MAGYAR GERONTOLÓGIA. 1. évfolyam 2. szám Július

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1 MAGYAR GERONTOLÓGIA 1. évfolyam 2. szám Július

2 Szerkesztıbizottság: MAGYAR GERONTOLÓGIA Fıszerkesztı: Dr. Semsei Imre, MTA doktor Rovatvezetık: Szociális gerontológia: Kísérletes gerontológia: Geriátria: Oktatás: Gerontopszichológia: Életmód: Társadalomgerontológia: Prevenció: Prof. Iván László Prof. Székely Miklós Prof. Székács Béla Prof. Bakó Gyula Prof. Molnár Péter Prof. Figler Mária Dr. Fábián Gergely Dr. Tóth István Szerkesztıbizottság tagjai: Dr. Boga Bálint, Budapest, a szerkesztıbizottság elnöke Csernáthné Kárándi Erzsébet, Hajdúböszörmény Dr. Halmos Béla, Eger Dr. Hazafi Klára, Pécs Dr. Németh Károly, Verıce Dr. Pék Gyızı, Debrecen Dr. Patyán László, Nyíregyháza Regius Ottó. Budapest Dr. Ruszwurm Andrea, Nagykanizsa Dr. Szilagyi, S. Jean, Nyíregyháza Dr. Telkes Zoltán, Visegrád Dr. Vértes László, Budapest Dr. Zöllei Magdolna, Szeged ii

3 MAGYAR GERONTOLÓGIA TARTALOMJEGYZÉK 1. évfolyam 2. szám (2009) KONGRESSZUSI SZÁM oldal Szerkesztıi levél (Dr. Semsei Imre) 1 A Nemzetközi Gerontológiai és Geriátriai Egyesület (IAGG) XIX. Kongresszusa 3 A Preventív Gerontológiai és Geriátriai Társaság VI. Kongresszusa (2008) 25 A Magyar Gerontológiai és Geriátriai Társaság XXX. és a Preventív Gerontológiai és Geriátrai Társaság V. kongresszusa (2007) 62 A Debreceni Egyetem Népegészségügyi Kar Gyógytornász Tanszék Nemzetközi Konferenciája 72 Gerontológia jegyzet 81 Meghívó 90 Jelentkezési lap 91 HUNGARIAN GERONTOLOGY CONTENTS Vol. 1. Nr. 2. (2009) CONGRESS EDITION Pages Editorial (Imre Semsei PhD) 1 XIX. Congress of the International Association of Gerontology and Geriatrics 3 VI. Congress of the Society for Preventive Gerontology and Geriatrics (2008) 25 XXX. Congress of the Hungarian Society of Gerontology and Geriatrics and V. Congress of the Society for Preventive Gerontology and Geriatrics (2007) 62 International Conference of the Department of Physiotherapy, Faculty of Population Health, University of Debrecen 72 Gerontology Book 81 Congress Announcement 90 Membership form (Society for Preventive Gerontology and Geriatrics) 91 iii

4 SZERKESZTİI LEVÉL Tisztelt Olvasóink! A Magyar Gerontológia második számát az elmúlt idıszak kongresszusainak szenteltük. Szeretnénk megismertetni a programot és az elhangzott elıadások összefoglalóit (mikor rendelkezésünkre áll) is azokkal, akiknek nem állt módjukban részt venni ezeken a konferenciákon. Akik valamely témát különösen érdekesnek tartanak, azok jelezzék a szerkesztıségnek, s ezek szerzıit felkérjük egy teljes cikk megírására. Elsıként a Nemzetközi Gerontológiai és Geriátriai Társaság (International Association of Gerontology and Geriatrics IAGG) XIX. kongresszusáról adunk hírt. Ez a konferencia a gerontológiai társaságok nemzetközi szövetségének 4 évenként megrendezésre kerülı nagy eseménye. Több ezer résztvevıvel ez a konferencia majd egy hétig tartott, s a világ minden tájáról érkeztek elıadók (több mint 6 ezer). A sok-sok elıadást és posztert természetesen nem áll módunkban ismertetni, de egy-egy szeletérıl ízelítıt adunk. Az elsı részben a magyar résztvevık összefoglalóit közöljük, hogy láthassuk kik és milyen mondandóval vettek részt a konferencián hazánkból. Aki behatóbban érdeklıdik, keresse a magyarországi résztvevıket, ık szolgálhatnak a részletekkel is. Ezt követıen a biogerontológia szekció 3 igen fontos szimpóziumán közremőködı elıadók absztraktjait olvashatjuk: 1. Az öregedés már nem egy megoldatlan biológiai probléma; 2. Miért öregszünk: a modern szintézis; 3. Egészséges öregedés: biológiai, klinikai és pszichológiai meghatározók populációs tanulmányozása címmel. Nem lehet leírni milyen élmény egy ilyen konferencia, ahol a legfrissebb kutatási eredményeket és trendeket is megismerhetjük, de szót válthatunk rég nem látott kollégákkal, vagy új ismeretségekre is szert tehetünk. Én már 1982 óta (XII. Kongresszus, Hamburg) veszek részt ezeken a konferenciákon, ahonnan mindig új ismeretekkel, ötletekkel és kapcsolatokkal tértem vissza. Természetesen az ez évi párizsi konferencia sem volt kivétel. A másik esemény Preventív Gerontológiai és Geriátriai Társaság VI. kongresszusa, melyre a múlt év novemberében került sor. A Gerontológiai Tudományos Koordinációs 1

