Understanding Osteoporosis: Pathophysiology, Risk Factors, Diagnosis, and Management

Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.

Strengthening Active Aging through Older People’s Association and Economic Activity of the Older People in Nepal

Aging is a natural lifelong process ending in death. Many older people are living in poverty. Older people are generally considered dependent on others as they grow older. The purpose of this article is to explore the entrepreneurship activities of Nepalese older adults. Data for this study were collected from the project Help Age International (HAI) implemented in Nepal. Qualitative data observations and interviews were used to collect data. The findings of this study show the formation of the Older People’s Association (OPA) has supported many older people to participate outside the home in various social activities. Moreover, regular deposits through OPAs offer little help. OPAs support older people in their need of financial support to implement minor entrepreneurship. Older people who received support were pleased and were actively involved in their activities and also regularly deposited money in them. Subsequently, older people’s participation in social activities has increased and also helped to lower elderly abuse, loneliness, and depression. Local governments should promote such activities which will help with healthy aging.

The Experience and Impact of a Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Older Adults Experiencing Cognitive Decline

Objectives: This study aimed to understand the experience and impact of a physical activity and sleep wrist-worn tracker (Fitbit)-based healthy lifestyle intervention for older patients attending a memory assessment service, who are experiencing cognitive impairment but do not receive a dementia diagnosis. Methods: A qualitative design was employed. Semi-structured interviews were conducted with a purposeful sample of thirteen participants recruited from a memory assessment service. Thematic analysis, that was data driven and inductive, was undertaken to analyse the data. Results: Two global themes were developed. “Understanding exercise and sleep as part of my lifestyle” was made up of themes representing how participants viewed exercise and sleep as part of their lifestyles in terms of acknowledging the positive impacts and the barriers to exercise and sleep. The second global theme “Understanding my experience of the healthy lifestyle intervention” was made up of themes that identified the positive impact of the intervention regarding improving health and wellbeing, enabling validation of proactive behaviours and motivation to engage in healthy lifestyle behaviours, so promoting positive behaviour change. Conclusion: Patients experiencing age-related cognitive impairment, applied and benefited from a healthy lifestyle Fitbit-based intervention to facilitate and promote physical activity, better sleep hygiene and healthy lifestyles.

Ageism: Millennial Persistence

This work develops the idea that is possible to affirm that beyond its nuances. Ageism has shown a surprising force of prevalence in western society. Nourished by mythical, empirical, ideological and health elements, it has been enormously successful in imposing an image of vulnerability, decrepitude and illness on older adults. Since 1969, when the first academic article on the subject was published, much has been written on the subject, but little progress has been made in terms of social and state policies and community awareness. When an attempt has been made to propose an alternative to decrepit (Aristotelian as we suggest in this paper) ageism, nothing has emerged but a new kind of ageism that has imposed the supposed need that the older adult “must” be “productive”, “young”, “vigorous”, posing the impossibility, in short, once again, of the older adult living spontaneously as an older adult.

Aging and Biological Oscillation: A Question of Geometry

Previous studies in different ethnic groups show changes in heart rate, respiratory rate, cortisol cycle, and sleep-wake cycle throughout life. Our purpose is to verify such changes by comparing the values of each variable before and after puberty. Puberty is associated with the end of growth and is an important point in our theoretical framework: when growth ends, changes occur in the geometry of the biological system. At the same time, this causes phase changes in the oscillatory variables, which are seen as chronodisruption. The results confirm the changes found by other authors in the evolution of the variables throughout life. Then, we can conclude that the variables studied present phase changes when growth ends, in accordance with the proposed theoretical framework.

