Multiple pathologies and drug consumption in a group of centenarians from Eastern Sicily

Multiple pathologies are characteristic for the elderly. We evaluated the prevalence of multiple pathologies in 28 randomly selected centenarians living in Eastern Sicily and compared the data with those obtained in another random group of 28 control subjects over 80 years of age. It has been revealed that 25% of the centenarians suffered from 0-3 pathologies, while the remaining 75% displayed more than 3 pathologies. The control subjects had 0-3 pathologies in 50% of over 80 years, while 50% were affected by more than 3 pathologies. In centenarians the most prevalent pathologies involved the sensorial apparatus (sight and hearing), followed by the digestive, urogenital and cardiovascular systems. In the control group the rank of occurrence was as follows: cardiovascular system, osteoarticular and respiratory apparatuses, and sensorium. We compared drug consumption in the two age groups. In the centenarians, 71.43% took 0-3 drugs, while 28.57% took more than 3 drugs. In the control group, 53.57% took 0-3 drugs, whereas 46.43% took more than 3 drugs.     

Sense of smell in centenarians from Eastern Sicily

The sense of smell was studied in a group of centenarians from Eastern Sicily, displaying a mini mental state examination score larger than 19. Analysis of the data demonstrated that centenarians retain the capacity to perceive olfactory stimuli. However, as compared to the results obtained in groups of young and elderly subjects, a statistically significant quantitative reduction (p < 0.001) in the sense of smell was revealed in the centenarians.     

Chitosan supplementation does not affect fat absorption in healthy males fed a high-fat diet, a pilot study.

BACKGROUND: The use of dietary supplements, especially those for weight control, is increasing. Advertising claims for some of these supplements may give consumers unrealistic expectations. For example, it is claimed that the supplement chitosan can block the absorption of up to 120 g of dietary fat per day. OBJECTIVE: To test the effect of a chitosan supplement used as directed, on the absorption of dietary fat. DESIGN: Seven healthy male volunteers with average age 28, range 23-30, average body mass index (BMI) 26, range 23-31, maintained a high fat intake (>120 g/day) for 12 days. On days 6-9, chitosan was taken as directed by the manufacturer prior to meals and snacks and totaled 15 capsules or 5.25 g of chitosan daily. A charcoal marker was consumed on days 2, 6 and 10 to mark the baseline and supplement periods. All feces were collected on days 2-12, and were divided based on the appearance of charcoal in the feces. Fecal fat content corresponding to the four baseline and four chitosan-supplemented days was measured. RESULTS: Average dietary fat intake did not differ between baseline (135+/-5 g), and chitosan (135+/-3 g) periods. Fecal fat excretion did not differ between the two periods (6.9+/-1.0 g/day baseline; 6.8+/-0.4 g/day chitosan). The fecal fat content as a percentage of fat consumed did not differ (5.1+/-0.7% baseline, 5.0+/-0.3% chitosan). Fecal mass did not differ (176+/-26 g/day baseline, 182+/-14 g/day chitosan). CONCLUSION: Consumption of this chitosan supplement did not increase fecal fat content and therefore did not block fat absorption.     

Quality of life and longevity: a study of centenarians

OBJECTIVE: Interest in centenarians has focused on two particular aspects: the antecedents of extreme old age and the psychophysical well-being of the very old. Our study deals with the latter aspect and aims to assess the quality of life of Italian centenarians. METHOD: Using data collected using two questionnaires designed to investigate quality of life in elderly people, three groups of 38 elderly subjects were compared: centenarians and subjects aged between 75 and 85 years and 86 and 99 years. RESULTS: The centenarians complained less spontaneously about their health (maintained in part by medical treatments), but declared having greater functional disability. Their cognitive function appears to be reasonably well preserved and they have lower scores for anxiety and depression than the subjects in the two younger groups. They consider themselves religious, satisfied with their financial situation but no longer interested in sex or involved in recreational activities. They report greater satisfaction with life and with social and family relations than do less elderly individuals. CONCLUSIONS: The centenarians we interviewed seem to be well adapted to their lives and to maintain a more positive attitude than the subjects in the two younger groups.     

Hypertension in a group of centenarians

The aim of the present study was to evaluate the frequency of hypertension in a group of extremely old persons: 73 centenarians resident in Calabria were studied, aged 100-110 years, (mean age 102.95 +/- 2.0), 54 women (73.9%) and 19 men (26.1%), in the period January 1st and April 30th, 1994. All the centenarians were visited at their homes. Hypertensive centenarians were 14 (19.1%), women 12 (85.7%) and men 2 (14.3%). Even if blood pressure progressively increases with age, we have not found it in centenarians. The lesser frequency of hypertension in centenarians certainly depends on genetic and constitutional factors, but also their way of life and alimentary habits (decreased sodium intake, increase of calcium and potassium intake), as we have proven in a recent work, could be determinant. Moreover, the presence of hypertensive centenarians might mean that hypertension does not prevent to reach an age by far above the average, if it is the only risk factor.     