5 Központtal közösen szervezett rendezvény a Szociális gerontológia a mai Magyarországon címet viselte, s útjára indította Nyíregyházi Gerontológiai Napok sorozatát (a sorozat következı rendezvényének felhívása is megtalálható a kötet végén). A hagyományteremtı konferencián a hazai gerontológiai élet számos prominens képviselıje is tartott elıadást, s megismerhettük a hazai szociális gerontológiai élet egy szeletét. Remélhetıleg megismerik ezt a konferencia-sorozatot az ország egészében, s egyre több résztvevıvel zajlik majd ez az eddig regionális résztvevıjő rendezvény. A harmadik esemény a Magyar Gerontológiai Társaság és a Preventív Gerontológiai és Geriátriai Társaság 2007 évi közös rendezvénye, melyrıl sajnos nem tudunk összefoglalókat bemutatni, de a program maga már sejteti a rendezvény súlyát és jelentıségét. A negyedik esemény a gerontológiához kapcsolódó egyik társszakma, a gyógytornászok rendezvénye. Igen nagy örömmel adunk hírt a társszakmák rendezvényeirıl is, hiszen a gerontológusok is sok új hírrel, ismerettel és ötlettel gyarapodhatnak ezen rendezvények anyagából is. Ebben a számban ismertetjük röviden a nem rég megjelent Gerontológia Jegyzetet is. Ezt a hiánypótló munkát 61 prominens közremőködı neve fémjelzi, gerontológusok, geriáterek, szociálgerontológusok és a társszakmák kiváló mővelıi, Dr. Semsei Imre szerkesztésében. Régi adóssága a hazai gerontológiai társadalomnak, hogy egy átfogó gerontológiai jegyzetet adjon ki, mely segédanyagul szolgálhat a hazai egyetemek gerontológiai oktatásában. Ezt törlesztettük most úgy, hogy a gerontológia mindhárom ága terítékre kerül a jegyzetben, s nem csak a BSc, de az MSc oktatásban is használható legyen a jegyzet, sıt idıként még a posztgraduális oktatásban (szakirányú továbbképzések, PhD) is. Emellett a gerontológia iránt érdeklıdı laikusok is haszonnal forgathatják a könyvet. A késıbbiekben megjelenik majd a jegyzet angol nyelvő fordítása, illetve további témákkal bıvítve és frissítve a második kiadás is. Nyíregyháza, július. 2

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7 SD6 028 AGEING AND POLITICS IN EUROPE AND THE USA SD TRENDS OF POLITICS OF AGEING IN HUNGARY Z. SZEMAN - Hungarian Academy of Sciences (Budapest, Hungary) The proportion of pensioners within the population in Hungary has been around 30% since The goal of the Socialist party was to win this large proportion of elderly voters. Right from the time it came into power in 2002 the socialist-liberal ruling coalition introduced measures improving the standard of living of pensioners. The paper shows the positive and negative consequences of these measures for politics, society and the economy. One effect was the re-election of the socialist-liberal government in 2006, followed for political considerations by further positive measures affecting all pensioners. These positive social measures also had a negative impact: they aggravated the problem of sustainability of the pension system and the general budget deficit. The paper also analyses how all these factors together with the Hungarian economic crisis transformed the original positive measures into the opposite. It examines which groups of the ageing are affected, to what extent and in what way. The study also deals with the short and long-term national strategy for ageing people elaborated by experts for the government in It analyses the question of which elements of it have been accepted by the decision-makers and which are at risk and why, which elements are threatened by the general economic crisis and what proposals have been thwarted by the functioning of the public administration system. 4

