Normal Elderly Persons Research Articles

Clinical consequences of age-related impairments in vascular compliance

Advancing age is associated with progressive reductions in the vascular distensibility of major vessels. Two clinically relevant consequences of physiologically impaired arterial compliance of aging, increased systolic blood pressure and decreased carotid arterial baroreflex sensitivity, are discussed. While arterial thickening and stiffening with age are associated with increased systolic blood pressure, diastolic blood pressure is generally stable or even decreases slightly with advancing age. Thus, the prevalence of isolated systolic hypertension increases dramatically with age. This long-neglected abnormality has recently attracted attention, and the view that systolic hypertension is harmless and its treatment fraught with a high incidence of serious adverse effects has now been shown to be myth. Several studies indicate substantial risk associated with isolated systolic hypertension, especially with regard to increasing prevalence of stroke. A recent multicenter trial has shown that systolic blood pressure can be safely lowered with low doses of thiazide diuretics. Currently, a National Institutes of Health sponsored multicenter trial aims to determine whether treatment of isolated systolic hypertension is associated with reduced risk. Age-related impairments in baroreflex sensitivity reduce the capacity of normal elderly persons to increase the heart rate in response to hypotensive stress and contribute to the increased prevalence with advancing age of orthostatic hypotension. This must be taken into account in the design of pharmacologic treatment regimens in older persons.

The Well, the Mentally Ill, the Old and the Old Old: a Community Survey of Elderly Persons in London

ABSTRACTA random sample of 396 elderly people living at home in the Greater London community was interviewed by psychiatrists using standardised assessments. The sample was divided into the old (aged 65–74) and the old/old (aged 75 and over). The proportions with mental illness were identified and excluded from the sample in order to allow comparison of mentally normal elderly persons between these age groups. Surprisingly few differences emerge. No difference in educational attainment appeared, but there was a small diminution (P < 0.01) in intellectual function to clinical testing, in the old/old. Leisure interests were maintained and high level life satisfaction, health and happiness were claimed.

Cerebrospinal fluid vasopressin, oxytocin, somatostatin, and beta-endorphin in Alzheimer's disease.

As a first step toward assessing the status of brain neuropeptide systems that may be involved in Alzheimer's disease (AD), the cerebrospinal fluid (CSF) concentrations of the neuropeptides arginine vasopressin, somatostatin, oxytocin, and beta-endorphin were measured in patients with AD, normal elderly subjects, and normal young subjects. The plasma arginine vasopressin level was also measured in the three groups. The CSF arginine vasopressin level was significantly lower in patients with AD than in either elderly or young normal subjects, but oxytocin and beta-endorphin levels did not differ between groups. The CSF osmolarity also did not differ between groups. The plasma arginine vasopressin level did not significantly differ between groups, but high plasma arginine vasopressin values were absent in the patients with AD. The CSF somatostatin level was significantly lower in patients with AD than in normal elderly persons, but it did not differ in young normal subjects. These results suggest that central vasopressinergic activity may be decreased in AD and confirm reports of low CSF somatostatin levels in AD.

Cognitive decline in advanced age: Future directions for the psychometric differentiation of normal and pathological age changes in cognitive function

In the effort to delineate the cognitive changes that are associated with advanced age, it is necessary to discriminate not only between the cognitive abilities of the young and the aged, but also between the cognitive abilities of the demented and nondemented elderly. The identification of the qualitative characteristics of age‐dependent cognitive decline is made difficult by the obscurity of the latter distinction, which is in turn a consequence of the insidious nature of the dementing process (American Psychiatric Association, 1980). It is not particularly helpful to compare the cognitive profile of the normal elderly person with that of the more severely demented patient, because the global nature of the cognitive deterioration in the more advanced stages of senile dementia produces deficits on virtually any cognitive measure, and therefore adds little contrast to the qualitative description of age‐specific changes in cognitive function. The approach adopted in the present review was to examine the co...

