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Kim HC, Lee HJ, Kim YT, Jang BC. Risk of Neurodegenerative Diseases in Elderly Koreans with an Initial Diagnosis of Type 2 Diabetes: A Nationwide Retrospective Cohort Study. J Diabetes Res 2023; 2023:7887792. [PMID: 38020200 PMCID: PMC10651337 DOI: 10.1155/2023/7887792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/30/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Type 2 diabetes (T2D) and neurodegenerative diseases (NDs) are common among elderly individuals. Growing evidence has indicated a strong link between T2D and NDs, such as Alzheimer's disease. However, previous studies have limitations in exploring the epidemiological relationship among these diseases as a group of NDs rather than as a specific type of ND. We aimed to investigate the risk of NDs in elderly Koreans who were first diagnosed with T2D and determine the association between T2D and NDs. We conducted a retrospective longitudinal cohort study of patients with who were initially diagnosed with T2D using the Korean National Health Information Database. The study participants were categorized into a T2D group (n = 155,459) and a control group (n = 155,459), aged 60-84 years, that were matched for age, sex, and comorbidities. We followed the participants for 10 years to investigate the incidence of NDs. The Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for NDs. The numbers of patients diagnosed with ND at the end of follow-up were as follows: 51,096/155,459 (32.9%) in the T2D group and 44,673/155,459 (28.7%) in the control group (χ2 = 622.53, p < 0.001). The incidences of NDs in the T2D and control groups were 44.68 (95% CI: 44.29, 45.07) and 36.89 (95% CI: 36.55, 37.24) cases per 1,000 person-years at risk, respectively. The overall incidence of NDs was higher in the T2D group than that in the control group (HR: 1.23, 95% CI: 1.22, 1.25, p < 0.001). This study revealed a higher incidence of NDs in elderly Koreans who were initially diagnosed with T2D. This suggests that T2D is a risk factor for NDs in elderly Koreans.
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Affiliation(s)
- Hee-Cheol Kim
- Department of Psychiatry, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
- Brain Research Institute, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Ho-Jun Lee
- Department of Psychiatry, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Yang-Tae Kim
- Department of Psychiatry, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Byeong-Churl Jang
- Department of Molecular Medicine, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
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Bosma MS, Caljouw MAA, Achterberg WP, Nijboer TCW. Prevalence, Severity and Impact of Visuospatial Neglect in Geriatric Stroke Rehabilitation, a Cross-Sectional Study. J Am Med Dir Assoc 2023; 24:1798-1805. [PMID: 37634546 DOI: 10.1016/j.jamda.2023.06.038] [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: 03/07/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES Visuospatial neglect (VSN) is a common cognitive deficit of lateralized attention after stroke and can have a negative influence on patients' daily activities, community participation, and caregiver burden. VSN prevalence has been investigated in several mixed-age populations, but rarely in only an older population. As the population in geriatric rehabilitation (GR) is understudied and VSN may influence rehabilitation goals in GR (return home), we examined the prevalence of VSN as well as associations between VSN (severity) and population characteristics and the impact of VSN on functioning, length of stay, and discharge destination after GR. DESIGN Multicenter cross-sectional study. SETTING AND PARTICIPANTS Stroke patients admitted to GR. METHODS Three VSN tests (Star cancelation task, Line bisection task, and Catherine Bergego Scale) were administered in the first 2 weeks of GR admission. To examine VSN severity, a composite score was calculated based on scores of the 3 tests. RESULTS A total of 114 stroke patients were included [55.3% female; mean age 80.2 (SD 8.0) years]. VSN prevalence was 47.4%, in which allocentric and egocentric neglect were more prevalent than VSN during activities of daily living. Participants with VSN spent more days in GR compared to participants without VSN (median 68.5 vs 35.5 days) and had fewer home returns. In addition, VSN participants showed less mobility, lower cognitive functioning, and less independence during self-care compared to participants without VSN. Mobility, self-care, cognition, duration of rehabilitation, and home return were negatively associated with VSN severity. CONCLUSIONS AND IMPLICATIONS VSN is very prevalent in the GR stroke population. VSN severely hampers older people during daily activities and their rehabilitation process and, therefore, has a major personal and societal impact. Accordingly, systematic assessment of VSN in the early phase of geriatric rehabilitation with multiple VSN screening tests is recommended.
