Plasticity. Human senescence is a slow, chronic process of poisoning that ultimately culminats in death. Elie Mechnikoff

Transcription

1 Plasticity Human senescence is a slow, chronic process of poisoning that ultimately culminats in death Elie Mechnikoff 1903

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3 Decline in death from CVD Nabel & Braunwald, NEJM 2012

4 Life expectancy at different periods & ages (AUS) Current cure and care not suitable for oldest old Natural age of death

5 Life expectancy at birth, top 10 OECD countries (2013)

6 Lifelong health = lifelong challenge Life expectancy changed Challenge changed Disease presentation changed Mattson et al., 2015 Ageing Res Rev; Andel et al., 2014 J Gerontol

7 Seals et al., J Physiol 2015

8 Pattern with chronological age Danish Twin studies, population based N=11307 Vestergaard et al., 2015 Aging&Mental Health

9 Pattern with chronological age Vestergaard et al., 2015 Aging&Mental Health

10 Pattern with chronological age Vestergaard et al., 2015 Aging&Mental Health

11 Prevalence diabetes Polonsky, NEJM 2012

12 Ng et al., Lancet 2014 Overweight and obesity 2010: cause of 3 4 million deaths, 3 9% of years of life lost worldwide Worldwide BMI 25kg/m2 or higher: Men: 29 37% Women: 24 28% Overweight/obese children: Developed countries 14 23% Developing countries 8 13%

13 Life expectancy increases = years with limitations.

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16 Health expenditure/person, 2009 (AUS)

17 State of Victoria, Department of Health & Human Services September 2015.

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19 the biggest problem in 2030 is functional impairment of people... due to walking disability, dementia, incontinence and lack of care Marian Kaljouw

20 Seals & Melov, Aging 2014

21 Life expectancy increases = years with limitations. Medicine = Prevention, Aged Care.

22 Naylor et al., Clin Pharm Ther 2013 Understanding Disease specific Aging specific

23 CELL SENESCENCE Fiction or future fact? Organs senescence Blood Skin Colon Liver Lung Spleen Testis Skin senescence & CVD Waaijer et al. Aging cell, 2012!!! Figure: Burton and Krizhanovsky, Cell Mol Life Sci Sijia Chen Mariëtte Waaijer Viviane Schouten Monique Slee Andrea Maier

24 Grey Power Sarcopenia, quality and amount of physical activity Aim: To understand the relations between muscle-related parameters and physical activity Esmee Reijnierse Anna Rojer Marijke Trappenburg Carel Meskers Andrea Maier Mirjam Pijnappels

25 SHAPE Sarcopenia, nutritional status, physical activity Aim: To understand the interrelations Esmee Reijnierse Anna Rojer Marijke Trappenburg Carel Meskers Marian de van der Schueren Andrea Maier Sjors Verlaan

26 STANDUP Orthostatic hypotension (OH) and physical performance/balance Aim: To improve assessment and non-pharmacological treatment of OH in geriatric outpatients Eline de Bruïne Sjoerd Timmermans Esmee Reijnierse Marijke Trappenburg Carel Meskers Andrea Maier

27 Mobility and Cognition Falls Loss of independence Loss of quality of life Aim To understand the relation between the age-related changes in cognition and mobility Marjon Stijntjes Andrea Maier Carel Meskers Eline Slagboom

28 Cognition Geriatric outpatient clinic cohort Functional and cognitive measures, 3T MRI AWARE Souvenaid for treatment dementia Amsterdam iadl Pain in dementia Pain experience (autonomic response) Orofacial pain Joint pain Hanneke Rhodius Tarik Binnekade Suzanne Delwel Sietske Sikkens Erik Scherder Philip Scheltens et al.

29 90+ Study 90+ Cognition Nienke Legdeur Pieter Jelle Visser Andrea Maier Philip Scheltens

30 PRE-MUSCLE Muscle mass Colorectal cancer Treatment Aim: Low muscle mass as a predictor for complications and not completing therapy in elderly with colorectal cancer? Received chemotherapy OR 95% CI p Age < Gender < Polypharmacy <.001 Stéphanie Looijaard Monique Slee Andrea Maier Joost Klaase + Multimorbidity <.001

31 EMP WER Aim: What is the impact of hospitalization on muscle mass and power in patients aged 70 years and older? Admission Discharge One month after discharge 1st assessment Muscle mass Grip strength Resting energy expenditure ADL & iadl 2nd assessment Muscle mass Grip strength 3th assessment ADL & iadl Jeanine van Ancum Eva Smeenk Hanna van Bruggen Floor Neelemaat Monique Slee Carel Meskers Andrea Maier Et al.

32 PAP Aim: To explore the stimulating and obstructive factors in older adults and medical staff towards Physical Activity Participation during hospitalisation Amber Schoenmakers Andrea Maier Kira Scheerman Oscar de Vries

33 Delirium Hospital admission 4. Post delirium care 1. Risk screening: Inouye, VMS, Delirium risk assessment score Post delirium Risk 3. Diagnosis: DOM, DRS-R98 Multidisciplinary intervention (secondary prevention) Diagnosis delirium 2. Delirium assessment: DOS, CAM, CAM-ICU Multidisciplinary intervention (primary prevention) Ralph Vreeswijk Kees Kalisvaart Andrea Maier

34 Prevention of functional decline in middle aged by physical IT based intervention based on the LIFE program PANINI Defining the comprehensive geriatric assessment in older people (GP, outpatients, inpatients)

35 Life expectancy increases = years with limitations. Medicine = Prevention, Aged Care. Interaction ageing hub.

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