Given the current obesity epidemic in tandem with the aging US population, it is imperative to identify methods for reducing cardiovascular disease (CVD) risk that will be efficacious for both sexes. Arterial stiffness (AS) is an independent risk factor for a first cardiovascular event that increases with advancing age and obesity. Previous studies have found that modest weight loss (WL) of 5 to 10 percent successfully reduces AS and other risk factors for CVD. However, it remains unclear whether WL via caloric restriction reduces AS similarly among sexes. We tested the hypothesis that WL via caloric restriction would reduce AS more in men than women because men accumulate more abdominal visceral fat (VF) and lose more with WL compared with women of similar age and adiposity. To test our hypothesis AS was assessed from measurements of pulse wave velocity and ultrasonography of the carotid artery (Ã -SI). Total body and VF were measured using dual energy x-ray absorptiometry and computed tomography scans, respectively. Subjects underwent a 12-week WL intervention. No baseline differences in AS were observed between sexes. However, men were heavier and demonstrated higher levels of VF while women were fatter and had higher levels of abdominal subcutaneous fat. Contrary to our hypothesis both sexes experienced similar decreases in AS with WL despite greater reductions in VF in men. Our findings suggest that VF loss is not the primary mechanism mediating reductions in AS with WL. Future studies are needed to determine the mechanisms of arterial destiffening with WL. / Master of Science

No / From the moment of birth, the human body plays host to a rich diversity of microbes. Body sites such as the skin, the gut and the mouth support communities of microorganisms (collectively known as the microbiome) that are both numerous and diverse. As our understanding of the microbiome advances, it is evident that these microbial populations participate in a multitude of symbiotic associations with us. The disruption of these associations can lead to a range of diseases beyond mere pathogenesis as microbial nutrition, signaling, and immune defense break down. It is known that changes in microbial composition occur as the human host ages and that diet and living conditions influence the microbiome of older individuals. However, the link between the microbiome and frailty is as yet mostly unexplored. Although the microbiome is likely to influence health factors that contribute to frailty, further work is needed to determine whether overall microbial signatures of frailty exist and, if so, what the diagnostic and therapeutic utility of these signatures might be.

The purpose of this study was to examine the pharmacokinetics of d-xylose in man as a function of age with particular emphasis on its absorption characteristics. This study required the development of a specific and sensitive method for the quantitation of xylose from plasma and urine. Following a clean-up procedure, plasma or urine samples are concentrated and undergo two sequential derivatization steps and then are quantitated by capillary column gas liquid chromatography (GLC). D-Xylose is frequently quantitated by a tedious colorimetric assay involving the use of thiourea, a proven animal carcinogen. We have evaluated a more expedient colorimetric assay employing less toxic reagents. Based upon these comparisons the "phloroglucinol" method has been recommended as a replacement for the currently used clinical method for quantitating d-xylose. The human studies revealed age related changes in some but not all d-xylose disposition parameters. Systemic, renal, and nonrenal clearances all declined with advancing age. The terminal elimination half life increased with age. Age had very little influence on the various volumes of distribution. In general, parameters relating to oral absorption showed no age-related dependence. In contrast to what is generally believed, the bioavailability of d-xylose did not decline with age. Lastly, this dissertation addresses the problem of how infusion data may best be fit. Concentration-time data may be fit by a nonlinear regression algorithm in two ways; (1) concentration-time data may be collected and fit both during infusion and after infusion is terminated, (2) concentration-time data may be collected only after the infusion is terminated and be fit as a bolus. Concentration-time data were computer simulated with random error and we found that fitting the entire curve gave the most accurate estimates of disposition parameters.

Cosmetic treatment with botulinum toxin type A injections is the top non-surgical cosmetic procedure in the U.S. Many patients are beginning treatment at a younger age to prevent the development of facial wrinkles associated with aging. However, there is limited data to support the use of prophylactic botulinum toxin injections. Patients beginning treatment at a younger age have fewer wrinkles requiring fewer units to treat, which reduces the overall cost of treatment. Patients also maintain higher levels of self- esteem by preventing or delaying the onset of facial wrinkles that can negatively impact their appearance. This study proposes that patients receiving botulinum toxin injections at a younger age (< 35) will have higher satisfaction with treatment outcomes. By demonstrating an association between starting age of injections and patient satisfaction, this study aims to provide merit for clinical trials studying the effectiveness of prophylactic botulinum toxin injections for cosmetic indications.