8 SD7 128 RECONCILING EMPLOYMENT AND FAMILY CARE IN EUROPEAN WELFARE STATES SD PROBLEMS OF EMPLOYMENT AND CARE FOR OLDER PEOPLE IN HUNGARY Z. SZÉMAN - Hungarian Academy of Sciences (Budapest, Hungary) The Hungarian population is ageing rapidly, by 2050 the number of persons 60+ will exceed that of the under 20s and the employment rate aged is low. In order to improve the dependency ratio and ensure the sustainability of the pension system it is essential to keep the ageing workforce on the labour market. For a long while the retirement age of 55 years for women made it possible for them to help, care for and nurse older family members. The pension reform of 1998 brought a gradual increase in the age of exit for women active on the labour market. The paper points out the problems arising as a consequence of the non-specific care model (the provision of eldercare by retired women), the labour market, pension system, elder care system aspects, and the trends arising as a consequence of the uniform increase of retirement age to 62 years. Because of the very low figure for a healthy life expectancy at birth, a strong need for care arises in an early stage of life. Now that women s later exit from the labour market is reducing the family care source, the care tasks previously performed by the family are shifting to formal care. The study points out the necessary steps and possible solutions needed to handle the situation through macro-level measures. 5

9 PA6 023 ON THE NATURE OF AGING I. SEMSEI* (Gerontology Science Coordination Center, Nyiregyhaza, Hungary) Senescence is a complex process and the aging hypotheses concentrated only on one or very few elements of this process. Asking the wrong question, simplifying by model creation etc. all contributed to a poor solution as to why aging occurs. Most of the theories, however, approached and sometimes solved a small part of the problem of aging. Disregarding them would be the same mistake as considering them as a solution of the senescence-problem. It seems that aging occurs because the information level of the system is not good enough to ensure the existence of the human body indefinitely in time against the deteriorating entropy effects. The aging process is a gradual drifting away of the system from the developmentally differentiated state which is a result of the evolution. The information level of the system continuously changes in time; it is altered by external and internal factors, programmed events of the system, perturbations caused by the adaptation process as well as by the fluid character of the genome. Consequently, the maximum life span is determined by the information level of the system, it is influenced by the external and internal factors and it is limited by the weakest element of the chain. Modification of the aging process is possible by optimization of the system but the maximum life span of about 120 years could be lengthened only by changing the information level of the human body. 6

10 PB6 166 EFFICACY OF CV RISK REDUCING ANTIHYPERTENSIVE TREATMENT AMONG ELDERLIES IN HUNGARY B. SZEKACS* (1.) Semmelweis University, Faculty of Medicine ; 2.) St Imre teaching Hosp., Budapest, Hungary) E. KEKES(1), I. JANOSI(2), I. KISS(3) - (1) IMS Kft, (Budapest, Hungary); (2) Planimeter Kft ( Budapest, Hungary); (3) A) Semmelweis Univ., Faculty of Med., Dept. Geriatric Med.; B) St. Imre Hosp. Dept Nephrology &Hypertension (Budapest, Hungary) Introduction Antihypertensive treatment used to reduce the CV risk among hypertensive elderlies, is usually not satisfactory. Objective to survey the CV risk and the efficacy and implementation of guidelines of the antihypertensive treatment used among hypertensive elderlies. Methods 3578 elderlies' records registered in 2007 were analyzed using the database of the Hypertension Registry of HSH. Evaluating viewpoints were the CV risk, the distribution of blood pressure levels resulted in therapeutically, the number as well as point of action of antihypertensive drugs used generally or in cases of hypertension with special organ damages. Results The incidence of high global CV risk was great among the elderly hypertensives: metabolic syndrome in males-m 29%, in females-f 39%, CRF (e.gfr<60ml/min) M22%, F36,2%, CHD: M20,6%, F18,5%, PAD M 22,2%, F16,9%. About half of the patients in each age-decade over 60 years with treated hypertension had blood pressure over 140/90 mmhg. The low combination rate of antihypertensives (as intensity of treatment) was unacceptably frequent in those cases when BPsyst. remained over 140 mmhg. Example: in case of patients with a BPsyst of mmHg, the use of few, max. 2 drugs was surprisingly high (27,2% at age 60-70years; 26,2% at years; 29,2% at >80years). The quality (point of action) of the antihypertensive treatment was also not found to be optimal in those cases, when special target-organ damage occurred in the hypertensive elderlies (for example: in CRF the preferation rate of beta receptor blockers within the 2-3 drug combinations was relatively too high. Conclusion The relatively great proportion of hypertensive elderlies with high CV global risk and not sufficiently controlled BP levels must be reduced by improving both the intensity and the quality of their antihypertensive treatment. 7

