1
|
Koga HK, Grodstein F, Williams DR, Demeo DL, Kubzansky LD. Relations of optimism and purpose in life to immune markers in aging. J Psychosom Res 2024; 184:111851. [PMID: 38964200 DOI: 10.1016/j.jpsychores.2024.111851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 06/13/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE Optimism and purpose in life are associated with improved health outcomes. More information is needed on biological mechanisms, including immunosenescence. We investigated if psychological well-being is associated with healthier immunosenescence-related measures including naïve and terminally differentiated CD4+ and CD8+ T cell percentages, CD4+:CD8+, and cytomegalovirus (CMV) IgG response. METHODS Participants were adults over age 50 from the Health and Retirement Study. Optimism was measured using the Life Orientation Test Revised. Purpose in life was assessed using the subscale from the Ryff psychological well-being measure. We examined the cross-sectional associations of optimism and purpose in life with measures of T cell subsets using linear regression and with CMV IgG using ordered logit regression, controlling for potential confounding factors. RESULTS The final analytic sample ranged from 7250 to 7870. After adjusting for sociodemographic factors, a 1-SD increment in optimism was associated with the percentage of naïve CD4+ T cells increasing by 0.6 (95%CI 0.2%, 1.0%). A 1-SD increment in purpose in life was associated with the percentage of naïve CD4+ T cells increasing by 0.9 (95%CI 0.5%, 1.3%) after adjusting for sociodemographic factors and the association was maintained after further adjustments for health conditions, depression, and health behaviors. For naïve CD8+ T cell percentages, CD4:CD8 ratios, and CMV IgG antibodies, associations were seen only in models that adjusted for age. No significant associations were seen in any models for the terminally differentiated CD4+ and CD8+ T cells. CONCLUSIONS We found associations of optimism and purpose in life with naïve CD4+ T cell percentages.
Collapse
Affiliation(s)
- Hayami K Koga
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Harvard Center for Population and Development Studies, Cambridge, MA, United States of America.
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States of America
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Department of African and African American Studies, Department of Sociology, Harvard University, Cambridge, MA, United States of America
| | - Dawn L Demeo
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| |
Collapse
|
2
|
Angelsen A, Nakrem S, Zotcheva E, Strand BH, Strand LB. Health-promoting behaviors in older adulthood and intrinsic capacity 10 years later: the HUNT study. BMC Public Health 2024; 24:284. [PMID: 38267907 PMCID: PMC10809656 DOI: 10.1186/s12889-024-17840-3] [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: 11/03/2023] [Accepted: 01/22/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND With the global population growing older, there is a need for more knowledge of how to improve and/or maintain functional capacities to promote healthy ageing. In this study we aimed to assess the effect of several known health-promoting behaviors in old age with intrinsic capacity ten years later. METHODS This was a prospective cohort study looking at participants that were ≥ 65 years at the time of the third wave of the Trøndelag Health Study (HUNT3, 2006-2008) who also took part in the 70 + sub-study of the fourth wave (HUNT4 70+, 2017-2019). Self-reported behavior data from short questionnaires, including diet and physical activity, were collected in HUNT3, and data on the five domains of intrinsic capacity defined by the World Health Organization were collected in HUNT4 70+. A composite index was created for both healthy life and intrinsic capacity, awarding points for how well participants adhered to guidelines for healthy living and their level of functional impairment, respectively. Ordinal logistic regression was used to assess the relationship between health-promoting behaviors and intrinsic capacity. RESULTS Of 12,361 participants in HUNT3 ≥ 65 years, 4699 (56.5% women) also participated in HUNT4 70+. On the health-promoting behaviors, lowest adherence to healthy living guidelines were seen for fruit and vegetables intake (47.2%), milk intake (46.7%) and physical activity (31.1%). On intrinsic capacity domains, highest impairment was seen in the domains of locomotion (29.7%), hearing (11.1%) and vitality (8.3%). A higher adherence to guidelines for healthy living was associated with higher intrinsic capacity 10 years later. A one-point increase in the healthy life index was associated with a 1.15 (95% confidence interval 1.10-1.21) times increased odds of being in a higher intrinsic capacity category. CONCLUSION Health-promoting behaviors in old age are associated with better intrinsic capacity ten years later. In clinical settings assessment of health-promoting behaviors could potentially be done using short questionnaires.
Collapse
Affiliation(s)
- Aslaug Angelsen
- Norwegian University of Science and Technology, Trondheim, Norway.
| | - Sigrid Nakrem
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | |
Collapse
|
3
|
Holtz AV, Fink A, Tamgüney G, Doblhammer G. Colonoscopy and Subsequent Risk of Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:747-760. [PMID: 38669559 PMCID: PMC11191466 DOI: 10.3233/jpd-240017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Background Parkinson's disease (PD) is caused by the misfolding and aggregation of α-synuclein in neurons into toxic oligomers and fibrils that have prion-like properties allowing them to infect healthy neurons and to be transmitted to animal models of PD by injection or oral exposure. Given α-synuclein fibrils' potential transmission on the gut-brain axis, α-synuclein may be transmitted through colonoscopy procedures. Objective This study examines a possible association between colonoscopy and PD. Methods Longitudinal health insurance data of 250,000 individuals aged 50+ from 2004-2019 was analyzed. Cox proportional hazard and competing risk models with death as a competing event were estimated to calculate the risk of PD. Colonoscopy was categorized as never receiving colonoscopy, colorectal cancer (CRC) screening without or with biopsy, destruction or excision (BDE), and diagnostic colonoscopy without or with BDE. Results We identified 6,422 new cases of PD among 221,582 individuals. The Cox model revealed a significantly increased risk of PD for patients who ever had a diagnostic colonoscopy without or with BDE (HR = 1.31; 95% CI: [1.23-1.40]; HR = 1.32 [1.22-1.42]) after adjustment for age and sex. After controlling for covariates and death, persons who ever underwent CRC screening had a 40% reduced risk of PD (CRHR = 0.60 [0.54-0.67]), while persons who underwent diagnostic colonoscopy had a 20% reduced risk of PD (CRHR = 0.81 [0.75-0.88]). Conclusions Colonoscopy does not increase the risk of PD, after adjusting for death and covariates. Individuals who underwent only CRC screening had the lowest risk of PD, which may be a result of a more health-conscious lifestyle.
Collapse
Affiliation(s)
- Anna-Victoria Holtz
- German Center for Neurodegenerative Diseases(DZNE), Demographic Studies, Bonn, Germany
- University of Rostock, Institute for Sociology and Demography, Rostock, Germany
| | - Anne Fink
- German Center for Neurodegenerative Diseases(DZNE), Demographic Studies, Bonn, Germany
| | - Gültekin Tamgüney
- Forschungszentrum Jülich, Institute of Biological Information Processing – Structural Biochemistry (IBI-7), Jülich, Germany
- Mathematisch-Naturwissenschaftliche Fakultät, Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Gabriele Doblhammer
- German Center for Neurodegenerative Diseases(DZNE), Demographic Studies, Bonn, Germany
- University of Rostock, Institute for Sociology and Demography, Rostock, Germany
| |
Collapse
|
4
|
Konswa AA, Alolaiwi L, Alsakkak M, Aleissa M, Alotaibi A, Alanazi FF, Rasheed AB. Experience of establishing a lifestyle medicine clinic at primary care level- challenges and lessons learnt. J Taibah Univ Med Sci 2023; 18:1364-1372. [PMID: 37305027 PMCID: PMC10248871 DOI: 10.1016/j.jtumed.2023.05.001] [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: 12/29/2022] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
On an international level, for more than 30 years, Lifestyle Medicine (LSM) Practice has had a great impact on both health Promotion and disease prevention. A practice which on a national KSA level, we are in eager need to adopt, due to the high prevalence of chronic diseases and unhealthy lifestyles. The establishment of the LSM clinic inside the Wazarat Health Center (WHC) more than one and half year ago, was a great advancement towards offering very important preventive and promotive services for people in real high need to these underutilized main elements in Primary Health Care (PHC) features. We identified quality oriented Key Performance Indicators and the clinically important outcomes for our patients. Our initial data showed great achievement on both fronts. We are currently studying the satisfaction of our customers and working on improving their level of health awareness and help seeking behavior. Furthermore, we are looking to benchmark our results. From our pilot project in WHC, we are preparing for an expansion plan to branch out other Primary Care centers in the Riyadh area to serve more people, and we aim to share the experience with other similar services and within the PHC centers allover KSA.
