The Institute of Geriatrics and Gerontology (IGG) of the Pontifical Catholic University of Rio Grande do Sul (PUCRS) began with the moving of its head Prof. Yukio Moriguchi to Southern Brazil for the building at Porto Alegre City of the milestone of a promising center of basic and advanced education and research on biology of aging and geriatric diseases. More than 20 years has passed and the IGG has entered a period of increasing demand for the care of a growing number of the elderly population in Latin America. Following these trends the need for increasing knowledge and research has led the IGG to greatly expand its personnel as well as other resources to build up a broad program on the prevention of chronic degenerative diseases, since its assumed that there is an increased risk for aged people to develop multiple chronic diseases usually accompanied with associated functional limitations. To achieve this aim the IGG has great interest in participating as a collaborating center with other countries in any project aiming a better understanding of human diseases. The IGG has been acquainted to international cooperative work, such as the support of Japan International Cooperation Agency (JICA), in agreement with Brazilian Cooperation Agency (BCA), which has been contributing for the acquisition of clinical and experimental machinery since its foundation. After November 1997, the IGG became a World Health Organization and Pan American Health Organization Collaborating Center for Prevention of Pathological Aging and Associated Chronic Degenerative Diseases. The combination of these two cooperative works with other clinical and research events has stimulated this Institute to expand even more its role on clinical practice, research and education on biology of aging and chronic degenerative diseases. In a general way, the work developed in this Institute focuses the prevention of pathological aging and chronic and degenerative diseases such as cardiovascular, neoplasm, and osteoarticular diseases, as well as dementia among other common diseases in the elderly. On the other hand, basic research on the biological process of aging has been recently developed. The IGG is a specialized Institute of the PUCRS with a educational and scientific role, and has postgraduate education and research as its main purpose. However, it also includes clinical trials and care to the aged in the general population among its goals. The main purposes of the Institute include the establishment and organization of postgraduate courses in Geriatrics and Gerontology and the development of research groups and investigation in the field of aging and its related issues. In order to perform these tasks the Institute has valuable research and clinical facilities located in a 2942 m2, that make possible to carry out its postgraduate courses in geriatrics. Likewise, the Institute has an in- and outpatient services, which are attached to the medical school of the university providing assistance for the aged population and fellowship programs. The IGG has also cooperative and exchanging programs with many international institutions. The Institute is engaged in a cooperative program with the World Health Organization (WHO) Collaborating Center based at Kyoto University, Japan, on prevention of heart and vascular diseases, and with JICA, in the Third Country Training Program (TCTP) in Geriatrics that used to offered the opportunity for specialization and training in clinical geriatrics for Latin-American physicians. There are ongoing research projects on the environmental influence in the aging process in cooperation with Kyoto, Kyorin and Aichi Medical Universities from Japan; aging, lipid metabolism and atherosclerosis projects with the Wake Forest University (USA). This way, the IGG has been providing its scholars a particular opportunity for continuous contact with the most advanced studies on aging and prevention of common diseases of the elderly. At the same time, the Institute is placing the name of the PUCRS and Brazil on the international scientific scenario.
The staff of the IGG is composed by 52 persons including all teaching body, physicians, technicians, secretaries and in-patient personnel. The teaching body is composed by eight permanent professors, all of them engaged in postgraduate education and research. Many professors from the Faculties of Medicine, Biosciences and Social Service of PUCRS participate in the research and educational program of IGG. Moreover, due to its intense research and exchange programs the Institute also invites professors of other national or international institutions to collaborate and to bring their experience and expertise knowledge. The permanent teaching body, place of post-graduation and respective field of research is listed below:
The educational program of the Institute aims post-graduation at any level, extension and training to allow the students to practice geriatric medicine, medical education or basic and applied research with confidence.
Post-graduation stricto sensu
Post-graduation lato sensu
Specialty in Geriatrics
Short-term research programs for graduate and undergraduate students
Contact us: Address: Institute of Geriatrics and Gerontology PUCRS Av. Ipiranga, 6690 Porto Alegre - RS 90610-000 Brazil Tel: +55 51 3336-8153 Fax: +55 51 3320-3862 e-mail: email@example.com Home page: www.pucrs.br/igg
During the last decades, the human population has been subjected to an aging process due to the progress of health promotion, mainly the management of infectious diseases, and the infantile mortality, besides the improvement of the quality of life. In general, the world population is increasing with the annual rate of 1.7%, while the segment of the population with 60 years or more is increasing with the annual rate raging between 2.55-3%. Therefore, this age group represents the portion of population with the largest growing rate.
Contemporaneous with the phenomena, demographic studies have shown a decrease in the rate of mortality in those above 60 years of age in the majority of the developing countries. In Brazil, the number of individuals aged 60 years and older was 8.3% of the total population. This frequency will duplicated and probably stabilize by the year 2050. Yet lacking overage and quality, health services are already burdened with degenerative diseases and mental disorders, frequent out patient appointments, high hospital bed occupation and high costs.
