摘要:

Urinary incontinence is common in the elderly, affecting 6–8% of people over 64 years in the community and up to 31 % in hospital and long-term care. It is possible to establish the diagnosis clinically in most incontinent patients with the likelihood of improving symptoms in the majority. Treatment of patients with urinary incontinence requires attention to general and specific measures. General measures include moderation of fluid intake to about 1.5 litres/day, reduced intake of caffeine-rich drinks, treatment of aggravating conditions such as urinary infection, oestrogen deficiency, increased solute load as in diabetes mellitus and uraemia, and drugs like diuretics, sedatives and antidepressants. Specific measures include pelvic floor exercises, vaginal cones, interferential therapy and oestrogens for patients with stress incontinence. Bladder retraining and anticholinergic drugs are for patients with urge incontinence, and alpha-blockers and 5-alpha reductase inhibitors for patients with overflow incontinence due to prostatic hyperplasi

ISSN:0304-324X    

DOI:10.1159/000213844

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In this paper we asked whether the increased production of two proinflammatory cytokines – tumor necrosis factor-α (TNFα) and interleukin-6 (IL6) in the absence of the inflammatory stimulus, a phenomenon frequently occurring in the elderly, may contribute to the decrease of natural killer (NK) cytotoxic activity. NK cell activity is a part of a nonspecific immunity directed against infected and transformed cells. We measured the levels of bioactive TNFα and IL6 during cytotoxic NK reactions and analyzed the effect of neutralizing monoclonal antibodies anti-TNFα and anti-IL6 on the outcome of cytotoxic reaction. Bioactive TNFα was produced in higher amounts during cytotoxic reactions of the elderly with low NK activity in comparison with its production by the elderly with high NK activity. Anti-TNFα decreased already low cytotoxic responses of the elderly while not having an effect on the cytotoxic potential of high responders. More of the bioactive IL6 was released during cytotoxic reactions of the elderly as compared with young people. There was, however, no relation between the height of NK cytotoxic activity and the amount of IL6. Our results suggest that the increased level of TNFα seen in the elderly low NK responders may pose a compensatory mechanism, necessary to keep the highest possible level of NK responses. The increased bioactivity of IL6 during NK reaction of the elderly does not seem to participate in the regulation of the level of NK cytotoxic

ISSN:0304-324X    

DOI:10.1159/000213845

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

A 3-year prospective cohort study was conducted to estimate the life expectancy free of dementia (dementia-free life expectancy) in a representative sample of older persons living in an urban Japanese community. For the persons aged 65 years and older, who were not demented at the baseline survey in 1988, mortality and incidence rates of dementia were calculated. At the age of 65 years, males showed a total life expectancy of 18 years, including 16 years free of dementia, and females showed a total life expectancy of 23 years, including 18 years without dementia. At 65 years, the dementia-free life expectancy represented 89% of the total life expectancy for males and 79% for females. Total life expectancy and dementia-free life expectancy were longer among females than among males. However, the life-years with dementia were longer among females. This result would be attributable to a higher incidence of dementia and a lower mortality among females.

ISSN:0304-324X    

DOI:10.1159/000213846

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

One hundred and seventy-one unrelated elderly healthy subjects selected according to the Senieur protocol (57 men and 114 women), aged 75–104 years, and 405 healthy individuals (238 men and 167 women), aged 18-65 years, were typed for HLA-A, HLA-B, and HLA-DR antigens. The purpose of the study was to investigate a possible association between HLA antigens and longevity. In the total group of elderly, an increased frequency of HLA-B16 (11.11 vs. 5.43%) and HLA-DR7 (38.33 vs. 15.67%) and a decreased frequency of HLA-B15 (1.75 vs. 5.18%) and HLA-DR4 (11.66 vs. 24.15%) were observed. The HLA-B 15DR4 haplotype was not represented (vs. 2.1 %), HLA-A1B8 was found with a low frequency (2.9 vs. 4.4%), and HLA-B8DR3 was very rarely found (1.6 vs. 10.1%), whereas the HLA-B 13DR7 haplotype was observed with an increased frequency (6.6 vs. 3.3%). These results are in agreement with other published data and suggest that longevity in humans may be influenced by the genetic backgroun

ISSN:0304-324X    

DOI:10.1159/000213847

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The underlying mechanism of calorie restriction (CR) extension of mammalian life spans operates by altering the rate of decline in reserve capacity (with time) as well as the exposure to growth stimulus, two mechanisms that seem to be related to the central genetically determined mechanism that controls mammalian life span over a 50-fold range. While genetic control is principally exerted at the level of metabolic rate and entrained protective defenses, CR appears to alter the rate of decline in reserve capacity and the exposure to growth stimulus without appreciable alteration of metabolic rate. CR accomplishes this by lowering the nutritionally driven level of insulin exposure, which in turn lowers overall growth factor exposure, improves age-declining maintenance of mitochondrial maximal function, and maintains a longer-term favorable balance of the insulimgrowth hormone antagonism. Obtaining the ‘halved’ insulin exposure in calorie-restricted animals (relative to ad libitum fed) can be specifically targeted in non-obese ad libitum fed humans by multiple techniques, a situation that may confer most of the life span extension of CR without restricting calories. The prospect for even further extension of the human life span is conside

ISSN:0304-324X    

DOI:10.1159/000213848

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0304-324X    

DOI:10.1159/000213849

出版商:S. Karger AG    

年代:1997

数据来源: Karger