Elva Dolores Arias-Merino

Physical function and associated factors in community-dwelling elderly people in Jalisco, Mexico

PURPOSE To determine the prevalence of disability in Basic Activities of Daily Living and Instrumental Activities of Daily Living (ADL and IADL, respectively), as well as associated factors in the Mexican community-dwelling elderly population. MATERIALS AND METHODS This is a cross-sectional study of a population 60 years and older who live in the State of Jalisco (Mexico). A total of 2553 persons were assessed regarding their functional and health conditions. The ADL and IADL were classified as dependent and non-dependent, and crude and adjusted Odds Ratio (OR) were calculated. RESULTS Mean age of participants was 71.6±8.7, 61.2% were women. A disability prevalence of 9.6% was found to perform ADL and of 31.5% for the IADL, 14.3% had cognitive impairment and 30.9% depression. Risk factors were found for dependence: being a woman, being ≥75 years old, low education level, having at least one chronic disease, cognitive impairment, depression, previous history of disability, and having been a lifelong housewife. CONCLUSIONS Functional difficulties are common in Mexican elderly population. These data show key variables for functional disability risk. A better understanding of functional capabilities, as well as of risk factors older adults face every day provide us with a guide to devise a prevention plan, to implement adequate interventions, or to provide appropriate care.

Detection of membrane fluidity in submitochondrial particles of platelets and erythrocyte membranes from Mexican patients with Alzheimer disease by intramolecular excimer formation of 1,3 dipyrenylpropane

It has been suggested that mitochondrial dysfunction and defects in membrane structure could be implied in AD pathogenesis. The aim of the present work was the study of membrane fluidity in submitochondrial platelet particles and erythrocyte membranes from Mexican patients. Blood samples were obtained from 30 patients with Alzheimer disease and 30 aged-matched control subjects. Membrane fluidity determinations were done using a very low concentration of the fluorescent dipyrenylpropane probe incorporated in both types of membranes. This probe is able to give excimer and monomer fluorescence, therefore it can be used to monitor fluidity changes in biological membranes. The data obtained showed that in submitochondrial particles from AD patients, the excimer to monomer fluorescent intensity ratio was lower (0.231 ± 0.008) than aged-matched control subjects (0.363 ± 0.014). Therefore, membrane fluidity was lower in AD samples. On the other hand, we found similar membrane fluidity in erythrocytes from AD patients and aged-matched controls: the fluorescent intensity ratios were 0.312 ± 0.03 and 0.305 ± 0.033, respectively. In addition, lipid peroxidation in submitochondrial particles and erythrocyte membranes was higher in AD samples than in aged-matched controls. These data suggest that submitochondrial platelet particles are more sensitive to oxidative stress than erythrocyte membranes.

Impact of participatory education on body mass index and blood glucose in obese type-2 diabetics

Exogenous obesity increases morbidity and mortality risk and has been associated with nutritional habits, which in turn can be affected by health education. Health education aims to promote patient participation in achieving behavior change and healthy lifestyles. The objective of this study is to show the advantages of participatory education in the modification of body mass index (BMI) in obese type-2 diabetics. A quasi-experimental study was performed with random allocation of two patient groups. The educational intervention was organized through a reflection-action process. BMI was measured at baseline and then monthly for 9 months during the intervention. The groups were analyzed by age and sex. Statistical analysis used the Student t test, with the mean difference for related groups. The control group showed a mean BMI of 33.89 + 1.96 and a final BMI of 33.2 +/- 2.15 (t:22.4; p:0.16). The experimental group had an initial value of 33.63 +/- 2.12 and a final BMI of 31.54 +/- 1.71; statistical difference: (t:11.55; p:0.003). The participatory educational intervention thus helped improve the BMI in obese type-2 diabetics.

Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60.

I am active: effects of a program to promote active aging.

