Prevalence Of Older Adults Research Articles

Association between cardiovascular disease risk and sarcopenia in community-dwelling Japanese older adults.

Sarcopenia's high prevalence in older adults with cardiovascular disease (CVD) suggests that the risk of comorbidity in sarcopenia might also be increased during the at-risk phase of CVD. However, the relationship between CVD risk and sarcopenia has not been elucidated. Therefore, the purpose of this cross-sectional study was to investigate the association between CVD risk and sarcopenia in community-dwelling Japanese older adults. The participants in this cross-sectional study included 14 923 community-dwelling Japanese older adults (mean age 73.2 ± 5.6 years). The present study estimated the CVD risk using the revised World Health Organization risk chart, and classified CVD risk into "low" (<10%) and "mid-high" (≥10%). Assessments of sarcopenia, muscle mass, muscle strength and gait speed were measured based on the clinical definitions. Among the participants, 654 people (4.4%) had sarcopenia, and 4857 (32.6%) had CVD mid-high risk. A multiple logistic model showed that the CVD mid-high risk was associated with sarcopenia (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.28-1.89). In addition, CVD mid-high risk was associated with low muscle mass (OR 1.74, 95% CI 1.50-2.01), low muscle strength (OR 1.25, 95% CI 1.14-1.37) and slow gait speed (OR 1.17, 95% CI 1.07-1.27) in the adjusted model. Among community-dwelling older adults, high or moderate CVD risk was associated with an increased risk of sarcopenia. Our findings could help identify older adults with a future high risk for sarcopenia. Geriatr Gerontol Int 2024; ••: ••-••.

Novel BMI cutoff points for obesity diagnosis in older Hispanic adults

Current body mass index (BMI) cutoff points (≥ 30 kg/m2) underestimate obesity prevalence in older adults. The aim of the present study was to propose new BMI cutoff points for identifying obesity in older Hispanic adults. In this study, new internally derived (ID) BMI cutoff point for obesity in older Hispanic adults was developed by analyzing data from the National Health and Nutrition Survey of 2018–2019 from Mexico. To evaluate the performance/validation of this newly proposed cutoff point, data from the "Study of the 1000", conducted in Northern Mexico, was utilized. Sensitivity, and negative predictive value (NPV) were assessed using receiver operating characteristic analysis, with obesity defined by fat mass index (FMI; ≥ 9.0 kg/m2 for men and ≥ 12.0 kg/m2 for women) as the reference method. The newly proposed ID BMI cutoff point was ≥ 27.2 kg/m2 which demonstrated high sensitivity (≥ 99.4%) and NPV (≥ 99.5%) in the total sample. Furthermore, the prevalence of obesity estimated by the new BMI cutoff point was comparable to that estimated by the FMI. The newly proposed BMI cutoff point provides a more accurate identification of obesity in older Hispanic adults. These findings have implications for improving obesity diagnosis and management in this population.

Analysis of Stroke Burden in China from 1990 to 2021 and Projections for the Next Decade