Healthy centenarians do not exist, but autonomous centenarians do: a population-based study of morbidity among Danish centenarians

OBJECTIVE: To assess the prevalence of common illnesses in an unselected population of centenarians. DESIGN: A population-based survey. SETTING: Denmark. PARTICIPANTS: All Danes who celebrated their 100th anniversary between April 1, 1995 and May 31, 1996: 276 persons. MEASUREMENTS: All participants (including proxies) were visited at their domicile for an interview (sociodemographic characteristics, activities of daily living, living conditions, need of assistance from other people, former health and current diseases, current medication) and a clinical examination (dementia screening test, heart and lung auscultation, neurological assessment, height and weight, electrocardiogram, arm and ankle blood pressure, assessment of hearing and vision capacity, a short physical performance test, bio-impedance, lung function test, blood test). Further health information was retrieved from medical files and national health registers. RESULTS: Seventy-five percent (207) of eligible subjects participated in the study. Cardiovascular disease was present in 149 (72%) subjects. Osteoarthritis (major joints) was present in 54%, hypertension (> or =140/ > or =90) in 52%, dementia in 51%, and ischemic heart disease in 28%. The mean number of illness was 4.3 (standard deviation (SD) 1.86). Only one subject was identified as being free from any chronic condition or illness. Sixty percent had been treated for illness with high mortality. In 25 autonomous (nondemented, functioning well physically, living at home) and 182 nonautonomous centenarians, comorbidities were equivalent. CONCLUSION: Because they have a high prevalence of several common diseases and chronic conditions, Danish centenarians are not healthy. However, a minor proportion was identified as being cognitively intact and functioning well.     

Functional evaluation of a group of centenarians in Eastern Sicily by means of the activity of daily living scale

A random sample of 28 centenarians was studied (32.56% of all centenarians in Eastern Sicily) within the framework of the Italian Multicenter Study on Centenarians. The activity of daily living (ADL) scale was applied to evaluate their capacity to perform everyday tasks autonomously. The study sample consisted of 8 males (28.57%) and 20 females (71.43%), overall mean age was 102.57 +/- 2.1 years. The patients fell into 3 groups according to their ADL scores independent group (with score A) 5 persons, 17.86% (2 males and 3 females); partially independent group (with scores B and C) 5 persons, 17.86% (1 male and 4 females); dependent group (with scores D-E-F-G and other) 18 persons, 64.29% (5 males and 13 females). We compared the results with a control study sample of 28 elderly patients (8 males, 20 females) over 85 years of age resident in a small village in Eastern Sicily (Graniti) and observed that the centenarians presented greater independence, especially the women.     

Multidimensional evaluation in a group of centenarians

A group of 40 Calabrian centenarians (12 males, 28 females) was studied from June 1 to December 31, 1993. Their age was ranging from 100 to 107 years (mean age: 102.3 +/- 1.8 years). Clinical evaluation was performed by recording anamnestic data, an objective examination, and by assessing cognitive performance, emotional and nutritional status, as well as functional activity. The following tests were applied: mini mental state examination (MMSE), geriatric depression scale (CDS), activity of daily living (ADL), and instrumental activity of daily living (IADL). The nutritional status was estimated by collecting answers to a questionnaire regarding nutritional habits and by measuring body weight, height and calculating body mass index (BMI). In assessment of the socio-economic conditions, the following parameters were considered: years of education, type of job, type of residence ownership, heating system used, toilet set available and the regular income. Our multidimensional evaluation has revealed, in agreement with other findings, that the Calabrian centenarians seem to be a selected population with an amazingly high activity, who overcame severe age-dependent diseases, probably because of their genetic pattern and of the environmental factors which may favor longevity.     

我国长寿地区百岁老人慢性肾脏病的流行病学调查

目的 探讨我国长寿地区百岁老人慢性肾脏病(CKD)的患病情况及相关危险因素.方法 选取7个中国长寿之乡的所有百岁老人,以及在该地区按百岁老人编码尾数随机选取的40～、60～、80～和90～岁人群为研究对象,进行CKD及相关危险因素的问卷调查、体格检查和血尿检测,采用非条件Logistic回归分析CKD的影响因素.结果 在资料完整的363名百岁老人中,CKD患病率为50.41%(95%CI 45.27%～55.56%),女性患病率高于男性;各年龄组间比较,女性CKD患病率都随年龄增加而升高,而男性的CKD患病率随年龄增加先升高后下降.多因素Logistics回归提示高尿酸血症、高TG、女性、贫血、增龄和高血压为CKD的危险因素.结论 我国长寿地区百岁老人CKD患病率为50.41%,CKD的危险因素为高尿酸血症、高TG、女性、贫血、增年和高血压.     

