Increase In Life Expectancy Research Articles

Age and sex-specific risk in fractures with Down syndrome in a retrospective case-control study from Germany.

The increasing life expectancy of individuals with Down syndrome has led to a growing awareness of mid- and late-life conditions. Based on the Disease Analyser database (IQVIA), this retrospective cohort study compared adults ≥18years of age with Down syndrome (ICD-10: Q90) in general practices in Germany with a propensity score-matched cohort without Down syndrome. The outcome was the first diagnosis of a fracture within 5years of the index date. The cumulative incidence of fractures over a 5-year period was presented using Kaplan-Meier curves. Univariable Cox regression analyses by age group and sex were performed to assess the association between Down syndrome and fractures. A total of 2547 individuals with Down syndrome and 12735 individuals without Down syndrome were included in the study. A significantly higher cumulative fracture incidence within 5years was observed in the age group 51-60years (9.3% Down syndrome vs. 4.8% without Down syndrome, P=0.003) as well as in the age group >60years (20.3% Down syndrome vs. 8.6% without Down syndrome, P<0.001) compared with the cohort without Down syndrome. Regression analysis showed a significant association between Down syndrome and fracture risk in women with Down syndrome aged 51-60years (hazard ratio [HR]=1.60; 95% confidence interval [CI]: 1.13-2.26), and in those aged 51-60years (HR=2.08; 95% CI: 1.27-3.41) and >60years (HR=2.98; 95% CI: 1.87-4.73)), but not in men. When comparing fractures in individuals with and without Down syndrome, shoulder and arm fractures were most common in the Down syndrome cohort. The results of our study indicate a positive association between individuals with Down syndrome and subsequent fractures in women and those aged >50years. Prevention of falls appears to be particularly important in these populations. However, future studies should clarify the extent to which socio-economic factors, such as housing, play a role in this context.

Studies on the Anti-Inflammatory Effect of Xiaoyao Pills in The Treatment of Postmenopausal Osteoporosis in Mice.

Osteoporosis is a common metabolic disease of elderly and postmenopausal women, with no obvious symptoms during its early stages. In the latter stages of this condition, the patients are prone to fractures, and this can seriously affect their health and quality of life. The worldwide increase in life expectancy has made osteoporosis a global concern. The Xiaoyao pills were previously used in the treatment of depression. In addition, the drug appeared to have estrogen-like activity, which affected the expression of ALP, an early osteoblast-specific marker, and COL-1, a major component of bone extracellular matrix. Xiaoyao pills were assessed for their effects on postmenopausal osteoporosis (PMOM) in mice. The target information of each herbal component of Xiaoyao pills was accessed through the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. Information from GeneCards, OMIM, PharmGkb, TTD, DrugBank, and other websites was used to construct the regulatory network of the herbal complex through Cytoscape and String network to assess the protein interactions. Mice were ovariectomized, and treated with high and low doses of Xiaoyao pills and these were compared to controls. Their symptoms were assessed by immunocytochemistry of bone tissues. The results suggested that Xiaoyao pills had the ability to alleviate the symptoms of PMOM in ovariectomized mice through the IL-17 signaling pathway. This drug has the potential to become a novel therapeutic agent for the treatment of osteoporosis.

Predictive modelling of cooling consumption in nursing homes using artificial neural networks: Implications for energy efficiency and thermal comfort

The growing need for cooling within the built environment, propelled by climate change and the expansion of nursing homes due to the increase in life expectancy, highlights the urgency of implementing energy-efficient strategies in buildings occupied by older populations. As of today, there remains a need for comprehensive research into the influence of indoor and outdoor conditions, building, operational, and occupant characteristics, on energy consumption specifically for nursing homes. This study develops a systemic artificial neural network-based model with a multi-layer perceptron architecture to assess HVAC energy implications during the cooling season for older populations. Using monitored data from eight nursing homes, the model includes cooling area, construction age, outdoor and indoor temperatures, and outdoor relative humidity as inputs, and cooling consumption as the output. Results show excellent predictive capability (R2=0.95), with mean error of −0.5 kWh, root mean squared error of 13.7 kWh, mean absolute error of 10.2 kWh, and relative error of 0.051. These outcomes are better compared to linear models (R2≈0.65) under the same data set. Adjusting operative temperatures adaptively can significantly enhance resident comfort and achieve up to 23.4 % energy savings, particularly in hotter, drier climates. These findings are of paramount importance for effective energy management in buildings.

