A REVIEW OF THE LATEST LONGEVITY SCIENCE RESEARCH
Gender-Based Outcomes in Percutaneous Coronary Intervention with Drug-Eluting Stents (from the National Heart, Lung, and Blood Institute Dynamic Registry)
Synopsis: Types of Stents Used Shows No Differences By Gender
Abbreviated Abstract: Gender-based outcomes have not been evaluated in unselected patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). We investigated whether gender influences the relative safety and efficacy of DESs compared with bare metal stents (BMSs) in routine clinical practice. Use of DESs was the only factor, other than age, that conferred a lower risk for the need for repeat PCI in women and men. In conclusion, the widespread use of DESs is safe and has decreased clinically driven revascularization compared with BMSs equally in women and men.
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Abbott DJ, Vlachos HA, Selzer F, Sharaf BL, Holper E, Glaser R, Jacobs AK, Williams DO. Gender-Based Outcomes in Percutaneous Coronary Intervention with Drug-Eluting Stents. Am J Cardiol. 2007 March 1; 99(5): 626-631.
Use of Dietary Supplements Among United States Adults with Coronary Artery Disease and Atherosclerotic Risks
Synopsis: Use of Dietary Supplement is Common by Americans for Coronary Artery Disease
Abbreviated Abstract: The study seeks to describe the use of dietary supplements promoted for cardiovascular health and the relation between supplement use and coronary artery disease (CAD) and the presence of major CAD risk factors. The aim is also to explore whether use of medications for the treatment of cardiovascular disease or diabetes mellitus (DM) is associated with supplement use. We performed a cross-sectional analysis of the 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) of 6,671 adults (representing 119.3 million US adults) aged ≥40 years. After controlling for sociodemographics, health, and lifestyle factors, we found that persons with CAD/Stroke used more supplements (any), vitamin E, folic acid, and niacin, and less fish oil. Those with DM used less coenzyme Q10, and adults with HTN/HC used more supplements (any), herbs (any), and ginseng. Adults with CAD/stroke who used medications for the treatment of cardiovascular disease or DM were more likely to use folic acid compared with those who did not use medications for these conditions. In adults with CAD/stroke, DM, or HTN/HC, those who did not use medications for these conditions were more likely to use herbs and other select supplements. In conclusion, use of dietary supplements is common in those with CAD or CAD risks.
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Buettner C, Phillips RS, Davis RB, Gardiner P, Mittleman MA. Use of Dietary Supplements Among United States Adults With Coronary Artery Disease and Atherosclerotic Risks. Am J Cardiol. 2007 March 1; 99(5): 661-666.
Effect of Raw Garlic vs Commercial Garlic Supplements on Plasma Lipid Concentrations in Adults with Moderate Hypercholesterolemia: A Randomized Trial
Synopsis: Garlic Has Not Been Shown to Lower LDL Cholesterol
Abbreviated Abstract: BACKGROUND - Garlic is widely promoted as a cholesterol-lowering agent, but efficacy studies have produced conflicting results. Garlic supplements differ in bioavailability of key phytochemicals. We evaluated the effect of raw garlic and 2 commonly used garlic supplements on cholesterol concentrations in adults with moderate hypercholesterolemia. METHODS: In this parallel-design trial, 192 adults with low-density lipoprotein cholesterol (LDL-C) concentrations of 130 to 190 mg/dL (3.36-4.91 mmol/L) were randomly assigned to 1 of the following 4 treatment arms: raw garlic, powdered garlic supplement, aged garlic extract supplement, or placebo. Garlic product doses equivalent to an average-sized garlic clove were consumed 6 d/wk for 6 months. CONCLUSION - None of the forms of garlic used in this study, including raw garlic, when given at an approximate dose of a 4-g clove per day, 6 d/wk for 6 months, had statistically or clinically significant effects on LDL-C or other plasma lipid concentrations in adults with moderate hypercholesterolemia.
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Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC. Effect of Raw Garlic vs Commercial Garlic Supplements on Plasma Lipid Concentrations in Adults with Moderate Hypercholesterolemia: A Randomized Trial. Arch Intern Med. 2007;167:346-353.
