Senior Subjects Research Articles

Comparison of haptic guidance and error amplification robotic trainings for the learning of a timing-based motor task by healthy seniors.

With age, a decline in the temporal aspect of movement is observed such as a longer movement execution time and a decreased timing accuracy. Robotic training can represent an interesting approach to help improve movement timing among the elderly. Two types of robotic training—haptic guidance (HG; demonstrating the correct movement for a better movement planning and improved execution of movement) and error amplification (EA; exaggerating movement errors to have a more rapid and complete learning) have been positively used in young healthy subjects to boost timing accuracy. For healthy seniors, only HG training has been used so far where significant and positive timing gains have been obtained. The goal of the study was to evaluate and compare the impact of both HG and EA robotic trainings on the improvement of seniors’ movement timing. Thirty-two healthy seniors (mean age 68 ± 4 years) learned to play a pinball-like game by triggering a one-degree-of-freedom hand robot at the proper time to make a flipper move and direct a falling ball toward a randomly positioned target. During HG and EA robotic trainings, the subjects’ timing errors were decreased and increased, respectively, based on the subjects’ timing errors in initiating a movement. Results showed that only HG training benefited learning, but the improvement did not generalize to untrained targets. Also, age had no influence on the efficacy of HG robotic training, meaning that the oldest subjects did not benefit more from HG training than the younger senior subjects. Using HG to teach the correct timing of movement seems to be a good strategy to improve motor learning for the elderly as for younger people. However, more studies are needed to assess the long-term impact of HG robotic training on improvement in movement timing.

Nonsynonymous polymorphisms in PLA2G7 gene are associated with the risk of coronary heart disease in a southern Chinese population.

Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays an important role in coronary heart disease (CHD). This study was aimed to investigate the associations of polymorphisms (R92H, V279F, I198T, and A379V) in PLA2G7 with CHD. A total of 322 patients with CHD and 414 CHD-free controls were included in the study. Polymorphisms in PLA2G7 were sequenced by DNA Sequencer and statistical analyses were performed to study the associations between polymorphisms and CHD. RH+HH genotype, RH genotype, and H allele of R92H were significantly associated with an increased risk of CHD (P=0.005, P=0.009, and P=0.003, respectively), while no associations were observed between V279F and I198T and CHD (A379V was not analyzed because of deviation from Hardy-Weinberg equilibrium). Correlations between R92H and CHD still existed after adjustment for confounding risk factors of CHD (P=0.001). Furthermore, stratified analyses showed subgroups of the senior, hypertension, non-smoking, non-diabetics, and male subjects brought a higher risk for CHD (P=0.015, P=0.001, P=0.001, P=0.002, and P=0.004, respectively). We also observed a lower level of protective factor HDL-C in CHD patients carrying genotype RH+HH than patients with RR (P=0.047). Furthermore, we conducted haplotype analysis and detected more harmful effects of haplotypes HVI and RVT as compared with other haplotypes (P=2.538×10(-3) and P=0.031). These findings indicated that R92H variant in PLA2G7 gene might contribute to CHD susceptibility in a southern Chinese population.

Health Self-Awareness in Senior Citizens: Focus on Physical, Emotional and Cognitive Health

Senior people usually express high levels of satisfaction and quality of life, even though they may be facing comorbidities and disabilities. This is an evidence of how unreliable quantitative measures, taken alone, can be when trying to understand the health levels of this population. Health self-awareness has been widely used in order to assess the health of old people. The present study describes how a sample of Brazilian senior citizens assesses their general health and verifies the relationship between negative health self-awareness and social-demographic factors as well as physical, emotional and cognitive impairment in this population. There were 427 senior subjects in the sample aged 65 or more from both genders. The primary outcome was assessed by the question: “on the whole, how do you assess your health?”. This variable was divided into 2 groups: positive perception (options very good and good) and negative perceptions (options fair, bad and very bad). The independent variables were: social demographic; physical aspects of health; emotional and humour aspects; and cognitive aspects. In our studies, 42.4% of seniors had negative health self-awareness. The logistic regression analyses showed that the social demographic factor could explain negative health self-awareness in 62.4% of the subjects. However, only the association with education was statistically significant (p < 0.001). Diabetes, self-referred depression and instrumental activities were statistically related to the worse health self-awareness (p = 0.01; 0.05; 0.02 and 0.05, respectively). The emotional aspect was responsible for 64.9% of the negative health self-awareness (p < 0.001), while the cognitive aspect (p = 0.052) had a predictive value of 57.6%. From the findings in the present study, it is possible to conclude functional loss and the presence of chronic diseases is not enough to explain negative health self-awareness in old people. It is important to take into account education and the presence of depressive symptoms.