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Affiliation(s)
- Martine S Bosma
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; Zorggroep Florence, Rijswijk, the Netherlands; University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands.
| | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
| | - Tanja C W Nijboer
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands
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Yang S, Boudier-Revéret M, Kwon S, Lee MY, Chang MC. Effect of Diabetes on Post-stroke Recovery: A Systematic Narrative Review. Front Neurol 2021; 12:747878. [PMID: 34970205 PMCID: PMC8712454 DOI: 10.3389/fneur.2021.747878] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/19/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Patients with stroke often have comorbid diabetes. Considering its detrimental effects on brain function, diabetes may increase the risk of poor recovery.Methods: The aim of this review was to investigate the effect of diabetes on post-stroke recovery by a systematic review. Several specific aspects of post-stroke recovery, including activities of daily living (ADL), motor, cognitive, and quality of life (QOL) recovery, were examined. We searched the PubMed, SCOPUS, Embase, and Cochrane Library databases for relevant studies on the effect of diabetes on post-stroke recovery, published until May 26, 2021. A total of 52,051 potentially relevant articles were identified. After reading the titles and abstracts and assessing their eligibility based on full-text articles, 34 publications were included in this review.Results: Of 29 studies that assessed ADL recovery after stroke, 22 studies suggested that diabetes had a negative effect on recovery of ADL after stroke. Regarding motor recovery, only one out of four studies showed that diabetes had some effect on motor recovery after stroke. Of the two studies on cognitive recovery, one reported that diabetes was an independent predictor of poor cognitive recovery after stroke. Three studies on QOL reported that a poor QOL after stroke was associated with the presence of diabetes.Conclusions: The current review suggests that the post-stroke recovery of ADL seems to be poorer in patients with diabetes than patients without diabetes. Further, there are insufficient data to conclude the effect of diabetes on motor and cognitive recovery, but it may have some influence on the quality of life after stroke.Systematic Review Registration: doi: 10.37766/inplasy2021.11.0032, identifier: INPLASY2021110032.
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Affiliation(s)
- Seoyon Yang
- Department of Rehabilitation Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Mathieu Boudier-Revéret
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - SuYeon Kwon
- Department of Rehabilitation Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Min Yong Lee
- Department of Dermatology, Ewha Womans University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Gyeongsan, South Korea
- *Correspondence: Min Cheol Chang
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Thomson J, New PW. Pharmacological management of stroke in older people. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2021. [DOI: 10.1002/jppr.1703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Julia Thomson
- Department of Medicine Rehabilitation and Aged Services Program, Kingston Centre Monash Health Clayton Australia
| | - Peter Wayne New
- Department of Medicine Rehabilitation and Aged Services Program, Kingston Centre Monash Health Clayton Australia
- Rehabilitation Services Caulfield Hospital Alfred Health Victoria Australia
- Epworth‐Monash Rehabilitation Medicine Unit Monash Medical School Monash University Parkville Australia
- Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University Parkville Australia
