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Author (up) Chew, B.H.; Khoo, E.M.; Chia, Y.C. file  url
  Title Social support and glycemic control in adult patients with type 2 diabetes mellitus Type Journal Article
  Year 2015 Publication Asia-Pacific Journal of Public Health Abbreviated Journal Asia Pac J Public Health  
  Volume 27 Issue 2 Pages Np166-73  
  Keywords Adult; Aged; Aged, 80 and over; Blood Glucose; Diabetes Mellitus, Type 2/*blood; Female; *Glycated Hemoglobin A; Humans; Male; Middle Aged; Self Report; *Social Support; Urban Population; family medicine; health education; noncommunicable diseases; psychological behavioral medicine; social determinants of health  
  Abstract INTRODUCTION: The purpose of this study is to examine the prevalence of social support and its association with glycemic control in patients with type 2 diabetes mellitus (T2D) in an urban primary care center within an academic institution. Social support is important in the management of chronic diseases. However, its association with glycemic control has been controversial. METHODS: This was part of a study examining religiosity in T2D patients. Nonsmoking patients with T2D for at least 3 years and aged 30 years and above were recruited. Social support was measured using The Social Support Survey-Medical Outcomes Study (SS), a self-administered questionnaire; the scores range from 19 to 95, and a high score indicates better social support. Glycemic control was measured using the 3 most recent glycosylated hemoglobin (HbA1c) levels within the past 3 years. RESULTS: A total of 175 participants completed the SS survey (response rate 79.0%). The mean age was 62.7 (standard deviation [SD] = 10.8) years, and the mean duration of diabetes was 11.74 (SD = 6.7) years. The mean HbA1c level was 8.15 (SD = 1.44). The mean SS score was 68.1. The prevalence of high and low social support were 29.7% and 24.0 %, respectively. A significant correlation was found between SS score and number of social supporters (n = 167). No significant correlation was found between the self-reported number of social supporters or the SS score and the mean HbA1c level. CONCLUSIONS: Social support was not associated with glycemic control in adult patients with T2D in this primary care setting.  
  Call Number Serial 2046  
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Author (up) Clemson, L.; Fiatarone Singh, M.A.; Bundy, A.; Cumming, R.G.; Manollaras, K.; O'Loughlin, P.; Black, D. file  url
  Title Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial Type Journal Article
  Year 2012 Publication BMJ (Clinical Research ed.) Abbreviated Journal Bmj  
  Volume 345 Issue Pages e4547  
  Keywords Accidental Falls--prevention & control; Activities of Daily Living; Aged; Aged, 80 and over; Female; Humans; Life Style; Male; Patient Compliance; Postural Balance--physiology; Resistance Training--methods; Treatment Outcome  
  Abstract OBJECTIVES: To determine whether a lifestyle integrated approach to balance and strength training is effective in reducing the rate of falls in older, high risk people living at home. DESIGN: Three arm, randomised parallel trial; assessments at baseline and after six and 12 months. Randomisation done by computer generated random blocks, stratified by sex and fall history and concealed by an independent secure website. SETTING: Residents in metropolitan Sydney, Australia. PARTICIPANTS: Participants aged 70 years or older who had two or more falls or one injurious fall in past 12 months, recruited from Veteran's Affairs databases and general practice databases. Exclusion criteria were moderate to severe cognitive problems, inability to ambulate independently, neurological conditions that severely influenced gait and mobility, resident in a nursing home or hostel, or any unstable or terminal illness that would affect ability to do exercises. INTERVENTIONS: Three home based interventions: Lifestyle integrated Functional Exercise (LiFE) approach (n=107; taught principles of balance and strength training and integrated selected activities into everyday routines), structured programme (n=105; exercises for balance and lower limb strength, done three times a week), sham control programme (n=105; gentle exercise). LiFE and structured groups received five sessions with two booster visits and two phone calls; controls received three home visits and six phone calls. Assessments made at baseline and after six and 12 months. MAIN OUTCOME MEASURES: Primary measure: rate of falls over 12 months, collected by self report. Secondary measures: static and dynamic balance; ankle, knee and hip strength; balance self efficacy; daily living activities; participation; habitual physical activity; quality of life; energy expenditure; body mass index; and fat free mass. RESULTS: After 12 months' follow-up, we recorded 172, 193, and 224 falls in the LiFE, structured exercise, and control groups, respectively. The overall incidence of falls in the LiFE programme was 1.66 per person years, compared with 1.90 in the structured programme and 2.28 in the control group. We saw a significant reduction of 31% in the rate of falls for the LiFE programme compared with controls (incidence rate ratio 0.69 (95% confidence interval 0.48 to 0.99)); the corresponding difference between the structured group and controls was non-significant (0.81 (0.56 to 1.17)). Static balance on an eight level hierarchy scale, ankle strength, function, and participation were significantly better in the LiFE group than in controls. LiFE and structured groups had a significant and moderate improvement in dynamic balance, compared with controls. CONCLUSIONS: The LiFE programme provides an alternative to traditional exercise to consider for fall prevention. Functional based exercise should be a focus for interventions to protect older, high risk people from falling and to improve and maintain functional capacity. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry 12606000025538.  
