Hasil untuk "Geriatrics"

E. Kelaiditi, Matteo Cesari, Matteo Cesari et al.

The frailty syndrome has recently attracted attention of the scientific community and public health organizations as precursor and contributor of age-related conditions (particularly disability) in older persons. In parallel, dementia and cognitive disorders also represent major healthcare and social priorities. Although physical frailty and cognitive impairment have shown to be related in epidemiological studies, their pathophysiological mechanisms have been usually studied separately. An International Consensus Group on “Cognitive Frailty” was organized by the International Academy on Nutrition and Aging (I.A.N.A) and the International Association of Gerontology and Geriatrics (I.A.G.G) on April 16th, 2013 in Toulouse (France). The present report describes the results of the Consensus Group and provides the first definition of a “Cognitive Frailty” condition in older adults. Specific aim of this approach was to facilitate the design of future personalized preventive interventions in older persons. Finally, the Group discussed the use of multidomain interventions focused on the physical, nutritional, cognitive and psychological domains for improving the well-being and quality of life in the elderly. The consensus panel proposed the identification of the so-called “cognitive frailty” as an heterogeneous clinical manifestation characterized by the simultaneous presence of both physical frailty and cognitive impairment. In particular, the key factors defining such a condition include: 1) presence of physical frailty and cognitive impairment (CDR=0.5); and 2) exclusion of concurrent AD dementia or other dementias. Under different circumstances, cognitive frailty may represent a precursor of neurodegenerative processes. A potential for reversibility may also characterize this entity. A psychological component of the condition is evident and concurs at increasing the vulnerability of the individual to stressors.

P. Heyn, B. C. Abreu, K. Ottenbacher

Chinese Geriatrics Society, General Practice Branch of Zhejiang Medical Association, the Expert Collaboration Group on Medically Unspecified Disease in General Practice

Emaciation is a clinical manifestation caused by multiple factors, characterized by its complex etiology and wide range of associated diseases, posing significant challenges for healthcare professionals in terms of evaluation and management. Its intrinsic linkage to aging-related comorbidities and the imperative for multidisciplinary collaboration further underscore the necessity and urgency of establishing standardized diagnostic and therapeutic consensus guidelines. This consensus provides a comprehensive overview of the definition, epidemiology, etiology, and pathogenesis of emaciation. It systematically outlines diagnostic approaches, including detailed history-taking, physical examinations, and auxiliary tests. Furthermore, it elaborates on treatment principles and measures, as well as management strategies tailored for specific populations. Emphasis is placed on the importance of community-based management, encompassing follow-up, referral systems, three-level prevention strategies, and health education. The consensus aims to enhance clinicians' capabilities in diagnosing and managing emaciation, improve patients' quality of life, and reduce the healthcare and economic burden on families and society.

L. A. Edilgireeva, V. A. Parfenov, M. G. Bashlachev et al.

BACKGROUND. In compressive-ischemic neuropathy of the ulnar nerve at the level of the cubital tunnel (cubital tunnel syndrome, CTS), surgical decompression is most effective. However, long-term surgical outcomes for CTS in elderly patients remain insufficiently studied.

Siming Lin, Siming Lin, Siming Lin et al.

BackgroundEndoplasmic reticulum stress (ERS) plays a critical role in skeletal muscle physiology and pathology, though the precise mechanisms remain unclear. Salubrinal, a selective inhibitor of eIF2α dephosphorylation, has been shown as a potential therapeutic agent for various conditions, but its effects on sarcopenia are not well understood. This study investigated the protective effects of salubrinal against H2O2-induced muscle cell injury and its impact on the eIF2α/ATF4 signaling pathway.MethodsGastrocnemius muscle samples from aged mice were used and cultured C2C12 myotubes were also used to explore the effects of Salubrinal through Western blotting, immunofluorescence, and apoptosis assays.ResultsOur results demonstrated that H2O2 treatment induced significant muscle cell damage, evidenced by reduced MHC1 expression and increased apoptosis. Salubrinal, in a concentration-dependent manner, mitigated these effects, preserving MHC1 expression and reducing apoptosis. Furthermore, salubrinal enhanced the expression of p-eIF2α and ATF4, suggesting that its protective effects are mediated through the eIF2α/ATF4 pathway.ConclusionThese findings highlight salubrinal’s potential as a therapeutic agent for muscle wasting conditions, particularly those related to oxidative stress and ERS.