Introduction: This study aimed to describe the temporal trends of stroke burden in different age and sex groups in China from 1990 to 2021, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), and to compare these data with global figures. Methods: Using data from the Global Burden of Disease database from 1990 to 2021, we analyzed changes in stroke burden in China and globally. The average annual percentage change (AAPC) was calculated using Joinpoint software to reflect trends. Stroke burden differences across various age groups and sexes were compared, and the ARIMA model was utilized for future projections. Results: Between 1990 and 2021, the age-standardized incidence rate (ASIR) of stroke in China decreased from 226.938 to 204.753 per 100,000, while the global ASIR decreased from 180.973 to 141.553 per 100,000. The age-standardized prevalence rate (ASPR) in China increased from 1,167.425 to 1,301.42 per 100,000, whereas the global ASPR decreased from 1,201.111 to 1,099.31 per 100,000. The age-standardized mortality rate (ASMR) in China fell from 242.18 to 138.029 per 100,000, while the global ASMR decreased from 144.313 to 87.454 per 100,000. China’s age-standardized DALY rate (ASDR) declined from 4,834.791 to 2,648.025 per 100,000, whereas the global ASDR decreased from 3,078.952 to 1,886.196 per 100,000. The AAPCs for ASIR, ASPR, ASMR, and ASDR in China were −0.370%, 0.326%, −1.793%, and −1.933%, respectively, compared to −0.291%, −0.807%, −1.601%, and −1.570% globally from 1990 to 2021. Age and sex significantly influenced the stroke burden, with higher incidence and mortality rates in males than in females. Projections for the next decade indicate that stroke incidence in China will remain stable, with an expected rise in ASPR, and declines in ASMR and ASDR. Globally, ASIR is expected to decline, while ASPR will rise, and ASMR and ASDR will continue to decrease. Conclusion: From 1990 to 2021, the incidence, mortality, and DALYs of stroke in China have decreased, while the prevalence has increased. Stroke burden is age-related, with higher prevalence in older adults and higher mortality in the elderly. Males are more susceptible to stroke and have a higher risk of death. Over the next decade, stroke prevalence in China is expected to rise, posing challenges due to population aging, even as mortality and disability rates decline. Sustained public health efforts will be necessary.

The Impact of Demographics and Comorbidities on Fall Incidence and Prevalence in Older Adults.

Falls among older adults are more than mere accidents; they are a silent epidemic, profoundly impacting the health and well-being of millions of older adults worldwide. This study examines the incidence and prevalence of falls among individuals aged 65 and above, focusing on the influence of demographic factors and comorbid conditions such as hypertension, diabetes mellitus, cancer, and obesity. A retrospective cohort study was conducted using data from the TriNetX network at Virginia Commonwealth University Health System (VCUHS) from 2019 to 2023. The study population included 16,400 individuals aged 65 and above who presented with fall-related trauma. Data on demographics, clinical diagnoses, procedures, and comorbid conditions were analyzed using descriptive statistics to evaluate the incidence and prevalence of falls. The mean age of the study population was 77.3 years, with a higher proportion of females (60.97%) compared to males (39.02%). Despite the larger number of female participants, incidence and prevalence of falls were highest among individuals aged 65-69 years, and fall rates were notably higher among males compared to females. This suggests that while fewer in number, males in our study experienced falls more frequently. Patients with hypertension had the highest incidence proportion (56.67%) and prevalence (75.75%) among comorbid conditions. Falls among older adults are significantly influenced by demographic factors and comorbid conditions. Hypertension, in particular, is associated with the highest fall risk. These findings highlight the need for targeted interventions to manage comorbidities and reduce fall risks among older adult patients.

Excess prevalence of preexisting chronic conditions in older adults with incident epilepsy.

Prior studies have examined chronic conditions in older adults with prevalent epilepsy, but rarely among those with incident epilepsy. Identifying the chronic conditions with which older adults present at epilepsy incidence assists with the evaluation of disease burden in this patient population and informs coordinated care development. The aim of this study was to identify preexisting chronic conditions with excess prevalence in older adults with incident epilepsy compared to those without. Using a random sample of 4 999 999 fee-for-service Medicare beneficiaries aged >65 years, we conducted a retrospective cohort study of epilepsy incidence in 2019. Non-Hispanic Black and Hispanic beneficiaries were oversampled. We identified preexisting chronic conditions from the 2016-2018 Medicare Beneficiary Summary Files and compared chronic condition prevalence between Medicare beneficiaries with and without incident epilepsy in 2019. We characterized variations in preexisting excess chronic condition prevalence by age, sex, and race/ethnicity, adjusting for the racial/ethnic oversampling. We observed excess prevalence of most preexisting chronic conditions in beneficiaries with incident epilepsy (n = 20 545, weighted n = 19 631). For stroke, for example, the adjusted prevalence rate ratio (APRR) was 4.82 (99% CI:4.60, 5.04), meaning that, compared to those without epilepsy, beneficiaries with incident epilepsy in 2019 had 4.82 times the stroke prevalence. Similarly, beneficiaries with incident epilepsy had a higher prevalence rate for preexisting neurological conditions (APRR = 3.17, 99% CI = 3.08-3.27), substance use disorders (APRR = 3.00, 99% CI = 2.81-3.19), and psychiatric disorders (APRR = 1.98, 99% CI = 1.94-2.01). For most documented chronic conditions, excess prevalence among beneficiaries with incident epilepsy in 2019 was larger for younger age groups compared to older age groups, and for Hispanic beneficiaries compared to both non-Hispanic White and non-Hispanic Black beneficiaries. Compared to epilepsy-free Medicare beneficiaries, those with incident epilepsy in 2019 had a higher prevalence of most preexisting chronic conditions. Our findings highlight the importance of health promotion and prevention, multidisciplinary care, and elucidating shared pathophysiology to identify opportunities for prevention.