Between Choice and Coercion? The Processes of Increased Economic Vulnerability Among Low-Income Older Workers

ABSTRACT The social phenomenon of extended working age has been subject to broad scholarly and social policy interest, as part of such trends as the aging of the population, increased life expectancy, shortage of the labor force, and policy debates on pension reforms. A major question about extending working age, or working after retirement, is whether it is a matter of choice, taking control of one’s later life, or is coerced, part of entering the precariat. This study provides a nuanced examination of the social processes that direct labor market participation among older workers by conducting an analysis of in-depth interviews with 42 low-income older workers in Israel. The study exposed several institutional constraints that increase their economic vulnerability, demonstrating how interrelated structural factors related to the labor market, gender, and immigration shape the precarity of the life of older workers and coerce their continuous labor market participation. We conclude by emphasizing the responsibility of governments to ensure that older workers’ labor market participation truly represents their “choice and control,” rather than being a matter of coercion.

Prevalence and general characteristics of dementia: a nationwide population-based study of electronic health records in Türkiye.

Türkiye is a country with an increasing life expectancy and an older adult population in parallel with the rest of the world. Several national small-scale studies were performed regarding the prevalence and characteristics of dementia in Türkiye, and the results of these studies differ from each other. We aimed to determine the prevalence of dementia in Türkiye to present the demographic characteristics, the frequency of use of health services, and the management of dementia. Patients aged 65 years and over with a diagnosis of any type of dementia between January 1, 2019, and December 31, 2020, were retrospectively screened from the electronic health records of the Ministry of Health using ICD-10 codes. In 2019, the total number of dementia cases identified in individuals aged 65 years and older was 247,727, of whom 150,529 (60.8%) were women. In 2020, the total number of dementia cases identified in this age group was 233,949, with 142,878 (61.1%) of these cases being women. The rate of patients admitted to the emergency department was 72.3% and 66.2% of all dementia patients in 2019 and 2020, respectively. In terms of the use of outpatient clinics, most patients with dementia were admitted to neurology (71.0% in 2019 and 62.4% in 2020). The geriatric medicine outpatient clinic was the least used by patients with dementia both in 2019 and 2020. The prevalence of patients living with dementia in Türkiye is lower than the global average. This suggests that most dementia cases are overlooked, highlighting the need to raise dementia awareness both in the community and among primary health care providers who frequently encounter older individuals. The study is significant in that it is the first to show the nationwide frequency of dementia in Türkiye.

Understanding the Complex Dynamics of Immunosenescence in Multiple Sclerosis: From Pathogenesis to Treatment.

Immunosenescence, the gradual deterioration of immune function with age, holds profound implications for our understanding and management of multiple sclerosis (MS), a chronic autoimmune disease affecting the central nervous system. Traditionally diagnosed in young adults, advancements in disease-modifying therapies and increased life expectancy have led to a growing number of older individuals with MS. This demographic shift underscores the need for a deeper investigation into how age-related alterations in immune function shape the course of MS, influencing disease progression, treatment effectiveness, and overall patient outcomes. Age-related immunosenescence involves changes such as shifts in cytokine profiles, the accumulation of senescent immune cells, and compromised immune surveillance, collectively contributing to a state known as "inflammaging". In the context of MS, these immunological changes disturb the intricate balance between inflammatory and regulatory responses, thereby impacting mechanisms of central immune tolerance and peripheral regulation. This paper stands out by combining the most recent advancements in immunosenescence with both pathophysiological and treatment perspectives on multiple sclerosis, offering a cohesive and accessible discussion that bridges theory and practice, while also introducing novel insights into underexplored concepts such as therapy discontinuation and the latest senolytic, neuroprotective, and remyelination therapies. Enhancing our understanding of these complexities will guide tailored approaches to MS management, ultimately improving clinical outcomes for affected individuals.

