Normal Aging and Dementia

Normal aging begins after 60 years of age. According to Harman, the accumulation of free radicals, which results from weakening of repair and protective mechanisms, takes place in the aging brain. It is believed that especially in the population of the most elderly there is increased incidence of both dementia and depression. The causes of these central nervous system disorders in the aging human body are changes at the molecular level, such as changes in the biochemical parameters, the accumulation of mutations in nuclear and mitochondrial DNA, and epigenetic changes. Biomarkers associated with aging of the brain include accumulated deposits of β-amyloid (Aβ), disturbed cholesterol homeostasis, altered neuroimaging parameters, and impaired glucose metabolism. Genetic factors are also responsible for normal aging, for example, SIRT1, AKT1, and CDKN1A, and among them the longevity genes, such as FOXO3A and CETP. Dementia as well as cognitive decline may be modified by poly-T variants of TOMM40 and APOE alleles via influencing the level of apolipoprotein E (apoE) in the brain and in the plasma as well as by its ability of Aβ clearance

Rehabilitation management in Parkinson's disease - review of the variety of forms

Introduction: Parkinson's disease is one of the most common central nervous system diseases. Despite many studies and the use of many different forms of drug treatment, it is still not possible to completely regress the disease. Drug treatment can effectively reduce the severity of stiffness, slow motion or tremor, but does not affect non-dopaminergic symptoms such as postural and gait stability disorders which can result in numerous falls. Materials and methods: Analysis of selected and available literature and scientific articles available in the Google Scholar and Pubmed search engine database. Keywords were used for this purpose: Parkinson's disease, Rehabilitation, and Therapy Results: The most common symptoms of a neurodegenerative disease, which is Parkinson's disease, include slow motion, increased muscle tone, resting tremor, and balance disorders. The etiopathogenesis of Parkinson's disease is still not fully understood, and for this reason a simple algorithm was still created for the diagnosis of the disease and possible further treatment. Kinesitherapy, which is individually tailored to the patient's needs, is the basic form of rehabilitation in Parkinson's disease. For this purpose, muscle stretching exercises, autogenic training, exercises improving efficiency, respiratory therapy or progressive muscle relaxation by the Jacobson method are used. In the case of physical therapy, which is complementary to rehabilitation, hydrotherapy, magnetotherapy and iontophoresis are used. In addition to the above-mentioned forms of rehabilitation, deep therapeutic stimulation of the brain, subcutaneous administration of apomorphine, basic forms of occupational therapy and speech therapy exercises are also used for therapeutic purposes. Conclusions: Despite the large amount of research and published results, there is still a great need for further work on the problems of people with Parkinson's disease

Assessing the risk of falls of older people using specialized diagnostic tests

Background: The phenomenon of population aging, resulting in an increase in the number of elderly people in need of medical assistance, necessitated the development of geriatric medicine. Its key assumption is to improve the quality of life of older people through early recognition, prevention and treatment of diseases of old age. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: geriatrics, aging process, falls Results: The fall belongs to a group of great geriatric problems contributing to the phenomenon of senile disability. The result of disturbances in the balance and problems associated with the weakening of the musculoskeletal system is a fall, which has very serious consequences for the health and functioning of an older person. The most important diagnostic tests related to falls of older people include: Timed Up & Go Test (TUG), Dynamic Gait Index (DGI), The Step Test, Stop Walking When Talking (SWWT), Four Square Step Test (FSST) Conclusions: Falling older people is statistically one of the biggest problems of this age group, and at the same time causing a huge number of complications in the lives of geriatric patients, which is why their prevention is so important. There is a further need for research and discussion on the effectiveness of forms of diagnostic to prevent the falls of older peopl

Degeneration of the lumbar intervertebral discs as a cause of root discomfort in the lumbar spine