Epigenetic Signatures of Aging: A Comprehensive Study of Biomarker Discovery

Background: Aging is a complex biological process that is associated with a decline in physiological functions and an increased risk of age-related diseases. Despite advances in molecular biology and genetics, the underlying mechanisms of aging remain largely unknown. Study: The identification of biomarkers of aging would provide a powerful tool for monitoring the effects of aging and for developing interventions to improve healthspan. Aging is associated with alterations in genetics, epigenetic marks, telomere shortening, cell senescence, and changes in the expression of genes involved in metabolism, inflammation, and DNA damage repair. Epigenetic changes, including modifications to DNA methylation and histone acetylation patterns, play a critical role in the aging process. As we age, these changes can lead to altered gene expression and contribute to the development of age-related diseases such as cancer, Alzheimer’s disease (AD) and cardiovascular disease (CVD). Conclusion: The discovery of aging biomarkers that are sensitive to these epigenetic changes has the potential to revolutionize our understanding of the aging process and inform the development of interventions to improve healthspan and extend lifespan.

Aging Trend and Situation in Nepal

Aging is a natural lifelong process until death. The proportions of the older population are increasing rapidly in Nepal too. There are 2.97 million older people in Nepal as of the 2021 census which is a 38.2% increase compared to the previous census of 2011. The proportion of the older population reached 10.21% of the total population of Nepal. During this decade, Nepal’s average population growth rate is 0.92% and the older population growth rate is 3.29% per year. On the other hand, Nepal’s total fertility is below replacement level, infant mortality is around 23 per thousand live births and average life expectancy is now around 71 years. The median age of Nepal is 25 years and the index of aging increased rapidly from 23.3 in 2011 to 36.7 in the 2021 census of Nepal. These indicators show aging is taking place rapidly and the caregiving burden may increase rapidly in the coming days due to the tendency of migration of the young population to other countries. In this context, the Nepal government needs to focus on how to manage the population and provide quality services and social security for the growing older people of Nepal.

About the Thermodynamics and Aging of Self-Organizing Systems

We know that the total daily energy dissipation increases in complex organisms like the humans. It’s very probable that this increase in total energy dissipation is related to the progressive increase in mass. But we also know that day by day the dissipation of energy per unit mass decreases in these organisms. We intend to verify if this decrease is only an expression of the second law of thermodynamics, or if it is related to the increase in mass that occurs in these organisms. For this, we set ourselves the following objectives: verify the correlation between total energy dissipation and the evolution of body mass, and verify the correlation between the dissipation of energy per unit of mass and the evolution of body mass. As a result of the data analysis, we found a high degree of correlation between total energy dissipation and the evolution of body mass. And we also found a high correlation between the energy dissipated per unit of mass and the evolution of body mass. We can conclude that self-organization produces not only an increase in mass, but also a decline in energy dissipation per unit mass beyond what is expected by the second law of thermodynamics.

Ignored Engagement: A Piloted Theory about Social Aspects of Aging

The society and culture of Bangladesh are quite different from the other countries of the world. It is difficult to receive a theory fully for explaining the condition of our own. However, the purpose of this paper is to review major sociological theories on aging and propose a new one. Data were collected from both primary and secondary sources. Content analysis and survey methods were used in this study. Through the baseline survey of four villages in the Bogra District of Bangladesh, 609 older people have been identified. Among them, 203 older people including 96 males and 107 females have been selected as a sample randomly and interviewed intensively. The contents of aging-related theories have been analyzed. The results of this study show that existing theories of aging are inadequate to explain the social aspects of older adults in Bangladesh;rather Ignored Engagement (A Piloted Theory) may be suitable to do this. This study may give future direction to academicians and policymakers to formulate and amend evidence-based policies and practices for the well-being of our older people.

Aging Experiences among Older People in Conakry/Guinea: Towards an Age-Friendly City and Community

Older people are a demographically significant group, who represent a vulnerable layer within conditions for active and healthy aging that may be lacking in both urban and rural areas. Objective: To identify the main barriers and opportunities for the establishment of age-friendly cities and communities in a low-income country. Methods: This was a qualitative study that involved focus group discussions with older people, and service providers (health and social services) in the city of Conakry. The older people were purposively selected with the support of older people associations, and men and women were equally represented in the sample. Results: The analysis focused on the experience of old age as well as the barriers and opportunities for active healthy aging specific to the sub-Saharan context. The results indicate that a good quality of life for older adults boils down to the acquisition of good health and decent housing. Other concerns frequently reported were food and education problems for their children and security. Conclusion: This study contributes to strengthening the understanding of the age-friendly cities and communities’ approach in the context of sub-Saharan African countries.