Aggrecanopathies: Report of a Spondyloepiphyseal Dysplasia Kimberley type (SEDK) in a family, caused by a previously undescribed likely pathogenic variant of the ACAN gene

The study of patients with short stature is complex and requires diagnostic algorithms in which the evaluation by Genetics is essential, seeking to rule out genetic syndromes that may explain the patient's manifestations. Among these possible causes, skeletal dysplasias should always be considered as a diagnostic possibility. We present the case of a family in which in the proband and in his progenitor a previously undescribed probably pathogenic variant was detected in the ACAN gene which encodes the Aggrecan Proteoglycan (PG), a fundamental component in the endochondral bone growth and in the articular cartilage, and whose alteration in heterozygous state produces Kimberley type Skeletal Spóndyloepiphyseal Dysplasia (SEDK) and other disorders known as aggrecanopathies. Molecular genetic analyses are becoming mandatory studies to achieve an accurate diagnosis in these cases. It is expected that the study of these conditions will shed light for a better understanding of the pathophysiology of osteoarthritis and for the development of new treatments for its management, given its high prevalence in older adults and the fact that aggrecan degeneration plays a central role in it.

Factors associated with the fragmentation and stability of the rest-activity rhythm in adults and older adults

ABSTRACT This cross-sectional study aimed to identify factors related to the fragmentation and stability of the rest-activity rhythm (RAR) in adults and older adults. It is part of a larger research project investigating aspects concerning sleep duration, quality, and disorders in a representative subsample of the population. Sociodemographic data, lifestyle, health habits and subjective sleep variables were obtained; RAR records were collected by means of actigraphy and analyzed using non-parametric variables (IS, IV, M10, L5, RA, sL5, and sM10). Study participants were 313 individuals with complete actigraphy records. There was a prevalence of older adults (50.2%) and females (51.1%). Females, individuals with 4–8 y of education, and those who used alcohol abusively exhibited lower RAR fragmentation. Higher fragmentation was observed in individuals who napped and those reporting poor sleep quality. Greater rhythm stability was evident in females, older adults, those with 4–8 y of education, and those who had a partner. Smokers demonstrated lower RAR stability. These findings may contribute valuable insights for decision-making aimed at preventing and treating issues related to fragmentation and instability of the rhythm and its possible consequences to health.

An undue emphasis on rural older adults in the Chief Medical Officer's annual report 2023?

The Chief Medical Officer's annual report 2023 presents an incomplete and skewed picture of the geography of older people in England. We show that there are higher absolute numbers of older people in urban areas in England and Wales, in contrast to key messages from the CMO report which suggest greater need in rural areas based on relative metrics. The absolute size of the urban–rural difference in the population of older people is projected to grow by 2043. Older adults in urban areas are much more likely to live in deprived areas than older adults in rural areas. The absolute number and prevalence of older adults in poorer health is also higher in urban areas, leading to greater healthcare needs. Policy-makers need to consider both absolute and relative demographic trends as well as making use of direct measures of health when planning how healthcare services for older adults are distributed geographically in England.

Global, regional, and national burden of neck pain, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050. Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2·5th and 97·5th percentiles of 100 draws of the posterior distribution. Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32·5% (23·9-42·3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing. Although age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain. Bill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.