Disinhibitory shift of recovery curve of somatosensory-evoked response in elderly: A magnetoencephalographic study

ObjectiveThe aim of the study was to investigate the functional differences between N20m and P30m components of somatosensory-evoked magnetic cortical field (SEF) in young and senior subjects. MethodsTwenty-nine healthy subjects, 13 younger (mean age: 21.8years) and 16 senior (63.8years), participated. Magnetic fields were measured using a 160-channel, whole head MEG. Single- and paired-pulse stimulations of 200 artifact-free MEG signal epochs were averaged separately. We calculated how aging affects recovery function of SEFs. ResultsThe senior showed a prolonged N20m peak latency compared to the younger, although the P30m peak latency was not significantly different between groups. The N20m ratios at 60 and 80ms in the senior were significantly increased compared to the ratios in the younger (60ms: P<0.05, 80ms: P<0.001). The P30m ratios at inter-stimulus interval (ISI) of 80 and 100ms showed even disinhibition in the senior than in the younger (P<0.05). The younger also showed a significantly negative correlation between P30m and N20m components’ recovery curves (R=0.72, P<0.05). ConclusionAging-related changes that occurred in recovery functioning were the decrease in N20m component suppression and the increase in P30m component recovery, indicating that the N20m and P30m components have different functions in aging-related recovery changes. SignificanceOur results show that the N20m ratio at an ISI of 80ms was significantly increased in the senior group, indicating that the second stimulus-evoked SEF was less inhibited by the initial stimulus at this ISI, suggesting less refractory effect or increased disinhibition.

Age-related differences in diffusion tensor indices and fiber architecture in the medial and lateral gastrocnemius.

To investigate age related changes in diffusion tensor indices and fiber architecture of the medial and lateral gastrocnemius (MG and LG) muscles using diffusion tensor imaging (DTI). The lower leg of five young and five senior subjects was scanned at 3 Tesla and DTI indices extracted using three methods: region of interest, histogram, and tract based. Tracked fibers were automatically edited to ensure physiologically relevant tracks. Pennation angles were measured with respect to the deep and superficial aponeuroses of both muscles. The three methods provided internally consistent measures of the DTI indices (correlation coefficient in the range of 0.90-0.99). The primary, secondary, and tertiary eigenvalues in the MG and LG increased significantly in the senior cohort (P < 0.05), while the small increase in fractional anisotropy with age was not significant (MG/LG: P = 0.39/0.85; 95% confidence interval: [-0.059/-0.056, 0.116/0.064]). Fiber lengths of MG fibers originating distally were significantly decreased in seniors (P < 0.05) while pennation angles decreased with age in the MG and LG but this was not significant. Fiber atrophy and increased fibrosis have opposing effects on the diffusion indices resulting in a complicated dependence with aging. Fiber architectural changes could play a role in determining aging muscle function.

The effect of acute exercise on circulating serum retinol binding protein 4 in seniors with and without impaired glucose tolerance (863.4)