Memory Training and Task Specificity in 90-99-Year-Old Seniors with Mild Cognitive Impairment

Managing memory deficits is a central problem among older adults with mild cognitive impairment (MCI). This study examined the effects of memory training on memory performance in an understudied “oldest-old” population ranging in age from 90 to 99 years. Eighteen mild to moderately cognitive-impaired older seniors, 90 years and older were recruited from memory clinics established in senior living communities. Treatment sessions took place, on average, twice weekly, for 55 minutes. Memory intervention included nineteen computer-based exercises customized to focus on memory loss. The specificity of memory training was very clear;memory training produced significant effects (F(3,51) = 2.81, p = 0.05) on memory performance, especially after 6 months of training, while other outcome measures showed no effects as predicted. Based on the results, it can be concluded that interventions targeting cognition and memory in the oldest-old MCI population can significantly improve memory function and reduce cognitive deficits.

Ability of Comprehensive Geriatric Assessment to Detect Frailty

Background and Aim of the Work: Frailty is a state of reduced physiological reserve associated with increased susceptibility to disability. It is associated with a high morbidity and mortality. This work assessed the ability of comprehensive geriatric assessment to detect frailty in elderly patients. Subjects and Methods: A total number of 104 elderly patients (above 60 years old) were included in this study and they were subjected to a comprehensive geriatric assessment (CGA) including: (history and full clinical examination, Mini mental status examination (MMSE), Geriatric depression scale (GDS), Activities of daily living (ADL), Instrumental activities of daily living (IADL). The patients were divided into frail and non-frail groups using Fried’s criteria as applied by Avila-Funes et al., 2008, each group included 52 patients. Results: There were no significant differences between the two groups regarding age gender or smoking habits. But there was higher percentage of ADL, IADL dependence in addition to higher incidence of depression and cognitive impairment among frail cases. Conclusion: Comprehensive geriatric assessment can be used to detect frailty and its associated impairment and comorbidities.

Handgrip strength and falls in community-dwelling Egyptian seniors

Purpose: To establish a relationship between falls and handgrip strength (GS) in communitydwelling senior citizens in Egypt. Subjects: Crosssectional study enrolling 132 subjects, all ≥60 years old. Materials and Methods: History of falls in the past year and their number as well as GS measurement in both hands using Baseline? pneumatic squeeze handheld dynamometer. Results: There is a highly significant difference between the GS of fallers and non-fallers in both hands (P = 0.000). There is a highly significant negative correlation between the mean GS and the number of falls (P = 0.003). There is a highly significant positive correlation between GS of the right hand with the number of falls (R = 0.226, P = 0.009), as for the correlation with the left GS it was a weaker positive correlation (R = 0.209, P = 0.16). Conclusion: Seniors with history of falls have a lower GS in both dominant and nondominant hands and it is directly related to the number of falls. GS is decreased in senior fallers even if within the normal range.

Association of Race and Change in Ankle-Brachial Index: The Atherosclerosis Risk in Communities (ARIC) Cohort

Objective: This study evaluates the association of self-reported race with change in ankle-brachial index (ABI) over time and modification of this association by paraoxonase gene (PON1, PON2 and PON3) single nucleotide polymorphisms (SNPs). Methods: This longitudinal study included 11,992 (N = 2952 Black, N = 9040 White) participants from the Atherosclerosis Risk in Communities (ARIC) cohort with PON genotyping. Mixed-effects models examined whether race was associated with change in ABI over time after adjustment for known peripheral artery disease (PAD) risk factors. Results: Change in ABI over time differed between Whites and Blacks (race-time interaction, p < 0.0001). Stratified analyses showed that ABI values were better in both Blacks and Whites who completed high school or more education compared to those who completed less education. None of the PON SNPs met the significance level (p < 0.001) after Bonferroni correction for multiple comparisons. Conclusions: ABI differences by race were small and although statistically significant, may not be clinically significant. Change in ABI over time varies by race and may be modified by education. Results suggest that higher education may influence the lifestyle and behavioral choices contributing to better ABI in both Blacks and Whites. Further studies are needed to confirm this observation.