11 PD6 704 THE COST OF ILLNESS AND BURDEN OF DEMENTIA DISORDERS IN EUROPE P. KENIGSBERG* (Karolinska Institute, Stockholm, Sweden) A. WIMO(5), K. ÉRSEK(1), L. GULACSI(1), A. GUSTAVSSON(4), A. JACQUES(6), L. JÖNSSON(4), K. KARPATI(1),. MCDAID(8), H. VALTONEN - (1) Corvinus University, Budapest, Hungary (Budapest, Hungary); (4) London School of Economics (Budapest, United Kingdom); (5) Karolinska Institute, Stockholm, Sweden (Sweden); (6) Alzheimer Europe, Edinburgh (United Kingdom); (8) London School of Economics, London, (United Kingdom) Introduction. The EuroCoDe (European Collaboration on Dementia) project from Alzheimer Europe convened an international group of economists to estimate cost of illness and burden of dementia disorders in the 27 European Union countries (EU27). Materials and methods A literature review was conducted for papers reporting cost of care for people with diagnosed dementia or possible/probable Alzheimer s disease; Two approaches were used: a bottom-up approach allowing stratification on disease severity and different cost types, and top-down cost of illness studies. Prevalence figures used for cost of illness estimates (7.2 million people with dementia in EU27) were based on a new EuroCoDe meta-analysis combined with population statistics from the United Nations. European cost model was built using 14 papers where both direct and indirect costs could be identified. For countries where no cost-of-illness figures were available, imputation was used, based on 4 identified care patterns: Northern (mainly formal care); Western (mix between formal and informal care), Southern and Eastern (mainly informal care). Imputation figures were also adjusted for differences in gross domestic product per person between countries. Results Estimated total cost of illness of dementia disorders in EU27 in 2008 was 160 billion euros (1.3% of GDP), of which 71.7 billion (45%) were direct costs and 88.6 billion (55%) indirect costs. Annual costs per person with dementia were 22,194, of which 9,925 in direct costs and 12,270 in informal care. Burden of dementia disorders was 2.12 million DALYs (disability-adjusted life years) in EU27, or 441 DALYs/100,000 persons. Burden of dementia disorders is higher than burden of diabetes (1.29 million DALYs and 268 DALYs/100,000 persons in EU27). Conclusion Cost and burden of dementia disorders are high. Economic database for dementia is still small, although expanding. Methodology for economic data collection should be improved, and more data should be collected in Eastern Europe. 8

