Association between statin use and physical function among community‐dwelling older Japanese adults

The management of hypercholesterolemia in older adults still represents a challenge in clinical medicine. The pathophysiological alterations of cholesterol metabolism associated with aging are still incompletely understood, even if epidemiological evidence suggests that serum cholesterol levels increase with ongoing age, possibly with a plateau after the age of 80 years. Age is also one of the main determinants of cardiovascular disease, according to all cardiovascular risk estimate tools. Cholesterol‐lowering treatment, therefore, would be expected to bring significant protection, even in these patients. Unfortunately, direct experimental evidence is extremely limited, particularly in the very old age strata of the population; a clinical benefit still seems to be present, but the risk for drug‐related adverse events is clearly higher. At any rate, at the present time, definite guidelines for the correct management of hypercholesterolemia in older patients are not available. Therefore, the decision whether or not a pharmacological treatment should be set up, and the choice of the drug, need to be tailored to the individual patient, and requires accurate clinical judgment. The specific aspects of frailty and disability, along with the actual age of the patients, have to be considered together, with a comprehensive assessment approach. The present review summarizes the evidence regarding the modifications of cholesterol metabolism in older patients, the impact of lipid‐lowering drugs on cardiovascular outcomes and focuses on the considerations that can help to define the most appropriate treatment strategy, in view of the individual functional profile. Geriatr Gerontol Int 2019; 19: 375–383.

“…A study carried out in community‐dwelling patients did not show a decline in physical function measures associated with muscle performance, with statin use …”

Section: Clinical Experimental Evidence With Cholesterol‐lowering Agementioning

confidence: 94%

Section: Safety Issuesmentioning

confidence: 99%

Management of high cholesterol levels in older people

Bertolotti

Lancellotti

Mussi

2019

“…For single‐leg standing, the time from the point when participants elevated their non‐dominant leg to the point when they lost their balance was measured, and its upper limit level was defined as 60 s …”

Section: Methodsmentioning

confidence: 99%

“…18 The direction of turn was free. For single-leg standing, the time from the point when participants elevated their non-dominant leg to the point when they lost their balance was measured, and its upper limit level was defined as 60 s. 19 The maximum gait speed was measured on a 10-m walkway, with 2-m acceleration and deceleration areas at the start and end sections. 20 The participants were instructed to walk as fast as possible and not to run on the walkway.…”

Section: Physical Functionmentioning

confidence: 99%

Age‐related changes in muscle elasticity and thickness of the lower extremities are associated with physical functions among community‐dwelling older women

Saito

Wakasa

Kimoto

et al. 2018

Aim To clarify the age‐related changes in muscle elasticity or thickness of the lower extremities in older women, and to analyze their relationship with physical functions. Methods The muscle elasticity and thickness of the rectus femoris and medial head of the gastrocnemius of 102 young women (young group) and 221 elderly women (elderly group) were measured using ultrasonography. In the elderly group, physical functions, including knee extension strength, Timed Up and Go test, single‐leg standing, maximum gait speed and Four Square Step Test were also measured. Results The elasticity of the rectus femoris and medial head of the gastrocnemius were significantly higher, but the muscle thickness of both muscles was significantly lower in the elderly group than in the young group (both P < 0.001). In the elderly group, the elasticity of the rectus femoris was significantly correlated with Timed Up and Go test, maximum gait speed and Four Square Step Test (ρ = 0.481, r = −0.387 and ρ = 0.401, respectively, all P < 0.001), and the medial head of the gastrocnemius was similar (ρ = 0.471, r = −0.489 and ρ = 0.422, respectively, all P < 0.001). The muscle thickness of the rectus femoris was significantly associated with knee extension strength (r = 0.444, P < 0.001). Conclusions Older women showed age‐related changes in high elasticity and atrophy of the rectus femoris and medial head of the gastrocnemius. The high elasticity of both muscles, not muscle thickness, was associated with dynamic balance and walking ability. Geriatr Gerontol Int 2019; 19: 61–65.

“…Participants were recruited from comprehensive health checks that were part of the Otasha-Kenshin study carried out in 2016 at the Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo, Japan). 10,11 The inclusion criteria were older communitydwelling individuals, aged ≥65 years. We excluded 54 participants, who did not consent to undergo cognitive assessment and those who found the CompBased-CAT difficult.…”

Section: Participantsmentioning

confidence: 99%

Development and validity of the Computer‐Based Cognitive Assessment Tool for intervention in community‐dwelling older individuals

Takahashi

Kawai

Suzuki

et al. 2020

Self Cite

Aim The Mini‐Mental State Examination is a widely used cognitive assessment tool. However, it has several limitations, including the learning effect and interrater reliability. Therefore, we developed a Computer‐Based Cognitive Assessment Tool (CompBased‐CAT), which runs on a tablet or personal computer. In this study, we examined the validity and discrimination ability of the CompBased‐CAT. Methods Participants were recruited from the Otasha‐Kenshin study carried out in 2016. We included 773 community‐dwelling older individuals in Japan (332 men, 441 women, aged 65–97 years). CompBased‐CAT scores were converted to z‐scores, and the correlation with Mini‐Mental State Examination scores was examined using Pearson's correlation coefficient. Furthermore, the ability to discern cognitive impairment was examined using the receiver operating characteristic curve. Results The Pearson's correlation coefficient for the Mini‐Mental State Examination scores and each task component of the CompBased‐CAT ranged from 0.24 to 0.41 (P < 0.001), and the correlation coefficient of the total z‐scores was 0.51 (P < 0.001). The sensitivity, specificity and area under the receiver operating characteristic curve of the discriminating ability of the CompBased‐CATool for cognitive impairment were 0.81, 0.77 and 0.85, respectively. Conclusions The CompBased‐CAT certainly possesses validity, discriminating ability and utility as a new cognitive assessment tool in community‐dwelling older individuals. Geriatr Gerontol Int 2020; ••: ••–••.