Osteoarthritis and Articular Cartilage: Biomechanics and Novel Treatment Paradigms

Background: Osteoarthritis is a widespread highly painful disabling age-related disease with no known cure. Although novel strategies for ameliorating osteoarthritic damage abound, it is likely that none will be successful over time if the entire spectrum of the disease and the effects of joint biomechanics on joint tissues are not carefully considered. Objectives: 1) To detail the structure of healthy articular cartilage, the key tissue affected by osteoarthritis. 2) To detail what aspects of cartilage damage best characterize osteoarthritis. 3) To consider the role of biomechanical factors in developing solutions to treat osteoarthritic joint damage. Methods: Literature sources from 1980 onwards that have contributed to our knowledge of the topics relevant to this paper were accessed and retrieved. The data were categorized into four predominant themes and conclusions about the state of our knowledge and future directives were formulated. Conclusions: Osteoarthritis prevalence remains high, and a cure appears elusive. A rich body of data has helped us to better understand the key tissue involved, and suggests a repair process might be feasible, if the basic collective information on the role of biomechanics in mediating or moderating articular cartilage integrity and function is forthcoming.

Anti-Aging Genes Improve Appetite Regulation and Reverse Cell Senescence and Apoptosis in Global Populations

Appetite regulation by nutritional intervention is required early in life that involves the anti-aging gene Sirtuin 1 (Sirt 1) with Sirt 1 maintenance of other cellular anti-aging genes involved in cell circadian rhythm, senescence and apoptosis. Interests in anti-aging therapy with appetite regulation improve an individual’s survival to metabolic disease induced by gene-environment interactions by maintenance of the anti-aging genes connected to the metabolism of bacterial lipopolysaccharides, drugs and xenobiotics. Interventions to the aging process involve early calorie restriction with appetite regulation connected to appropriate genetic mechanisms that involve mitochondrial biogenesis and DNA repair in neurons. In the aging process as the anti-aging genes are suppressed as a result of transcriptional dysregulation chronic disease accelerations and connected to insulin resistance, non-alcoholic fatty liver disease (NAFLD) and neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease. Interests in the gene-environment interaction indicate that the anti-aging gene Sirt 1that regulates food intake has been repressed early in the aging process in various global populations. The connections between Sirt 1 and other anti-aging genes such as Klotho, p66Shc (longevity protein) and Forkhead box proteins (FOXO1/ FOXO3a) have been associated with programmed cell death and alterations in these anti-aging genesregulate glucose, lipid and amyloid beta metabolism that are important to various chronic diseases.

New antioxidant SkQ1 is an effective protector of rat eye retinal pigment epithelium and choroid under conditions of long-term organotypic cultivation

Cells have intrinsic mechanisms for cleaning harmful oxidants represented mainly by reactive oxygen species (ROS). Despite the antioxidant defense, ROS can cause serious damage to the retina that with age leads to various eye diseases and even blindness. Among numerous cell sites of ROS generation, mitochondrial electron transport is of crucial importance. Recently, for the purpose of cleaning ROS in the mitochondrial matrix, powerful mitochondria- targeted antioxidant “SkQ1” has been invented. We studied SkQ1 effects upon tissues of rat posterior eye cup that consisted: retinal pigment epithelium (RPE) ? choroidal coat ? scleral coat. The eye cups were isolated from the eyes of adult albino rats and cultivated in rotary tissue culture system in the presence of 20 nM SkQ1 or without this compound. After 7 days - 1 month in vitro eye cup samples were studied by immunohistochemistry, routine histology, morphometry, and digital image analysis. We have found that under chosen, “in vitro like in vivo” conditions 20 nM SkQ1 effectively reduced cell death in RPE and choroid, protected RPE from disintegration caused by cell phenotypic transformation and withdrawal from the layer, suppressed transmigration of choroidal coat cells. In the ex vivo model we used degenerative processes were more pronounced in the eye cup center where SkQ1 effect was most vivid. All this give us hopes for effectiveness of SkQ1 treatment of retinal central part that is very susceptible to light-induced over-oxidation injury and mostly suffering in many age-related diseases, AMD, in particular.

