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Yang C, Gao Y, An R, Lan Y, Yang Y, Wan Q. Oral frailty: A concept analysis. J Adv Nurs 2024; 80:3134-3145. [PMID: 38214108 DOI: 10.1111/jan.16042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 11/20/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
AIM To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people. DESIGN Rodgers and Knafl's evolutionary concept analysis approach. METHODS The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method. DATA SOURCES Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms 'oral frail*', 'oral health' and 'aged' respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded. RESULTS A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non-specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function. CONCLUSIONS Oral frailty is an age-related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field. IMPACT Oral frailty is increasingly recognized as an age-related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied. Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults.
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Affiliation(s)
- Chengfengyi Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Yue Lan
- School of Nursing, Peking University, Beijing, China
| | - Yue Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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Li T, Shen Y, Leng Y, Zeng Y, Li L, Yang Z, Wang S, Jiang Y. The prevalence of oral frailty among older adults: a systematic review and meta‑analysis. Eur Geriatr Med 2024; 15:645-655. [PMID: 38528284 DOI: 10.1007/s41999-023-00930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/29/2023] [Indexed: 03/27/2024]
Abstract
BACKGROUND In recent years, oral frailty was proposed as a new concept regarding dental and oral health in older adults. Poor oral health is linked to preserving general health and has become a geriatric public health problem that deeply affects healthy aging. While in present, evidence on the prevalence associated with oral frailty in older adults remains unclear. OBJECTIVE To systematically evaluate the prevalence of oral frailty among older adults, stratified by relevant factors such as gender, source, study design, region, and the evaluation scales for oral frailty and provide an evidence-based foundation for healthcare professionals and policymakers to formulate relevant measures. METHODS Ten electronic databases were systematically searched from inception to September 2023, including PubMed, Web of Science, Embase, PsycINFO, The Cochrane Library, CINAHL, China National Knowledge Infrastructure Database (CNKI), Chinese Biomedical Database (Sinomed), Weipu Database, and Wanfang database. Based on the Stata 15.0 software package, a random effect model was used to calculate the pooled prevalence of oral frailty among older adults. In addition, sensitivity analysis, subgroup analysis, and meta-regression were conducted based on different study characteristics to detect heterogeneity sources. Funnel plots, Begg's and Egger's tests were used to evaluate the publication bias. RESULTS Eighteen studies with a total of 12,932 older adults were included for meta-analysis. The pooled prevalence of oral frailty and oral pre-frailty was 24% (95% CI: 20-28%) and 57% (95% CI: 52-61%) respectively. Based on different assessment tools of oral frailty, the pooled prevalence of oral frailty was higher when using the OFI-8 scale (44.1%; 95% CI: 35.4-52.8%) than the OFI-6 scale (18.3%; 95% CI: 15.8-20.8%) or OF checklist (22.1%; 95% CI: 17.4-26.7%). The prevalence of oral frailty was higher among older adults in females (23.8%; 95% CI: 18.4-29.2%), hospital settings (31%, 95% CI: 16.6-45.5%), cross-sectional design (26.7%, 95% CI: 19.2-34.2%), and China (45.9%, 95% CI: 34.4-57.3%). CONCLUSIONS Our study showed that oral frailty was common among older adults and various characteristics may affect its prevalence. Thus, healthcare professionals and policymakers should take oral frailty seriously in clinical practice and program planning and develop more preventive measures for oral frailty among older adults.
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Affiliation(s)
- Tao Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yinli Shen
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yingjie Leng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - You Zeng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Long Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Zijiang Yang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Siyu Wang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yunlan Jiang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
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Nagaraj NK. Hearing Loss and Cognitive Decline in the Aging Population: Emerging Perspectives in Audiology. Audiol Res 2024; 14:479-492. [PMID: 38920961 PMCID: PMC11200945 DOI: 10.3390/audiolres14030040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 06/27/2024] Open
Abstract
In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer's disease is discussed, with the aim of enhancing our understanding of these interconnected conditions. Highlighting the evolving significance of audiologists in the dual management of cognitive health and hearing impairments, the author focuses on their role in identifying early signs of cognitive impairment and evaluates various cognitive screening tools used in this context. The discussion extends to adaptations of hearing assessments for older adults, especially those diagnosed with dementia, and highlights the significance of objective auditory electrophysiological tests. These tests are presented as vital in assessing the influence of aging and Alzheimer's disease on auditory processing capabilities and to signal cognitive dysfunction. The article underscores the critical role of audiologists in addressing the challenges faced by the aging population. The perspective calls for further research to improve diagnostic and therapeutic strategies in audiology, and emphasizes the need for a multidisciplinary approach in tackling the nexus of hearing loss, auditory processing, and cognitive decline.
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Affiliation(s)
- Naveen K Nagaraj
- Cognitive Hearing Science Lab, Communicative Disorders & Deaf Education, Utah State University, Logan, UT 84322, USA
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Fan W, Zhong X, Wu Q, Zhang L, Yang Z, Gu Y, Guo Q, Chen X, Yu C, Zhang K, Ding W, Qi H, Zhao J, Zhang L, Zhang S, Niu J. Association between hearing loss and physical performance in patients on maintenance hemodialysis. Kidney Res Clin Pract 2024; 43:358-368. [PMID: 38148523 PMCID: PMC11181039 DOI: 10.23876/j.krcp.22.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/18/2023] [Accepted: 06/20/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. METHODS This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. RESULTS Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = -0.356, p < 0.001 and r = -0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73-1.81), 1.69 (1.07-2.70), and 2.87 (1.69-4.88) (p for trend = 0.005). CONCLUSION Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.
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Affiliation(s)
- Weifeng Fan
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Xiaojing Zhong
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Qing Wu
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Lihong Zhang
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Zhenhao Yang
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Yong Gu
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Chen Yu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kun Zhang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wei Ding
- Department of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hualin Qi
- Department of Nephrology, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Junli Zhao
- Department of Nephrology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Liming Zhang
- Department of Nephrology, Shanghai Jing'an District Zhabei Central Hospital, Shanghai, China
| | - Suhua Zhang
- Department of Nephrology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Jiangsu, China
| | - Jianying Niu
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
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Yévenes-Briones H, Caballero FF, Struijk EA, Arias-Fernández L, Lana A, Rey-Martinez J, Rodríguez-Artalejo F, Lopez-Garcia E. Association Between Speech Reception Threshold in Noise and Multimorbidity: The UK Biobank Study. Otolaryngol Head Neck Surg 2024; 170:480-489. [PMID: 37622533 DOI: 10.1002/ohn.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/17/2023] [Accepted: 08/06/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To investigate the association between hearing function, as approached with the functional auditory capacity, and multimorbidity. STUDY DESIGN Cross-sectional study. SETTING The UK Biobank was established from 2006 to 2010 in the United Kingdom. This cross-sectional analysis included 165,524 participants who provided baseline information on hearing function. METHODS Functional auditory capacity was measured with a digit triplet test. Three categories were defined according to the speech reception threshold in noise (SRTn): normal (SRTn < -5.5 dB signal-to-noise ratio [SNR]), insufficient (SRTn ≥ -5.5 to ≤ -3.5 dB SNR) and poor hearing function (SRTn > -3.5 dB SNR). To define multimorbidity, 9 chronic diseases were considered, including chronic obstructive pulmonary disease, dementia, Parkinson's disease, stroke, cancer, depression, osteoarthritis, coronary heart disease, and diabetes; multimorbidity was defined as the coexistence of 2 or more in the same individual. Analyses were conducted using logistic models adjusted for relevant confounders. RESULTS Among the study participants, 54.5% were women, and the mean (range) age was 56.7 (39-72) years. The prevalence of insufficient and poor hearing function and multimorbidity was 13% and 13.2%, respectively. In comparison with having a normal SRTn, the odds ratio (95% confidence interval) of multimorbidity associated with insufficient SRTn was 1.13 (1.08-1.18), and with poor SRTn was 1.25 (1.14-1.37). CONCLUSION Insufficient and poor hearing function was associated with multimorbidity. This association suggests common biological pathways for many of the considered morbidities.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Alberto Lana
- Department of Medicine, Universidad de Oviedo/ISPA, Oviedo, Spain
| | - Jorge Rey-Martinez
- Neurotology Unit, ENT Department, Hospital Universitario Donostia, San Sebastián-Donostia, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM, Madrid, Spain
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Davidson A, Souza P. Relationships Between Auditory Processing and Cognitive Abilities in Adults: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:296-345. [PMID: 38147487 DOI: 10.1044/2023_jslhr-22-00716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
PURPOSE The contributions from the central auditory and cognitive systems play a major role in communication. Understanding the relationship between auditory and cognitive abilities has implications for auditory rehabilitation for clinical patients. The purpose of this systematic review is to address the question, "In adults, what is the relationship between central auditory processing abilities and cognitive abilities?" METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to identify, screen, and determine eligibility for articles that addressed the research question of interest. Medical librarians and subject matter experts assisted in search strategy, keyword review, and structuring the systematic review process. To be included, articles needed to have an auditory measure (either behavioral or electrophysiologic), a cognitive measure that assessed individual ability, and the measures needed to be compared to one another. RESULTS Following two rounds of identification and screening, 126 articles were included for full analysis. Central auditory processing (CAP) measures were grouped into categories (behavioral: speech in noise, altered speech, temporal processing, binaural processing; electrophysiologic: mismatch negativity, P50, N200, P200, and P300). The most common CAP measures were sentence recognition in speech-shaped noise and the P300. Cognitive abilities were grouped into constructs, and the most common construct was working memory. The findings were mixed, encompassing both significant and nonsignificant relationships; therefore, the results do not conclusively establish a direct link between CAP and cognitive abilities. Nonetheless, several consistent relationships emerged across different domains. Distorted or noisy speech was related to working memory or processing speed. Auditory temporal order tasks showed significant relationships with working memory, fluid intelligence, or multidomain cognitive measures. For electrophysiology, relationships were observed between some cortical evoked potentials and working memory or executive/inhibitory processes. Significant results were consistent with the hypothesis that assessments of CAP and cognitive processing would be positively correlated. CONCLUSIONS Results from this systematic review summarize relationships between CAP and cognitive processing, but also underscore the complexity of these constructs, the importance of study design, and the need to select an appropriate measure. The relationship between auditory and cognitive abilities is complex but can provide informative context when creating clinical management plans. This review supports a need to develop guidelines and training for audiologists who wish to consider individual central auditory and cognitive abilities in patient care. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24855174.