In this scope, it is urgent to developed research programs aimed to the detection and prevention of those chronic-degenerative diseases and related risk factors to able us to implement actions coordinated by primary health care units, by young people's education and health and in social and medical support programs for the caregivers.
Based in these ideas, the Institute of Geriatric and Gerontology, have a several research programs, included in three major objectives:
to investigate the genetic-environmental variables "successful aging-related"
to investigate the genetic-environmental variables chronic-degenerative diseases-related
To investigate the aspects of biology of aging, using experimental models.
The current lines and fields of research that have been carried out in the Institute are hereafter briefly summarized in order to clearly identify the main purpose of each field.
1. Preventive and clinical geriatrics
It looks for the establishment of the main risk factor for diseases in the elderly and tries to define the pattern of a natural process of aging to distinguish it from the pathological process caused by some undermining somatic or psychic disease. Its main projects are associated to longitudinal and observational long-term studies that are included in the specific projects referred below.
2. Nutrition and metabolism in the elderly
It follows the basis of the previous line and aims the determination of the main metabolic and nutritional disorders of the elderly in an attempt to define specific patterns in geriatric patients; and from this point, to determine the characteristic diet of the elderly and to study the significance of certain diets, e. g., traditional Japanese diet, on the aging process and their influence in the nutritional status of the elderly, or the factors that may modify the metabolism leading to nutritional deficiencies or deteriorated metabolic states. Some of the ongoing projects have the purpose to determine the differences of food intake and the nutritional status between Japanese individuals from Okinawa who stayed there and those who migrated to Brazil as part of the Campo Grande Project, which has been performed in association with the Kyoto University-based WHO Collaborating Center.
3. Biology of Aging
The research on this field started in the Institute in 1995 and has three main goals: (1) aging-related changes in cells and tissues focusing on the morphological aspects of age changes in cells that play an important role in the decline of the physiological capacities of the body like skeletal muscle fibers, hepatic cells and kidney cells. The changes in the composition and amount of extra-cellular components as collagen are also object of study. (2) Search for experimental models for aging research into the Brazilian fauna, which allow observation and experimentation on the changes that occur in cells and organisms during their life. (3) Longevity and genetic factors, where the influence of the genes on the longevity is studied using animal models.
4. Cell death, senility and oncogenes
Research line created in the fall of 1995 comes in accordance to the interest of the Institute in advancing in the investigation on the biological phenomenon of the aging process at the cell level and the relation between cell senility, cell cycle (growth and proliferation) and programmed cell death (apoptosis). The key project in this field ongoing now aims to determine the shifts occurred on the colonic mucosa when it turns senile or modified in an attempt to establish a senile rate for this organ, and tries also to demonstrate the genes implicated in this process, such as p53, retinoblastoma, bcl-2, etc. Also this line tries to define the relationship among aging, cell death, carcinogenesis and oncogenes, in a view that these factors seem to be correlated.
5. Gut: benign and malignant digestive diseases
This line has its main purposes on endoscopic detection and treatment of benign and malignant digestive diseases as well as endoscopic differentiation of hyperplastic and pre-malignant polyps by magnification imaging, and comparative studies on the prevalence of Helicobacter pylori infection and its relation with atrophic gastritis and the physiopathological differences on this issue between Japanese and Brazilian adults and ancients. It gives practical priority to gastrointestinal tumors since the diagnosis and treatment of these tumors still far behind of the common Japanese practice and attempts to the introduction of the routine Japanese system to deal with these tumors. Moreover, in the Japanese communities in the state of Rio Grande do Sul and Santa Catarina investigation and guidance projects on gastrointestinal tumors have been developed, and the second part of this project refers to the endoscopic screening of the Japanese citizens and their descents. This line has also the purpose of organizing clinical trials on drugs, searching for new risk factors implicated on gastrointestinal tumors, and on screening for detection of early tumors.
6. Bone metabolism and osteoporosis
Osteoporosis is a disease extremely associated with aging, mainly implicated with women but also complicating men, being for this reason one of the oldest research field in this Institute. The diagnosis of osteoporosis has improved a lot in the past decades, especially related to measuring of the bone mass that has been used in the laboratory of osteoporosis at this Institute since 1991. The aims of this line are the definition of new risk factors for osteoporosis, the assessment of bone mass in the general population and subgroups with particular risk factors, comparing bone mass of Japanese and Brazilian citizens.
