Association between telomere length, frailty and death in older adults.

Frailty is considered a clinical marker of functional ageing. Telomere length (TL) has been proposed as a biomarker of biological age but its role in human ageing is controversial. The main aim of the study was to evaluate the longitudinal association of TL with incident frailty and mortality in two cohorts of Spanish community–dwelling older adults. TL was determined at baseline in blood samples from older adults included in Toledo Study for Healthy Aging and ENRICA cohorts while frailty was determined by frailty phenotype (FP) at baseline and at follow-up (3.5 years). Deaths occurring during follow-up were also recorded. Associations of TL with frailty and mortality were analysed by logistic regression with progressive adjustment. Data were separately analysed in the two cohorts and in all subjects by performing a meta-analysis. TL was not different between frail and non-frail subjects. Longer telomeres were not associated with lower risk of prevalent frailty. Similarly, TL at baseline failed to predict incident frailty (OR: 1.04 [0.88–1.23]) or even the development of a new FP criterion (OR: 0.97 [0.90–1.05]) at follow-up. Lack of association was also observed when analysing the development of specific FP criteria. Finally, while frailty at baseline was significantly associated with higher risk of death at follow-up (OR: 4.08 [1.97–8.43], p < 0.001), TL did not significantly change the mortality risk (OR: 1.05 [0.94–1.16]). Results show that TL does not predict incident frailty or mortality in older adults. This suggests that TL is not a reliable biomarker of functional age.post-print660 K

Effectiveness of a randomized intervention by a geriatric team in frail hospital inpatients in non‐geriatric settings: FRAILCLINIC project

Background: Little research has been undertaken on the benefits of frailty management within different hospital settings. The objective of this study is to provide evidence on the viability and effectiveness of frailty management in non‐geriatric hospital settings on mortality and functional decline after discharge. Methods: Data from the FRAILCLINIC (NCT02643069) study were used. FRAILCLINIC is a randomized controlled trial developed in non‐geriatric hospital inpatient settings (emergency room, cardiology and surgery) from Spain (2), Italy (2) and the United Kingdom (1). Inpatients must met frailty criteria (according to the Frailty Phenotype and/or FRAIL scale), ≥75 years old. The control group (CG) received usual care. The intervention group (IG) received comprehensive geriatric assessment (CGA) and a coordinated intervention consisting in recommendations to the treating physician about polypharmacy, delirium, falls, nutrition and physical exercise plus a discharge plan. The main outcomes included functional decline (worsening ≥5 points in Barthel Index) and mortality at 3 months. We used multivariate logistic regression models adjusted by age, gender and the Charlson index. Intention‐to‐treat (ITT) and per‐protocol (PP) analyses were used. Results: Eight hundred twenty one participants (IG: 416; mean age 83.00 ± 4.91; 51.44% women; CG: 405; mean age 82.46 ± 6.03; 52.35% women) were included. In the IG, 77.16% of the participants followed the geriatric team's recommendations as implemented by the treating physicians. The intervention showed a benefit on functional decline and mortality [OR: 0.67(0.47–0.96), P‐value 0.027 and 0.29(0.14–0.57), P‐value < 0.001, respectively) when fully followed by the treating physician. A trend to benefit (close to statistical significance) in functional decline and mortality were also observed when any of the recommendations were not followed [OR (95% CI): 0.72 (0.51–1.01), P‐value: 0.055; and 0.64 (0.37–1.10), P‐value: 0.105, respectively]. Conclusions: An individualized intervention in frail in‐patients reduces the risk of functional deterioration and mortality at 3 months of follow‐up when a care management plan is designed and followed

