Cardiolocomotor coupling in young and elderly people.

Background: Walking is a complex act that requires the coordination of locomotor, cardiovascular, and autonomic systems. Aging affects each of these systems and may alter physiological mechanisms regulating the interactions between them.

Methods: We examined the effects of healthy aging on cardiac-locomotor coupling using treadmill walking at incremental speeds from 0.

Antiapoptotic effect of implanted embryonic stem cell-derived early-differentiated cells in aging rats after myocardial infarction.

This study tested whether implanted embryonic stem cell-derived early-differentiated cells (EDCs) lead to improvement in cardiac function by preventing cardiac apoptosis in aging rats after myocardial infarction. Cardiac apoptosis after transplantation of EDCs was assessed in situ by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling reaction (TUNEL) staining as well as by measurements of protein levels of cleaved caspases 3, Bax, and Bcl-2. Our results indicate that cell transplantation improved cardiac function at 6-months observation.

Association between reduced heart rate variability and cognitive impairment in older disabled women in the community: Women's Health and Aging Study I.

Objectives: To examine the independent association between heart rate variability (HRV), a marker of cardiac autonomic function, and cognitive impairment.

Design: Cross-sectional analysis of baseline data from Women's Health and Aging Study I.

Setting: Urban community in Baltimore, Maryland.

Cerebral blood flow velocity and periventricular white matter hyperintensities in type 2 diabetes.

Objective: Diabetes increases the risk for cerebromicrovascular disease, possibly through its effects on blood flow regulation. The aim of this study was to assess the effects of type 2 diabetes on blood flow velocities (BFVs) in the middle cerebral arteries and to determine the relationship between white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) and BFVs.

Research Design And Methods: We measured BFVs in 28 type 2 diabetic and 22 control subjects (aged 62.

Modeling baroreflex regulation of heart rate during orthostatic stress.

During orthostatic stress, arterial and cardiopulmonary baroreflexes play a key role in maintaining arterial pressure by regulating heart rate. This study presents a mathematical model that can predict the dynamics of heart rate regulation in response to postural change from sitting to standing. The model uses blood pressure measured in the finger as an input to model heart rate dynamics in response to changes in baroreceptor nerve firing rate, sympathetic and parasympathetic responses, vestibulo-sympathetic reflex, and concentrations of norepinephrine and acetylcholine.

Impaired executive function is associated with delirium after coronary artery bypass graft surgery.

Objectives: To determine the extent to which preoperative performance on tests of executive function and memory was associated with delirium after coronary artery bypass graft (CABG) surgery.

Design: Prospective observational cohort study.

Setting: Two academic medical centers and one Department of Veterans Affairs medical center in Massachusetts.

Long-term effects of analgesics in a population of elderly nursing home residents with persistent nonmalignant pain.

Background: Little is known about the long-term effects of analgesics on functional status and well-being of nursing home residents with chronic pain.

Methods: Using the Minimum Data Set, we performed a longitudinal study of nursing home residents (n = 10,372) with persistent pain. Using propensity score adjustment techniques, we compared the effect of different analgesics on changes in physical, cognitive, emotional, and social functioning, and examined rates of adverse events over a 6-month period.

Enhanced vasoreactivity and its response to antihypertensive therapy in hypertensive elderly women.

Several previous studies have demonstrated sex differences in cardiovascular autonomic control in healthy young women, but little is known about the regulation of blood pressure in hypertensive elderly women, who have the greatest risk of adverse cardiovascular events. Therefore, we examined sex differences in physiological responses to upright tilt in 21 healthy (13 men and 8 women), 22 controlled hypertensive (10 men and 12 women), and 18 uncontrolled hypertensive (9 men and 9 women) elderly men and women. Of these, 19 normotensives, 18 controlled hypertensives, and 14 uncontrolled hypertensives completed 6 months of observation or pharmacological therapy for uncontrolled hypertension.

Cognitive function in normal-weight, overweight, and obese older adults: an analysis of the Advanced Cognitive Training for Independent and Vital Elderly cohort.

Objectives: To assess how elevated body mass index (BMI) affects cognitive function in elderly people.