Collapse
Affiliation(s)
| | - Lina Alolaiwi
- Family Medicine Department at Prince Sultan Military Medical City, KSA
- Saudi Board of Family Medicine, KSA
| | | | - Mohamed Aleissa
- Saudi Board of Family Medicine, KSA
- CIC& LSM Clinics, Prince Sultan Military Medical City, KSA
| | - Azzam Alotaibi
- Saudi Board of Family Medicine, KSA
- Al-Wazarat Health Center, Prince Sultan Military Medical City, KSA
| | | | - Abdulaziz bin Rasheed
- Saudi Board of Family Medicine, KSA
- Family Medicine Administration at Prince Sultan Military Medical City, KSA
| |
Collapse
|
5
|
Robb C, Carr PR, Ball J, Owen A, Beilin LJ, Newman AB, Nelson MR, Reid CM, Orchard SG, Neumann JT, Tonkin AM, Wolfe R, McNeil JJ. Association of a healthy lifestyle with mortality in older people. BMC Geriatr 2023; 23:646. [PMID: 37821846 PMCID: PMC10568769 DOI: 10.1186/s12877-023-04247-9] [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: 02/02/2023] [Accepted: 08/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Unhealthy lifestyle behaviours such as smoking, high alcohol consumption, poor diet or low physical activity are associated with morbidity and mortality. Public health guidelines provide recommendations for adherence to these four factors, however, their relationship to the health of older people is less certain. METHODS The study involved 11,340 Australian participants (median age 7.39 [Interquartile Range (IQR) 71.7, 77.3]) from the ASPirin in Reducing Events in the Elderly study, followed for a median of 6.8 years (IQR: 5.7, 7.9). We investigated whether a point-based lifestyle score based on adherence to guidelines for a healthy diet, physical activity, non-smoking and moderate alcohol consumption was associated with subsequent all-cause and cause-specific mortality. RESULTS In multivariable adjusted models, compared to those in the unfavourable lifestyle group, individuals in the moderate lifestyle group (Hazard Ratio (HR) 0.73 [95% CI 0.61, 0.88]) and favourable lifestyle group (HR 0.68 [95% CI 0.56, 0.83]) had lower risk of all-cause mortality. A similar pattern was observed for cardiovascular related mortality and non-cancer/non-cardiovascular related mortality. There was no association of lifestyle with cancer-related mortality. CONCLUSIONS In a large cohort of initially healthy older people, reported adherence to a healthy lifestyle is associated with reduced risk of all-cause and cause-specific mortality. Adherence to all four lifestyle factors resulted in the strongest protection.
Collapse
Affiliation(s)
- Catherine Robb
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia.
| | - Prudence R Carr
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
| | - Jocasta Ball
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
| | - Lawrence J Beilin
- School of Medicine, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Anne B Newman
- Department of Epidemiology, Centre for Aging and Population Health, University of Pittsburgh, Pittsburgh, USA
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
| | - Johannes T Neumann
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
- German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Andrew M Tonkin
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road , Melbourne, Victoria, 3004, Australia
| |
Collapse
|
6
|
Robb C, Carr P, Ball J, Owen A, Beilin LJ, Newman AB, Nelson MR, Reid CM, Orchard SG, Neumann JT, Tonkin AM, Wolfe R, McNeil JJ. Association of a Healthy Lifestyle with Mortality in Older People. RESEARCH SQUARE 2023:rs.3.rs-2541145. [PMID: 36993471 PMCID: PMC10055537 DOI: 10.21203/rs.3.rs-2541145/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Background Unhealthy lifestyle behaviours such as smoking, high alcohol consumption, poor diet or low physical activity are associated with morbidity and premature mortality. Public health guidelines provide recommendations for adherence to these four factors, however, their impact on the health of older people is less certain. Methods The study involved 11,340 Australian participants (median age 7.39 [Interquartile Range (IQR) 71.7, 77.3]) from the ASPirin in Reducing Events in the Elderly study, followed for a median of 6.8 years (IQR: 5.7, 7.9). We investigated whether a point-based lifestyle score based on adherence to guidelines for a healthy diet, physical activity, non-smoking and moderate alcohol consumption was associated with all-cause and cause-specific mortality. Results In multivariable adjusted models, compared to those in the unfavourable lifestyle group, individuals in the moderate lifestyle group (Hazard Ratio (HR) 0.73 [95% CI 0.61, 0.88]) and favourable lifestyle group (HR 0.68 [95% CI 0.56, 0.83]) had lower risk of all-cause mortality. A similar pattern was observed for cardiovascular related mortality and non-cancer/non-cardiovascular related mortality. There was no association of lifestyle with cancer-related mortality. Stratified analysis indicated larger effect sizes among males, those ≤ 73 years old and among those in the aspirin treatment group. Conclusions In a large cohort of initially healthy older people, reported adherence to a healthy lifestyle is associated with reduced risk of all-cause and cause-specific mortality.
Collapse
|
7
|
Bluethmann SM, Flores E, Grotte M, Heitzenrater J, Truica CI, Olsen NJ, Sciamanna C, Schmitz KH. Adapting an Evidence-Based Exercise and Education Program for Older Breast Cancer Survivors for the REJOIN Trial. J Aging Phys Act 2023; 31:59-67. [PMID: 35700977 PMCID: PMC10903157 DOI: 10.1123/japa.2022-0013] [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: 01/10/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 02/03/2023]
Abstract
Physical activity (PA) promotes survival and mitigates symptoms in older breast cancer survivors (BCS), especially to reduce joint pain associated with adjuvant hormonal treatment. The purpose is to describe the adaptation process for an evidence-based exercise and education curriculum (i.e., Fit & Strong!) to support older BCS participating in the Using Exercise to Relieve Joint Pain and Improve Aromatase Inhibitor Adherence in Older Breast Cancer Survivors trial. We reviewed all educational materials with scientific/clinical experts to identify necessary content changes. Next, we conducted semistructured phone interviews with BCS to review all educational materials and conducted a real-time pretest for the trial. Overall, BCS found the adapted materials and experience acceptable (mean score of 9.2/10 for satisfaction). Content changes included simplifying exercise instructions, prioritizing content related to the trial goals, and updating photographs. Because of COVID, the pretest was conducted via Zoom. Our multistep adaptation process provided an acceptable intervention to meet the needs of older BCS. Lessons learned will be applied to the forthcoming pilot trial.