Association of Endogenous Sex Hormone with C-Reactive Protein Levels in Middle-Aged and Elderly Men
Synopsis: Sex Hormones with C-Reaction Protein Increases Total Bioavailable Hormones in Men
Abbreviated Abstract: BACKGROUND - In women, postmenopausal oestrogen supplementation increases levels of systemic markers of inflammation, which are important predictors of coronary heart disease (CHD) risk. Whether endogenous sex hormone levels in men are also related to systemic subclinical inflammation is still unknown. OBJECTIVE - We tested the hypothesis that higher endogenous sex hormones levels within the physiological range may be associated with systemic subclinical inflammation. METHODS - Circulating sex hormone and high-sensitivity C-reactive protein (hs-CRP) levels were determined in 400 apparently healthy men aged between 40 and 80 years. RESULTS - Higher levels of total as well as bioavailable oestradiol (E2) were associated with increased natural log hs-CRP levels, which remained statistically significant after adjustment for age and cardiovascular risk factors. After adjustment for age and cardiovascular risk factors, physiological levels of total (TT) or bioavailable testosterone or dehydroepiandrosterone sulfate (DHEAS) were not associated with hs-CRP. CONCLUSION - Endogenous total and bioavailable E2 levels are significantly associated with CRP among middle-aged and elder men.
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Pour HR, Grobbee DE, Muller M, van der Schouw YT. Association of Endogenous Sex Hormone with C-reactive Protein Levels in Middle-Aged and Elderly Men. Clin Endocrinol. 2007 Mar;66(3):394-8.
Exogenous Oestradiol and Progesterone Administration Does Not Cause Oedema in Healthy Young Women
Synopsis: Progesterone Does Not Cause Oedema, Study Shows
OBJECTIVE - Oedema is an increase in the extravascular component of extracellular fluid volume (ECFV). Fluid movement across the ECF is controlled by hydrostatic and oncotic pressures, which are influenced by oestradiol and progesterone. Thus we hypothesized that oestradiol decreases, while combined oestradiol + progesterone increases, protein and fluid movement out of the vasculature. SUBJECTS - Subjects were eight healthy women (22 ± 2 years). DESIGN - Oestrogens and progesterone were suppressed with a gonadotropin-releasing hormone antagonist for 16 days; oestradiol was added for days 5–16 (E2) and progesterone was added for days 13–16 (E2-P4). MEASUREMENTS - We estimated intravascular (plasma) volume (PV), transcapillary albumin escape rate (TERalb), and Starling forces (hydrostatic pressures of plasma and interstitium, plasma colloid pressure, capillary filtration coefficient) in the forearm on days 2 (GnRH antagonist), 9 (E2) and 16 (E2-P4). Neither E2 nor E2-P4 altered TERalb sufficiently to impact Starling forces indicating neither E2 nor P4 administration at these levels would likely cause oedema.
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Stachenfeld NS, Taylor HS. Exogenous Oestradiol and Progesterone Administration Does Not Cause Oedema in Healthy Young Women. Clin Endocrinol. 2007 Mar;66(3):410-8.
Dehydroepiandrosterone Substitution in Female Adrenal Failure: No Impact on Endothelial Function and Cardiovascular Parameters Despite Normalization of Androgen Status
Synopsis: No Cardiac Affects Shown With the Use of DHEA
Abbreviated Abstract: BACKGROUND - Female adrenal insufficiency implicates reduced production of the adrenal androgen precursor dehydroepiandrosterone (DHEA) and low androgen levels. Oral DHEA restores androgen deficit but the clinical implications and safety of substitution therapy is uncertain. DESIGN - Six months randomized, double-blind, placebo-controlled crossover study. Treatment consisted of DHEA 50-mg or placebo. Each treatment period was followed by a 2-month washout period. RESULTS - DHEA treatment normalized androgen status to levels seen in healthy women. DHEA and placebo treatment had no effect on echocardiographic parameters of myocardial dimensions or systolic and diastolic function, noninvasive endothelial cell function at the level of the brachial artery, 24-h blood pressure and heart rate, cardiac output and maximal oxygen consumption during exercise cycle testing. Remarkably, all participants had evidence of concentric left ventricular remodelling by echocardiography. CONCLUSION - Restoration of physiological androgen levels using 6 months of DHEA replacement in this pilot study did not affect cardiovascular parameters and endothelial function in female adrenal insufficiency.
