8^th International Conference on Geriatrics Gerontology & Palliative Nursing July 30-31, 2018 | Barcelona, Spain

Masahiro Hayashi is a Neurologist. He worked in a national hospital having an institute of neurology for fifteen years. He is a Specialist in Parkinson’s disease,

spinocerebellar degeneration and dementing disorders. He has made a study of neuropathology and neuroimaging. Currently, neuroimaging is his area of specialization. He works as a Clinician at the Department of Neurology and Psychiatry in the private hospital in Japan.

Pisa syndrome is one of the abnormal postures. The term Pisa syndrome is defined as a lateral bending of a trunk. The mechanisms underlying Pisa syndrome have not been fully explained yet. It was originally considered as a consequence of treatment with antipsychotics which induce a cholinergic-dopaminergic imbalance. Subsequently, the term has been generally applied to trunk lateral deviation≥10°. Recently, it was reported that asymmetric functioning of basal ganglia could lead directly to asymmetric regulation of postural muscle tone related to a lateral deviation. We investigated the two schizophrenic patients. They developed Pisa syndrome while exposed to the long-term treatment with antipsychotics. In one case, 123I-FP-CIT dopamine transporter-single photon emission tomography imaging disclosed asymmetrical DAT uptake in the stiratum, which may be associated to asymmetric functioning of basal ganglia. Furthermore, it is possible that schizophrenic patients with Pisa syndrome developed the similar dysfunction of basal ganglia due to the exposure of long-term dopamine D2-receptor blockade. Because Pisa syndrome become irreversible condition in the advanced disease stages, early its recognition and the pharmacological adjustment especially the dosage of antipsychotic drugs should be important. Furthermore, postural deformities such as Pisa syndrome are frequent disabling complications of neurodegenerative diseases, especially Lewy body disease, frontotemporal dementia. The postural deformities have a multifactorial pathophysiology. Because the effects of levodopa treatment are limited, we have introduced botulinum toxin as therapeutic tool for the treatment of some neurological disorders. Botulinum toxin treatment resulted in significant improvement of the tension of muscles related to abnormal postures. We report these outcomes, including the pathogeny of Pisa syndrome and postural deformities this time.

Ivana Beatrice Mânica da Cruz has her expertise in genetic and environmental factors that could act on human aging modulation and risk of some chronic diseases prevalent in the elderly people. She is Biologist and has MSc and PhD degree in Genetics and Molecular Biology. Currently she is working as Associate Professor in Federal University of Santa Maria (UFSM, Brazil) where coordinates an MSc course of Gerontology. Moreover, she is Adviser of Pharmacological graduate program. Her research studies involve specially two lines projects that could be considered relevant in gerontology and geriatrics areas: Aging biology studies related to genetic and pharmacological SA-HP imbalance with approach from epidemiological investigation to cell culture in vitro analysis; and Pharmacogenomic and nutrigenomic studies associated to diseases prevalent in elderly people. These studies are specially concentrated about the effects of Amazon fruits on oxidative-inflammatory modulation aging-associated.

Statement of the Problem: Aging is a complex event where mitochondrial dysfunction has been in the spotlight for a long time. Since, prior evidences suggested that mitochondrial dysfunctions are related to oxidative-inflammatory and genotoxic processes, our research team has dedicated special efforts to understand the role of a bidirectional imbalance related to superoxide anion (SA) and hydrogen peroxide (SA-HP) on aging modulation and age-associated chronic non-transmissible diseases (CNTDs).

 

Methodology & Theoretical Orientation: Here, we reviewed 294 studies (16 from our group) English published and PubMed-Medline indexed involving a bilateral SA-HP imbalance triggered by a human single nucleotide polymorphism (rs4880 SNP) found in superoxide dismutase manganese-dependent gene (SOD2), which produces an enzyme acting inside of mitochondria (Val16Ala-SOD2).