Collapse
Affiliation(s)
- Shirley M Bluethmann
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
| | - Eileen Flores
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
| | - Meghan Grotte
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Jared Heitzenrater
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Cristina I Truica
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
- Department of Medicine, Milton S. Hershey Medical Center, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Nancy J Olsen
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
- Department of Medicine, Milton S. Hershey Medical Center, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Christopher Sciamanna
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Department of Medicine, Milton S. Hershey Medical Center, The Pennsylvania State University College of Medicine, Hershey, PA,USA
| | - Kathryn H Schmitz
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA,USA
- Milton S. Hershey Medical Center, Cancer Institute, The Pennsylvania State University, Hershey, PA,USA
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, State College, Hershey, PA,USA
| |
Collapse
|
8
|
Yi H, Ng ST, Chang CM, Low CXE, Tan CS. Effects of neighborhood features on healthy aging in place: the composition and context of urban parks and traditional local coffeeshops in Singapore. BMC Geriatr 2022; 22:969. [PMID: 36522627 PMCID: PMC9753030 DOI: 10.1186/s12877-022-03679-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Healthy aging in place is affected by what the neighborhood provides for older adults. The mixed-methods ethnographic study explored the built environmental and contextual effects of urban parks and traditional local coffeeshops (kopitiam) on health practices among older adults in Singapore. METHODS A door-to-door survey with 497 older adults from 32 residential blocks in a public housing town assessed exercise and smoking. The walking distances from the residential blocks to the facilities were calculated. Regression analysis examined the associations between the distance and rates of exercise and smoking. Ethnographic assessment data contextualized the quantitative findings. RESULTS Older adults' exercise was associated with proximity to an urban park but not traditional local coffeeshops. High rates of smoking were clustered in the housing blocks close to the coffeeshops, which provided casual drinking places with smoking tables. The proximity to the coffeeshops was significantly associated with increased smoking and decreased exercise. A walking distance of 200 m to the park and coffeeshops was found to discriminate the outcomes. CONCLUSIONS The findings suggested that walking distances of a few blocks influenced health behaviors among older adults. Their smoking habits appeared to be maintained through environmental features and cultural norms attached to the coffeeshops. Policy of urban planning and redevelopment for the aging population needs to consider the socioecology of healthy aging in place.
Collapse
Affiliation(s)
- Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
| | - Shu Tian Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheng Mun Chang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheryl Xue Er Low
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| |
Collapse
|
9
|
Hautekiet P, Saenen ND, Martens DS, Debay M, Van der Heyden J, Nawrot TS, De Clercq EM. A healthy lifestyle is positively associated with mental health and well-being and core markers in ageing. BMC Med 2022; 20:328. [PMID: 36171556 PMCID: PMC9520873 DOI: 10.1186/s12916-022-02524-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Studies often evaluate mental health and well-being in association with individual health behaviours although evaluating multiple health behaviours that co-occur in real life may reveal important insights into the overall association. Also, the underlying pathways of how lifestyle might affect our health are still under debate. Here, we studied the mediation of different health behaviours or lifestyle factors on mental health and its effect on core markers of ageing: telomere length (TL) and mitochondrial DNA content (mtDNAc). METHODS In this study, 6054 adults from the 2018 Belgian Health Interview Survey (BHIS) were included. Mental health and well-being outcomes included psychological and severe psychological distress, vitality, life satisfaction, self-perceived health, depressive and generalised anxiety disorder and suicidal ideation. A lifestyle score integrating diet, physical activity, smoking status, alcohol consumption and BMI was created and validated. On a subset of 739 participants, leucocyte TL and mtDNAc were assessed using qPCR. Generalised linear mixed models were used while adjusting for a priori chosen covariates. RESULTS The average age (SD) of the study population was 49.9 (17.5) years, and 48.8% were men. A one-point increment in the lifestyle score was associated with lower odds (ranging from 0.56 to 0.74) for all studied mental health outcomes and with a 1.74% (95% CI: 0.11, 3.40%) longer TL and 4.07% (95% CI: 2.01, 6.17%) higher mtDNAc. Psychological distress and suicidal ideation were associated with a lower mtDNAc of - 4.62% (95% CI: - 8.85, - 0.20%) and - 7.83% (95% CI: - 14.77, - 0.34%), respectively. No associations were found between mental health and TL. CONCLUSIONS In this large-scale study, we showed the positive association between a healthy lifestyle and both biological ageing and different dimensions of mental health and well-being. We also indicated that living a healthy lifestyle contributes to more favourable biological ageing.
Collapse
Affiliation(s)
- Pauline Hautekiet
- Sciensano, Risk and Health Impact Assessment, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium. .,Centre for Environmental Sciences, Hasselt University, 3500, Hasselt, Belgium.
| | - Nelly D Saenen
- Sciensano, Risk and Health Impact Assessment, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium.,Centre for Environmental Sciences, Hasselt University, 3500, Hasselt, Belgium
| | - Dries S Martens
- Centre for Environmental Sciences, Hasselt University, 3500, Hasselt, Belgium
| | - Margot Debay
- Centre for Environmental Sciences, Hasselt University, 3500, Hasselt, Belgium
| | - Johan Van der Heyden
- Sciensano, Epidemiology and Public Health, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, 3500, Hasselt, Belgium.,Centre for Environment and Health, Leuven University, 3000, Leuven, Belgium
| | - Eva M De Clercq
- Sciensano, Risk and Health Impact Assessment, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| |
Collapse
|
10
|
Fernández-Ballesteros R, Valeriano-Lorenzo E, Sánchez-Izquierdo M, Botella J. Behavioral Lifestyles and Survival: A Meta-Analysis. Front Psychol 2022; 12:786491. [PMID: 35185686 PMCID: PMC8854179 DOI: 10.3389/fpsyg.2021.786491] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the study is to determine the association between Behavioral Lifestyles (regular physical activity, healthy diet, sleeping, and weight control) and longevity in the elderly. A search strategy was conducted in the PsycInfo, Medline, PubMed, Web of Science (WoS), and Scopus databases. The primary outcome was mortality/survival. Four variables (mean of participant's age at the baseline of the study, follow-up years of the study, gender, and year of publication) were analyzed to evaluate the role of potential moderators. Ninety-three articles, totaling more than 2,800,000 people, were included in the meta-analysis. We found that the lifestyles analyzed predict greater survival. Specifically, doing regular physical activity, engaging in leisure activities, sleeping 7-8 h a day, and staying outside the BMI ranges considered as underweight or obesity are habits that each separately has a greater probability associated with survival after a period of several years.
Collapse
Affiliation(s)
| | | | | | - Juan Botella
- Department of Social Psychology and Methodology, Autonomous University of Madrid, Madrid, Spain
| |
Collapse
|
11
|
Raina P, Ali MU, Joshi D, Gilsing A, Mayhew A, Ma J, Sherifali D, Thompson M, Griffith LE. The combined effect of behavioural risk factors on disability in aging adults from the Canadian Longitudinal Study on Aging (CLSA). Prev Med 2021; 149:106609. [PMID: 33984371 DOI: 10.1016/j.ypmed.2021.106609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/19/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022]
Abstract
The objective of this study was to explore how behavioural risk factors (smoking, physical activity, and nutrition) cluster together and assess how clusters of behavioural risk factors are associated with functional disability by age and sex at the individual and population level. We used currently available baseline cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The CLSA is a national, population-based longitudinal study established to understand and examine health of an aging population. This study included 51,338 Canadian men and women aged 45 to 85 years residing in the community in 10 Canadian provinces. Behavioural risk factors included smoking, physical activity, and nutrition. The main outcome used in the study was functional disability, which was assessed using a questionnaire adapted from the Older Americans Resources and Services Multidimensional Assessment Questionnaire. In this analyses of unique combinations of the risk factors of smoking, physical activity, and nutritional risk, the magnitude of the association of the behavioural risk factors with functional disability was dependent on which risk factors were included and differed by age and sex strata. Of the risk factors, physical activity accounted for between 70% to 90% of the total population level risk in individuals with all three risk factors, suggesting it is a key driver of the population burden of disability. Together, these results show that considering unique clusters of risk factors, as well as age and sex, is essential for tailoring public health strategies to reduce the burden of disability among aging populations.