12 PD6 814 CONCEPTION OF A NEW HEALTH CARE STRATEGY FOR THE ELDERLY IN HUNGARY B. BOGA* (HAGG, Budapest, Hungary) O. REGIUS(1), G. CSILLIK- (1) Hungarian Association of Gerontology and geriatrics (Budapest, Hungary) In Hungary recently elaboration of a new aging strategy has got onto agenda of the government. This strategy will include all respects of aging population and extends to next decades. HAGG participates in the preparations of it, mainly of health chapter. This strategy is urgent on the basis of recent facts: 1. 21,6% of the population are 60 years old or older 2. Life expectancy is less than that in Western Europe (by 8-10 years) 3. Difference between the total and healthy life expectancy is large (about 8 years) 4. 45% of the elderly are restricted by their health status in everyday activities. Elements of the new strategy: 1. Prevention: launched in middle-age. a. Primary prevention: retardation of aging process and prevention multimorbidity (mentalhygiene, motion, gymnastics, nutrition, dwelling, education, etc.) It is task for all sectors of the society. Main responsibility is at general pratcitional. b. Secondary prevention: obligatory introduction of socalled milestone-screening at age 60,70, etc. Participation of the elderly in general screening program e.g. cancer. c. Tertiary prevention: it is part of the treatment on all levels with special attention in order to prevent progression, complications. 2. Special experts with geriatric knowledge in all medical disciplines 3. National geriatric care setting with 3 levels of health provision: a. Geriatric consultation for outpatients b. Mobile geriatric team: for all departments in hospital, for nursing homes, etc. c. Geriatric hospital department with acute, readaptation and day hospital subdepartments. A regional, territorial system is needed, with a geriatric center with all subdepartments, in other towns only post-acute and day hospital subdepartments. 4. Integrated health and social care system with common leadership and task distribution. 5. Education of staff, suitable infrastructure, legislation. The final approval is expected this year. 9

13 PA7 055 TELOMERASE ACTIVATORS AS POTENTIAL ANTI-SENESCENCE AGENTS I. TARKANYI* (University of Debrecen, Medical and Health Science Center, Debrecen, Hungary) J. ARADI(1), J. MOZES(1), G. BAKO(2) - (1) University of Debrecen, Department of Biochemistry and Molecular Biology (Hungary); (2) University of Debrecen, 3rd Department of Internal Medicine (Hungary) Introduction: Proliferation of telomerase negative cells results in progressive telomere shortening. When telomeres reach a critical length, proliferation will be irreversibly arrested. Although telomere shortening and onset of senescence termed to be the traditional faith of primary proliferating cells, it seems that deficiencies in telomere maintenance mechanisms will install an early senescent phenotype with the loss of function at cellular and systemic level. Manifestation of chronic diseases, independent from etiology, has been associated with shorter telomeres and telomerized tissues were proposed as solution. Methods: Application of molecules that activate already present telomerase enyzme could be the clinically safest method to activate telomerase. We discovered previously, that an oligonucleotide (termed C16AS), composed of a 13-mer antisense moiety against the template site of the telomerase RNA component and a 5 attached 16- mer oligocitidilate, is able to activate the telomerase enzyme. We tested activation properties of C16AS in cell free in vitro systems using a modified version of the Telomere Repeat Amplification Protocol.We designed derivates of C16AS with modified primary sequences thus altered three dimensional structures in order to identify sequence motifs affecting activation efficacy. Results: We observed that derivates with 14 or 18-mer citidilate moieties preserve activating properties, with a slight increase in activation potency in case of the 18-mer. Using derivates where oligocitidilate was fully or partially replaced resulted in diminution or complete loss of activation. Conclusion: Therapies targeting chronic diseases and regeneration, as well as methods aiming rejuvenation, like application of telomerase activating agents, might have an increased importance in the future. According the results, it seems that C16AS acquires a specific three dimensional structure and activates telomerase with an aptamer-like effect. Derivates of the original compound have enhanced activation properties, thus further development into an in vivo telomerase activator seems to be reasonable. 10