Design: Cross-sectional study.

Setting: Data for this cross-sectional study were taken from a multicenter randomized controlled trial, the Advanced Cognitive Training for Independent and Vital Elderly trial.

The elderly people of post-Soviet Ukraine: medical, social, and economic challenges.

Over the past 14 years, since Ukraine became an independent nation, the country has made major strides toward achieving political and economic reforms, exemplified by the recent populist uprising for fair and free elections. Despite these successes, many challenges still lie ahead, particularly in the area of health care for older people. The average life expectancy in Ukraine is only 67 years, and those who achieve old age often live in poverty.

Regional cerebral autoregulation during orthostatic stress: age-related differences.

Background: We used transcranial Doppler ultrasonography to examine the cerebral blood flow response to orthostatic stress in the middle and posterior cerebral circulations and to determine the effects of healthy aging on regional cerebral blood flow regulation.

Methods: Continuous simultaneous middle (MCA) and posterior (PCA) cerebral artery blood flow velocities (BFV) and mean arterial pressure (MAP) were measured in response to standing from a sitting position in 13 younger (30 +/- 7 years) and 13 older (73 +/- 4 years) healthy participants.

Results: The older participants had a significantly larger decline in MAP (-31% +/- 3 in the older and -21% +/- 2 in the younger) and a smaller increase in heart rate (HR) (15 bpm +/- 1 in the older, 24 bpm +/- 2 in the younger) during the posture change.

Noise-enhanced balance control in patients with diabetes and patients with stroke.

Objective: Somatosensory function declines with diabetic neuropathy and often with stroke, resulting in diminished motor performance. Recently, it has been shown that input noise can enhance human sensorimotor function. The goal of this study was to investigate whether subsensory mechanical noise applied to the soles of the feet via vibrating insoles can be used to improve quiet-standing balance control in 15 patients with diabetic neuropathy and 15 patients with stroke.

Sex differences in the emergency department evaluation of elderly patients with syncope.

Background: Current data suggest that 30%-50% of patients with syncope leave the hospital without a defined etiology of their syncopal event. Recent studies have shown significant differences in both presentation and therapy in women with coronary disease and congestive heart failure.

Methods: To assess the impact of sex on the frequency of syncope and the rate of identifying a specific etiology among elderly patients who present to the emergency department (ED), a retrospective chart review was performed during a 1-year period.

The role of homocysteine in multisystem age-related problems: a systematic review.

Homocysteine is a sulfur-containing amino acid that is involved in one-carbon metabolism. Hyperhomocysteinemia is a common phenomenon among elderly people. There is growing evidence of an association between hyperhomocysteinemia and geriatric multisystem problems, including coronary artery disease, stroke, peripheral vascular disease, cognitive impairment, dementia, depression, osteoporotic fractures, and functional decline.

Effect of blood pressure and diabetes mellitus on cognitive and physical functions in older adults: a longitudinal analysis of the advanced cognitive training for independent and vital elderly cohort.

Objectives: To evaluate the effect of blood pressure (BP) and diabetes mellitus (DM) on cognitive and physical performance in older, independent-living adults.

Design: Longitudinal study with secondary data analysis from the Advanced Cognitive Training for Independent and Vital Elderly randomized intervention trial.

Setting: Six field sites in the United States.

Foot pressure distribution during walking in young and old adults.

Background: Measurement of foot pressure distribution (FPD) is clinically useful for evaluation of foot and gait pathologies. The effects of healthy aging on FPD during walking are not well known. This study evaluated FPD during normal walking in healthy young and elderly subjects.

Blood pressure and blood flow variation during postural change from sitting to standing: model development and validation.

Short-term cardiovascular responses to postural change from sitting to standing involve complex interactions between the autonomic nervous system, which regulates blood pressure, and cerebral autoregulation, which maintains cerebral perfusion. We present a mathematical model that can predict dynamic changes in beat-to-beat arterial blood pressure and middle cerebral artery blood flow velocity during postural change from sitting to standing. Our cardiovascular model utilizes 11 compartments to describe blood pressure, blood flow, compliance, and resistance in the heart and systemic circulation.