Collapse
Affiliation(s)
- Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada.
| | - Muhammad Usman Ali
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Anne Gilsing
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Diana Sherifali
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; School of Nursing, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Mary Thompson
- Department of Statistics & Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
12
|
Kim AR, Park HY. Theme Trends and Knowledge-Relationship in Lifestyle Research: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7503. [PMID: 34299955 PMCID: PMC8306612 DOI: 10.3390/ijerph18147503] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 12/15/2022]
Abstract
Healthy living habits (healthy eating, regular physical activity, abstinence from smoking, restrictions on alcohol consumption, and stress management) can help prevent a significant number of diseases. The purpose of this study is to use a bibliometric analysis to analyze the relationships between countries, institutions and authors through lifestyle studies from 2016 to 2020 to find out the latest research trends. This study utilized bibliometric data collected through Scopus including thesis titles, authors, agencies, countries/regions, publication years, and keywords. Data were analyzed using the VOS viewer (Vers. 1.6.13; Leiden University, Leiden, The Netherlands) and the findings were used to visualize similarity mapping techniques. Publication of lifestyle-related research papers has steadily increased between 2016 and 2020. The country/region most actively conducting such research was the United States, also home to the majority of institutions conducting work in the field. PloS ONE published the most lifestyle-related research under the field of Medicine. Identified keywords were related to risk measures, psychosocial factors, prevention, health promotion, and risk factors. Lifestyle research is a promising field of research worldwide and has great potential to improve human health, the environment, and quality of life. The findings are expected to promote future research and give direction to the advancement of the field of research by comprehensively analyzing and summarizing lifestyle research trends.
Collapse
Affiliation(s)
- Ah-Ram Kim
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju 26493, Korea;
| | - Hae Yean Park
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju 26493, Korea
| |
Collapse
|
13
|
Krittanawong C, Kaplin S, Tang WHW, Jneid H, Virani SS, Messerli FH. Social media and predictive analysis regarding dietary approaches to stop hypertension. Prog Cardiovasc Dis 2021; 68:88-90. [PMID: 34245778 DOI: 10.1016/j.pcad.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Chayakrit Krittanawong
- The Michael E. DeBakey VA Medical Center, Houston, TX, USA; Section of Cardiology, Baylor College of Medicine, Houston, TX, USA.
| | - Scott Kaplin
- Department of Cardiovascular Medicine, NYU Langone - Long Island, Mineola, NY, USA
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Hani Jneid
- The Michael E. DeBakey VA Medical Center, Houston, TX, USA; Section of Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - Salim S Virani
- The Michael E. DeBakey VA Medical Center, Houston, TX, USA; Section of Cardiology, Baylor College of Medicine, Houston, TX, USA
| | - Franz H Messerli
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY, USA; University of Bern, Switzerland; Jagiellonian University Krakow, Poland
| |
Collapse
|
14
|
Therkildsen P, Nielsen BD, de Thurah A, Hansen IT, Nørgaard M, Hauge EM. All-cause and cause-specific mortality in patients with giant cell arteritis: a nationwide, population-based cohort study. Rheumatology (Oxford) 2021; 61:1195-1203. [PMID: 34164660 DOI: 10.1093/rheumatology/keab507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/11/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To investigate whether giant cell arteritis (GCA) is associated with increased all-cause and cause-specific mortality. METHODS A nationwide, population-based cohort study in Denmark using medical and administrative registries. GCA cases were defined as patients aged ≥50 years from 1996-2018 with a first-time discharge diagnosis of GCA and ≥3 prescriptions for prednisolone within 6 months following diagnosis. Each GCA patient was matched based on age, sex and calendar time to 10 persons without a history of GCA. Index date was the date for the third prednisolone prescription. We used a pseudo-observation approach to calculate all-cause and cause-specific mortality, adjusted risk differences (RDs) and relative risks (RRs). RESULTS We included 9908 GCA patients and 98204 persons from the general population. The median time for GCA patients to redeem the third prednisolone prescription was 74 days (IQR: 49-106). Among GCA patients, the overall mortality was 6.4% (95% CI: 5.9-6.9) 1 year after index date and 45% (95% CI: 44-47) after 10 years. Compared to the reference cohort, adjusted RDs and RRs of deaths in the GCA cohort were 2.2% (95% CI: 1.7-2.7) and 1.49 (95% CI: 1.36-1.64) after 1 year, and 2.1% (95% CI: 1.0-3.3) and 1.03 (95% CI: 1.00-1.05) 10 years after index date. GCA patients had a higher risk of death due to infectious, endocrine, cardiovascular, and gastrointestinal diseases. CONCLUSIONS GCA is associated with increased all-cause mortality, particularly within the first year following the diagnosis. Cause-specific mortality indicates that mortality in GCA may in part be due to glucocorticoid-related complications.
Collapse
Affiliation(s)
- Philip Therkildsen
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Berit Dalsgaard Nielsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Internal Medicine, Horsens Regional Hospital, Horsens, Denmark
| | - Annette de Thurah
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ib Tønder Hansen
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mette Nørgaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
15
|
Bluethmann SM, Truica C, Klepin HD, Olsen N, Sciamanna C, Chinchilli VM, Schmitz KH. Study design and methods for the using exercise to relieve joint pain and improve AI adherence in older breast cancer survivors (REJOIN) trial. J Geriatr Oncol 2021; 12:1146-1153. [PMID: 34049837 DOI: 10.1016/j.jgo.2021.05.011] [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: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Aromatase Inhibitors (AIs) are recommended for survival in post-menopausal breast cancer survivors (BCS) with hormone-sensitive disease. AI Adherence is suboptimal, especially in older BCS. Joint pain is a common AI-related symptom that is associated with low AI adherence. The Using Exercise to Relieve Joint Pain in Older Breast Cancer Survivors (REJOIN) Trial will evaluate the efficacy of a self-management intervention (exercise + education) to increase knowledge/self-efficacy for symptom management, reduce joint pain and potentially increase AI adherence in older BCS planning to take AIs. METHODS This randomized controlled pilot trial will include sedentary BCS, 65 years and older, diagnosed with stage I-III hormone-sensitive breast cancer, who have completed primary cancer treatment and are planning to initiate AIs. We will adapt an evidence-based physical activity program for older adults that includes bi-weekly, supervised exercise sessions plus 30 min of education. The 16-week intervention program includes: 8-weeks of supervised sessions plus 8-weeks of self-guided home sessions with periodic phone coaching. We will conduct geriatric assessments plus measurements of exercise, joint pain, and AI adherence (baseline, 4, 6 and 12 months). DISCUSSION REJOIN is one of the first trials to exclusively target older BCS using a self-management intervention, informed by geriatric assessment and exercise physiology, to improve health outcomes in survivorship. The REJOIN trial could lay the foundation for transdisciplinary research that bridges the gap between clinical and public health perspectives in healthy aging, with the opportunity to translate clinical interventions into non-pharmacological tools for a growing, yet underserved population of older survivors. TRIAL REGISTRATION NCT03955627.
Collapse
Affiliation(s)
- Shirley M Bluethmann
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America; Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America.
| | - Cristina Truica
- Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America; Department of Medicine, The Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America
| | - Heidi D Klepin
- Department of Internal Medicine, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Nancy Olsen
- Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America; Department of Medicine, The Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America
| | - Christopher Sciamanna
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America; Department of Medicine, The Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America
| | - Vernon M Chinchilli
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America
| | - Kathryn H Schmitz
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America; Cancer Institute, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, United States of America; Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, State College, PA, United States of America
| |
Collapse
|
16
|
Burton WN, Schultz A, Edington DW. Health and Wealth: The Importance for Lifestyle Medicine. Am J Lifestyle Med 2021; 15:407-412. [PMID: 34366738 DOI: 10.1177/15598276211005348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Many people spend years dreaming about their retirement. Unfortunately, today's workers will likely work longer, suffer greater economic uncertainty, and might have poorer health status compared with retirees in previous generations. Preserving good health during the working years is associated with a more consistent employment record, greater financial resources, and reduced risk of disease. Making smart financial decisions as a younger adult also translates to improved finances in retirement. While many people are aware of these relationships, many continue to make poor health choices. Employers and lifestyle medicine professionals can both work to improve financial well-being in retirement. Employers can offer effective worksite financial wellness programs and promote participation in retirement savings programs. Physicians and other health providers can foster healthy behaviors, encourage preventive services compliance, and help adults foster overall financial and health well-being. Adopting a healthy lifestyle as early as possible would increase the likelihood that today's workers will enjoy financial security in retirement.
