Increase In Physical Disability Research Articles

Correlations of inflammatory processes caused by cerebral stroke with the outcome of the disease

Introduction. Inflammation plays a central role in the pathogenesis of stroke, so understanding inflammatory processes can greatly improve stroke treatment options. In this analysis, we review the positive and negative role of neuroinflammatory mechanisms in stroke.Negative influence of inflammatory cells and mediators in brain injury patients. All neuroinflammatory reactions and mediators play a negative role in initiating the pathological response to stroke and thus promote the development of inflammatory processes.Nosocomial infection. Elevated inflammatory markers and other prognostic factors are directly associated with higher rates of in-hospital complications such as pneumonia, urinary tract infection, and unfavorable stroke outcomes. New treatment directions can significantly improve clinical outcomes by reducing the incidence of hospital-acquired infections, which are one of the main complications after stroke.Vascular dementia. Stroke is a causative factor in vascular dementia, but certain neuroinflammatory processes in the brain are also involved. These processes may have detrimental effects on cognitive function after stroke. Therapeutic approaches that enhance pro-inflammatory cytokines and the immune system may be useful in preventing cognitive dysfunction, particularly after stroke.Physical disability. A stroke associated with ischemic, hemorrhagic, and neuroinflammatory processes in the course of the disease can cause a reduction or increase in physical disability and neurological deficit, which are very important for daily activities and quality of life.Positive influence of inflammatory cells and mediators in brain injury patients. All inflammatory cells and mediators play a positive role in complicating the pathological response to stroke and also in maintaining brain cell homeostasis.Discussion. Since the situation in this matter is quite controversial, a debatable question arises whether inflammatory processes have a positive or negative effect on the course and outcome of the disease in patients with stroke.Conclusions. After reviewing the latest scientific articles on this topic, we can say that the inflammatory process plays an ambiguous role in the pathogenesis of stroke and that its influence on the course and outcome of the disease can be both positive and negative. Therefore, today it is necessary to carry out more detailed scientific research in order to gain a deeper understanding of this issue and to achieve a better cure for the disease.

Trajectories and determinants of ageing in Portugal: insights from EpiDoC, a nationwide population-based cohort

IntroductionThe population in Portugal is ageing due to increased life expectancy and reduced fertility rates. We aimed to estimate the health trajectories of Portuguese older adults (60 + years old) in a 10-year period and to assess associated sociodemographic, lifestyle factors and multimorbidity status.MethodsUsing the population-based EpiDoC cohort, we estimated the trajectories of health-related quality of life and physical function of 4135 Portuguese older adults over 10 years using linear mixed models. Factors associated to health-related quality of life and physical function were assessed using linear mixed models and random intercept tobit regression, respectively.ResultsThe physical disability of participants increased by 0.263 (0.240, 0.286), and health-related quality of life declined by 0.074 (-0.084, -0.063), over 10 years. With advancing age, older adults reported a faster reduction in health-related quality of life and faster increase in physical disability. In general, women were in worse health than men at baseline, albeit with a similar rate of change throughout the follow-up. Higher education and regular exercise were associated with better health-related quality of life and physical function while multimorbidity and excess weight were associated with worse reporting of these outcomes.ConclusionsThese findings, based on longitudinal data with 10 years of follow-up, are essential to effectively plan resource allocation, plan better healthcare and design informed public health policies in Portugal.Brief summaryThis study characterizes ageing in Portugal showing increased physical disability and decreased health-related quality of life with advancing age older adults, helping to develop public health policies.

Proteoglycan Extracted from Ganoderma lucidum Ameliorated Diabetes-Induced Muscle Atrophy via the AMPK/SIRT1 Pathway In Vivo and In Vitro.

