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The study products were also evaluated for safety. Results The intention-to-treat analysis showed that there was no significant difference between the groups in terms of the ADAS-cog total score. Orientation, as measured by the respective ADAS-cog subscale, was significantly improved compared to placebo at 24 weeks post-MKP administration (P = 0.022). Topoisomerase inhibitor No serious adverse events due to MKP intake were observed. Conclusion To the best of our knowledge, this is the first study to report the effects of MKP on human cognition. These preliminary results suggested the safety of daily MKP intake and its potential to improve orientation in adults without dementia. Further clinical studies are needed to confirm the present findings and the benefits of MKP on cognitive function.Purpose Reduced kidney function has been associated with an increased risk for adverse outcomes. Accurate assessment of glomerular filtration rate (GFR) is key to diagnosis and management of kidney disfunction. Debate exists on the best GFR estimation equation for elderly people. This study aimed to compare the predictive validity and discriminative ability of four GFR equations in relation to 2-year and 6-year mortality in exceptional longevity (EL) (those over 95 years old with intact health) individuals and is an ideal model to address factors relating to life span and age-related diseases. Patients and methods This study used 6 years' data of 278 EL from the Rugao longevity cohort. Baseline GFR was estimated using four equations Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, Modification of Diet in Renal Disease Study (MDRD) equation, Berlin Initiative Study-1 (BIS) equation, and modified MDRD equation. Predictive validity was tested using Cox proportional hazards analysis. Overall improvement in reclassification based on estimated GFR (eGFR) was assessed applying net reclassification improvement (NRI). Results Mean age of participants was 97±2 years with median follow-up of 2.6 years. Median (IQR) eGFR by CKD-EPI, MDRD, BIS, and modified MDRD equations were 73.9 (62.2-77.6), 82.3 (67.4-98.6), 56.4 (47.9-63.9), and 101.5 (83.1-121.6) mL/min per 1.73 m2, respectively. Higher eGFREPI was associated with lower mortality after multivariate adjustment (for continuous eGFREPI, HRtwo-year 1.018, 95% CI 1.002-1.033, P=0.023; HRsix-year 1.013, 95% CI 1.002-1.025, P=0.022), while eGFR from other equations did not show any associations with mortality. NRI for two-year mortality was 0.14 and approximately significant, which may favor the CKD-EPI when compared to BIS equation (P=0.052). Conclusion The CKD-EPI equation showed more accurate estimation of kidney function in the elderly with respect to GFR distribution and predictability of mortality risk.Introduction The clinical benefit of invasive therapy in elderly patients with acute coronary syndrome (ACS) remains unclear. Furthermore, the decision-making process to treat this growing patient group is also debatable. The purpose of this study was to assess the association between elderly ACS patients, the treatment choice and their in-hospital outcomes after non-ST-elevation (NSTE)-ACS in a consecutive series of patients >75 years of age. Methods and results Consecutive patients >75 years presenting with NSTE-ACS in our hospital between July 2017 and July 2018 were included during the first 2 days of hospital admission. Demographic data, prior medical history and present medical condition were documented. During day 0 and day 2, geriatric assessments (Clinical Frailty Scale [CFS], Barthel index, Charlson comorbidity index, "timed up and go" test [TUG], Mini-Mental Status Test [MMS], Geriatric Depression Scale [GDS], SF-36 for quality of life, instrumental activities of daily living [IADL], Killip-ment. Conclusion Effective revascularization techniques are still underused in patients of older age in the case of ACS. For decision-making, geriatric tests alone may not predict treatment in those patients, but the combination of different tests may better predict treatment and perhaps the clinical outcomes in those patients. Furthermore, frail patients are at higher risk for not receiving guideline recommended therapy.Background There is little research in the efficacy and safety of a pharmaco-invasive strategy (PIS) in patients ≥75 years versus less then 75 years of age. We aimed to evaluate and compare the influence of advanced age on the risk of death and major adverse cardiac events (MACE) in patients undergoing PIS. Methods Between January 2010 and November 2016, 14 municipal emergency rooms in São Paulo, Brazil, used full-dose tenecteplase to treat patients with STEMI as part of a pharmaco-invasive strategy for a local network implementation. Results A total of 1852 patients undergoing PIS were evaluated, of which 160 (9%) were ≥75 years of age. Compared to patients less then 75 years, those ≥75 years were more often female, had lower body mass index, higher rates of hypertension; higher incidence of hypothyroidism, chronic renal failure, prior stroke, and diabetes. Compared to patients less then 75 years of age, in-hospital MACE and mortality were higher in patients with ≥75 years (6.5% versus 19.4%; p less then 0.001; and 4.0% versus 18.2%; p less then 0.001, respectively). Patients ≥75 years had higher rates of in-hospital major bleeding (2.7% versus 5.6%; p=0.04) and higher incidence of cardiogenic shock (7.0% versus 19.6%; p less then 0.001). By multivariable analysis, age ≥75 years was independent predictor of MACE (OR 3.57, 95% CI 1.72 to 7.42, p=0.001) and death (OR 2.07, 95% CI 1.12-3.82, p=0.020). Conclusion In patients with ST-segment elevation myocardial infarction undergoing PIS, age ≥75 years was an independent factor that entailed a 3.5-fold higher