Collapse
Affiliation(s)
- Wayne N Burton
- University of Illinois School of Public Health, Chicago, Illinois
| | - Alyssa Schultz
- Global Health Management Research Core, Ann Arbor, Michigan
| | | |
Collapse
|
17
|
Garcia Meneguci CA, Meneguci J, Sasaki JE, Tribess S, Júnior JSV. Physical activity, sedentary behavior and functionality in older adults: A cross-sectional path analysis. PLoS One 2021; 16:e0246275. [PMID: 33513196 PMCID: PMC7846014 DOI: 10.1371/journal.pone.0246275] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/17/2021] [Indexed: 12/17/2022] Open
Abstract
Disability is negatively associated with the health of older adults, and it can be mediated by healthy lifestyles and behaviors throughout one's life. In this context, understanding the interrelationships between sedentary behavior, physical activity and functionality may assist in the implementation of effective public health actions. Thus, the aim of the present study was to investigate the relationships between both physical activity and sedentary behavior and functionality in older adults and the possible mediators. The variables analyzed were selected according to the content analysis of International Classification of Functioning, Disability and Health model, and included activity, participation, health conditions, body functions and structures, environmental factors and personal factors. 419 individuals participated in the study. Physical activity was directly associated with disability in instrumental activities of daily living (IADL), and the association was mediated by self-esteem, aerobic endurance, and agility/balance. Sedentary behavior was indirectly associated with IADL disability, and the association was mediated by aerobic resistance, nutritional status, and agility/balance. Regarding the basic activities of daily living (BADL), physical activity showed an indirect association mediated by aerobic resistance and IADL. The association of sedentary behavior with BADL was mediated by aerobic resistance and lower limb flexibility. These results reinforce the idea that functionality is multidimensional, and the mediating factors must be considered when strategies for promoting physical activity and reducing sedentary behavior are designed.
Collapse
Affiliation(s)
| | - Joilson Meneguci
- Graduate Program in Health Care, Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil
| | - Jeffer Eidi Sasaki
- Graduate Program in Physical Education, Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil
| | - Sheilla Tribess
- Graduate Program in Physical Education, Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil
| | - Jair Sindra Virtuoso Júnior
- Graduate Program in Health Care, Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil
- Graduate Program in Physical Education, Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil
| |
Collapse
|
18
|
Mazza E, Ferro Y, Pujia R, Mare R, Maurotti S, Montalcini T, Pujia A. Mediterranean Diet In Healthy Aging. J Nutr Health Aging 2021; 25:1076-1083. [PMID: 34725664 PMCID: PMC8442641 DOI: 10.1007/s12603-021-1675-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/22/2021] [Indexed: 12/28/2022]
Abstract
The World elderly population is expected to double before 2050. Unhealthy habits and unhealthy lifestyles are commonly associated with age-related diseases or their worsening. Modification in daily lifestyle and diet may help preventing age-related diseases onset and efficiently affecting their evolution, thus promoting the Healthy Aging process, concept recently coined to describe the disease-free aging process. This review highlights the role of nutrition science in promoting healthy aging. Since the Mediterranean Model demonstrated to be a useful style in supporting healthy aging, promotion of this correct lifestyle by health policies seems to be the best approach to achieve this target.
Collapse
Affiliation(s)
- E Mazza
- Elisa Mazza, Department of Medical and Surgical Science, University Magna Grecia, Viale Europa, 88100 Catanzaro, Italy. E-mail: , telephone numbers: +3909613697231
| | | | | | | | | | | | | |
Collapse
|
19
|
Cui K, Song R, Xu H, Shang Y, Qi X, Buchman AS, Bennett DA, Xu W. Association of Cardiovascular Risk Burden With Risk and Progression of Disability: Mediating Role of Cardiovascular Disease and Cognitive Decline. J Am Heart Assoc 2020; 9:e017346. [PMID: 32869681 PMCID: PMC7726997 DOI: 10.1161/jaha.120.017346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Cardiovascular risk burden has been linked to cardiovascular disease (CVD) and cognitive decline, but its association with disability is unclear. We aimed to examined the association of cardiovascular risk burden assessed by the Framingham general cardiovascular risk score (FGCRS) with the risk and progression of disability and estimated the extent to which CVD and cognitive decline mediate this association. Methods and Results A total of 1480 older adults with no disabilities (mean age=79.32±7.38 years) from the Rush Memory and Aging Project were followed for up to 21 years. FGCRS at baseline was calculated and categorized into tertiles. Disability was assessed annually with activities of daily living. The number of CVDs was calculated by summing up the CVD events. Global cognitive function was assessed annually with a battery of 19 tests. Data were analyzed using the Cox model, linear mixed effects model, and mediation analysis. At the end of the follow-up, 713 (48.2%) participants developed disability. Compared with the lowest tertile of the FGCRS, the multiadjusted hazards ratios of disability were 1.34 (95% CI, 1.11-1.62) for the highest tertile. In addition, the highest FGCRS was associated with a change in activities of daily living score over time (β=0.057; 95% CI, 0.021-0.093). The association between FGCRS and change in activities of daily living was 13.8% mediated by the accumulation of CVDs and 25.1% by cognitive decline, respectively. Conclusions Higher cardiovascular risk burden increased the risk of disability and accelerated its progression over time. CVD accumulation and cognitive decline may partially mediate the association.
Collapse
Affiliation(s)
- Kaiwang Cui
- Department of Epidemiology and BiostatisticsSchool of Public HealthTianjin Medical UniversityTianjinChina
- Tianjin Key Laboratory of Environment, Nutrition and Public HealthTianjinChina
- Center for International Collaborative Research on Environment, Nutrition and Public HealthTianjinChina
| | - Ruixue Song
- Department of Epidemiology and BiostatisticsSchool of Public HealthTianjin Medical UniversityTianjinChina
- Tianjin Key Laboratory of Environment, Nutrition and Public HealthTianjinChina
- Center for International Collaborative Research on Environment, Nutrition and Public HealthTianjinChina
| | - Hui Xu
- Department of Epidemiology and BiostatisticsSchool of Public HealthTianjin Medical UniversityTianjinChina
- Tianjin Key Laboratory of Environment, Nutrition and Public HealthTianjinChina
- Center for International Collaborative Research on Environment, Nutrition and Public HealthTianjinChina
| | - Ying Shang
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Xiuying Qi
- Department of Epidemiology and BiostatisticsSchool of Public HealthTianjin Medical UniversityTianjinChina
- Tianjin Key Laboratory of Environment, Nutrition and Public HealthTianjinChina
- Center for International Collaborative Research on Environment, Nutrition and Public HealthTianjinChina
| | - Aron S. Buchman
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
| | - David A. Bennett
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
| | - Weili Xu
- Department of Epidemiology and BiostatisticsSchool of Public HealthTianjin Medical UniversityTianjinChina
- Tianjin Key Laboratory of Environment, Nutrition and Public HealthTianjinChina
- Center for International Collaborative Research on Environment, Nutrition and Public HealthTianjinChina
- Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
| |
Collapse
|
20
|
Murtaza B, Amjad M, Shahid M, Imran M, Shah NS, Abbas G, Naeem MA, Amjad M. Compositional and health risk assessment of drinking water from health facilities of District Vehari, Pakistan. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2020; 42:2425-2437. [PMID: 31712939 DOI: 10.1007/s10653-019-00465-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
Arsenic (As) is a potentially toxic and carcinogenic metalloid. It has gained considerable attention owing to its high ecotoxic nature. High As contamination of groundwater in scattered areas is the current status of Pakistan. A number of assessments exist for the As contamination of the drinking water in District Vehari, Pakistan. However, there is scarcity of data about As contents in drinking water of health facilities and healthcare centers in District Vehari. The current study, therefore, was carried out to assess As concentration and associated health risk in the drinking water of three health facilities (district head quarter, rural health center and basic health unit) of District Vehari. In total, 75 drinking water samples were collected and examined for As contents in addition to physicochemical characteristics such as electrical conductivity, pH, total soluble salts, chloride, carbonates, bicarbonates, fluoride, nitrate, nitrite, calcium, magnesium and iron. Results indicated that the groundwater samples are not fully fit for drinking purposes with respect to several parameters, especially the alarming levels of As. It was found that 52% of drinking water samples of Vehari have As concentration greater than WHO permissible limit (10 µg/L) and 17% have As concentration greater than Pak-EPA permissible limit (50 µg/L). The risk assessment parameters (average daily dose, hazard quotient and carcinogenic risk) showed possible carcinogenic and non-carcinogenic risks associated with ingestion of As-contaminated drinking water in the healthcare facilities. Based on the results of the present study, it is anticipated that hospitals and health centers in Vehari are in need of safe drinking water. The implementation of national/international standards for drinking water in healthcare facilities is a necessary measure to improve the services and increase local access to safe drinking water. The same may be applied to other public offices and organizations such as educational institutes and district government offices.