Cultural beliefs and indigenous knowledge about the red fox (Vulpes vulpes) in the Hindu Kush ranges of north-western Pakistan

ABSTRACT We conducted this study to see if cultural beliefs and indigenous knowledge about the red fox (Vulpes vulpes) differed among demographic parameters in Chitral, Pakistan. We interviewed 600 participants (40 from Bumburet and Rumbur; 560 from Mulkhow, Torkhow, Mastuj, Lotkoh, Laspur, and Chitral town) using quantitative, structured questionnaires from June 2020 to September 2021. The questionnaire contained five questions about cultural beliefs and four about the knowledge about red foxes. We found greater association among females (versus males), with low levels of education and age (less than 20 and greater than 40 years) and beliefs that displaying red fox tail protects from accidents, increases life expectancy, protects from evil eyes and magic spells, and brings good luck. Of two indigenous tribes interviewed, the Kalasha people living in rural settings disregarded superstitious beliefs and had more knowledge about the red fox than Khow people.

Improving normothermic machine perfusion and blood transfusion through biocompatible blood silicification

The growing world population and increasing life expectancy are driving the need to improve the quality of blood transfusion, organ transplantation, and preservation. Here, to improve the ability of red blood cells (RBCs) for normothermic machine perfusion, a biocompatible blood silicification approach termed "shielding-augmenting RBC-in-nanoscale amorphous silica (SARNAS)" has been developed. The key to RBC surface engineering and structure augmentation is the precise control of the hydrolysis form of silicic acid to realize stabilization of RBC within conformal nanoscale silica-based exoskeletons. The formed silicified RBCs (Si-RBCs) maintain membrane/structural integrity, normal cellular functions (e.g., metabolism, oxygen-carrying capability), and enhance resistance to external stressors as well as tunable mechanical properties, resulting in nearly 100% RBC cryoprotection. In vivo experiments confirm their excellent biocompatibility. By shielding RBC surface antigens, the Si-RBCs provide universal blood compatibility, the ability for allogeneic mechanical perfusion, and more importantly, the possibility for cross-species transfusion. Being simple, reliable, and easily scalable, the SARNAS strategy holds great promise to revolutionize the use of engineered blood for future clinical applications.

Environmental sustainability, medical waste management, energy and medicine consumption of the surgical intensive care nurses: A qualitative study.

In intensive care units, it is noticeable that there is intensive use of resources in the treatment and care process, leading to a significant amount of waste generation. In addition, the demand for intensive care, increasing life expectancy and surgical interventions, complex comorbidities and ecological crisis make it necessary to make critical care more sustainable. To explore the perspectives of nurses working in surgical intensive care units regarding responsible medical waste management, energy and medication consumption. This qualitative descriptive study was conducted in surgical intensive care units of a university hospital in Turkey in November 2023. Twenty-three nurses filled in an introductory form and participated in a semi-structured interview. Data were analysed using inductive content analysis. Three main themes were determined: environmentally sustainable intensive care, prevention of waste in intensive care; responsible consumption and recycling; suggestions for institutional and individual behavioural change regarding environmental sustainability. The majority of nurses lack knowledge about sustainable development goals. However, in the intensive care unit, they provided effective and creative solutions for medical waste management, energy and medication consumption and individual and institutional behavioural change regarding environmental sustainability. Sustainability strategies should be created in institutions to ensure responsible medical waste management, energy and medicine consumption and reduce carbon footprint. In accordance with this purpose, 'Green teams' including unit-based doctors, nurses and paramedics should be established. Training should be provided and awareness should be raised to reduce energy use resulting from heating, lighting, ventilation and air conditioning.