Antihypertensive therapy increases cerebral blood flow and carotid distensibility in hypertensive elderly subjects.

Many physicians are reluctant to lower blood pressure to recommended levels in elderly hypertensive patients because of concern about producing cerebral hypoperfusion. Because hypertension is associated with potentially reversible structural and functional alterations in the cerebral circulation that may improve with treatment, we investigated whether long-term pharmacological reduction of systolic blood pressure will improve, rather than worsen, cerebral blood flow and its regulation. Three groups of elderly subjects 65 years of age or older were studied prospectively: normotensive subjects (N=19), treated hypertensive subjects with systolic pressure <140 mm Hg (N=18), and uncontrolled hypertensive subjects with systolic pressure >160 mm Hg at entry into the study (N=14).

Effect of blood pressure on cognitive functions in elderly persons.

Background: Little is known about what specific cognitive functions are affected by elevated blood pressure (BP) and how orthostatic BP change is related to cognitive impairment. The aim of this study was to determine the effect of BP and its postural change on cognitive functions in otherwise healthy elders.

Methods: In 70 healthy persons (mean age, 72 +/- 4 years), supine systolic BP (SBP) was assessed 3 times using a sphygmomanometer, and the average values were obtained for the analysis.

Emergence of complex dynamics in a simple model of signaling networks.

Various physical, social, and biological systems generate complex fluctuations with correlations across multiple time scales. In physiologic systems, these long-range correlations are altered with disease and aging. Such correlated fluctuations in living systems have been attributed to the interaction of multiple control systems; however, the mechanisms underlying this behavior remain unknown.

Multimodal pressure-flow method to assess dynamics of cerebral autoregulation in stroke and hypertension.

Background: This study evaluated the effects of stroke on regulation of cerebral blood flow in response to fluctuations in systemic blood pressure (BP). The autoregulatory dynamics are difficult to assess because of the nonstationarity and nonlinearity of the component signals.

Methods: We studied 15 normotensive, 20 hypertensive and 15 minor stroke subjects (48.

Is pulse pressure a predictor of cardiovascular complications in a frail elderly nursing home population?

Background And Aims: Previous studies have focused on systolic blood pressure (SBP), diastolic pressure (DBP), and more recently pulse pressure (PP) as risk factors for adverse cardiovascular (CV) endpoints in elderly people. However, the relation between these pressures and CV complications in the frail nursing home population has not been well studied. The aims of this project are to determine the value of PP in predicting CV complications in a nursing home population, and to compare its predictive value with SBP, DBP, and mean arterial pressure (MAP).

Cerebral pressure-flow relations in hypertensive elderly humans: transfer gain in different frequency domains.

The dynamics of the cerebral vascular response to blood pressure changes in hypertensive humans is poorly understood. Because cerebral blood flow is dependent on adequate perfusion pressure, it is important to understand the effect of hypertension on the transfer of pressure to flow in the cerebrovascular system of elderly people. Therefore, we examined the effect of spontaneous and induced blood pressure changes on beat-to-beat and within-beat cerebral blood flow in three groups of elderly people: normotensive, controlled hypertensive, and uncontrolled hypertensive subjects.

Cerebral white matter changes and geriatric syndromes: is there a link?

Cerebral white matter lesions (WMLs), also called "leukoaraiosis," are common neuroradiological findings in elderly people. WMLs are often located at periventricular and subcortical areas and manifest as hyperintensities in magnetic resonance imaging. Recent studies suggest that cardiovascular risk factors are associated with the development of WMLs.

Spectral indices of human cerebral blood flow control: responses to augmented blood pressure oscillations.

We set out to fully examine the frequency domain relationship between arterial pressure and cerebral blood flow. Oscillatory lower body negative pressure (OLBNP) was used to create consistent blood pressure oscillations of varying frequency and amplitude to rigorously test for a frequency- and/or amplitude-dependent relationship between arterial pressure and cerebral flow. We also examined the predictions from OLBNP data for the cerebral flow response to the stepwise drop in pressure subsequent to deflation of ischaemic thigh cuffs.