Day 1 :
Keynote Forum
Vinod Nikhra
Hindu Rao Hospital & NDMC Medical College, New Delhi, India
Keynote: Metabolic Disequilibrium and Aging: Modifying Favourably with Fibromyalgia and Chronic Pa
Biography:
Dr Vinod Nikhra is a Senior Consultant Physician and Faculty at NDMC Medical College and Hindu Rao Multi-speciality Public Hospital, New Delhi, India. He is a healthcare administrator, academician and clinician. He has been a Visitor at Cleveland Clinic Foundation, Cleveland and an Observing Physician at Alabama Medical Center – a tertiary care hospital in Opelika, Alabama, USA. He has been elected a Fellow by International Medical Sciences Academy and the Royal Society of Medicine, London. He has been Editor of ‘Madhya, the midage’, the official Journal of Association for Health in Middle Age during 2003-2006. He has been on Reviewer panel of, among others, the Family Practice, an Oxford University medical journal and International Journal of Obesity. His published books include, ‘Aging slowly, Living longer’ and ‘The Anti-obesity Guide’. Over the years he has contributed about hundred papers in leading national and international medical journals.
Abstract:
METABOLIC DISEASE AND AGING: There is increasing evidence that metabolic disequilibrium and disorders influence the aging process and survival including the quality of life (QOL). The adipose tissue mediates various age-associated metabolic disorders such as insulin resistance (IR), metabolic syndrome (MetS), dyslipidemia and type 2 diabetes mellitus (T2DM), altogether which can negatively affect the lifespan and sends signals to modify the aging process in various tissues and organs. The role of master-switch and genomic guardian, p53 is important in this context. CALORIE RESTRICTION (CR): The energy needs are determined by the body composition, especially the fat free lean mass and level of physical activity, and there is a change in nutritional needs during the middle age and later. The diet-gene interaction is a major determinant of health and illness, and the amount and type of food ingestion and caloric intake, in general, influence the health and life span. An excess calorie intake causes overnutrition and nutritional overload leading to increased adipose stores culminating as weight gain and obesity, which lead to IR, MetS, T2DM and other metabolic alterations. At the subcellular and cellular level there is increased potentially damaging exposure to reactive oxygen species (ROS). CR MECHANISMS AND PATHWAYS: There have been identified several metabolic and genetic pathways that govern food ingestion, metabolism and life span. Experimentally, the CR has been shown to achieve increased lifespan in a broad spectrum of life forms from yeast, nematode, fruit fly, rodents and primates, including Homo sapiens, endosing that a diet adequately fulfilling nutritional needs, but low in calories may improve health, prevent many late-onset diseases and extend the life span. But, the benefits of CR are not a passive result of lower caloric intake but the consequence of an active regulatory intervention mimicking the food scarcity and activating certain genetic and metabolic programs that result in various vital beneficial effects. The genetic and molecular studies in model organisms, in fact, suggest that CR is a regulated process, in which the SIRT (Silent Information Regulator 2) gene plays an important role. IMPACT OF CR ON QOL AND DISEASE: CR has long been recognized for its ability to extend life span and mitigate aging and stall disease processes in various organs. The data from animal and human studies indicate that the CR affects favourably several metabolic and molecular factors that modulate cardiovascular age-related alterations including Cardiac and arterial stiffness, hypertension and heart rate variability. These effects, in combination with various other benefits, such as protection against adiposity, IR and T2DM, neurodegenerative diseases and cancer, suggest that the CR may have a major beneficial effect on health status, quality of life and life span in humans.
- Aging and Gerontology, Aging and Geriatrics, Neuroplasticity and Aging.
Location: WEBINAR
Session Introduction
Kelvin M. Leshabari
H3 Research Unit of I Katch Technology Ltd. Dar es Salaam, Tanzania
Title: Neuroplasticity and Aging
Biography:
Kelvin is a clinical researcher in geriatric endocrinology/cardiology. He trained in Medicine and was thereafter a fellow at different institutions in the Netherlands and Belgium. He received his MSc degree from the University of Leiden (The Netherlands) back in the summer of 201. Kelvin practices clinical geriatrics in up to 30 of his work time. He has managed to establish and follow-up a cohort of 100 geriatric clients in a year time. At present, he is the principal investigator of Cardio-metabolic Risk Intervention & Surveillance programme in Tanzania (CRISTA) where he spent up to 0 of his work time.
Abstract:
Objective: To estimate the prevalence of subclinical hypothyroidism among adult population aged > 65 years in a typical sub-urb of sub Saharan Africa. Methods: A cross-sectional screening was done at a private hospital clinic setting in Dar es Salaam, Tanzania from August 2018 to Feb 2019. Adult patients (age> 65 years) were the target population. Data collected included symptoms & signs at clinic presentation; date of birth; gender; thyroid function tests (i.e. serum-TSH, serum T3 and T4 levels); systolic & diastolic BP; glycaemia stata (both FBG & HBA1c levels); past & current medical history; drugs history; alcohol & smoking history as well as family & social history. For those who were found to have abnormal thyroid function tests values, a separate appointment for USS thyroid scan was booked and findings analysed.Continuous data were summarized using median (with inter quartile range) while categorical data were summarized using frequency (with proportions) Generalised linear model was used for main data analysis. SAS version 9.4 was used for analysis. Verbal informed consent was sought from each participant prior to screening session. Results: We managed to screen 311 different adult residents of Ubungo-Msewe area in Dar es Salaam. Median age was 64 (IQR: 55 – 73.4) years. Point prevalence of sub-clinical hypothyroidism was found to be 9.4%. Males with subclinical hypothyroidism were also found to have known co-morbidities (Diabetes mellitus: 38% vs. 11.3%; Isolated Systolic Hypertension: 66.9% vs. 24.1%; chronic heart failure: 10.5% vs. 1.2%) compared to females (all P< 0.01). None of the respondents with screen-positive results for subclinical hypothyroidism were on treatment at the time of screening. Females were more likely to return for further clinical evaluation post-screening. Conclusion: the burden of subclinical hypothyroidism is higher than expected in this study population. Screened participants with subclinical hypothyroidism were likely to have clinically significant co-morbidities. There appears to be a gender effect in response to screening results for subclinical hypothyroidism.