Faltering mortality improvements at young-middle ages in high-income English-speaking countries.

Before the COVID-19 pandemic, stagnating life expectancy trends were reported in some high-income countries (HICs). Despite previous evidence from country-specific studies, there is a lack of comparative research that provides a broader perspective and challenges existing assumptions. This study aims to examine longevity trends and patterns in six English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom, United States) by combining period and cohort perspectives and to compare them with other HICs. Using data from the Human Mortality and World Health Organization Mortality Databases, we estimated partial life expectancy, lifespan inequality and cohort survival differences for 1970-2021, as well as the contribution of causes of death to the gap in life expectancy between English-speaking countries and the average for other HICs in 2017-19. In the pre-pandemic period, the increase in life expectancy slowed in all English-speaking countries, except Ireland, mainly due to stagnating or rising mortality at young-middle ages. Relative to other HICs, those born in Anglophone countries since the 1970s experienced relative survival disadvantage, largely attributable to injuries (mainly suicides) and substance-related mortality (mainly poisonings). In contrast, older cohorts enjoyed advantages for females in Australia and Canada and for males in all English-speaking countries except the United States. Although future gains in life expectancy in wealthy societies will increasingly depend on reducing mortality at older ages, adverse health trends at younger ages are a cause for concern. This emerging and avoidable threat to health equity in English-speaking countries should be the focus of further research and policy action.

Analyzing key health factors influencing life expectancy using machine learning

With the rapid development of global medical technology and the steady improvement of social living standards, life expectancy per capita has become one of the most important indicators of a country or region's level of development. It not only reflects the quality of life and health of the local people, but also profoundly affects the economic growth and social stability of the country. In underdeveloped countries, life expectancy at birth is generally lower than in more developed countries due to resource constraints and poor medical facilities. This phenomenon has triggered extensive research interest in whether there is some correlation between life expectancy per capita and economic growth, and how improving life expectancy can contribute to a country's economic transformation and development. The purpose of this paper is to explore the impact of life expectancy per capita on economic growth and how to promote the economic transformation and development of countries by increasing life expectancy. Through a comparative study of Asian countries such as China, Singapore and Japan, this paper analyzes the impact of different factors on life expectancy through technical methods such as visual analysis, hypothesis testing, regression modeling, and decision tree modeling, and explores how these factors play a role in economic growth. The results of this study may have some guiding significance for improving life expectancy.

Resource dependence and life expectancy in sub-Saharan Africa: Does financial sector stability break the curse?

Natural resource wealth can contribute to human and economic development if the revenues from natural resource sectors are effectively invested by the government. In particular, countries with abundant natural resources have the potential to experience significant development and improvements in their quality of life. This study first examines the impact of natural resource rents on life expectancy in sub-Saharan Africa. We then investigate the moderating role of the financial sector in this relationship. Using mainly the Generalized Moments Method in a panel of 44 Sub-Saharan African countries over the period 1990–2021, the results obtained in this paper reveal a negative effect of natural resource rents on life expectancy, supporting the resource curse-health hypothesis. However, the stability of the financial system moderates this relationship and makes it positive, at specific thresholds. These results are consistent with Hirschman's conjecture that production leakage is low in landlocked countries, but that there are stronger links with public revenues than with other sectors of activity. The ‘wealth channel’ lubricated by the financial sector that this study identifies calls for greater caution when adopting non-rentier policies in countries exploiting their natural wealth, specifically countries with low human capital. We suggest that a portion of resources should be allocated to financing human capital in order to increase life expectancy.

Alzheimer's Disease Mortality Rate: Correlation with Socio-Economic and Environmental Factors.