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The association of comorbidity measures and mortality in geriatric rehabilitation inpatients by cancer status: RESORT. Support Care Cancer 2021; 29:4513-4519. [PMID: 33462725 PMCID: PMC8236474 DOI: 10.1007/s00520-020-05967-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/22/2020] [Indexed: 10/26/2022]
Abstract
BACKGROUND Multimorbidity is highly prevalent in older adults, both those with and without cancer, and is associated with an increased risk of mortality. The aim of this study was to investigate if multimorbidity measures in geriatric rehabilitation inpatients differ in their association with mortality, dependent on a diagnosis of cancer. METHODS REStORing health of acutely unwell adulTs (RESORT) is an ongoing longitudinal inception cohort of geriatric rehabilitation inpatients. Comorbidity was measured at admission using the Charlson Comorbidity Index (CCI), age-adjusted CCI (CCI-A), Cumulative Illness Rating Scale-Geriatrics (CIRS-G) and the CIRS-G severity index. Patients were allocated to a cancer status group (no cancer, history of cancer, or active cancer). The association of comorbidity indices with mortality was analyzed using Cox regression analyses. RESULTS Of the 693 patients (mean age 82.2 ± 7.5 years), 523 (75.4%) had no history of cancer, 96 (13.9%) past cancer, and 74 (10.7%) active cancer. Three months post-discharge, patients with active cancer had a higher mortality risk compared to patients with no cancer (HR = 3.57, 95% CI 2.03-6.23). CCI and CCI-A scores were significantly associated with higher mortality risk in all cancer status groups. CONCLUSION In geriatric rehabilitation patients, incremental CCI and CCI-A scores were associated with higher mortality in all three cancer status groups. However, patients with active cancer had a significantly higher 3-month mortality compared to those with no or past cancer, and this is likely determined by the advanced nature of the malignancies in this group.
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Liu H, Wu X, Cao J, Jiao J, Zhu C, Song B, Jin J, Liu Y, Wen X, Cheng S. Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay and Mortality Among Immobile Hemorrhagic Stroke Patients Younger Than 50 Years. Front Neurol 2020; 11:487. [PMID: 32625159 PMCID: PMC7314940 DOI: 10.3389/fneur.2020.00487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/04/2020] [Indexed: 12/17/2022] Open
Abstract
Objective: The burden of comorbidity among young patients with hemorrhagic stroke is high. This study examines the effect of comorbidity on the length of stay (LoS) and mortality among immobile hemorrhagic stroke patients younger than 50 years. Materials and Methods: A retrospective post-hoc analysis study design was used. A total of 767 younger adults (mean age 41.64 ± 8.16 years) hospitalized for hemorrhagic stroke between November 2015 and July 2017 were evaluated. All-cause mortality was recorded for 90 days after admission regardless of whether death occurred before or after discharge. Comorbidity was assessed using the Charlson Comorbidity Index (CCI), categorized as low (0–1) and high (≥2). A multiple linear regression model was applied to examine the association between CCI and LoS. Survival was evaluated with Kaplan–Meier and Cox regression analyses. Results: The mean CCI of all patients was 1.25 (SD ± 0.79) and median was 1.0 (IQR 1, 1). The average LoS for patients with a low CCI was 17.73 (± 11.59) days compared with 19.49 (± 15.21) days in those with a high CCI (p = 0.142). The mortality rate was 6.0% (12.10% for high CCI vs. 4.82% for low CCI, p = 0.002). After controlling for confounders, high CCI was not associated with longer LoS (regression coefficient 0.825, 95% CI −1.155 to 2.805; p = 0.413), whereas high CCI was associated with greater likelihood of death than a low CCI (hazard ratio 3.417, 95% CI 1.626 to 7.180; p = 0.001). Conclusions: High global comorbidity was associated with increased short-term mortality but not with LoS. Measures to manage comorbidities aimed at reducing negative clinical impacts of stroke among younger adults are warranted.