Physical conditioning and left ventricular performance in the elderly: Assessment by radionuclide angiocardiography

In contrast to young persons, normal elderly persons who undergo symptom-limited dynamic exercise demonstrate a decrease in left ventricular (LV) contractile performance characterized by a decrease in LV ejection fraction. To test the hypothesis that physical conditioning can be achieved in older persons and produces improvement in the exercise-induced decrease in LV ejection fraction observed during normal aging, we examined 24 normal elderly persons (mean age 72.0 years) before and after a 12-week program of physical training. The subjects had been screened for evidence of cardiovascular disease including rest and exercise stress electrocardiograms. All subjects underwent rest and exercise upright sitting radionuclide angiocardiography before and after the training program. The subjects achieved cardiovascular training effects as measured by increased functional capacity and decreased double product at one-half the maximum work load attained at the initial stress test. A significant increase occurred after training in the cardiac index response to exercise (p < 0.02) and in the augmentation of the end-diastolic volume index produced by exercise (p < 0.05). However, the exercise-induced decrease in LV ejection fraction and increase in LV end-systolic volume index remained unaltered by training. In conclusion, although older persons can achieve overall training effects from a program of physical conditioning, the age-associated differences in LV contractile performance remained unchanged. Our data suggest that deconditioning is not a significant contributor to the decline in LV contractile performance in the elderly.

Inferential processing of context: Studies of cognitively impaired subjects

Language comprehension tasks involving pronoun coreference were administered to a group of demented patients, a group of patients with cardiac disease, and groups of normal elderly persons and young adults. Pronoun coreference was constrained by either lexical, syntactic, or contextual cues. No differences were found between old and young subjects for any task. While the demented patients were impaired on all tasks, the cardiac patients were specifically impaired in the inferential processing of context.

The effects of ageing on the pigmented nerve cells of the human locus caeruleous and substantia nigra.

The nucleolar volume and melanin content of the human locus caeruleus and substantia nigra has been measured in 70 persons of age range new born to 91 years, all of whom were at death free from overt neurological illness. Both cell types show a reduction in nucleolar size with advancing age, which becomes disproportionately larger towards old age. At 90 years of age, the change in nucleolar volume in cells of the locus caeruleus amounts to about 5% whereas cells of the substantia nigra show a loss of 20%. The greater decrease in nucleolar volume in cells of the substantia nigra is attributed to the higher concentration of melanin pigment occurring in these cells at old age, rather than the absolute amount present. This marked decline in nucleolar volume in cells of substantia nigra indicates a reduced activity in the cell which, in turn, may be reflected in the difficulty in control and coordination in muscular activity commonly seen in normal elderly persons.

51Cr Labelling of Normal Human T and B Lymphocytes for Kinetic Studies in Vivo

Lymphocyte traffic between blood and tissues was assessed by 51Cr labelling of lymphocytes and subsequent autologous reinfusion in 10 normal elderly persons. The technique for isolation and platelet depletion of lymphocyte suspensions is described. By the labelling procedure used about 70 μCi 51Cr may be incubated in about 100 million lymphocytes. This permits measurement of lymphocyte‐bound radioactivity on the T and B fractions separately. The blood disappearance curves for labelled lymphocytes indicate the existence of exchangeable pools in the tissues of T as well as of B lymphocytes, that of the T lymphocytes being apparently larger. A characteristic finding in the blood disappearance curves for total lymphocytes is an increase in lymphocyte‐bound radioactivity in the blood 4–6 h after reinfusion, designated reappearance. The disappearance curve of the B lymphocytes shows reappearance 4–10 h after reinfusion, whereas that of the T lymphocytes falls exponentially without any recordable reappearance. On the basis of the disappearance curves and a knowledge of the topographic distribution of T and B lymphocytes in the lymphoid tissues, a model of T and B lymphocyte traffic in the lymph nodes is discussed. This model operates with T and B lymphocyte passage by way of postcapillary venules and describes the migration in and around the germinal centres. The T lymphocytes in the periphery of the germinal centres are assumed to derive mainly from the afferent lymph, whereas the B lymphocytes in the centres are exchanged with lymphocytes in the blood in an exchangeable pool. The functional implications are discussed.