Salomón Salazar-Londoño, Valeria Pérez-Foucrier, Jonathan Patricio Baldera et al.

Objectives: To investigate whether temporal muscle thickness (TMT) can serve as a predictor of change in nutritional widely used biomarkers in patients at risk of dementia. Design: Longitudinal observational study. Setting: Secondary analysis from a 24-week study conducted across three centers in Norway between 2018 and 2020. Participants: Patients with mild cognitive impairment (MCI) or with two cardiometabolic disorders were included (n = 165). Measurements: Baseline and longitudinal statistical analysis were carried out to establish the association for outcomes (albumin, weight, C-Reactive Protein and Episodic Memory Quality) with TMT. Results: At baseline, there was a positive association between TMT and weight (Estimate=1.5157, p = 0.009). At follow-up, positive associations were observed between TMT and albumin levels (Estimate=0.3031, P = 0.048), as well as TMT and weight (Estimate=1.8954, P = 0.001). Conclusion: TMT is a possible accessible tool in clinical practice for monitoring health variables beyond cognitive decline in patients at risk of dementia.

Anna Lena Küstner, Aline Schönenberg, Tino Prell

BackgroundBoredom proneness in later life has been linked to poorer psychological and functional outcomes, yet little is known about how individual Views on Ageing (VoA) influence boredom or whether boredom per se predicts rehabilitation success. We therefore examined (1) the cross-sectional associations of positive and negative VoA with boredom proneness, and (2) the longitudinal effect of boredom on functional gains during a two-week geriatric rehabilitation.MethodsIn a sample of 120 inpatients (mean age 83.4 ± 6.4 years; 70.8% female) undergoing geriatric early complex rehabilitation, boredom was measured at admission using the eight-item Short Boredom Proneness Scale (SBPS). VoA were assessed with a 16-item questionnaire covering the domains physical decline, continuous growth, self-knowledge and social losses. Functional status was quantified by the Barthel Index at admission and discharge. We first fitted linear regression models of SBPS on VoA, adjusting sequentially for age, sex, living situation, education, and depressive symptoms (GDS). Next, we applied a longitudinal mixed-effects model to test SBPS as a predictor of functional improvement.ResultsNegative VoA strongly predicted higher SBPS (B = 0.39, p < 0.001) even after full adjustment (adj R2 = 0.39). Higher SBPS was associated with smaller changes in functional status in unadjusted (β = −0.93, p = 0.014), partially adjusted (β = −0.77, p = 0.009), and fully adjusted models (β = −0.84, p = 0.012). ANCOVA confirmed a negative SBPS effect on discharge Barthel (β = −0.90, p = 0.002). Mixed modeling revealed a significant Time × SBPS interaction (β = −0.94, p = 0.010), indicating that each SBPS point reduced expected rehabilitation gain by 0.94 Barthel points (ICC = 0.19).ConclusionOlder patients holding negative VoA are more prone to boredom. This proneness is further associated with less functional recovery during rehabilitation. Interventions targeting maladaptive VoA and boredom may enhance engagement and improve rehabilitative outcomes.

Konstantinos Kyriakos, Radosław Perkowski

Introduction. With global aging trends, understanding the nutritional status and physical fitness of older adults is crucial for promoting healthy aging and independence. Aim. The aim of this study was to assess nutritional status, physical fitness, and demographic parameters among older adults. Material and Methods. Using reliable assessment tools, data were collected from 40 participants aged 60 years and above. Assessments included the Mini Nutritional Assessment (MNA), Timed Up & Go Test (TUG), and Handgrip Strength Test (HGS). Statistical analyses were conducted to explore correlations and differences. Results. Most participants exhibited normal nutritional status (n = 38; 95%) and generally normal mobility and handgrip strength. However, no significant correlations were found between nutritional status, physical fitness, and demographic factors. Conclusions. While the majority demonstrated favorable health indicators, some individuals were at risk of malnutrition and functional limitations. Surprisingly, age did not correlate significantly with nutritional status or physical fitness. Further research with larger cohorts and sensitive assessment tools is needed to elucidate these relationships fully.

Fang-Lin Kuo, Zih-Yong Liao, Pei-Chun Liao et al.