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Gasparre D, Pepe I, Laera D, Abbatantuono C, De Caro MF, Taurino A, D’Erasmo D, Fanizzi P, Antonucci LA, Pantaleo A, Cavallaro G, Pontillo V, Taurisano P, Quaranta N. Cognitive functioning and psychosomatic syndromes in a subjective tinnitus sample. Front Psychol 2023; 14:1256291. [PMID: 38192387 PMCID: PMC10773809 DOI: 10.3389/fpsyg.2023.1256291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Tinnitus is the perception of a sound in the absence of any corresponding external sound source. Current research suggests a relationship among emotional, cognitive, and psychosomatic symptoms and the occurrence or maintenance of chronic tinnitus. This study aimed to detect the prevalence and role of psychosomatic conditions, as defined by the Diagnostic Criteria for Psychosomatic Research (DCPR), and cognitive functioning in a group of patients with tinnitus. Methods Sixty-two patients with subjective tinnitus and 62 non-tinnitus controls were recruited from the Otorhinolaryngology Unit of the University of Bari. Pure-tone audiometry was performed in all tinnitus subjects, and sound level tolerance was evaluated. Additionally, tinnitus handicap (Tinnitus Handicap Inventory [THI]), psychopathological symptoms (Symptom Checklist-90, Revised [SCL-90-R]), anxiety (State-Trait Anxiety Inventory [STAI-Y1/2]), depression (Beck Depression Inventory [BDI]), cognitive impairment (Mini-Mental State Examination [MMSE]), executive functions (Frontal Assessment Battery [FAB]), and psychosomatic syndromes (DCPR) were evaluated. Parametric and non-parametric tests were used to detect cognitive and symptomatological differences between patients and controls. The predictivity of these factors for tinnitus severity was studied using multiple regression (Backward Elimination). All tests were considered significant at p < 0.05 (family wise error corrected for each comparison). Results 69.4% tinnitus patients met multiple DCPR criteria, compared to 32.3% of controls. Tinnitus patients exhibited elevated rates of illness denial (ꭓ2 = 9.02; p < 0.009), demoralization (ꭓ2 = 8.05; p < 0.018), somatization (ꭓ2 = 4.92; p < 0.063) and functional symptoms (ꭓ2 = 5.21; p < 0.06) scoring significantly higher on the BDI, STAI-Y1, and STAI-Y2, and SCL-90-R compared to controls. Patients with tinnitus showed lower MMSE scores, compared to controls (t = -2.282; p < 0.001). No association between tinnitus severity and global cognitive impairment emerged. Conversely, executive function deficits were associated to tinnitus severity. Among the cognitive and psychological factors, only trait anxiety, one or more psychosomatic syndromes, and somatization clusters were strongly correlated with tinnitus severity. Discussion Our findings suggest a relationship between tinnitus severity, psychological, psychosomatic symptoms, and frontal impairment. Additionally, the influence of tinnitus on cognitive functions paves the way for integrated, multidisciplinary diagnostic and treatment options for patients. Although preliminary, our findings highlight the importance of early cognitive and psychological screening to improve patients' quality of life.
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Affiliation(s)
- Daphne Gasparre
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Ilaria Pepe
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Domenico Laera
- Clinical Psychology Service, Mental Health Department, ASL Taranto, Taranto, Italy
| | - Chiara Abbatantuono
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Maria Fara De Caro
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Alessandro Taurino
- Department of Education, Psychology, Communication, University of Bari, Palazzo Chiaia-Napolitano, Bari, Italy
| | - Daniele D’Erasmo
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Piero Fanizzi
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Linda A. Antonucci
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Alessandra Pantaleo
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giada Cavallaro
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Vito Pontillo
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Paolo Taurisano
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
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Solfrizzi V, Scafato E, Custodero C, Piazzolla G, Capogna L, Procaccio A, Gandin C, Galluzzo L, Ghirini S, Matone A, Dibello V, Sardone R, Daniele A, Lozupone M, Panza F. Biopsychosocial frailty and mild cognitive impairment subtypes: Findings from the Italian project on the epidemiology of Alzheimer's disease (IPREA). Alzheimers Dement 2023; 19:3306-3315. [PMID: 36757048 DOI: 10.1002/alz.12944] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Frailty is a critical intermediate status of the aging process including physical, cognitive, and psychosocial phenotypes. We operationalized a biopsychosocial frailty construct, estimating its association with mild cognitive impairment (MCI) and its subtypes. METHODS In 1980, older individuals from the population-based Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA), we investigated cross-sectional associations among biopsychosocial frailty, MCI, and its subtypes. RESULTS Participants with biopsychosocial frailty showed an increased odds ratio (OR) of MCI [OR: 4.36; 95% confidence interval (CI): 2.60-7.29; Fisher's exact p < 0.01], particularly for nonamnestic MCI single domain (naMCI-SD, OR:3.28; 95% CI: 1.35-7.97; Fisher's exact p = 0.02) and for nonamnestic MCI multiple domain (naMCI-MD, OR:6.92; 95% CI: 3.37-14.21; Fisher's exact p < 0.01). No statistically significant associations between amnestic MCI single or multiple domain and biopsychosocial frailty were observed. DISCUSSION In a large, older Italian cohort, a biopsychosocial frailty phenotype was associated with MCI, in particular, could be associated with some of its subtypes, that is, naMCI-SD, and naMCI-MD.
