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Shriner D, Bentley AR, Zhou J, Ekoru K, Doumatey AP, Chen G, Adeyemo A, Rotimi CN. Time-to-event modeling of hypertension reveals the nonexistence of true controls. eLife 2020; 9:62998. [PMID: 33258447 PMCID: PMC7707825 DOI: 10.7554/elife.62998] [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: 09/10/2020] [Accepted: 11/13/2020] [Indexed: 11/13/2022] Open
Abstract
Given a lifetime risk of ~90% by the ninth decade of life, it is unknown if there are true controls for hypertension in epidemiological and genetic studies. Here, we compared Bayesian logistic and time-to-event approaches to modeling hypertension. The median age at hypertension was approximately a decade earlier in African Americans than in European Americans or Mexican Americans. The probability of being free of hypertension at 85 years of age in African Americans was less than half that in European Americans or Mexican Americans. In all groups, baseline hazard rates increased until nearly 60 years of age and then decreased but did not reach zero. Taken together, modeling of the baseline hazard function of hypertension suggests that there are no true controls and that controls in logistic regression are cases with a late age of onset.
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Affiliation(s)
- Daniel Shriner
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
| | - Jie Zhou
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
| | - Kenneth Ekoru
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
| | - Ayo P Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
| | - Guanjie Chen
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, United States
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Cardoso RB, Caldas CP, de Souza PA, Brandão MAG, Santana RF. Proposal of Nursing Diagnosis "Readiness for Enhanced Healthy Aging": A Concept Analysis. Int J Nurs Knowl 2020; 32:134-143. [PMID: 32592527 DOI: 10.1111/2047-3095.12296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To analyze the concept of healthy aging and propose the development of a nursing diagnosis METHODS: Concept analysis using the method proposed by Walker and Avant FINDINGS: Four bibliographic databases were searched, and 36 articles were included in the analysis. Seven antecedents, seven attributes, and three consequences for "healthy aging" were identified. CONCLUSIONS The concept analysis supported the development of the new nursing diagnosis "readiness for enhanced healthy aging," which can assist nurses in implementing actions aimed at promoting the health of older adults. IMPLICATION FOR NURSING PRACTICE The establishment of a nursing diagnosis may provide nurses the opportunity to implement interventions that promote the maintenance of functional and cognitive capacity, psychological and spiritual well-being, and social engagement, aiming at healthy aging with high quality of life.
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Affiliation(s)
- Rosane Barreto Cardoso
- Rosane Barreto Cardoso, MS, is a PhD student in Nursing, University of the State of Rio de Janeiro - UERJ, Rio de Janeiro, Brazi
| | - Célia Pereira Caldas
- Célia Pereira Caldas, RN, PhD, is a Full Professor at Public Health Department, Nursing College, University of the State of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Priscilla Alfradique de Souza
- Priscilla Alfradique De Souza, RN, PhD, is an Assistant Professor at the Alfredo Pinto School of Nursing, Federal University of the State of Rio de Janeiro - UNIRIO, Rio de Janeiro, Brazil
| | - Marcos Antônio Gomes Brandão
- Marcos Antônio Gomes Brandão, RN, MSN, PhD, is an Associate Professor at Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosimere Ferreira Santana
- Rosimere Ferreira Santana, RN, PhD, is an Associate Professor at the School of Nursing, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
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Pettigrew S, Jongenelis MI, Jackson B, Warburton J, Newton RU. A randomized controlled trial and pragmatic analysis of the effects of volunteering on the health and well-being of older people. Aging Clin Exp Res 2020; 32:711-721. [PMID: 31201669 DOI: 10.1007/s40520-019-01241-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 06/05/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Volunteering among older people has the potential to deliver health benefits to the individual, along with economic and social benefits to society. However, it is not clear whether healthier people are more likely to engage in volunteering, whether volunteering improves health, or the extent to which the relationship may be reciprocal. There is an identified need for longitudinal work, especially in the form of randomized controlled trials, to establish causality. AIMS To assess the effects of commencing volunteering among older non-volunteers utilizing a randomized controlled trial approach involving per-protocol and pragmatic analyses. METHODS Of the 445 Australians aged 60 + years who participated in the study, 201 were assigned to an intervention arm that required them to participate in a minimum of 1 h/week of formal volunteering in a position of their choice. The remaining participants were assigned to a control condition and asked to continue their lives as usual, but were not discouraged from commencing volunteering. RESULTS Across the assessed physical, psychological, and social variables, a significant difference in sit-to-stand scores was found in both the per-protocol and pragmatic analyses, and a further significant difference in the fast pace walk was identified in the pragmatic analyses. CONCLUSION The results provide some support for policies and programs designed to encourage older people to engage in volunteering to maintain or improve their health. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12615000091505.