Running title: Lifestyle consequences of COVID-19 lockdown in older adults

Epidemiol Health > Accepted Articles Original article Epidemiology and Health 2022;e2022026. DOI: https://doi.org/10.4178/epih.e2022026 [Accepted] Published online Feb 21, 2022. The medium-term consequences of COVID-19 lockdown on lifestyle among Spanish older people with hypertension, pulmonary, cardiovascular, and musculoskeletal-diseases, depression, and cancer Irene Rodríguez-Gómez1 , Coral Sánchez-Martín1 , Francisco J. García-García2 , Esther García-Esquinas3 , Marta Miret4 , Germán Vicente-Rodriguez5 , Narcís Gusi6 , Asier Mañas7 , José A. Carnicero8 , Marcela Gonzalez-Gross9 , José L. Ayuso-Mateos10 , Fernando Rodríguez-Artalejo11 , Leocadio Rodríguez-Mañas12 , Ignacio Ara Royo1 1Universidad de Castilla-La Mancha, Toledo, Spain 2Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain 3Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Korea 4Department of Psychiatry. School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain 5Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain 6Instituto Internacional de Investigación e Innovación en Envejecimiento, Universidad de Extremadura, Cáceres, Spain 7Universidad de Castilla-La Mancha, Toledo, Spain 8University Hospital. Getafe, Spain, Getafe, Spain 9ImFINE Research Group, Universidad Politécnica de Madrid. , Madrid, Spain 10Department of Psychiatry. School of Medicine. Universidad Autónoma de Madrid , Madrid, Spain 11Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain 12University Hospital. Getafe, Spain, Getafe, Spain Correspondence Ignacio Ara Royo ,Email: [email protected] Received: Oct 14, 2021 Accepted after revision: Feb 21, 2022 Abstract Objectives: To assess the influence of different chronic diseases on lifestyle and health behaviours changes after COVID-19 lockdown in Spanish older people compared to people without these diseases and compare the differences in these changes between both periods. Method: 1092 participants (80.3±5.6y;66.5%women) from two Spanish cohorts were included. Telephone-based questionaries were used to evaluate health risk behaviours and lifestyle during lockdown and 7-months later. Self-reported physician-based diagnosis of chronic diseases was also reported. Cox-proportional models adjusted for main confounders were applied. Results: Improvements concerning lifestyle were found in older people with chronic diseases, although they worsened the physical component (except cancer). When they were compared to those without these diseases, hypertension was associated with a lower frequency of increased alcohol consumption (Hazard ratio:0.73[95% confidence interval:0.55;0.99]). Pulmonary diseases were associated with a lower risk of both decreased sedentary time (0.58[0.39;0.86]) and worsening sleep quality (0.56[0.36;0.87]), while CVD was only associated with a lower frequency of decreased sedentary time (0.58[0.38;0.88]). Depression was linked to a higher risk of increasing diet quality (1.53[1.00;2.36]). Cancer was less likely to worsen sleep quality (0.44[0.22;0.89]), but more likely to worsen their social contact frequency (2.05[1.05;3.99]). No significant association related to musculoskeletal diseases. Conclusions: Beneficial changes in health risk behaviours and lifestyle after the COVID-19 lockdown in older people with chronic diseases were found. Particularly, older people with hypertension, pulmonary disease and cancer showed beneficial changes after lockdown compared to their counterparts without diseases. Those with CVD and depression showed lifestyles that could involve a health risk

Genome-wide meta-analysis of muscle weakness identifies 15 susceptibility loci in older men and women.

Low muscle strength is an important heritable indicator of poor health linked to morbidity and mortality in older people. In a genome-wide association study meta-analysis of 256,523 Europeans aged 60 years and over from 22 cohorts we identify 15 loci associated with muscle weakness (European Working Group on Sarcopenia in Older People definition: n = 48,596 cases, 18.9% of total), including 12 loci not implicated in previous analyses of continuous measures of grip strength. Loci include genes reportedly involved in autoimmune disease (HLA-DQA1 p = 4 × 10-17), arthritis (GDF5 p = 4 × 10-13), cell cycle control and cancer protection, regulation of transcription, and others involved in the development and maintenance of the musculoskeletal system. Using Mendelian randomization we report possible overlapping causal pathways, including diabetes susceptibility, haematological parameters, and the immune system. We conclude that muscle weakness in older adults has distinct mechanisms from continuous strength, including several pathways considered to be hallmarks of ageing

Frequency and characteristics of familial melanoma in Spain: The FAM-GEM-1 Study

Similar to that observed in other countries, familial melanoma accounts for 6.6% of melanoma diagnoses in Spain. Although no differences in the multivariate analysis were found, some better prognosis factors, such as Breslow index, seem more frequent in familial melanoma, which reflect a better early detection marker and/or a different biological behavior

Genome-wide meta-analysis of muscle weakness identifies 15 susceptibility loci in older men and women

Low muscle strength is an important heritable indicator of poor health linked to morbidity and mortality in older people. In a genome-wide association study meta-analysis of 256,523 Europeans aged 60 years and over from 22 cohorts we identify 15 loci associated with muscle weakness (European Working Group on Sarcopenia in Older People definition: n = 48,596 cases, 18.9% of total), including 12 loci not implicated in previous analyses of continuous measures of grip strength. Loci include genes reportedly involved in autoimmune disease (HLA-DQA1p = 4 × 10−17), arthritis (GDF5p = 4 × 10−13), cell cycle control and cancer protection, regulation of transcription, and others involved in the development and maintenance of the musculoskeletal system. Using Mendelian randomization we report possible overlapping causal pathways, including diabetes susceptibility, haematological parameters, and the immune system. We conclude that muscle weakness in older adults has distinct mechanisms from continuous strength, including several pathways considered to be hallmarks of ageing