Retinol binding protein 4 (RBP4) is an adipokine that contributes to insulin resistance and impaired glucose tolerance. There are no published reports concerning the influence of acute exercise on circulating RBP4. We sought to characterize this response in (1) healthy, normoglycemic males (CON; 23±4 y, BMI 22.3±9.4), (2) seniors with normal fasting glucose and glucose tolerance (S‐NGT; 70±5 y, BMI 24.2±6.5), and (3) seniors with impaired glucose tolerance (S‐IGT; 73±8 y, BMI 26.4±5.3; n=7 per group). Glucose tolerance was based on a 75 g oral glucose tolerance test wherein 2 h glucose values (mg/dL) were: 97±21 (CON), 106±24 (S‐NGT), and 159±13 (S‐IGT; p&lt;0.05 vs. CON and S‐NGT). 48 h after determining VO2max (ml/kg/min) in CON (56±10, p&lt;0.05 vs. S‐NGT and S‐IGT), S‐NGT (33±8), and S‐IGT (29±8) subjects, participants completed 20‐min of cycling at 85% VO2max. RBP4 was assessed (ELISA) in venous samples obtained before exercise and 50‐min and 24 h post exercise. Pre‐exercise RBP4 concentrations (ug/mL) were greater (p&lt;0.05) in S‐IGT (76±23) vs. S‐NGT (61±7) or CON (44±7) subjects. Values obtained at 50‐min and 24 h post exercise showed further increases after exercise (p&lt;0.05) in the S‐IGT (99±23 and 77±25, respectively) vs. both S‐NGT (56±7 and 39±9) and CON subjects (40±7 and 47±21). These data indicate that in senior subjects with IGT, circulating RBP4 is elevated before exercise, with persistent elevation in recovery (50‐min and 24 h) from exercise. Ongoing studies will determine whether skeletal muscle RBP4 regulates insulin‐glucose homeostasis.

Biomedical Engineering and Elderly Support

The undoubted growing percentage of senior population (age 65+) has been obvious in the modern society during the last few decades. Ambient Assisted Living (AAL) technologies arise as a promising means of elderly care, thereby reducing both carers’ workload and public health services costs. LongLastingMemories, an EU funded project, aimed at alleviating senior people mental and physical health problems by integrating state of the art computer-aided technology and prolonging their independent living by providing a smart home solution. Five rounds of multicentric pilots were planned and conducted in order to test that objectives such as accessibility, user acceptance and perceived effectiveness of the service were met by the final LLM prototype. A questionnaire survey was conducted after each pilot with several stakeholders, such as senior subjects and formal careers, proving the wide acceptance of our service and its applicability in the domain of elderly healthcare.

Ingestion of Chlorella Reduced the Oxidation of Erythrocyte Membrane Lipids in Senior Japanese Subjects

Accumulation of phospholipid hydroperoxide (PLOOH) in erythrocyte membranes is an abnormality found in patients with senile dementia, including those with Alzheimer's disease. In our previous studies, dietary xanthophylls (polar carotenoids such as lutein) were hypothesized to inhibit lipid peroxidation. In the present study, we conducted a randomized, double-blind, placebo-controlled human trial to assess the impact for a total of 2 months Chlorella supplementation (8 g Chlorella/day/person; equivalent to 22.9 mg lutein/day/person) on PLOOH and carotenoid concentrations in erythrocytes as well as plasma of 12 normal senior subjects. After 1 or 2 months of treatment, erythrocytes and plasma lutein concentrations increased in the Chlorella group but not in the placebo group. In the Chlorella-supplemented group, erythrocyte PLOOH concentrations after a total of 2 months of treatment were lower than the concentrations before supplementation. These results suggest that Chlorella ingestion improved erythrocyte antioxidant status and lowered PLOOH concentrations. These reductions might contribute to maintaining the normal function of erythrocytes and prevent the development of senile dementia.

Prediction Equations for Single-Breath Diffusing Capacity in Subjects Aged 65 to 85 Years

In senior subjects, diffusing capacity of the lung for carbon monoxide (Dlco) is interpreted using prediction equations derived from primarily younger adult populations. Our objectives were to provide reference equations for single-breath Dlco for a cohort of healthy, never-smoking, white, European adults between 65 and 85 years of age and to compare the predicted values of this sample with those from other studies involving middle-aged adults. Reference equations were derived from a randomly selected sample from the general population of 431 healthy never smoker subjects aged 65 to 85 years (262 women and 169 men). Spirometry, lung volume determinations by plethysmography, and single-breath Dlco (corrected for hemoglobin) were performed following the American Thoracic Society/European Respiratory Society guidelines. Reference values and lower and upper limits of normal were derived using a piecewise polynomial model. In addition to age, our reference equations confirmed the height and body size dependence of Dlco and diffusing capacity for alveolar volume (Dlco/Va) in older subjects. Practically all of the reference values obtained by extrapolating reference equations of middle-aged adults underestimated the true diffusing capacity of the healthy elderly volunteers. Middle-aged reference equations underestimated Dlco by 2.1% to 22.3% in women and 2.8% to 37.8% in men. In addition, Dlco/Va was overestimated up to 18% and 39.8% in women and men, respectively, whereas other equations underestimated Dlco/Va up to 22.2% and 11.9% in women and men, respectively. These results underscore the importance of using prediction equations appropriate to the origin and age characteristics of the subjects being studied.