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Affiliation(s)
- Simone Pettigrew
- School of Psychology, Curtin University, Kent St, Bentley, WA, 6102, Australia.
| | | | - Ben Jackson
- School of Human Sciences (Exercise and Sports Science), University of Western Australia, Perth, Australia
| | - Jeni Warburton
- La Trobe Rural Health School, La Trobe University, Melbourne, Australia
| | - Robert U Newton
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Urtamo A, Jyväkorpi SK, Kautiainen H, Pitkälä KH, Strandberg TE. Major cardiovascular disease (CVD) risk factors in midlife and extreme longevity. Aging Clin Exp Res 2020; 32:299-304. [PMID: 31612429 PMCID: PMC7033063 DOI: 10.1007/s40520-019-01364-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/21/2019] [Indexed: 12/19/2022]
Abstract
Background The studies on the association of various midlife risk factors with reaching 90 years or more are scarce. We studied this association in a socioeconomically homogenous cohort of businessmen. Methods The study consists of men (n = 970) from the Helsinki Businessmen Study cohort (born 1919–1928). Five major cardiovascular disease (CVD) risk factors (smoking, BMI, blood pressure, serum lipids, fasting glucose), consumption of alcohol and coffee, self-rated health and self-rated fitness, were assessed in 1974, at an average age of 50 years. The number of major risk factors was tested as a risk burden. The Charlson Comorbidity Index and the RAND-36 (SF-36) Physical and Mental health summary scores were calculated from surveys in year 2000, at age of 73 years. Mortality dates were retrieved through 31 March 2018 from the Population Information System of Finland. Results 244 men survived to the age of 90 representing 25.2% of the study cohort. The survivors had less risk factor burden in midlife, and less morbidity and higher physical health summary score in 2000. Of those with five major risk factors only 7% survived up to 90 years, whereas 51% of those without any risk factors reached that age. Single risk factors reducing odds of reaching 90 years were smoking (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.34–0.67), glucose (0.66, 0.49–0.88), BMI (0.63, 0.46–0.86), and cholesterol (0.71, 0.53–0.96). Conclusion Lack of five major CVD risk factors in midlife strongly increased odds of reaching 90 years of age and also predicted factors related to successful ageing in late life.
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Affiliation(s)
- Annele Urtamo
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland.
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Timo E Strandberg
- Clinicum, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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5
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Individual healthy aging indices, measurements and scores. Aging Clin Exp Res 2019; 31:1719-1725. [PMID: 31463926 DOI: 10.1007/s40520-019-01327-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/15/2019] [Indexed: 10/26/2022]
Abstract
The positive gerontological approach to aging has resulted in successive terminologies to describe the process of aging, including successful aging, active aging, healthy aging, or healthy and active aging, amongst others. Each definition proposed by geriatricians, psychologists, sociologists or public health specialists has been based on specific aspects of aging that are most important to the authors' discipline, explaining the current difficulty in determining which is the best set of criteria to determine "good aging". Two successive analyses of the measurements used in longitudinal studies from 1989 to 2018 testify to this heterogeneity in the types of questions proposed to evaluate the quality of the individual aging process. To confront this complexity, new and integrated indices have successively been proposed to quantify and qualify the survival period of aging individuals. The present paper aims to describe and compare the value of the "healthy aging index", the "modified healthy aging index", the "healthy aging score" and the "selfie aging test". Attempts to date to identify the best individual measurement of "aging well" have been interesting, and certainly show promise, but their limitations to specific populations call for more concerted effort from the scientific community to obtain worldwide validation. Another option would be to identify the best self-assessment questionnaire and include it in a mobile device, enabling longer term personal follow-up of aging functions. There is a clear lack of data of this type at present, and an urgent need to obtain such information, to enable early and targeted interventions.
