Limitations in activities of daily living and support needs – Analysis of GEDA 2019/2020-EHIS

Being able to perform activities of daily living is an important component of a person's ability to function. If these activities are impaired, support is needed. Using data from GEDA 2019/2020-EHIS, we present how many people aged 55 and older living in private households in Germany experience limitations in activities of daily living. Severe limitations in basic (fundamental) activities (e.g. food intake) are reported by 5.8% of women and 3.7% of men. The proportion increases with age as 13.4% of women and 9.0% of men aged 80 and older experience limitations. Severe limitations of instrumental activities of daily living (e.g. grocery shopping) are rather rare in participants less than 80 years of age. But at age 80 and older the proportion rises to 35.9% of women and 21.0% of men. A total of 68.1% of afflicted women and 57.5% of men receive help and support related to limitations of basic activities. Women are also more likely to report a lack of support (48.8% vs. 43.2%). The situation is slightly better with regard to instrumental activities. The results of GEDA 2019/2020-EHIS show in which areas of daily life older and very old people are impaired, give an impression of who is affected particularly strongly and indicate where support services are insufficient. As such, these results provide clues as to where support can be provided to enable older people to keep living in their own homes for a long time

Die essentielle Bedeutung des "Classical Transient Receptor Potential 6" (TRPC6)-Ionenkanals für die akute vaskuläre Hypoxiereaktion der Lunge : Untersuchungen an isolierten pulmonalarteriellen glatten Muskelzellen