Abstract Background Functional training is essential for maintaining the independence of older adults, especially in rural areas with limited resources. In this study, we assess the short-term and long-term impacts of the Precision Functional Training (PFT) program on mobility outcomes, specifically walking performance, and cognitive ability in community-dwelling older adults. The unique feature of this training program was its countywide, community-based, and tailored approach, designed to strengthen the functional abilities of older adults living in rural areas. Methods 158 older adults aged 65 years and above were assessed in this one-group pre–posttest study conducted in 11 community care stations in Chiayi County, Taiwan. Participants had two follow-ups, with data collection on mobility and cognition. The 12-week PFT program, led by certified trainers, integrated aerobic, strength, and cognitive elements. Primary outcomes, including changes in gait, falls, and cognition, were analyzed using linear mixed effects and logit models. Results Strengthening mobility is critical to slowing functional decline in older adults. The PFT program led to significant improvements in cognitive function and several gait parameters compared with the baseline. Participants with limited mobility showed enhanced activities of daily living 1-month post-training, but these gains did not persist at the 1-year mark. No significant differences were observed in fall occurrence and knee extension strength. Conclusions The training did not have a long-term effect; thus, more frequent practice may be necessary. Risk assessment and community-based interventions, particularly for older adults with a higher risk of falls, are recommended. Future prospective randomized controlled trials are needed to evaluate the PFT program’s effectiveness in preserving mobility.

Sandeep Grover, Ajit Avasthi

The psychiatric assessment of elderly differs from assessment of adult patients on various accounts. In this continuing medical education series, we discuss the generic aspects of psychiatric assessment of elderly. In this document we describe the SAFEST approach for psychiatric evaluation of elderly. This involves understanding the signs and symptoms [S], Additional Diagnosis- comorbid physical and psychiatric diagnosis [A], level of functioning, frailty, falls, forceful acts-abuse, forensic issues [F], collecting extra information pertaining to nutritional status, the environment in which the patient is living, constipation, urinary symptoms (incontinence/retention), and weight loss [E], understanding the ongoing stressors, suicidality, substance use disorder, sleep-related issues, sexual history, supervision of medication, safety issues, social support, spirituality and religiousness [S] and collecting the treatment history [T]. Clinicians should also give due importance to physical examination. While carrying out the mental status examination due importance must be given to assessment of cognitive functions. Basic investigations must be carried out in all the elderly patients, whenever feasible before starting psychotropic medications. A detailed case formulation should be made by taking the history, physical examination findings, mental status examination findings and the investigations.

Chris P. Verschoor, Chris P. Verschoor, Emilie Picard et al.

Granzymes are a family of serine-proteases that act as critical mediators in the cytolytic and immunomodulatory activities of immune cells such as CD8+ T-cells and natural killer (NK) cells. Previous work indicates that both granzyme B (GZB) and K (GZK) are increased with age in CD8+ T-cells, and in the case of GZB, contribute to dysfunctional immune processes observed in older adults. Here, we sought to determine how GZB and GZK expression in NK-cells, and CD4+, CD8+, and gamma-delta T-cells, quantified in terms of positive cell frequency and mean fluorescence intensity (MFI), differed with age, age-related health-traits and the antibody response to high-dose influenza vaccine. We found that the frequency and MFI of GZB-expressing NK-cells, and CD8+ and Vδ1+ T-cells, and GZK-expressing CD8+ T-cells was significantly higher in older (66–97 years old; n = 75) vs. younger (24–37 years old; n = 10) adults by up to 5-fold. There were no significant associations of GZB/GZK expression with sex, frailty or plasma levels of TNF or IL-6 in older adults, but those who were seropositive for cytomegalovirus (CMV) exhibited significantly higher frequencies of GZB+ NK-cells, and CD4+, CD8+ and Vδ1+ T-cells, and GZK+ CD8+ T-cells (Cohen’s d = .5–1.5). Pre-vaccination frequencies of GZB+ NK-cells were positively correlated with vaccine antibody responses against A/H3N2 (d = .17), while the frequencies of GZK+ NK and CD8+ T-cells were inversely associated with A/H1N1 (d = −0.18 to −0.20). Interestingly, GZK+ NK-cell frequency was inversely correlated with pre-vaccination A/H1N1 antibody titres, as well as those measured over the previous 4 years, further supporting a role for this subset in influencing vaccine antibody-responses. These findings further our understanding of how granzyme expression in different lymphoid cell-types may change with age, while suggesting that they influence vaccine responsiveness in older adults.