Muscle atrophy often occurs in type 2 diabetes (T2D) and leads to an increase in physical disability and insulin resistance. However, there are very few studies that have investigated potential natural products used for this condition. In this study, we demonstrated that FYGL (Fudan-Yueyang-G. lucidum), a proteoglycan extracted from Ganoderma lucidum, ameliorated muscle atrophy in rat and mouse models of diabetes. Histopathological analysis of muscle revealed that oral administration of FYGL significantly prevented reduction of the cross-sectional area of muscle fibers and overexpression of muscle atrophic factors in diabetic rats and mice. Muscle RNA-seq analysis in vivo indicated that FYGL regulated genes related to myogenesis, muscle atrophy, and oxidative phosphorylation. Also, FYGL activated AMPK in vivo. Furthermore, the underlying molecular mechanisms were studied in palmitate-induced C2C12 muscle cells using immunofluorescence staining and Western blotting, which revealed that FYGL inhibited muscle atrophy by stimulating ATP production and activating the AMPK/SIRT1 pathway, thus promoting oxidative metabolism. This result rationalized the in vivo findings. These results suggest FYGL as a promising functional food ingredient for the prevention of T2D-induced muscle atrophy.

Changes in health and social relationships on loneliness among older adults

ABSTRACT Purpose Loneliness affect older people’s health and well-being. This study explored the effects of changes in health and social relationships on loneliness in older adults. Methods Data were from the 2011 and 2015 surveys of the Taiwan Longitudinal Survey on Aging. Individuals who were aged ≥55 years at the baseline (2011) and who completed both waves of the survey were included in the analysis (n = 2,512). In the 2015 wave, loneliness was predicted on the basis of the factors identified in the 2011 wave and the changes in health and social relationship between the two waves. Multiple linear regression analysis was performed. Results Decreased social group participation, decreased receiving instrumental social support, increased negative support, decreased feeling of usefulness to others, decreased informational support, decreased financial life satisfaction, increased stress, and increased depressive symptoms were related to a higher level of loneliness, whereas increased social support and social participation as well as decreased stress and depressive symptoms were related to a lower level of loneliness. Changes in depressive symptoms, a reduction in financial satisfaction, and an increase in stress were related to both the social and emotional dimensions of loneliness. Decreased social connection, social support, and social participation were related to social loneliness, whereas an increase in physical disability was related to emotional loneliness. Conclusion Older people’s changes in social support, social participation, financial satisfaction, stress, and depressive symptoms may affect their loneliness afterward. Social networks and resources should be developed in the community for older adults.

Acceptance-based telephone support around the time of transition to secondary progressive multiple sclerosis: A feasibility randomised controlled trial

IntroductionTransitioning to secondary progressive multiple sclerosis (SPMS) is a difficult time for people, fraught with uncertainty and an increase in physical disability. In parallel, healthcare appointments become less frequent, most disease modifying treatments are withdrawn, and social contacts typically become more difficult to maintain. The aim of this study was to assess whether providing a brief, Acceptance and Commitment Therapy (ACT)–based telephone support intervention during transition to SPMS is feasible, effective and valued by participants. MethodA single centre, mixed-methods, two-arm feasibility randomised controlled trial (RCT), comparing (i) ACT-based support + treatment as usual to (ii) treatment as usual only, was conducted for those who had transitioned to SPMS. Feasibility, signal of efficacy and acceptability were assessed in both groups by self-report measures at 3 timepoints (baseline, 8 weeks, 12 weeks), and feedback interviews analysed using framework analysis following the completion of the study. ResultsThe recruitment strategy was not feasible: 14 of 40 were recruited (35%) during the four-month time period (Mage = 53, 10 women). The data collection procedures and trial processes were feasible and acceptable to participants, reflected through all measures being completed, no attrition, and positive participant interview feedback. The intervention did not demonstrate a signal of efficacy between baseline and 8-week or 12-week follow up on measures, but wide confidence intervals preclude drawing strong conclusions. Positive interview feedback suggested outcomes not being captured through self-report measures. DiscussionDue to an unsuccessful recruitment strategy and mixed evidence of efficacy, certain adjustments should be made to the intervention and methodology before progressing to a definitive trial. A more efficient recruitment strategy, or longer recruitment period is needed to recruit a large enough sample. Adaptations to the ACT intervention may be needed to ensure that it targets psychological flexibility, which could include changing the workbook or session delivery based on interview feedback, however the small sample size means we should interpret the efficacy findings with caution.