Die Hypoxische Pulmonale Vasokonstriktion (HPV) ist eine physiologische Antwort der Lunge auf alveoläre Hypoxie, bei der die Perfusion des Blutes zur Optimierung des Gasaustausches an die Ventilation angepasst wird. Dieser erstmals 1946 durch von Euler und Liljestrand postulierte Regulationsmechanismus ist hinsichtlich Sauerstoffsensor- und Signaltransduktionsweg noch nicht umfassend geklärt. Untersuchungen an isolierten pulmonalarteriellen glatten Muskelzellen (PASMC) zeigen einen Hypoxie-induzierten Anstieg der intrazellulären Ca2+-Konzentration ([Ca2+]i) und eine darauf folgende Kontraktion. Dies weist auf eine Funktion der PASMC sowohl als Sensor- als auch als Effektorzelle für die HPV hin. Darüberhinaus wird aber auch eine Rolle des Endothels durch Freisetzung von vasokonstriktiv wirkenden Substanzen wie Endothelin-1 (ET-1) im Zusammenhang mit der HPV diskutiert. Dabei scheint die akute Phase der HPV (Dauer: Sekunden bis Minuten) endothelunabhängig und die protrahierte Phase der HPV (Dauer: Stunden) endothelabhängig zu sein. Zur Untersuchung der HPV auf der Ebene der PASMC wurde in der vorliegenden Arbeit eine geeignete Zellisolierungs- und Meßmethodik für PASMC der Ratte etabliert. Die Zellen wurden dabei insbesondere aus dem präkapillären Bereich der intrapulmonalarteriellen Gefäße gewonnen. Bei der Charakterisierung der kultivierten Zellen mittels der Immunofluoreszenzmethode zeigte sich für die Passagen P0, P1 und P3 eine positive Färbung für die für glatte Muskelzellen typischen Proteine alpha-Aktin und die schweren Ketten des Myosins. Endothelzellen konnten durch eine fehlende Färbung gegen den von Willebrand Faktor ausgeschlossen werden. Untersuchungen mittels des Western-Blots zeigten keinen Unterschied bezüglich der Menge des alpha-Aktins und der schweren Ketten des Myosins bei einem Vergleich zwischen P1 und P3, was auf einen Erhalt des kontraktilen Zustands im Zuge der Kultivierung der PASMC hinwies. Als geeignete Messmethodik für die Untersuchung der Hypoxieantwort stellte sich die Messung der intrazellulären Ca2+-Konzentration [Ca2+]i mittels Fura-2 heraus. Ein Vergleich der Reaktion der PASMC von P0, P1 und P3 auf ET-1 als positiven Stimulus ergab eine Abnahme des transienten Anstiegs der [Ca2+]i mit zunehmender Passage. Deshalb wurden alle darauffolgenden Experimente mit nicht-passagierten PASMC (= Passage 0) durchgeführt. Zur Schaffung der hypoxischen Bedingungen für die Untersuchung der Hypoxieantwort der PASMC wurde ein Perfusionssystem etabliert. In einem zweiten Schritt erfolgte die Übertragung der Zellisolierung und der [Ca2+]i-Messtechnik von Ratten auf Maus PASMC, da dies auch die Untersuchung von PASMC aus gendefizienten Mäusen ermöglichte. Da frühere Untersuchungen auf eine wichtige Rolle der Rezeptor-aktivierbaren, nicht-selektiven klassischen „transient receptor potential“ TRPC-Kanäle für die Regulation des Tonus glatter Muskelzellen hinweisen und TRPC6 eine essentielle Komponente der Rezeptor-operierten Ca2+-durchlässigen nichtselektiven Kationenkanäle in den glatten Muskelzellen ist, wurde die Bedeutung der TRPC6-Kanäle für die Hypoxieantwort untersucht. Dabei zeigte sich, dass PASMC von Wildtyp (WT)-Mäusen, aber nicht von TRPC6-/--Mäusen unter Hypoxie mit einem Anstieg der [Ca2+]i reagierten. Alle Messungen erfolgten nach Sensibilisierung der PASMC mit ET-1. Dieser Anstieg der [Ca2+]i wurde im Wesentlichen durch den Einstrom von Ca2+-Ionen aus dem Extrazellulärraum durch spannungsabhängige L-Typ Ca2+-Kanäle (VOCC) bewirkt, da die Inhibition derselben mittels Nicardipin einen Anstieg der [Ca2+]i verhinderte. Im Gegensatz zu den VOCC sind TRPC6-Kanäle auch für andere Kationen als Ca2+ durchlässig. Untersuchungen mittels der Mn2+-Quench-Methode zeigten für PASMC der WT-Mäuse einen größeren Hypoxie-induzierten Mn2+-Einstrom als für PASMC der TRPC6-/--Mäuse, das auf einen Hypoxie-induzierten Kationen-Einstrom durch TRPC6- Kanäle hinweist. Aus früheren Untersuchungen ist bekannt, dass in Anwesenheit von extrazellulären Na+-Ionen der Kationeneinwärtsstrom durch TRPC6-Kanäle hauptsächlich durch Na+-Ionen und nur zu einem geringen Prozentsatz (ca. 4%) durch Ca2+-Ionen verursacht wird. Dies führt zu der Hypothese, dass die durch den Na+-Ioneneinstrom verursachte Membrandepolarisierung möglicherweise unter Inhibition von spannungsabhängigen Kalium (KV)-Kanälen einen Ca2+-Einstrom durch VOCC bewirkt. Da sowohl die Anreicherung von Diacylglycerol (DAG) durch Inhibition der DAG-Kinase mittels des DAG-Kinase Inhibitors R59949 als auch t-BHP (tertiäres Butyl-Wasserstoffperoxid) einen Anstieg der [Ca2+]i nur in WT, aber nicht in TRPC6-/--PASMC unter Hypoxie bewirkte, und im Rahmen der HPV besonders ROS (Reaktive Sauerstoffspezies) wie O2-. und H2O2 als Mediatoren diskutiert werden, scheint die TRPC6-Aktivierung unter Hypoxie durch eine ROS-vermittelte DAG-Akkumulation verursacht zu werden. Um dies genauer aufschlüsseln zu können, wäre einerseits die Messung der zellulären DAG-Konzentration und andererseits die Ermittlung der genauen Rolle von ROS unter Hypoxie ein wichtiges Ziel für weitere Untersuchungen.Hypoxic pulmonary vasoconstriction (HPV) is a physiological response of the lung to alveolar hypoxia that machtes blood perfusion with ventilation to optimize pulmonary gas exchange. Although this mechanism was first described by von Euler and Liljestrand in 1946, the underlying oxygen sensing and signal transduction processes have not been fully elucidated. Investigations with isolated pulmonary arterial smooth muscle cells (PASMC) have demonstrated that hypoxia induces an increase in the intracellular [Ca2+] ([Ca2+]i) of PASMC with subsequent cell contraction. This suggests that PASMC are the sensor as well as the effector cells of HPV. In addition, a role for the endothelium in HPV is discussed in the context of the release of vasoactive substances such as endothelin-1 (ET-1). However the acute phase of HPV (duration: seconds to minutes) seems to be endothelium-independent, while the sustained phase of HPV (duration: hours) is endothelium-dependent. In the present study, a technique for investigation of HPV at the level of PASMC was developed. Cells were isolated from the precapillary region of the intrapulmonary arteries. The cultured cells from passages P0, P1 and P3 were characterized by immunofluorescence and exhibited positive staining for the typical smooth muscle proteins alpha-actin and myosin heavy chain. Endothelial cells were excluded by a negative staining for von Willebrand factor. Investigations by Western blot indicated no quantitative differences in alpha-actin and myosin heavy chain levels between P1 and P3, which pointed to a maintenance of the contractile state of the PASMC in culture. Measurement of [Ca2+]i using fura-2 proved to be a useful technique for the investigation of the response to hypoxia. A comparison of the response of PASMC from P0, P1 and P3 to ET-1 indicated a decrease in the transient elevations in [Ca2+]i with the number of passages. Therefore, all experiments were performed with non-passaged PASMC (= passage 0). To ensure hypoxic conditions for the investigation of the PASMC response to hypoxia, a perfusion system was established. In a second step, the cell isolation- and [Ca2+]i-imaging-technique was transferred from rat to mouse cells, because PASMC from gene deficient mice could then be investigated. Since previous investigations suggested a possible role of receptor-operated non-selective classical “transient receptor potential” (TRP)-channels for the regulation of the tonus of smooth muscle cells, and TRPC6 as an essential component of receptor-operated nonselective cation-channels in smooth muscle cells, the importance of TRPC6-channels for Anhang 112 the response to hypoxia was investigated. Here PASMC from wild type (WT)-mice, but not from TRPC6-/--mice indicated an increase in [Ca2+]i under hypoxic conditions. All measurements were performed after sensitization of the PASMC with ET-1. This increase in [Ca2+]i was caused primarily by Ca2+-entry from the extracellular space through voltagedependent L-type Ca2+-channels (VOCC), because the inhibition of VOCC by nicardipin prevented an increase in [Ca2+]i. In contrast to VOCC, TRPC6-channels are also permeable for other cations other than Ca2+. Investigation by Mn2+-quenching indicated a larger hypoxia-induced Mn2+ influx for PASMC from WT-mice than for PASMC from TRPC6-/--mice, demonstrating a hypoxiainduced cation influx through TRPC6-channels. It is kown from previous investigations,that in the presence of extracellular Na+-ions the cation inward-current through TRPC6-channels is mainly caused by Na+-ions and only for a small percentage (~ 4%) by Ca2+.Thus it can be hypothesized that the membrane depolarization caused by Na+-influx results in a Ca2+-entry through VOCC possibly involving the inhibition of voltage-dependent potassium (KV)-channels. Since diacylglycerol (DAG) accumulation by DAG-kinase inhibition using the DAG-kinase inhibitor R59949 as well as tert-butylhydroperoxide (t-BHP) resulted in an increase of [Ca2+]i in WT but not in TRPC6-/- PASMC under hypoxia, and reactive oxygen species (ROS) like O2 -. and H2O2 are discussed as mediator of HPV, the activation of TRPC6 under hypoxia appears to be caused by a ROS-mediated DAG accumulation. In order to get more detailed information about this it would be necessary to measure the DAG-concentration and to investigate the concrete function of ROS under hypoxia