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Affiliation(s)
- Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Emanuele Scafato
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Custodero
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Giuseppina Piazzolla
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Lavinia Capogna
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Annagrazia Procaccio
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Claudia Gandin
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Galluzzo
- Department of Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Silvia Ghirini
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alice Matone
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBrain", University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
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Zupo R, Donghia R, Castellana F, Bortone I, De Nucci S, Sila A, Tatoli R, Lampignano L, Sborgia G, Panza F, Lozupone M, Colacicco G, Clodoveo ML, Sardone R. Ultra-processed food consumption and nutritional frailty in older age. GeroScience 2023; 45:2229-2243. [PMID: 36826622 PMCID: PMC10651811 DOI: 10.1007/s11357-023-00753-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Frailty is a multidisciplinary public health issue and nutrition is key concern. Given the scientific consistency about inflammation as shared pathway to poor nutrition and frailty, food processing seems a suitable target to gain evidence in frailty prevention nutrition settings. This study aimed to assess diet in relation to nutritional frailty using the NOVA classification. Browsing the dataset of the Salus in Apulia, 2185 older adults were found to have completed the nutritional assessment, providing eligible data for this study goal. A validated construct, based on the co-presence of physical frailty by CHS criteria plus nutritional imbalance, was applied to characterize nutritional frailty phenotypes. Using the NOVA classification, daily food and beverage intakes from an 85-item self-administered FFQ were assigned to three categories, and effect sizes were tested among groups according to nutritional frailty status (presence/absence). Raw and adjusted logistic regression models were run to assess associations between NOVA food categories by quintiles of daily exposure (very-low, low, mild, moderate, high) and nutritional frailty. Nutritional frailty prevalence was 27%, being more frequent in males. Eating more unprocessed or minimally processed foods was inversely related to nutritional frailty, even after adjustment (OR: 0.10, 95%CI 0.07-0.16), showing a downward ORs behavior toward lower consumption quintiles. Listing in the quintile of moderate consumption of processed foods meant a nearly 50% increase in nutritional frailty probability (OR: 1.46, 95%CI 1.03-2.06), while the probability was double for the highest quintile against the lowest (OR: 3.22, 95%CI 2.27-4.58). A growing probability of nutritional frailty was found for increasing consumption of ultra-processed foods, but significance was lacking. The contribution of food processing to poor nutrition needs to be considered when promoting a better understanding of effective nutritional screening in aging. Therefore, food processing should be accounted for when composing diet guidelines for the older population within the framework of multidisciplinary efforts to ease the frailty healthcare burden.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Institute of Clinical Physiology, National Research Council (IFC-CNR), Pisa, Italy
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Giancarlo Sborgia
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Colacicco
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari Aldo Moro, Bari, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
- Local Healthcare Authority of Taranto, Taranto, Italy
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10
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Zupo R, Moroni A, Castellana F, Gasparri C, Catino F, Lampignano L, Perna S, Clodoveo ML, Sardone R, Rondanelli M. A Machine-Learning Approach to Target Clinical and Biological Features Associated with Sarcopenia: Findings from Northern and Southern Italian Aging Populations. Metabolites 2023; 13:metabo13040565. [PMID: 37110223 PMCID: PMC10142879 DOI: 10.3390/metabo13040565] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Epidemiological and public health resonance of sarcopenia in late life requires further research to identify better clinical markers useful for seeking proper care strategies in preventive medicine settings. Using a machine-learning approach, a search for clinical and fluid markers most associated with sarcopenia was carried out across older populations from northern and southern Italy. A dataset of adults >65 years of age (n = 1971) made up of clinical records and fluid markers from either a clinical-based subset from northern Italy (Pavia) and a population-based subset from southern Italy (Apulia) was employed (n = 1312 and n = 659, respectively). Body composition data obtained by dual-energy X-ray absorptiometry (DXA) were used for the diagnosis of sarcopenia, given by the presence of either low muscle mass (i.e., an SMI < 7.0 kg/m2 for males or <5.5 kg/m2 for females) and of low muscle strength (i.e., an HGS < 27 kg for males or <16 kg for females) or low physical performance (i.e., an SPPB ≤ 8), according to the EWGSOP2 panel guidelines. A machine-learning feature-selection approach, the random forest (RF), was used to identify the most predictive features of sarcopenia in the whole dataset, considering every possible interaction among variables and taking into account nonlinear relationships that classical models could not evaluate. Then, a logistic regression was performed for comparative purposes. Leading variables of association to sarcopenia overlapped in the two population subsets and included SMI, HGS, FFM of legs and arms, and sex. Using parametric and nonparametric whole-sample analysis to investigate the clinical variables and biological markers most associated with sarcopenia, we found that albumin, CRP, folate, and age ranked high according to RF selection, while sex, folate, and vitamin D were the most relevant according to logistics. Albumin, CRP, vitamin D, and serum folate should not be neglected in screening for sarcopenia in the aging population. Better preventive medicine settings in geriatrics are urgently needed to lessen the impact of sarcopenia on the general health, quality of life, and medical care delivery of the aging population.
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Affiliation(s)
- Roberta Zupo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Alessia Moroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy
| | - Feliciana Catino
- Department of Innovation and Smart City, Municipality of Taranto, 74121 Taranto, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Simone Perna
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, University of Milan, 20133 Milan, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | | | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- IRCCS Mondino Foundation, 27100 Pavia, Italy
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11
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Scafato E, Solfrizzi V, Custodero C, Casieri G, Falco C, Maggipinto R, Gandin C, Galluzzo L, Ghirini S, Matone A, Dibello V, Sardone R, Daniele A, Lozupone M, Panza F. Associations of a biopsychosocial frailty phenotype with all-cause dementia, Alzheimer's disease, vascular dementia, and other dementias: the Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA). GeroScience 2023:10.1007/s11357-023-00781-x. [PMID: 37014539 PMCID: PMC10400737 DOI: 10.1007/s11357-023-00781-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
Frailty is a critical intermediate status of the aging process including physical, cognitive, and psychosocial domains/phenotypes. We operationalized a new biopsychosocial frailty construct, estimating its impact on the odds of all-cause dementia, Alzheimer's disease (AD), vascular dementia (VaD), and other dementias in 2838 older individuals from the population-based Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA). Biopsychosocial frailty operationalization was based on the results of a previous comprehensive geriatric assessment and the presence of physical frailty. In this cross-sectional study, participants with biopsychosocial frailty showed an increased odds ratio of all-cause dementia [odds ratio (OR): 5.55, 95% confidence interval (CI): 3.72-8.28, p < 0.001], in particular for probable AD (OR: 3.62, 95% CI: 1.55-8.45, p < 0.001), probable VaD (OR: 10.05, 95% CI: 5.05-19.97, p < 0.001), and possible VaD (OR: 17.61, 95% CI: 6.42-48.32, p < 0.001). No statistically significant association was found between this biopsychosocial frailty phenotype and possible AD (OR: 2.84, 95% CI: 0.81-9.97, p = 0.09) or other dementias (OR: 1.77, 95% CI: 0.75-0.21, p = 0.19). In conclusion, in a large cohort of Italian older individuals, a biopsychosocial frailty model was associated to all-cause dementia, probable AD, and probable and possible VaD. In the next future, other large and prospective population-based studies evaluating the association between the biopsychosocial frailty phenotype and incident all-cause dementia, AD, and VaD are needed, addressing also potential bias and confounding sources.
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Affiliation(s)
- Emanuele Scafato
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy.
| | - Carlo Custodero
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Giovanna Casieri
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Claudia Falco
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Rosselia Maggipinto
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Claudia Gandin
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Galluzzo
- Department of Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Silvia Ghirini
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alice Matone
- Osservatorio Nazionale Alcol, Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
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12
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Li N, Ma W, Ren F, Li X, Li F, Zong W, Wu L, Dai Z, Hui SCN, Edden RAE, Li M, Gao F. Neurochemical and functional reorganization of the cognitive-ear link underlies cognitive impairment in presbycusis. Neuroimage 2023; 268:119861. [PMID: 36610677 PMCID: PMC10026366 DOI: 10.1016/j.neuroimage.2023.119861] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/11/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Recent studies suggest that the interaction between presbycusis and cognitive impairment may be partially explained by the cognitive-ear link. However, the underlying neurophysiological mechanisms remain largely unknown. In this study, we combined magnetic resonance spectroscopy (MRS) and resting-state functional magnetic resonance imaging (fMRI) to investigate auditory gamma-aminobutyric acid (GABA) and glutamate (Glu) levels, intra- and inter-network functional connectivity, and their relationships with auditory and cognitive function in 51 presbycusis patients and 51 well-matched healthy controls. Our results confirmed reorganization of the cognitive-ear link in presbycusis, including decreased auditory GABA and Glu levels and aberrant functional connectivity involving auditory networks (AN) and cognitive-related networks, which were associated with reduced speech perception or cognitive impairment. Moreover, mediation analyses revealed that decreased auditory GABA levels and dysconnectivity between the AN and default mode network (DMN) mediated the association between hearing loss and impaired information processing speed in presbycusis. These findings highlight the importance of AN-DMN dysconnectivity in cognitive-ear link reorganization leading to cognitive impairment, and hearing loss may drive reorganization via decreased auditory GABA levels. Modulation of GABA neurotransmission may lead to new treatment strategies for cognitive impairment in presbycusis patients.