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Christiansen JJ, Andersen NH, Sorensen KE, Pedersen EM, Bennett P, Andersen M,
Christiansen JS, Jorgensen JO, Gravholt CH. Dehydroepiandrosterone Substitution in Female Adrenal Failure: No Impact on Endothelial Function and Cardiovascular Parameters Despite Normalization of Androgen Status. Clin Endocrinol. 2007 Mar;66(3):426-33.
Age Dependent Impairment of Endothelial Progenitor Cells is Corrected by Growth Hormone Mediated Increase of Insulin-Like Growth Factor-1
Synopsis: Growth Hormone Mediated Increase of Insulin-Like Growth Factor-1 to Benefit the Interior Walls of the Heart
Abbreviated Abstract: Aging is associated with an increased risk for atherosclerosis. A possible cause is low numbers and dysfunction of endothelial progenitor cells (EPC) which insufficiently repair damaged vascular walls. We hypothesized that decreased levels of insulin-like growth factor-1 (IGF-1) during age contribute to dysfunctional EPC. We measured the effect of growth hormone (GH), which increases endogenous IGF-1 levels, on EPC in mice and human subjects. We compared EPC number and function in healthy middle-aged male volunteers (57.4±1.4 years) before and after a 10 day treatment with recombinant GH (0.4 mg/d) with that of younger and elderly male subjects (27.5±0.9 and 74.1±0.9 years). Middle-aged and elderly subjects had lower circulating CD133+/VEGFR-2+ EPC with impaired function and increased senescence. GH treatment in middle-aged subjects elevated IGF-1 levels, increased circulating EPC with improved colony forming and migratory capacity, enhanced incorporation into tube-like structures, and augmented endothelial nitric oxide synthase expression in EPC comparable to that of the younger group. EPC senescence was attenuated, whereas telomerase activity was increased after GH treatment. Treatment of aged mice with GH (7 days) or IGF-1 increased IGF-1 and EPC levels and improved EPC function, whereas a two day GH treatment did not alter IGF-1 or EPC levels. Ex vivo treatment of EPC from elderly individuals with IGF-1 improved function and attenuated cellular senescence. Growth hormone-mediated increase in IGF-1 reverses age-related EPC dysfunction and may be a novel therapeutic strategy against vascular disorders with impairment of EPC.
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Thum T, Hoeber S, Froese S, Klink I, Stichtenoth DO, Galuppo P, Jakob M, Tsikas D, Anker SD, Poole-Wilson PA, Borlak J, Ertl G, Bauersachs J. Age Dependent Impairment of Endothelial Progenitor Cells is Corrected by Growth Hormone Mediated Increase of Insulin-like Growth Factor-1. Circ Res. 2007 Feb 16;100(3):381-90.
Determinants of Serum Total and Free Testosterone Levels in Women Over the Age of 65 Years
Synopsis: Low Body Mass, An Independent Risk Factor For Lower Testosterone
Abbreviated Abstract: CONTEXT - Little is known about testosterone (T) levels and their determinants in women of late postmenopausal age. OBJECTIVE - We describe levels of total and free T and selected factors that influence these levels in a random sample of older women.
Design: Levels of serum total T and free T by microdialysis were measured using ultrasensitive assays in 347 community-dwelling women aged 65–98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to define factors associated with total and free T levels. CONCLUSIONS - Bilateral oophorectomy, estrogen use, corticosteroid use, and low body mass index are independent risk factors for lower T levels in women aged 65 yr and over. Although highly prevalent in women of this age, the physiological significance of low T levels in late postmenopausal women requires further investigation.
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Cappola AR, Ratcliffe SJ, Bhasin S, Blackman MR, Cauley J, Robbins J, Zmuda JM, Harris T, Fried LP. Determinants of Serum Total and Free Testosterone Levels in Women over the Age of 65 Years. J Clin Endocrinol Metab. 2007 92: 509-516.