Platelet function in elderly scorbutics.

Platelet function tests were carried out on eight elderly patients with clinical and biochemical scurvy. These results are compared with the results of similar tests carried out on 14 normal elderly persons, 15 elderly persons with senile purpura and 27 young normal subjects. The findings and significance of these are discussed.

Measurements of all-night sleep in normal elderly persons: effects of aging.

Journal of the American Geriatrics SocietyVolume 15, Issue 5 p. 405-414 MEASUREMENTS OF ALL-NIGHT SLEEP IN NORMAL ELDERLY PERSONS: EFFECTS OF AGING* A. KALES M.D., Corresponding Author A. KALES M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorT. WILSON M.D., Corresponding Author T. WILSON M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorJ. D. KALES M.D., J. D. KALES M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Anatomy and Brain Research Institute, U.C.L.A. Medical Center.Search for more papers by this authorA. JACOBSON M.S., A. JACOBSON M.S. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Anatomy and Brain Research Institute, U.C.L.A. Medical Center.Search for more papers by this authorM. J. PAULSON PH.D., Corresponding Author M. J. PAULSON PH.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorE. KOLLAR M.D., Corresponding Author E. KOLLAR M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorR. D. WALTER M.D., R. D. WALTER M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Neurology, U.C.L.A. Medical Center.Search for more papers by this author A. KALES M.D., Corresponding Author A. KALES M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorT. WILSON M.D., Corresponding Author T. WILSON M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorJ. D. KALES M.D., J. D. KALES M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Anatomy and Brain Research Institute, U.C.L.A. Medical Center.Search for more papers by this authorA. JACOBSON M.S., A. JACOBSON M.S. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Anatomy and Brain Research Institute, U.C.L.A. Medical Center.Search for more papers by this authorM. J. PAULSON PH.D., Corresponding Author M. J. PAULSON PH.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorE. KOLLAR M.D., Corresponding Author E. KOLLAR M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Psychiatry, University of California at Los Angeles (U.C.L.A.) Medical Center.760 Westwood Plaza, Los Angeles, California 90024Search for more papers by this authorR. D. WALTER M.D., R. D. WALTER M.D. Departments of Psychiatry, Anatomy, and Neurology, Neuropsychiatric and Brain Research Institutes, U.C.L.A. Medical Center, Los Angeles, California Department of Neurology, U.C.L.A. Medical Center.Search for more papers by this author First published: May 1967 https://doi.org/10.1111/j.1532-5415.1967.tb02072.xCitations: 100 † Work supported in part by grant MH-10083 (Department of Anatomy), California Department of Mental Hygiene Grant 66-2-44 and NIMH Training Grant 5TI MH-6415 of the Brain Research Institute, U.C.L.A. Medical Center. ‡ Part of this study was presented in preliminary form before the meeting of the Association for the Psychophysiological Study of Sleep, March 1966, Gainesville, Florida. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. 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The effect of ACTH on the plasma and urinary corticoids in normal elderly persons and in patients with senile psychosis.

As part of an investigation to determine the relationship between stress tolerance and the development of senile psychosis, the authors measured the effect of ACTH, administered intramuscularly, on the plasma and urinary corticoids in 30 normal aged persons and 32 patients with senile psychosis. The patients tended to have higher plasma corticoid levels and lower urinary corticoid amounts per gram creatinine, but the differences were not statistically significant. The authors suggest that the greater response of patients with senile psychosis to physical and psychological stress might be due to pituitary or hypothalamic dysfunction rather than to a difference in corticoid output, and further investigation of these possibilities seems warranted.

Recent studies on the biological role of rapid eye movement sleep.

Recent studies on the biological role of rapid eye movement sleep.