Studies have shown that various antioxidants are decreased in different age-related degenerative diseases and thus, oxidative stress would have a central role in the pathogenesis of many disorders that involve neuronal degeneration, including Alzheimer's disease (AD). The present study aimed to assess the nutritional status of Se in AD patients and to compare with control subjects with normal cognitive function. The case–control study was carried out on a group of elderly with AD (n 28) and compared with a control group (n 29), both aged between 60 and 89 years. Se intake was evaluated by using a 3-d dietary food record. Se was evaluated in plasma, erythrocytes and nails by using the method of hydride generation atomic absorption spectroscopy. Deficient Se intake was largely observed in the AD group. AD patients showed significantly lower Se levels in plasma, erythrocytes and nails (32·59 μg/l, 43·74 μg/l and 0·302 μg/g) when compared with the control group (50·99 μg/l, 79·16 μg/l and 0·400 μg/g). The results allowed us to suggest that AD has an important relation with Se deficiency.

There is a growing number of elderly kidney transplant (Ktx) recipients. Elderly recipients present lower acute rejection rates but higher incidence of infection and malignancies. Aging per se seems to result in a shift to memory profile and chronic kidney disease (CKD) in premature immunological aging. Understanding aging and CKD effects on the immune system can improve elderly Ktx immunosuppression. We analyzed the effects of aging and CKD in the immune system, comparing healthy adults (HAd) (n=14, 26±2y), healthy elderly (HEld) (n=15, 79±7y), end stage renal disease (ESRD) adults (EnAd) (n=18, 36±7y) and ESRD elderly (EnEld) (n=31, 65±3y) prior to Ktx regarding their naïve, memory and regulatory T and B peripheral lymphocytes. Aging and ESRD presented additive effect decreasing absolute numbers of B and T-lymphocytes, affecting memory, naive and regulatory subsets without synergic effect. Both resulted in higher percentages of T memory subsets and opposing effects on regulatory T (TREG) subsets, higher percentage in aging and lower in ESRD. Combined effect of aging and ESRD also resulted in higher regulatory B cell percentages. In addition to global lymphopenia and TCD4+ memory shift in both aging and ESRD, aging shifts to an immunoregulatory profile, inducing a increase in TREG percentages, contrasting with ESRD that decreases TREGs. Differential immunosuppression regimens for elderly Ktx may be required. (ClinicalTrials.gov number: NTC01631058).

The results of this study underscore the importance of considering the level of education in the analysis of cognitive performance in depressed elderly patients, as well as the relevance of developing new cognitive function tests in which level of education has a reduced impact on the results.

INTRODUCTION: Substantial medical research has established an inverse relationship between quality of life and illness. However, there exists minimal evidence for such a connection in the context of stable and controlled diseases. OBJECTIVE: We wished to correlate multimorbidity with quality of life for elderly patients who suffer from stable chronic diseases. METHODS: We used a tool to evaluate quality of life, namely World Health Organization quality of life-BRIEF, together with a scale of multimorbidity known as the Cumulative Illness Rating Scale - Geriatric Version. Furthermore, the quality of life data were correlated with scores recorded on the Cumulative Illness Rating Scale - Geriatric Version, the number of drugs used, and individual perceptions of health and age. RESULTS: We studied 104 elderly patients who suffered from chronic diseases. The patients had exhibited neither acute events nor secondary complications, their cognition was intact, and they were functionally independent. The Cumulative Illness Rating Scale - Geriatric Version showed an inverse correlation with the physical domain (p= 0.008) and a tendency toward an inverse correlation with the psychological domain (p= 0.052). Self-perception of health showed a high correlation with the physical domain (p= 0.000), psychological domain (p= 0.000) and environmental domain (p= 0.000). The number of drugs used correlated only with the physical domain (p= 0.004). Age and social domain showed a tendency toward a positive correlation (p= 0.054). DISCUSSION: We uncovered an inverse relationship between quality of life and multimorbidity in a group of patients who suffered from stable chronic diseases, with no functional limitations, pain or complications. Our data suggest that a patient’s knowledge that they have a certain clinical condition changes their subjective assessment of quality of life in the related domain. CONCLUSION: The perceived quality of life of the sample was affected by multimorbidity in the physical domain, with a tendency toward commensurate effects in the psychological domain.

Parenchymal bands, ground-glass opacities, septal lines, bronchiectasis, micronodules, reticular opacities, and lung cysts were more prevalent among the elderly.

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Objective To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge.Methods A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control.Results We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency.Conclusion This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills.

Background/Aims: Oxidative stress plays a central role in Alzheimer’s disease (AD). Pro198Leu cytosolic glutathione peroxidase (GPx1) polymorphism seems to be associated with a lower activity of this enzyme, but there are no studies with AD patients. Thus, the aim was to determine the frequency of the GPx1 Pro198Leu polymorphism in AD patients and to verify its relation to glutathione peroxidase (GPx) activity and selenium (Se) status. Methods: The study was carried out in a group of AD elderly (n = 28) compared to a control group (n = 29). Blood Se concentrations were measured through hydride generation atomic absorption spectroscopy. GPx activity was determined using a commercial kit, and the polymorphism using amplified DNA sequencing. Results: The distribution of genotypes was not different between groups. The variant allele frequency was 0.179 (AD group) and 0.207 (control group). Although no differences regarding GPx activity were found between individuals with different genotypes, lower blood Se levels were found in Pro/Pro AD patients compared to Pro/Pro control subjects, which was not found in the Pro/Leu groups. Moreover, the association between the erythrocyte Se concentration and GPx activity was affected by the Pro198Leu genotype. Conclusions: Results indicate that this polymorphism had apparently affected Se status in AD patients and that more studies in this field are necessary.