The Relative Contributions of Aging, Health, and Lifestyle Factors to Serum Testosterone Decline in Men
Synopsis: Health and Lifestyle May Affect Age-Related Hormones
Abbreviated Abstract: CONTEXT - Although it is known that serum testosterone (T) concentrations decline with age, the relative contributions of changes in health and lifestyle to that decline have not been adequately assessed. OBJECTIVE - The objective of this study was to establish the relative importance of aging, health, and lifestyle in contributing to male T decline. DESIGN - A prospective cohort study of health and endocrine functioning in randomly selected men with a baseline visit and two follow-up visits was conducted. Participants: Participants included 1667 men aged 40 to 70 at baseline. MAIN OUTCOME MEASURES - Main outcome measures included total serum T, calculated free T (FT), and SHBG. RESULTS - There were substantial declines in total serum T and FT levels associated with aging alone. However, many health and lifestyle changes were associated with accelerated decline. A 4- to 5-kg/m2 increase in body mass index or loss of spouse was associated with declines in total serum T comparable to that associated with approximately 10 yr of aging. Results were similar for FT, but fewer factors were associated with SHBG after age was taken into account. CONCLUSIONS - Both chronological aging and changes in health and lifestyle factors are associated with declines in serum T. Comorbidities and lifestyle influences may be as strongly associated with declining T levels as is aging itself over the short- to midterm. These results suggest the possibility that age-related hormone decline may be decelerated through the management of health and lifestyle factors.
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Travison TG, Araujo AB, Kupelian V, O’Donnell AB, McKinlay JB. The Relative Contributions of Aging, Health, and Lifestyle Factors to Serum Testosterone Decline in Men. J Clin Endocrinol Metab. 2007 92: 549-555.
Serum Adiponectin is a Predictor of Coronary Heart Disease: A Population-Based 10-Year Follow-Up Study in Elderly Men
Synopsis: High Levels of Adiponectin Equals Lower Risk of Coronary Heart Disease
Abbreviated Abstract: OBJECTIVE - Our objective was to investigate whether adiponectin could predict CHD in a population-based cohort of elderly men. Design and Setting: From 1991–1995 a baseline investigation was carried out in 832 healthy men aged 70 yr in the Uppsala Longitudinal Study of Adult Men (ULSAM study). They were followed up to 10.4 yr using Swedish national registry data. Main outcome measures were defined as death or first-time hospitalization for CHD (n = 116). Associations were analyzed using Cox’s proportional hazards regression, presented as hazard ratios (HR) with 95% confidence intervals (CI) for 1 SD increase in the predictor variable. Results: In a multivariable analysis including total cholesterol (HR, 1.24; CI, 1.02–1.50), high-density lipoprotein cholesterol (HR, 0.72; CI, 0.58–0.89), smoking (HR, 1.39; CI, 0.91–2.14), and systolic blood pressure (HR, 1.26; CI, 1.05–1.52), serum adiponectin was associated with lower risk for CHD (HR, 0.81; CI, 0.66–0.99). The association was independent of BMI and remained significant after adjustment for insulin sensitivity index. Conclusions - In this population-based cohort of healthy men, elevated serum levels of adiponectin were associated with a lower risk for CHD. Importantly, the association between adiponectin and CHD was independent of other well-known risk factors.
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Frystyk J, Berne C, Berglund L, Jensevik K, Flyvbjerg A, Zethelius B. Serum Adiponectin is a Predictor of Coronary Heart Disease: A Population-Based 10-Year Follow-Up Study in Elderly Men. J Clin Endocrinol Metab. 2007 92: 571-576.
Soy Isoflavones Do Not Affect Bone Resorption in Postmenopausal Women: A Dose-Response Study Using a Novel Approach with 41 Ca
Synopsis: Soy Isoflavones Do Not Affect Bone Resorption
Abbreviated Abstract: INTRODUCTION - The purpose of this 3-way crossover study was to identify the effective dose of soy protein isolate enriched with isoflavones for suppressing bone resorption in postmenopausal women using a novel, rapid assessment of antibone resorbing treatments. Methods: Thirteen postmenopausal women (6 yr since menopause) were predosed with 41Ca iv. After a 200-d baseline period, subjects were given 43 g soy protein/d that contained 0, 97.5, or 135.5 mg total isoflavones in randomized order. Serum isoflavone levels and biochemical markers were measured at the end of each phase. Twenty-four-hour urine samples were collected approximately every 10 d during each phase for 41Ca/Ca analysis by accelerator mass spectrometry. RESULTS - Serum isoflavone levels reflected the amount of isoflavones consumed in a dose-dependent manner. None of the isoflavone levels had a significant effect on biochemical markers of bone turnover, urinary cross-linked N teleopeptides of type I collagen and serum osteocalcin, or bone turnover as assessed by urinary 41Ca/Ca ratios. CONCLUSIONS - Soy protein with isoflavone doses of up to 135.5 mg/d did not suppress bone resorption in postmenopausal women. This is the first efficacy trial using the novel technique of urinary 41Ca excretion from prelabeled bone.