Aurel Popa-Wagner
University of Medicine Essen, Germany
Title: CELLULAR AUTOPHAGY – TREATMENT TARGET FOR THE AGING PROCESS
Biography:
Dr. Popa-Wagner has completed his PhD at the age of 31 years from University of Karlsruhe postdoctoral studies from University of Southern California. In 2012, he joined the the Department of Psychiatry, University of Medicine, Rostock, Germany and from 2017 he joined the Chair of Vascular Neurology and Dementia at the Clinic of Neurology, Medical University, Essen, Germany. He has published more than 120 papers in reputed journals and has been serving as an Associate Editor for several journals and editorial board member of repute for many journals.
Abstract:
As life expectancy increases, there is an ever growing interest in preventing these diseases and multiple studies are looking for the answer to a healthy aging. Recently, several studies have focused on various aspects of ageing and autophagy. Cellular autophagy plays an important role in cytoprotection and in maintaining cellular homeostasis by preventing accumulation of toxic proteins and by eliminating pathogens. We hypothesized that pharmacological stimulation of autophagy may lead to partial regeneration of aged tissues and may stimulate healthy aging from a cognitive, as well as a functional point of view. Our objective was to assess the efficacy of the drug SPT100 to extend life and improve cognitive function and spatial memory (Water-Maze) and motor function (Rotor-Rod), by stimulating autophagy processes at tissue and cellular level in the brain and the liver through transcriptomic, genomic, proteomic and imunohistochemical methods. We found that treatment with SPT100 did not extend the life span of aged rats. However, SPT100 improved the cognitive and motor functions of the aged rats, as assessed with Elevated Plus maze, Latency Curiosity Test and Forced Swim. This compound has also promising anti-inflammatory and anti-apoptotic effects on the central nervous system. We hypothesized that long-term treatment with SPT100 could reduce gene expression of various inflammation markers, including: C11, CR3, Tgfb, Cxcl10, CXCR4, Fcgr3a and Stat. Thus, by RT–PCR, we found significant decreases in the expression of mRNA coding for inflammation and astroglial markers. These results may offer a basis for further studies regarding the protective mechanisms of autophagy stimulation on the aging process.
Yuanmay Chang
Institute of long term care, MacKay Medical College, Taiwan
Title: Aerobic Exercise on Sleep Quality and Physical Fitness with aged schizophrenia patients
Biography:
Chang Yuanmay has worked in the Nursing Department of Shin-Kong Medical Center since she graduated from 1992. After her PhD graduated from University of Wisconsin-Milwakee, she had been Chief Nurse Officer in 2003-2011. With very high motivation and multidisciplinary training, she is capable to coordinate well with others and showed herself to possess many of the skills that any successful professional requires. Now She is an associate professor in long term care in Mackay medical college. She has published more than 20 papers in journals and has been serving as a reviewer of Journal of Advanced Nursing.
Abstract:
The Moderate Aerobic Intensity Training (MIT) is used to describe the sleep quality and physical fitness of the elderly schizophrenia whom have insomnia: softness, balance ability and lower limb muscle strength. Method: This study was an quasi-experimental study, we select 30 patients with chronic schizophrenia in a northern psychiatric center in Taipei. The experimental group (EG) received MIT for 12 weeks. Exercise course for 50 minutes three times a week, total have 9 balance training, 10 softness training and 11 lower extremity strength training. The control group (CG) receive treatment as usual. Measurement included sleep quality assessment (SQA) by Insomnia Severity Index Chinese version (ISI-C), nursing daily sleep record and actiwatch (with sleep duration, wake after sleep onset). Functional fitness test (FFT) : Body mass index (BMI), Waist-to-hip ratio (WHR), 30-second chair stand (lower limb muscle strength), seated forward bend (lower limb flexibility), 8-foot up-and-go (static balance), single-leg stand with eyes closed (static balance). A total of five measurement times including pretest, 4th, 8th, and 12th week after exercise, and no intervention in the 16th week after stopping exercise. Results: Data analysis with SPSS version 22.0, using descriptive statistics, independent T test, repeated measure ANOVA, and linear regression for statistical analysis. In the objective of SQA, nursing daily sleep record and actiwatch (with sleep duration, wake after sleep onset) total of five times measurement had no significant differences in both groups. In the subjective evaluation, the ISI-C of EG began to improve at the 4th week (β = -5.667, p =.003) and had significant difference until the 12th week(β= -9.067, p <.001). The ISI-C of the EG decreased after no exercise (β= -2.667, p =.190). The effects of physical fitness, the EG began to be effective in the 4th week after intervention, the most significant benefit reached the peak of the eighth week , and remained flat until the 12th week: 30-second chair stand (β = 5.933, p <.001), 8-foot up-and-go (β = -1.619, p <.001), single-leg stand with eyes closed (β = 6.277, p <.001) and physical fitness continued significant to the 16th week. BMI and WHR had no significant differences due to no diet control. Seated forward bend was improved in both group but no significant difference. Conclusion :This study was a 12-week MIT intervention to improve sleep quality and fitness in patients with schizophrenia. It is recommended that ward routine adjustment of exercise time according to FITT principles and patient mental status, accumulating at least 150 minutes per week, effective exercise improves FFT and SQA.