Preoperative anxiety in patients admitted for brain surgery: A systematic review

IntroductionUp to 80% of patients scheduled for surgery experience preoperative anxiety, which may implicate perioperative psychological and physical discomforts. Several studies focused on this phenomenon in neurosurgical setting, still controversial evidence exists.ObjectivesOur aim is to synthesize this evidence, investigating prevalence, implications and therapy of preoperative anxiety in brain surgery patients.MethodsWe performed a systematic review of literature by searching PubMed, Embase, and Cochrane Library databases. Data were extracted using the PICO framework. PRISMA guidelines were applied, and the risk of bias was assessed using the RoB 2 and ROBINS tools, as was the methodological quality of the included studies, following GRADE criteria; we excluded articles with serious risk of bias and/or low quality.ResultsWe included 27 articles, accounting for 2558 patients of twelve different countries. Prevalence of anxiety before brain surgery was up to 89%, reaching higher levels in women. Anxiety concerned mostly anesthesia and surgical outcome. No correlation emerged between level of anxiety and laterality, histological type of tumor or survival rate. Before surgery, anxious patients performed worse in cognitive tasks and had worse subjective evaluation of their cognitive abilities. After surgery, preoperative anxiety was associated with depression, longer hospitalization, increase of physical disability and lower quality of life. Effective approaches to reduce anxiety were acupuncture, music therapy, virtual reality and pharmacological support.ConclusionsPreoperative anxiety in brain surgery patients is a common experience that should not be underestimated to achieve a better perioperative care through early detection and adequate pharmacological or non-pharmacological management.

Effect of Resistance Training with Different Intensities on Airway Resistance Indices and Fatigue and Muscular Endurance in Women with Multiple Sclerosis (MS)

Background: Airways resistance and broncho-spasm due to exercise are very common. Factors such as exercise, temperature, humidity, air pollution, and disease affect this complication. This study was performed due to the increase in physical disability of muscle weakness in patients with MS and the lack of information on the effect of different strength training exercises on air resistance. Objectives: The current study aimed to investigate the effect of resistance training with different intensities on airway resistance indices of women with MS. Methods: Thirty six women with Multiple sclerosis who had a disability criterion ranged from 1 to 4 (based on Krutzke’s disability scale) were sampled using the targeted and purposive sampling methods. They were selected based on the initial health conditions and then were randomly assigned to each of the three groups (each consisting of 12 participants). The first group received resistance training for 12 weeks, three sessions a week with intensity 60% 1RM, and the second group received resistance training for 12 weeks, three sessions a week with intensity 80% 1RM. Those in the control group didn’t have an exercise program. Results: Airway resistance indices were measured both before and after 12 weeks of resistance training, airway resistance indices in both groups was significantly decreased, and these changes were significant in both experimental groups as compared to the control group. Conclusions: According to the findings, in addition to improving balance, fatigue, and muscle endurance, high-intensity resistance training had similar effects to moderate-intensity exercise on pulmonary function indices in women with MS.

Assessment of Interleukin-17A, Interleukin-10 and Transforming Growth Factor-Beta1 Serum Titers in Relapsing Remitting Multiple Sclerosis Patients Treated with Avonex, Possible Biomarkers for Treatment Response.

Individual response to interferon beta (IFN-β) 1a treatment is heterogeneous in multiple sclerosis (MS). Our objective was to find a connection between serum levels of interleukin (IL)-10, IL-17 and transforming growth factor beta (TGF-β)1 in MS patients treated with IFN-β in order to identify the nonresponders (NR). We included in the study 32 healthy subjects and 32 MS patients: 10 naive, 10 early treated and 12 late treated with INF-β1a. Serum determination of cytokines and brain MRI were performed at the beginning of the study, after 6 and 12 months. Rio score was calculated at the end of the study. MS patients had initially a significant higher level of IL-17 and a lower level of TGF-β1 compared to healthy subjects. IL-17 level in early treated patients was significantly lower compared to the naive and late treated groups. INF-β1a treatment significantly increased IL-10 and decreased IL-17 levels. Initial low levels of IL-10 were associated with an increase in physical disability. IL-17 levels positively correlated with the number of relapses and MRI activity. Nine patients were NR to Avonex. Patients with a Rio score of 3 had higher initial levels of IL-17 and those with a Rio score of 0 had higher initial levels of IL-10 and TGF-β1. IFN-β1a decreased IL-17 and increased IL-10 seric levels; IL-17 significantly correlated with MS activity; TGF-β1 activity is titer-dependent, increased levels were associated with IL-17 inhibition; NR patients to IFN-β1a will have initial high IL-17 and low IL-10 and TGF-β seric levels.