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Cheong JM, Martin BR, Jackson GS, Elmore D, McCabe GP, Nolan JR, Barnes S, Peacock M, Weaver CM. Soy Isoflavones Do Not Affect Bone Resorption in Postmenopausal Women: A Dose-Response Study Using a Novel Approach with 41 Ca. J Clin Endocrinol Metab. 2007 92: 577-582.
CD8+ T-Cell Responses Identify Beta-Cell Autoimmunity in Human Type 1 Diabetes
Synopsis: Type 1 Diabetes, New Intervention May Open Door to Prediction and Prevention
Abbreviated Abstract: Despite the understanding that type 1 diabetes pathogenesis is mediated by T-cells, detection of these rare lymphocytes remains largely elusive. Suitable T-cell assays are highly needed, since they could offer preclinical diagnoses and immune surrogate end points for clinical trials. Although CD4+ T-cell assays have met with limited success, CD8+ T-cells are increasingly recognized as key actors in the diabetes of the NOD mouse. CD8+ T-cells are likely to play a role also in humans and may provide new markers of ß-cell autoimmunity. we have implemented an islet-specific CD8+ T-cell interferon- enzyme-linked immunospot (ISL8Spot) assay. The ISL8Spot assay is capable of detecting and quantifying ß-cell–reactive CD8+ T-cells directly ex vivo, without any preliminary expansion, using either fresh or frozen samples. Positive ISL8Spot responses separate new-onset diabetic and healthy samples with high accuracy (86% sensitivity, 91% specificity), using as few as five immunodominant epitopes. Moreover, sensitivity reaches 100% when the ISL8Spot assay is complemented by antibody determinations. Combination of CD8+ T-cell measurements with immune intervention strategies may open new avenues toward type 1 diabetes prediction and prevention.
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Mallone R, Martinuzzi E, Blancou P, Novelli G, Afonso G, Dolz M, Bruno G, Chaillous L, Chatenoud L, Bach JM, van Endert P. CD8+ T-Cell Responses Identify Beta-Cell Autoimmunity in Human Type 1 Diabetes. Diabetes. 2007 Mar;56(3):613-21.
Two Years of Treatment with Dehydroepiandrosterone Does Not Improve Insulin Secretion, Insulin Action, or Postprandial Glucose Turnover in Elderly Men or Women
Synopsis: DHEA Does Not Improve Insulin Secretion
Abbreviated Abstract: To determine if dehydroepiandrosterone (DHEA) replacement improves insulin secretion, insulin action, and/or postprandial glucose metabolism, 112 elderly subjects with relative DHEA deficiency ingested a labeled mixed meal and underwent a frequently sampled intravenous glucose tolerance test before and after 2 years of either DHEA or placebo. Despite restoring DHEA sulphate concentrations to values observed in young men and women, the changes over time in fasting and postprandial glucose concentrations, meal appearance, glucose disposal, and endogenous glucose production were identical to those observed after 2 years of placebo. The change over time in postmeal and intravenous glucose tolerance test insulin and C-peptide concentrations did not differ in men treated with DHEA or placebo. In contrast, insulin and C-peptide concentrations were greater (P < 0.05) in women after DHEA than after placebo. However, since DHEA tended to decrease insulin action, the change over time in disposition indexes did not differ between DHEA- and placebo-treated women. We conclude that 2 years of replacement of DHEA in elderly men and women does not improve insulin secretion, insulin action, or the pattern of postprandial glucose metabolism.
