Geriatric Men Research Articles

Evaluation of Serum Electrolytes among Geriatric and Non-Geriatric Men in Osisoma, ABA, Nigeria

Background: Ageing is a progressive development associated with a decline in the physiological functions, which increases susceptibility to organ dysfunction (especially the kidney) in geriatrics. This facilitates the risk of electrolyte imbalance, as the kidneys play a crucial role in maintaining these electrolyte concentration. Aim: This was a cross-sectional study designed to evaluate serum sodium ( ), potassium ( ), chloride ( ), and bicarbonate ( ) levels, and understand their prevalence among apparently healthy geriatric and non-geriatric men residing in Osisoma, Aba. Methodology: A total of 100 apparently healthy participants were enrolled for this study, comprising of 50 geriatric men aged 65 years and above, and 50 non-geriatric men aged 20-30 years. From both groups, serum samples were used for the analyses of sodium ( ), potassium ( ), chloride ( ), and bicarbonate ( ) using Spectrophotometer. The data obtained was analyzed statistically using Statistical Package for Social Science (SPSS version 25), student’s t-test, one way analysis of variance (ANOVA), pearson correlation coefficient and P values less than 0.05 were considered statistically significant. Results: The mean values of sodium (136.6+3.9mmol/L), potassium (3.9+0.5mmol/L), chloride (100.2+3.9mmol/L) and bicarbonate (24.4+4.3 mmol/L) levels in geriatric subjects showed no statistical significant difference (P > 0.05) when compared to the mean values of sodium (136.9+2.3 mmol/L), potassium (3.9+0.4 mmol/L), chloride (100.8+2.8 mmol/L) and bicarbonate (24.9+3.9 mmol/L) in non-geriatric subjects. The study also revealed a significant difference (P = 0.001) in the mean value of bicarbonate (24.8+4.3 mmol/L; 25.8+1.9mmol/L, and 18.1 +3.3 mmol/L) among geriatric subjects, when compared based on age range using ANOVA. There was a significant negative correlation between the ages and bicarbonate levels (r = -0.4, P = 0.008), a non-significant positive correlation between ages and sodium levels (r = 0.1, P = 0.498), and chloride levels (r = 0.2, P = 0.125), and a non-significant negative correlation between the ages and potassium levels (r = -0.1, P = 0.691) in geriatric subjects. Conclusion: The result from this study showed no significant alteration of serum electrolytes between geriatric and non-geriatric subjects, and a significant alteration of bicarbonate levels among the geriatric subjects. This present study has shown that ageing without any comorbidities has lesser effect on serum electrolytes.

Metformin improves skeletal muscle and physical capacity by stabilizing neuromuscular junction in older adults

ObjectivesMetformin is an anti-diabetic drug with protective effects on skeletal muscle and physical capacity. However, the relevant mechanisms of action on skeletal muscle remain poorly understood. We investigated the potential contribution of neuromuscular junction (NMJ) degradation to skeletal muscle and physical capacity in geriatric men taking metformin. MethodWe recruited geriatric men for placebo (Age=73.1 ± 4.2 years, n = 70) and metformin (Age=70.1 ± 4.5 years, n = 62) groups. The patients in the metformin group received 1700 mg of metformin twice a day for 16 weeks. We measured plasma c-terminal agrin-fragment-22 (CAF22) and neurofilament light chain (NfL) as markers of neuromuscular junction (NMJ) degradation and neurodegeneration, respectively, with relevance to handgrip strength (HGS) and short physical performance battery (SPPB; a marker of physical capacity) in older adults taking metformin. These findings were associated with reduced oxidative stress in the metformin group. ResultsAt baseline, both groups had similar HGS, gait speed, SPPB scores, and plasma biochemistry. Metformin improved HGS, gait speed, and cumulative SPPB scores in geriatric men (all p < 0.05). Metformin also reduced plasma CAF22 and NfL levels when compared to baseline. Similar observations were not found in the placebo group. Correlation analysis revealed significant correlations of plasma CAF22 with HGS, gait speed, and cumulative SPPB scores in the metformin group. These observations were associated with reduced oxidative stress in the metformin group. ConclusionAltogether, the restorative effects of metformin on skeletal muscle and physical capacity involve NMJ stabilization. Our data is clinically relevant for geriatric men with functional disabilities.