Suen, Wai Chiu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 117-128). / Abstract also in Chinese. / ACKNOWLEDGEMENTS --- p.ii / LIST OF ABBREVIATIONS --- p.iii / ABSTRACT --- p.v / 摘要 --- p.vii / LIST OF PUBLICATIONS --- p.viii / TABLE OF CONTENTS --- p.ix / Chapter CHAPTER 1. --- INTRODUCTION --- p.1 / Chapter 1.1. --- Nature of Telomeres / Chapter 1.1.1. --- Telomere structure --- p.1 / Chapter 1.1.2. --- Importance of telomeres --- p.2 / Chapter 1.1.3. --- Telomere length attrition during replicative senescence --- p.3 / Chapter 1.1.4. --- Telomere length maintenance --- p.6 / Chapter 1.1.5. --- "Oxidative stress, inflammatory process and telomere length" --- p.7 / Chapter 1.1.6. --- Telomere attrition rate --- p.8 / Chapter 1.2. --- "Age, Gender and Telomere Length" / Chapter 1.2.1. --- Age and telomere length --- p.10 / Chapter 1.2.2. --- Gender difference of telomere length --- p.10 / Chapter 1.3. --- Health Status and Telomere Length --- p.13 / Chapter 1.3.1. --- Coronary heart diseases --- p.13 / Chapter 1.3.2. --- Cancers --- p.14 / Chapter 1.3.3. --- Infections and chronic inflammation --- p.15 / Chapter 1.3.4. --- Bone mineral density --- p.16 / Chapter 1.3.5. --- Neurodegenerative diseases --- p.17 / Chapter 1.3.6. --- Frailty and mortality --- p.19 / Chapter 1.4. --- "Lifestyles, Environment and Telomere Length" --- p.21 / Chapter 1.4.1. --- Obesity --- p.21 / Chapter 1.4.2. --- Smoking --- p.22 / Chapter 1.4.3. --- Physical activity --- p.23 / Chapter 1.4.4. --- Diet --- p.23 / Chapter 1.4.5. --- Psychological stress --- p.24 / Chapter 1.4.6. --- Socioeconomic status --- p.24 / Chapter 1.5. --- Methods of Measuring Telomere Length --- p.27 / Chapter 1.6. --- Aims and Hypotheses of the Study --- p.31 / Chapter 1.6.1. --- Aims --- p.31 / Chapter 1.6.2. --- Hypotheses --- p.31 / Chapter CHAPTER 2. --- SUBJECTS AND METHODS --- p.33 / Chapter 2.1. --- Subjects Recruitment --- p.34 / Chapter 2.2. --- Interview --- p.34 / Chapter 2.3. --- Anthropometry --- p.35 / Chapter 2.4. --- DNA Extraction and Storage --- p.35 / Chapter 2.5. --- Telomere Length Measurement --- p.37 / Chapter 2.5.1. --- Terminal restriction fragment analysis --- p.37 / Chapter 2.5.2. --- Quantitative real-time PCR --- p.39 / Chapter 2.6. --- Self-perceived Health --- p.46 / Chapter 2.7. --- Medical History --- p.46 / Chapter 2.8. --- Bone Mineral Density --- p.47 / Chapter 2.9. --- Frailty Index --- p.47 / Chapter 2.10. --- Mortality Rate --- p.50 / Chapter 2.11. --- Smoking --- p.50 / Chapter 2.12. --- Physical Activity --- p.51 / Chapter 2.13. --- Dietary Intakes --- p.51 / Chapter 2.15. --- Socioeconomic Status --- p.52 / Chapter 2.16. --- Statistical Analysis --- p.53 / Chapter CHAPTER 3. --- RESULTS AND DISCUSSIONS --- p.55 / Chapter 3.1. --- Demographics --- p.55 / Chapter 3.2. --- Telomere Length Distribution --- p.64 / Chapter 3.2.1. --- Age and telomere length --- p.64 / Chapter 3.2.2. --- Gender and telomere length --- p.68 / Chapter 3.3. --- Health Status and Telomere Length --- p.71 / Chapter 3.3.1. --- Self-perceived health --- p.71 / Chapter 3.3.2 --- History of diseases --- p.74 / Chapter 3.3.3. --- Bone mineral density --- p.80 / Chapter 3.3.4. --- Frailty index --- p.86 / Chapter 3.3.5. --- Mortality rate --- p.91 / Chapter 3.4. --- "Lifestyles, Environment and Telomere Length" --- p.94 / Chapter 3.4.1. --- Smoking --- p.94 / Chapter 3.4.2. --- Physical activity --- p.99 / Chapter 3.4.3. --- Diet --- p.104 / Chapter 3.4.4. --- Socioeconomic status --- p.109 / Chapter CHAPTER 4. --- CONCLUSIONS --- p.115 / Chapter 4.1. --- General conclusions --- p.115 / Chapter 4.2 --- The Significance of telomere length in the elderly --- p.115 / Chapter 4.3. --- Future Works and Prospect --- p.116 / References --- p.117