Post-Stroke Depression in Older Adults: An Overview.

Detailed data on post-stroke depression (PSD) in older adults are limited in spite of the high vulnerability of this population to stroke. In fact, PSD prevalence in older adults ranges from 16.0 to 43.9%; however, timing and instruments of evaluation often differ significantly across all available studies. The etiology, genetic and inflammatory factors, as well as structural brain alterations, are claimed as part of a multifaceted mechanism of action in PSD onset. Thus, the aim of this narrative review was to further elaborate on the prevalence, etiology, diagnosis, consequences and treatment of PSD in older adults. The consequences of PSD in older adults may be devastating, including a poor functional outcome after rehabilitation and lower medication adherence. In addition, lower quality of life and reduced social participation, higher risk of new stroke, rehospitalization, and mortality have been reported. In this scenario, treating PSD represents a crucial step to prevent these complications. Both pharmacological and non-pharmacological therapies are currently available. The pharmacological treatment utilizes antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TAs) and new multimodal antidepressants (NMAs). Non-pharmacological therapies include psychological interventions and non-invasive brain stimulation techniques, while excluding drug administration. In the general population experiencing PSD, SSRIs (sertraline in particular) are the most prescribed, whereas the combination of antidepressants and psychotherapy is underused. Furthermore, about one-third of patients do not receive treatment for PSD. In regard to older adults with PSD, the possibility of more adverse effects or contraindications to antidepressant prescription due to comorbidities may limit the therapeutic window. Although drugs such as citalopram, escitalopram, sertraline, venlafaxine, and vortioxetine are usually well tolerated by older patients with PSD, the few randomized controlled trials (RCTs) specifically considering older adults with PSD have been conducted with fluoxetine, fluvoxamine, reboxetine, citalopram and nortriptyline, often with very small patient samples. Furthermore, data regarding the results of non-pharmacological therapies are scarce. High-quality RCTs recruiting large samples of older adults are needed in order to better manage PSD in this population. In addition, adequate screening and diagnosis instruments, with reliable timing of evaluation, should be applied.

Sports Health in Older Age: Prevalence and Risk Factors - Systematic Review

Exercise prevalence in older adults often shows low levels, with a considerable portion of this demographic being physically inactive. Myriad studies have also depicted gender disparities in exercise prevalence, highlighting that men tend to engage in more physical activity compared to women. The primary objective of this research is to highlight sports health in older age, prevalence, and risk fac-tors through a systematic review. This research employs a systematic review method by searching reputable journal databases such as Science Direct and Pubmed. The inclusion criteria in this study were articles published in the last five years related to exercise in the elderly, addressing topics such as exercise prevalence, risk factors for exercise, physical activity participation, the health of the elderly, and barriers to exercise. The exclusion criteria in this study were articles published in non-reputable journals. The researchers selected and analyzed 16 articles meeting the inclusing criteria for this systematic review. For standard operations, this study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) assessment. The research findings reveal that within the first group, various risk factors significantly impede exercise in older adults, including chronic health conditions such as heart disease and diabetes. In addition, factors such as lack of knowledge about the benefits of exercise, fear of injury, and social isolation contributed to reduced participation in physical activity. Furthermore, the findings with-in the second group underscore the significance of information that various exercises through health sports activities to support body health in old age. The results of the third group show that some treatments of sports health therapy are suitable for the elderly. Understanding these multifaceted factors is paramount to design effective interventions to increase sports participation in the elderly. Therefore, the promotion of active and healthy lifestyles in older adults should consider the social, economic and health factors that influence individuals' decisions. This holistic approach can contribute to improving the quality of life and well-being of older adults, concurrently reducing the burden of age-related diseases. Keywords: active lifestyle, older age, physical activity, Sports Health

Comparing AGS Beers 2019, STOPP version 2, and EU(7)-PIM list in Portuguese older adults in primary health care

