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Is the Hierarchy of Loss in Functional Ability Evident in Midlife? Findings from a British Birth Cohort. PLoS One 2016; 11:e0155815. [PMID: 27187493 PMCID: PMC4871329 DOI: 10.1371/journal.pone.0155815] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 05/04/2016] [Indexed: 11/19/2022] Open
Abstract
Background Difficulties performing a range of physical tasks of daily living have been shown to develop in older populations in a typically observed sequence, known as the hierarchy of loss. Nearly all previous research has been undertaken using populations aged over 75. This study aimed to use cross-sectional and longitudinal data to test for evidence of the hierarchy of loss from midlife onwards. Methods The prevalence of reported difficulty undertaking 16 physical tasks in the MRC National Survey of Health and Development at age 60–64 were calculated, with Mokken scaling used to confirm the hierarchical order. Logistic regression was used to calculate the odds ratios of reporting difficulty performing tasks at the bottom of the hierarchy (i.e. feeding, washing and/or toileting) at age 60–64 by reported difficulty at the top of the hierarchy (i.e. gripping, walking and/or stair climbing) at age 43. Results At age 60–64, tasks associated with balance, strength and co-ordination, such as climbing stairs, were the first tasks participants reported difficulty with and tasks associated with upper limb mobility, such as feeding yourself, were the last. In a fully-adjusted model, participants who reported difficulty at the top of the hierarchy at age 43 were 2.85 (95% CI: 1.45–5.60) times more likely to report difficulty with tasks at the bottom of the hierarchy at age 60–64. Conclusion This study presents evidence of the hierarchy of loss in a younger population than previously observed suggesting that targeted interventions to prevent functional decline should not be delayed until old age.
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Luders E, Cherbuin N. Searching for the philosopher's stone: promising links between meditation and brain preservation. Ann N Y Acad Sci 2016; 1373:38-44. [PMID: 27187107 DOI: 10.1111/nyas.13082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In the context of an aging population and increased prevalence of dementia and other neurodegenerative diseases, developing strategies to decrease the negative effects of aging is imperative. The scientific study of meditation as a potential tool to downregulate processes implicated in brain aging is an emerging field, and a growing body of research suggests that mindfulness practices are beneficial for cerebral resilience. Adding further evidence to this notion, an increasing number of imaging studies report effects of meditation on brain structure that are consistent with our understanding of neuroprotection. Here, we review the published findings in this field of research addressing the question of whether meditation diminishes age-related brain degeneration. Altogether, although analyses are still sparse and based on cross-sectional data, study outcomes suggest that meditation might be beneficial for brain preservation-both with respect to gray and white matter-possibly by slowing down the natural (age-related) decrease of brain tissue. Nevertheless, it should also be recognized that, until robust longitudinal data become available, there is no evidence for causation between meditation and brain preservation. This review includes a comprehensive commentary on limitations of the existing research and concludes with implications and directions for future studies.
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Affiliation(s)
- Eileen Luders
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California.,Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
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103
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Midlife job profiles and disabilities in later life: a 28-year follow-up of municipal employees in Finland. Int Arch Occup Environ Health 2016; 89:997-1007. [DOI: 10.1007/s00420-016-1133-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
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104
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Cooper R, Muniz-Terrera G, Kuh D. Associations of behavioural risk factors and health status with changes in physical capability over 10 years of follow-up: the MRC National Survey of Health and Development. BMJ Open 2016; 6:e009962. [PMID: 27091818 PMCID: PMC4838696 DOI: 10.1136/bmjopen-2015-009962] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES (1) To describe changes in objective measures of physical capability between ages 53 and 60-64 years; (2) to investigate the associations of behavioural risk factors (obesity, physical inactivity, smoking) and number of health conditions (range 0-4: hand osteoarthritis (OA); knee OA; severe respiratory symptoms; other disabling or life-threatening conditions (ie, cancer, cardiovascular disease, diabetes)) at age 53 years with these changes. DESIGN Nationally representative prospective birth cohort study. SETTING England, Scotland and Wales. PARTICIPANTS Up to 2093 men and women from the Medical Research Council National Survey of Health and Development, who have been followed-up since birth in 1946, and underwent physical capability assessments performed by nurses following standard protocols in 1999 and 2006-2010. MAIN OUTCOME MEASURES Grip strength and chair rise speed were assessed at ages 53 and 60-64 years. Four categories of change in grip strength and chair rise speed were identified: decline, stable high, stable low, a reference group who maintained physical capability within a 'normal' range. RESULTS Less healthy behavioural risk scores and an increase in the number of health conditions experienced were associated in a stepwise fashion with increased risk of decline in physical capability, and also of having low levels at baseline and remaining low. For example, the sex and mutually adjusted relative-risk ratios (95% CI) of being in the stable low versus reference category of chair rise speed were 1.58 (1.35-1.86) and 1.97 (1.57-2.47) per 1 unit change in behavioural risk score and health indicator count, respectively. CONCLUSIONS These findings provide evidence of the associations of a range of modifiable factors with age-related changes in physical capability. They suggest the need to target multiple risk factors at least as early as mid-life when aiming to promote maintenance and prevent decline in physical capability in later life.