Xi Lin, Liyan Guo, Sheng Lin et al.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and related sarbecoviruses enter host cells by receptor-recognition and membrane-fusion. An indispensable step in fusion is the formation of 6-helix bundle by viral spike heptad repeats 1 and 2 (HR1 and HR2). Here, we report the construction of 5-helix bundle (5HB) proteins for virus infection inhibition. The optimal construct inhibits SARS-CoV-2 pseudovirus entry with sub-micromolar IC50. Unlike HR2-based peptides that cannot bind spike in the pre-fusion conformation, 5HB features with the capability of binding to pre-fusion spike. Furthermore, 5HB binds viral HR2 at both serological- and endosomal-pH, highlighting its entry-inhibition capacity when SARS-CoV-2 enters via either cell membrane fusion or endosomal route. Finally, we show that 5HB could neutralize S-mediated entry of the predominant SARS-CoV-2 variants and a wide spectrum of sarbecoviruses. These data provide proof-of-concept evidence that 5HB might be developed for the prevention and treatment of SARS-CoV-2 and other emerging sarbecovirus infections.

Kaya D, Aydin AE, Isik AT

Derya Kaya,1 Ali Ekrem Aydin,2 Ahmet Turan Isik1 1Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey; 2Department of Geriatric Medicine, Sivas State Hospital, Sivas, TurkeyCorrespondence: Derya KayaUnit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylül University, Balçova, Izmir 35340, TurkeyTel +90 232 412 43 41Fax +90 232 412 43 39Email deryakaya29@gmail.comPurpose: Essential tremor (ET) is the most common movement disorder in which dysautonomia symptoms can be present. We aimed to evaluate the presence of orthostatic hypotension (OH) and its relationship with the clinical features.Patients and Methods: Forty-four elderly patients with ET and 118 healthy elderly controls were included. OH was assessed via the head-up tilt table test and defined, according to the change in position, as a drop of at least 20 mmHg in systolic blood pressure and/or 10 mmHg in diastolic blood pressure. Tremor severity was evaluated using the Fahn-Tolosa-Marin Tremor Rating (FTMTR) Scale. All patients underwent geriatric comprehensive assessment.Results: There were no differences between the controls and patients with ET regarding age and gender. The mean age was 72.8± 6.1, the mean disease duration 19.1± 13.5 years and the mean FTMTR score was 30.9± 17.1 in patients with ET. The frequency of OH at the 1st minute in patients with ET was higher than in controls (31.8% vs 17.8%, p=0.046). Furthermore, the frequency of jaw tremor in patients with OH was higher than in those without OH (35.7% vs 6.7%, p=0.025). About 28.6% of ET patients with OH had orthostatic symptoms.Conclusion: We demonstrated that ET patients, particularly those with jaw tremors, had OH and that most of them were asymptomatic. Therefore, in order to protect patients from complications related to OH, it would be appropriate to evaluate OH in the follow-up and treatment of elderly patients with ET.Keywords: essential tremor, orthostatic hypotension, head-up tilt table test, jaw tremor, elderly

Ming-Hsiu Chiang, Huan-Ju Lee, Yi-Jie Kuo et al.

Introduction: Although surgery has been proven to improve the long-term survival of older adults with hip fracture, in-hospital mortality directly resulting from repair of hip fracture is undesirable. This study aimed to identify potential prognostic factors that predict in-hospital mortality risk in elderly patients following hip fracture surgery. Materials and Methods: This case–control study comprehensively collected data from older adults with hip fracture admitted to a single medical centre. Age was selected as the cross-matching factor. Univariate and binary multivariate logistic regression models were used to estimate the odds ratios with 95% confidence intervals. A receiver operating characteristic curve was constructed to quantify the discrimination power of the model. Results: Among a total of 841 older adults who received hip fracture surgery, 17 died during hospitalisation, yielding a 2.0% in-hospital mortality rate. Using a binary multivariate logistic regression model to perform a comparison with 51 age-matched patients in survival groups, the model revealed that estimated glomerular filtration rate (eGFR) and malignant cancer history were the only 2 factors significantly correlated with in-hospital mortality. The prognostic values for the eGFR and malignant cancer history were acceptable, with areas under the curve of .76 and .67, respectively. Conclusion: The prevalence of in-hospital mortality following hip fracture is low. After adjustment for age, eGFR and malignant cancer history were identified as factors significantly correlated with in-hospital mortality. The findings of this study could assist in the early screening and detection of patients with high in-hospital mortality risks.