PurposeThis study aims to identify PIM prevalence in older adults according to the 2019 Beers criteria, Screening Tool of Older Person’s Prescriptions version 2 (STOPP v2) criteria, and the Portuguese EU(7)-PIM list and also to analyze the concordance between these criteria.MethodsA retrospective study was conducted among 1200 Portuguese older adults (≥ 65 years old), users of primary health care. Demographic, clinical, and pharmacological data were collected concerning the period between April 2021 and August 2022. A comparative analysis was performed between the three PIM identification criteria, and the concordance was determined according to the Lin concordance correlation coefficient.ResultsThe mean age was 76.3 (SD 7.7) years old and 57.6% of the older adults were females. Our findings indicate varying prevalence rates among these criteria with 63.8% (95% CI 61.0–66.6%), 66.8% (95% CI 64.1–69.5%), and 50.1% (95% CI 47.2–53.0%) of the older adults take at least one PIM according to the EU(7)-PIM list, Beers 2019, and STOPP v2 criteria, respectively. The highest prevalence observed was for proton pump inhibitors according to EU(7)-PIM list (30.1%, 95% CI 27.6–32.9) and Beers criteria (30.1%, 95% CI 27.6–32.9) and alprazolam according to STOPP v2 criteria (10.1%, 95% CI 8.4–11.9%). A poor concordance between criteria was observed (< 0.834). The highest concordance coefficient was found between the EU(7)-PIM list and the Beers criteria (0.833), and the lowest between the EU(7)-PIM list and STOPP criteria (0.735).ConclusionThis study reveals varying prevalence rates of PIM in older adults, as assessed by different criteria, and highlights the need for targeted interventions and improved prescribing practices. In the future, studies should focus on the occurrence of negative outcomes in older adults associated with PIM consumption.

Vascular Calcification Heterogeneity from Bench to Bedside: Implications for Manifestations, Pathogenesis, and Treatment Considerations.

Vascular calcification (VC) is the ectopic deposition of calcium-containing apatite within vascular walls, exhibiting a high prevalence in older adults, and those with diabetes or chronic kidney disease. VC is a subclinical cardiovascular risk trait that increases mortality and functional deterioration. However, effective treatments for VC remain largely unavailable despite multiple attempts. Part of this therapeutic nihilism results from the failure to appreciate the diversity of VC as a pathological complex, with unforeseeable variations in morphology, risk associates, and anatomical and molecular pathogenesis, affecting clinical management strategies. VC should not be considered a homogeneous pathology because accumulating evidence refutes its conceptual and content uniformity. Here, we summarize the pathophysiological sources of VC heterogeneity from the intersecting pathways and networks of cellular, subcellular, and molecular crosstalk. Part of these pathological connections are synergistic or mutually antagonistic. We then introduce clinical implications related to the VC heterogeneity concept. Even within the same individual, a specific artery may exhibit the strongest tendency for calcification compared with other arteries. The prognostic value of VC may only be detectable with a detailed characterization of calcification morphology and features. VC heterogeneity is also evident, as VC risk factors vary between different arterial segments and layers. Therefore, diagnostic and screening strategies for VC may be improved based on VC heterogeneity, including the use of radiomics. Finally, pursuing a homogeneous treatment strategy is discouraged and we suggest a more rational approach by diversifying the treatment spectrum. This may greatly benefit subsequent efforts to identify effective VC therapeutics.

Frailty prevalence in older adults with atrial fibrillation: A cross-sectional study in a resource-limited setting.