The solubilisation of boar sperm membranes by different detergents - a microscopic, MALDI-TOF MS, 31P NMR and PAGE study on membrane lysis, extraction efficiency, lipid and protein composition

<p>Abstract</p> <p>Background</p> <p>Detergents are often used to isolate proteins, lipids as well as "detergent-resistant membrane domains" (DRMs) from cells. Different detergents affect different membrane structures according to their physico-chemical properties. However, the effects of different detergents on membrane lysis of boar spermatozoa and the lipid composition of DRMs prepared from the affected sperm membranes have not been investigated so far.</p> <p>Results</p> <p>Spermatozoa were treated with the selected detergents Pluronic F-127, sodium cholate, CHAPS, Tween 20, Triton X-100 and Brij 96V. Different patterns of membrane disintegration were observed by light and electron microscopy. In accordance with microscopic data, different amounts of lipids and proteins were released from the cells by the different detergents. The biochemical methods to assay the phosphorus and cholesterol contents as well as ³¹P NMR to determine the phospholipids were not influenced by the presence of detergents since comparable amounts of lipids were detected in the organic extracts from whole cell suspensions after exposure to each detergent. However, matrix-assisted laser desorption and ionization time-of-flight mass spectrometry applied to identify phospholipids was essentially disturbed by the presence of detergents which exerted particular suppression effects on signal intensities. After separation of the membrane fractions released by detergents on a sucrose gradient only Triton X-100 and sodium cholate produced sharp turbid DRM bands. Only membrane solubilisation by Triton X-100 leads to an enrichment of cholesterol, sphingomyelin, phosphatidylinositol and phosphatidylethanolamine in a visible DRM band accompanied by a selective accumulation of proteins.</p> <p>Conclusion</p> <p>The boar sperm membranes are solubilised to a different extent by the used detergents. Particularly, the very unique DRMs isolated after Triton X-100 exposure are interesting candidates for further studies regarding the architecture of sperm.</p