NON-SURGICAL MANAGEMENT OF PERFORATED JEJUNAL DIVERTICULUM

Jejunal diverticulitis complicated by perforation is rare and shows an uncharacteristic presentation and thus poses a difficulty in the early diagnosis ofthe condition.However, diverticulitis and its complications should always be considered in geriatric men who present with an acute abdomen. We describe a 77-year-old man who originally presented with acute abdominal pain having free gas under right dome of diaphragm on X-ray abdomen, upon further evaluation with CT abdomen, a diagnosis of contained jejunal diverticular perforation was made.Onceoptimized he was then managed non-operatively with intravenous fluids, antibiotics, and total parenteral nutrition and supportive care. His overall recovery during hospitalization was uneventful. A follow-up CT abdomen showed no new pocket of fluid or free air. As jejunal perforation is a rare finding, early laparotomy done based upon free gas on X-ray alone may be correlated with an overall higher risk of mortality due to the diseases proximity to duodenojejunal flexure and thus conservative management in selected group of patients may prevent inadvertent celiotomy and morbidity and mortality arising out of it.

EFFECT OF HATHA YOGA SADHANA AND SIMPLIFIED KUNDALINI YOGA ON SELECTED PHYSIOLOGICAL VARIABLE AMONG GERIATRIC MEN WITH LOW BACK ACHE

The present study was designed to find out the effect of Hatha yoga sadhana and simplified kundalini yoga on physiological variable among Geriatric men with low back ache. It was hypothesized that there would be significant differences in systolic blood pressure among Geriatric men with low back ache due to the influences of Hatha yoga sadhana and simplified kundalini yoga. To achieve the purpose of the study, 45 Geriatric men with low back ache from Chennai aged between 60 and 65 years . The Experimental group I and II underwent Hatha yoga sadhana and simplified kundalini yoga for the period of 6 weeks of an hour in the morning. The control group was not exposed to any specific training but they participated in the regular activities. The pre-test and post-test were conduct before and after the training for three groups. The data pertaining to the variables collected from the three groups before and after the training period were statistically analyzed by using Analysis of Covariance (ANCOVA) to determine the significant difference and tested at 0.05 level of significance.

EFFECT OF HATHA YOGA SADHANA AND SIMPLIFIED KUNDALINI YOGA ON SELECTED PHYSIOLOGICAL VARIABLE AMONG GERIATRIC MEN WITH LOW BACK ACHE

The purpose of the present study was to find out the effect of hatha yoga sadhana and simplified kundalini yoga on selected physiological variable among geriatric men with low back ache. The study was conducted on 45 Geriatric men with low back ache Totally three groups, namely, control &amp; experimental group I &amp; II, consisting or 15 Geriatric men with low back ache underwent six weeks practice in Hatha yoga sadhana and simplified kundalini yoga whereas the control group did not under go any type of training. The pulse rate was measured before and after the experimentation using the standard equipment ( Citizen) . The data were analyzed by Analysis of Co-variance (ANCOVA) and it was concluded that the Hatha yoga sadhana and simplified kundalini yoga had significant (P &lt; 0.05) effect on the Pulse rate level.

Efficacy of Yogic Practices on Hemoglobin and Depression Among Geriatric Men

Efficacy of Yogic Practices on Hemoglobin and Depression Among Geriatric Men

Effect of Posterior Tibial Nerve Stimulation on Fecal Incontinence among Geriatrics

Background and aim:Incontinenceis one of the most common causes for admission to a residential facility. Fecal incontinence becomes more prevalent at the age of 70. In both men and women, fecal incontinence is a common condition, particularly among the elderly. Although a few research suggests that posterior tibial nerve stimulation can aid with fecal incontinence, more research is needed. Preoperative and postoperative measures are compared to determine treatment outcomes. Thus, the goal of this research is to see how posterior tibial nerve stimulation affects fecal incontinence in geriatrics.Methods:The research was conducted as a pilot study at SIMATS, using samples taken from Saveetha hospital's neuro IPD and physiotherapy OPD. A total of 15 patients were chosen at random based on the inclusion and exclusion criteria. The research included both geriatric men and women with fecal incontinence who were examined using the Wexner score prior and after intervention. The posterior tibial nerve was stimulated with electrical stimulation twice a day for 4 weeks.Result: The occurrence of incontinent episodes in geriatric individuals was drastically decreased, with a significant value of p&lt;0.001.Conclusion: The use of posterior tibial nerve stimulation in the elderly has been proven to be asuccessful therapy technique for reducing fecal incontinence episodes. In terms of treatment, the findings of this study seem promising.