Kazuki Uemura, Takehiko Doi, Kota Tsutsumimoto et al.

Abstract Background Bioelectrical impedance analysis (BIA)‐derived phase angle is expected to be an efficient prognostic marker of health adverse events with aging as an alternative of muscle mass. We aimed to examine the predictive ability of phase angle for incident disability in community‐dwelling elderly and determine the optimal cut‐off values. Methods Community‐dwelling elderly aged ≥65 years (n = 4452; mean age = 71.8 ± 5.3 years, 48.3% women) without disability at baseline participated in this prospective cohort study. Phase angle and appendicular skeletal muscle mass (ASM) were examined using a multi‐frequency BIA at baseline. Other potential confounding factors (demographics, cognitive function, depressive symptoms, medications, and physical performance) were also assessed. Incident disability was monitored on the basis of long‐term care insurance certification. Results Over a follow‐up of 24 months, 4.0% (n = 174) experienced disability, with an overall incidence rate of 20.6 per 1000 person‐years. The Cox hazard regression analysis showed that phase angle, as a continuous variable, was independently associated with incident disability after adjusting the covariates [male: hazard ratios (HRs) = 0.61, 95% confidence interval (CI) = 0.37–0.98; female: HR = 0.58, 95% CI = 0.37–0.90], although body mass index adjusted ASM was not. Receiver operating characteristic analysis indicated moderate predictive abilities of phase angle for incident disability [male: area under the receiver operating characteristic curve (AUC) = 0.76, 95% CI = 0.70–0.83; female: AUC = 0.71, 95% CI = 0.65–0.76], while those of body mass index adjusted ASM were low (male: AUC = 0.59, 95% CI = 0.521–0.66; female: AUC = 0.58, 95% CI = 0.52–0.63). Multivariate Cox regression analysis showed that low phase angle categorized by cut‐off value (male, ≤4.95°; female, ≤4.35°) was independently related to increased risk of incident disability (HR = 1.95, 95% CI = 1.37–2.78). Conclusions Lower phase angle independently predicts the incident disability separately from known risk factors. BIA‐derived phase angle can be used as a valuable and simple prognostic tool to identify the elderly at risk of disability as targets of preventive treatment.

Leon G. Martens, Jiao Luo, Fleur L. Meulmeester et al.

The antioxidant vitamin E (α-tocopherol, α-TOH) protects lipids from oxidation by reactive oxygen species. We hypothesized that lifestyle factors associate with vitamin E metabolism marked by urinary α-tocopheronolactone hydroquinone (α-TLHQ) and α-carboxymethyl-hydroxychroman (α-CEHC levels), as potential reflection of lipid oxidation. We conducted a cross-sectional study in the Netherlands Epidemiology of Obesity Study. Serum α-TOH, and urinary α-TLHQ and α-CEHC were quantified by liquid chromatography coupled with tandem mass spectrometry. Information on the lifestyle factors (sleep, physical activity (PA), smoking and alcohol) were collected through questionnaires. Multivariable linear regression analyses were performed to assess the associations between the lifestyle factors and α-TOH measures. A total of 530 participants (46% men) were included with mean (SD) age of 56 (6) years. Of the examined lifestyle factors, only poor sleep was associated with a higher serum α-TOH (mean difference: 4% (95% CI: 1, 7%)). Current smoking was associated with higher urinary α-CEHC (32%: (14%, 53%)), with evidence of a dose–response relationship with smoking intensity (low pack years, 24% (2, 52%); high pack years, 55% (25, 93%)). Moderate physical activity was associated with a lower α-TLHQ relative to α-CEHC (−17%: (−26, −6%), compared with low PA). Only specific lifestyle factors associate with vitamin E metabolism. Examining serum α-TOH does not provide complete insight in vitamin E antioxidant capacity.

Meizi Guo, Junli Zhao, Yingjiu Zhai et al.