Collapse
Affiliation(s)
- Behzad Murtaza
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari, 61100, Pakistan.
| | - Muhammad Amjad
- Public Health Engineering Department, District Water Testing Laboratory, Vehari, Pakistan
| | - Muhammad Shahid
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari, 61100, Pakistan
| | - Muhammad Imran
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari, 61100, Pakistan
| | - Noor Samad Shah
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari, 61100, Pakistan
| | - Ghulam Abbas
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari, 61100, Pakistan
| | - Muhammad Asif Naeem
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari, 61100, Pakistan
| | - Muhammad Amjad
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari, 61100, Pakistan
| |
Collapse
|
21
|
Liu Y, Mitsuhashi T, Yamakawa M, Sasai M, Tsuda T, Doi H, Hamada J. Combined effects of body mass index and unhealthy behaviors on disability in older Japanese adults: the Okayama study. PeerJ 2019; 7:e8146. [PMID: 31803538 PMCID: PMC6886483 DOI: 10.7717/peerj.8146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/03/2019] [Indexed: 11/22/2022] Open
Abstract
Background Body mass index (BMI) is a significant predictor of functional disability in older adults. However, when evaluated, the association between BMI and incident functional disability, considering behaviors only as covariates or not, may not be appropriate. The primary purpose of the study was to investigate the combined effects of BMI and unhealthy behaviors on the risk of incident functional disability. Methods This was a retrospective cohort study that took place in Okayama City, Japan. Data on BMI and unhealthy behaviors were obtained using the health check-up questionnaire. The certification of Long-Term Care Insurance was used to measure functional disability. Cox proportional hazard models were used; adjusted hazard ratios (HRs) with 95% confidence interval (CI) were calculated for incidence of functional disability across categories of BMI and number of unhealthy behaviors. Results The relationship between BMI and incident functional disability was U-shaped (HR = 1.18, 95% CI [1.11–1.25], among the underweight range; and 1.26 [1.19–1.34] among the obesity range), and its risk was significantly higher within the normal-to-overweight range of BMI values with co-occurring unhealthy behaviors (with normal weight range and one, 1.17 [1.01–1.21]; two, 1.29 [1.18–1.41]; and three or four unhealthy behaviors 1.38 [1.24–1.54]; as well as among overweight range and one, 1.16 [1.05–1.27]; two, 1.26 [1.15–1.38]; and three or four unhealthy behaviors, 1.47 [1.31–1.64]). In each BMI category, the risk of incident functional disability increased with increasing number of unhealthy behaviors (p < 0.05 for linear tread), with the highest risk (1.87 [1.58–2.20]) occurring in combination with at least three unhealthy behaviors with BMI ≥ 27.5, for both sexes (2.20 [1.64–2.92] in men and 1.66 [1.35–2.04] in women). Conclusion It is necessary to consider the combined effects of BMI and behaviors on incident functional disability. Furthermore, interventions targeting multiple behaviors should be considered as such interventions may offer greater benefits than simple interventions.
Collapse
Affiliation(s)
- Yangyang Liu
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama University, Okayama, Japan
| | - Michiyo Yamakawa
- Department of Epidemiology and Preventive Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Megumi Sasai
- Sri Lanka Office, Japan International Cooperation Agency, Colombo, Sri Lanka
| | - Toshihide Tsuda
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan
| | - Hiroyuki Doi
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Jun Hamada
- Department of Health Economics and Policy, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| |
Collapse
|
22
|
Amiri S, Behnezhad S. Smoking as a risk factor for physical impairment: a systematic review and meta-analysis of 18 cohort studies. J Addict Dis 2019; 38:19-32. [PMID: 31809656 DOI: 10.1080/10550887.2019.1690928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
23
|
Sloane PD, Zimmerman S. Lower Extremity Impairment Parallels Cognitive Impairment as a Cause of Disability: A Call for Public Awareness. J Am Med Dir Assoc 2019; 20:1187-1189. [PMID: 31564463 DOI: 10.1016/j.jamda.2019.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Philip D Sloane
- Cecil G. Sheps Center for Health Services Research and Departments of Family Medicine and Internal Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC.
| | - Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, NC
| |
Collapse
|
24
|
von Bonsdorff MB, Haapanen MJ, Törmäkangas T, Pitkälä KH, Stenholm S, Strandberg TE. Midlife Cardiovascular Status and Old Age Physical Functioning Trajectories in Older Businessmen. J Am Geriatr Soc 2019; 67:2490-2496. [PMID: 31444889 DOI: 10.1111/jgs.16150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/02/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The associations between cardiovascular disease (CVD) risk and later physical functioning have been observed, but only a few studies with follow-up into old age are available. We investigated the association between cardiovascular status in midlife and physical functioning trajectories in old age. DESIGN Prospective cohort study. SETTING Helsinki Businessmen Study. PARTICIPANTS We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3490). MEASUREMENTS Three CVD status groups were formed based on clinical measurements carried out in 1974: signs of CVD (diagnosed clinically or with changes in ECG, chronic disease present or used medication, n = 563); healthy and low CVD risk (n = 593) and high CVD risk (n = 1222). Of them, 1560 men had data on physical functioning from at least one of four data collection waves between 2000-2010. Ten questions from the RAND-36 (SF-36) survey were used to construct physical functioning trajectories with latent class growth mixture models. Mortality was accounted for in competing risk models. RESULTS A five-class solution provided the optimal number of trajectories: "intact," "high stable," "high and declining," "intermediate and declining," and "consistently low" functioning. Compared with low CVD risk, high CVD risk in midlife decreased the risk of being classified into the intact (fully adjusted β = -3.98; standard error = 2.0; P = .046) relative to the consistently low physical functioning trajectory. Compared with low CVD risk, those with signs of CVD were less likely to follow the intact, high stable, or high and declining relative to the consistently low trajectory (all P < .018). CONCLUSION Among businessmen, a more favorable CVD profile in midlife was associated with better development of physical functioning in old age. J Am Geriatr Soc 67:2490-2496, 2019.