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Affiliation(s)
- Ning Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Wen Ma
- Department of Otolaryngology, the Central Hospital of Jinan City, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fuxin Ren
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiao Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fuyan Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wei Zong
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lili Wu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Zongrui Dai
- Westa College, Southwest University, Chongqing, China
| | - Steve C N Hui
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Muwei Li
- Vanderbilt University Institute of Imaging Science, Nashville, TN, USA
| | - Fei Gao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
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13
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Liver Fibrosis and Hearing Loss in an Older Mediterranean Population: Results from the Salus in Apulia Study. J Clin Med 2022; 11:jcm11237213. [PMID: 36498787 PMCID: PMC9736605 DOI: 10.3390/jcm11237213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Aging is the main negative prognostic factor for various chronic diseases, such as liver fibrosis, and clinical disorders such as hearing loss. This study aimed to investigate the association between age-related hearing loss (ARHL) and age-related central auditory processing disorder (CAPD), and the risk for liver fibrosis in a cross-sectional study on an aging population. Methods: Liver fibrosis risk was judged on the fibrosis-4 (FIB-4) score. Peripheral ARHL was evaluated with pure tone audiometry using a calibrated audiometer. The pure tone average (PTA), calculated as a threshold ≤ 40 dB (HL) in the better ear, was measured at the frequencies 0.5−4 kHz. For age-related CAPD assessment, we employed the Synthetic Sentence Identification with an Ipsilateral Competitive Message test (SSI-ICM). General linear Logistic regression models were used to estimate the association. Results: The increase in the PTA 0.5−2 kHz (coefficient: 0.02, SE: 0.01, CI 95%: 0.01 to 0.03) was directly associated with a higher risk of liver fibrosis (FIB-4 ≥ 2.67). Moreover, the reduction in SSI (coefficient: −0.02, SE: 0.01, CI 95%: −0.03 to −0.01) was inversely associated with FIB-4 values < 2.67. Conclusion: Our results show an association between liver fibrosis and both ARHL and CAPD, linked by the typical consequence of aging. We also assume a role of inflammatory responses and oxidative stress.
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14
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Yang Z, Ni J, Teng Y, Su M, Wei M, Li T, Fan D, Lu T, Xie H, Zhang W, Shi J, Tian J. Effect of hearing aids on cognitive functions in middle-aged and older adults with hearing loss: A systematic review and meta-analysis. Front Aging Neurosci 2022; 14:1017882. [PMID: 36452439 PMCID: PMC9704725 DOI: 10.3389/fnagi.2022.1017882] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/13/2022] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE The study aimed to examine the effects of hearing aids on cognitive function in middle-aged and older adults with hearing loss. DATA SOURCES AND STUDY SELECTION PubMed, Cochrane Library, and Embase were searched for studies published before 30 March 2022. Randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) were included in the search. Restriction was set on neither types, severity, or the time of onset of hearing impairment nor cognitive or psychiatric statuses. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed the study quality of RCTs. Cognitive function outcomes were descriptively summarized and converted to standardized mean difference (SMD) in the meta-analysis. Meta-analysis was conducted in RCTs. Sub-group analyses were conducted by cognitive statuses, psychiatric disorders, and cognitive domains. RESULTS A total of 15 studies met the inclusion criteria, including five RCTs (n = 339) and 10 NRSIs (n = 507). Groups were classified as subjects without dementia or with normal global cognition, subjects with AD or dementia, and subjects with depressive symptoms. For subjects without dementia, improvements were found in global cognition, executive function, and episodic memory. For subjects with depressive symptoms, improvements were found in immediate memory, global cognition, and executive function. No improvement was found in subjects with AD or dementia. In total, four RCTs were included in the meta-analysis. For subjects without dementia (SMD = 0.11, 95% confidence interval [CI]: -0.15-0.37) and those with AD, no significant effect was found (SMD = -0.19, 95% CI: -0.65-0.28). For subjects without dementia, no significant effect was found in language (SMD = 0.14, 95% CI: -0.30-0.59) or general executive function (SMD = -0.04, 95% CI: -0.46-0.38). Further sub-group analysis found no significant effect in executive function (SMD = -0.27, 95% CI: -0.72-0.18) or processing speed (SMD = -0.02, 95% CI: -0.49-0.44). CONCLUSION Hearing aids might improve cognitive performance in domains such as executive function in subjects without dementia. The effects on subjects with depressive symptoms remained unclear. No improvement was found in subjects with AD or dementia. Long-term RCTs and well-matched comparison-group studies with large sample sizes are warranted. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022349057.
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Affiliation(s)
- Zhizhong Yang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingnian Ni
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuou Teng
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mingwan Su
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mingqing Wei
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ting Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Tao Lu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Hengge Xie
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Shi
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jinzhou Tian
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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15
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Liu Y, Qian P, Guo S, Liu S, Wang D, Yang L. Frailty and hearing loss: From association to causation. Front Aging Neurosci 2022; 14:953815. [PMID: 36158533 PMCID: PMC9490320 DOI: 10.3389/fnagi.2022.953815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundObservational studies suggest that frailty is associated with hearing loss (HL) but with inconsistent results. This study aims to examine such association and to assess its causality.Materials and methodsThe cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression models were used to assess the association between HL and frailty index (FI). Genetic variants associated with the FI and HL were obtained from a large genome-wide association study (GWAS) meta-analysis and UK Biobank GWAS. The inverse variance weighting (IVW) method was used to estimate causal effects. Sensitivity analyses were performed to further validate the robustness of results.ResultsIn this cross-sectional analysis, results support the possibility that frailty may be associated with a higher risk of developing HL, with self-reported [odds ratio (OR) = 2.813; 95% CI, 2.386, 3.317; p < 0.001], speech frequency HL (OR = 1.975; 95% CI, 1.679–2.323; p < 0.001), and high frequency HL (OR = 1.748; 95% CI, 1.459–2.094; p < 0.001). In the adjusted model, frail participants remained at high risk of HL. Mendelian randomization (MR) studies showed a bidirectional causal association between genetically predicted FI and risk of HL (FI for exposure: OR = 1.051; 95% CI, 1.020–1.083; p = 0.001; HL for exposure: OR = 1.527; 95% CI, 1.227–1.901; p < 0.001).ConclusionOur observational study found that inter-individual differences in frailty were associated with the risk of developing HL. Genetic evidence suggests a potential bidirectional causal association between FI and HL. Furthermore, the potential mechanisms of this association require investigation.
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Affiliation(s)
- Yun Liu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Peiyi Qian
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shuli Guo
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shuangyan Liu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dahui Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lei Yang,
| | - Lei Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lei Yang,
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16
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Mazeaud S, Castellana F, Coelho-Junior HJ, Panza F, Rondanelli M, Fassio F, De Pergola G, Zupo R, Sardone R. Coffee Drinking and Adverse Physical Outcomes in the Aging Adult Population: A Systematic Review. Metabolites 2022; 12:metabo12070654. [PMID: 35888778 PMCID: PMC9318773 DOI: 10.3390/metabo12070654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 02/01/2023] Open
Abstract
Declining physical functioning covers a prominent span of later life and, as a modifiable driver to be leveraged, lifestyle plays a critical role. This research aimed to undertake a systematic review investigating the association between levels of coffee consumption and declining conditions of physical functioning during aging, such as sarcopenia, frailty, weakness, falls, and disability, while trying to explain the underlying mechanisms, both from a metabolic and social angle. The literature was reviewed from inception to May 2022 using different electronic databases, not excluding the grey literature. Two independent researchers assessed the eligibility of 28 retrieved articles based on inclusion criteria; only 10 met the eligibility requirements. Different levels of coffee consumption were considered as exposure(s) and comparator(s) according to PECO concepts, while middle age was an inclusion criterion (40+ years). No limitations were set on the tool(s) assessing physical functioning, type of dietary assessment(s), study setting, general health status, country, and observational study design (cohort, cross-sectional). The cross-sectional design outnumbered the longitudinal (90%, n = 9/10). The overall quality rating was judged poor (70%) to good (30%). It was found that higher exposure to coffee drinking is strongly associated with better physical functioning outcomes, and the findings showed consistency in the direction of association across selected reports. Countering physical decline is a considerable challenge in easing the burden of population aging. For preventive models that aim to allow a better lifestyle, it has to be kept in mind that increased coffee consumption does not lead to poor physical functioning.