The progressive increase in the number of deaths caused by Alzheimer's disease (AD) in Brazil and around the world between 2010 and 2020 raises questions in scientific society. At the same time, there is also an increase in life expectancy at birth (LEB). Thus, the aim of this study was, for the first time, to compare the increase in AD mortality rate (ADMR) in Brazilian regions over the years 2010 to 2020 with the increase in LEB, and investigate the possible correlation between these demographic transition phenomena and pesticide sales and exposure during this period. Data were extracted from the Brazilian Institute of Geography and Statistics (IBGE), from the Department of Informatics and Technology of the Brazilian Ministry of Health (DATASUS) and from the Brazilian Institute of the Environment and Renewable Natural Resources (IBAMA). There was a significant increase in life expectancy at birth and in ADMR over the years between 2010 and 2020 in all Brazilian regions, with the female population in the South region being the most affected. In conclusion, there is a strong positive correlation between the increase in ADMR and LEB; ADMR and Human Development Index (HDI) and ADMR and pesticide sales and exposure in Brazil over the years studied.

Characteristics of streptozotocin-induced and okadaic acid-induced models of Alzheimer's disease

alzheimer's disease is the main cause of dementia in people over the age of 65, which affects millions of patients worldwide. Since the prevalence of this pathology increases significantly with the increase in life expectancy, the societal consequences of Alzheimer's disease will be dire if no effective therapy is developed in the near future. Fundamental experimental work is a mandatory and necessary stage of preclinical research for the safe and effective development of new approaches to the treatment of dementia as part of clinical trials in the future. Streptozotocin is a natural chemical obtained from Streptomyces achromogenes, primarily classified as an antibiotic, the introduction of which leads to the activation of oxidative stress and damage to the myelin sheath. This chemical compound promotes the accumulation of characteristic abnormal proteins, called β-amyloid and tau protein, which leads to imitation of neuropathological, behavioral, metabolic and molecular symptoms that resemble human Alzheimer's disease. Okadaic acid is a C38 fatty acid polyester phycotoxin, which is a powerful and selective inhibitor of serine/threonine phosphatases: PP-1c, PP1, PP2A and PP2B, which leads to a decrease in dephosphorylation of phosphorylated tau protein and, accordingly, to hyperphosphorylation of tau protein. Hyperphosphorylation of tau protein is responsible for the deposition of neurofibrillary tangles in vivo and in vitro, which ultimately causes synaptic dysfunction and neuronal death. In addition, okadaic acid activates kinases that regulate tau protein phosphorylation: GSK3β, CDK5, MAPK, ERK1/2, AMPK. The activation of kinases significantly contributes to the phosphorylation of tau protein. Okadain administration is also reported to significantly activate the expression of BACE1, one of the key enzymes in the amyloidogenic cascade. The mechanisms of molecular and morphological changes of the Alzheimer's type in the brain of experimental animals when streptozotocin and okadaic acid are administered are similar in many respects. These include induction and activation of neurodegeneration, apoptosis and necrosis of neurons, development of oxidative stress and inhibition of antioxidant systems, deficiency of neurotransmitters and mitochondrial dysfunction, etc. Both proposed toxins effectively contribute to the simulation of dementia of the Alzheimer's type in the experiment.

Phytochemical Composition and Toxicological Screening of Anise Myrtle and Lemon Myrtle Using Zebrafish Larvae.

Plants are an immense source of drugs, and 50% of modern pharmacopeia has a plant origin. With increasing life expectancy in humans, many age-related degenerative diseases converge on oxidative cellular stress pathways. This provides an opportunity to develop broad treatments by targeting the cause of common pathologic cell degeneration. Toxicological effects can be readily assessed in a live animal model system to establish potential fauna for clinical use. Here, we characterized and evaluated the antioxidant potential and toxicological effects of anise myrtle (Syzygium anisatum) and lemon myrtle (Backhousia citriodora) leaves. Using zebrafish larvae, a model for high-throughput pre-clinical in vivo toxicology screening, we identified safe levels of extract exposures for development of future therapeutics. The antioxidant capacity and toxicity were very similar in these two myrtles. The LC50-96h for anise myrtle was 284 mg/L, and for lemon myrtle, it was 270 mg/L. These measurements are comparable to ongoing studies we are performing using the same criteria in zebrafish, which allow for robust testing and prioritization of natural fauna for drug development.