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Affiliation(s)
- Hongpeng Liu
- Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Xinjuan Wu
- Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Jing Cao
- Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Jing Jiao
- Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Chen Zhu
- Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Baoyun Song
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jingfen Jin
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yilan Liu
- Department of Nursing, Wuhan Union Hospital, Wuhan, China
| | - Xianxiu Wen
- Department of Nursing, Sichuan Provincial People's Hospital, Chengdu, China
| | - Shouzhen Cheng
- Department of Nursing, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Kabboord AD, Godfrey D, Gordon AL, Gladman JRF, Van Eijk M, van Balen R, Achterberg WP. The modified functional comorbidity index performed better than the Charlson index and original functional comorbidity index in predicting functional outcome in geriatric rehabilitation: a prospective observational study. BMC Geriatr 2020; 20:114. [PMID: 32223742 PMCID: PMC7104537 DOI: 10.1186/s12877-020-1498-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background In the inpatient rehabilitation of older patients, estimating to what extent the patient may functionally recover (functional prognosis), is important to plan the rehabilitation programme and aid discharge planning. Comorbidity is very common in older patients. However, the role of comorbidity in making a functional prognosis is not clearly defined. The aim of this study was to investigate a modified and weighted Functional Comorbidity Index (w-FCI) in relation to functional recovery and compare its predictive performance with that of the Charlson comorbidity index (CCI) and the original Functional Comorbidity Index (FCI). Methods The COOPERATION study (Comorbidity and Outcomes of Older Patients Evaluated in RehabilitATION) is a prospective observational cohort study. Data of patients that were admitted in an inpatient geriatric rehabilitation facility in the UK between January and September 2017, were collected. The outcome measures were: the Elderly Mobility Scale (EMS) and Barthel index (BI) at discharge, EMS gain/day and BI gain/day. Baseline comorbidity was assessed using the CCI, the FCI and the w-FCI. Correlations, receiver operating curves (ROC), and multiple linear regression analyses were performed. The models were adjusted for age, gender and EMS or BI on admission. Results In total, 98 patients (mean age 82 years; 37% male) were included. The areas under the ROC curves of the w-FCI (EMS at discharge: 0.72, EMS gain/day: 0.72, BI at discharge: 0.66 and BI gain/day: 0.60) were higher than for the CCI (0.50, 0.53, 0.49, 0.44 respectively) and FCI (0.65, 0.55, 0.60, 0.49 respectively). The w-FCI was independently associated with EMS at discharge (20.7% of variance explained (PVE), p < 0.001), EMS gain/day (11.2PVE, p < 0.001), and BI at discharge (18.3 PVE, p < 0.001). The FCI was only associated with EMS gain/day (3.9 PVE, p < 0.05). None of the comorbidity indices contributed significantly to BI gain/day (w-FCI: 2.4 PVE, p > 0.05). Conclusions The w-FCI was predictive of mobility & function at discharge and mobility gain per day, and outperformed the original FCI and the CCI. The w-FCI could be useful in assessing comorbidity in a personalised way and aid functional prognosis at the start of rehabilitation.
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Affiliation(s)
- Anouk D Kabboord
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands.
| | - Deborah Godfrey
- Lings Bar Hospital, Nottingham Healthcare NHS Trust, Nottingham, UK
| | - Adam L Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.,Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK.,CLAHRC East Midlands, Nottingham, UK.,University Hospitals of Derby and Burton University Hospitals NHS Foundation Trust, Derby, UK
| | - John R F Gladman
- Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK.,CLAHRC East Midlands, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Monica Van Eijk
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands.,Department of Old-Age Medicine Hubertusduin, HMC Bronovo, The Hague, the Netherlands
| | - Romke van Balen
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands
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What is geriatric rehabilitation and how should it be organized? A Delphi study aimed at reaching European consensus. Eur Geriatr Med 2019; 10:977-987. [DOI: 10.1007/s41999-019-00244-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/17/2019] [Indexed: 01/17/2023]
Abstract
Abstract
Purpose
Many European countries have developed services to rehabilitate the increasing number of older people who experience an acute or subacute decrease in function after a medical event such as a hip fracture or stroke. However, there are important differences between countries regarding patient selection, organization of services, length of stay, and content of the rehabilitation process. The lack of consensus around, and quality criteria for, geriatric rehabilitation limits opportunities for exchange of best practice and scientific research.