14 PA8 030 AGE-RELATED CHANGES IN THE CENTRAL REGULATION OF ENERGY METABOLISM IN RATS M. BALASKO* (University of Pecs, Medical School, Pecs, Hungary) E. PETERVARI(1), A. GARAMI(1), S. SOOS(1), M. SZEKELY(1) - (1) Department of Pathophysiology and Gerontology, Medical School, University of Pecs (Pecs, Hungary) Introduction: Long-term body weight (BW) regulation shows two characteristic age-related trends: obesity of the middle-aged, and anorexia of aging (sarcopenia). These observations suggest regulatory changes in energy balance. Methods and materials: The effects of intracerebroventricular (ICV) administration of neuropeptide Y (NPY), corticotropin-releasingfactor (CRF) or alpha-msh were recorded on food-intake (FI) and BW in various age-groups of male Wistar rats. FI was recorded in a Feedscale system (Columbus), body temperature (Tc), activity (ACT), heart rate (HR), feeding frequency (FF) and feeding duration (FD) in a biotelemetric (MiniMitter) system. ANOVA repeated measures were used for statistical analysis. Results: Central injection of NPY increased, while CRF suppressed FI. Both effects were attenuated in the 24 or 12 months-old rats vs. the 3 months-old age-group. The anorexigenic effect of ICV alpha-msh-injection was minimal at 1.5-months, very pronounced in 3-4 months-old rats, then at ages of 6 and 12 months it decreased, to become maximal in the oldest (24-26 months-old) group. The alpha-msh-infusion induced transient anorexia and BW fall at 4-months, while in 24- months-old rats a sustained and pronounced fall in FI and BW developed. In old rats both the initial FF and its fall to alpha-msh-infusion were lower than in young ones. FD decreased similarly in both groups. In old rats HR exhibited a more pronounced and lasting elevation (suggesting a rise in metabolic rate) than in young animals, and a similar transient rise in daytime Tc as in the young groups. Conclusions: The effects of central regulatory peptides show agerelated alterations. The catabolic effects of alpha-msh were different depending on age: the pronounced effect in the young adult group gradually decreased, but reached again a peak in the old animals. Such changes might contribute to the explanation of both obesity in the middle-aged and sarcopenia in the old. (OTKA 49321, ETT 271/2006) 11

15 PB8 134 DEBRECEN LONGEVITY STUDY II. HEALTH AND FREE RADICALS IN OLDEST OLD RESIDENTS S. IMRE* (Medical and Health Science Center, University of Debrecen, Debrecen, Hungary) A. KOVACS(1), K. NAGY(1), Z. VARGA(1), M. UDVARDY(3), Z. SZIKSZAI(2), G. PARAGH(1) - (1) 1 st. Department of Internal Medicine, Medical and Health Science Center, University of Debrecen (Debrecen, Hungary); (2) Institute of Nuclear Research of the Hungarian Academy of Sciences (Hungary); (3) Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Center, University of Debrecen (Hungary) Introduction: Among the elderly population in Hungary the number and proportion of the oldest old (defined as age 90 years or older ) residents would increase most significantly in the near future. We decided to make a systemic analysis of this target group under this title: Debrecen Longevity Study. It is well known that the toxic effects of oxygen free radicals contribute not only to the incidence of age associated diseases, but also to the aging as a biological phenomenon. To study the damaging effect of oxygen free radicals and the efficiency of antioxidant defense in this special group three parameters were examined: plasma vitamin E and lipidperoxid contents as well as the carbonil contents of plasma proteins. Methods: The laboratory results of 185 persons above 90 years old have been presented. For healthy controls in the evaluation of vitamin E contents 100 persons with an average age of 37,5 +/-9.9 years have been used. For healthy controls in the evaluation of lipidperoxid and carbonil contents three age groups, years of age ( 60 persons ), years of age ( 40 persons ) and years of age ( 40 persons ) have been used. Results: Significantly higher levels of alfa tocoferol ( p < ) and gamma - tocoferol ( p <0.05 ) were observed in the oldest old residents as compared with the values found in healthy controls. The trend of significant ( p < )increase was observed in the contents of lipidperoxid and carbonil as a function of age in healthy controls, but the increase was not significant over 80 years of age. Conclusions: It could be concluded that the oldest old residents had a native resistance to the damaging effect of oxygen free radicals. 12