  Call Number Serial 404  
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Author (up) Feng, L.; Chiam, P.C.; Kua, E.-H.; Ng, T.P. file  url
  Title Use of complementary and alternative medicines and mental disorders in community-living Asian older adults Type Journal Article
  Year 2010 Publication Archives of Gerontology and Geriatrics Abbreviated Journal Arch Gerontol Geriatr  
  Volume 50 Issue 3 Pages 243-249  
  Keywords Aged; Aged, 80 and over; *Asian Continental Ancestry Group; Attitude to Health/*ethnology; Complementary Therapies/*utilization; Cross-Sectional Studies; Depression/therapy; Drug Utilization; *Drugs, Chinese Herbal; Female; Humans; Logistic Models; Male; Mental Disorders/*therapy; Middle Aged; Multivariate Analysis; Patient Acceptance of Health Care; Singapore  
  Abstract The use of complementary and alternative medicines (CAMs) and its link with mental health is poorly understood. It is not clear whether mentally ill persons use CAM because conventional medical care does not meet their needs. In a nationally representative random sample of 1092 individuals aged 60 in Singapore, we determined CAM use and the prevalence of mental disorders using Geriatric Mental State (GMS) and found that overall CAM use, predominantly Chinese herbal medicines, was reported by an estimated 42.7% of the population. Depression (odds ratio=OR=1.94; 95% CI=1.26-2.98) and poor self-rated mental health (OR=2.44; 95% CI=1.25-4.80) were associated with CAM use, independently of other risks factors and correlates of CAM use. Although depressed Asians more frequently used CAM than conventional health care, we could find no evidence in this study to indicate that among individuals with depression, CAM users compared to nonusers, were less likely to seek treatment from general and mental health professionals or were more likely to have negative beliefs and attitudes about mental illnesses and its treatment. This is consistent with the common observation that the use of CAM complements rather than replaces conventional treatments.  
  Call Number Serial 1347  
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Author (up) Joanisse, M.; Gagnon, S.; Voloaca, M. file  url
doi  openurl
  Title The impact of Stereotype Threat on the simulated driving performance of older drivers Type Journal Article
  Year 2013 Publication Accident; Analysis and Prevention Abbreviated Journal Accid Anal Prev  
  Volume 50 Issue Pages 530-538  
  Keywords Aged; Aged, 80 and over; Analysis of Variance; Automobile Driving/*psychology; Chi-Square Distribution; Computer Simulation; Female; Humans; Male; Middle Aged; Ontario; Questionnaires; *Stereotyping; Task Performance and Analysis; User-Computer Interface  
  Abstract Older drivers are perceived as being dangerous and overly cautious by other drivers. We tested the hypothesis that this negative stereotype has a direct influence on the performance of older drivers. Based on the Stereotype Threat literature, we predicted that older driving performance would be altered after exposure to a Stereotype Threat. Sixty-one older drivers aged 65 and above completed a simulated driving assessment course. Prior to testing, half of the participants were told that the objective of the study was to investigate why older adults aged 65 and above were more implicated in on-road accidents (Stereotype Threat condition) and half were showed a neutral statement. Results confirmed that exposure to the threat significantly altered driving performance. Older adults in the Stereotype Threat condition made more driving mistakes than those in the control group. Interestingly, under a Stereotype Threat condition, older adults tended to commit more speeding infractions. We also observed that domain identification (whether driving is deemed important or not) moderated the impact of the threat. Taken together, these results support recent older drivers' performance models suggesting that the interaction between individual and social factors need to be considered when examining older drivers' performance.  