Phospholipases and Reactive Oxygen Species Derived Lipid Biomarkers in Healthy and Diseased Humans and Animals – A Focus on Lysophosphatidylcholine

Phospholipids (PL) are converted into lipid biomarkers by the action of phospholipases and reactive oxygen species (ROS), which are activated or released under certain physiological and pathophysiological conditions. Therefore, the in vivo concentration of such lipid biomarkers [e.g., lysophospholipids (LPLs)] is altered in humans and animals under different conditions such as inflammation, stress, medication, and nutrition. LPLs are particularly interesting because they are known to possess proand anti-inflammatory properties and may be generated by two different pathways: either by the influence of phospholipase A2 or by different reactive oxygen species that are generated in significant amounts under inflammatory conditions. Both lead to the cleavage of unsaturated acyl residues. This review provides a short summary of the mechanisms by which lipid biomarkers are generated under in vitro and in vivo conditions. The focus will be on lysophosphatidylcholine (LPC) because usually, this is the LPL species which occurs in the highest concentration and is, thus, easily detectable by chromatographic and spectroscopic methods. Finally, the effects of lipid biomarkers as signaling molecules and their roles in different human and animal pathologies such as infertility, cancer, atherosclerosis, and aging will be shortly discussed

Einschränkungen bei Alltagsaktivitäten und Unterstützungsbedarfe – Auswertungen der Studie GEDA 2019/2020-EHIS

Die Ausübung von Aktivitäten des täglichen Lebens ist ein wichtiger Bestandteil der Funktionsfähigkeit eines Menschen. Falls Einschränkungen vorliegen, ist Unterstützung bei diesen Tätigkeiten erforderlich. Anhand von Daten der Studie GEDA 2019/2020-EHIS wird dargestellt, wie viele der in Privathaushalten lebenden Personen ab 55 Jahren in Deutschland Einschränkungen in Alltagsaktivitäten aufweisen. Schwere Einschränkungen in den basalen (grundlegenden) Aktivitäten (z. B. der Nahrungsaufnahme) geben 5,8 % der Frauen und 3,7 % der Männer an. Der Anteil nimmt mit dem Alter zu, von den ab 80-Jährigen sind 13,4 % der Frauen und 9,0 % der Männer betroffen. Schwere Einschränkungen bei den instrumentellen Aktivitäten des täglichen Lebens (z. B. Einkäufe erledigen) sind bei Personen unter 80 Jahren eher selten. Der Anteil bei den ab 80-Jährigen liegt bei den Frauen bei 35,9 % und bei den Männern bei 21,0 %. Bei Einschränkungen der basalen Aktivitäten erhalten 68,1 % der betroffenen Frauen und 57,5 % der Männer Hilfe und Unterstützung. Frauen berichten zudem häufiger über fehlende Unterstützung (48,8 % vs. 43,2 %). Bei den instrumentellen Aktivitäten ist die Lage etwas besser. Die Ergebnisse aus der Studie GEDA 2019/2020-EHIS zeigen, in welchen Bereichen des täglichen Lebens ältere und hochaltrige Menschen eingeschränkt sind, geben einen Eindruck, wer besonders betroffen ist und wo Unterstützungsleistungen nicht ausreichend sind. Sie liefern damit Anhaltspunkte, wo unterstützend angesetzt werden kann, um älteren Menschen einen langen Verbleib in der eigenen Häuslichkeit zu ermöglichen

Prevalence and correlates of frailty among older adults: findings from the German health interview and examination survey