Thesis (Ph. D.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

Preserving and improving the health and well-being of older people is a significant public health issue of the 21st century. The increased attention to the promotion of health in old age has given rise to an extensive body of literature on the subject of “healthy aging” – a discourse dedicated to understanding the multidimensional factors associated with aging and health and the application of this knowledge. Adopting a place-based, qualitative approach, this dissertation addresses key gaps in the healthy aging literature. The public life of older people aging in place was examined to understand how neighbourhoods, as important physical and social places of aging, contribute to the well-being and healthy aging of older people. This dissertation employed a critical geographical gerontology research framework and a methodology called ‘friendly visiting’ which combines ethnography, narrative and case study research and utilizes participant observation, visual methods and interview techniques. The qualitative data were analyzed using grounded theory and an adapted coding strategy that integrated the textual, visual, and auditory data. The analysis process highlighted theoretically-informed themes that characterized participant’s perceptions and experiences of their neighbourhoods. Findings reveal neighbourhoods are important places of aging that impact the well-being of older people aging in place. This dissertation provides insight into the micro-territorial functioning of neighbourhoods for older people. Embedded within these environments are key sites for informal public life called third places (e.g., parks, streets and coffee shops). Third places are important material and social places for older populations. Preparing for, journeying to, and engaging in these public sites promotes healthy aging by providing opportunities for engagement in life and facilitating social networks. Results advance healthy aging and aging and place research, contribute to gerontological and geographical methodologies, and have implications for policy and practice in areas such as health promotion and age-friendly community initiatives.

Preserving and improving the health and well-being of older people is a significant public health issue of the 21st century. The increased attention to the promotion of health in old age has given rise to an extensive body of literature on the subject of “healthy aging” – a discourse dedicated to understanding the multidimensional factors associated with aging and health and the application of this knowledge. Adopting a place-based, qualitative approach, this dissertation addresses key gaps in the healthy aging literature. The public life of older people aging in place was examined to understand how neighbourhoods, as important physical and social places of aging, contribute to the well-being and healthy aging of older people. This dissertation employed a critical geographical gerontology research framework and a methodology called ‘friendly visiting’ which combines ethnography, narrative and case study research and utilizes participant observation, visual methods and interview techniques. The qualitative data were analyzed using grounded theory and an adapted coding strategy that integrated the textual, visual, and auditory data. The analysis process highlighted theoretically-informed themes that characterized participant’s perceptions and experiences of their neighbourhoods. Findings reveal neighbourhoods are important places of aging that impact the well-being of older people aging in place. This dissertation provides insight into the micro-territorial functioning of neighbourhoods for older people. Embedded within these environments are key sites for informal public life called third places (e.g., parks, streets and coffee shops). Third places are important material and social places for older populations. Preparing for, journeying to, and engaging in these public sites promotes healthy aging by providing opportunities for engagement in life and facilitating social networks. Results advance healthy aging and aging and place research, contribute to gerontological and geographical methodologies, and have implications for policy and practice in areas such as health promotion and age-friendly community initiatives.

