Rev Invest Clin
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There are two widely used tools to classify frailty in older adults: the frailty phenotype and the frailty index. Both have been validated for prediction of adverse outcomes. ⋯ The higher the number of deficits in an index, the higher the estimates for adverse outcomes, independent of the type of deficit added.
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The relationship between frailty and cognitive impairment has been recognized for decades, but it was not until a few years ago that the interest in this relationship increased and is now being understood. Epidemiological evidence suggests that physical frailty may be linked to cognitive impairment since both conditions share pathophysiological mechanisms at the cellular and systemic levels. ⋯ However, full understanding of the mechanisms underlying the relationship between frailty and vascular cognitive impairment remains fragmented. This review examines the link between frailty and vascular cognitive decline and also explores the role of vascular changes in the genesis of both conditions.
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The most common dementias such as Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia are associated with a decline in cognitive and social abilities. Although the molecular mechanisms of tissue damage in these dementias are not completely understood, these neurodegenerative illnesses share certain alterations such as neuroinflammation and gliosis. Increasing evidence suggests that microgliosis and astrogliosis play a key role in neuroinflammation observed in these dementias. Here we provide an overview of the participation of microglia and astrocytes in the neuroinflammatory response in common dementias.
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The proportion of persons aged 85 and over, the so-called "oldest old", is increasing dramatically worldwide. While a quarter of this population is affected by dementia, little is known about the specific features of cognitive functioning in the oldest old. In the presence of clinical specificities such as numerous comorbidities, multi-medication and visual and/or auditory loss, which are very frequent in extreme old age, neuropsychological assessment can be particularly challenging. This article presents an overview of the epidemiology of cognitive functioning in the oldest old, and discusses the issues regarding neuropsychological assessment and dementia in this specific elderly population.
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Comparative Study
Serous Cystadenomas Follow a Benign and Asymptomatic Course and Do Not Present a Significant Size Change During Follow-Up.
Serous cystadenoma is a benign pancreatic cystic neoplasm. Conservative management is favored. We studied the clinical characteristics and course of serous cystadenoma in patients undergoing surgery or conservative management only at an academic referral center. ⋯ Size change of serous cystadenoma was minimal and patients remained asymptomatic during follow-up. Surgery should be limited to symptomatic and selected cases.