The early recognition of dementia in the elderly: A preliminary communication about a longitudinal study using the gms–agecat package (community version)

A random community sample of 1070 subjects aged over 65 was interviewed by trained non-medical interviewers using the Geriatric Mental State, community version (GMSA). A sub-sample of 126 subjects was selected so as to contain possible early cases of dementia, pseudo-dementia, and normal subjects; and re-interviewed, a mean 1 year and 23 weeks later, by a group of psychiatrists in training. The computer diagnosis AGECAT, based on GMSA applied by non-medical raters, had predicted at initial interview, nine out of twelve cases of dementia at follow-up and five out of nine borderline cases. An Organic/Depression Index may prove useful in predicting which of those cases with early organic levels will eventually develop dementia, depression or recover.     

北京和重庆市育龄期妇女风疹抗体水平调查

目的了解北京和重庆市育龄期妇女风疹抗体水平,为控制先天性风疹综合征(CRS)提供科学依据。方法2006年6~8月随机抽取北京和重庆市各1个区作为调查点,对20~39岁育龄期妇女623人(北京市311人,重庆市312人)进行血清流行病学调查。结果北京和重庆市育龄期妇女风疹抗体阳性率分别为85.21%和78.53%,自然感染获得抗体阳性率分别为85.08%和77.89%;风疹抗体分布与年龄、地区有关,随着年龄的增长抗体阳性率和几何平均浓度有下降的趋势。结论制定科学的风疹疫苗使用策略和免疫程序,提高育龄期妇女的免疫力,是减少CRS发病的有效手段。     

年龄因素对健康人心率变异性的影响

目的探讨年龄因素对健康人心率变异性（ＨＲＶ）的影响。材料与方法将２３６例健康人分为五个年龄组，使用美国先进医用设备公司５．０版本ＨＲＶ软件做短时时域及频域ＨＲＶ分析。结果年龄因素对健康人ＨＲＶ短时时域和频域分析的多项指标产生显著影响，随着年龄增大，时域指标中的ＨＲＳＤ、ＳＤＡＮＮ、ｒＭＳＳＤ及ＰＮＮ５０均逐渐降低；随着年龄增长，频域指标中各频段下的绝对面积，即：ＶＬＦ、ＬＦ、ＭＦ及ＨＦ均逐渐降低；而频域指标中各频段下的相对面积，即：ＶＬＦＰ、ＬＦＰ、ＭＦＰ、ＨＦＰ随着年龄增长呈不同的发展趋势。ＬＦ／ＨＦ随着年龄的增加而逐渐升高。结论ＨＲＶ随着年龄的增加而下降，尤以迷走神经活性下降为显著。频域指标中各频段的相对面积较绝对面积能更敏感地反映交感、迷走神经张力的消长。     

男性胆囊结石患者血清性激素和前列腺素改变的探讨

借助RIA,对28例胆囊结石男性(平均57.5岁)及26名健康中、老年男性(平均63.3岁)进行了血清雌二醇(E_2)、孕酮、睾酮和前列腺素类(PGs)检测,以探索胆石形成机理。结果,1)在胆石男病人中.平均E_2和平均孕酮水平均高,他们的平均睾酮则低下,与健康对照男性相应诸值比较,差异非常显著或显著(P<0.001,0.05,0.05);2)至于平均PGs,胆石男性组者与健康对照男性相比,前者也相当高(23.01pg/ml对16.31pg/ml),只是两组间差异尚无统计学意义。作者等初步设想,胆石男性小,如同胆石女性那般,本症也可能是某种垂体性腺激素分泌紊乱性疾病。     

Effects of age and chronic renal failure on the urinary excretion kinetics of famotidine in man

Summary The plasma and urine concentrations of famotidine, a new, potent H₂-receptor antagonist, have been measured in 16 healthy young adults, 8 healthy elderly people and 18 patients with varying degrees of renal dysfunction after intravenous administration.Both the plasma elimination and renal excretion of famotidine were decreased in the elderly volunteers and renal patients. The renal clearance of famotidine averaged 4.43 ml/min/kg (310 ml/min) in normal young volunteers, which exceeded the mean creatinine clearance 1.55 ml/min/kg (109 ml/min), suggesting net secretion is a significant mechanism for elimination of famotidine.The ratio of famotidine renal clearance to creatinine clearance decreased as creatinine clearance decreased; these results suggest that the deterioration in the secretion process was much faster than that in glomerular filtration and are incompatible with the intact nephron hypothesis. Nevertheless, both total body clearance and renal clearance were significantly correlated with creatinine clearance.The apparent half-life was also significantly correlated with creatinine clearance. Since famotidine is essentially free of dose-related adverse effects, dose adjustment in patients with mild renal insufficiency and in elderly people is not required; however, either a prolonged dosing interval or a decrease in daily dose during long-term therapy may be adapted for the patients with severe renal insufficiency to avoid accumulation and the potential undesirable effects.     