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Affiliation(s)
- Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | | | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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105
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Lin PS, Hsieh CC, Cheng HS, Tseng TJ, Su SC. Association between Physical Fitness and Successful Aging in Taiwanese Older Adults. PLoS One 2016; 11:e0150389. [PMID: 26963614 PMCID: PMC4786127 DOI: 10.1371/journal.pone.0150389] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 02/12/2016] [Indexed: 11/20/2022] Open
Abstract
Population aging is escalating in numerous countries worldwide; among them is Taiwan, which will soon become an aged society. Thus, aging successfully is an increasing concern. One of the factors for achieving successful aging (SA) is maintaining high physical function. The purpose of this study was to determine the physical fitness factors associated with SA in Taiwanese older adults (OAs), because these factors are intervenable. Community-dwelling OAs aged more than 65 years and residing in Northern Taiwan were recruited in this study. They received a comprehensive geriatric assessment, which includes sociodemographic data, health conditions and behaviors, activities of daily living (ADL) and instrumental ADL (IADL) function, cognitive and depressive status, and quality of life. Physical fitness tests included the grip strength (GS), 30-second sit-to-stand (30s STS), timed up-and-go (TUG), functional reach (FR), one-leg standing, chair sit-and-reach, and reaction time (drop ruler) tests as well as the 6-minute walk test (6MWT). SA status was defined as follows: complete independence in performing ADL and IADL, satisfactory cognitive status (Mini-Mental State Examination ≥ 24), no depression (Geriatric Depression Scale < 5), and favorable social function (SF subscale ≥ 80 in SF-36). Adjusted multiple logistic regression analyses were performed. Among the total recruited OAs (n = 378), 100 (26.5%) met the aforementioned SA criteria. After adjustment for sociodemographic characteristics and health condition and behaviors, some physical fitness tests, namely GS, 30s STS, 6MWT, TUG, and FR tests, were significantly associated with SA individually, but not in the multivariate model. Among the physical fitness variables tested, cardiopulmonary endurance, mobility, muscle strength, and balance were significantly associated with SA in Taiwanese OAs. Early detection of deterioration in the identified functions and corresponding intervention is essential to ensuring SA.
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Affiliation(s)
- Pay-Shin Lin
- Department of Physical Therapy & Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Health Aging Research Center, Chang Gung University & Chang Gung Memorial Hospital, Taoyuan, Taiwan
- * E-mail:
| | - Chih-Chin Hsieh
- Department of Physical Therapy & Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Huey-Shinn Cheng
- Internal & Geriatric Medicine, Chang Gung Memorial Hospital, LinKou Branch, Taoyuan, Taiwan
| | - Tsai-Jou Tseng
- Department of Physical Therapy & Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shin-Chang Su
- Department of Physical Therapy & Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Cosco TD, Kaushal A, Richards M, Kuh D, Stafford M. Resilience measurement in later life: a systematic review and psychometric analysis. Health Qual Life Outcomes 2016; 14:16. [PMID: 26821587 PMCID: PMC4730639 DOI: 10.1186/s12955-016-0418-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/24/2016] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To systematically review and examine the psychometric properties of established resilience scales in older adults, i.e. ≥60 years. METHODS A systematic review of Scopus and Web of Science databases was undertaken using the search strategy "resilience" AND (ageing OR aging)". Independent title/abstract and fulltext screening were undertaken, identifying original peer-reviewed English articles that conducted psychometric validation studies of resilience metrics in samples aged ≥60 years. Data on the reliability/validity of the included metrics were extracted from primary studies. RESULTS Five thousand five hundred nine studies were identified by the database search, 426 used resilience psychometrics, and six psychometric analysis studies were included in the final analysis. These studies conducted analyses of the Connor Davidson Resilience Scale (CD-RISC) and its shortened 10-item version (CD-RISC10), the Resilience Scale (RS) and its shortened 5- (RS-5) and 11- (RS-11) item versions, and the Brief Resilient Coping Scale (BRCS). All scales demonstrated acceptable levels of internal consistency, convergent/discriminant validity and theoretical construct validity. Factor structures for the RS, RS-11 and CD-RISC diverged from the structures in the original studies. CONCLUSION The RS, RS-5, RS-11, CD-RISC, CD-RISC10 and BRCS demonstrate psychometric robustness adequate for continued use in older populations. However, results from the current study and pre-existing theoretical construct validity studies most strongly support the use of the RS, with modest and preliminary support for the CD-RISC and BRCS, respectively. Future studies assessing the validity of these metrics in older populations, particularly with respect to factor structure, would further strengthen the case for the use of these scales.
