Validation of the Greek translation of the cognitive disorders examination (Codex) for the detection of dementia in primary care

OBJECTIVE: To validate the Greek translation of the Cognitive Disorders Examination (Codex) and to investigate its potential for implementation for the detection of dementia in the Greek population. / METHOD: Subjects aged ≥60 years with and without dementia, based on the diagnostic criteria DSM-IV-TR, were included in the study. Translation of the test Codex from French to Greek and back-translation from Greek to French were conducted to verify the validity of the translation. The Greek version of the Codex and the Mini Mental State Examination (MMSE) were administered to 17 patients with dementia and 27 patients without dementia. / RESULTS: The median age of the participants was 82 years (range 61–93 years) for patients with dementia and 73 years (range 61–84 years) for patients without dementia. The average level of education was 9.0 years (range 2–20 years) for patients with dementia and 10.5 years (range 3–16 years) for those without. The average score on the MMSE was 15.7 (range 7–27) for patients with dementia and 28.3 (range 25–30) for those without dementia. The sensitivity of Codex for the detection of dementia was 94.1% and its specificity was 88.9%. / CONCLUSIONS: The Greek version of Codex can detect dementia reliably. Its validation as a diagnostic tool for use in the Greek population will require testing on a larger sample of individuals

Does Increased Arterial Stiffness Increase the Risk for Postural Hypotension?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75516/1/j.1076-7460.2005.04503.x.pd

Healthy aging in elderly cochlear implant recipients: a multinational observational study

Background: Given an increase in the aging population and its impact on healthcare systems, policy makers for provision of health and social services are aiming to keep older adults in good health for longer, in other words towards ‘healthy aging’. Our study objective is to show that rehabilitation with cochlear implant treatment in the elderly with hearing impairment improves the overall health-related quality of life and general well-being that translate into healthy aging. Methods: The multicentre, prospective, repeated measures, single-subject, clinical observational study will accrue 100 elderly, first-time, unilateral CI recipients (≥ 60 years) and analyze changes on specific measurement tools over ca. 20 months from preimplant to postimplant. Evaluations will consist of details collected through case history and interview questionnaires by clinicians, data logging, self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in overall quality of life will be the HUI-3. Discussion: The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare effects of CI rehabilitation in adults immediately before their implantation, (pre-implant) and after gaining 1–1.5 years of experience (post-implant). The broad approach will lead to a greater understanding of how useful hearing impacts the quality of life in elderly individuals, and thus improves potentials for healthy aging. Outcomes will be described and analyzed in detail. Trial registration: This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), 7 March 2017 under the n° NCT03072862

Stone consolidation: a critical discussion of theoretical insights and field practice

Stone consolidants have been extensively used for the preservation of historical structures since the 19th century. However, their true effectiveness in practice is often a source of debate, largely because of known cases where badly chosen treatments were unsuccessful, or even caused an accelerated degradation of the substrate. Researchers have therefore strived to better understand, and possibly predict, the behavior of consolidants on-site, in order to assist practitioners in their decision making. Despite the large number of publications available on the subject, however, the contribution of scientific research for practical applications remains scarce. Reasons for this include the limited accessibility of scientific publications and the lack of documentation or preparatory studies from the field. This unfortunately compromises the knowledge exchange between researchers and practitioners, which we consider to be a main challenge that this field must overcome. The target of this letter is to reconnect the critical problems identified on-site through practical experience with the conceptual research outcomes that could help solve them. For this, we present an informed evaluation of the most needed research, along with a synthetic overview of the insights that scientific research can offer in terms of consolidant selection, application and monitoring

Reliability of orthostatic beat-to-beat blood pressure tests: implications for population and clinical studies

Objective: To assess the test–retest reliability of orthostatic beat-to-beat blood pressure responses to active standing and related clinical definitions of orthostatic hypotension. Methods: A random sample of community-dwelling older adults from the pan-European Survey of Health, Ageing and Retirement in Europe, Ireland underwent a health assessment that mimicked that of the Irish Longitudinal Study on Ageing. An active stand test was performed using continuous blood pressure measurements. Participants attended a repeat assessment 4–12 weeks after the initial measurement. A mixed-effects regression model estimated the reliability and minimum detectable change while controlling for fixed observer and time of day effects. Results: A total of 125 individuals underwent repeat assessment (mean age 66.2 ± 7.5 years; 55.6% female). Mean time between visits was 84.3 ± 23.3 days. There was no significant mean difference in heart rate or blood pressure recovery variables between the first and repeat assessments. Minimum detectable change was noted for changes from resting values in systolic blood pressure (26.4 mmHg) and diastolic blood pressure (13.7 mmHg) at 110 s and for changes in heart rate (10.9 bpm) from resting values at 30 s after standing. Intra-class correlation values ranged from 0.47 for nadir values to 0.80 for heart rate and systolic blood pressure values measured 110 s after standing. Conclusion: Continuous orthostatic beat-to-beat blood pressure and related clinical definitions show low to moderate reliability and substantial natural variation over a 4–12-week period. Understanding variation in measures is essential for study design or estimating the effects of orthostatic hypotension, while clinically it can be used when evaluating longer term treatment effects

Opportunities for organoids as new models of aging.