Evaluation of theophylline pharmacokinetics in a pediatric population using mixed effects models

Routine clinical pharmacokinetic data collected prospectively from pediatric patients receiving theophylline were analyzed using the NONMEM (nonlinear mixed effects model) digital computer program. A total of 314 measured serum theophylline concentrations (STCs) were obtained from 84 hospitalized patients ranging in age from 4 months to 15.2 years with the majority of patients between the ages of 1 and 8 years. Fifty-six percent were male. The race/ethnicity distribution was 71.4% Latin, 15.5% black, 11.9% Caucasian, and 1.2% (one subject) Pakistani. Of the total number of observed STCs, 16.2% reflected some degree of outpatient dosing. The pharmacokinetic model used was a one-compartment open model with either zero-order or first-order absorption and first-order elimination. Age was the most important determinant of theophylline clearance (Cl);weight was inferior to age and did not statistically improve the model (p>0.005when combined with age. Total Clincreased by 10%/year over the age range of 1 to 15 years of age. Black race and male gender were associated with higher Clvalues: for a given age, Clwas 34% higher for blacks than the reference population composed of the remaining patients, and Clfor males was 25% higher than that for females. The volume of distribution (Vdfor the population was estimated to be 0.62 L/kg. The interindividual variability in Cland Vdexpressed as coefficients of variation were 19 and 28%, respectively. The residual intraindividual error variance corresponded to a standard deviation of 2.8 g/ml. The STCs that represented some degree of outpatient dosing were 21 % lower than those reflecting only inpatient dosing. Alternate models that include weight as a determinant of theophylline clearance are also provided. The NONMEM method of determining population pharmacokinetics is well suited to the pediatric population since it does not require a large number of STCs per patient. In this study a mean of only 3.7 STCs per patient were utilized to provide information which should prove useful in the design and adjustment of theophylline dosage regimens in children.     

Assessment of Skin Barrier Function Using Transepidermal Water Loss: Effect of Age

To probe age-related changes in skin barrier function, transepidermal water loss (TEWL) rates have been measured in young (19–42 years) and old (69–85 years) subjects. TEWL was determined at ventral forearm skin sites, which had been occluded for 24 hr with polypropylene chambers. Baseline TEWL rates (J , which showed no dependence on age, were measured for each subject before and after the experiment. Following removal of the occlusive chamber, TEWL was monitored continuously from t = 0.5 min until its return to the baseline (preocclusion) level, which was typically in the range of 2–7 g/m²/hr. Initial TEWL rates (mean ± SD) were found to differ significantly between young (28.6 ± 7.5 g/m²/hr; n = 26) and old (36.9 ± 10.5 g/m²/hr; n = 18) subjects (P < 0.01). Relaxation of TEWL to J was significantly slower in the aged cohort, such that the characteristic time for diffusion of water in the stratum corneum was estimated to be (mean ± SD) 176 ± 59 min for the young subjects, compared to 360 ± 76 min for the old (P < 0.001.). Thus, the initial TEWL value following removal of occlusion is significantly greater, and the excessive stratum corneum hydration produced by occlusion is dissipated more slowly, in old skin than in young. A hypothesis to explain the slower relaxation of perturbed TEWL in old skin is proposed.     

肱骨大结节内骨小梁变化与年龄的关系

目的:观察国人肱骨大结节内骨小梁变化的年龄特征,为应用肱骨大结节内骨小梁的变化进行年龄鉴定提供依据。方法:随机拍摄10~93岁177例汉族人上肢双侧肩部前后位X线片,并对每个性别每个年龄组X线片上肱骨大结节内骨小梁的疏密度、粗细及与骨髓腔的融合情况进行观察。结果:根据观察结果,将肱骨大结节内骨小梁的这些指标的变化分成5期。随着年龄的增长,国人肱骨大结节内骨小梁疏密度、粗细及与骨髓腔融合时间表现出不同的特征。结论:肱骨大结节内骨小梁的变化具有年龄相关性。这为应用其进行年龄鉴定提供了国人的参考依据。     

Birth weight and age at menopause in Australian female twin pairs: exploration of the fetal origin hypothesis

In a twin sample where duration of gestation can be controlled, a specific example of the fetal origins hypothesis concerning association between low birth weight and early age at menopause is explored. The hypothesis is based on the physiologically plausible path from intrauterine growth retardation and reduced numbers of primary follicles to an earlier menopause. The sample comprised 323 Australian female twin pairs where both co-twins had reached menopause naturally and reported on their weight at birth. Regression analysis showed no linear association between the two variables (P = 0.371, r(2) = 0.0009). Intra-pair differences in age at menopause were investigated in the context of relative birth weight of co-twins. In 265 pairs an intra-pair birth weight difference was reported. In monozygotic (MZ) pairs (n = 168) this allowed for control of genetic effects as well as gestation duration. No significant differences dependent on birth weight relative to co-twin were found for age at natural menopause in either MZ or dizygotic (DZ) twin pairs, even in pairs whose birth weights differed markedly. There was some indication that twins with premature ovarian failure were heavier at birth than twins with normal or later menopausal age. We conclude that the hypothesis that lower birth weight is associated with earlier menopause is not supported by our data.     

Age and sex based genetic locus heterogeneity in type 1 diabetes

BACKGROUND: Two genome scans for susceptibility loci for type 1 diabetes using large collections of families have recently been reported. Apart from strong linkage in both studies of the HLA region on chromosome 6p, clear consistent evidence for linkage was not observed at any other loci. One possible explanation for this is a high degree of locus heterogeneity in type 1 diabetes, and we hypothesised that the sex of affected offspring, age of diagnosis, and parental origin of shared alleles may be the bases of heterogeneity at some loci. METHODS: Using data from a genome wide linkage study of 356 affected sib pairs with type 1 diabetes, we performed linkage analyses using parental origin of shared alleles in subgroups based on (1) sex of affected sibs and (2) age of diagnosis. RESULTS: Among the results obtained, we observed that evidence for linkage to IDDM4 on chromosome 11q13 occurred predominantly from opposite sex, rather than same sex sib pairs. At a locus on chromosome 4q, evidence for linkage was observed in sibs where one was diagnosed above the age of 10 years and the other diagnosed below 10 years of age. CONCLUSIONS: We show that heterogeneity tests based on age of diagnosis, sex of affected subject, and parental origin of shared alleles may be helpful in reducing locus heterogeneity in type 1 diabetes. If repeated in other samples, these findings may assist in the mapping of susceptibility loci for type 1 diabetes. Similar analyses can be recommended in other complex diseases.