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Affiliation(s)
- T D Cosco
- MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK
| | - A Kaushal
- MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK
| | - M Richards
- MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK
| | - D Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK
| | - M Stafford
- MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK.
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Moreira MA, Zunzunegui MV, Vafaei A, da Câmara SMA, Oliveira TS, Maciel ÁCC. Sarcopenic obesity and physical performance in middle aged women: a cross-sectional study in Northeast Brazil. BMC Public Health 2016; 16:43. [PMID: 26775160 PMCID: PMC4715318 DOI: 10.1186/s12889-015-2667-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 12/21/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Sarcopenia and obesity have been independently associated with physical function decline, however little information is currently available on the relationship between sarcopenic obesity and physical performance, mainly in middle aged women. The present study aims to estimate the prevalence of sarcopenic obesity and to explore the relationship between sarcopenic obesity and physical performance in middle-aged women from Northeast Brazil. METHODS A cross-sectional study of women (40-65 years) living in Parnamirim, a city in Northeast Brazil (n = 491). Physical performance was assessed by grip strength, knee extensor and flexor strength (isometric dynamometry), gait speed, and chair stands. Using bioelectrical impedance analysis (BIA), appendicular skeletal muscle mass divided by height squared (kg / m(2)) was used to define sarcopenia. Waist circumference ≥ 88 cm was defined as abdominal obesity. Sarcopenic obesity was defined as the coexistence of obesity and sarcopenia. The physical performance outcomes were regressed in four groups defined by combinations of sarcopenia and obesity, adjusting for potential confounders (age, education and menopausal status). RESULTS Prevalence rates of the four obesity-sarcopenia groups were: Sarcopenic obesity (7.1 %), obesity (67.4 %), sarcopenia (12.4 %) and normal (13 %). Women with sarcopenic obesity had significantly lower grip strength, weaker knee extension and flexion and longer time to raise from a chair compared with non-obese and non-sarcopenic women (p.values < 0.001). Except for the chair stands, these statistically significant differences were also found between sarcopenic obese and obese women. There was no significant difference for gait speed across the four groups (p = 0.50). CONCLUSION Sarcopenic obesity was present in 7 % of this population of middle-aged women from Northeast Brazil and it was associated with poor physical performance. Sarcopenic obesity may occur in middle-aged women with performance limitations beyond pure sarcopenia-related muscle mass or obesity alone.
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Affiliation(s)
- Mayle A Moreira
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
| | - Maria Victoria Zunzunegui
- Institut de Recherché en Santé Publique, School of Public Health, Université de Montréal, Québec, Canada.
| | - Afshin Vafaei
- Department of Public Health Sciences, Carruthers Hall, Queen's University, Kingston, Canada.
| | - Saionara M A da Câmara
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
| | - Tamyres S Oliveira
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
| | - Álvaro C C Maciel
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil.