Natural history of skeletal muscle involvement in myotonic dystrophy type 1: a retrospective study in 204 cases.

Myotonic dystrophy type 1 (DM1) is the most frequent muscular dystrophy in adult. The aim of this study was to investigate the natural history of skeletal muscle weakness in adults, in a cross-sectional, retrospective study. In a cohort of 204 adult DM1 patients, we quantified muscle impairment, handgrip force and physical disability. Muscle strength was similarly affected in the legs and in the arms, the right and left side, and distally more than proximally in patients. The earliest and the most affected skeletal muscles were the digit flexors, foot dorsiflexors and neck flexors; whereas the elbow and knee extensors and flexors were the least affected muscle groups. The rate of decline of the muscle strength was -0.111 units/year. The handgrip values were lower in DM1 patients than the normative values and the rate of decline in handgrip force per year was -0.24 kg. Limitation in mobility or walking is observed in 84 % of DM1 patients but requirement of wheelchair is infrequent (3 %). The decrease in muscle strength, handgrip force and the increase in physical disability were highly correlated with duration of the disease and the number of CTG repeats in the blood. Significant association was found between decline in muscle strength and the age at onset, physical disability and the age of patients at evaluation, handgrip force and gender. Decline in muscle weakness is very slow and although limitation when walking is a common manifestation of DM1 in patients, the requirement of wheelchair is infrequent.

Rituximab postprogressive multifocal leukoencephalopathy: a Feasible therapeutic option in selected cases.

Rituximab postprogressive multifocal leukoencephalopathy: a Feasible therapeutic option in selected cases.

The natural history of Charcot-Marie-Tooth type 1A in adults: a 5-year follow-up study

Charcot-Marie-Tooth type 1A is the most prevalent hereditary demyelinating polyneuropathy. The aim of this study was to investigate the natural history of the disease in adults during a 5-year follow-up and to compare the changes over time with those found in normal ageing. In a cohort of 46 adult Charcot-Marie-Tooth type 1A patients, impairments and physical disability were scored at baseline and at 1, 3 and 5 years. Standardized nerve conduction studies and electromyography were performed at baseline and at 5 years. Twenty-six healthy age- and sex-matched controls were evaluated at baseline and at 5 years. Forty-four of 46 Charcot-Marie-Tooth type 1A patients (range 17-69 years) and 26 controls (range 25-65 years) completed the 5-year follow-up. The decrease in muscle strength and in compound muscle action potential amplitudes was similar for patients and controls alike. However, in contrast to the control group, physical disability increased over time in the patient group. In patients, muscle strength and physical disability after 5 years were closely related to these parameters at baseline. None of the other assessed baseline characteristics, i.e. age, gender, compound muscle action potential amplitude and motor nerve conduction velocity, predicted the extent of deterioration of muscle strength or physical disability. In adult Charcot-Marie-Tooth type 1A patients, the decline in axonal function and in muscle strength may reflect, to a considerable extent, a process of normal ageing. The slow increase in physical disability in adulthood may well be explained by decreased reserves and compensatory mechanisms together with progression of skeletal deformations due to muscle weakness.

Parkinson's disease epidemiology in the Northampton District, England, 1992.

