Age-related alterations in systemic and cerebral hemodynamics are not well understood. The purpose of this study is to characterize age-related alterations in beat-to-beat oscillations in arterial blood pressure (BP), heart rate (HR), cerebral blood flow (CBF), cardiac baroreflex sensitivity (BRS) and dynamic cerebral autoregulation (dCA) across the adult life span. We studied 136 healthy adults aged 21–80 years (60% women). Beat-to-beat BP, HR and CBF velocity were measured at rest and during sit-stand maneuvers to mimic effects of postural changes on BP and CBF. Transfer function analysis was used to assess BRS and dCA. Carotid-femoral pulse wave velocity (cfPWV) was measured to assess central arterial stiffness. Advanced aging was associated with elevated cfPWV, systolic and pulse BP, cerebrovascular resistance and CBF pulsatility, but reduced mean CBF velocity. Compared to the young and middle-aged, older adults had lower beat-to-beat BP, HR and CBF variability in the low frequency ranges (LF) at rest, but higher BP and CBF variability during sit-stand maneuvers. BRS was reduced, while dCA gain was elevated at rest in older adults. Multiple linear regression analysis indicated that systolic BP variability is correlated positively with cfPWV independent of HR variability. In conclusion, advanced aging is associated with elevated pulsatility in BP and CBF, reduced beat-to-beat LF oscillations in BP, HR and CBF, and impaired BRS and dCA at rest. The augmented BP and CBF variability in older adults during sit-stand maneuvers indicate diminished cardiovascular regulatory capability and increased hemodynamic stress on the cerebral circulation with aging.

Introduction/Aims: Oculopharyngeal muscular dystrophy (OPMD) is a late-onset, progressive muscle disease. Quantitative muscle ultrasound (QMUS) assesses structural changes in muscles and is a sensitive biomarker in neuromuscular disorders. Our aim of this study was to determine whether QMUS can detect muscle pathology and can be used as longitudinal imaging biomarker in OPMD.Methods: Genetically confirmed OPMD patients, recruited by their treating physicians or from the national neuromuscular database, were examined twice, 20 months apart, using QMUS of orofacial and limb muscles, and measurements of functional capacity and muscle strength. Absolute echo intensity (AEI) and muscle thickness of all muscles were analyzed and correlated with clinical data. Results:The tongue, deltoid, iliopsoas, rectus femoris, and soleus muscles showed increased AEI at baseline compared with normal values in 43 OPMD patients, with the rectus femoris being most often affected (51%).The AEI and muscle thickness of 9 of 11 muscles correlated significantly with the motor function measure, 10-step stair test, swallowing capacity, dynamometry, Medical Research Council grade, tongue strength, and bite force (r = 0.302 to À0.711). Between baseline and follow-up, deterioration in AEI was found for the temporalis, tongue, and deltoid muscles, and decreased muscle thickness was detected for the temporalis, masseter, digastric, tongue, deltoid, iliopsoas, and soleus muscles (P < .05). No relation was found between the change in AEI and repeat length or disease duration.