Background: The change in the lifestyle of modern man and the related lack of physical activity caused that pain in the spine has become a civilization problem, covering an increasing population regardless of latitude. Degenerative changes of the spine, also in the lumbar region, are the most frequently diagnosed cause of patients' dysfunction. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: lumbar spine, degenerative changes, dysfunctions Results: Currently, in addition to injuries and mechanical loads, the causes of lumbar spine dysfunction also include abnormal spinal nutritional composition and genetic factors, with the greatest emphasis on genes encoding type 1 collagen. During diagnostics, apart from X-ray imaging, computed tomography and resonance imaging methods should not forget about properly conducted interviews and functional tests. Kinesitherapy assisted by physical treatment methods such as laser therapy or ultrasound should play a major role in rehabilitation. Kinesitherapy should be tailored to the individual patient, and exercises selected so that the patient can also do them at home. Conclusions: In the prevention of degenerative changes of the lumbar spine, there should be a much greater emphasis on patient education related to risk factors or learning ergonomic work. Despite much work on this topic, there is still a need to improve public awareness and further research on prevention

A holistic approach to the problem of Rheumatoid Arthritis in geriatric patients

Rheumatoid arthritis is a chronic disease and belongs to the group of systemic connective tissue diseases having an autoimmune basis. The most commonly reported symptoms by patients are pain, swelling and difficulty moving the affected joints. The course of rheumatoid arthritis is different in the elderly, the onset of the disease in the elderly is more severe than in the young, and large proximal joints are primarily involved. Make a diagnosis as soon as possible and start treatment, the greater the chance of delaying disease progression and even remission, which will minimize disability. In the treatment of rheumatoid arthritis in the elderly, who often have co-morbidities and often mobility difficulties, the role of physiotherapist and nursing care is extremely important next to medical treatment. The use of kinesitherapy allows you to increase the range of motion of the joints and maintain them in good functional condition. Physiotherapy, on the other hand, has analgesic and anti-inflammatory effects. This effect is enhanced by properly selected pharmacological treatment, carried out with the help of disease-modifying drugs, anti-inflammatory drugs, glucocorticosteroids and biological drugs

Review of the methodology of lower limb prosthesis

Background: The replacement of inefficient or lost organs, especially in the case of lower ends, is associated with a huge experience for the patient, especially in emotional terms. However, with the development of medicine and technology, they allow patients, with properly conducted rehabilitation, to achieve satisfaction with the obtained effects of the treatment. The variety of forms of lower limb prosthesis depends primarily on the location of the prosthesis. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Prosthesis, Lower limb, Amputation Results: The lower limb prosthesis is built from a funnel that matches the stump, the mechanism of the knee joint, shin and the foot. Pours that are used at the lower extremities include: a quadrangular funnel, an ICS longitudinal oval or a CAD-CAM, a full-contact hip funnel, a residual femoral funnel or vacuum syphilis used in people with neoplastic amputations. In the case of knee joints, the distinction is made based on the number of axes around which the movement takes place. So we distinguish uniaxial and multi-axis joints. As important as the other parts is the construction of the prosthetic foot, because it is responsible for supporting the limb stabilizers through passive control of the ankle bending. Conclusions: With the new generation of lower limbs prostheses, the patient can lead an active professional life, as well as practice various sports disciplines. However, this does not change the fact that there is still a great need for research, and holistic cooperation to increase the efficiency and satisfaction of life of amputees in the lower limbs

Rehabilitation of patients with paraplegia - a review of the diversity of forms

Abstract: Background: Damage to the spinal cord most often occurs as a result of spine injury, often causing the disability. In every patient with paraplegia, complications may occur in the form of: sensory disorders, bedsores, contractures, urinary and stool incontinence, paresis or limb paralysis, as well as sexual problems. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Rehabilitation, Paraplegia, Neurology Results: Losing the function of locomotion and self-care in everyday activities is a great psychological burden, both for the sick person and his family. Rehabilitation proceeding should include physical, psychological and social aspects. For paraplegics, the introduction of early and appropriately targeted treatment may reduce the risk of onerous complications and allow for maximum self-empowerment in basic activities. For a person with disability, it is a chance to achieve self-acceptance and return to a dignified life in society. Conclusions: Problems of patients with paraplegia, despite the fact that they were described in many books and articles, should still be considered in studies that would use the latest news from the world of science. Patients struggling with this problem still expect further measures to improve their quality of life