Effects of Age on the Structure of Functional Connectivity Networks During Episodic and Working Memory Demand

The aim of the study was to investigate age-related differences in large-scale functional connectivity networks during episodic and working memory challenge. A graph theoretical approach was used providing an exhaustive set of topological measures to quantify age-related differences in the network structure on various scales. In a single session, 10 young (22-30 years) and 10 senior (62-77 years) subjects performed an episodic and a working memory task during functional magnetic resonance imaging. Networks of functional connectivity were constructed by correlating the blood oxygenation level-dependent (BOLD) signal for every pair of voxels. Statistical network parameters yield a global characterization of the network topology, the quantification of the importance of specific regions, and shifts in local connectivity. An age-related increase in the density and size of the networks and loss of small-worldness was observed, related to an expanded distribution of brain activity during both memory demands in seniors, and a more specific and localized activity in young subjects. In addition, we found highly symmetrical neural networks in young subjects accompanied by a strong coupling between parietal and occipital regions. In contrast, seniors showed pronounced left-hemispheric asymmetry with decreased connectivity within occipital areas, but increased connectivity within parietal areas. Moreover, seniors engaged an additional frontal network strongly connected to parietal areas. In contrast to young subjects, seniors showed an almost identical structure of network connectivity during both memory tasks. The chosen network approach is explorative and hypothesis-free. Our results extend seed-based and BOLD-signal intensity focused studies, and support present hypotheses like compensation and dedifferentiation.

Vibroarthrography in patients with knee arthropathy

Osteo-arthropathy (OA) is one of the most common diseases of the knee joint, but functional information is limited on imaging analyses. We aimed to clarify the functional pathology based on vibroarthrography (VAG) signals at the knee joint during standing-up and sitting-down movements in patients with OA of the knee joints. VAG signals and angular changes of the knee joint during standing-up and sitting-down movements were recorded in 145 knees, including 46 knees with OA in 27 patients, 49 knees in 26 age-matched healthy senior subjects, and 50 knees in 25 healthy young subjects. The level of VAG signals was greater in the knees with OA at 50-99 and 100-149 Hz compared to the age-matched control knees during movements. We considered that the increase in VAG signals in these ranges of frequency suggested the pathological change of OA during weight-loaded movements. This method of VAG recording is fully noninvasive, and can be used by therapists during interventions to obtain physical information regarding functional pathological changes of the knee joint.

Wii Fit® training vs. Adapted Physical Activities: which one is the most appropriate to improve the balance of independent senior subjects? A randomized controlled study

Objective: To compare the effectiveness of three protocols (Adapted Physical Activities, Wii Fit®, Adapted Physical Activities + Wii Fit®) on the balance of independent senior subjects. Design: Case comparison study. Settings: Healthy elderly subjects living in independent community dwellings. Subjects: Thirty-six subjects, average age 75.09 ± 10.26 years, took part in this study, and were randomly assigned to one of the four experimental groups: G1 followed an Adapted Physical Activities training programme, while the second group (G2) participated in Wii Fit® training and the third one (G3) combined both methods. There was no training for the fourth group (G4). All subjects trained once a week (1 hour) for 20 weeks and were assessed before and after treatment. Main measures: The Tinetti test, unipedal tests and the Wii Fit® tests. Results: After training, the scores in the Tinetti test decreased significantly (P < 0.05) for G1, G2 and G3 respectively in static conditions and for G1 and G3 in dynamic conditions. After training, the performance in the unipedal tests decreased significantly (P < 0.05) for G1 and G3. The position of the centre of gravity was modified significantly (P < 0.05) for G2 and G3. Conclusion: After 20 training sessions, G1 (Adapted Physical Activities), G2 (Wii Fit®) and G3 (Adapted Physical Activities and Wii Fit®) improved their balance. In addition, G1 and G3 increased their dynamic balance. The findings suggest that Adapted Physical Activities training limits the decline in sensorial functions in the elderly.