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Affiliation(s)
- Simon Mazeaud
- UFR of Biology, Campus Universitaire des Cézeaux, University of Clermont Auvergne (UCA), 63000 Clermont-Ferrand, France;
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, Department of Basic Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy; (F.C.); (R.S.)
| | - Hélio José Coelho-Junior
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas 13083-970, Brazil;
- Department of Geriatrics, Neurosciences, and Orthopedics, Teaching Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70013 Bari, Italy;
| | - Mariangela Rondanelli
- Unit of Human and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Federico Fassio
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy;
| | - Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, Department of Basic Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy; (F.C.); (R.S.)
- Correspondence:
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, Department of Basic Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy; (F.C.); (R.S.)
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Prevalence of Hearing Impairment by Age: 2nd to 10th Decades of Life. Biomedicines 2022; 10:biomedicines10061431. [PMID: 35740452 PMCID: PMC9220865 DOI: 10.3390/biomedicines10061431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Accurate data on the prevalence of hearing impairment and severity across age and gender are paramount to formulate hearing health policies. Here, we sought to analyze audiometric data from a large group of age-diverse people in Japan, which has not been previously described in detail. Methods: We analyzed retrospective hearing threshold data of 23,860 participants (10−99 years; left-right hearing threshold difference <15 dB; air-bone gap ≤10 dB) at 500, 1000, 2000, and 4000 Hz, and then classified them for hearing impairment severity according to the WHO Classification. Findings: There was a significant gender difference in median hearing thresholds, starting in 20-year-olds up to early 80-year-olds. Twenty-five percent of men in their late 50s had some level of HI, ~50% in their late 60s, and ~75% in their late 70s. For women, 25% had some level of HI in their early 60s, ~50% in their early 70s, and ~75% in their late 70s. For participants in their early 80s, 50% of either gender had moderate or more severe HI. Interpretation: Our results, derived from a large number of participants, provide basic information about the prevalence of hearing loss by age decade. Since people can expect to live longer than those in previous generations, our detailed data can inform national social systems responsible for hearing screening in making decisions about hearing-aid qualification, which may reduce barriers to older people’s independence, productivity, and quality of life.
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Piccirillo JF. JAMA Otolaryngology-Head & Neck Surgery-The Year in Review, 2021. JAMA Otolaryngol Head Neck Surg 2022; 148:399-401. [PMID: 35323890 DOI: 10.1001/jamaoto.2022.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Washington University School of Medicine in St Louis, St Louis, Missouri
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19
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Zupo R, Castellana F, De Nucci S, Sila A, Aresta S, Buscemi C, Randazzo C, Buscemi S, Triggiani V, De Pergola G, Cava C, Lozupone M, Panza F, Sardone R. Role of Dietary Carotenoids in Frailty Syndrome: A Systematic Review. Biomedicines 2022; 10:632. [PMID: 35327434 PMCID: PMC8945528 DOI: 10.3390/biomedicines10030632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 02/07/2023] Open
Abstract
Unbalanced diets and altered micronutrient intake are prevalent in the aging adult population. We conducted a systematic review to appraise the evidence regarding the association between single (α-carotene, β-carotene, lutein, lycopene, β-cryptoxanthin) or total carotenoids and frailty syndrome in the adult population. The literature was screened from study inception to December 2021, using six different electronic databases. After establishing inclusion criteria, two independent researchers assessed the eligibility of 180 retrieved articles. Only 11 fit the eligibility requirements, reporting five carotenoid entries. No exclusion criteria were applied to outcomes, assessment tools, i.e., frailty constructs or surrogates, recruitment setting, general health status, country, and study type (cohort or cross-sectional). Carotenoid exposure was taken as either dietary intake or serum concentrations. Cross-sectional design was more common than longitudinal design (n = 8). Higher dietary and plasma levels of carotenoids, taken individually or cumulatively, were found to reduce the odds of physical frailty markedly, and the evidence showed consistency in the direction of association across all selected studies. Overall, the methodological quality was rated from moderate (27%) to high (73%). Prevention of micronutrient deficiencies has some potential to counteract physical decline. Considering carotenoids as biological markers, when monitoring micronutrient status, stressing increased fruit and vegetable intake may be part of potential multilevel interventions to prevent or better manage disability.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Simona Aresta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
| | - Carola Buscemi
- Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.B.); (C.R.); (S.B.)
| | - Cristiana Randazzo
- Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.B.); (C.R.); (S.B.)
| | - Silvio Buscemi
- Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy; (C.B.); (C.R.); (S.B.)
- Unit of Gastroenterology, Section of Obesity, Metabolic Diseases and Clinical Nutrition, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
| | - Vincenzo Triggiani
- Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, 70124 Bari, Italy;
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Claudia Cava
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Via F. Cervi 93, 20131 Milan, Italy;
| | - Madia Lozupone
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70124 Bari, Italy; (M.L.); (F.P.)
| | - Francesco Panza
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70124 Bari, Italy; (M.L.); (F.P.)
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (F.C.); (S.D.N.); (A.S.); (S.A.); (R.S.)
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20
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Utoomprurkporn N, Stott J, Costafreda S, Bamiou DE. The Impact of Hearing Loss and Hearing Aid Usage on the Visuospatial Abilities of Older Adults in a Cohort of Combined Hearing and Cognitive Impairment. Front Aging Neurosci 2022; 14:785406. [PMID: 35283751 PMCID: PMC8914172 DOI: 10.3389/fnagi.2022.785406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/02/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction It has been proposed that hearing loss may result in improved visuospatial abilities. The evidence for this assertion is inconsistent, and limited to studies in congenitally deaf children, despite older adults with age-related hearing loss constituting the vast majority of the hearing impaired population. We assessed visuospatial (visuoconstruction and visuospatial memory) ability in older adult hearing aid users with and without clinically significant cognitive impairment. The primary aim of the study was to determine the effect of hearing loss on visuospatial abilities. Method Seventy-five adult hearing aid users (HA) aged over 65 were recruited, out of whom 30 had normal cognition (NC-HA), 30 had mild cognitive impairment (MCI-HA), and 15 had dementia (D-HA). The Rey Osterrieth Complex figure test (ROCFT) copy, 3 min recall and 30 min recall tests were performed to evaluate the visuoconstructional and visuospatial memory abilities of the participants. Results There were significant differences between the ROCFT copy, 3 min recall, and 30 min recall among the three cohorts (p < 0.005). Compared with previously published normative data, the NC-HA performed significantly better in the ROCFT copy (p < 0.001), immediate recall (p < 0.001), and delay recall (p = 0.001), while the MCI-HA performed similarly to the expected norms derived from population (p = 0.426, p = 0.611, p = 0.697, respectively), and the D-HA performed below this norm. Conclusion Though visuospatial abilities tend to decline when the global cognitive functioning declines, we found suggestive evidence for positive effects of age-related hearing loss on visuospatial cognitive ability. Participants with mild cognitive impairment and hearing loss, who would have been expected to perform worse than normative data, were in fact performing as well as cognitively healthy subjects without hearing loss. Visuospatial ability could be targeted when providing rehabilitation for the older adults with hearing loss.
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Affiliation(s)
- Nattawan Utoomprurkporn
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- UCL Ear Institute, University College London, London, United Kingdom
- Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- *Correspondence: Nattawan Utoomprurkporn,
| | - Joshua Stott
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Sergi Costafreda
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Doris-Eva Bamiou
- UCL Ear Institute, University College London, London, United Kingdom
- NIHR Biomedical Research Centre Hearing and Deafness, London, United Kingdom
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21
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Lozupone M, D'Urso F, Copetti M, Sardone R, Arcuti S, Castellana F, Galizia I, Lofano L, Veneziani F, Piccininni C, Barulli MR, Grasso A, Battista P, Tortelli R, Capozzo R, Griseta C, Doricchi F, Quaranta N, Resta E, Daniele A, Seripa D, Solfrizzi V, Bellomo A, Logroscino G, Panza F. The diagnostic accuracy of late-life depression is influenced by subjective memory complaints and educational level in an older population in Southern Italy. Psychiatry Res 2022; 308:114346. [PMID: 34953202 DOI: 10.1016/j.psychres.2021.114346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/29/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022]
Abstract
The prevalence of late-life depression (LLD) depends on the study sample, measurements, and diagnostic approaches. We estimated the 30 item-Geriatric Depression Scale (GDS-30) accuracy against the gold standard LLD diagnosis made with the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, focusing on the prevalence of a late-life major depressive disorder (MDD), in a population-based sample of 843 subjects aged>65 years, subdivided into three groups: normal cognition, subjective memory complaints, and mild cognitive impairment. At the optimal cut-off score (≥4), the GDS-30 showed 65.1% sensitivity and 68.4% specificity for LLD (63% and 66% for late-life MDD, respectively). Using the standard cut-off score (≥10), the GDS-30 specificity reached 91.2%, while sensitivity dropped to 37.7%, indicating a lower screening accuracy [area under the curve(AUC):0.728, 95% confidence interval(CI):0.67-0-78]. The GDS-30 performance was associated with educational level, but not with age, gender, cognition, apathy, and somatic/psychiatric multimorbidity. For subjective memory complaints subjects, at the optimal cut-off score (≥7), the GDS-30 showed better discrimination performances (AUC=0.792,95%CI:0.60-0.98), but again the educational level affected the diagnostic performance. In subjective memory complaints subjects, symptom-based scales like the GDS-30 may feature a better performance for diagnosing depression in older age, but the GDS-30 seems to require adjustment to the patient's educational level.