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Franzon K, Zethelius B, Cederholm T, Kilander L. The impact of muscle function, muscle mass and sarcopenia on independent ageing in very old Swedish men. BMC Geriatr 2019; 19:153. [PMID: 31142271 PMCID: PMC6542054 DOI: 10.1186/s12877-019-1142-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/22/2019] [Indexed: 12/22/2022] Open
Abstract
Background Preserved functions of daily life and cognition are cornerstones of independent aging, which is crucial for maintaining a high quality of life. The aim of this study was to examine the impact of sarcopenia, and its underlying components, on independent ageing in a cohort study of very old men. Methods The presence of sarcopenia and independent ageing at a mean age of 87 was investigated in 287 men from the Uppsala Longitudinal Study of Adult Men. Five years later 127 men were re-evaluated for independent ageing. Sarcopenia was defined by two different definitions from the European Working Group on Sarcopenia in Older People. In the first definition sarcopenia was defined as skeletal muscle index < 7.26 kg/m2 and either gait speed ≤0.8 m/s or hand grip strength < 30 kg. In the later up-dated definition, HGS < 27 kg and/or chair stand test > 15 s defines probable sarcopenia, which is confirmed by SMI < 7.0 kg/m2. Independent ageing was defined as a Mini-Mental State Examination score of ≥25 points, absence of diagnosed dementia, community-dwelling, independency in personal care and ability to walk outdoors alone. Results Sarcopenia at baseline was observed in 21% (60/287) and 20% (58/287), respectively, due to definition. The prevalence of independent ageing was 83% (239/288) at baseline and 69% (87/127) five years later. None of the sarcopenia diagnoses were associated with independent ageing. In contrast, gait speed was both in cross-sectional (odds ratio (OR) per one standard deviation increase 2.15, 95% confidence interval (CI) 1.47–3.15), and in longitudinal multivariate analyses (OR 1.84, 95% CI 1.19–2.82). In the cross-sectional analysis also higher hand grip strength was associated with independent ageing (OR 1.58, 95% CI 1.12–2.22), while a slower chair stand test was inversely associated (OR 0.61, 95% CI 0.43–0.86). Muscle mass; i.e. skeletal muscle index, was not associated with independent ageing. Conclusions For very old men, especially a higher gait speed, but also a higher hand grip strength and a faster chair stand test, were associated with independent ageing, while skeletal muscle index alone, and the composite sarcopenia phenotype measured with two different definitions, were not.
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Affiliation(s)
- Kristin Franzon
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Box 564, 751 22, Uppsala, Sweden.
| | - Björn Zethelius
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Box 564, 751 22, Uppsala, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Box 564, 751 22, Uppsala, Sweden
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Midlife predictors of active and healthy aging (AHA) among older businessmen. Aging Clin Exp Res 2019; 31:225-231. [PMID: 30584642 PMCID: PMC6373373 DOI: 10.1007/s40520-018-1100-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/13/2018] [Indexed: 12/14/2022]
Abstract
Background Active and healthy aging (AHA) is an important phenomenon in aging societies. Aims Our aim was to investigate midlife predictors of AHA in a socioeconomically homogenous male cohort. Methods In 2010, AHA was defined in the Helsinki Businessmen Study (men born in 1919–1934) with six criteria: (1) being alive, (2) responding to the mailed survey, (3) no reported cognitive problems, (4) feeling of happiness, (5) no difficulties in activities of daily living (ADL), and (6) no significant chronic diseases. Midlife factors were assessed in 1974 (n = 1759, mean age 47 years). Of the survivors in 2010 (n = 839), 10.0% (n = 84) fulfilled all AHA criteria, whilst 13.7% (n = 115) had chronic diseases but fulfilled other five criteria. Midlife predictors of AHA were analyzed with logistic models. Results Of the midlife factors, smoking [Odds ratio (OR) 0.44, 95% confidence interval (CI) 0.25–0.77], higher body mass index (BMI) (OR 0.75, 0.59–0.96), and higher total cholesterol (OR 0.76, 0.60–0.97) prevented significantly full AHA criteria, whereas higher self-rated health (SRH) (OR 1.73, 1.07–2.80) predicted significantly of fulfilling all AHA criteria. Midlife smoking (OR 0.87, 0.84–0.91), higher BMI (OR 0.73, 0.61–0.86), and higher alcohol consumption (OR 0.73, 0.60–0.90) prevented significantly of fulfilling the five AHA criteria with chronic diseases, and higher SRH (OR 1.90, 1.37–2.63) predicted significantly the five AHA criteria (chronic diseases present). Discussion Our study suggests that midlife factors, especially good SRH and low levels of cardiovascular risk factors, are associated with AHA. Conclusions The study emphasizes the importance of life-course predictors of healthy aging.