Facial fractures in the elderly: epidemiology, clinical characteristics, and management

With an ageing population, the elderly will increasingly represent a growing subgroup of trauma. A high-risk group with multiple comorbidities, decreased physiological reserves and frailty, this contributes to the complexity of management in facial trauma. Falls represent the most common presentation for facial-related injuries, but there are variations amongst gender that is important to aid diagnosis, management, and treatment plans. Our aim is to identify epidemiological trends of facial fractures in the elderly, understand differences amongst gender and elderly age groups, and the impact this has on clinical outcomes and management. A retrospective review was conducted from January 2012 to January 2017 at the Royal Adelaide Hospital, Adelaide. All facial fractures of the elderly, 65 years and above, that attended or were referred to the unit were included in this study. Three hundred fifty-five elderly patients presented with a facial fracture with falls (82.5%) as the most common mechanism of injury. The orbitozygomatic fracture was the most common type of facial fracture with 48.7% of the cohort sustaining an associated injury. There were differences between men and women for age, age groups, socioeconomic status, season, alcohol, mechanism of injury, and facial fractures (p<0.05). The 75–85 and 85+ age groups were 2.4 and 15.1 times more likely to have a fall-related facial fracture than the 65–75 age group, and less likely to have surgery (p<0.05). Associated injuries were independently associated with increased length of stay (p<0.001). Geriatric men and women have differences in facial fractures and aetiologies, but an overall non operative approach was favoured on a balanced approach of comorbidities, function, and quality of life. Elderly patients are complex with associated injuries and comorbidities, and they often require interdisciplinary care across fields of medicine and surgery to minimize their length of stay and yield good outcomes. Level of evidence: Level III, therapeutic; diagnostic; risk/prognostic study.

Prostate Cancer in the Elderly Male: Diagnostic and Management Considerations

Along with an aging US population comes the growing need for clinical guidelines inclusive of and specific to this unique group. Prostate cancer (PCa) is increasingly recognized as a substantial cause of mortality and morbidity in the elderly. This review seeks to address the unmet need for standardized PCa screening and management protocols for geriatric men and to synthesize recommendations based on recent literature. Guidelines regarding PCa screening in elderly men are still being optimized, with many organizations moving toward inclusion of pre-screening global health assessment. Physician compliance with screening and treatment of PCa in geriatric patients is suboptimal, despite advanced age being a predictor of advanced disease. Elderly patients may experience treatment-related side effects which differ from their younger counterparts. Providers treating older men are encouraged to utilize comprehensive health assessments which account for comorbidities, functional status, and global well-being, along with shared decision-making, in determining diagnostic and therapeutic pathways.

Pelvic Floor Muscle Rehabilitation to Improve Sexual Function in Geriatric Men

Background: There is a growing population of geriatric men experiencing sexual health concerns. These issues may stem from surgical interventions of the prostate gland, age-related changes affecting erectile dysfunction, or other concerns. Objectives: To illuminate the male sexual dysfunctions lessened via pelvic floor muscle rehabilitation and proper education to assist clinicians in achieving positive patient outcomes. Methods: The literature was reviewed from 1996 to 2015 using PubMed. Results: Effective conservative care strategies exist for appropriate patients via pelvic floor muscle therapy, manual therapy, education regarding cardiovascular health, and triage to psychological and sexual counseling. Conclusion: Efficacy is present for this population, but some conditions are more effectively treated conservatively than others.

Gender based Dosing of Metoprolol in the Elderly using Population Pharmacokinetic Modeling and Simulations

This article seeks to clarify if gender-based differences occur in the pharmacokinetics of metoprolol in the elderly patients. There are a series of physiologic changes that occur in the elderly ranging from decreased hepatic blood flow to increased adiposity causing higher plasma concentrations at therapeutic doses as compared to the healthy young population. Population pharmacokinetic modeling were performed using MONOLIX and Monte-Carlo simulations were conducted using MATLAB. The data was based from a previously published dataset where elderly patients, having multiple comorbidities, were administered a 50mg dose of metoprolol. Metoprolol was modeled using a one-compartment model and resulted in the following population pharmacokinetic parameters: volume of distribution, V=38L (CV=155%), clearance rates, CL-Men=105L/hour and CL-Women=59.1L/hour (38%), time lag, Tlag=0.469 hour (CV=17%), and the absorption rate constant, Ka=0.235 hr-1 (CV=23%). Gender stratified doses resulting in an equivalent systemic metoprolol exposure in geriatric patients have been identified. Metoprolol doses resulting a similar AUC in a healthy young male administered 50mg tablet were 15mg for geriatric women and 25mg for geriatric men. Further, Metoprolol doses of 25mg for geriatric women and 50mg for geriatric men resulted in an equivalent AUC to a healthy young males dosed with a 100mg tablet. A 15mg Metoprolol tablet may need to be compounded to account for the gender differences in Metoprolol pharmacokinetics.