Background Active aging involves a general lifestyle strategy that allows preservation of both physical and mental health during the aging process. “I am Active” is a program designed to promote active aging by increased physical activity, healthy nutritional habits, and cognitive functioning. The purpose of this study was to assess the effectiveness of this program. Methods Sixty-four healthy adults aged 60 years or older were recruited from senior centers and randomly allocated to an experimental group (n=31) or a control group (n=33). Baseline, post-test, and 6-month follow-up assessments were performed after the theoretical–practical intervention. Effect sizes were calculated. Results At the conclusion of the program, the experimental group showed significant improvement compared with the control group in the following domains: physical activity (falls risk, balance, flexibility, self-efficacy), nutrition (self-efficacy and nutritional status), cognitive performance (processing speed and self-efficacy), and quality of life (general, health and functionality, social and economic status). Although some declines were reported, improvements at follow-up remained in self-efficacy for physical activity, self-efficacy for nutrition, and processing speed, and participants had better nutritional status and quality of life overall. Conclusion Our findings show that this program promotes improvements in domains of active aging, mainly in self-efficacy beliefs as well as in quality of life in healthy elders.

Prevalence of Successful Aging in the Elderly in Western Mexico

Objectives. The aim of this paper is to estimate the prevalence of successful aging in the elderly in Western Mexico and to analyze its variability by age, sex, education, marital status, and pension. Methods. This study employs data from the Health, Wellbeing, and Aging Study (SABE) in Jalisco and Colima, Mexico. Successful aging was operationalized in accordance with no important disease, no disability, physical functioning, cognitive functioning, and being actively. There were a total of 3116 elderly. Results. 12.6% of older adults were “successful” aging. The old-old is a lower proportion of successful aging people; it ranges from 18.9% among people aged 60–69 years to 3.9% in the 80–89 years and up to 1% in people 90 and older. There were also differences according to sex (P = .000), with a higher proportion of successful aging men (18.4% compared with 9.2% of women). There were differences in educational level (P = .000); those higher with education were found to be more successful aging, and also there were differences in marital status for married people (P = .000). Discussion. A small number of older adults meet the criteria definition of successful aging, suggesting the need to analyze in depth the concept and the indicators.

Prevalence of Dementia, Emotional State and Physical Performance among Older Adults in the Metropolitan Area of Guadalajara, Jalisco, Mexico

Background. Dementia affects memory, thinking, language, judgment, and behavior. Depression, is common in older adults with dementia. The concomitance of dementia and depression increases disability with impaired activities of daily living (ADL), increasing the chances of institutionalization and mortality. Methods. Cross-sectional study of a population 60 years and older who live in the State of Jalisco, Mexico. A total of 1142 persons were assessed regarding their cognitive function, emotional state, and physical performance. Door-to-door interview technique was assigned in condition with multistage probability random sampling. Cognitive function, depression and functional disability were assessed by applying standardized Minimental State Examination (Folstein), Geriatric Depression Scale, and the Katz index, respectively. Diagnosis of dementia was performed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, the Fourth Edition. Data were analyzed using SPSS software. Results. Prevalence of demency was 9.5% (63.35% women, and 36.7% men). Demency was associated with being woman, being older than 70 years, low level of education, not having the economic benefit of retirement, being single or living without a partner, low level of education, suffering from depression and have functional disability in ADL. Conclusion. Dementia is more common in women and is related to depression and disability.

Altered β-amyloid precursor protein isoforms in Mexican Alzheimer's Disease patients

Objective: To determine the β-amyloid precursor protein (βAPP) isoforms ratio as a risk factor for Alzheimer’s Disease and to assess its relationship with demographic and genetic variables of the disease. Methods: Blood samples from 26 patients fulfilling NINCDS-ADRDA diagnostic criteria for AD and 46 healthy control subjects were collected for Western blotting for βAPP. A ratio of βAPP isoforms, in optical densities, between the upper band (130 Kd) and the lower bands (106–110 Kd) was obtained. Odds ratios were obtained to determine risk factor of this component. Results: βAPP ratio on AD subjects was lower than that of control subjects: 0.3662 ± 0.1891 vs. 0.6769 ± 0.1021 (mean ± SD, p<0.05). A low βAPP ratio (<0.6) showed an OR of 4.63 (95% CI 1.45 ± 15.33). When onset of disease was taken into account, a βAPP ratio on EOAD subjects of 0.3965 ± 0.1916 was found vs. 0.3445 ± 0.1965 on LOAD subjects (p>0.05). Conclusions: Altered βAPP isoforms is a high risk factor for Alzheimer’s disease, although it has no influence on the time of onset of the disease.