Frailty is a common condition among older adults and is associated with an increased risk of adverse health outcomes, including mortality, disability, dysmobility, falls, and hospitalization. In patients with atrial fibrillation (AF), these risks are further exacerbated. However, evidence linking AF and frailty, particularly in the South American context, is limited. This study aimed to assess frailty and other geriatric conditions in older outpatients with atrial fibrillation in a resource-limited setting in Lima, Peru. In this cross-sectional study, we included adults aged 60 years and older diagnosed with atrial fibrillation who were attending outpatient check-ups. Patients who were hospitalized, receiving chemotherapy induction, or presenting with acute infections or exacerbations were excluded. Standardized questionnaires were used to assess frailty, cognitive impairment, and functional dependence. Statistical analysis was performed using R Studio version 4.3.1, with a significance level set at p < 0.05. Among the 200 patients who agreed to participate (mean age 74.76 ± 8.42 years, 41% females), 28.5% exhibited frailty, and 46.5% were classified as prefrail. Frailty and prefrailty were significantly associated with older age (p<0.01), female gender (p = 0.01), illiteracy (p<0.01), heart failure (p<0.01), falls (p<0.05), cognitive impairment (p<0.01), and functional dependence (p<0.01). Multivariate analysis revealed significant associations between frailty and cognitive impairment (p<0.05), frailty and functional dependence (p<0.05), and cognitive impairment and functional dependence (p<0.05). One-third of older outpatients with atrial fibrillation were identified as frail, while half were classified as prefrail. In this population, frailty frequently coexists with cognitive impairment and functional dependence, highlighting the need for timely screening and the implementation of evidence-based interventions for individuals with atrial fibrillation in resource-limited settings.

Addressing Nutrition Risk in Older Adults in Community Settings

Nutrition risk, and subsequent malnutrition, can be common in community- dwelling older adults in Europe and other high-income regions. While a major factor in predicting loss of independence, hospitalization and mortality, they also largely preventable, but older adults often have limited supports to prevent or manage nutrition concerns in communities, compared with hospital settings. Primary care and other community settings are well-situated to provide screening and follow-up, although several barriers may exist when implementing preventative or curative interventions. Indeed, malnutrition prevalence in older adults ranges from less than 1% to almost 20% in high-income countries, which suggests there is disparity in prevention and treatment strategies. This narrative review aims to highlight the prevalence and costs of malnutrition, then focus on recent examples of community-based nutrition risk mitigation to guide the establishment of care pathways for malnutrition management in primary and community care. In particular, care pathways incorporating routine screening, which includes monitoring of dietary intake and weight of patients, with risk-based follow-up are shown to reduce nutrition risk. Likewise, leveraging both medical interventions from dietitians and non- medical interventions such as addressing food insecurity or social isolation are required to mitigate nutrition risk.

AN OPEN LABELLED CLINICAL TRIAL TO EVALUATE THE EFFICACY OF MATRA BASTI WITH SUKUMARA GHRITA FOLLOWED BY THE ADMINISTRATION OF VAISHWANARA CHURNA IN THE MANGEMENT OF VIBANDHA VIS-A-VIS CONSTIPATION IN GERIATRIC AGE GROUP

Background: Constipation is a frequently reported bowel symptom in the elderly with considerable impact on quality of life and health expenses. Disease-related morbidity and even mortality have been reported in the affected frail elderly. Although constipation is not a physiologic consequence of normal aging, decreased mobility, medications, underlying diseases, and rectal sensory-motor dysfunction may all contribute to its increased prevalence in older adults. Direct and explicit description of Vibandha as a disease is not found in Ayurveda but different presentation of Purisha like Baddha Purisha, Ghana Purisha/Grathita Purisha, Sushka Purisha, Mala avabaddhata are found in different contexts of Ayurveda, these can be taken as various manifestations of Vibandha Objective Of The Study: To evaluate the effect of Matra basti with Sukumara ghrita, followed by the administration of Vaishwanara churna with ghrita in the management of Vibandha vis-a-vis constipation in geriatric population. Methods: A clinical study with pre-post design. Data was collected on before intervention ie 0 day,mid intervention ,after matrabasti ie 9th day and and after the complete course of intervention,after internal administration of vaishwanara churna ie on 31 st day.The data obtained were analysed statistically by applying descriptive statistics,Paired t test and Chi square test,using statistical presentation system software (SPSS) for windows. Intervention:Matra basti with sukumara ghrita for the first 8 consecutive days of intervention in the dose of 60 ml. After Matra basti, Vaishwanara churna with ghrita as anupana was administered internally in the dosage of 12 gms in two equally divided doses, before food, for 22 days. Total duration of the study was 30 days Bristol Stool form scale and Patient assessment of constipation-Quality of life were used to assess the pre and post data gathered through pre designed research proforma.The results having ‘p’ value of &lt;0.001 was considered to be statistically highly significant in this study. Results: Overall assessment showed significant improvement in all the 32 subjects in this study. Interpretation and Conclusion: It can be concluded that Matra basti with sukumara ghrita followed by internal administration of Vaishwanara churna showed better results in Bristol Stool form scale and Patient assessment of constipaion- Quality of life.