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Koike S, Hardy R, Richards M. Adolescent self-control behavior predicts body weight through the life course: a prospective birth cohort study. Int J Obes (Lond) 2016; 40:71-6. [PMID: 26449420 PMCID: PMC4704138 DOI: 10.1038/ijo.2015.213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/24/2014] [Accepted: 08/23/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Weight gain has become one of the biggest issues for healthy aging in middle- and high-income countries. Self-control of emotional reward cues is an important behavioral factor for regulation of weight gain through voluntary diet control and physical activity. METHODS We tested the associations between teacher-rated self-control at ages 13 and 15 years, and measured body mass index (BMI) between ages 15 and 60-64 years, controlling for confounding factors such as affective symptoms and cognition, using 3873 study members in the Medical Research Council National Survey of Health and Development, also known as the British 1946 birth cohort. RESULTS Multivariable regression analysis after adjustment for all covariates showed that lower self-control was associated with higher BMI in all measure points (P<0.05). Multilevel modeling using a cubic model showed that there was an association between self-control and BMI at 15 years in females (male: BMI=-0.00 kg m(-2) per 1 s.d. on the self-control score (95% confidence interval (CI): -0.12 to 0.11), P =0.94; female: BMI=-0.27 (-0.42 to -0.11), P<0.001). The association became stronger with age in both sexes (BMI=-0.065 (-0.082 to -0.048), P<0.001; BMI=-0.036 (-0.057 to -0.015), P<0.001). By age 60-64 years, the association between self-control and BMI in men had increased to -0.70 (-0.96 to -0.44) and -0.67 (-1.04 to -0.30) in women. CONCLUSIONS Lower adolescent self-control was associated with higher BMI through the life course, and this becomes stronger with age. Investigations to test whether intervention to self-control improves obesity are recommended.
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Affiliation(s)
- S Koike
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK
- Office for Mental Health Support, Division for Counseling and Support, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - R Hardy
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK
| | - M Richards
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK
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Population Aging at Cross-Roads: Diverging Secular Trends in Average Cognitive Functioning and Physical Health in the Older Population of Germany. PLoS One 2015; 10:e0136583. [PMID: 26323093 PMCID: PMC4556449 DOI: 10.1371/journal.pone.0136583] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/05/2015] [Indexed: 11/19/2022] Open
Abstract
This paper uses individual-level data from the German Socio-Economic Panel to model trends in population health in terms of cognition, physical fitness, and mental health between 2006 and 2012. The focus is on the population aged 50–90. We use a repeated population-based cross-sectional design. As outcome measures, we use SF-12 measures of physical and mental health and the Symbol-Digit Test (SDT) that captures cognitive processing speed. In line with previous research we find a highly significant Flynn effect on cognition; i.e., SDT scores are higher among those who were tested more recently (at the same age). This result holds for men and women, all age groups, and across all levels of education. While we observe a secular improvement in terms of cognitive functioning, at the same time, average physical and mental health has declined. The decline in average physical health is shown to be stronger for men than for women and found to be strongest for low-educated, young-old men aged 50–64: the decline over the 6-year interval in average physical health is estimated to amount to about 0.37 SD, whereas average fluid cognition improved by about 0.29 SD. This pattern of results at the population-level (trends in average population health) stands in interesting contrast to the positive association of physical health and cognitive functioning at the individual-level. The findings underscore the multi-dimensionality of health and the aging process.
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110
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Gogol M. Stress und optimales Altern. Z Gerontol Geriatr 2015. [DOI: 10.1007/s00391-015-0934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Godfrey A, Lara J, Del Din S, Hickey A, Munro CA, Wiuff C, Chowdhury SA, Mathers JC, Rochester L. iCap: Instrumented assessment of physical capability. Maturitas 2015; 82:116-22. [PMID: 25912425 PMCID: PMC4551273 DOI: 10.1016/j.maturitas.2015.04.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/03/2015] [Accepted: 04/05/2015] [Indexed: 11/05/2022]
Abstract
Instrumented testing of five physical capability tasks with a single accelerometer. Evaluated on a large cohort of older adults. iCap provides robust quantitative data about physical capability. iCap captures gait and postural control data known as sensitive to ageing/pathology. Methodology may have practical utility in a wide range of surveys and studies.
