We attended the media roundtable organized by the Nestlé Nutrition Institute. Here we post video interviews with the speakers and some key thoughts as well.

Childhood nutrition is established and an important part of the medical curriculum. What about elderly people’s nutrition?

Prof. Cornel Sieber (Nurnberg, Germany)

Malnutrition in the elderly is a huge problem. It occurs in 5-12% of mobile patients, 32-50% of hospitalized and almost 85% in nursing homes.The MNA® (Mini Nutritional Assessment) is used for diagnosis widely.

Juergen Bauer, M.D. (Nurnberg, Germany)

Regular screening for everyone above 65 would be essential. The MNA® SF (Mini Nutritional Assessment) contains 6 questions: more than 300 publications have been published on the MNA®, so it is getting accepted globally.

Prof. Heike Bischoff-Ferrari (Zurich, Switzerland)

The prevalence of hip fracture is above 30% in people above 60. The repeat rate of hip fractures is 19%! Obesity leads to higher risk of vitamin D deficiency.

David Thomas (Saint Louis, USA)

Older people are malnourished and have less calorie intake that leads to higher risk or mortality so oral nutritional supplements have outstanding benefit.

Ferdinand Haschke (Head of Nestlé Nutrition Institute)

Several oral communications on centenarians at the IAGG 2009 conference confirmed and elaborated on the themes mentioned in the poster summary article published on this blog.

B. Willcox (Pacifc Health Research Institute) presented the characteristics of supercentenarians, age 110 and over; in Okinawa. The majority had minimal disease until late in life with cataracts (42%) and fractures (33%) being common. Coronary heart disease (8%), stroke (8%), cancer (0%), diabètes (0%) were rare or absent. Most were independent at age 100 and few were institutionalized before age 105, at which point they often exhibited rapid decline. The author concluded that this group had an « élite phenotype ».

RPV studied the Tirupati centenarians in India. The centenarians and nonagenarians scored higher on health practices and health motivation than other groups. (RPV was not present. This comment is based on his abstract)

L Gavrilov studied centenarians in the US through World War I draft registration data. The author found that the stout body build was negatively associated with centenarian survival. Farming and having large number of children was positively associated with attaining centenarian status. Obesity at a young age was predictive of a three time lower chance for survival to age 100!

D. Jopp studied « self-efficacy » of centenarians and noted that they are able to distance themselves from problems, such as failing health.

G. Hann studied the intergenerational relationship of Korean centenarians.  In Korea, longevity is interpreted in terms of a relational/family context rather than as an individual achievement. Most Korean centenarians live with their adult children’s family. Issues are caregiver burden and the fact that their children are old and cannot yet exercise elder status, as long as their parents are alive.

Commentary: There clearly does exist a genetic type favoring centenarian status. However, at any age, we can see that proper prevention, absence of obesity, good psychological make-up, and presence of a support network will favor better longevity…Without necessarily reaching centenary status, isn’t it everyone’s goal to live life to the fullest? Much of the answer lies in our hands (and legs!), heart and mind.

Centenarians were the  subject of 6 posters at the IAGG conference.

Y Gondo (Osaka) studied the functional status of  semi-supercentenarians, those who have survived beyond 105 years of age, in order to determine whether those reaching this age were frail survivors or  different from those who reach age 100. This study shows that only those who are “highly functional” at 100 (!) reach 105 and that they may well harbor genes that confer extreme longevity.

M. Roszkowska  (Warsaw) studied the cardiovascular genetics of 148 centenarians and concluded that they had lower presence of risk factors observed in younger myocardial infarction patients.

J McCormack  (Melbourne) studied 109 centenarians in Australia. They are predominantly female and widowed. 65% are aware of time and place; 60% are mobile. 51% are continent. They are not necessarily more disabled than nonagenarians.

K Szczerbinska (Krakow) found that the  prevalance of depression symptoms decreased in centenarians compared to patients age 65 and over, and in particular if the centenarian remained in homecare. The author noted nonetheless that under-treatment of depression in the aged seemed to be frequent.

Y. Son (Busan) studied Korean centenarians and observed that they generally live with their oldest child and derive strong support from the family.

S. Freeman (Sendai) studied the burden of Japanese  caregivers, noting that they were not necessarily more burdened by centenarians than for other age groups.

Commentary: Research on centenarians should be encouraged, as it sheds light on a combination of genetic, behavioral, environmental factors that favor longevity. We have only scratched the surface of the subject. But we can already say that the centenarian studies enable us to confirm the factors that favor longevity, even in those whose genetic composition is not ideal. These factors include lifestyle, exercise, proper nutrition, psychological outlook, family support system…No surprises and yet, so often undervalued. A further note which was common to many of the papers presented at the IAGG: the diversity of the aged. Chronological and biological age are indeed often quite different.

Put down that dessert, get on your bikes, and smile!

After 5 days, hundreds of presentations and almost 7000 attendants, the International Congress of Gerontology and Geriatrics officially ended with a spectacular closing ceremony.

Prof. Heung Bong CHA at the IAGG Closing Ceremony representing the next event taking place in Korea in 2013:

Topic of the next conference will be digital aging:

BLAJA-LISNIC from Chişinău,  Republic of Moldova, described her poster presentation: The clinical interpretation of the old patient with community-acquired pneumonia

John Naslund from the Centre for Hip Health and Mobility, Vancouver, Canada presented his project, Examining Older Women’s Conceptions of Physical Health Using Photovoice, in details:

An early session on Wednesday focused on the European Alzheimer Disease Consortium (EADC) Initiative chaired by Bruno Vellas.

Giovani FRISONI (BRESCIA, Italy): Neuro-Imaging And Biomarkers: Rational for Prevention

• There are markers to diagnose Alzheimer, but there aren’t markers for tracking progression.
• Conclusion: Positron emission tomography with Fludeoxyglucose is a potential marker in diagnosis and tracking progression.

An early session on Wednesday focused on the European Alzheimer Disease Consortium (EADC) Initiative chaired by Bruno Vellas.

Pieter J VISSER (AMSTERDAM, The Netherlands): The DESCRIPA Study

• They included 881 Alzheimer patients with an average MMSA score of 27.4.
• Markers of pathophysiology of Alzheimer: EEG, SPECT focusing on hypoperfusion, CSF markers and medical temporal lobe atrophy.
• It turned out early markers are EEG and CSF (beta amiloid and tau levels).

An early session on Wednesday focused on the European Alzheimer Disease Consortium (EADC) Initiative chaired by Bruno Vellas.

Pierre-Jean OUSSET (TOULOUSE, France): The ICTUS Study

• Aim is to find milestones in progression of Alzheimer, to find the factors of prediction of decline in mental status.