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Affiliation(s)
- Madia Lozupone
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy; Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
| | - Francesca D'Urso
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimiliano Copetti
- Biostatistics Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Rodolfo Sardone
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | - Simona Arcuti
- Biostatistics Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Fabio Castellana
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | - Ilaria Galizia
- Psychiatric Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Lucia Lofano
- Psychiatric Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Federica Veneziani
- Psychiatric Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Carla Piccininni
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maria Rosaria Barulli
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Alessandra Grasso
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | | | - Rosanna Tortelli
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Rosa Capozzo
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Chiara Griseta
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | - Fabrizio Doricchi
- Global Brain Health Institute, University of California, San Francisco, USA
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Emanuela Resta
- Translational Medicine & Management of Health Systems, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Davide Seripa
- Geriatric Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy; Hematology and Stem Cell Transplant Unit, Vito Fazzi Hospital, ASL Lecce, Lecce, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy; Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.
| | - Francesco Panza
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy; Dipartimento di Psicologia, Sapienza University of Rome, Rome, Italy; Laboratorio di Neuropsicologia dell'Attenzione, Fondazione Santa Lucia IRCCS, Neurorehabilitation Hospital, Rome, Italy.
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22
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Kwok SS, Nguyen XMT, Wu DD, Mudar RA, Llano DA. Pure Tone Audiometry and Hearing Loss in Alzheimer's Disease: A Meta-Analysis. Front Psychol 2022; 12:788045. [PMID: 35153910 PMCID: PMC8833234 DOI: 10.3389/fpsyg.2021.788045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/27/2021] [Indexed: 12/22/2022] Open
Abstract
An association between age-related hearing loss (ARHL) and Alzheimer's Disease (AD) has been widely reported. However, the nature of this relationship remains poorly understood. Quantification of hearing loss as it relates to AD is imperative for the creation of reliable, hearing-related biomarkers for earlier diagnosis and development of ARHL treatments that may slow the progression of AD. Previous studies that have measured the association between peripheral hearing function and AD have yielded mixed results. Most of these studies have been small and underpowered to reveal an association. Therefore, in the current report, we sought to estimate the degree to which AD patients have impaired hearing by performing a meta-analysis to increase statistical power. We reviewed 248 published studies that quantified peripheral hearing function using pure-tone audiometry for subjects with AD. Six studies, with a combined total of 171 subjects with AD compared to 222 age-matched controls, met inclusion criteria. We found a statistically significant increase in hearing threshold as measured by pure tone audiometry for subjects with AD compared to controls. For a three-frequency pure tone average calculated for air conduction thresholds at 500-1,000-2,000 Hz (0.5-2 kHz PTA), an increase of 2.3 decibel hearing level (dB HL) was found in subjects with AD compared to controls (p = 0.001). Likewise, for a four-frequency pure tone average calculated at 500-1,000-2,000-4,000 (0.5-4 kHz PTA), an increase of 4.5 dB HL was measured (p = 0.002), and this increase was significantly greater than that seen for 0.5-2 kHz PTA. There was no difference in the average age of the control and AD subjects. These data confirm the presence of poorer hearing ability in AD subjects, provided a quantitative estimate of the magnitude of hearing loss, and suggest that the magnitude of the effect is greater at higher sound frequencies. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021288280.
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Affiliation(s)
- Susanna S. Kwok
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Xuan-Mai T. Nguyen
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Diana D. Wu
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Raksha A. Mudar
- Department of Speech and Hearing Sciences, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Daniel A. Llano
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Department of Speech and Hearing Sciences, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, United States
- Carle Neuroscience Institute, Carle Foundation Hospital, Urbana, IL, United States
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23
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Fu Y, Chen W, Guo L, Liu Y. The Inverted-U Relationship Between Dietary Inflammatory Potential and Hearing Loss Among Adults Aged 20 Years and Over in the United States: A Cross-Sectional Study. J Inflamm Res 2021; 14:6671-6683. [PMID: 34916819 PMCID: PMC8669755 DOI: 10.2147/jir.s337737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/20/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to examine the relationship between dietary inflammatory index and objective hearing loss (HL). Materials and Methods A cross-sectional analysis of a nationally representative sample of participants was performed based on data in National Health and Nutrition Examination Survey (NHANES) (2009-2016). HL was defined as pure tone averages >25 dB at 500, 1000, and 2000 Hz (low frequency); 3000, 4000, 6000, and 8000 Hz (high frequency) in either ear. The energy-adjusted dietary inflammatory index (E-DII) score was calculated for each participant based on two 24-h dietary recalls to assess diet-associated inflammation. Multivariable logistic regression was used to examine the linear relationship between HL and E-DII score or E-DII quartiles. Restricted cubic spline was applied to identify any non-linear associations of the E-DII score with hearing loss. Subgroup analyses were performed by age and gender to explore the moderating roles of these factors. Akaike's Information Criterion (AIC) values were used to select the better-fitted model among linear and non-linear models. Results An inverted-U shaped relationship with low-frequency hearing loss (LFHL) was identified for the E-DII score (P-nonlinear =0.023) after adjustment for potential confounders. But significant linear or nonlinear association between E-DII score and high-frequency hearing loss (HFHL) was not found. Conclusion E-DII score had inverted-U relationship with LFHL. Both pro-inflammatory diet and anti-inflammatory diet seemed to be associated with a decreased risk of LFHL compared to diet that was neither pro-inflammatory diet nor anti-inflammatory diet.
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Affiliation(s)
- Yanpeng Fu
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Wenyu Chen
- Nursing Department, Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Liqing Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Yuehui Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
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24
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Hura N, Bernstein IA, Mady LJ, Agrawal Y, Lane AP, Rowan NR. Otolaryngic sensory loss as a measure of frailty among older US adults. Int Forum Allergy Rhinol 2021; 12:771-779. [PMID: 34878232 DOI: 10.1002/alr.22918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Frailty is a syndrome characterized by reduced physiologic reserve and increased vulnerability to poor health outcomes. Disruption of sensorineural function appears to serve as a novel biomarker of frailty. Using population-level data, we sought to characterize the association between otolaryngic sensory dysfunction and frailty. METHODS A cross-sectional analysis of the 2011-2012 US National Health and Nutrition Examination Survey was performed on adults ≥40 years of age (n = 2138). Participants were grouped by subjective gustatory dysfunction (sGD), olfactory dysfunction (sOD), hearing loss (sHL), and measured hearing loss (mHL) with pure tone averages (PTAs). Frailty was operationalized using a continuous 36-item frailty index (FI) scored from 0 to 1, stratified in 4 categories ("non-frail," "vulnerable," "frail," or "most frail"). RESULTS All sensory loss groups had significantly higher FI scores than those without sensory loss (sGD = 0.15; sOD = 0.14; sHL = 0.15; low-frequency mHL = 0.16; high-frequency mHL = 0.14 vs control = 0.11; p < 0.007 for all). "Vulnerable" individuals had increased odds of sOD (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.05-2.00), whereas "frail" individuals had increased odds of sOD (aOR, 1.85; 95% CI, 1.26-2.71) and low-frequency mHL (aOR, 4.01; 95% CI, 1.27-12.63). The "most frail" individuals had increased odds of sHL (aOR, 11.72; 95% CI, 2.88-47.66) and high-frequency mHL (aOR 5.10; 95% CI, 1.72-15.12). PTAs were linearly associated with FI (low: β = 10.15; 95% CI, 1.78-18.51; high: β = 19.85; 95% CI, 5.19-34.53). CONCLUSION Otolaryngic sensory loss is associated with increased frailty. Independent association of frailty with measures of olfaction and hearing suggests that olfactory and hearing assessments may help identify at-risk individuals with modifiable risk factors.