Plasma Carotenoid Concentrations before and after Supplementation with Astaxanthin in Middle-Aged and Senior Subjects

A randomized, double-blind human trial was conducted to assess the effect on the plasma carotenoid concentration of 4- or 12-week astaxanthin supplementation (1 or 3 mg/d) of 20 Japanese middle-aged and senior subjects. The plasma carotenoid concentration was significantly higher after the astaxanthin supplementation than that before in both the 1 mg/d (10 subjects) and 3 mg/d (10 subjects) groups.

Antioxidant effect of astaxanthin on phospholipid peroxidation in human erythrocytes

Phospholipid hydroperoxides (PLOOH) accumulate abnormally in the erythrocytes of dementia patients, and dietary xanthophylls (polar carotenoids such as astaxanthin) are hypothesised to prevent the accumulation. In the present study, we conducted a randomised, double-blind, placebo-controlled human trial to assess the efficacy of 12-week astaxanthin supplementation (6 or 12mg/d) on both astaxanthin and PLOOH levels in the erythrocytes of thirty middle-aged and senior subjects. After 12 weeks of treatment, erythrocyte astaxanthin concentrations were higher in both the 6 and 12mg astaxanthin groups than in the placebo group. In contrast, erythrocyte PLOOH concentrations were lower in the astaxanthin groups than in the placebo group. In the plasma, somewhat lower PLOOH levels were found after astaxanthin treatment. These results suggest that astaxanthin supplementation results in improved erythrocyte antioxidant status and decreased PLOOH levels, which may contribute to the prevention of dementia.

Erythrocytes Carotenoids after Astaxanthin Supplementation in Middle-Aged and Senior Japanese Subjects

A randomized, double-blind human trial was conducted to assess the effect of 4- or 12-week astaxanthin supplementation (1 or 3 mg/day) on the carotenoid compositions of erythrocytes in Japanese middle-aged and senior subjects. Erythrocyte astaxanthin concentrations after 4- or 12-weeks of supplementation (3 mg/day) was significantly higher than after placebo or 1 mg astaxanthin supplementations. No differences were observed in either the carotenoid compositions or the phospholipid hydroperoxide concentrations in erythrocytes after astaxanthin intake in both the 1 and 3 mg/day groups.

Effect of yoga on mental health: Comparative study between young and senior subjects in Japan

Background:Japan has a large number of senior citizens. Yoga can be wisely applied in old age care. There is no any age restriction to practice yoga. The effect may differ by age. There is a need to study the mechanism of action of yoga with respect to age.Aim:This study was conducted in Japan to find the effect of yoga on mental health between young and senior people.Materials and Methods:Twenty-five normal healthy volunteers of both sexes were divided into two groups according to age. Fifteen participants of the age group between 65 to 75 years and 10 participants of the age group between 20 to 30 years were selected. This study was approved by the ethical committee of Kawasaki University of Medical Welfare. Selected individuals were subjected to 90 min of yoga classes once or twice a week for a month. Salivary amylase activity was assessed before and after yoga practice. State Trait Anxiety Inventory (STAI) was given before yoga on the first day and after one month of practice to assess the change in State anxiety and Trait anxiety.ResultsSenior group – Salivary amylase activity decreased from 111.2±42.7 to 83.48±39.5 kU/L [average±standard deviation]. Younger group – Salivary amylase activity reduced from 60.74±31.8 to 42.39±24 kU/L. Senior group – State anxiety score decreased from 41.13 ±8.43 to 30.8±6.49, Trait anxiety score reduced from 45.66±7.5 to 40.73±8.3. Younger group – State anxiety score reduced from 38.7±4.8 to 30.8±4.1,Trait anxiety score reduced from 46.2±7.9 to 42.9±9.1. Changes were statistically significant with P<0.05.Conclusion:Decrease in Salivary amylase activity may be due to reduction in sympathetic response. Reduction in State and Trait anxiety score signifies that yoga has both immediate as well as long-term effect on anxiety reduction. Thus yoga helps to improve the mental health in both the groups.