Background: Despite having the third highest proportion of people aged 60 years and older in the world, Germany has been recently reported as having the lowest prevalence of frailty of 15 European countries. The objective of the study is to describe the prevalence of frailty in a large nationwide population-based sample and examine associations with sociodemographic, social support and health characteristics. Methods: We performed a cross-sectional analysis of the first wave of the German Health Interview and Examination Survey for Adults (DEGS1) conducted 2008–2011. Participants were 1843 community-dwelling people aged 65–79 years. Frailty and pre-frailty were defined, according to modified Fried criteria, as 3 and more or 1–2 respectively, of the following: exhaustion, low weight, low physical activity, low walking speed and low grip strength. The Oslo-3 item Social Support Scale (OSS-3) was used. Patient Health Questionnaire (PHQ-9) measured depressive symptoms and the Digit Symbol Substitution Test (DSST) measured cognition. Associations between participants’ characteristics and frailty status were examined using unadjusted and adjusted multinomial logistic regression models estimating relative risk ratios (RRR) of frailty and pre-frailty. Results: The prevalence of frailty among women was 2.8% (CI 1.8-4.3) and pre-frailty 40.4% (CI 36.3-44.7) and among men was 2.3% (CI 1.3-4.1) and 36.9% (CI 32.7-41.3) respectively. Independent determinants of frailty, from unadjusted models, included older age, low socioeconomic status, poor social support, lower cognitive function and a history of falls. In adjusted models current depressive symptoms (RRR 12.86, CI 4.47-37.03), polypharmacy (RRR 7.78, CI 2.92-20.72) and poor hearing (RRR 5.38, CI 2.17-13.35) were statistically significantly associated with frailty. Conclusions: Frailty prevalence is relatively low among community-dwelling older adults in Germany. Modifiable characteristics like low physical activity provide relevant targets for individual and population-level frailty detection and intervention strategies

who is missed and why?

Background Public health monitoring depends on valid health and disability estimates in the population 65+ years. This is hampered by high non- participation rates in this age group. There is limited insight into size and direction of potential baseline selection bias. Methods We analyzed baseline non-participation in a register-based random sample of 1481 inner-city residents 65+ years, invited to a health examination survey according to demographics available for the entire sample, self-report information as available and reasons for non-participation. One year after recruitment, non- responders were revisited to assess their reasons. Results Five groups defined by participation status were differentiated: participants (N = 299), persons who had died or moved (N = 173), those who declined participation, but answered a short questionnaire (N = 384), those who declined participation and the short questionnaire (N = 324), and non-responders (N = 301). The results confirm substantial baseline selection bias with significant underrepresentation of persons 85+ years, persons in residential care or from disadvantaged neighborhoods, with lower education, foreign citizenship, or lower health-related quality of life. Finally, reasons for non-participation could be identified for 78 % of all non-participants, including 183 non- responders. Conclusion A diversity in health problems and barriers to participation exists among non-participants. Innovative study designs are needed for public health monitoring in aging populations

Changes in physical functioning among men and women aged 50–79 years in Germany: an analysis of National Health Interview and Examination Surveys, 1997–1999 and 2008–2011

Background: This study examines changes in physical functioning among adults aged 50-79 years in Germany based on data from two German National Health Interview and Examination Surveys conducted in 1997–1999 (GNHIES98) and 2008–2011 (DEGS1). Methods Using cross-sectional data from the two surveys (GNHIES98, n = 2884 and DEGS1, n = 3732), we examined changes in self-reported physical functioning scores (Short Form-36 physical functioning subscale (SF-36 PF)) by sex and age groups (50–64 and 65–79 years). Covariables included educational level, living alone, nine chronic diseases, polypharmacy (≥5 prescribed medicines), body mass index, sports activity, smoking and alcohol consumption. Multimorbidity was defined as ≥2 chronic diseases. Multivariable models were fitted to examine consistency of changes in physical functioning among certain subgroups and to assess changes in mean SF-36 PF scores, adjusting for changes in covariables between surveys. Results: Mean physical functioning increased among adults aged 50–79 years between surveys in unadjusted analyses, but this change was not as marked among men aged 65–79 years who experienced rising obesity (20.6 to 31.5%, p = 0.004) and diabetes (13.0 to 20.0%, p = 0.014). Prevalence of multimorbidity and polypharmacy use increased among men and women aged 65–79 years. In sex and age specific multivariable analyses, changes in physical functioning over time were consistent across subgroups. Gains in physical functioning were explained by improved education, lower body mass index and improved health-related behaviours (smoking, alcohol consumption, sports activity) in women, but less so among men. Conclusions: Physical functioning improved in Germany among adults aged 50–79 years. Improvements in the population 65–79 years were less evident among men than women, despite increases in multimorbidity prevalence among both sexes. Changes in health behaviours over time differed between sexes and help explain variations in physical functioning. Targeted health behaviour interventions are indicated from this study