Japan has a rapidly growing elderly population. The proportion of citizens aged 65 years and over was 22.1% in 2008, and is projected to as high as 27% by 2015 (Health and Welfare Statistics Association 2009). In accordance, elderly individuals requiring care are also increasing. To cope with this situation, the long term care service system was implemented in Japan in 2000. Since then, the number of elderly requiring care doubled from 2.2 to 4.4 million (Health and Welfare Statistics Association 2008).One of the important challenges for people requiring care is how to prevent a decrease in activities of daily living (ADL). To address this issue, we initiated the Yamato Study, a population-based study of individuals utilizing the long term care service system, to develop preventive methods for diminishing ADL levels (Nishiwaki et al. 2005(Nishiwaki et al. , 2007.Another critical risk for people requiring care is increased mortality. Kuzuya et al. (2006) demonstrated that decreased ADL is associated with higher mortality rates while Takeda (2004) showed that higher requisite care levels are associated with higher mortality rates. These studies suggest that ADL level is an important predictor of mortality in elderly requiring care. A number of studies targeting independent elderly people in the community have also indicated that body stature (Grabowski and Ellis 2001;Al Snih et al. 2007), muscle strength (Al Snih et al. 2002), and serum albumin levels (Sahyoun et al. 1996;Okamura et al. 2008) are significant predictors of mortality. To date, however, only a few studies have explored risk factors for mortality other than ADL in elderly people requiring care to date (Enoki et al. 2007a(Enoki et al. , 2007b. This study aimed to clarify multiple risk factors for two-year mortality through follow-up of the Yamato Study elderly cohort who utilize the long term care service system.
Abstract. The objectives of this research were to characterize plasma profiles of growth hormone (GH), prolactin (PRL) and insulin-like growth factor-I (IGF-I) during gestation and the lactation period in goats, as well as in their suckling growing kids. There were no obvious changes in the GH or PRL profiles during gestation, but secretion of both GH and PRL increased acutely after parturition. The elevated GH concentrations were maintained until 3 months after parturition, whereas the PRL concentrations decreased gradually after parturition. The elevated hormone concentrations are thought to be caused mainly by an increase in the secretory pulse amplitudes. In contrast to the GH and PRL profiles, the plasma IGF-I concentrations during late gestation were significantly higher than the post-parturition concentrations, and the IGF-I concentrations in late gestation decreased gradually until the day of parturition. The plasma GH, PRL and IGF-I concentrations in kids 1 week after birth were high, and concentrations of each hormone decreased thereafter. These results show that the increased secretory potencies of pituitary GH and PRL after parturition are caused mainly by an increase in the secretory pulse amplitudes and that plasma GH is inversely related to plasma IGF-I compared over gestation and the lactation period in goats. Key words: GH, PRL, IGF-I, Gestation, Lactation.(J. Reprod. Dev. 45: [273][274][275][276][277][278][279][280][281] 1999) G estation is a composite of integrated processes, resulting in the successful development of fetuses and the birth of offspring. The energy and nutrient requirements in pregnant animals are increased during gestation [1]. The survival of newborn animals is dependent on an adequate supply of milk secreted from the mammary glands of the mother after parturition [2]. Since growth hormone (GH) regulates many aspects of metabolic activity [3], it is meaningful to examine the GH profiles throughout gestation and during the lactation period in animals. Plasma or serum concentrations of GH and prolactin (PRL) in ruminants have been observed to elevate acutely during the periparturient period [4][5][6][7][8][9]. In these published observations, however, blood samples were usually collected for only a few weeks around parturition, and plasma profiles of GH and PRL have never been examined throughout gestation. Moreover, the blood samples were collected only about once a day, although GH and PRL are known to be secreted in transient pulses [3,[10][11][12][13][14]. PRL is required for the initiation of lactation [15,16]; therefore, it is of interest to determine how the pulsatile secretory patterns of both GH and PRL change throughout gestation and during the lactation period in animals. The anabolic action of GH is
To date, no study has investigated the nutritional status of vitamin D in frail elderly people living at home. The purposes of this study were to assess serum 25-hydroxyvitamin D (25[OH]D) levels and associated factors in noninstitutionalized elderly people who had various levels of physical disability, and to propose an adequate vitamin D nutritional status for the elderly by interpreting the serum 25(OH)D levels in relation to serum parathyroid hormone (PTH) levels in this population. Health examinations were conducted in the winter and summer of 2003. The subjects were 143 elderly people in the winter, and 120 elderly people in the summer, who all used the long-term care insurance system at home. Serum 25(OH)D concentrations were determined with a chemiluminescence protein-binding assay, and serum intact PTH concentrations were determined with an immunoradiometric assay. The subjects' disease histories and lifestyle information were obtained through an interview. Activities of daily living (ADL) levels were evaluated using the Barthel index, and grip strength was measured with a digital hand dynamometer. Average serum 25(OH)D levels in the winter and summer were 54.2 nmol/l (SD 29.0) and 53.3 nmol/l (SD 32.3), respectively, and intact PTH concentrations in the winter and summer were 4.2 pmol/l (SD 1.8) and 4.3 pmol/l (SD 1.8), respectively. The proportion of people who had a low 25(OH)D (<30 nmol/l) and high intact PTH levels (>6.9 pmol/l) were 15%-20% and 8%, respectively. Significant predictors of low serum 25(OH)D concentrations were low ADL levels, female sex, and low fish consumption in both seasons. Serum 25(OH)D concentrations of less than 50 nmol/l were associated with elevated serum intact PTH concentrations. In conclusion, elderly people requiring care at home are at high risk of hypovitaminosis D, and their low serum 25(OH)D levels are mainly associated with low ADL levels. In addition, maintenance of serum 25(OH)D concentrations above 50 nmol/l may prevent hypovitaminosis D-induced hyperparathyroidism.
The number of elderly subjects requiring care is rapidly increasing, however, their health status has not been well studied. The purposes of this study were to describe the health characteristics of the elderly at home who were using long-term care insurance, and to clarify factors that influence dependence for activities of daily living (ADL). The subjects were 194 elderly people living at home, who were approved for care. The items surveyed were the demographic characteristics, care level (or level of dependence for ADL), Barthel index, grip strength, thigh muscle volume, cognitive impairment using the mini-mental state examination (MMSE), depressed mood using the geriatric depression scale (GDS-15), and serum albumin and hemoglobin levels. The grip strength (p = 0.0001), thigh muscle volume (p = 0.0030), MMSE score (p = < 0.0001) and serum albumin level (p = < 0.0001) decreased, while the GDS-15 score (p = 0.0142) increased with deteriorating care levels. The proportion of subjects not requiring assistance for the items "bathing" and "stair-climbing" in the Barthel index was markedly low in the subjects belonging to the relatively low (mild) care levels. The logistic regression analysis showed that factors associated with dependence for "bathing" and "stair-climbing" were the use of day-services, male sex, decline of grip strength, and a high GDS-15 score. In conclusion, it is important to strengthen the muscles of the upper half of the body, and to correct depressed moods for maintaining levels of ADL in the elderly requiring care at home.
This 2-year cohort study has demonstrated that a decrease in serum albumin levels is associated with a decrease in ADL levels. A third factor may play a role in adversely affecting both serum albumin and ADL levels in frail elderly people.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.