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Hirvonen K, Laivuori H, Lahti J, Strandberg T, Eriksson JG, Hackman P. SIRT6 polymorphism rs117385980 is associated with longevity and healthy aging in Finnish men. BMC MEDICAL GENETICS 2017; 18:41. [PMID: 28399814 PMCID: PMC5387321 DOI: 10.1186/s12881-017-0401-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 03/30/2017] [Indexed: 01/13/2023]
Abstract
Background Sirtuin-6 (SIRT6) is involved in various crucial cellular pathways, being a key regulator of telomere structure, DNA repair, metabolism, transcriptional control and the NF-kappa B pathway. Sirt6 knock-out mice have been reported to develop typical features of aging and senescence at the age of 2–3 weeks and die within 4 weeks. The aim of this study was to investigate whether sequence variations of SIRT6 are associated with aging and longevity in Finnish men. Methods The sample of this study consisted of 43 longer-living and healthy males and 92 male control subjects who have died of natural causes at an average age of 66,6 (±4,1) years and who belonged to the Helsinki Birth Cohort Study (HBCS). Single nucleotide polymorphisms (SNPs) in the exons and their surroundings of the SIRT6 were studied using direct PCR sequencing. Results The SNP rs117385980 (C > T), situated 23 bases downstream of the exon 2 exon/intron border was found in heterozygous form in 1/43 longer-living healthy men (Minor allele frequency (MAF) 0,0116) and in 9/92 controls (MAF 0,0489). To replicate this finding, we studied a group of 63 healthy men at an average age of 83 years from the Helsinki Businessmen Study (HBS)–cohort. The heterozygosity of the same SNP was seen in 2/63 men from the HBS–cohort (MAF 0,0159). Fisher exact test was performed in our two combined study samples. The P-value for all samples combined was 0.07 and the odds ratio 3.53 (95% confidence interval 0.96–13.4). Conclusions These results suggest an inverse association between the T allele of rs117385980 and longevity. The result needs to be confirmed in a larger study. It remains to be determined whether rs117385980 itself has an effect or if it is a mere genetic marker for some other yet undiscovered sequence variant causing a functional effect.
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Affiliation(s)
- Katariina Hirvonen
- The Folkhälsan Institute of Genetics and the Department of Medical Genetics, University of Helsinki, Helsinki, Finland.
| | - Hannele Laivuori
- Medical and Clinical Genetics and Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland.,Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Centre, Helsinki, Finland
| | - Timo Strandberg
- University of Helsinki, Helsinki, Finland.,Helsinki University Central Hospital, Geriatrics, Helsinki, Finland.,Institute of Health Sciences/Geriatrics, University of Oulu, Oulu, Finland
| | - Johan G Eriksson
- Folkhälsan Research Centre, Helsinki, Finland.,University of Helsinki, Helsinki, Finland.,Department Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.,Department of General Practice and Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Peter Hackman
- The Folkhälsan Institute of Genetics and the Department of Medical Genetics, University of Helsinki, Helsinki, Finland
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Strandberg TE, Michel JP, Maggi S. Healthy ageing requires a triple strategy. Aging Clin Exp Res 2016; 28:369-70. [PMID: 27154876 DOI: 10.1007/s40520-016-0583-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/22/2016] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Stefania Maggi
- Aging Branch, Institute of Neuroscience, CNR, Via Giustiniani, 2, 35128, Padua, Italy.
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