Integrated Care and Social Protection for Senior Citizens In West Africa: A Scoping Review

Background: West Africa's population is aging at a rapid rate, and the prevalence of older adults with multiple chronic conditions is rising. However, there is little information available about healthcare policies for this age group in this region ten years after the Madrid International Plan of Action on Ageing (MIPAA). To manage the physical and psychosocial needs of senior citizens, a greater integration of healthcare services is required.&#x0D; Methods: A scoping review was conducted adhering to the Joana Briggs Institute’s systematic scoping review protocol guidelines. A simple search strategy was developed to collate relevant articles from PubMed, Google Scholar, and AJOL, as well as policy databases, between 2002 and 2022. Articles were included if published in English and related to primary care, social care, and multi-morbidity among older persons in West Africa.&#x0D; Results: The findings yielded three thematic issues. First, most West African countries have policies on healthy aging; however, only a few have coherent policies on access to healthcare for older people and the availability of social safety nets, highlighting the need for policymakers to provide coherence and avenues for integration. Secondly, while integration of non-communicable disease services focuses on individual-level services rather than multi-sectoral integration, there is also a poor focus on mental health and sexual and reproductive health integration. Finally the inherent capacity development needs and technical up-skilling requirements require a whole-system approach with contextual nuances.&#x0D; Conclusion: The literature is increasingly recognizing an aging population and the prevalence of multi-morbidity in West Africa. Countries in West Africa, in response to the MIPAA, have formulated policies with regards to older persons' healthcare needs; however, improvements in clinical care at the individual setting level may not be sufficient. A deliberate whole-system approach that fosters multi-sectoral collaboration for integrated healthcare might go a long way toward better outcomes for senior citizens and a step forward toward universal health coverage.

High prevalence of subjective cognitive decline in older Chinese adults: a systematic review and meta-analysis.

Subjective cognitive decline (SCD) is considered a preclinical stage of Alzheimer's disease. However, reliable prevalence estimates of SCD in the Chinese population are lacking, underscoring the importance of such metrics for policymakers to formulate appropriate healthcare strategies. To systematically evaluate SCD prevalence among older Chinese adults. PubMed, Web of Science, The Cochrane Library, Embase, CNKI, Wanfang, VIP, CBM, and Airiti Library databases were searched for studies on SCD in older Chinese individuals published before May 2023. Two investigators independently screened the literature, extracted the information, and assessed the bias risk of the included studies. A meta-analysis was then conducted using Stata 16.0 software via a random-effects model to analyze SCD prevalence in older Chinese adults. A total of 17 studies were included (n = 31,782). The SCD prevalence in older Chinese adults was 46.4% (95% CI, 40.6-52.2%). Further, subgroup analyzes indicated that SCD prevalence was 50.8% in men and 58.9% among women. Additionally, SCD prevalence in individuals aged 60-69, 70-79, and ≥ 80 years was 38.0, 45.2, and 60.3%, respectively. Furthermore, SCD prevalence in older adults with BMI <18.5, 18.5-24.0, and > 24.0 was 59.3, 54.0, and 52.9%, respectively. Geographically, SCD prevalence among older Chinese individuals was 41.3% in North China and 50.0% in South China. In terms of residence, SCD prevalence was 47.1% in urban residents and 50.0% among rural residents. As for retired individuals, SCD prevalence was 44.2% in non-manual workers and 49.2% among manual workers. In the case of education, individuals with an education level of "elementary school and below" had an SCD prevalence rate of 62.8%; "middle school, "52.4%; "high school, "55.0%; and "college and above, "51.3%. Finally, SCD prevalence was lower among married individuals with surviving spouses than in single adults who were divorced, widowed, or unmarried. Our systematic review and meta-analysis identified significant and widespread SCD prevalence in the older population in China. Therefore, our review findings highlight the urgent requirement for medical institutions and policymakers across all levels to prioritize and rapidly develop and implement comprehensive preventive and therapeutic strategies for SCD.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023406950, identifier: CRD42023406950.

