Jorjani Biomedicine Journal

Background & Objective: Dementia is associated with serious effects on memory, cognition and ability to carry out daily activities. There is evidence that impairment in activity of daily living (ADL) is even reported among elder patients who suffer from mild cognitive disorders. Therefore, we aimed to determine the status of ADL and instrumental activity of daily living (IADL) in healthy and cognitive impaired elderlies (MCI, Mild, and Moderate dementia).
Methods: In this cross-sectional study which was conducted in 2016, 300 elderlies (60 years and above) were selected using a classified cluster sampling in four groups (each group of 75 individuals). These groups comprised of healthy old people and elderlies with mild cognitive impairment (MCI) and mild to moderate dementia that were residing in rural areas of Isfahan and Tehran and were classified between stages of 1 to 5 according to the Global Deterioration Scale (GDS). All individuals in four groups were assessed by ADL and IADL evaluation tools. The geriatric depression scale (GDS-15) and DSM-IV scale were performed on healthy elderlies by a physician to confirm the lack of mild dementia or depression. Data were analyzed by SPSS 20 software and using descriptive statistics, analysis of variance and independent samples T-test.
Results: According to the cognitive impairment screening results by GDS, 76 elderlies were healthy, 75 were in MCI group, 72 individuals were diagnosed with mild dementia and 77 were suffering from moderate dementia. The mean scores of ADL tool on the basis of different cognitive stages of elderlies were statistically significant (p<0.001). The ADL scores among elderlies were lowered by increasing the severity of cognitive impairment. Moreover, the average scores of IADL among elderlies with different cognitive status were significantly different (p<0.001). The IADL scores in cases with moderate dementia were markedly declined in comparison to healthy subjects and elderlies with MCI and mild dementia.
Conclusion: Although applying the ADL and IADL tools are not considered as gold standards in rapid assessment of cognitive impairments among elderlies, they could be considered as useful and user friendly tools to detect performance alterations in elderlies with dementia to provide healthcare by geriatric teams.

Background and objectives: Proper nutrition and exercise are two effective factors in improving liver function in old age. The aim of this study was to investigate the effect of aerobic training (T) with consumption of Citrus aurantium (CA) on SIR1 and PGC-1α gene expression levels in the liver tissue of elderly rats.
Method: In this experimental study, 25 elderly female rats were placed in five groups of 5 rats, including 1) control, 2) sham, 3) CA, 4) T and 5) T+CA. Over the course of eight weeks, groups 4 and 5 ran on the treadmill three sessions per week at 65 to 75 percent of the maximum running speed, and groups 3 and 5 received 300 mg/kg/day of CA extract peritoneally. Forty- eight hours after the last training session and CA consumption, SIR1 and PGC-1α gene expression levels in the liver tissue were measured by real-time PCR method. In order to analyze the findings, the Shapiro-Wilk, one-way ANOVA with Tukey’s post- hoc tests were used (P≤0.05).
Results: T had a significant effect on increasing SIR1 (P = 0.009) and PGC-1α (P = 0.001) gene expression levels; CA had a significant effect on reducing SIR1 gene expression levels and increasing PGC-1α (P = 0.001); T + CA had a greater effect on increasing PGC-1α gene expression levels than T and CA (P = 0.001).
Conclusion: Although eight weeks of T and CA consumption alone appear to improve PGC-1α gene expression levels in the liver tissue of elderly rats, concurrent T and CA consumption has more favorable effects than each of them alone.

The COVID-19 crisis has changed the world and many aspects of our lives, even the way we treat the elderly. Evidently, the pandemic has put tremendous pressure on the healthcare system of every country, and there have been insufficient healthcare resources for the affected patients. We should seek to develop more care models for the elderly, so that when all human services are stopped.

Although social isolation could be easily implemented during COVID-19, it affects the elderly and increases their loneliness. Our experience of the COVID-19 pandemic has been unpleasant, changes in the style of social communication in the elderly and their using of new technologies indicate resilience and adaptation in the face of crises in the elderly, which is a valuable lesson learned from the circumstances.