16 PB8 217 DEBRECEN LONGEVITY STUDY I. THE HEMORHEOLOGICAL STATUS IN OLDEST OLD RESIDENTS A. KOVACS* (Medical and Health Science Center, University of Debrecen, Hungary, Debrecen, Hungary) Z. SZIKSZAI(2), G. PARAGH(1), E. VARADY(3), S. IMRE(1) - (1) 1st. Department of Internal Medicine, Medical and Health Science Center, University of Debrecen (Debrecen, Hungary); (2) Institute of Nuclear Research of the Hungarian Academy of Sciences (Hungary); (3) Laboratory of Debrecen Health Public Benefit Company (Hungary) Introduction: Among the elderly population the number and proportion of the oldest-old (defined as age 90 years or older) will increase most significantly in the near future. Since there was no similar study on this target group in Hungary, we decided to make a systemic analysis of the social, clinical and biological conditions of them under this title: Debrecen Longevity Study. Debrecen is the second largest city in the country, and the oldest old residents represent 0.4 % of the total population (834 residents). Methods: The pro-bands were examined in their homes with an interview, based on a questionnaire which contained questions about their nutrition, health status, physical activity, etc. After the interview medical and laboratory investigation were performed in order to evaluate the general health status of the subjects. We examined 52 routine laboratory parameters. Since age-specific reference values are not available for the oldest-old persons neither in clinical practice, nor in the scientific literature, our results could be compared only to the general, adult reference values. Results: Blood samples were obtained from 304 persons (228 women, 76 men) randomly selected from the total oldest-old population. Most of the investigated parameters were in the normal range. The alterations were not extreme, but they were statistically significant. We compared these results with our earlier laboratory screening test (completed in 2001) of Debrecen residents between and years respectively. Thus we had the opportunity to compare three age groups. We have experienced significant decreasing trends at cholesterol and triglyceride levels, while there is an increasing trend at HDL-cholesterol level. Conclusions: During aging the population becomes increasingly selected, namely over 90 years only the survivors are alive. As the proportion of survivors increases, some parameters stop worsening or even show some improvement. 13

17 PB8 226 STANDARD GERIATRIC ASSESSMENT IN A GERIATRIC WARD G. BAKÓ* (Division of Geriatric Medicine, Debrecen, Hungary) A. SZABÓ(1), F. TIZEDES(1), I. TÁRKÁNYI(1), E. NAGY(1), M. HORVÁTH(1) (1) Division of Geriatric Medicine (Debrecen, Hungary) Introduction The population of Hungary is getting older similarly to the world. The majority of them suffers from multimorbidity and need hospitalization. Patients and methods Since there is no proper data of health state of elderly patients in our region we made a geriatric assessment among our randomly selected patients over 65 years. We processed the data of 368 patients (249 female and 119 male) accepted from their home to our ward as acute cases hospitalized between We used the standard geriatric assessment questionnaires. Results Over the age of 65 almost all of the patients are still able for independent daily living. The decrease of independence continuously grows with age. Elderly patients tend to use less instruments, they could learn fewer new things. By the scale of the instrumental activities of daily living a large part of the elderly can hardly live without help. Tinetti s balance and gait examination shows that advancing in age the risk of falling increases gradually, the chance of falling reached 100 % at the age of 95+. Fractures happened over the age of 65 was increased gradually and reached 100 % at the age of 95+. The nutritional status was estimated with the help of the MNA. It showed, that 60-70% of them has a high risk of malnutrition. Nearly 40-50% of the patients suffer from moderate depression. The prevalence of a serious depression shows a slight increase with advance in lifeyears. With the help of MMSE we assessed the degree of dementia. In the age between 75 and 80 ages in 2% we noticed serious, in 5% medium, and in 23% moderate dementia. Conclusion We conclude that, our elder patients are in need of more help, care, solicitude. Furthermore all of these examinations helped us in proper diagnosis, careful treatment. 14

18 PB8 403 LONGEVITY STUDY IN DEBRECEN IV. THE INTERACTION BETWEEN THE PHSYSICAL / NUTRITIONAL CULTURE AND THE GENERAL HEALTH STATUS IN THE LONG-LIVED ELDERLY. S. HYUN * (Medical and Health Science Center, University of Debrecen, Debrecen, Hungary) A. KOVACS(1), H. SZILVASI(1), Z. SZIKSZAI(2), G. PARAGH(1), S. IMRE(1) - (1) 1st. Department of Internal Medicine, Medical and Health Science Center, University of Debrecen (Debrecen, Hungary); (2) Institute of Nuclear Research of the Hungarian Academy of Sciences (Hungary) Introduction: There is a new conception of healthy aging, that is the interaction between health condition and physical/nutritional culture. This interaction was studied in the long-lived elderly (over 90 years old) in Debrecen city, the east of Hungary. Methods: 228 subjects (169 women, 59 men) randomly selected from the total number of the long-lived elderly were examined and interviewed by means of a questionnaire which contained 159 questions regarding their status of health, nutrition, and physical activity. Results: Based on a self-evaluation, 67% of them had good, very good or excellent and 10% of them had bad health conditions. The hypertonia (81%), arthrosis, spondylosis (76%), and the hypacusis (74%) are manifested as the major complaints among their sicknesses. The rates of the dementia and NIDDM were 31% and 16%, respectively. The incidence rate of the full urine incontinence was 34% in old people s homes, but it was only seen in 19% of the people living in their own houses. 36% of them do gymnastics regularly (69.5% daily). 50.5% of them have free play, 40.5% barely move in their flats while 9% are bedridden. Most of the elderly who were examined consume fruits (52.6%) and butter/margarine (46.2%) daily. Vegetable (50%) and fowl (65.4%) are consumed several times weekly. 68.4% of them eat 3 times a day. 96.2% of them consume soup daily. 40.2% drink a cup of coffee daily, 31.1% drink tea a couple of times a day, 8.3% consume a glass of wine. 13.2% of them are on a diet [because of bile (51.8%), diabetes (24.1%)]. We found only 2.6% smoking rate. Conclusion: Significant correlations were found between parameters of the health condition and the physical / nutritional culture. These results support a new conception of the healthy aging. 15