Aparición y desarrollo de la atención conjunta en la infancia

La Atención Conjunta constituye la primera condición sobre la que se construye la comunicación. De ahí el enorme interés que despierta su estudio, dada su influencia sobre el desarrollo cognitivo, social, emocional, y lingüístico humano. Este artículo presenta una revisión de la investigación sobre la aparición y el desarrollo de la Atención Conjunta en la infancia, poniendo de relieve los principales elementos de debate sobre dicha temática. Comenzamos examinando el concepto de intencionalidad en la definición de la Atención Conjunta, para describir a continuación la secuencia de desarrollo de dicha capacidad. Finalizamos el trabajo ofreciendo algunos datos que relacionan la Atención Conjunta con el desarrollo del lenguaje, y sugiriendo direcciones en las que se puede orientar la investigación en este campo

Tailoring of refractive index profiles in LiNbO3 optical waveguides by low-fluence swift-ion irradiation

Proton-exchange LiNbO3 planar optical waveguides have been irradiated with swift ions (Cl 30 MeV) at very low fluences in the range 5 × 1010-5 × 1012 cm-2. Large modifications in the refractive index profiles, and therefore in the optical performance, have been obtained due to the generation of amorphous nano-tracks by the individual ion impacts. Moreover, a fine tuning of the refractive index can be achieved by a suitable control of the fluence (δn/δ ∼ 10-14 cm2 or δn ≈ 10-5 for δ ≤ 109 cm-2). An effective medium approach has been used to account for those changes and determine the amorphous fraction of material. The results have been compared with information extracted from complementary RBS channelling experiments. From the calculated amorphous fractions a radius of ∼2 nm for the amorphous tracks have been estimated. © 2007 IOP Publishing Ltd.The authors acknowledge funding from the project MEC/ MAT2005-06359-C03-01-02 from Ministerio de Educacion y ´ Ciencia. A Garc´ıa-Navarro and J Carnicero acknowledge the financial support of the MEC through their FPU fellowships.Peer Reviewe

Endoglin and Other Angiogenesis Markers in Recurrent Varicose Veins

Background: Surgery on varicose veins (crossectomy and stripping) may lead to recurrence, with clinical and socioeconomic repercussions. The etiopathogenesis of varicose veins has yet to be fully understood. Objective: Study the expression of endoglin and other molecules involved in the neovascularisation process in patients suffering from this disease. Methods: Total of 43 patients that have undergone surgery for varicose veins (24 primary and 19 recurrent). Endoglin and other molecules were identified on the venous wall (proximal -saphenofemoral junction- and distal), via real-time RT-PCR, and in serum, via ELISA: endoglin (Eng), vascular endothelial growth factor (VEGF-A), its receptors 1 and 2 (VEGFR1 or FLT1), (VEGFR2 or FLK), and the hypoxia-inducible factor (HIF-1A). All the patients signed a consent form. Results: The recurrent group recorded a higher expression of Eng, VEGF-A, VEGFR1, and VEGFR2 at the level of proximal venous wall compared to the primary group. HIF-1A did not record any differences. As regards the determination of the distal venous wall, no markers recorded differences between the groups. Among the serum determinations, only sFLT1 recorded a significant drop among the patients with recurrent varicose veins. Conclusions: Patients with recurrent varicose veins record a higher expression of endoglin and other markers of angiogenesis in proximal veins. Endoglin in the blood (sEng) serves no apparent purpose in recurrent varicose veins

Endoglin and Other Angiogenesis Markers in Recurrent Varicose Veins

Background: Surgery on varicose veins (crossectomy and stripping) may lead to recurrence, with clinical and socioeconomic repercussions. The etiopathogenesis of varicose veins has yet to be fully understood. Objective: Study the expression of endoglin and other molecules involved in the neovascularisation process in patients suffering from this disease. Methods: Total of 43 patients that have undergone surgery for varicose veins (24 primary and 19 recurrent). Endoglin and other molecules were identified on the venous wall (proximal -saphenofemoral junction- and distal), via real-time RT-PCR, and in serum, via ELISA: endoglin (Eng), vascular endothelial growth factor (VEGF-A), its receptors 1 and 2 (VEGFR1 or FLT1), (VEGFR2 or FLK), and the hypoxia-inducible factor (HIF-1A). All the patients signed a consent form. Results: The recurrent group recorded a higher expression of Eng, VEGF-A, VEGFR1, and VEGFR2 at the level of proximal venous wall compared to the primary group. HIF-1A did not record any differences. As regards the determination of the distal venous wall, no markers recorded differences between the groups. Among the serum determinations, only sFLT1 recorded a significant drop among the patients with recurrent varicose veins. Conclusions: Patients with recurrent varicose veins record a higher expression of endoglin and other markers of angiogenesis in proximal veins. Endoglin in the blood (sEng) serves no apparent purpose in recurrent varicose veins