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Sleep disordered breathing in the elderly: comparison of women and men

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The prevalence of obstructive sleep apnea syndrome in patients up to the age of 60 is known to be two times higher in men then in women. Hormonal changes during menopause might underlie changes in this relationship in the elderly. This study was designed to detect differences in the type and frequency of sleep-disordered breathing between women and men over the age of 65 years, having the same body mass index. The study was conducted using a matched-pair approach consisting of a sample population of 40 pairs of patients over the age of 65. All patients met the following exclusion criteria: age below 65, heart failure, chronic obstructive lung disease. Polygraphy was conducted by means of a portable recorder. All measured indices were higher in men than in women. The apnea index was 2.8 ±4.1 in men and 0.6 ±1.4 in women. The apnea/hypopnea index was 10.2 ±11.4 and 4.8 ±3.9, respectively. These differences were significant (P<0.05). Significant differences also were observed when central (men 8.1 ±13.1, women 3.1 ±8.2), mixed (men 5.1 ±11.4, women 0.4 ±1.3), and obstructive (women men 8.6 ±20.1, 1.0 ±4.3) apnea indices were compared. In conclusion, the study demonstrates that elderly patients showed gender-dependent differences in the type and frequency of sleep-related breathing disorders. Men suffered from all kinds of apnea more frequently than women.
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Memory, depression, and progressing old age in women

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In this study we investigated the interrelationships among memory function, depression, and progressing age in the elderly women. We hypothesized that memory deficit would increase with progressing old age and would be further enhanced in the presence of depression. The study was conducted on 44 female volunteers of the mean age of 67.8 ±1.1(SE) years (range 55-83). The population sample was dichotomized into the depressed and non-depressed subgroups. All subjects were closely homogenous with respect to the post-menopausal status and general life factors. The methodology was based on a group survey in which The Center for Epidemiologic Studies Depression Scale questionnaire and a visual letter recall test were used for the assessment of depression and memory, respectively. The results failed to support the hypothesis. In the first place we found that the mean memory deficit was similar in both depressed and non-depressed subjects, amounting to about 40% of missed letters on recall. Memory deficit progressed with age only in the subgroup of depressed women, but rather surprisingly, it was not associated with the level of depression that actually declined with age in this subgroup. We conclude that progressing old age alone is not necessarily entwined with the intensification of either depression or memory decline. Depression is a factor in memory decline through brain mechanisms unrelated to the intensity of depressive symptoms.
Several lines of evidence suggest that physical exercise not only influences the development of muscles, cardiovascular and respiratory systems, but also exerts a significant influence on the central nervous system. We examined the influence of strength and endurance training on cognitive performance in 33 healthy elderly volunteers (women, mean age 63.5 ±4.5 yr) over a 3-month period of supervised training program. A control group consisted of 8 age-matched (mean age 66.3 ±4.6) healthy volunteers who did not participate in any exercise training program. To evaluate the cognitive performance in our subjects we used two tests: face/name association test and Stroop test. The tests were applied shortly before and immediately after the training program. In the experimental group, a significant improvement in the association test performance, on average, from 71.6 ±7.3% to 79.7 ±7.2% (P<0.0001) was observed over the 3-month training period. There were no changes in the Stroop test results over the same time. Likewise, there were no changes in the control groups. Our data demonstrate that the training regime that is strictly followed over a relatively short period of time may improve the performance in associative memory tasks in elderly subjects. The study supports the notion that physical exercise influences cognitive performance and extend this notion to be valid for healthy elderly subjects.
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