7. Metabolism of lipids in the elderly
The aim of this line of research is to investigate the nutritional aspects of the elderly in relation to their lipidic metabolism in generally, based on previous studies demonstrating that fish-rich diets may help on prevention of atherosclerosis by the omega-3 multi-saturated heavy-chain fatty acid found in many marine species, probably by their potential anti-atheromatous effects, since they reduce the serum lipids, inhibit the platelet aggregation, blood coagulation, and have anti-hypertensive and anti-inflammatory properties. The current project in this line is a pilot study on the feasibility, efficacy and tolerability of the use of omega-3 fat acids in the treatment of carotid artery atherosclerosis in the elderly controlled by colored echographic assessment. Secondary ongoing projects investigate the feasibility, efficacy and tolerability of the use of fluvastatin and fenofibrate in the treatment of non-familial hypercholesterolemia and combined hyperlipidemia of the elderly, respectively.
8. Atherosclerosis and lipid disorders
One of the first lines of research in this Institute, it focuses on heart and vascular disorders, the main cause of death among adults in the western, and in atherosclerosis, a multifactorial basic process implicated in the coronary artery diseases (CAD), that is frequently evidenced as acute myocardial infarction and sudden death, a major cause of disabling and death among us. A clinical protocol is assessing the echographic patterns of the atheromatous plaque in carotid arteries, and another one, a basic protocol aim the determination of cell death and the expression of oncogenes in the plaque. Studies on serum lipoproteins permit to identify their types and to demonstrate the links between lipid disorders and atherosclerosis, since that their disorders are also associated with CAD in elderly and ancient patients. It is in this combination, lipidic disorders, atherosclerosis-CAD, and aging that this line concentrates its ongoing clinical and basic projects.
9. GENE-environmental SYStem interactions on aging - GENESYS Research Program
GENESYS Program was created with the purpose of studying the interaction of the genes with the environment in the scope of aging process. The two major areas of the study are: the gene-environmental interactions related to chronic-degenerative diseases and related to successful aging.
The structure of GENESYS Program is based on an inter-disciplinary and research network that involve different researchers from several biological basic areas as: molecular biology, genetic, immunology, chemistry, etc. and several clinical areas as: internal medicine, pediatrics, cardiology, etc. Three major investigations were implemented and are being developed in this Program:
study in immigrant communities of Rio Grande do Sul-Brazil, mainly Italian and Japanese populations analyzing several environmental and genetic aspects related to cardiovascular diseases;
investigations of genetic and environmental risk factors prevalence in several age groups of population, from study developed in Gravataí City. This city is in an industrializing process, and the demographics and epidemiological profile is very similar that of observed in Rio Grande do Sul. In these two first projects, a multiple approach was been used, including following investigations: a) immunogenetic variables in elderly population; b) gene polymorphism related to cardiovascular diseases such as: Angiotesine converting enzyme gene (ACE), Apoliprotein E (Apo E) gene and Paraoxonase gene (POBA); c) variables related to lifestyle and nutrition that can affect the health of the population and a longevity with life quality;
Furthermore, diet and nutrition factors that influence the risk cardiovascular prevalence, as the presence of resveratrol compound in red wine from different RS regions, and in Veranópolis region.
A great part of this research are supported by grant Brazilian governmental from as Fundação de Amparo a Pesquisa do Rio Grande do Sul (FAPERGS) and international support as Japan International Cooperation Agency (JICA).
10. Veranópolis Project
This is an epidemiological study that has been developed in the countryside city of Veranópolis, state of Rio Grande do Sul. This study assesses individuals who are 80 years or older, and has the purpose of characterizing the physiological aspects of aging and the frequency of their disorders, as well as to compare the physiological aspects of an adequate process of aging with their life styles. The first part of the project examined the results obtained between 1994 and 1996. The longitudinal follow-up of this population will allow the identification of clinical features and life styles that may be of diagnostic value for the aged. These informations may provide important clues on preventive measures for people on this age, and an improvement on the rate of life expectancy and in their quality of life may be expected.
11. Life style and longevity
Under JICA's financial support, this project was performed by collecting clinical and laboratory data on Japanese citizens living in the Japanese communities of the States of Rio Grande do Sul, Santa Catarina and Paraná. Yearly, a team from this Institute goes to these States using a well-equipped vehicle ready for clinical and some laboratory exams. Besides the free-of-charge assistance to the communities, the obtained information is used to compare these data with those obtained from Japanese citizens living in Japan, therefore attempting to establish possible relations between the two groups and the related aspects regarding aging and longevity of each one.
12. Genetic factors and environment in hypertension
This is a project under WHO supervision and cooperation which attempts to establish gene patterns and environmental influence on high blood pressure. In its first phase has established the features and diet styles and compared it with the prevalence of hypertension in many regions of the world. In that phase, researchers from the Kyoto University WHO Collaborating Center and from IGG have studied the same aspects in many cities of the States of Rio Grande do Sul and Mato Grosso do Sul.