 

Findings: In biological terms, SA is constantly produced by mitochondrial respiratory chain. Therefore, SOD2 is considered first line of antioxidant enzyme that dismutates SA to HP. The SOD2-SNP is located at mitochondrial sequence target that triggers SOD2-inactive cytoplasmic protein into mitochondria. A-allele produces an alpha-helix SOD2 protein that is more efficient to into mitochondria, whereas V-allele produces a beta-sheet SOD2 protein that is partially arrested in mitochondrial membranes. 132 studies analyzed association between A-allele and several cancer types, considering that A-allele increases SA-dismutation producing an excess of HP levels. HP leaves from mitochondria to cytoplasm producing hydroxyl radical (HR) that is highly mutagenic increasing cancer-susceptibility. Main risk associated to AA-genotype is prostate cancer. V-allele presents lower SOD2-efficient and SA excess react with nitric oxide (NO) triggering lipoperoxidation. Therefore VV-genotype has been associated with different metabolic diseases, such as hypercholesterolemia, its response to rosuvastatin, and chronic inflammation.

 

Conclusion & Significance: SA-HP imbalance seems to have a critical role on elderly-prevalent CNTDs and could be considered an emergent geriatric focus related to prevention and control of CNTDs.

Joana Alegria Pereira has an Integrated Master in Psychology, with a specialization in Clinical and Health Psychology by University of Minho. Since 2013, she has collaborated with different research groups, having started this journey in the University Research Group on Self-regulation (EPSI-UM), in matters of homework and parental involvement. After completing the integrated master's degree, she has joined the team of NeuroRehabLab (M-ITI), aim to contribute to the clinical validation of new methodologies of cognitive and motor rehabilitation in post-stroke. At the moment, she collaborates as research assistant in the project "Aging with Security in the Alentejo Understanding to Act" (ESACA - Refª: ALT20-03-0145-FEDER-000007). This project aims to respond to one of the most pressing societal problems of Portuguese society and the Alentejo region - Aging - by providing future goods and services that correspond to the needs felt by the elderly and institutions (public and social sector).

The risk of violence on the elderly increases according to the impact of intrinsic predictors (physical, psychological, emotional and social isolation) and extrinsic to the elderly (stress and social isolation of the caregiver, financial problems, drugs, alcohol, mental health, ageism and lack of compliance with the rights of the elderly). The purpose of this study was to understand the correlation between the elderly with depressive symptomatology and the predictors of the risk of violence against them. The method used was a quantitative approach using the Statistical Package program for Social Sciences (IBM-SPSS). There was a participation of 237 elderly people aged 65-96 years, of the project “Aging in Safety in Alentejo - Understanding to Act”, at the University of Évora. The Geriatric Depression Scale (GDS 15, brief version, Yesavage et al., 1983) and the Predictors of Risk of Violence (E-IOA and VASS adaptation) were applied. About the results, 50 elderly (21.1%) had mild depressive symptomatology, and 14 (5.9%) had severe depressive symptomatology. Of the 64 elderly individuals who presented depressive symptomatology 55 were female. In the relationship between the severity of depressive symptomatology and predictors of risk of violence, significant results were found in three dimensions: Current supports and relationships, family context and cognitive / emotional difficulties. The main conclusion of the study is the relationship between depression and risk of violence in the elderly without social support networks, with complex family context and with cognitive and emotional changes. These factors contribute to greater physical and mental vulnerability of the elderly, resulting in cases of anxiety and stress, which present a depressive symptomatology and the risk of violence.

Tatiana Mestre holds a degree in Social Education from the University of Algarve and holds a Masters and Postgraduate Diploma in Community Psycogerontology from the Beja Polytechnic Institute and a pre-doctorate in Sociology. At the moment, she's a PhD student in Sociology at the University of Évora. Since 2012, it works directly with the elderly, in various social responses (nursing homes, convalescence institutions, medium and long term). She is currently working as a research assistant on the "Aging with Security in the Alentejo Understanding to Act" (ESACA) project. This project aims to respond to one of the most urgent social problems of Portuguese society and the region of Alentejo - Aging - providing future goods and services that correspond to the needs felt by the elderly and institutions (public and social sector).

