Multiple variable regression analysis and item reduction yielded a final tool named the Beijing Friendship Hospital Osteoporosis Self-assessment Tool for Elderly Male (BFH-OSTM). Receiver operating characteristic (ROC) curve was generated to compare the validation of the BFH-OSTM and Osteoporosis Self-assessment Tool for Asians (OSTA) for identifying elderly male at increased the risk of primary osteoporosis in the 574 hospital-checkup males.ResultsIn screening the 1,870 community-dwelling subjects with DXA, 14.2% (266/1,870) had osteoporosis, and a further 51.8% (969/1,870) had osteopenia. Of the items screened in the questionnaire, weight, height and previous history of fragility fracture were predictive of osteoporosis. A final tool (BFH-OSTM) was based on body weight and fragility fracture history only. The BFH-OSTM index (cutoff =70) had a sensitivity of 85% and specificity of 53% for identifying osteoporosis according to the WHO criteria, with an area under the ROC curve of 0.763. The predictive value of BFH-OSTM was validated in the 574 hospital-checkup population, which performed better than OSTA.ConclusionThe BFH-OSTM may perform well for identifying elderly male at increased risk for osteoporosis and applying it would result in more prudent use of BMD measurement by DXA, especially for Han Chinese male.

Independent factors associated with serum levels of 25- Hydroxyvitamin D in very elderly Chinese males

Independent factors associated with serum levels of 25- Hydroxyvitamin D in very elderly Chinese males

Factors associated with low femoral neck bone mineral density in very elderly Chinese males

ObjectiveThis study was designed to identify factors associated with the femoral neck bone mineral density (FNBMD) of the very elderly (aged 80 or more) Chinese males. MethodsA total of 1177 very elderly Chinese males were recruited into the study, and subjected to FNBMD, biochemical parameters, bone turnover markers, and serum sex steroids assays. Univariate and multivariate regression analyses were performed to identify factors independently related to FNBMD. ResultsIt was demonstrated that age (β=−0.003, P=0.035), concomitant chronic obstructive pulmonary disease (COPD, β=−0.027, P=0.009), serum β-C-telopeptide of type 1 collagen (β-CTX, β=−0.097, P<0.001), and parathyroid hormone (PTH, β=−0.001, P=0.004) were negatively correlated with the FNBMD, while body mass index (BMI, β=0.009, P<0.001), and serum estradiol (β=0.001, P=0.038) were positively related to FNBMD in very elderly Chinese males. ConclusionAn integrated intervention should be implemented to increase the BMD of the very elderly males, with special attention to preventing and curing COPD, reducing serum β-CTX and PTH levels, as well as keeping a proper BMI and serum estradiol level.

Resistin might not be a risk factor for carotid artery atherosclerosis in elderly Chinese males.

ObjectiveTo investigate the correlation between the serum resistin level and carotid artery atherosclerosis in elderly Chinese males.MethodsThe study enrolled 235 elderly Chinese males [median age 76 (range 60–97) years] scheduled for ultrasound examination of carotid artery plaque and determination of carotid artery intima-media thickness (CIMT). They were divided into carotid atherosclerotic plaque (CAP) and carotid atherosclerotic plaque-free (CAP-free) groups according to the ultrasound results. Their clinical profiles were collected, and the serum resistin and other blood biochemistry levels were determined.ResultsThe CAP group was older and had a thicker mean CIMT than the CAP-free group. However, there was no difference in the serum resistin level between the groups. CIMT was positively correlated with age (r = 0.299, P < 0.001). The serum resistin level was not correlated with CIMT, even after controlling for age. Multiple linear regression analysis revealed that age (β = 0.001, P < 0.001) and body mass index (β = 0.002, P = 0.015) were significantly and positively correlated with the mean CIMT. Only age [odds ratio (OR): 1.159; 95% confidence interval (CI): 1.078–1.183, P < 0.001] was associated with the presence of carotid artery atherosclerotic plaque. The serum resistin level was not correlated with the mean CIMT or associated with the presence of carotid artery atherosclerotic plaque.ConclusionThe results suggest that resistin might not be a risk factor for atherosclerosis in elderly Chinese males.

Heterozygote Advantage of the MTHFR C677T Polymorphism on Specific Cognitive Performance in Elderly Chinese Males without Dementia

Aims: Aging is associated with cognitive deterioration, and genetic factors are implicated in individual cognitive differences in the aged. The C677T mutation in the 5,10-methylenetetrahydrofolate reductase gene (MTHFR) yields a common thermolabile variant (T) with reduced enzyme activity and consequent elevation of serum homocysteine concentrations. We designed the present study to investigate whether this functional polymorphism may affect global and specific cognitive functions in older Chinese males without dementia. Methods: The subjects included 356 elderly males without major psychiatric disorders or dementia, who were assessed by the Cognitive Abilities Screening Instruments (CASI) and the Wechsler Digit Span Task tests. Results: A significant association was found between the MTHFR C677T polymorphism and total CASI scores (p = 0.012), particularly in short-term memory (p = 0.002) and concentration/mental manipulation (p = 0.007). Post hoc tests indicated that the C/T heterozygotes achieved better cognitive function test results than C/C or T/T carriers. No association was found between the MTHFR genotype and the Wechsler Digit Span Task tests. Conclusion: These results suggest that a heterozygote advantage exists for the MTHFR C677T polymorphism in specific cognitive functions in elderly Chinese males without dementia.