In a population of 302,000, in a Midlands district of England, the estimated prevalence of idiopathic Parkinson's disease (IPD) increased from 108 to 121 per 100,000 from 1982 to 1992. Individual general practice prevalence ranged quite widely. Webster ratings were significantly more often scored in 1992, but at a lower level of severity, suggesting earlier diagnosis. Incidence in 1992 was estimated as 12 per 100,000 per annum. Micrographia, when copying interlocking pentagons, was significantly related to Hoehn & Yahr scores. Over the 10-year period, there has been a considerable change in prescribing: a positive response to medication was confirmed as a good diagnostic indicator. Progression of symptoms and an increase of physical disability was noted in those of the 1982 study alive in 1992.

Changes in Impairment Level, Functional Status, and Use of Assistive Devices by Older People With Depressive Symptoms

We sought to understand how functional status, impairment level, and use of assistive devices change over 3 years for older adults with depressive symptoms. We further explored factors that predict change in severity of depressive symptoms. This study used data from the Rehabilitation Engineering Research Center on Aging Consumer Assessment Study, a longitudinal study of coping strategies of elders with disabilities. Seventy-three participants with depressive symptoms were interviewed at baseline and 3 years later. During 3 years, participants experienced increased physical disability (p = .001), a decline in severity of depressive symptoms (p = .03), and an increase in the total number of assistive devices owned. A significant number of older adults will experience a decrease in depressive symptoms over 3 years, despite an increase in physical disability. They also will obtain more assistive devices as they age.

Long-term emotional state of multiple sclerosis patients treated with interferon beta

Objective: To assess the long-term emotional state of multiple sclerosis (MS) patients treated with interferon beta (IFNβ) for at least four years. Methods: Patients who had started IFNβ therapy prior to 2000 with a baseline psychological assessment were identified and scheduled for long-term emotional assessment with the following questionnaires-the Hamilton Depression Rating Scale, the Beck Depression Inventory and the State-Trait Anxiety Inventory. Results: A total of 262 patients started IFNβ therapy in our MS clinic within the period 1995-1999. Baseline emotional assessment was available from 246 MS patients. Long-term assessment was conducted on 234 patients. After a mean follow-up of 65 months (43-98), 52 patients (22.3%) had withdrawn from IFNβ therapy. The comparisons, obtained from baseline and follow-up scores, showed an improvement in the depressive and anxiety symptoms of patients who adhered to IFNβ treatment. Logistic regression analysis indicated that an increase in physical disability and the presence of depressive symptoms at baseline were best predictors for long-term depressive symptoms. Conclusions: The present results support the absence of emotional worsening in MS patients treated with IFNβ for a long period of time. Increased disability and the presence of baseline depressive symptoms predicted the presence of depressive symptoms at follow-up.

Old and Ill and Still Feeling Well? Determinants of Subjective Well-Being in ≥60 Year Olds: The Role of the Sense of Coherence

The authors investigated the determinants of subjective well-being in a sample of elderly by applying a salutogenetic model of subjective well-being in which sense of coherence (SOC) plays a central role. The hypothesis was that subjective evaluation and SOC as a personality resource explain more variance of subjective well-being than the objective changes resulting from the aging process. A sample of >or=60-year-old patients of an internal hospital, previously examined between 1994 and 1997, were once more contacted between 2000 and 2002. Fifty-six patients were investigated by means of psychometric scales and biographic interviews. Compared with the sample of the first investigation, a positive selection effect could be found for the sample of the present investigation with regard to age- and health-related variables, however, not with regard to subjective well-being. A path model formulated in advance was tested. Despite an increase in physical disability, subjective well-being remained constant for both points in time. The path model supported the hypothesis that subjective well-being at the second measurement point was hardly influenced by "objective" conditions of aging and functional impairment but was significantly influenced by the individual's subjective evaluation of the present situation as well as the sense of coherence. Our results support a salutogenetic model of subjective well-being in our sample; these findings should, however, be replicated in other samples.

Mental and physical health of elderly people: five-year follow-up of a total population.

The change in mental and physical functioning over 5 years for 594 survivors of a community survey of the elderly is described. An increase in cognitive impairment, physical disability and incontinence over the period was found with increasing age. Women in the two oldest age groups had a significantly greater increase in physical disability than men. An annual incidence of cognitive impairment of 1.4% was found and the implications of this are discussed.