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Basu R, Man CD, Campioni M, Basu A, Nair KS, Jensen MD, Khosla S, Klee G, Toffolo G,
Cobelli C, Rizza RA. Two Years of Treatment with Dehydroepiandrosterone Does Not Improve Insulin Secretion, Insulin Action, or Postprandial Glucose Turnover in Elderly Men or Women. Diabetes. 2007 56: 753-766.
Cigarette Smoke – An Aging Accelerator?
Abstract: Cigarette smoking reduces life span by an average of 7 years, and tobacco consumption accounts for a shortening of disease free life by 14 years. The exact mechanisms by which smoking causes disease and death are generally not well understood, but evidence continues to mount that cigarette smoking exhausts cellular defense and repair functions, leading to an accumulation of damage e.g. mutations and malfunctioning proteins. In this review, we make an attempt to ascribe many of the deleterious effects of smoking on human health to a general principle, namely the acceleration of aging processes by cigarette smoke chemicals.
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Bernhard D, Moser C, Backovic A, Wick G. Cigarette Smoke – An Aging Accelerator? Exp Gerontol. 2007 Mar;42(3):160-5.
Protective Effect of an Extract of the Oyster Mushroom, Pleurotus Ostreatus, on Antioxidants of Major Organs of Aged Rats
Abbreviated Abstract: This study was undertaken to investigate the putative antioxidant activity of the oyster mushroom, Pleurotus ostreatus, on lipid peroxidation and antioxidant status of major organs of aged (24 month old) rats when compared to young (4 month old) rats. Elevated levels of malondialdehyde (MDA) and significantly lowered levels of reduced glutathione (GSH) and of vitamins C and E were observed in the liver, kidneys, heart and brain of aged rats, when compared to values in young rats. Quantitative analysis of the activities of the antioxidant enzymes catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (Gpx) revealed significantly lower values in the liver, kidneys, heart and brain of aged rats. Administration of the extract of P. ostreatus to aged rats resulted in elevated levels of reduced glutathione and vitamins C and E and in increased activities of CAT, SOD and Gpx so that the values in most of these parameters did not differ significantly from those in young rats. In addition, the level of MDA was lowered on administration of mushroom extract to aged rats. These results suggest that treatment with an extract of P. ostreatus can improve the antioxidant status during ageing, therein minimizing the occurrence of age-associated disorders associated with involvement of free radicals.
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Jayakumar T, Thomas PA, Geraldine P. Protective Effect of an Extract of the Oyster Mushroom, Pleurotus Ostreatus, on Antioxidants of Major Organs of Aged Rats. Exp Gerontol. 2007 Mar;42(3):183-91.
Free Insulin-like Growth Factor-1 and Cognitive Function in Older Persons Living in Community
Synopsis: Growth Hormones May Play a Role in Cognitive Performance
Abbreviated Abstract: CONTEXT - Increasing evidences from experimental and human studies suggest that the activity of the growth hormone (GH/insulin-like growth factor-I) axis may contribute to the age-related cognitive decline and poor cognition in late life. OBJECTIVE - The aim of the present study was to evaluate the relationship of total serum free IGF-I and its binding protein-3 with cognitive performance in older persons aged 80 years or older. DESIGN - Cognitive performance was evaluated using five items enclosed in the Minimum Data Set for Home Care assessment form: short-term memory, procedural memory, cognitive skills in daily decision making, verbal expression, comprehension. Free insulin-like growth factor-I (free IGF-I) and IGF-binding protein-3 (IGFBP-3) in blood were measured. Analysis of covariance (ANCOVA) was used to examine the relationship between cognitive impairment and the serum free IGF-I and IGFBP-3 concentrations. RESULTS - After adjustment for potential confounders, individuals with verbal expression problems and individuals with comprehension problems had a significantly lower serum levels of readily dissociable IGF-I than participants without cognitive impairments. The serum IGFBP-3 presented the same behavior of free IGF-I. CONCLUSION - The present study suggests that among old-old subjects living in the community lower levels of total serum free IGF-I and IGFBP-3 are associated with impairment of cognitive performance. This finding suggests that the GH/IGF-I axis may play an important role in the age-related decline of cognitive performance.