Chronic actinic dermatitis in Asian skin: a Singaporean experience

To study the characteristics of chronic actinic dermatitis (CAD) in a heterogeneous group of Singaporean patients. The photobiologicial features of all patients phototested and diagnosed with CAD from January 2005 to December 2009 were examined retrospectively. Fifty-eight patients were diagnosed as having CAD. The mean age at diagnosis was 62 years (range 35-83). Forty-one were (70.7%) Chinese, six (10.3%) Indians, eight (13.8%) Malays, and three (5.2%) Others. Forty-seven were (81.0%) male and 11 (19.0%) were female. Forty-nine (84.5%) had Fitzpatrick skin phototype IV and nine (15.5%) had phototype V. Three of 26 (11.5%) tested for human immunodeficiency virus were positive. The face, neck, and forearms were most commonly affected. Thirty-two patients (55.2%) had reduced minimal erythema dose (MED) to both ultraviolet B (UVB)and ultraviolet A (UVA), 23 patients (39.7%) had lowered MED to UVB only, while three (5.1%) had reduced MED to UVA only. Patients were followed up for a mean of 16.8 months. All were treated with photoprotection and topical steroids; however, a few required oral immunosuppression with partial improvement. In Singapore, CAD was seen more commonly in elderly Chinese males of Fitzpatrick skin phototype IV. Reduced MED to both UVB and UVA was the most common phototest finding.

Association study of a functional catechol-O-methyltransferase polymorphism and executive function in elderly males without dementia

Cognitive function in older people is a major factor influencing quality of life. The catechol-O-methyltransferase (COMT) gene, which is essential in the metabolic degradation of prefrontal dopamine, has been considered as a leading candidate gene in the variation in cognitive performance. The aim of this study was to investigate the effect of a functional COMT (Val158Met) polymorphism on several cognition domains in a relatively homogeneous population consisting of elderly Chinese males without dementia. Six neuropsychological measurements, including Spatial Span Forward and Backward, Digit Span Forward and Backward, and Trail Making Test-A and -B, were assessed in 161 aged males. It was found that the Met/Met carriers showed a better performance than the Val/Met and Val/Val subjects on the Digit Span Forward (a measure of general attention; p=0.017, after correction for education level) test, but not on the other cognitive tests. These findings suggest that the COMT Val158Met genotype may contribute to differences in normal cognitive aging, particularly in the area of general attention.

Relationship between smoking and dyslipidemia in western Chinese elderly males

The relationship between smoking and dyslipidemia was studied in 2,160 elderly Chinese males. Levels of triglycerides (TGs) in current smokers were shown to be significantly higher and levels of high-density lipoprotein cholesterol (HDL-C) lower than for those who had never smoked or had stopped smoking. Interestingly, the level of apoprotein B (apoB) was more frequently abnormal in very heavy smokers compared with light smokers, while low-density lipoprotein cholesterol (LDL-C) levels were more frequently normal in very heavy smokers. When comparing other factors that influence blood lipids, such as alcohol intake, body mass index (BMI), and age, smoking had the greatest influence and was shown to be an independent risk factor for dyslipidemia.

Unusual Cause of Hypokalemic Paralysis in Aged Men: Sjögren Syndrome

Hypokalemic paralysis is a less recognized but reversible disorder in elderly patients. This report describes two elderly Chinese males (age 74 and 78 years) who had progressive muscle weakness and eventually paralysis. Physical examination showed symmetrical flaccid paralysis of extremities. Both had the major biochemical abnormality of profound hypokalemia (1.4 and 1.8 mmol/L) accompanied by high urine K+ excretion and hyperchloremic metabolic acidosis. A positive urine anion gap and alkaline urine pointed to the diagnosis of distal renal tubular acidosis. Large doses of potassium chloride supplementation were required to restore muscle strength. Pertinent investigations, including elevated titers of antinuclear antibody and rheumatoid factor, positive anti-Ro antibody, low serum C3 and C4 levels, and delayed saliva excretion on salivary scintigraphy suggested Sjögren syndrome. Despite the lack of sicca syndrome at the initial presentation, both had development of typical sicca syndrome and positive Schirmer test at the 5-month and 1-year follow-up, respectively. Potassium citrate supplement and prednisolone therapy completely corrected the hypokalemia and metabolic acidosis. Extraglandular involvement with distal renal tubular acidosis preceding the typical sicca syndrome may induce hypokalemic paralysis and unveil Sjögren syndrome in elderly males.