Methods
33 experts, mostly geriatricians with experience in geriatric rehabilitation, from 18 European countries were invited to participate in a modified Delphi study. They were asked to react to 68 statements using a five-point Likert scale. The statements were formulated on the basis of literature review and practice experience, and were initially piloted among Dutch elderly care physicians. Consensus was defined beforehand as an Interquartile Range (IQR) of </= 1 for each statement.
Results
Consensus was reached on 61 (90%) statements after two rounds. The resulting consensus covers: the need for a multidisciplinary approach to Geriatric Rehabilitation after CGA; inclusion of patients with temporary confusion or cognitive decline; use of structured goal-oriented rehabilitation plans; the necessity of an early start of rehabilitation; preference for ambulatory rehabilitation or Geriatric Rehabilitation at home; the advantage of protocolled treatment programs; the need for consensus on patient outcome assessment instruments; and education and training in Geriatric Rehabilitation for healthcare professionals.
Conclusion
These consensus statements provide a first step towards more coherent organization and delivery of geriatric rehabilitation across Europe.
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Szybalska A, Broczek K, Slusarczyk P, Kozdron E, Chudek J, Puzianowska-Kuznicka M, Kostka T, Skalska A, Mossakowska M. Utilization of medical rehabilitation services among older Poles: results of the PolSenior study. Eur Geriatr Med 2018; 9:669-677. [PMID: 30294398 PMCID: PMC6153710 DOI: 10.1007/s41999-018-0077-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/07/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rehabilitation tailored to older adults' needs might improve their functional performance and quality of life, as well as increase social participation. The aim of the study was to evaluate the use of medical rehabilitation services among older Poles in relation to socio-economic and health-related determinants. MATERIALS AND METHODS Data regarding medical rehabilitation were obtained from the nationwide, multidisciplinary PolSenior project (2007-2012) conducted on representative sample of 4813 respondents (48.3% women) aged 65+ years. Socio-economic status, physical functioning, falls, chronic pain, and formal disability occurrence, as well as self-rated health were accounted for. RESULTS One in six respondents (18.9% women vs. 15.8% men, p < 0.005) underwent medical rehabilitation during 12 months prior to the survey. Respondents mostly received electrotherapy or light radiation therapy (61.3%). Multivariate logistic regression analysis revealed that women aged 80+ years and men aged 90+ years had a significantly lower chance of using rehabilitation services compared to the youngest study participants (65-69 y.o.). City dwellers used rehabilitation services nearly twice as frequently as rural dwellers. Respondents with university education level were most likely to take part in these services. Dependence in IADL decreased participation in medical rehabilitation, while formal disability and chronic pain promoted utilization of rehabilitation services. CONCLUSIONS Younger age, city dwelling, higher education, functional independence, formal disability certificate, and chronic pain increased participation in medical rehabilitation. Such results of the study should be considered in planning actions towards reducing health inequalities at the national level and promoting health and well-being among older adults.
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Affiliation(s)
- Aleksandra Szybalska
- International Institute of Molecular and Cell Biology in Warsaw, 4 Ks. Trojdena Street, 02-109, Warsaw, Poland.
| | - Katarzyna Broczek
- Department of Geriatrics, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Slusarczyk
- International Institute of Molecular and Cell Biology in Warsaw, 4 Ks. Trojdena Street, 02-109, Warsaw, Poland
| | - Ewa Kozdron
- Department of Recreation Methodology, Faculty of Tourism and Recreation, Jozef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Monika Puzianowska-Kuznicka
- Department of Human Epigenetics, Mossakowski Medical Research Centre, PAS, Warsaw, Poland
- Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Medical University of Lodz, Lodz, Poland
| | - Anna Skalska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Cracow, Poland
| | - Malgorzata Mossakowska
- International Institute of Molecular and Cell Biology in Warsaw, 4 Ks. Trojdena Street, 02-109, Warsaw, Poland
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