The progressive aging of the population corresponds with a movement in gerontology focusing on factors that promote the positive aspects of aging. The concept of healthy aging corresponds with the multifaceted nature of health but few researchers have examined this concept using a multidimensional approach. The creation of a biopsychosocial definition of healthy aging draws on previous literature to determine important components and potential predictors. The major domains of this definition include physical, cognitive, social, and psychological health. Using cross-sectional and longitudinal data from the Manitoba Study of Health and Aging (MSHA), the purpose was to develop a multidimensional construct of healthy aging based on the four components outlined above. The association between each of the components and the overall construct of healthy aging was examined. A significant interaction was found between physical and cognitive health, indicating that each dimension of health must be assessed in the context of the other. The definition was validated against mortality and institutionalization. Overall healthy aging was significantly associated with future mortality and institutionalization. In addition, healthy aging was compared with the construct of self-rated health to investigate if they are separate constructs. Results indicated that they were overlapping constructs but each variable also had an independent effect on future mortality and institutionalization. Significant demographic predictors of healthy aging at time 2 included younger age and higher education. A greater number of chronic conditions; the presence of vascular factors such as high blood pressure, stroke, heart problems, and chest pain; the presence of neurological factors such as memory problems and nerve trouble; and the presence of other conditions such as chronic pain, eye and ear trouble, and foot problems were also associated with not meeting criteria for healthy aging at time 2. Overall the findings from this study provide support for the importance of a multidimensional definition of healthy aging that is distinct from the construct of self-rated health. The findings underscore the need to assess individual characteristics, such as age, sex, and education, when attempting to predict future health outcomes. A greater understanding of the factors that are associated with healthy aging may encourage opportunities to promote healthy aging. This research may have important implications for researchers, clinicians, and policymakers as they focus on improving quality of life for our aging population.

The progressive aging of the population corresponds with a movement in gerontology focusing on factors that promote the positive aspects of aging. The concept of healthy aging corresponds with the multifaceted nature of health but few researchers have examined this concept using a multidimensional approach. The creation of a biopsychosocial definition of healthy aging draws on previous literature to determine important components and potential predictors. The major domains of this definition include physical, cognitive, social, and psychological health. Using cross-sectional and longitudinal data from the Manitoba Study of Health and Aging (MSHA), the purpose was to develop a multidimensional construct of healthy aging based on the four components outlined above. The association between each of the components and the overall construct of healthy aging was examined. A significant interaction was found between physical and cognitive health, indicating that each dimension of health must be assessed in the context of the other. The definition was validated against mortality and institutionalization. Overall healthy aging was significantly associated with future mortality and institutionalization. In addition, healthy aging was compared with the construct of self-rated health to investigate if they are separate constructs. Results indicated that they were overlapping constructs but each variable also had an independent effect on future mortality and institutionalization. Significant demographic predictors of healthy aging at time 2 included younger age and higher education. A greater number of chronic conditions; the presence of vascular factors such as high blood pressure, stroke, heart problems, and chest pain; the presence of neurological factors such as memory problems and nerve trouble; and the presence of other conditions such as chronic pain, eye and ear trouble, and foot problems were also associated with not meeting criteria for healthy aging at time 2. Overall the findings from this study provide support for the importance of a multidimensional definition of healthy aging that is distinct from the construct of self-rated health. The findings underscore the need to assess individual characteristics, such as age, sex, and education, when attempting to predict future health outcomes. A greater understanding of the factors that are associated with healthy aging may encourage opportunities to promote healthy aging. This research may have important implications for researchers, clinicians, and policymakers as they focus on improving quality of life for our aging population.