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Affiliation(s)
- Nanki Hura
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Isaac A Bernstein
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA
| | - Leila J Mady
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andrew P Lane
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
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Zupo R, Castellana F, De Nucci S, De Pergola G, Lozupone M, Bortone I, Castellana M, Sborgia G, Lampignano L, Giannelli G, Panza F, Sardone R. Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study. Biomedicines 2021; 9:1617. [PMID: 34829846 PMCID: PMC8615636 DOI: 10.3390/biomedicines9111617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022] Open
Abstract
Age is a major contributor to the liver fibrosis rate and its adverse health-related outcomes, including mortality, but older populations are still under-explored. We investigated multimorbidity and inflammatory biomarkers in relation to the increasing liver fibrosis risk to delineate 8-year all-cause mortality trajectories in 1929 older adults from the population-based Salus in Apulia Study. Liver fibrosis risk was assumed using the fibrosis-4 (FIB-4) score, assigned to three liver fibrosis risk groups (low, intermediate, high). In the secondary analyses, the APRI score was also calculated to allow for comparisons. Male subjects (prevalence difference: -13.49, 95% confidence interval (CI): -18.96 to -8.03), a higher multimorbidity burden (effect size, ES: -0.14, 95% CI: -0.26 to -0.02), a higher prevalence of physical frailty (ES: 6.77, 95% CI: 0.07 to 13.47), and a more pronounced inflammatory pattern as indicated by tumor growth factor-α circulating levels (ES: -0.12, 95% CI: -0.23 to -0.01) were significantly more common in the highest-risk FIB-4 score group. Liver function characterized by lipid profile and platelet levels worsened with increasing FIB-4 risk score. The 8-year risk of death was nearly double in subjects in the highest-risk FIB-4 score group, even after controlling for possible confounders. Furthermore, a steeper mortality curve was clearly observed for FIB-4 scores as compared with the APRI scoring system with respect to liver fibrosis risk. In conclusion, using a scoring tool based on simple routine biomarkers to detect liver fibrosis risk may enhance biological knowledge of age-related outcomes of chronic liver disease and be helpful in the clinical setting to identify subjects at risk for adverse health-related outcomes, including mortality.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Madia Lozupone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Marco Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Giancarlo Sborgia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70124 Bari, Italy;
| | - Francesco Panza
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
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Yévenes-Briones H, Caballero FF, Struijk EA, Rey-Martinez J, Montes-Jovellar L, Graciani A, Rodríguez-Artalejo F, Lopez-Garcia E. Association Between Hearing Loss and Impaired Physical Function, Frailty, and Disability in Older Adults: A Cross-sectional Study. JAMA Otolaryngol Head Neck Surg 2021; 147:951-958. [PMID: 34554203 DOI: 10.1001/jamaoto.2021.2399] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Several studies have examined the association between hearing loss (HL) and physical function, with inconsistent results. Few used pure-tone thresholds and considered possible confounders in the association. Objective To examine the association between hearing loss and impaired lower extremity function, frailty syndrome, and disability in older adults. Design, Setting, and Participants The Seniors-ENRICA-2 is a cohort study that was established in 2015-2017 in Spain. The present study was conducted from December 2015 to June 2017. Data were analyzed from January 2, 2021, to March 10, 2021. This cross-sectional analysis included 1644 community-dwelling individuals aged 65 years or older (range, 66-91 years) of both sexes. Participants had hearing threshold measurements and data on impaired lower extremity function, frailty syndrome, and disability. Exposures Hearing loss defined as pure-tone average greater than 40 dB HL in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency (3, 4, and 8 kHz). Main Outcomes and Measures Impaired lower extremity function was defined with the Short Physical Performance Battery; the frailty syndrome was defined as having at least 3 of the 5 criteria, including weakness, slow walking speed, low physical activity, exhaustion, and weight loss; and disability in instrumental activities of daily living (IADL) was evaluated with the Lawton and Brody scale. Results Of the 1644 participants, 831 were men (50.5%); mean (SD) age was 73.8 (4.3) years. The prevalence of moderate HL was 13.6% at speech frequency. After adjustment for age, sex, lifestyle, comorbidities, impaired cognition, and social isolation, HL in standard frequency was associated with impaired lower extremity function, with an odds ratio (OR) of 2.20 (95% CI, 1.25-3.88); the corresponding estimate for the frailty syndrome was 1.85 (95% CI, 0.98-3.49) and for the IADL disability, was 2.25 (95% CI, 1.29-3.94). When considering speech frequency pure-tone average, HL was also associated with impaired function (OR, 2.59; 95% CI, 1.57-4.28), frailty syndrome (OR, 1.85; 95% CI, 1.06-3.22), and IADL disability (OR, 2.18; 95% CI, 1.32-3.60). Conclusions and Relevance In this cross-sectional analysis of data from the Seniors-ENRICA-2 cohort study, hearing loss was associated with impaired lower extremity function, frailty syndrome, and IADL disability. It may be useful to examine this association with the mechanisms elucidated in further studies.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Jorge Rey-Martinez
- Neurotology Unit, ENT Department, Hospital Universitario Donostia, San Sebastián-Donostia, Spain
| | - Lourdes Montes-Jovellar
- Otolaryngology Department, Head and Neck Section, Hospital Universitario Ramón Y Cajal, Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain.,IMDEA-Food Institute, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain.,IMDEA-Food Institute, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain.,IMDEA-Food Institute, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
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Zupo R, Castellana F, Guerra V, Donghia R, Bortone I, Griseta C, Lampignano L, Dibello V, Lozupone M, Coelho-Júnior HJ, Solfrizzi V, Giannelli G, De Pergola G, Boeing H, Sardone R, Panza F. Associations between nutritional frailty and 8-year all-cause mortality in older adults: The Salus in Apulia Study. J Intern Med 2021; 290:1071-1082. [PMID: 34437740 DOI: 10.1111/joim.13384] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Preventive nutritional management of frailty, a multidimensional intermediate status in the ageing process, may reduce the risk of adverse health-related outcomes. We investigated the ability of a measure combining physical frailty with nutritional imbalance, defined as nutritional frailty, to predict all-cause mortality over a period of up to 8 years. METHODS We analysed data on 1,943 older adults from the population-based 'Salus in Apulia Study'. Physical frailty was operationalized using Cardiovascular Health Study criteria and cognitive frailty by combining physical frailty with cognitive impairment. A novel five-item construct was built to assess the extent of nutritional imbalance identified with a machine learning algorithm. Cox models and Kaplan-Meier survival probability analyses of physical frailty, nutritional imbalance (two or more of the following: low body mass index, low skeletal muscle index, ≥2.3 g/day sodium intake, <3.35 g/day potassium intake and <9.9 g/day iron intake), cognitive frailty and the novel nutritional frailty phenotype (physical frailty plus nutritional imbalance) were applied to assess all-cause mortality risk, adjusted for age, sex, education and multimorbidity. RESULTS The overall prevalence of nutritional frailty was 4.52% (95% confidence interval, CI:3.55-5.44), being more frequent in males. Subjects with nutritional frailty were at higher risk for all-cause mortality [hazard ratio (HR):2.31; 95%CI:1.41-3.79] than those with physical frailty (HR:1.45,95% CI:1.0-2.02), nutritional imbalance (HR:1.39; 95%CI:1.05-1.83) and cognitive frailty (HR:1.06; 95%CI:0.56-2.01). CONCLUSIONS Efforts to identify, manage and prevent frailty should include the nutritional domain. The nutritional frailty phenotype may highlight major nutritional determinants that could drive survival and health trajectories in older adults.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Vito Guerra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Chiara Griseta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | | | - Vincenzo Solfrizzi
- "C. Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, Research Hospital, National Institute of Gastroenterology "Saverio de Bellis", Castellana Grotte, Bari, Italy
| | - Giovanni De Pergola
- Scientific Direction, Research Hospital, National Institute of Gastroenterology "Saverio de Bellis", Castellana Grotte, Bari, Italy
| | - Heiner Boeing
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy.,German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Francesco Panza
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
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Hearing Loss and Cognitive Impairment: Epidemiology, Common Pathophysiological Findings, and Treatment Considerations. Life (Basel) 2021; 11:life11101102. [PMID: 34685474 PMCID: PMC8538578 DOI: 10.3390/life11101102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022] Open
Abstract
In recent years, there has been increasing research interest in the correlation between hearing impairment and cognitive decline, two conditions that have demonstrated a strong association. Hearing loss appears as a risk factor for cognitive impairment, especially among certain populations, notably nursing home residents. Furthermore, hearing loss has been identified as a modifiable age-related condition linked to dementia, and it has been estimated that midlife hearing loss, if eliminated, might decrease the risk of dementia in the general population. Several mechanisms have been suggested to explain the pathologic connections between hearing loss and dementia; however, clear evidence is missing, and the common pathophysiological basis is still unclear. In this review, we discussed current knowledge about the relationship between hearing loss and dementia, and future perspectives in terms of the effects of hearing rehabilitation for early prevention of cognitive decline.