The biology of aging is challenging to study, particularly in humans. As a result, model organisms are used to approximate the physiological context of aging in humans. However, the best model organisms remain expensive and time-consuming to use. More importantly, they may not reflect directly on the process of aging in people. Human cell culture provides an alternative, but many functional signs of aging occur at the level of tissues rather than cells and are therefore not readily apparent in traditional cell culture models. Organoids have the potential to effectively balance between the strengths and weaknesses of traditional models of aging. They have sufficient complexity to capture relevant signs of aging at the molecular, cellular, and tissue levels, while presenting an experimentally tractable alternative to animal studies. Organoid systems have been developed to model many human tissues and diseases. Here we provide a perspective on the potential for organoids to serve as models for aging and describe how current organoid techniques could be applied to aging research

Phenomenon of declining blood pressure in elderly - high systolic levels are undervalued with Korotkoff method

<p>Abstract</p> <p>Background</p> <p>Systolic blood pressure (SBP) decline has been reported in octogenarians. The aim was to study if it could be observed while measuring SBP with two methods: Korotkoff (K-BP) and Strain-Gauge-Finger-Pletysmography (SG-BP), and which of them were more reliable in expressing vascular burden.</p> <p>Methods</p> <p>A cohort of 703 men from a population of Malmö, Sweden, were included in "Men born in 1914-study" and followed-up at ages: 68 and 81 years. 176 survivors were examined with K-BP and SG-BP at both ages, and 104 of them with Ambulatory Blood Pressure at age 81/82. Ankle Brachial Index (ABI) was measured on both occasions, and Carotid Ultrasound at age 81.</p> <p>Results</p> <p>From age 68 to 81, mean K-BP decreased in the cohort with mean 8.3 mmHg, while SG-BP increased with 13.4 mmHg. K-BP decreased in 55% and SG-BP in 31% of the subjects. At age 81, K-BP was lower than SG-BP in 72% of subjects, and correlated to high K-BP at age 68 (r = --.22; p < .05). SG-BP at age 81 was correlated with mean ambulatory 24-h SBP (r = .480; p < .0001), daytime SBP (r = .416; p < .0001), nighttime SBP (r = .395; p < .0001), and daytime and nighttime Pulse Pressure (r = .452; p < .0001 and r = .386; p < .0001). KB-BP correlated moderately only with nighttime SBP (r = .198; p = .044), and daytime and nightime pulse pressure (r = .225; p = .021 and r = .264; p = .007). Increasing SG-BP from age 68 to 81, but not K-BP, correlated with: 24-h, daytime and nighttime SBP, and mean daytime and nighttime Pulse Pressure. Increasing SG-BP was also predicted by high B-glucose and low ABI at age 68, and correlated with carotid stenosis and low ABI age 81, and the grade of ABI decrease over 13 years.</p> <p>Conclusion</p> <p>In contrast to K-BP, values of SG-BP in octogenarians strongly correlated with Ambulatory Blood Pressure. The SG-BP decline in the last decade was rare, and increasing SG-BP better than K-BP reflected advanced atherosclerosis. It should be aware, that K-BP underdetected 46% of subjects with SG-BP equal/higher than 140 mmHg at age 81, which may lead to biased associations with risk factors due to differential misclassification by age.</p

Recommendation of RILEM TC 271-ASC: New accelerated test procedure for the assessment of resistance of natural stone and fired-clay brick units against salt crystallization

This recommendation is devoted to testing the resistance of natural stone and fired-clay brick units against salt crystallization. The procedure was developed by the RILEM TC 271-ASC to evaluate the durability of porous building materials against salt crystallization through a laboratory method that allows for accelerated testing without compromising the reliability of the results. The new procedure is designed to replicate salt damage caused by crystallization near the surface of materials as a result of capillary transport and evaporation. A new approach is proposed that considers the presence of two stages in the salt crystallization test. In the first, the accumulation stage, salts gradually accumulate on or near the surface of the material due to evaporation. In the second, the propagation stage, damage initiates and develops due to changes in moisture content and relative humidity that trigger salt dissolution and crystallization cycles. To achieve this, two types of salt were tested, namely sodium chloride and sodium sulphate, with each salt tested separately. A methodology for assessing the salt-induced damage is proposed, which includes visual and photographical observations and measurement of material loss. The procedure has been preliminarily validated in round robin tests