19 SA6 044 AGING IS NO LONGER AN UNSOLVED BIOLOGICAL PRIOBLEM SA THE CAUSES OF BIOLOGICAL AGEING ARE KNOWN L. HAYFLICK - University of California, San Francisco (The Sea Ranch, CA, United States of America) The finitude of life is divided into aging, longevity determination, age associated diseases and death. The efficacy of repair and turnover systems is favored over molecular dysfunction until reproductive maturation when the balance slowly shifts in favor of accumulating dysfunctional molecules caused by increasing entropy (dispersal of energy) and resulting in the aging phenotype. The molecules that compose repair and turnover systems also suffer the same fate as do their substrate molecules. It is these maintenance systems that are the determinants of longevity. The genome indirectly governs the anabolic determinants of longevity. This is fundamentally different from the stochastic, catabolic processes of aging. Age changes simply increase vulnerability to age-associated diseases. SA UNDERSTANDING THE BIOLOGICAL REASONS FOR AGEING R. HOLLIDAY - The Australian Academy of Science (Canberra, Australia) A broad biological approach makes it possible to understand why ageing exists and also why different mammalian species have very different maximum lifespans. It has become apparent that the best strategy for animals' survival is to develop to an adult and reproduce, but not to 16

20 invest resources in maintaining the soma indefinitely. There is a trade-off between the investment of resources in reproduction, and the survival time of the soma. At a stroke, this solves the problem of different rates of ageing in different species, because those that develop and reproduce fast have short lifepans, and those that develop and reproduce slowly have long lifespans. This difference is due to the resources invested in the maintenance of the adult soma. There is much evidence that the efficiency of maintenance correlates with maximum longevity. Thus, ageing can be defined as the eventual failure of maintenance. It has also become evident that there are many maintenance mechanisms, and these depend on very many genes, and the investment of considerable metabolic resources. A broad interpretation of the different degenerative changes during ageing should be adopted, with the general conclusion that ageing is multi-causal. SA AGEING IS SOLVED BUT ITS SOLUTION ALSO HIGHLIGHTS ITS COMPLEXITY - GEARING UP FOR THE CHALLENGES AHEAD T. KIRKWOOD - Institute for Ageing and Health, Campus for Ageing and Vitality, University of Newcastle (Newcastle upon Tyne, United Kingdom) After a long period when ageing was dismissed as just too complicated for serious scientific study, we now have a very good idea about the underlying reasons for why ageing occurs and how it is caused. Ageing occurs through the gradual, lifelong accumulation of damage that results from the limited capacity for maintenance and repair, which in turn has been strongly shaped through natural selection (the disposable soma ). Nevertheless, the fact that the enigma of ageing is now solved does not mean that the detailed understanding that will be needed to make practical use of its solution is near at hand. The intrinsic complexity of the mechanisms indicated by the solution requires the adoption of systems-biology approaches to the analysis of: (i) how the networks of cellular maintenance are vulnerable to damage, (ii) how these networks are regulated, (iii) how damage plays into the pathogenesis of degenerative diseases, and (iv) where interventions might most successfully be targeted. These challenges will require radical changes in the ways that ageing has been investigated to date. Reference: Kirkwood TBL. A systematic look at an old problem. Nature 2008; 45: