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Hypertension
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
Degenerative medial changes to the aorta and large predominantly elastic arteries are discussed in Chapter 15. These are most marked in hypertensive people at any age and are attributable to the fatiguing effects of cyclic stress (Prokop et al., 1970; Gent, 1972; Sandor, 1972; O'Rourke, 1976, 1982b; Kaplan, 1994). These changes can be considered as accelerated aging. As with aging, they are not apparent in the peripheral, predominantly muscular arteries (Hayoz et al., 1992). The most extreme form of medial degeneration is cystic medial necrosis, where there is breakdown of elastin and collagen fibers in the aortic wall and collection of hyaline mucoid material. This is the basic cause of dissecting aortic aneurysm (Isselbacher, 2001) and is most common in elderly hypertensive subjects and in people with an inherited defect of elastin fibers (such as Marfan syndrome, see Chapter 20).
Adherence and the Elderly
Published in Lynn B. Myers, Kenny Midence, Adherence to Treatment in Medical Conditions, 2020
James C. McElnay, C. Rosaleen McCallion
Ageing has been defined “… as a process that converts healthy adults into frail ones, with diminished reserves in most physiological systems and an exponentially increasing vulnerability to most diseases and death” (Miller, 1994). It is difficult to distinguish between what constitutes natural ageing and what constitutes accelerated ageing due to disease processes among elderly patients. Cross-sectional studies, comparing findings in elderly people with those in younger people, have helped to highlight changes associated with the ageing process. In certain organs, such as the kidneys, a subgroup of people appear to experience a gradual decline in function over time, roughly a 1% loss in function per year starting around the age of 30, while in others function remains constant well into old age (Kane et al., 1994). Such changes will obviously have a profound effect on drugs which are dependent on the kidney for elimination. Age-related changes in the eye including decreased pupil size and growth of the lens leads to decreased accommodation, acuity, colour sensitivity and depth of perception (Kane et al., 1994) which can lead to difficulties for elderly people in distinguishing between tablets which look similar.
Premature Aging
Published in Nate F. Cardarelli, The Thymus in Health and Senescence, 2019
In 1886 Hutchinson described an unusual patient, a boy 3 1/2 years of age; bald, lacking nipples, very thin skin, and unusual facies.1 A second case was observed by Gilford in 1897.2 Symptoms were similar — a striking appearance of old age in a young child. Later, Gilford coined the term progeria for such cases. The term has come to mean either premature aging or accelerated aging. Both definitions are incorrect, as we shall see. It is also neutrally termed the “Hutchinson-Gilford Syndrome”. Both physicians believed that what they were seeing was new and unique. Actually even a cursory glance at the older literature indicates knowledge of individuals with a similar condition.3–5
Understanding the Role of Virtual Outreach and Programming for LGBT Individuals in Later Life
Published in Journal of Gerontological Social Work, 2022
Anyah Prasad, Michael Immel, Alice Fisher, Timothy M Hale, Kamal Jethwani, Amanda J Centi, Bob Linscott, Kathrin Boerner
We chose the focus group discussion as a format to engage research participants. Focus group discussions are ideal when participants have something in common, and all have a stake in the issue being discussed (Barbour & Morgan, 2017). Participants can bounce off ideas from one another, diversify opinions, and flesh out the issue more comprehensively. We organized five focus groups across Massachusetts: one in an urban center, one in a more rural area, and one each with transgender, bisexual, and people of color (POC) subgroups. The urban and rural groups were open to everybody, and the three subgroups were held in urban areas. The urban group had participation from POC and bisexual individuals; the rural group included bisexual and transgender individuals. State residents aged 50 or older and who self-identified as LGBT were eligible to participate in the study. We chose age 50 instead of 65 as the inclusion criteria because thinking about and planning for aging may start much earlier than retirement. Besides, the risk of poor health appears at an earlier age for LGBT individuals than their heterosexual and cisgender peers (Boehmer et al., 2014). The literature also describes experiences of accelerated aging in the LGBT community (Correro & Nielson, 2020). Each focus group had 6–8 participants. The research team included members from the community, community advocacy group, state university, and a regional health conglomerate. The institutional review boards at the university and health conglomerate approved the study protocols and waived the need for written consent to ensure anonymity.
Ageing with neuromuscular disease: getting lost in transitions
Published in Disability and Rehabilitation, 2022
Louise Abildgaard Møller, Bente Martinsen, Ulla Werlauff, Pia Dreyer
In addition to normal physiological ageing, people ageing with physical disability experience secondary complications and accelerated impairments [11]. The forms of functional decline associated with the normal process of ageing may overlap with NMD-induced disability, resulting in physical tasks being even more demanding. Additionally, the risk of comorbidity increases with age, adding to the complexity and costs related to healthcare needs [12]. Furthermore, persons ageing with chronic mobility disability are at risk of developing a number of related secondary conditions and experience decline in physical functioning that mirrors normative age-related changes but occur more rapidly, resulting in a phenomenon called “accelerated ageing” [11,13,14]. Thus, as people with NMD grow older, bodily changes caused by NMD may be hard to discern from normal age-related changes, e.g. sarcopenia [10]. As a result, of accelerated ageing, age-related changes may appear at an early point in adulthood, complicating the separation of age-related changes from disease progression. Both the progressiveness of NMD and ageing per se lead to an insidious course of weakness [15] and possibly influence the experience of transitioning to ageing life with NMD.
Should drug discovery scientists still embrace the amyloid hypothesis for Alzheimer’s disease or should they be looking elsewhere?
Published in Expert Opinion on Drug Discovery, 2020
Bruno Pietro Imbimbo, Stefania Ippati, Mark Watling
Aging is the leading risk factor for AD. Compounds that treat fundamental biological mechanisms of aging (senolytic drugs) have been proposed to treat chronic diseases of aging [44]. Aging biology provides numerous novel targets for new drug development for AD (Figure 2). Because of the multifaceted nature of biological aging, combination therapeutic approaches appear a rational approach and repurposing drugs already on the market represents another logical and expeditious strategy for developing new therapies for AD. However, novel compounds for new and relevant biological targets will clearly also be needed. Due to the abundance of misfolded proteins that accumulate in the brain with aging, drugs that enhance autophagy and clearance of these misfolded proteins represent a very attractive target as they may be effective in multiple pathologies. Promising approaches are also those modulating the neuroimmune or microglial response in AD. Finally, approaches antagonizing accelerated aging processes are theoretically very attractive (Table 2). Genetic studies using large databases are leading to more individualized risk prediction for cognitive decline and AD, and have identified novel targets for possible treatment, especially in the innate immune pathways.