MACE and 2-fold higher mortality rate compared to patients less then 75 years of age.Skeletal muscle aging manifests as a decline in muscle quantity and quality that accelerates with aging, increasing the risk of sarcopenia. Sarcopenia is characterized by a loss of muscle strength and mass, and contributes to adverse health outcomes in older adults. Intervention studies have shown that sarcopenia may be treated by higher protein intake in combination with resistance exercise (RE). In comparison, less is known about the role of whole protein-containing foods in preventing or treating sarcopenia. Liquid milk contains multiple nutrients and bioactive components that may be beneficial for muscle, including proteins for muscle anabolism that, alone or with RE, may have myoprotective properties. However, there is a lack of evidence about the role of milk and its effects on muscle aging. This narrative review considers evidence from three observational and eight intervention studies that used milk or fortified milk, with or without exercise, as an intervention to promote muscle health and function in older adults (aged 50-99 years). The observational studies showed no association between higher habitual milk consumption and muscle-related outcomes. The results of intervention studies using fortified milk in relation to elements of sarcopenia were also negative, with further inconclusive results from the studies using a combination of (fortified) milk and exercise. Although milk contains nutrients that may be myoprotective, current evidence does not show beneficial effects of milk on muscle health in older adults. This could be due to high habitual protein intakes (>1.0 g/kg BW/d) in study participants, differences in the type of milk (low-fat vs whole) and timing of milk consumption, length of interventions, as well as differences in the sarcopenia status of participants in trials. Adequately powered intervention studies of individuals likely to benefit are needed to test the effectiveness of a whole food approach, including milk, for healthy muscle aging.Chemobrain is one of the problems that may arise during or after treatment and there is currently no specific treatment for this condition. Our case was a 76-year-old female patient who presented to our clinic with complaints of forgetfulness that did not affect daily living activities for the last year. Breast cancer was diagnosed in 2013 and she has been receiving anastrozole treatment for 6 years after local mass excision surgery and radiotherapy. After a comprehensive geriatric evaluation, cognitive impairment due to systemic cancer therapy was detected and treatment was started with Theracurmin 90 mg twice a day therapy. After 3-months of Theracurmin therapy, she had no cognitive improvement during the follow-up. This case report demonstrated that Theracurmin treatment may be a new option for chemobrain.Purpose Frailty is a geriatric syndrome that is usually considered as a set of physical deficits (unidimensional concept); however, it can also concern the psychological and social domains of human functioning (multidimensional concept). The FRAIL scale is a diagnostic tool which ascertains only physical frailty, whereas the Tilburg Frailty Indicator (TFI) is a diagnostic instrument for multidimensional frailty. The study investigates if non-robust physical status and multidimensional frailty affect the same individuals and whether simultaneous employment of the FRAIL scale and TFI identifies specific subgroups of elderly people which require different interventions. Patients and methods In this cross-sectional study, 1024 community dwelling elderly individuals at the age of 65 years or older (mean age 72.6 ± 6.3 years; range 65-93 years) were evaluated with the FRAIL scale and TFI. Results According to the FRAIL scale, 52.9% of the subjects were physically non-robust, but according to TFI, 54.6% presented multidimensional frailty. These two diagnostic tools were concordant in their outcomes in 77.1% (ie, 42.3% of individuals were physically and multidimensionally frail but 34.8% were robust according to both two instruments); however, in 22.9% the outcomes were discordant. Consequently, by simultaneous employment of the FRAIL scale and TFI, four distinct functional categories have been distinguished (i) non-robust physical status with multidimensional frailty, (ii) exclusive non-robust physical status, (iii) exclusive multidimensional frailty, and (iv) full robust status. Conclusion By applying simple physical and multidimensional frailty diagnostic tools, subgroups of elderly people may be identified that require specific management strategies to improve their functional status.Background Flourishing is related to positive outcomes for physical and mental health, as well as overall wellbeing. The aim of the present study was to determine the validity and reliability of the Flourishing Scale (FS) among a sample of older participants in Iran. Methods In this validation study, 300 older people were selected by cluster sampling method. Data were collected using a checklist for demographic characteristics, the FS, and the Oxford happiness questionnaire. The validity (face, content, convergent, and construct) and reliability (Cronbach's alpha, test-retest) of the FS was evaluated in this cross-sectional study. Results The exploratory factor analysis demonstrated a one-dimensional structure consisting of 8 items with an eigenvalue of 3.583. The model had a good fit [χ2 = 52.983, p less then 0.001, χ2/df = 2.944, GFI = 0.958, CFI = 0.915, IFI = 0.949, TLI = 0.919, AGFI = 0.948, and RMSEA = 0.081, SRMR = 0.086] with all factor loadings greater than 0.5 and statistically significant. A test of concurrent validity showed a direct and significant association between the FS and the Oxford happiness questionnaire (r = 0.