Objectives The aims of this study were to (i) investigate instrumented physical capability (iCap) as a valid method during a large study and (ii) determine whether iCap can provide important additional features of postural control and gait to categorise cohorts not previously possible with manual recordings. Study design Cross-sectional analysis involving instrumented testing on 74 adults who were recruited as part of a pilot intervention study; LiveWell. Participants wore a single accelerometer-based monitor (lower back) during standardised physical capability tests so that outcomes could be compared directly with manual recordings (stopwatch and measurement tape) made concurrently. Main outcome measures Time, distance, postural control and gait characteristics. Results Agreement between manual and iCap ranged from moderate to excellent (0.649–0.983) with mean differences between methods low and deemed acceptable. Additionally, iCap successfully quantified (i) postural control characteristics which showed sensitivity to distinguish between 5 variations of the standing balance test and (ii) 14 gait characteristics known to be sensitive to age/pathology. Conclusions Our findings show that iCap can provide robust quantitative data about physical capability during standardised tests while also providing sensitive (age/pathology) postural control and gait characteristics not previously quantifiable with manual recordings. The methodology which we propose may have practical utility in a wide range of clinical and public health surveys and studies, including intervention studies, where assessment could be undertaken within diverse settings. This will need to be tested in further validation studies in a wider range of settings.
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Affiliation(s)
- A Godfrey
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - J Lara
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - S Del Din
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - A Hickey
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - C A Munro
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - C Wiuff
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - S A Chowdhury
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - J C Mathers
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - L Rochester
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK.
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Bousquet J, Kuh D, Bewick M, Strandberg T, Farrell J, Pengelly R, Joel M, Rodriguez Mañas L, Mercier J, Bringer J, Camuzat T, Bourret R, Bedbrook A, Kowalski M, Samolinski B, Bonini S, Brayne C, Michel J, Venne J, Viriot-Durandal P, Alonso J, Avignon A, Bousquet P, Combe B, Cooper R, Hardy R, Iaccarino G, Keil T, Kesse-Guyot E, Momas I, Ritchie K, Robine J, Thijs C, Tischer C, Vellas B, Zaidi A, Alonso F, Andersen Ranberg K, Andreeva V, Ankri J, Arnavielhe S, Arshad S, Augé P, Berr C, Bertone P, Blain H, Blasimme A, Buijs G, Caimmi D, Carriazo A, Cesario A, Coletta J, Cosco T, Criton M, Cuisinier F, Demoly P, Fernandez-Nocelo S, Fougère B, Garcia-Aymerich J, Goldberg M, Guldemond N, Gutter Z, Harman D, Hendry A, Heve D, Illario M, Jeandel C, Krauss-Etschmann S, Krys O, Kula D, Laune D, Lehmann S, Maier D, Malva J, Matignon P, Melen E, Mercier G, Moda G, Nizinkska A, Nogues M, O’Neill M, Pelissier J, Poethig D, Porta D, Postma D, Puisieux F, Richards M, Robalo-Cordeiro C, Romano V, Roubille F, Schulz H, Scott A, Senesse P, Slagter S, Smit H, Somekh D, Stafford M, Suanzes J, Todo-Bom A, Touchon J, Traver-Salcedo V, Van Beurden M, Varraso R, Vergara I, Villalba-Mora E, Wilson N, Wouters E, Zins M. Operative definition of active and healthy ageing (AHA): Meeting report. Montpellier October 20–21, 2014. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2014.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Halfon N, Long P, Chang DI, Hester J, Inkelas M, Rodgers A. Applying A 3.0 Transformation Framework To Guide Large-Scale Health System Reform. Health Aff (Millwood) 2014; 33:2003-11. [DOI: 10.1377/hlthaff.2014.0485] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Neal Halfon
- Neal Halfon ( ) is director of the UCLA Center for Healthier Children, Families, and Communities and is a professor of pediatrics, health policy and management, and public policy at the University of California, Los Angeles
| | - Peter Long
- Peter Long is the president and CEO of Blue Shield of California Foundation, in San Francisco
| | - Debbie I. Chang
- Debbie I. Chang is vice president of Policy and Prevention at Nemours, in Newark, Delaware
| | - James Hester
- James Hester is a senior adviser at Population Health Systems, in Burlington, Vermont
| | - Moira Inkelas
- Moira Inkelas is an associate professor of health policy and management at the University of California, Los Angeles
| | - Anthony Rodgers
- Anthony Rodgers is a principal at Health Management Associates, in San Francisco
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Abstract
The world's population is ageing and an important part of this demographic shift is the development of chronic illness. In short, a person who does not die of acute illnesses, such as infections, and survives with chronic illnesses is more likely to develop additional chronic illnesses. Chronic respiratory diseases are an important component of these diseases associated with ageing. This article reviews the relationship between ageing and chronic respiratory disease, and also how certain chronic diseases cluster with others, either on the basis of underlying risk factors, complication of the primary disease or other factors, such as an increased state of inflammation. While death is inevitable, disabling chronic illnesses are not. Better understanding of how individuals can age healthily without the development of multiple chronic illnesses should lead to an improved global quality of life.
