Are Health Behaviors and Self-Rated Health Related to Cardiovascular Health and Functional Performance? Results from the Lookup 7+ Cross-Sectional Survey among Persons Aged 65+

Self-perception of the neighborhood environment, cognitive impairment and functional limitations in community-dwelling older adults: A cross-sectional study

AIMS

It is important to identify the association between characteristics of the neighborhood environment, cognitive impairment and functional limitations to organize early and effective intervention strategies.

METHODS

A cross-sectional survey of 308 community-dwelling older adults was conducted. Logistic Regression analyses were performed to verify the associations between self-perceived characteristics of the neighborhood environment (Neighborhood Environment Walkability Scale), cognitive impairment (Mini-Mental State Examination) and functional limitations (mobility, lower limb muscle strength and balance).

RESULTS

Significant negative associations were observed: (1) better infrastructure, traffic and safety and mobility limitation; (2) better infrastructure and muscle weakness; (3) better safety and balance limitation; and (4) better streets/sidewalks and cognitive impairment. On the other hand, positive associations were observed between poor safety with mobility limitation and muscle weakness.

CONCLUSIONS

Our findings contribute to greater knowledge about neighborhood characteristics regarding mental and physical health in community-dwelling older adults.

The prevalence of undernutrition and associated factors in older obese patients

BACKGROUND

Both obesity and malnutrition are common health problems in older adults.

AIM

The aim of our study is to investigate the prevalence of undernutrition and related factors in older obese patients.

METHODS

1911 older outpatients who underwent comprehensive geriatric assessment were included in this cross-sectional study. Body mass index (BMI) was categorized as follows: 'Underweight' = BMI < 18.5, 'Normal weight' = 18.5 ≤ BMI < 25, 'Overweight' 25 ≤ BMI < 30, and 'Obesity' ≥ BMI 30. Mini-Nutritional Assessment scores > 23.5, 17-23.5, or < 17 were categorized as well-nourished, malnutrition risk, and malnutrition, respectively. Those who were not well-nourished were considered undernutrition.

RESULTS

Of 1911 patients, with a mean age of 77.34 ± 8.0 years, 931 (48.7%) were obese. Of whom 6.0% were malnourished and 26.3% were at risk of malnutrition. Age, females, widowed and those living with their children, the number of drugs used, and the presence of heart failure, Parkinson's disease, and dementia, decreased calf circumference and muscle strength were higher in obese patients with undernutrition than obese well-nourished patients (p < 0.05). After adjustment for the aforementioned factors, basic and instrumental activities of daily livings, and Tinetti scores were lower, and falls and Geriatric Depression Scale-15 scores were higher in those with undernutrition compared to those with well-nourished among older obese patients (p < 0.05).

CONCLUSIONS

Half of the older patients were obese and undernutrition was observed in one out of every three older obese patients. Undernutrition was associated with decreased functional capacity, impairment in balance and gait functions, falls, and depressed mood. Therefore, we recommend to screen older obese patients for nutritional status.

Mediation of Grip Strength on the Association Between Self-Rated Health and Estimated Cardiovascular Disease Risk

Background: Grip strength and self-rated health (SRH) have been reciprocally related, and each has been associated with cardiovascular disease (CVD) risk. However, the pathway between SRH and grip strength in the association with CVD risk remains uncertain. This cross-sectional study evaluated whether grip strength mediates the association between SRH and estimated CVD risk. Methods: In 15,930 Koreans 40-79 years of age without CVD history from the 2014 to 2018 Korea National Health and Nutrition Examination Survey, the risk of 10-year atherosclerotic cardiovascular disease (ASCVD) was calculated using Pooled Cohort Equations. Relative grip strength (RGS) was defined as measured grip strength divided by body mass index. SRH was assessed using a single questionnaire. Results: After adjusting for the covariates, males in the non-highest RGS tertiles, the fair/poor/very poor SRH groups, or the other joined categories of RGS tertiles and SRH groups (except the highest RGS tertile and good SRH group) had higher odds for 10-year ASCVD risk ≥7.5% than the reference group. The ASCVD risk was higher in females in the lowest RGS tertile, the poor/very poor SRH group, or the combined category of lowest RGS tertile and poor SRH group than the reference group. RGS significantly mediated the relationship between better SRH and the lower ASCVD risk (indirect effect: β = -0.078, 95% CI [-0.097 to -0.060], P < 0.05) and reduced the total effect of SRH on the ASCVD risk (direct effect: β = -0.225, t = -3.203, P = 0.001). RGS mediated 26% of the association between SRH and ASCVD risk. Conclusion: Grip strength may have a mediating role in the relationship between SRH and the estimated 10-year risk of ASCVD.

Prevalence of dyslipidemia and hypercholesterolemia awareness: results from the Lookup 7+ online project

Background

Cardiovascular disease still represents the leading cause of death worldwide. Management of risk factors remains crucial; despite this, hypercholesterolemia, which is one of the most important modifiable cardiovascular risk factor, is still high prevalent in general population. The aim of this study is to determine the prevalence of dyslipidemia and hypercholesterolemia awareness in a very large population.

Methods

More than 65 000 users completed the online, self-administered survey. It was structured like a ‘journey’ where each stage corresponded to a cardiovascular risk factor: blood pressure, body mass index, cholesterol, diet, physical exercise, smoke and blood sugar. At the end, the user received a final evaluation of his health status.

Results

The mean age was 52.5 years (SD 13.9, range 18–98), with 35 402 (53.7%) men. About 56% of all participants believed to have normal cholesterol values, when only 40% of them really showed values <200 mg/dl. Only about 30% of all participants self-predicted to have abnormal cholesterol values whereas we found high cholesterol levels in about 60% of people.

Conclusions

Dyslipidemia is very prevalent and half of the people with high cholesterol is not aware of having high values.