Temporal trends and projection of blindness and vision loss prevalence in older adults in BRICS countries.

Blindness and vision loss (BVL) is a major global health issue affecting older adults, but its burden in transition countries has received limited attention. Therefore, we aimed to assess the trends in the burden of BVL among older adults between 1990 and 2019 across Brazil, Russia, India, China, and South Africa (BRICS), and predict the burden by 2040. Data on BVL and its related causes were obtained from the Global Burden of Disease 2019 study. We investigated the temporal trends by calculating the average annual percentage change using joinpoint regression analysis. Subsequently, we performed Bayesian age-period-cohort modeling to estimate the burden of BVL and its related causes by 2040. Most BRICS countries experienced a significant decline (p < 0.05) in age-standardized prevalence rates, and the decreasing trends tend to continue. However, by 2040, the number of BVL cases is expected to increase by approximately 50% across BRICS, with an estimated approximately 192, 170, 25, 17, and 7 million cases in China, India, Russia, Brazil, and South Africa, respectively. The related ranks of BVL causes are also estimated to change in the future, particularly in India. The different burdens and trends of BVL across BRICS reflected the different stages of population health transition. Effective eye disease prevention requires appropriate public health interventions. Developing effective health policies and services for older adults is urgently needed in BRICS countries.

Abstract 14515: Distinct Genetic Mechanisms for Bradyarrhythmias From Multi-Center Multi-Ancestry Meta-Analyses

Background: With an increasing prevalence in older adults, bradyarrhythmias pose a major public health problem. Hypothesis: Genetics can inform on disease pathophysiology and implicate targets for therapeutic development for bradyarrhythmias. Methods: We first performed ancestry-specific genome-wide association studies (GWAS) and combined the results in meta-analyses of up to 1.3 million individuals including 9,511 sinus node dysfunction (SND) cases, 34,086 distal conduction disease (DCD) cases, and 28,899 pacemaker implantation (PM) cases. We evaluated the biological relevance of bradyarrhythmia loci by analyses of transcriptomes, pleiotropy, and partitioned heritability based on cardiac single cell RNA sequencing data. Finally, we performed rare variant burden testing in 460,000 whole exome sequenced individuals (cases: 1,766 SND, 12,422 DCD &amp; 5,646 PM) from UK Biobank and Mass General Brigham Biobank. Results: Common variant analyses identified 13, 28, and 21 loci for SND, DCD, and PM, respectively. SND and DCD were moderately genetically correlated (r g = 0.64). Common variant loci included genes underlying familial forms of bradyarrhythmias (HCN4 and SCN5A) and genes regulating population-level variation in electrocardiographic traits. Four well-known common variant arrhythmia loci ( SCN5A / SCN10A , CCDC141 , TBX20 , and CAMK2D ) were shared for SND and DCD, while other loci were more specific for SND ( PITX2 , HCN4 , ZFHX3 ) or DCD ( CAV1 and NKX2 - 5 ). We observed an inverse association between predicted cardiac expression of SCN10A and risk of SND and DCD, and positive associations of predicted cardiac expression of CEP68 and STRN with risk of SND and DCD, respectively. Among 9 cardiac cell types, cardiomyocyte-expressed genes were enriched for contributions to DCD heritability. Rare variant analyses implicated LMNA for all bradyarrhythmia subtypes; SMAD6 and SCN5A for DCD; and TTN , MYBPC3 , and SCN5A for PM. Conclusions: We identify novel genes and loci associated with bradyarrhythmias. The genetic architectures of SND and DCD are both overlapping and distinct. Multiple genetic mechanisms involving ion channels, sarcomeric components, cellular homeostasis, and cardiac development may influence the development of bradyarrhythmias.