Rationale: In contemporary society, ageing is a phenomenon that marks all developed societies. Portugal is one of the most ageing countries in Europe. Analyzing the social representations of violence on the elderly, from the current and past conceptions and daily practices of the elderly allows us to have access to the dominant constructions in society about the social phenomenon that is violence and the way it is socially and individually expressed by its main actors.

 

Objective: To analyze the social representations of a group of elderly people about violence on the elderly and the reasons why this violence occurs.

 

Methods: Exploratory and descriptive research with qualitative approach, supported by Theory of Social Representations. It was attended by 237 elderly people aged 65-96 years, from the project “Ageing Safely in Alentejo” from University of Évora. The Free Speech Association technique was used and data were processed through qualitative data analysis software. All the ethical

procedures of human research were followed.

 

Results: In social representations of violence on the elderly the words most evoked by the elderly were injustice, to which are added the mistreatment, badness, bad, lack of respect, sadness, horrible and abandonment. About the reasons that lead to violence on the elderly the words such as lack of respect, lack of education and badness are predominant. These terms refer to the social devaluation of the elderly and their role in today's society, as in the representations about violence.

 

Conclusions: The social representations of these elderly people about violence and their reasons points to the stereotypes associated with the prevalent ageism in our society, where the social devaluation of the elderly dominates the daily life conceptions and practices.

Anna Prat is a young nurse who works in the geriatric field in a hospital in central region of Catalonia where the population is getting older. She is passionate about

the work and, above all, she is eager to improve and create new projects based on the needs of the population and the work environment. She believes in the importance of giving holistic and high quality care to the patients and their families in order to meet their needs.

Aging is an outstanding issue in our society. Comparing statistics, we have seen that from 2010 to 2017 the population of more than 70 years old has had a growth of about 1% in Bages, a central region of Catalonia. Within this old population we want to a stand out to the geriatric patient, with whom we work in our area. Increasingly, more healthcare is offered to this type of patients and, for this reason, we believe in the importance of offering a better quality care, both to him and his family, when they need palliative care regardless their pathology. In order to improve holistic care towards the patient and his family, we believe it is important to create a protocol of action in the frail geriatric patient in the end of life. A protocol with the aim to improve the knowledge of multidisciplinary team that care for this type of patients was used. Therefore, within this protocol we emphasize the importance of determining the functions of every professional involved, through the tools to offer quality care, as well as respecting the will of the patient with the ability to decide and accompany the family in the different phases of this process.

Kelvin M Leshabari is a Medical Doctor with interest in Clinical Research. Specifically his research interests are on biological mechanisms of ageing as well as geriatric endocrinology/geriatric cardiology. He trained in Medicine and graduated MD degree in 2008. Thereafter he was a fellow in clinical research at different centres in Belgium and the Netherlands. He received his MSc degree from the University of Leiden in the Netherlands in 2015. He is the Principal Investigator of Cardiometabolic Risk Treatment & Prevention Intervention and Surveillance programme in Tanzania (CRISTA).

Objective: To highlight the challenges and opportunities in the reported statistics of diseases and deaths among the elderly population of Tanzania.

 

Methods: A rapid appraisal of available gaps from known facts and figures targeting the elderly cohort of Tanzania.

 

Findings: The proportion of people aged 60 years and above almost doubled (5.2% (2010) vs. 2.9% (in 2000), p<0.01) between two consecutive national censuses. Furthermore, life expectancy at birth rose from 50 (in early 1990’s) to 61 years in 2010. There is no evidence of any concrete policy on elderly care in Tanzania. There is scanty evidence of elderly research in Tanzania. The few available elderly population morbidity & mortality statistics of Tanzania were derived from hospital based data.

 

Conclusion: There is palpable evidence that the elderly segment is rapidly growing in the population pyramid of Tanzania.

 

Recommendations: There is a need for reliable and sustainable resource allocation in support for elderly care services in Tanzania.