  Call Number Serial 1060  
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Author (up) Liu, W.; Lipsitz, L.A.; Montero-Odasso, M.; Bean, J.; Kerrigan, D.C.; Collins, J.J. file  url
  Title Noise-enhanced vibrotactile sensitivity in older adults, patients with stroke, and patients with diabetic neuropathy Type Journal Article
  Year 2002 Publication Archives of Physical Medicine and Rehabilitation Abbreviated Journal Arch Phys Med Rehabil  
  Volume 83 Issue 2 Pages 171-176  
  Keywords Adult; Aged; Aged, 80 and over; Diabetic Neuropathies/complications/*rehabilitation; Female; Fingers/innervation; Foot/innervation; Humans; Hypesthesia/etiology/*rehabilitation; Male; Middle Aged; *Noise; Perceptual Masking; Sensory Thresholds; Statistics, Nonparametric; Stroke/complications/*rehabilitation  
  Abstract OBJECTIVE: To test the hypothesis that vibrotactile detection thresholds in older adults, patients with stroke, and patients with diabetic neuropathy can be significantly reduced with the introduction of mechanical noise. DESIGN: A randomized controlled study. SETTING: A university research laboratory. PARTICIPANTS: Twelve healthy elderly subjects (age range, 67-85y), 5 patients with stroke (age range, 24-64y), and 8 patients with diabetic neuropathy (age range, 53-77y). INTERVENTIONS: Each subject's detection thresholds (ie, minimum level of stimulus to be detected) for a vibrotactile stimulus without and with mechanical noise (ie, random vibration with a small intensity) were determined by using a 4-, 2-, and 1-stepping algorithm. The stimuli were applied to the fingertip and/or to the first metatarsal of the foot. MAIN OUTCOME MEASURE: Detection threshold for a vibrotactile stimulus. RESULTS: The detection threshold at the fingertip for the vibration stimulus with mechanical noise was significantly lower than that without mechanical noise for all 12 elderly subjects, for 4 of the 5 patients with stroke, and all 8 patients with diabetic neuropathy. For the 8 patients with diabetes, mechanical noise also significantly reduced the vibrotactile detection threshold at the foot. CONCLUSIONS: Reduced vibrotactile sensitivity in older adults, patients with stroke, and patients with diabetic neuropathy can be significantly improved with input mechanical noise. Noise-based techniques and devices may prove useful in overcoming age- and disease-related losses in sensorimotor function.  
  Call Number Serial 1259  
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Author (up) Petersen, R.C.; Smith, G.E.; Ivnik, R.J.; Kokmen, E.; Tangalos, E.G. file  url
  Title Memory function in very early Alzheimer's disease Type Journal Article
  Year 1994 Publication Neurology Abbreviated Journal Neurology  
  Volume 44 Issue 5 Pages 867-872  
  Keywords Aged; Aged, 80 and over; Alzheimer Disease/complications/*diagnosis; Female; Humans; Male; Memory Disorders/*diagnosis/etiology; *Neuropsychological Tests; Psychiatric Status Rating Scales; Statistics as Topic  
  Abstract The detection of very early Alzheimer's disease (AD) can be important for both theoretical and practical reasons. Typically, a memory impairment is the first sign of incipient disease, but the early clinical diagnosis can be challenging. We investigated several aspects of memory function in AD and normal aging to determine which indices of performance were most sensitive at detecting early impairments. We evaluated 106 pairs of patients with probable AD and matched controls from the Mayo Clinic Alzheimer's Disease Patient Registry using a logistic regression model that included measures of memory function, verbal and nonverbal intelligence, attention, and language. Results indicated that an index of learning, especially with semantic cuing, was most sensitive at separating the two groups. We then matched subsets of individuals from the larger groups of AD and control subjects on the Mini-Mental State Examination (range of scores, 24 to 26). A logistic regression analysis on these matched groups yielded the same results. A measure of learning with facilitation of performance using cues appears to be the best discriminator at detecting very mild AD. These measures can be useful in selecting patients for interventional strategies.  
