Summary: Because of recent insights into the pathogenesis of age‐related bone loss, we investigated whether intermittent parathyroid hormone (PTH) administration antagonizes the molecular mechanisms of the adverse effects of aging on bone. Parathyroid hormone produced a greater increase in vertebral trabecular bone mineral density and bone volume as well as a greater expansion of the endocortical bone surface in the femur of 26‐ when compared to 6 ‐month‐old female C57BL/6 mice. Moreover, PTH increased trabecular connectivity in vertebrae, and the toughness of both vertebrae and femora in old, but not young, mice. Parathyroid hormone also increased the rate of bone formation and reduced osteoblast apoptosis to a greater extent in the old mice. Most strikingly, PTH reduced reactive oxygen species, p66^Shc phosphorylation, and expression of the lipoxygenase Alox15, and it increased glutathione and stimulated Wnt signaling in bone of old mice. Parathyroid hormone also antagonized the effects of oxidative stress on p66^Shc phosphorylation, Forkhead Box O transcriptional activity, osteoblast apoptosis, and Wnt signaling in vitro. In contrast, administration of the antioxidants N‐acetyl cysteine or pegylated catalase reduced osteoblast progenitors and attenuated proliferation and Wnt signaling. These results suggest that PTH has a greater bone anabolic efficacy in old age because in addition to its other positive actions on bone formation, it antagonizes the age‐associated increase in oxidative stress and its adverse effects on the birth and survival of osteoblasts. On the other hand, ordinary antioxidants cannot restore bone mass in old age because they slow remodeling and attenuate osteoblastogenesis by interfering with Wnt signaling.

Older adults with severe cognitive impairment have trouble responding to questions about their osteoarthritis knee or hip pain, which makes pain management difficult. Therefore, the Pain Behaviors for Osteoarthritis Instrument for Cognitively Impaired Elders (PBOICIE) was developed as an alternative. This article reports the development and psychometric testing of the PBOICIE in three studies. The 6-item PBOICIE was not associated with the Verbal Descriptor Scale but was significantly associated with Keefe’s method for observing pain behaviors in patients with knee osteoarthritis, with r= 0.36 to 0.55, indicating good concurrent validity. The 6-item PBOICIE was able to discriminate older adults’ pain behaviors before and after administration of an analgesic agent (2.9 ± 1.89 versus 1.97 ± 1.98; p < 0.001). This study has shown that multifaceted pain assessments are needed in older adults with osteoarthritis knee or hip pain, as the observed behaviors did not parallel but added information to verbal report.

The purpose of this study was to evaluate a multi-component method for capturing nutrient intake, which used observation, photography, and an innovative computer program. To assess reliability and accuracy, multiple responsible employees (REs) independently conducted nutrient intake assessments on simulated meals; each RE’s results relating to energy intake were compared to those from the other REs and to those obtained by pre- and post-meal weighing of the food items. System efficiency was assessed by having REs perform independent assessments on the same set of simulated meals using either the new or traditional hospital method for which the REs had to document each food item served and then find the items in a computer database–steps that were automated in the new method. Interrater reliability for energy intake estimated on clinic wards was excellent (intraclass correlation coefficient = 0.975, 95% CI 0.958 to 0.992) and there was a high level of agreement between the REs’ estimates and the true values determined by food weighing; per the method of Bland and Altman the mean difference between the two types of estimates was 0.3 kcal (95% CI, −8.1 to 8.7 kcal) with limits of agreement of −79.5 kcal to 80.1 kcal. Compared to the traditional method, energy intake assessments could be completed using the multi-component method in less than a third of the time. These results indicate the multi-component method is an accurate, reliable, and efficient method of obtaining energy intake assessments for hospitalized patients.

Sleep fragmentation increases as Alzheimer’s disease (AD) progresses. Its effects on cognition, specifically vigilant attention, are profoundly important because vigilant attention is thought to be the first step in memory acquisition. To our knowledge, no one has experimentally studied the effect of sleep fragmentation on vigilant attention in persons with AD. Therefore, this study piloted an experimental method using sound (tones produced by an audiometer) to induce sleep fragmentation. Participants enrolled in the University of Arkansas for Medical Sciences Memory Research Center ([MRC] n + 4) underwent one night of undisturbed and one of fragmented sleep. All participants tolerated the earphone needed for the tone-induced sleep fragmentation (TISF) method, and we were able to score awakenings in real time. However, only 50% of tones produced awakenings. The findings suggest that this experimental method is feasible for use in persons with mild AD. Based on the results, we will increase the duration, intensity, and frequency of tones delivered for optimal result.