Mortality and morbidity due to the failure to treat mild anemia unrelated to cancer in elderly Americans—Review of the literature and case presentation

Even mild iron deficiency anemia, as defined by the World Health Organization, is associated with increased mortality and significant morbidity in elderly individuals who are cancer free. Yet, anemia in the elderly is often dismissed as a benign sign of aging. This problem is exacerbated by the fact that elderly individuals often suffer from gastrointestinal complaints that preclude treatment with iron supplements by mouth. The FDA has approved two brands of injectable iron for treating such patients. Nonetheless, a major American health maintenance organization refuses to treat elderly patients with injectable iron, even when it is indicated, unless their anemia is associated with cancer. This may well reflect a public health crisis afflicting many elderly residents of the United States.

The Effects of Standardized Ginkgo Biloba Extracts (GBE) on Subjective Cognitive Decline (SCD) in Middle-Aged Adults: A Review

Subjective cognitive decline (SCD) is defined as the presence of self-reported cognitive complaints with unimpaired performance in neuropsychological cognitive tests. SCD has been identified as a precursor of mild cognitive impairment (MCI) and potentially represents the earliest clinical sign of Alzheimer’s disease (AD). Standardized extracts of Ginkgo biloba (GBE) are widely used as a treatment for cognitive impairment. Nonetheless, most of the available review articles focus on the effects of GBE in MCI and dementia but not in SCD and its specific cognitive effects. Thus, this review collects and discusses the available published clinical data for the effects of standardized GBE on the early stages of cognitive decline among an age group where SCD becomes a topic—the middle-aged adults. Randomized clinical trials (RCTs), systematic reviews and meta-analyses of standardized GBEs in cognitive decline subjects were searched using PubMed/MEDLINE, Science direct, Cochrane, and Google Scholar until January 2019. Data from relevant RCT were critically evaluated to determine the potential effects of GBE on SCD. The results showed that the number of available GBE studies on SCD is small. Eight studies were selected in which subjects reported memory impairment, in some cases with concerns (worries), and with an average age at onset SCD of 60 years. Six studies gave a proof of efficacy for GBE for the treatment of SCD in at least one cognitive parameter. One study is inconclusive, however, a post-hoc analysis demonstrates efficacy in preventing AD with intake >4 years. The most common GBE dosage used was 240 mg GBE/day over a minimum period of 8 weeks. Hence, there might be beneficial effects of GBE to prevent, improve or delay SCD in the generation of 50 years or older. However, larger, well-defined RCTs using SCD criteria are necessary to further substantiate this effect in SCD subjects.

Systematic Thinking Underlying People with Diabetes’ Beliefs on Health Outcomes: An Information Integration Theory Approach

A sample of 76 older adults (27 with diabetes and 49 without diabetes) were selected to judge three information factors, metamemory related to—drug organization—stress and physical activity in relation to their perception of self-care. In order to do so, an Integration Information Theory was considered to determine systematic cognitive algebra rules underlying judgment about 24 different health self-care scenarios. Results indicate that older adults without diabetes use a summative cognitive rule to integrate relevant health information but older adults with diabetes do not. Both groups agreed that metamemory was the most relevant factor to their self-care followed by stress and physical activity. However, valuation of these factors does depend on the type of group. Implications of these results to healthcare a behavioral nursing intervention are discussed in this paper.