The journal of nutrition, health & aging
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Despite negative topline phase 3 clinical trial results for bapineuzumab and solanezumab in mild to moderate AD, findings from these trials and recent advances suggest renewed optimism for anti-amyloid therapies. Aβ immunotherapy has now demonstrated its ability to engage CNS Aβ and modify downstream CNS biomarkers in bapineuzumab treated patients, and to show likely cognitive benefits in mild patients treated with solanezumab. The current availability of potent BACE inhibitors provides additional opportunities to test the value of reducing Aβ in the clinic. Trial enhancements, such as selecting and enriching for early stage AD, treating participants longer and using more sensitive composite endpoints may further improve our chances of demonstrating clinical efficacy and securing beneficial treatments for patients.
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J Nutr Health Aging · Jan 2013
Promoting access to innovation for frail old persons. IAGG (International Association of Gerontology and Geriatrics), WHO (World Health Organization) and SFGG (Société Française de Gériatrie et de Gérontologie) Workshop--Athens January 20-21, 2012.
Frailty tends to be considered as a major risk for adverse outcomes in older persons, but some important aspects remain matter of debate. ⋯ Frailty in older adults is a syndrome corresponding to a vulnerability to a stressor. Diagnostic tools have been developed but none can integrate at the same time the large spectrum of factors and the simplicity asked by the clinical practice. An agreement with an international common definition is necessary to develop screening and to reduce the morbidity in older persons.
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J Nutr Health Aging · Aug 2012
Screening for delirium within the interRAI acute care assessment system.
To develop and validate a screening strategy for delirium within the inter RAI acute care comprehensive assessment system. ⋯ The interRAI AC delirium screening strategy is a valid measure of delirium in older subjects in acute medical wards.
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J Nutr Health Aging · Aug 2012
The integration of frailty into clinical practice: preliminary results from the Gérontopôle.
Disability is commonly considered as an irreversible condition of advanced age. Therefore, preventive actions need to be taken before the disabling cascade is fully established, that is in the pre-disability phase defined "frailty syndrome". The complexity and heterogeneity of frailty requires a clinical approach based on multidimensionality and multidisciplinary. In this paper, we present the main characteristics of the newborn Platform for Evaluation of Frailty and Prevention of Disability (Toulouse, France). ⋯ The Platform clinically evaluates and intervenes on frailty for the first time at the general population-level. This model may serve as preliminary step towards a wider identification of early signs of the disabling cascade in order to develop more effective preventive interventions.
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J Nutr Health Aging · Jul 2012
Glomerular filtration rate estimated by Cockcroft-Gault formula better predicts anti-Xa levels than modification of the diet in renal disease equation in older patients with prophylactic enoxaparin.
Older people have an increased risk of low molecular weight heparin accumulation leading to an increased bleeding risk. The objective of this study was to assess whether reduced glomerular filtration rate (GFR), estimated by the Cockcroft-Gault or modification of the diet in renal disease (MDRD) equations, indicates drug accumulation by increased anti-Xa levels in older subjects receiving prophylactic enoxaparin treatment. ⋯ In hospitalized patients older than 65 years old, the Cockcroft-Gault equation, in contrast to the MDRD equation, is able to predict the risk of higher anti-Xa levels.