# Nail structural alterations and zinc levels in the elderly: an observational cross-sectional study

## TL;DR

This study examines nail changes in elderly individuals and their potential link to zinc levels, finding no significant association.

## Contribution

The study investigates the relationship between nail structural alterations and zinc levels in the elderly using a cross-sectional observational design.

## Key findings

- Most elderly subjects showed altered nail profiles, particularly in toenails.
- Nail zinc concentrations were not significantly different between those with and without nail changes.
- Subgroup analyses based on comorbidities and medications found no significant discrepancies.

## Abstract

Nails in the elderly undergo several structural changes related to aging with respect to surface, thickness, color, and growth pattern. The present study explores the potential association between nail alterations and zinc levels in this population.

A total of 64 subjects aged ≥60 years with or without nail changes were recruited from the Dermatology and Venereology Outpatient Clinic at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Their nail features were observed clinically and evaluated utilizing dermoscopy, and nail clippings weighing a total of 200 milligrams were collected from each subject for nail zinc concentration measurement. Appropriate statistical tests were employed to determine the relationship between nail zinc levels and the structural alterations, as well as the patients’ comorbidities and medications, at a significance level of 0.05.

Most subjects in our study showed altered nail profiles in multiple digits (75.0%) with a predilection for toenails (62.3%), and the first toenail was primarily affected. The commonest dermoscopic features displayed in altered nails include nail plate pigmentation (n = 64), distal edge thickening (n = 39), and surface changes (n = 34). The average nail zinc concentration was lower in the elderly with nail changes than in those without, albeit with no statistically significant differences (p = 0.687). Subgroup analyses according to comorbidities (hypertension, diabetes mellitus type 2, and dyslipidemia) and medications (antihypertensives, antidiabetics, antidyslipidemic drugs, and anticonvulsants) also exhibited no discrepancies.

This study highlights the complex interactions among nail structural changes, zinc levels, comorbidities, and medications; hence, further research is warranted to obtain a deeper understanding.