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Landi F, Capoluongo E, Russo A, Onder G, Cesari M, Lulli P, Minucci A, Pahor M, Zuppi C, Bernabei R. Free Insulin-like Growth Factor-1 and Cognitive Function in Older Persons Living in Community. Growth Horm IGF Res. 2007 Feb;17(1):58-66.
A Higher Dose of Vitamin D Reduces the Risk of Falls in Nursing Home Residents: A Randomized, Multiple-Dose Study
Synopsis: Vitamin D Reduces the Number of Falls in Nursing Homes
Abbreviated Abstract: OBJECTIVES - To determine the effect of four vitamin D supplement doses on falls risk in elderly nursing home residents. DESIGN - Secondary data analysis of a previously conducted randomized clinical trial. SETTING - Seven hundred twenty-five-bed long-term care facility. PARTICIPANTS - One hundred twenty-four nursing home residents (average age 89). INTERVENTION - Participants were randomly assigned to receive one of four vitamin D supplement doses (200 IU, 400 IU, 600 IU, or 800 IU) or placebo daily for 5 months. MEASUREMENTS - Number of fallers and number of falls assessed using facility incident tracking database. RESULTS - Over the 5-month study period, the proportion of participants with falls was 44% in the placebo group, 58% in the 200 IU group, 60% in the 400 IU group, 60% in the 600 IU group, and 20% in the 800 IU group. Participants in the 800 IU group had a 72% lower adjusted-incidence rate ratio of falls than those taking placebo over the 5 months. No significant differences were observed for the adjusted fall rates compared to placebo in any of the other supplement groups. CONCLUSION - Nursing home residents in the highest vitamin D group (800 IU) had a lower number of fallers and a lower incidence rate of falls over 5 months than those taking lower doses. Adequate vitamin D supplementation in elderly nursing home residents could reduce the number of falls experienced by this high falls risk group.
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Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A Higher Dose of Vitamin D Reduces the Risk of Falls in Nursing Home Residents: A Randomized, Multiple-Dose Study. J Am Geriatr Soc. 2007 Feb;55(2):234-9.
Early Postmenopausal Hormone Therapy Improves Postural Balance
Synopsis: Risks of Hip Fracture Relative to Menopause
Abbreviated Abstract: OBJECTIVE - Postmenopausal hormone therapy (HT) results in more substantial reductions in the risk of hip fracture when initiated sooner rather than later after menopause. We studied the effects of postmenopausal HT on the postural balance of postmenopausal women. DESIGN - One hundred women with a mean age of 52.5 years were randomly and blindly assigned to either a sequential estradiol-norethisterone acetate regimen or placebo for 3 months, after which all participants received open HT for a further 3 months. Postural balance was assessed as sway velocity using a force platform. Results: After 3 months of HT, sway velocity had improved (decreased) from baseline by 7.0%. Continued HT for 6 months further improved sway velocity by 12% from baseline to reach values similar to those historically found in younger women or in postmenopausal women after long-term HT. Closer proximity to menopause and more pronounced increases in serum estradiol values were associated with stronger improvements in sway velocity. HT also improved dizziness. CONCLUSIONS - Initiation of HT soon after menopause rapidly improved postural balance to levels normally seen in young women. We suggest that improved postural balance can contribute to the protection against fractures associated with HT and explain the more substantial reduction in hip fracture risk after HT initiated sooner, compared with later, after menopause. Further study is required to confirm these results.
Naessen T, Lindmark B, Lagerstrom C, Larsen HC, Persson I. Early Postmenopausal Hormone Therapy Improves Postural Balance. Menopause. 2007 Jan-Feb;14(1):14-9.
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About the Kronos Longevity Research Institute
Kronos Longevity Research Institute (KLRI), a not-for-profit 501(c)(3) organization, is a leader in developing new modes of prevention and treatment to enhance human longevity. KLRI is the only independent research institute devoted exclusively to translating basic discoveries in the process of aging into useful tools, improved medical care and healthier lives. KLRI’s research is conducted by its own highly regarded scientists and through collaboration with some of the nation’s leading medical research centers. Because KLRI conducts pioneering research in an area of science that is poorly understood, KLRI offers the potential to make seminal contributions that benefit not only the growing population of older Americans, but people everywhere and generations to follow.
For more information about KLRI, visit our website at www.kronosinstitute.org.
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