Zebrafish as an innovative model for exploring cardiovascular disease induction mechanisms and novel therapeutic interventions: a molecular insight.

Cardiovascular disease (CVD) is a common cardiac disorder that leads to heart attacks, strokes, and heart failure. It is primarily characterized by conditions that impact the heart and blood arteries, including peripheral artery disease, arrhythmias, atherosclerosis, myocardial ischemia, congenital heart abnormalities, heart failure, rheumatic heart disease, hypertension, and cardiomyopathies. These conditions are mainly effect the heart and blood vessels, causing blockages or weakened pumping, due to severe hereditary and environmental factors. The frequency of CVD is rising significantly as life expectancy increases. Despite this, no effective treatment or management for its symptoms has been found. One of the most difficult obstacles to overcome, is finding a suitable animal model for drug screening and drug development. Although rodents, mice, swine, and mammals serve as the basis for most animal models of cardiovascular disease, no model accurately captures the epidemiology of the condition. Zebrafish (Danio rerio) have drawn the interest of the international scientific community due to certain shortcomings of the previously discussed animal models because they are smaller, less costly, and have an incredibly high rate of reproduction. This review article emphasizes the significance of using zebrafish as an animal model to investigate the possible facets of cardiovascular disease. Moreover, the ultimate purpose of this review article is to establish the advantages of employing zebrafish over other animal models and to investigate the boundaries of using zebrafish to study human disease. Furthermore, the mechanisms of cardiovascular diseases induction in zebrafish were covered to improve understanding for readers. Finally, the analysis of cardiotoxicity using Zebra fish model, is also explained. In order to stop the health index from deteriorating, the current study also covers some innovative, effective, and relatively safer treatments for treatment and management of cardiotoxicity.

Prevalence and Patterns of Ocular Comorbidities among Geriatric Population Residents in Rural Eastern India: A Cross-Sectional Study

Background: With the increase in overall life expectancy, the number of people above 60 years old will increase globally from 1 billion in 2020 to 1.4 billion in 2050 and is expected to double by 2.1 billion by 2050 with an increase in age-related comorbidities. Age-related ocular co-morbidities are a major comorbidity. According to India's visual impairment and blindness data, cataracts and severe and moderate visual impairment are the most common cases. Objective: To assess the ocular comorbidities among the geriatric population. Methods: A community-based cross-sectional study was undertaken in the field practice area of the Rural Health Training Center (RHTC), Jamujhari, Khordha, affiliated with the Department of Community Medicine, IMS &amp; SUM Hospital, Bhubaneswar. Stratified random sampling was done, and one stratum constituted three nearby adopted villages. Four strata were included to select the households, and the first household was selected randomly in each village. A socio-demographic profile and detailed clinical history were collected, and the required clinical examinations were conducted after obtaining consent. Results: The prevalence of ocular morbidity (OM) was found to be 96.8%. Refractive error (RE) has the highest prevalence (86.52%), including prescription-corrected glasses users, whereas age-related macular degeneration (ARMD) and ectropion (EC) have the lowest prevalence (3.2%). Conclusions: The study findings show a need for proactive management and earlier screening for better quality of life in the geriatric population.

Preventing periprosthetic osteolysis in aging populations through lymphatic activation and stem cell-associated secretory phenotype inhibition

With increases in life expectancy, the number of patients requiring joint replacement therapy and experiencing periprosthetic osteolysis, the most common complication leading to implant failure, is growing or underestimated. In this study, we found that osteolysis progression and osteoclast differentiation in the surface of the skull bone of adult mice were accompanied by significant expansion of lymphatic vessels within bones. Using recombinant VEGF-C protein to activate VEGFR3 and promote proliferation of lymphatic vessels in bone, we counteracted excessive differentiation of osteoclasts and osteolysis caused by titanium alloy particles or inflammatory cytokines LPS/TNF-α. However, this effect was not observed in aged mice because adipogenically differentiated mesenchymal stem cells (MSCs) inhibited the response of lymphatic endothelial cells to agonist proteins. The addition of the JAK inhibitor ruxolitinib restored the response of lymphatic vessels to external stimuli in aged mice to protect against osteolysis progression. These findings suggest that inhibiting SASP secretion by adipogenically differentiated MSCs while activating lymphatic vessels in bone offers a new method to prevent periprosthetic osteolysis during joint replacement follow-up.

