In delayers, low levels of risk
factors will result in a low rate of accumulation of pathologies, eventually surpassing the threshold for cognitive decline. In these individuals, the association between cognitive decline and neuropathological features is expected to resemble the association in younger elderly. In escapers on the other hand, the composition, rather than amount, of the accumulated pathologies is likely to play a bigger role in cognition—a large variety of minimal pathologies (each one by itself is not sufficient for causing dementia) will trigger the dementing processes. The greater proportion of resilient individuals in the oldest-old, compared to younger Inhibitors,research,lifescience,medical population, may account for the diminished association between pathology and cognition. The fact that not all oldest-old are necessarily resilient,
may explain the discrepancies in findings in different studies. To date, research of the oldest-old is limited Inhibitors,research,lifescience,medical not only by the medical and physical features of extreme age, but also by administrative considerations. The NINCDS gold standard for AD clinical diagnostic criteria are limited to Inhibitors,research,lifescience,medical age 90,155 leading to exclusion of those at highest risk from major international studies. Thus, raising the awareness of the clinical and pathological meaning of dementia in the oldest-old is of enormous urgency. Only extensive research will enable us to provide this rapidly growing population with good quality of life and graceful aging. Abbreviations: AD Alzheimer’s disease; ADL Activities of Daily Living; ApoE apolipoprotein E; BADL basic ADL; IADL instrumental ADL; MCI mild cognitive impairment; MMSE Mini-Mental State Examination; Inhibitors,research,lifescience,medical MRI magnetic resonance imaging; NINCDS National Institute Inhibitors,research,lifescience,medical of Neurological and Communicative Disorders and Stroke—Alzheimer’s
Disease; PET positron emission tomography; VaD vascular dementia. Footnotes Conflict of interest: No potential conflict of BGB324 manufacturer interest relevant to this article was reported.
The term sarcopenia (in Greek, sarx for flesh else and penia for loss), first proposed by Irwin Rosenberg, describes the age-related loss of skeletal muscle mass and strength.1 Sarcopenia is a common impaired state of health with a high personal toll and huge financial costs.2 However, sarcopenia has no accepted clinical definition and no codes in the International Classification of Diseases 9th Revision (ICD-9).2 Therefore, the European Working Group on Sarcopenia in Older People (EWGSOP), assembled in 2009, developed definitions, diagnostic criteria, categories, and stages in sarcopenia.2 According to the EWGSOP, sarcopenia is diagnosed by the presence of low muscle mass along with low muscle function (strength or physical performance).