Alterations in extracellular matrix composition in the aging larynx.

To study by immunohistochemistry the alterations of collagens I, III, IV, and V and elastin in the aging process of the human larynx. Cadaver study. Universidade Estadual Paulista, Botucatu Medical School, São Paulo State University (UNESP), Brazil. Thirty vocal folds were obtained at autopsy from 10 adult men (aged 30 to 50 years) and 20 geriatric men (10 aged 60 to 75 years and 10 aged >75 years). Mid membranous vocal fold slides were subjected to immunohistochemical reactions. Digital imaging software (ImageJ) was used to quantify the increase in brownish staining of the lamina propria structures of vocal folds, from superficial to deep layers. There was an increase of collagen I and III immunoexpression in the elderly larynges, in both layers. Collagens IV and V were immunoexpressed in the vessels endothelium of the lamina propria and in the basement membrane. The immunoexpression of elastin decreased in the elderly larynges, in both lamina propria layers of the vocal folds. A clear increase of collagens I and III and a decrease of elastic fibers were observed in the lamina propria of vocal folds. The concentration of collagens IV and V was the same across age groups. These findings suggest that as men age, the density of the extracellular matrix increases, brought about by an increase in collagen, while the loss of elastin results in decreased viscoelasticity.

On model selections for repeated measurement data in clinical studies.

Repeated measurement designs have been widely used in various randomized controlled trials for evaluating long-term intervention efficacies. For some clinical trials, the primary research question is how to compare two treatments at a fixed time, using a t-test. Although simple, robust, and convenient, this type of analysis fails to utilize a large amount of collected information. Alternatively, the mixed-effects model is commonly used for repeated measurement data. It models all available data jointly and allows explicit assessment of the overall treatment effects across the entire time spectrum. In this paper, we propose an analytic strategy for longitudinal clinical trial data where the mixed-effects model is coupled with a model selection scheme. The proposed test statistics not only make full use of all available data but also utilize the information from the optimal model deemed for the data. The performance of the proposed method under various setups, including different data missing mechanisms, is evaluated via extensive Monte Carlo simulations. Our numerical results demonstrate that the proposed analytic procedure is more powerful than the t-test when the primary interest is to test for the treatment effect at the last time point. Simulations also reveal that the proposed method outperforms the usual mixed-effects model for testing the overall treatment effects across time. In addition, the proposed framework is more robust and flexible in dealing with missing data compared with several competing methods. The utility of the proposed method is demonstrated by analyzing a clinical trial on the cognitive effect of testosterone in geriatric men with low baseline testosterone levels.

Hyaluronic acid behavior in the lamina propria of the larynx with advancing age.

To analyze the hyaluronic acid behavior in the lamina propria of the larynx with advancing age. Prospective study. UNESP-Univ Estadual Paulista, Botucatu Medical School, Brazil. Thirty vocal folds were obtained at necropsy from 10 adult males (30-50 years old) and 20 geriatric males (10: 60-75 years old; 10: over 76 years old). Midmembranous vocal fold sections were subjected to immunohistochemical reactions. Digital imaging software (ImageJ) was used to quantify the hyaluronic acid distribution over the lamina propria of vocal folds, from superficial to deep layers. Hyaluronic acid distribution was homogeneous for the larynges, at both superficial and deep layers (41.6 and 38.5, respectively). For both 30- to 50-year-old men geriatric age groups, hyaluronic acid level was lower at both layers. Hyaluronic acid level in the lamina propria of the larynx of geriatric men decreases with advancing age at both layers of the lamina.

No Correlation between Beta2-Adrenergic Receptor Polymorphisms and the Severity and Clinical Control of Geriatric Asthma and COPD

Background: Polymorphisms of the β2-adrenergic receptor (ADRB2) have previously been associated with non-specific bronchial hyper-responsiveness, adverse response to β2-agonists and variable effects on lung function. The objective of this study was to determine whether genotypic variance in ADRB2 polymorphisms in a cohort of geriatric men and women with asthma and/or COPD correlate with disease severity, baseline pulmonary function, and the ability to maintain clinical control of their disease. Methods: This comparative, prospective cohort study sequenced two ADRB2 polymorphisms, Arg16 --> Gly and Gln27 --> Glu, in 103 geriatric patients with a clinical history of asthma and/or COPD. Primary endpoints included pulmonary exacerbation rate, hospitalization rate, and quality of life scores. Results: Arg/Arg genotype comprised 13.6% of the cohort. No significant differences in baseline pulmonary functions were noted across genotypic variants. No significant difference was associated with genotype and change in lung function, exacerbations, clinical hospitalizations, exercise tolerance and subjective quality of life assessment over 6 months of follow-up. Conclusion: We conclude that in a geriatric asthma and/or COPD population, ADRB2 polymorphisms are not a factor in the ability to control disease.