Cross-Cultural Differences in Adjustment to Aging: A Comparison Between Mexico and Portugal

Objective: To compare Adjustment to Aging (AtA) and Satisfaction with Life in a Mexican and a Portuguese older sample. Method: A total of 723 (n = 340 Mexican and n = 383 Portuguese) older adults were included and assessed with the AtA Scale (ATAS) and the Satisfaction with Life Scale (SWL). Informed consent was obtained from all participants. Portuguese participants were significantly older than Mexicans (mean age 85.19 and 71.36 years old, respectively) and showed higher education level (p < .001). No significant differences on gender and marital status were found. Results: Mexicans considered all aspects of AtA absolutely more important than their Portuguese counterparts (p < .001). For Mexicans, being cherished by their family (82.1%), being healthy, without pain or disease (75.9%), having spiritual religious and existential values (75%) and having fun and laughter (75%) were the most important for AtA, compared to having curiosity and an interest in learning (22.5%), creating and being creative (20.1%) and leaving a mark and seed for the future (18.0%) for Portuguese participants. Mexicans also reported a higher SWL than Portuguese participants. Mean scores were 6.10 (SD = 0.76) and 3.66 (SD = 1.47) respectively (p < .001). AtA and SWL were correlated in the Mexican sample (p = .001), but not in the Portuguese (p = .100). Discussion: Differences on AtA between Mexican and Portuguese older adults should be explained considering their cultural and social context, and their socio-demographic characteristics. The enhancement of AtA, and its relevance to improve well-being and longevity can become a significant resource or health care interventions.

P4-187: Membrane fluidity in platelets and erythrocite of Mexican patients with probable Alzheimer's disease using an intramolecular excimer formation of 1,3 dipyrenylpropane

hypomorphic mice began to die showing symptoms of arteriosclerosis, osteoporosis, increased serum calcium and phosphorous, and cognitive decline. Overexpression of Klotho induced resistance to oxidative stress likely due to the inhibition of the insulin/IGF-1 pathway known to extend lifespan. Klotho is a type I transmembrane protein with homology to the -glucosidase family of sugar modifying enzymes. It is a hormone secreted into the serum by kidney, and into the CSF by the choroid plexus to affect systems throughout the body. We have shown that Klotho is decreased in the brain with aging in non-human primates and rodents and hypothesized that increasing Klotho levels would be protective against both normal and pathological age-related changes in the brain. Methods: We used standard methods to generate stable cell lines in HEK293 and sheep choroid plexus cells driving firefly luciferase expression. We likewise utilize transient transfection, luciferase assays, promoter trapping assays, western blotting, and MALDI-TOF mass spectrometry. Results: We generated stable cell lines expressing 1800 bp upstream of the human Klotho start codon driving transcription of firefly luciferase. Basal levels of luciferase were decreased upon incubation with hydrogen peroxide and increased with insulin or Vitamin D. A library of small molecules is being screened to identify those able to increase Klotho gene expression. We similarly generated a series of promoter sequences driving firefly luciferase gene expression (1800, 900, 800, 700, 600, 500bp). We are determining the critical elements and regions of the promoter for the transcription of Klotho. Using the promoter trapping technique we identified SP1 binding to the promoter region and are further probing to isolate transcription factors essential for Klotho gene regulation. Conclusions: By targeting Klotho gene regulation at the level of transcription we may be able to induce therapeutic effects in the brain to protect against aging-related cognitive decline and ameliorate devastating effects of progressive neurodegenerative diseases such as Alzheimer’s disease.