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Affiliation(s)
- Miguel J Divo
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carlos H Martinez
- Division of Pulmonary Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - David M Mannino
- Depts of Preventive Medicine and Environmental Health, University of Kentucky College of Medicine and University of Kentucky College of Public Health, Lexington, KY, USA
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115
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Abstract
Research on healthy ageing lacks an agreed conceptual framework and has not adequately taken into account the growing evidence that social and biological factors from early life onwards affect later health. We conceptualise healthy ageing within a life-course framework, separating healthy biological ageing (in terms of optimal physical and cognitive functioning, delaying the onset of chronic diseases, and extending length of life for as long as possible) from changes in psychological and social wellbeing. We summarise the findings of a review of healthy ageing indicators, focusing on objective measures of physical capability, such as tests of grip strength, walking speed, chair rises and standing balance, which aim to capture physical functioning at the individual level, assessing the capacity to undertake the physical tasks of daily living. There is robust evidence that higher scores on these measures are associated with lower rates of mortality, and more limited evidence of lower risk of morbidity, and of age-related patterns of change. Drawing on a research collaboration of UK cohort studies, we summarise what is known about the influences on physical capability in terms of lifetime socioeconomic position, body size and lifestyle, and underlying physiology and genetics; the evidence to date supports a broad set of factors already identified as risk factors for chronic diseases. We identify a need for larger longitudinal studies to investigate age-related change and ethnic diversity in these objective measures, the dynamic relationships between them, and how they relate to other component measures of healthy ageing. Robust evidence across cohort studies, using standardised measures within a clear conceptual framework, will benefit policy and practice to promote healthy ageing.
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Affiliation(s)
- Diana Kuh
- MRC University Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, UK
| | - Sathya Karunananthan
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Howard Bergman
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Rachel Cooper
- MRC University Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, UK
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116
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Cooper R, Strand BH, Hardy R, Patel KV, Kuh D. Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study. BMJ 2014; 348:g2219. [PMID: 24787359 PMCID: PMC4004787 DOI: 10.1136/bmj.g2219] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To examine associations between three commonly used objective measures of physical capability assessed at age 53 and a composite score of these measures and all cause mortality; to investigate whether being unable to perform these tests is associated with mortality. DESIGN Cohort study. SETTING MRC National Survey of Health and Development in England, Scotland, and Wales. PARTICIPANTS 1355 men and 1411 women with data on physical capability at age 53 who were linked to the National Health Service (NHS) central register for death notification. MAIN OUTCOME MEASURE All cause mortality between ages 53 (1999) and 66 (2012). RESULTS For each of the three measures of physical capability (grip strength, chair rise speed, and standing balance time) those participants unable to perform the test and those in the lowest performing fifth were found to have higher mortality rates than those in the highest fifth. Adjustment for baseline covariates partially attenuated associations but in fully adjusted models the main associations remained. For example, the fully adjusted hazard ratio of all cause mortality for the lowest compared with the highest fifth of a composite score of physical capability was 3.68 (95% confidence interval 2.03 to 6.68). Those people who could not perform any of the tests had considerably higher rates of death compared with those people able to perform all three tests (8.40, 4.35 to 16.23). When a series of models including different combinations of the measures were compared by using likelihood ratio tests, all three measures of physical capability were found to improve model fit, and a model including all three measures produced the highest estimate of predictive ability (Harrell's C index 0.71, 95% confidence interval 0.65 to 0.77). There was some evidence that standing balance time was more strongly associated with mortality than the other two measures. CONCLUSIONS Lower levels of physical capability at age 53 and inability to perform capability tests are associated with higher rates of mortality. Even at this relatively young age these measures identify groups of people who are less likely than others to achieve a long and healthy life.
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Affiliation(s)
- Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London WC1B 5JU, UK
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