Functional and Nutritional State in Elderly Men With Compensated Hypogonadism

There are few data investigating the relationship between compensated hypogonadism and functional and nutritional status of elderly individuals. Impairment of functional and nutritional status of elderly men with compensated hypogonadism needs to be investigated. In this study, we tried to evaluate the association of functional and nutritional status with testosterone and LH levels in elderly with compensated hypogonadism. A cross-sectional study was performed. A total of 1124 patients older than 70 years were screened. A total of 250 patients (patient group) with compensated hypogonadism and 250 subjects (control group) with normal hormone levels were allocated in the study. All parameters were compared in patient and control groups. The correlations between hormone levels and activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Mental State Examination (MMSE), Mini Nutritional Assessment (MNA), and Geriatric Depression Scale (GDS) were evaluated. ADL, IADL, MMSE, and MNA scores were significantly lower in the patient group. Testosterone and LH levels were correlated with ADL (R = 0.221 and R = -0.262), IADL (R = 0.210 and R = -0.277), MMSE (R = 0.331 and R = -0.341), MNA (R = 0.211 and R = -0.297), and GDS (R = -0.214 and R = -0.211) in the patient group independently from age and body mass index. Our study showed that geriatric men with compensated hypogonadism had worse functionality, cognitive function, nutritional status, and mood compared with healthy controls.

Pharmacologically Induced Erections Among Geriatric Men

Intracavernous injection of vasoactive drugs for the treatment of erectile impotence has become a standard therapeutic technique. Previous reports detailing experience with this treatment are based on patient populations significantly younger than most patients who suffer from impotence. The geriatric population, which comprises the majority of patients with impotence, is unique due to the physical, psychological and social changes associated with the aging process. To characterize better elderly men with impotence, and determine whether intracavernous injection therapy is safe and effective in this age group, a retrospective analysis was performed upon patients attending the male sexual dysfunction clinic at our university medical center who received a standard papaverine and phentolamine mixture (30mg. papaverine and 1.0mg. phentolamine per ml.). The etiology of impotence, degree of patient satisfaction and complication rate of 65 patients 65 years or older (mean age 70 years) undergoing papaverine plus phentolamine self-injection therapy were compared to a similar sized group of impotent men approximately 20 years younger (mean age 47 years). Significant differences in etiology of impotence were evident between the 2 groups. Treatment response rates were equal for the 2 age groups although elderly patients required a higher dose of papaverine and phentolamine to obtain an erection, and used the medication less frequently. Complications were few, of minimal consequence and occurred with equal frequency between the 2 age groups.

Normalization of Abnormal Diurnal Weight Gain Among Chronically Psychotic Geriatric Patients

We studied 20 geriatric and 87 nongeriatric chronically psychotic male inpatients, 16 acutely psychotic male control subjects, and 14 male normal subjects. The subjects were weighed at 7 a.m. and 4 p.m. weekly for 3 weeks. We normalized the diurnal weight gain (NDWG) as a percentage by subtracting the 7 a.m. weight from 4 p.m. weight, multiplying the difference by 100, and then dividing the result by the 7 a.m. weight. NDWG was .509% +/- .337%, 2.209% +/- 1.529%, .631% +/- .405%, and .533% +/- .410%, among the geriatric men, nongeriatric men, control subjects, and normal subjects respectively. Differences in diagnoses and drugs did not explain these findings. We hypothesize that abnormal diurnal weight gain may be a risk factor for premature death among chronically psychotic inpatients.

Relationships between speech intelligibility and the slope of second-formant transitions in dysarthric subjects

The relationship between speech intelligibility on a single-word identification test and the average second-formant (F2) slope of selected test words was examined for a group of 25 men and ten women with amyotrophic lateral sclerosis (ALS). A Spearman rank-order correlation coefficient greater than 0.80 was obtained for both the male and female subjects. This moderately high correlation indicates that the F2 slope index is a useful acoustic measure of speech proficiency in ALS. F2 slope indices are reported for normal control populations of geriatric men and women. In addition, progressive deterioration of the F2 slope index is illustrated in a case study of one woman with ALS.

Effects of chronic institutionalization on the physical working capacity and trainability of geriatric men.

Effects of chronic institutionalization on the physical working capacity and trainability of geriatric men.