  Call Number Serial 1139  
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Author (up) Rauchs, G.; Piolino, P.; Mezenge, F.; Landeau, B.; Lalevee, C.; Pelerin, A.; Viader, F.; de la Sayette, V.; Eustache, F.; Desgranges, B. file  url
doi  openurl
  Title Autonoetic consciousness in Alzheimer's disease: neuropsychological and PET findings using an episodic learning and recognition task Type Journal Article
  Year 2007 Publication Neurobiology of Aging Abbreviated Journal Neurobiol Aging  
  Volume 28 Issue 9 Pages 1410-1420  
  Keywords Aged; Aged, 80 and over; Alzheimer Disease/*physiopathology/*radionuclide imaging; *Brain Mapping; Consciousness/*physiology; Female; Fluorodeoxyglucose F18/pharmacokinetics; Humans; Male; Mental Recall/*physiology; Neuropsychological Tests; *Positron-Emission Tomography; Statistics as Topic; Statistics, Nonparametric  
  Abstract OBJECTIVE: This study aims to map in patients with mild Alzheimer's disease (AD) the correlations between resting-state brain glucose utilization measured by FDG-PET and scores reflecting autonoetic consciousness in an episodic learning and recognition task. METHODS: Autonoetic consciousness, that gives a subject the conscious feeling to mentally travelling back in time to relive an event, was assessed using the Remember/Know (R/K) paradigm. RESULTS: AD patients provided less R responses (reflecting autonoetic consciousness) and more K ones (indicating the involvement of noetic consciousness) than healthy controls. Correct recognitions associated with a R response correlated with the metabolism of frontal areas bilaterally whereas those associated with a K response mainly correlated with the metabolism of left parahippocampal gyrus and lateral temporal cortex. CONCLUSIONS: These data show that recollection is impaired in AD and recognition is more based on a feeling of familiarity than in controls. In addition, the findings of our correlative approach indicate that the impairment of episodic memory is mainly subserved by the dysfunction of frontal areas and of the hippocampal region.  
  Call Number Serial 534  
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Author (up) Rehman, A.; Rausch, P.; Wang, J.; Skieceviciene, J.; Kiudelis, G.; Bhagalia, K.; Amarapurkar, D.; Kupcinskas, L.; Schreiber, S.; Rosenstiel, P.; Baines, J.F.; Ott, S. file  url
  Title Geographical patterns of the standing and active human gut microbiome in health and IBD Type Journal Article
  Year 2016 Publication Gut Abbreviated Journal Gut  
  Volume 65 Issue 2 Pages 238-248  
  Keywords Adolescent; Adult; Aged; Aged, 80 and over; Clostridium/isolation & purification; Female; Germany; Humans; India; Inflammatory Bowel Diseases/*microbiology; Intestinal Mucosa/*microbiology; Lithuania; Male; Microbiome; Microbiota; Middle Aged; RNA, Ribosomal; RNA, Ribosomal, 16S/analysis; Young Adult; Colonic Microflora; Crohn's Disease; Ibd Basic Research; Inflammatory Bowel Disease; Ulcerative Colitis  
  Abstract OBJECTIVE: A global increase of IBD has been reported, especially in countries that previously had low incidence rates. Also, the knowledge of the human gut microbiome is steadily increasing, however, limited information regarding its variation on a global scale is available. In the light of the microbial involvement in IBDs, we aimed to (1) identify shared and distinct IBD-associated mucosal microbiota patterns from different geographical regions including Europe (Germany, Lithuania) and South Asia (India) and (2) determine whether profiling based on 16S rRNA transcripts provides additional resolution, both of which may hold important clinical relevance. DESIGN: In this study, we analyse a set of 89 mucosal biopsies sampled from individuals of German, Lithuanian and Indian origins, using bacterial community profiling of a roughly equal number of healthy controls, patients with Crohn's disease and UC from each location, and analyse 16S rDNA and rRNA as proxies for standing and active microbial community structure, respectively. RESULTS: We find pronounced population-specific as well as general disease patterns in the major phyla and patterns of diversity, which differ between the standing and active communities. The geographical origin of samples dominates the patterns of beta diversity with locally restricted disease clusters and more pronounced effects in the active microbial communities. However, two genera belonging to the Clostridium leptum subgroup, Faecalibacteria and Papillibacter, display consistent patterns with respect to disease status and may thus serve as reliable 'microbiomarkers'. CONCLUSIONS: These analyses reveal important interactions of patients' geographical origin and disease in the interpretation of disease-associated changes in microbial communities and highlight the added value of analysing communities on both the 16S rRNA gene (DNA) and transcript (RNA) level.  