Complications associated with hospitalization after spinal cord injury

Abstract: Background: Spinal cord injuries are a traumatic phenomenon not only for the physical sphere, but equally affect the human psyche. The patient ceases to be independent in his actions, he must face a completely new situation for himself and the environment. Particularly difficult is the first period after injury, associated with hospitalization. That is why it is so important to prevent the most common complications of spinal injuries during this period. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Spinal Cord, Injury, Trauma, Complications Results: The most common complications associated with the hospital stay of patients with spinal cord injury include: complications in the respiratory system (including pneumonia, atelectasis and respiratory failure), decubitus ulcers, periarticular neurogenic ossification, autonomic dysreflexia, spasticity or disorders in the functioning of the urinary tract. Decubitus ulcers due to their nature are a huge problem for hospitalized patients, in epidemiological studies it was estimated to occur at nearly 20 per cent. Spasticity is one of the most serious complications hindering the effective rehabilitation process of post-traumatic persons. In the case of disorders associated with the urinary system, it is important to classify dysfunctions based on the neurogenic evaluation of the sphincter muscles and detrusor. Conclusions: Due to the increasing number of spinal cord and spinal cord injuries and the serious nature of their complications, this topic should continue to be an area of very intensive scientific research, both theoretical and clinical. The given issues should be familiar not only to the medical community but also to the family and the patient's environment

Dysfunctions of the immune system associated with age

Abstract Background: The human immune system consists of innate and adaptive responses. Innate immune response is the first line of the body's defense, while the adaptive response eliminates pathogens in later stages of infection. Cooperation between innate and adaptive immune response is important to effectively eliminate pathogens. An integral part of the aging of the human body is the aging of the immune system, which results in functional disorders directly affecting the deterioration of health. Abnormal functioning of the immune system is a predisposing factor to the occurrence of old-age diseases, as well as reduces the effectiveness of protective vaccination especially recommended to geriatric patients. Material and Methods: The current state of knowledge on age-related immune dysfunctions has been reviewed. The analysis concerned publications in English and Polish language published in the years 2003-2018, which were collected in the PubMed and Google Scholar database. Particular attention was paid to publications presenting the results of research conducted on a group of geriatric people in order to analyze the facts from the research. The publications were searched on the basis of key phrases, among others: the immune system of the elderly, chronic inflammation, innate immunity and adaptive immunity. Results: A review of current knowledge showed the seriousness of the problem of the aging of the immune system. In addition to reducing the efficiency of the immune system, special attention should be paid to chronic inflammation that predisposes to old-age diseases, as well as to reduce the effectiveness of immunization, which is a serious threat. Conclusion: Analyzing the sources of chronic inflammation in the elderly, particular attention was paid to the phenotype of aging cells, changes in the intestinal microflora of the elderly, the role of adipose tissue in the process of inflammation and changes in the levels of steroid hormones. Public awareness of the etiology of the problem is an excellent method of counteracting the negative effects of immunodeficiency. One of the recommendations is physical activity as part of the elimination of adipose tissue capable of securing an infinite number of pro-inflammatory cytokines

Dizziness and balance disorders in the elderly

Background: Patients in the geriatric age are characterized by the presence of degenerative changes, significantly affecting their daily functioning. One of the most common symptoms accompanying the elderly include dizziness and balance disorders. This is an extremely important issue, because even every third patient can report such ailments. Often, especially in the group of geriatric patients, these problems are related to disorders in the circulatory system, and more specifically to orthostatic hypotension. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: geriatrics, dizziness, balance disorders. Results: In the treatment of dizziness and disorders of the balance we distinguish pharmacological and non-pharmacological methods where kinesitherapy (exercises) looms large. In the case of pharmacological treatment, attention should be focused on causal therapy because symptomatic treatment can cause side effects and should therefore be used as soon as possible. In many cases, pharmacological treatment can be fully replaced by normal and individually conducted physiotherapeutic procedures. Training to which a patient is subjected should consist of many elements, which, however, will be adapted to the conditions that can meet a patient in everyday life. In diagnostics of the above-mentioned problems, research on stabilometric platforms is becoming more and more important. Increasingly, also in the rehabilitation of patients with a problem with equilibrium, modern technology in the form of virtual reality is used. Conclusions: Dizziness and balance disorders can result in many problems, which is why correct diagnosis and effective treatment are so important, especially because it is a problem for more and more people. Greater importance should be attached to prevention. Although modern forms of fighting these disorders are being introduced, there is still a need for further research on their effectiveness