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Liver frailty and all-cause mortality in the older participants of the Salus in Apulia Study. GeroScience 2021; 44:835-845. [PMID: 34378088 DOI: 10.1007/s11357-021-00434-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/05/2021] [Indexed: 12/24/2022] Open
Abstract
The liver contribution to the biological network underlying physical frailty in aging is underestimated. How best to measure this contribution magnitude and impact on health risk trajectories in frail individuals is not yet entirely clear. We analyzed the association of a novel liver frailty phenotype with the risk of death in older participants of the Salus in Apulia Study cohort. Clinical and physical examination, routine biomarkers, medical history, and anthropometry were analyzed in 1929 older adults (65 +). Physical frailty was classified by Cardiovascular Health Study criteria, and liver fibrosis risk by fibrosis-4 (FIB-4). The liver frailty phenotype was defined as physical frailty plus high-risk liver fibrosis (score > 2.67). Physical frailty, high-risk liver fibrosis, and liver frailty subjects were compared to subjects without these conditions (non-frail). Proportional Cox regression tested the adjusted association between liver frailty and all-cause mortality for each category. The liver frailty prevalence was relatively low (3.8%), but higher in men (58.1%). Compared to non-frail older subjects, liver frailty subjects were significantly older (effect size (ES) - 1.11, 95% confidence interval (CI) - 1.35 to - 0.87), with a lower education (ES 0.48, 95%CI 0.24 to 0.71) and higher multimorbidity (ES 15.81, 95%CI 4.20 to 27.41). Cox multivariate analyses showed a two-fold increased risk of overall mortality (hazard ratio 2.09, 95%CI 1.16-3.74) even after the adjustment for age, sex, education, and alcohol consumption. The liver frailty phenotype runs twice the risk of overall mortality compared with the non-frail population. This clinical tool, validated in a Southern Italian population, is based on simple sets of measures that can conveniently be assessed also in the primary care setting.
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Dibello V, Zupo R, Sardone R, Lozupone M, Castellana F, Dibello A, Daniele A, De Pergola G, Bortone I, Lampignano L, Giannelli G, Panza F. Oral frailty and its determinants in older age: a systematic review. THE LANCET HEALTHY LONGEVITY 2021; 2:e507-e520. [DOI: 10.1016/s2666-7568(21)00143-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/01/2023]
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Castellana F, Lampignano L, Bortone I, Zupo R, Lozupone M, Griseta C, Daniele A, De Pergola G, Giannelli G, Sardone R, Panza F. Physical Frailty, Multimorbidity, and All-Cause Mortality in an Older Population From Southern Italy: Results from the Salus in Apulia Study. J Am Med Dir Assoc 2021; 22:598-605. [PMID: 33493467 DOI: 10.1016/j.jamda.2020.12.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES We first estimated the prevalence of physical frailty in older subjects from the population-based Salus in Apulia Study (Apulia, Southern Italy), and its impact on all-cause mortality. Second, we explored the relationship between multimorbidity and physical frailty. DESIGN Cross-sectional and longitudinal analyses from a population-based study. SETTING AND PARTICIPANTS We analyzed data from the Salus in Apulia study, a population-based sample of 1929 subjects aged 65 years and older. METHODS These older participants underwent clinical, physical, and laboratory assessments. Physical frailty was operationalized using slightly modified Fried criteria. Multimorbidity status was defined as the co-presence of 2 or more chronic conditions. RESULTS The overall prevalence of physical frailty in this older population from Southern Italy was 14.8% [95% confidence interval (CI): 13.26-16.49]. Physical frailty subjects were significantly older (P < .01), had a lower educational level (P < .01), increased executive dysfunction (P < .01), higher serum levels interleukin-6 (P < .01), and white blood cells (P = .01). Multimorbidity status (P < .01), diabetes mellitus (P = .05), peripheral age-related hearing loss (P < .01), cognitive impairment (P < .01), chronic obstructive pulmonary disease (P = .02), and metabolic syndrome (P = .02) were also directly related to physical frailty. Apathy increased according to the severity of physical frailty status (P = .02). There was a significant increased risk of all-cause mortality for physical frailty subjects (hazard ratio: 1.48; 95% CI: 1.03-2.12, adjusted for age and sex) during the observation from the date of enrollment to the date of death (mean ± SD: 55.70 ± 22.19 months, median: 54 months). CONCLUSIONS AND IMPLICATIONS Frailty is the consequence of the contributory action of the aging process and some chronic diseases that hasten some of the changes concurrent with aging.
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Affiliation(s)
- Fabio Castellana
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Luisa Lampignano
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Ilaria Bortone
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Roberta Zupo
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Chiara Griseta
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni De Pergola
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Rodolfo Sardone
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy
| | - Francesco Panza
- Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy.
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32
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Jaiswal A, Martiniello N, Holzhey P, Aubin G, Dumassais S, Huang S, Major G, Mirmiran R, Tangkhpanya F, Boie NR, Wittich W. Cognitive Impairment in Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Scoping Review Protocol. Front Psychiatry 2021; 12:661560. [PMID: 34349679 PMCID: PMC8326366 DOI: 10.3389/fpsyt.2021.661560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: As the prevalence of age-related sensory impairment increases, more evidence emerges on the association between uni-sensory and cognitive impairment (CI) in older adults. However, the link between CI and concurrent hearing and vision impairment (referred to as dual sensory impairment/DSI) is not well-understood, and this combined effect may be additive or multiplicative. Moreover, the existing evidence on CI in older adults with DSI is scattered and limited. Through this systematic scoping review, we aim to map existing evidence on CI in older adults with DSI, and to summarize what is known about the prevalence, incidence and risk factors of CI, and tools used to screen or assess CI in older adults with DSI. Methods and Analysis: We will use the Joanna Briggs Institute framework to perform the review. Eleven databases [MEDLINE, CINAHL/EBSCO, EMBASE, Mednar, WorldWideScience, PsycEXTRA, OAIster, OpenGrey (SIGLE), Global Health, PsycINFO, and Web of Science] and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) will be searched. Study selection will be completed using Covidence, and data will be extracted using an a priori data extraction tool. To be included, studies had to be peer-reviewed, had older adults with DSI as the focal population, and are related to CI. Data will be presented using a narrative summary with emphasis on implications for future research and practice. Discussion: Reliable cognitive screening is of the utmost importance for prevention and treatment of CI within DSI population. The study findings will have significant implications for health services delivery and policy research. The summarized findings on the prevalence, incidence, associated risk factors, and CI screening and assessment tools will inform geriatric care. The review will also document knowledge gaps on CI in the DSI population and identify areas of interest for future studies. Ethics and Dissemination: The scoping study, being a review of existing documents, does not require ethics approval. The findings will be disseminated with relevant stakeholders using knowledge translation activities such as scientific presentations and publications. We intend to use the findings to conduct a Delphi study to evaluate which CI tools are suitable for older population with DSI.
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Affiliation(s)
- Atul Jaiswal
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal/Institut Nazareth et Louis-Braille du Centre Intégré de Santé et de Services Sociaux de la Montérégie-Centre, Longueuil, QC, Canada
| | | | - Peter Holzhey
- School of Optometry, Université de Montréal, Montreal, QC, Canada
| | - Gabrielle Aubin
- School of Optometry, Université de Montréal, Montreal, QC, Canada
| | | | - Stephanie Huang
- School of Optometry, Université de Montréal, Montreal, QC, Canada
| | - Geneviève Major
- School of Optometry, Université de Montréal, Montreal, QC, Canada
| | - Roxane Mirmiran
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Walter Wittich
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal/Institut Nazareth et Louis-Braille du Centre Intégré de Santé et de Services Sociaux de la Montérégie-Centre, Longueuil, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal/Centre de Réadaptation Lethbridge-Layton-Mackay du Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada
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