  Call Number Serial 1991  
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Author (up) Robine, J.-M.; Herrmann, F.R.; Arai, Y.; Willcox, D.C.; Gondo, Y.; Hirose, N.; Suzuki, M.; Saito, Y. file  url
  Title Exploring the impact of climate on human longevity Type Journal Article
  Year 2012 Publication Experimental Gerontology Abbreviated Journal Exp Gerontol  
  Volume 47 Issue 9 Pages 660-671  
  Keywords Aged, 80 and over; Agriculture; Climate; Environment; Female; Geography; Humans; Japan; Longevity--physiology; Male; Mortality; Residence Characteristics; Seasons; Sex Factors; Socioeconomic Factors  
  Abstract The purpose of this study was to examine the impact of physical geographic factors and climate conditions on human longevity. The centenarian rate (CR) in 2005 was computed for Japan's 47 prefectures, whose geography and climate vary greatly. Several pathways, such as excess winter mortality, land use and agricultural production, possibly linking physical and climate factors with extreme longevity, were explored. The probability of becoming a centenarian varies significantly among the Japanese prefectures. In particular, the computation of CR(70) demonstrated that the actual probability for individuals 70 years old in 1975 of becoming centenarians in 2005 was 3 times higher, on average, in Okinawa, both for males and females, than in Japan as a whole. About three quarters of the variance in CR(70) for females and half for males is explained by the physical environment and land use, even when variations in the level of socio-economic status between prefectures are controlled. Our analysis highlighted two features which might have played an important role in the longevity observed in Okinawa. First, there is virtually no winter in Okinawa. For instance, the mean winter temperature observed in 2005 was 17.2 degrees C. Second, today, there is almost no rice production in Okinawa compared to other parts of Japan. In the past, however, production was higher in Okinawa. If we consider that long term effects of harsh winters can contribute to the mortality differential in old age and if we consider that food availability in the first part of the 20th century was mainly dependent on local production, early 20th century birth cohorts in Okinawa clearly had different experiences in terms of winter conditions and in terms of food availability compared to their counterparts in other parts of Japan. This work confirms the impact of climate conditions on human longevity, but it fails to demonstrate a strong association between longevity and mountainous regions and/or air quality.  
  Call Number Serial 482  
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Author (up) Rupsingh, R.; Borrie, M.; Smith, M.; Wells, J.L.; Bartha, R. file  url
doi  openurl
  Title Reduced hippocampal glutamate in Alzheimer disease Type Journal Article
  Year 2011 Publication Neurobiology of Aging Abbreviated Journal Neurobiol Aging  
  Volume 32 Issue 5 Pages 802-810  
  Keywords Aged; Aged, 80 and over; Alzheimer Disease/diagnosis/*metabolism; Biological Markers/analysis; Choline/metabolism; Creatine/metabolism; Female; Glutamic Acid/analysis/*deficiency; Hippocampus/chemistry/*metabolism; Humans; Inositol/metabolism; Magnetic Resonance Spectroscopy/methods; Male  
  Abstract Altered neurometabolic profiles have been detected in Alzheimer disease (AD) using (1)H magnetic resonance spectroscopy (MRS), but no definitive biomarker of mild cognitive impairment (MCI) or AD has been established. This study used MRS to compare hippocampal metabolite levels between normal elderly controls (NEC) and subjects with MCI and AD. Short echo-time (TE=46 ms) (1)H spectra were acquired at 4T from the right hippocampus of 23 subjects with AD, 12 subjects with MCI and 15 NEC. Absolute metabolite levels and metabolite ratios were compared between groups using a multivariate analysis of covariance (covariates: age, sex) followed by post hoc Tukey's test (p<0.05 significant). Subjects with AD had decreased glutamate (Glu) as well as decreased Glu/creatine (Cr), Glu/myo-inositol (mI), Glu/N-acetylaspartate (NAA), and NAA/Cr ratios compared to NEC. Subjects with AD also had decreased Glu/mI ratio compared to MCI. There were no differences between subjects with MCI and NEC. Therefore, in addition to NAA/Cr, decreased hippocampal Glu may be an indicator of AD.  
  Call Number Serial 138  
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