Exceptional longevity does not result in excessive levels of disability

Late-life loss of independence in daily living is a central concern for the aging individual and for society. The implications of increased survival to advanced age may be different at the population level than at the individual level. Here we used a longitudinal multi-assessment survey of the entire Danish 1905 cohort from 1998 to 2005 to assess the loss of physical and cognitive independence in the age range of 92 to 100 years. Multiple functional outcomes were studied, including independence, which was defined as being able to perform basic activities of daily living without assistance from other persons and having a MiniMental State Examination (MMSE) score of 23 or higher. In the aggregate, the 1905 cohort had only a modest decline in the proportion of independent individuals at the 4 assessments between age 92 and 100 years: 39%, 36%, 32%, and 33%, with a difference between first and last assessment of 6% [95% confidence interval (CI), −1–14%]. For participants who survived until 2005, however, the prevalence of independence was reduced by more than a factor of 2, from 70% in 1998 to 33% in 2005 (difference, 37%; 95% CI, 28–46%). Similar results were obtained for the other functional outcomes. Analyses of missing data resulting from nonresponse and death suggest that the discrepancy between the population trajectory and the individual trajectory is caused by increased mortality among dependent individuals. For the individual, long life brings an increasing risk of loss of independence. For society, mortality reductions are not expected to result in exceptional levels of disability in cohorts of the very old.     

Yohimbine does not affect fat distribution in men

Forty-seven men with a mean age of 42 years were assigned in random, double-blind fashion to treatment with either placebo or high-dose yohimbine (peak dose, 43 mg/day). Thirty-three subjects completed the six-month program. Variables assessed throughout the study included: body weight and body mass index; total cholesterol and HDL; body fat; and fat distribution as measured both by waist-to-hip ratio and by CT scan. Treatment with yohimbine had no effect on any variable in comparison with the control group.     

Heat shock response by EBV-immortalized B-lymphocytes from centenarians and control subjects: a model to study the relevance of stress response in longevity

'Successful aging', i.e. the ability to attain old age in relatively good health, is believed to be related to the capability to cope with different environmental stresses. Independently of their specific differentiation, all body cells respond to hyperthermia and other stresses with the production of Heat Shock Proteins (HSPs) that play an important role in cell survival. We investigated the heat shock response in B-lymphoid cell lines from 44 centenarians and 23 younger subjects, by studying both HSP70 synthesis and cell survival after hyperthermic treatment. Interestingly, no significant difference could be found between the two age groups as far as HSP70 synthesis was concerned; moreover, cell lines from centenarians appeared to be less prone to heat-induced apoptosis than lines from younger controls. These results, which are in contrast with previous findings showing an age-related decrease of the HSP70 synthesis and of hyperthermic response, corroborate the above mentioned hypothesis that the biological success of centenarians is due to the preservation of the capability to cope with stresses. An A/C polymorphism identified in the promoter region of HSP70-1 gene had been previously shown to affect the probability to attain longevity in females. To investigate if this effect was related to any influence of this polymorphism on HSP70 protein synthesis the correlation between A/C polymorphism and protein synthesis was investigated. We found that cells from AA centenarian females displayed a lower synthesis of HSP70.     

Association between longevity and cytokine gene polymorphisms. A study in Sardinian centenarians

BACKGROUND AND AIMS: Human longevity seems to be directly correlated with optimal functioning of the immune system, suggesting that some genetic determinants of longevity reside in those polymorphisms for the immune system genes which regulate immune-inflammatory responses, in particular cytokine gene polymorphisms. The frequency of -174C single nucleotide polymorphism (SNP) in the promoter region of the interleukin (IL)-6 gene is increased in Italian male centenarians. Moreover, the frequency of -1082G SNP at the 5' flanking region of the IL-10 gene coding sequence is increased among male centenarians, and that of +874A SNP at the interferon (IFN)-gamma gene was found more frequently in female centenarians. These findings indicate that different alleles at different cytokine gene codings for pro- (IL-6, IFN-gamma) or anti-inflammatory (IL-10) cytokines may affect the individual life-span expectancy, influencing the type and intensity of immune-inflammatory responses against environmental stressors. METHODS: In the present study, we analyzed these IL-6, IL-10 and IFN-gamma gene polymorphisms in 112 (36 male, 76 female) centenarians from the island of Sardinia, whose population shows a genetic background quite different from that of mainland Italy, as well as in 137 sixty-year-old controls from the same geographic area. RESULTS: No significant differences were observed on analyzing IL-6, IL-10 and IFN-gamma polymorphism frequencies among centenarians and controls, either on the whole and when the data were analyzed according to gender. CONCLUSIONS: These data indicate that gene polymorphisms of cytokines playing a major regulatory role in the inflammatory response do not affect life expectancy in the Sardinian population. Thus, cytokine/longevity associations have a population-specific component, being affected by the population-specific gene pool as well as by gene-environment interactions, behaving as survival rather than longevity genes.     