Collapse
Affiliation(s)
- Mikaela B von Bonsdorff
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Markus J Haapanen
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Timo E Strandberg
- University of Helsinki, Clinicum and Helsinki University Hospital, Helsinki, Finland.,Centre for Life Course Health Research, University of Oulu, Oulu, Finland
| |
Collapse
|
25
|
Shen A. Religious Attendance, Healthy Lifestyles, and Perceived Health: A Comparison of Baby Boomers with the Silent Generation. JOURNAL OF RELIGION AND HEALTH 2019; 58:1235-1245. [PMID: 30467618 DOI: 10.1007/s10943-018-0736-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Baby boomers are aging, and their health is an important concern. Research has suggested that (1) aging boomers are more vulnerable to mental and physical health problems than their parents' generation; (2) adoption of healthy lifestyles is critically important for the health of the aging population; and (3) religious attendance, often found to be associated with health-related outcomes, is lower among aging boomers than their parents' generation. In this research, we use a large national dataset to examine (1) whether the baby boom generation lags behind their parents' generation in adoption of healthy lifestyles and perceived health; and (2) if it does, whether the lag might possibly be attributed to lower religious attendance. We analyzed data collected by University of Michigan's Health and Retirement Study from the silent generation in 1994 and from the baby boom generation in 2010 when both generation cohorts were at about the same age (age 49-64 years). The results indicated that (1) the baby boom generation lagged behind the silent generation in adoption of three healthy lifestyles (not smoking, not drinking excessively, and not being overweight or obese) and in perceived health; (2) the lag may be partially attributed to lower religious attendance in the baby boom generation. We also discuss implications for the health of the baby boom generation and for promoting healthy lifestyles and health to the baby boom generation.
Collapse
Affiliation(s)
- Anyuan Shen
- School of Business, State University of New York at New Paltz, New Paltz, USA.
| |
Collapse
|
26
|
Hu B, Li L. The Protective Effects of Informal Care Receipt Against the Progression of Functional Limitations Among Chinese Older People. J Gerontol B Psychol Sci Soc Sci 2018; 75:1030-1041. [DOI: 10.1093/geronb/gby107] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Indexed: 02/06/2023] Open
Abstract
AbstractObjectiveThis study investigates the impacts of receiving informal care on the progression of functional limitations among older people aged 60 and older in China.MethodsThe data come from three waves of the China Health and Retirement Longitudinal Survey, which collected health- and aging-related information on a nationally representative sample of Chinese older people from 2011 to 2015. Multilevel regression models were used to analyze the data.ResultsThe protective effect of receiving informal care is stronger for the first 2 years after the baseline survey and tends to fade away or be reversed 4 years later. The protective effect is stronger among older people receiving low-intensity informal care and is gradually weakened with an increase in care intensity.DiscussionTrajectories of function capabilities are deeply embedded in social relationships. In the context of rapid population aging and increasing demand for informal care, government support for caregivers is needed to sustain the protective effects of informal care.
Collapse
Affiliation(s)
- Bo Hu
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Lei Li
- Institute of International Economics, School of Economics, Nankai University, Tianjin, China
| |
Collapse
|
27
|
Geyer S, Eberhard S, Schmidt BMW, Epping J, Tetzlaff J. Morbidity compression in myocardial infarction 2006 to 2015 in terms of changing rates and age at occurrence: A longitudinal study using claims data from Germany. PLoS One 2018; 13:e0202631. [PMID: 30138437 PMCID: PMC6107226 DOI: 10.1371/journal.pone.0202631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/07/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND According to James Fries morbidity compression is present if morbidity rates are decreasing to a larger extent than mortality rates. Compression also occurs if age at onset is increasing at a faster pace than age at death. These two variants of the compression hypothesis were formulated as a population concept. Compression has seldom been studied with a specific disease as application. METHODS Morbidity compression was examined in terms of myocardial infarction (MI) by using German claims data covering the years 2006 to 2015. The findings are based on an annual case number of about 2 m women and men aged 18 years and older. Analyses were performed by means of proportional hazards regression and by using linear regression. RESULTS Decreases of morbidity rates were more pronounced than those of mortality. For men, the hazard ratio for contracting MI in 2015 as compared to 2006 was hr = 0.66 and hr = 0.71 for the female population. The respective results for mortality were hr = 0.75 in men and hr = 1.0 in women. They can be interpreted in favor of morbidity compression. For the subgroup of women and men with MI, changes of onset age revealed marked gender differences. For 2015 as compared with 2006, age at MI-occurrence in men increased by 10.5 months as compared to an increase of 10.4 months for age at death. In women changes were smaller and statistically not significant. The findings referring to women have to be interpreted against the backdrop of higher onset age and higher age at death than in men. CONCLUSIONS Taken together, morbidity compression has occurred in terms of decreasing MI-rates as well as in terms of increased onset age in men. It can be concluded that both processes have led to an improvement of healthy lifetime. Decreasing morbidity rates in women are also pointing towards morbidity compression, a finding that is not complemented by changes of onset age. Our data are demonstrating that morbidity rates and age at onset may vary independently. From this perspective morbidity compression is a multi-faceted phenomenon.
Collapse
Affiliation(s)
- Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Sveja Eberhard
- Local Statutory Health Insurance of Lower Saxony (AOK Niedersachsen), Hannover, Germany
| | | | - Jelena Epping
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | - Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| |
Collapse
|
28
|
Heiland EG, Welmer AK, Wang R, Santoni G, Fratiglioni L, Qiu C. Cardiovascular Risk Factors and the Risk of Disability in Older Adults: Variation by Age and Functional Status. J Am Med Dir Assoc 2018; 20:208-212.e3. [PMID: 30006016 DOI: 10.1016/j.jamda.2018.05.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/17/2018] [Accepted: 05/20/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aimed to quantify the increased risk of disability associated with cardiovascular risk factors among older adults, and to verify whether this risk may vary by age and functional status. DESIGN Longitudinal population-based cohort study. SETTING Urban area of Stockholm, Sweden. PARTICIPANTS Community-dwelling and institutionalized adults ≥60 years in the Swedish National study on Aging and Care in Kungsholmen free of cardiovascular diseases and disability (n = 1756) at baseline (2001-2004). MEASURES Incident disability in activities of daily living (ADL) was ascertained over 9 years. Cardiovascular risk factors (physical inactivity, alcohol consumption, smoking, high blood pressure, diabetes, high body mass index, high levels of total cholesterol, and high C-reactive protein) and walking speed were assessed at baseline. Data were analyzed using Cox proportional hazards models, stratifying by younger-old (age 60-72 years) and older-old (≥78 years). RESULTS During the follow-up, 23 and 148 persons developed ADL-disability among the younger- and older-old, respectively. In the younger-old, the adjusted hazard ratio (HR) of developing ADL-disability was 4.10 (95% confidence interval [CI] 1.22-13.76) for physical inactivity and 5.61 (95% CI 1.17-26.82) for diabetes. In the older-old, physical inactivity was associated with incident ADL-disability (HR 1.99, 95% CI 1.36-2.93), and there was a significant interaction between physical inactivity and walking speed limitation (<0.8 m/s), showing a 6-fold higher risk of ADL-disability in those who were both physically inactive and had walking speed limitation than being active with no limitation, accounting for a population-attributable risk of 42.7%. CONCLUSIONS/IMPLICATIONS Interventions targeting cardiovascular risk factors may be more important for the younger-old in decreasing the risk of disability, whereas improving physical function and maintaining physical activity may be more beneficial for the older-old.
Collapse
Affiliation(s)
- Emerald G Heiland
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden.
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Rui Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden
| | - Giola Santoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Stockholm University, Stockholm, Sweden.
| |
Collapse
|
29
|
Visser M, Wijnhoven HAH, Comijs HC, Thomése FGCF, Twisk JWR, Deeg DJH. A Healthy Lifestyle in Old Age and Prospective Change in Four Domains of Functioning. J Aging Health 2018; 31:1297-1314. [PMID: 29809092 PMCID: PMC7322976 DOI: 10.1177/0898264318774430] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The aim of this article is to study the associations between healthy lifestyle in old age and decline in physical, psychological, cognitive, and social functioning. Method: A population-based sample of 3,107 Dutch men and women aged 55 and 85 years (1992/1993; Longitudinal Aging Study Amsterdam) was used with five 3-yeary follow-up examinations. Lifestyle score, based on smoking status, alcohol consumption, physical activity, and body mass index (BMI), ranged from 0 (unhealthy) to 4 (healthy). Outcomes included gait speed, depressive symptoms, cognitive status, and social contacts. Results: Persons with a healthy lifestyle had a 10.6% slower decline in gait speed (0.04 m/s, 95% confidence interval [CI] = [0.03, 0.05]), 10.8% slower increase in depressive symptoms (–1.07 [–1.70, –0.44]), a 1.8% slower decline in cognitive functioning (0.47 [0.23, 0.70]), and a 4.9% slower decline in social contacts (0.58 [0.01, 1.15]) compared with persons with no or one healthy lifestyle factor. Discussion: A healthy lifestyle benefits physical, psychological, cognitive, and social functioning up to very old age.