Non-invasive myocardial work as an independent predictor of postprocedural NT-proBNP in elderly patients undergoing transcatheter aortic valve replacement.

Aortic stenosis has become the most prevalent valvular disease with increasing life expectancy and the ageing of the population, representing a significant clinical burden for health care providers. Its treatment has been revolutionized by transcatheter aortic valve replacement (TAVR) as a safe and minimally invasive option for elderly patients. Left ventricular (LV) functional measurement is of particular importance before TAVR, however, increased afterload significantly influences the conventional echocardiographic parameters. Non-invasive myocardial work examines myocardial deformation in the context of instantaneous LV pressure, thus, it might be a more reliable measure of LV function. Accordingly, we aimed to study non-invasive myocardial work and its relationship with functional outcome following TAVR.We enrolled 90 TAVR candidates (80 [75-84] years; 44% female). Using echocardiography, we quantified ejection fraction (EF), global longitudinal strain (GLS), global myocardial work index (GWI) and global constructive work (GCW) before and 12 months after the procedure. Serum NT-proBNP levels were also measured. EF did not change (52.6 ± 13.1 vs. 54.2 ± 10.5%; p = 0.199), while GLS increased (-13.5 ± 4.6 vs. -15.2 ± 3.8%; p < 0.001). GWI decreased (1913 ± 799 vs. 1654 ± 613 mmHg%; p < 0.001) and so did GCW (2365 ± 851 vs. 2177 ± 652 mmHg%; p = 0.018). History of atrial fibrillation (AF) (β = 0.349) and preprocedural GCW (β = -0.238) were independent predictors of postprocedural NT-proBNP (p< 0.001).GLS, GWI and GCW changed after TAVR while there was no alteration in EF. The preprocedural GCW and history of AF were independent predictors of postprocedural NT-proBNP. Accordingly, myocardial work indices may help patient selection and the prediction of the functional outcome in this population.

2165 Barriers perceived by medical students when considering a career in geriatric medicine.

Abstract Introduction Despite the UK’s increasing life expectancy, and increase in the elderly population, there is an overwhelming lack of Geriatricians in the UK; as of 2022, there is only 1 consultant Geriatrician per 8031 individuals over the age of 65 (BGS, 2023). To meet the complex care needs of this population, there must be a focus on increasing the interest that doctors have towards Geriatric Medicine, with the overall aim being to recruit more doctors into the speciality. Method The aim of this review was to investigate what factors medical students perceive as barriers to pursuing a career in Geriatric Medicine and then, from identifying these, generate a set of comprehensive suggestions as to how to tackle these barriers at a medical school level to increase the interest and ultimately uptake of Geriatric Medicine. The qualitative review contains literature published between 2003 and 2023 accessed using MedLine. Results Six themes were identified in answering our question: (a) high emotional burden, (b) caring for patients with complex needs, (c) negative preconceptions of non-clinical factors (prestige, salary, career progression), (d) negative influence of clinical educators, (e) lack of intellectual stimulation and (f) lack of exposure to the speciality and the elderly. Conclusion The barriers perceived by medical students when considering Geriatrics as a speciality are complex and multifaceted; these barriers must be tackled promptly in order to secure the next generation of Geriatricians. We suggest that this work can be used as a foundation for further qualitative studies with UK medical students to investigate barriers that are specific to UK students. From this, interventional courses designed to increase Geriatric Medicine uptake could be developed to strengthen the UK Geriatric Medicine workforce.