Laboratory blood parameters in a group of centenarians

Several laboratory blood parameters in a group of healthy centenarians (7 males and 15 females) living in Eastern Sicily were studied and compared with those recorded in a group of healthy elderly subjects (5 males and 12 females) from 80 to 87 years of age. Almost all the laboratory test parameters analyzed were within the range considered to be normal for adult subjects. The exceptions were some renal function markers such as azotemia and creatinine, which were higher in the centenarians, and total cholesterol levels, which were significantly lower in the male centenarians as compared to the elderly male subjects. The conclusion is drawn, therefore, that laboratory tests reflect the health conditions rather than the age of an individual.     

Undiagnosed coeliac disease does not appear to be associated with unfavourable outcome of pregnancy

BACKGROUND: In a previous hospital based study, we suggested that undiagnosed coeliac disease has a prevalence, among pregnant women, of 1:80, and is a cause of unfavourable outcome of pregnancy. AIMS: In order to confirm or dismiss this hypothesis, which has significant public health implications, we carried out a large population based study on a stratified sample from the whole Campania region. PATIENTS: During the period of the study, 5345 women were admitted to the OBS-GYN wards regional network: 5055 (95%) were enrolled in the study. METHODS: Antihuman IgA class antitissue transglutaminase (TGASE) antibodies were tested by an ELISA method. Endomysial antibodies (EMA) were investigated on thin sections of human cord blood by an immunofluorescence test. The HLA class II DQA1*0501/DQB1*02 and DQA1*0301/DQB1*0302 haplotypes were assessed using the Eurospital Eu-DQ kit. Duodenal biopsy was not considered feasible by the ethics committee for pregnant women near delivery. RESULTS: Fifty one of 5055 patients had confirmed positive results. We added to these 12 women with known coeliac disease, giving a prevalence rate for coeliac disease of 1:80 (exactly the value observed during the first study). Comparing the 51 TGASE positive with 4997 negative women, we did not observe an excess risk of abortion, premature delivery, small birth weight, or intrauterine growth retardation. Anaemia was more frequent in cases than controls. CONCLUSIONS: Undiagnosed coeliac disease is frequent among pregnant women (>1%) but is not associated with an unfavourable outcome of pregnancy.     

Uric acid does not affect the prevalence and extent of coronary artery disease. Results from a prospective study

BackgroundHyperuricemia may be involved in the atherosclerotic process due to endothelial dysfunction and facilitation of smooth muscle cell proliferation. However, debates still exist on the independent role of hyperuricemia, due to its association with several cardiovascular risk factors, such as hypertension, hyperlipidemia, obesity and insulin resistance. Thus, the aim of the current study was to investigate in a consecutive cohort of patients undergoing coronary angiography whether hyperuricemia is associated with the extent of coronary artery disease.Methods and ResultsOur population is represented by a total of 1901 consecutive patients undergoing coronary angiography between May 2007 and January 2010 at the Azienda Ospedaliera “Maggiore della Carità”, Novara, Italy. We additionally evaluated platelet aggregation by PFA-100 (Collagen/Epinefrine) and Multiplate. Quantitative coronary angiography and analysis of IMT were performed by experienced cardiologists who had no knowledge of the patients’ clinical information. Higher uric acid was associated with advanced age, larger prevalence of male gender, diabetes, renal insufficiency, hypertension, previous CABG and MI, but with a lower prevalence of family history of CAD. Patients with high uric acid were more often on calcium antagonists, ace-inhibitors, angiotensin receptor antagonists, and, as expected, on diuretics. A significant relationship was observed between uric acid and the prevalence (OR [95% CI] = 1.18 [1.04–1.32], p = 0.01) and severity of CAD (OR [95% CI] = 1.17 [1.03–1.33], p = 0.014). However, the relationship disappeared after correction for baseline confounding factors for both prevalence (OR [95% CI] = 1.06 [0.93–1.21], p = 0.35) and extent of CAD (OR [95% CI] = 1.0 [0.87–1.15], p = 0.96). No relationship was observed between acid uric and IMT (p = 0.73) analyzed in 359 consecutive patients. Finally, there was no relationship between uric acid and platelet aggregation in patients with or without aspirin therapy, as measured by PFA-100 and Multiplate.ConclusionsOur study showed that uric acid is not associated with platelet aggregation, the extent of coronary artery disease and IMT. Thus, waiting for the results of additional large studies, uric acid may not be considered as a risk factor for coronary artery disease, and its reduction by specific therapies may not be recommended to prevent coronary artery disease and atherosclerosis.