Abstract Background Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. Hepatotoxicity is a barrier that limits the ability of primary care physicians to prescribe statins for patients with elevated liver transaminase values and/or underlying liver disease. However, limited population-based data are available on the use of statin therapy and on the hepatotoxicity of statins in very elderly patients. This prospective study evaluated the liver enzyme elevation during statin therapy in very elderly patients (≥80 years old). Methods Patients with hypercholesterolemia (LDL-C levels ≥3.4 and < 5.7 mmol/L), atherosclerosis, coronary heart disease (CHD), or a CHD-risk equivalent were enrolled and received once-daily statin treatment. Multivariate logistic regression models were used to study the impact of age, gender, hepatitis B infection, fatty liver disease, biliary calculus, other chronic diseases, drug kinds, alcohol abuse, statin variety, and statin dose variables. Results A total of 515 consecutive patients ranging from 80 to 98 years old were included in the analysis. These patients were treated with simvastatin, fluvastatin, pravastatin, rosuvastatin, or atorvastatin. Twenty-four patients (4.7, 95% CI 2.7–6.6) showed an increase in their hepatic aminotransferase levels. No significant difference of hepatic aminotransferase elevation rates was observed in different statin treatment groups. The incidence of mild, moderate, and severe elevation of aminotransferase levels was 62.5% (15/24), 29.2% (7/24), and 8.3% (2/24), respectively. None of the patients developed hepatic failure. Nine patients with moderate or severe aminotransferase elevations discontinued therapy. The time of onset of hepatic aminotransferase elevation ranged from 2 weeks to 6 months after statin treatment. The onset of hepatic aminotransferase elevation was within 1 month for 70.8% of patients. The patients took 2 weeks to 3 months to recover their liver function after statin therapy cessation. Multivariate analysis identified chronic hepatitis B infection and alcohol consumption as independent factors associated with the hepatic response to statins: OR, 12.83; 95% CI (4.36–37.759) and OR, 2.736; 95% CI (1.373–5.454), respectively. Conclusion The prevalence of elevated transaminases was higher than published data in very elderly patients. Overall, statin treatment is safe for patients ≥80 years old.

Mateusz Domeracki, Agnieszka Braun, Marcin Kożuchowski et al.

Admission The first successful attempt to use stimulants neuro modulation properties date back to the first half of the twentieth century. Due to the high technological limitations, the use of peripheral nerve electrostimulators the early eighties XX century was relatively small and involved few patients treated primarily due to neuropathic pain and patients psychosurgical. The development of modern batteries in the eighties of the twentieth century, standardization and implementation process to achieve consensus on the guidelines for operations in the field of functional neurosurgery, they contributed to intensified "Renaissance" functional neurosurgery. Material and methods Articles in the EBSCO database were analyzed using the keywords: peripheral nerves, stimulation, electrostimulation, neurosurgery. Furthermore, neural searched betting sites in terms of the technical aspects of this equipment. Available literature was subjectively selected. Then searched the latest version of each article. Results Offered different tools offered technical specifications. Technological developments have allowed the convenience to use devices, min. by increasing control by the user or representative of the operation of the pacemaker. Conclusions The development of technology and neuroscience neurostymulatorów resulted in the development of many available on the market. However, more research is needed to determine the exact parameters of stimulation, which would get the largest size stimulation effect while minimizing adverse effects.

Sandeep Grover

Mahboubeh Dadfar, David Lester, Fazel Bahrami

The present study is aimed at examining the level of death anxiety and the sex-related differences among old-aged Iranian individuals sample to compare the old-aged persons with young college students and to explore the psychometric properties of the Arabic Scale of Death Anxiety (ASDA) factors in old-aged sample. A sample of 146 volunteer Iranian individuals took part in the study. The mean ages were 68.58 (SD = 7.10), men 68.81 (SD = 7.44) and women 68.28 (SD = 6.76), respectively. The mean score of the ASDA was 51.09 (SD = 20.19). Cronbach’s alpha of the ASDA was found to be high (0.94); and Spearman-Brown coefficient was 0.92. Women had a significantly higher mean total score on the ASDA. Old-aged individuals had a significantly higher mean ASDA total score than younger college students (M age = 25.77). The factor analysis of the ASDA items yielded three factors accounting for 67.88% of the total variance labeled (F1) fear of dead people and tombs; (F2) fear of lethal disease and postmortem events; and (F3) death fear. These factors were highly replicable with previous factors extracted from a middle-aged Kuwaiti sample. On the basis of the present results, there are the following three general conclusions: death anxiety is not significantly correlated with age; the sex-related differences on death anxiety are striking in the Iranian samples; and the ASDA has a highly replicable factor structure among two Iranian and Arab countries.