Selecting healthy volunteers in specific populations: a retrospective analysis of clinical and laboratory screening

Healthy volunteers must undergo a medical examination before enrollment in a clinical trial. An increasing number of trials include specific populations designed to match the target populations of the drugs tested. Our study aimed at evaluating which investigations are the most appropriate in different sub-populations of healthy volunteers. Data from 350 healthy volunteers who attended our Research Center from 1997 to 2004 were retrospectively analysed. Volunteers were distributed into five sub-populations: young men, senior men, overweight men, young women, postmenopausal women. The screening procedure comprised a review of medical history, physical examination, electrocardiogram and laboratory tests. Ineligibility criteria were classified as non-medical causes, protocol specific medical causes and non-specific medical causes. A total of 148 subjects (42%) were not-eligible, mainly because of non-specific medical causes (111 subjects), including abnormal medical history (34.5% of all ineligibilities). Blood pressure abnormalities were frequent in all sub-populations except young women. Electrocardiographic abnormalities led to ineligibility of only five overweight men and one menopausal woman. Abnormal laboratory tests accounted for 19.6% of ineligibilities. In senior subjects and overweight men, serologies, liver function tests and lipid profile contributed importantly to the selection process. Low red cells count was the most frequent laboratory abnormality in young women. Erythrocyte sedimentation rate, phosphocalcic metabolism and standard clotting tests led to frequent insignificant and non-contributive abnormalities. Our study confirms that a complete review of medical history is essential and determines the major part of ineligibilities. Complementary laboratory tests are always needed and may be adjusted to the population considered.

Decrease in stereognostic ability of the tongue with age

Rehabilitation of eating and swallowing functions from the viewpoint of quality of life should attempt to restore not only the physical, but also sensory function. As the size and shape of the intra-oral bolus of food provides oral sensory information important for eating and swallowing, we investigated the stereognostic ability of the tongue in 269 young adults (mean age: 24.5 years) and 60 seniors (mean age: 80.5 years); all of whom had no eating or swallowing complaints. Assessment of the stereognostic ability involved identifying 20 differently shaped test pieces placed in the oral cavity. The young adults identified a significantly higher number of differently shaped test pieces than the seniors (mean correct number of responses: 16.5 and 10.1 respectively; P < 0.001). Gender and the presence of palatal covers did not have any significant effect on stereognostic ability. The test pieces were categorized into six groups based on the shape. When the young adults misidentified a piece, they often selected another piece within the same group, almost never selecting a piece from another group. The seniors, however, chose test pieces from different groups. Moreover, to determine whether stereognosis could be improved through training, we conducted training involving four senior subjects in their 80s, who correctly identified 10 or fewer pieces. After the training, the number of correct answers increased significantly (P < 0.05). These findings indicate that seniors show decreased stereognostic ability of the tongue compared with young adults and suggest the possibility of recovering the ability using our training method.

Age-related relative volume preservation of the dominant hand cortical region

Aging is usually associated with a progressive difficulty in learning new skills. Similarly, the dexterity in the non-dominant hand is usually decreased with age, while the dominant hand maintains a relative preservation in agility. We investigated if age-related volume loss affects the hand areas asymmetrically by comparing structural measures of the dominant hand area versus the non-dominant area. We performed a region of interest analysis of T1-weighted images focusing on the sensorimotor cortex corresponding to the hand area. We evaluated images from young subjects (younger than 65 years of age, n = 38, mean age = 24 ± 7 years) and senior subjects (65 years or older, n = 61, mean age = 73 ± 6 years). We observed that older adults exhibited greater leftward gray matter asymmetry of sensorimotor cortex, due in large part to more pronounced age-related loss of gray matter in the right hemisphere. These results are consistent with evidence that disuse leads to atrophy and suggest that age-related declines in gray matter, and perhaps function, may be limited by increasing the use of the non-dominant hand.

Simple Analysis of the Pulse Wave for Blood Vessel Evaluation

A pulse wave is considered to be a good indicator to evaluate the viscoelastic properties of blood vessels. The wave is composed of an incident wave and a reflected wave. The evaluation of blood vessels may be possible from the analysis of this reflected wave, because the reflected wave propagates to the peripheral artery. We propose a simple method of estimating the reflected wave from the pulse wave observed at common carotid artery, making use of a commercial piezoelectric transducer. First, we estimate the incident wave from the observed blood flow velocity. Then, the reflected wave is estimated by subtracting the incident wave from the observed pulse wave. The amplitudes of the reflected wave obtained in senior subjects were larger than those of junior subjects. This result is in good agreement with the common point of view about the vessel wall, that the attenuation during pulse wave propagation is usually small in elderly people.