Collapse
Affiliation(s)
- Marjolein Visser
- 1 Vrije Universiteit Amsterdam, The Netherlands.,2 VU University Medical Center, Amsterdam, The Netherlands
| | | | - Hannie C Comijs
- 2 VU University Medical Center, Amsterdam, The Netherlands.,3 GGZ inGeest, Amsterdam, The Netherlands
| | | | - Jos W R Twisk
- 2 VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- 2 VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
30
|
Zhang S, Tomata Y, Newson RB, Sugawara Y, Tsuji I. Combined healthy lifestyle behaviours and incident disability in an elderly population: the Ohsaki Cohort 2006 Study. J Epidemiol Community Health 2018; 72:679-684. [PMID: 29627784 DOI: 10.1136/jech-2018-210464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/15/2018] [Accepted: 03/23/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND The joint impact of healthy lifestyle behaviours (HLBs) on incident disability among elderly populations is still uncertain. This cohort study was conducted to estimate the population-attributable fraction (PAF) of combined HLBs for disability reduction in elderly Japanese. METHODS We analysed 10-year follow-up data for 9910 community-dwelling elderly people (≥65 years) in a prospective cohort study. Information on lifestyle behaviours and food consumption was collected via a questionnaire in 2006. The exposure variable was defined as a healthy lifestyle index (HLI), which represented the summed number of HLBs ('never or former smoker', 'time spent walking ≥0.5 hour/day' and 'vegetable and fruit consumption volume ≥median'). Data on incident disability were retrieved from the public Long term Care Insurance database. HRs and 95% CIs were estimated by Cox proportional regression and the PAFs and their 95% CIs were estimated with the multivariate-adjusted model. RESULTS The 10-year incidence of disability was 35.7%. An inverse dose-response relationship was observed (HR (95% CI): 0.85(0.81 to 0.90) for each one-point increase of the HLI score, p-trend <0.001). Based on multivariate-adjustment, adherence to each one additional HLB gives PAF of 10.5%(95% CI 9.0% to 12.0%) for disability reduction. The PAF would have been 25.9%(14.2% to 36.0%) if all subjects had adhered to all three HLBs. CONCLUSION Combined HLBs may have a substantial impact on reducing the risk of incident disability among elderly people. Even having one more healthy lifestyle habit may bring considerable benefit.
Collapse
Affiliation(s)
- Shu Zhang
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Roger B Newson
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
31
|
Villarreal AE, Grajales S, López L, Oviedo DC, Carreira MB, Gómez LA, Montalván A, Vásquez V, Britton GB. Limitations in Activities of Daily Living among Dementia-Free Older Adults in Panama. AGEING INTERNATIONAL 2018. [DOI: 10.1007/s12126-018-9321-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
32
|
Swan JH, Brooks JM, Amini R, Moore AR, Turner KW. Smoking Predicting Physical Activity in an Aging America. J Nutr Health Aging 2018; 22:476-482. [PMID: 29582886 PMCID: PMC6369697 DOI: 10.1007/s12603-017-0967-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Tobacco smoking and physical inactivity are among leading behavioral risk factors for ill health in older adults. This study considers how smoking is associated with physical activity. DESIGN Using a Life-Course model, data are analyzed regarding this relationship, controlling for, and interacted with, life-course and other factors. Daily smokers and sometimes smokers were hypothesized to engage in less leisure-time physical activity than those who never smoked, while those who stopped smoking were expected to do more than never smokers. Analyses were performed using SAS-Callable SUDAAN. SETTING AND PARTICIPANTS Secondary data from ten years of a national sample of adults aged 18 and over of the National Health Interview Survey, 2001-2010, are used (N = 264,945, missing data excluded, of 282,313 total cases). MEASUREMENTS Daily smokers, occasional smokers, and smoking quitters are compared to never smokers with regard to requisite physical activity (150 minutes per week of moderate, 100 of vigorous, and/or 50 of strengthening activity). Life-course measures include birth cohorts, age, and year of survey, as well as gender, race/ethnicity, and education. RESULTS Overall, hypotheses are supported regarding daily smokers and quitters; but the hypothesis is strongly rejected among sometimes smokers, who are much more likely to do requisite physical activity. Findings differ by age, sometimes smokers age 65 and over being less likely to do physical activity. Findings among all men are similar to the overall findings, while those among all women are similar to those for older respondents. Associations of smoking status with physical activity vary greatly by race/ethnicity. CONCLUSIONS Daily smokers may be most in need of both smoking cessation and leisure-time physical activity interventions. Smoking-cessation efforts may pay greater physical activity benefits among women and the aged, while smoking-reduction efforts may provide better outcomes among men. Smoking reduction efforts may pay more exercise benefits among African-Americans and Hispanics.
Collapse
Affiliation(s)
- J H Swan
- James H. Swan, Ph.D. Professor of Applied Gerontology, Department of Rehabilitation and Health Services, University of North Texas,, Denton, TX, USA,
| | | | | | | | | |
Collapse
|
33
|
Jin Y, Tanaka T, Ma Y, Bandinelli S, Ferrucci L, Talegawkar SA. Cardiovascular Health Is Associated With Physical Function Among Older Community Dwelling Men and Women. J Gerontol A Biol Sci Med Sci 2017; 72:1710-1716. [PMID: 28184412 PMCID: PMC5861882 DOI: 10.1093/gerona/glw329] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 01/06/2017] [Indexed: 01/08/2023] Open
Abstract
Background Age related decline in physical function is a significant concern affecting the quality of life of older individuals. Methods We examined the associations between baseline overall cardiovascular health (CVH), its components, and physical function in 906 men and women from the InCHIANTI cohort. Physical function was assessed using the Short Performance Physical Battery and poor physical function was defined as an Short Performance Physical Battery score less than 10. Overall CVH score, ranging from 0 to 12 in the cohort, was operationalized using adherence to ideal levels for health behaviors including smoking status, physical activity, body mass index, and diet quality; and health factors including blood pressure, plasma cholesterol, fasting blood glucose, with higher scores indicating better CVH. Results Mean age at baseline was 74 (SD = 6.7) years and 55% were women. At baseline and over 9 years, as compared to the lowest tertile of overall CVH score, the highest tertile was associated with a 69% (p < .001) and 63% (p < .001), respectively, lower risk of poor physical function. Among the CVH components, adherence to ideal levels of health behaviors was more strongly and consistently associated with lower odds of poor physical function than health factors. Conclusions Better overall CVH was protective against poor physical function in community-dwelling men and women aged 65 years and older. Improving CVH may be instrumental in the prevention of poor physical function in older adults.
Collapse
Affiliation(s)
- Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, District of Columbia
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Yan Ma
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, District of Columbia
| | | | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, District of Columbia.,Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, District of Columbia.,Sumner M. Redstone Global Center for Prevention and Wellness at the George Washington University, District of Columbia
| |
Collapse
|
34
|
Freire Junior RC, Fernandes TG, Borges GF, Guerra RO, de Abreu DCC. Factors associated with low levels of physical activity among elderly residents in a small urban area in the interior of the Brazilian Amazon. Arch Gerontol Geriatr 2017; 75:37-43. [PMID: 29180130 DOI: 10.1016/j.archger.2017.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 11/07/2017] [Accepted: 11/13/2017] [Indexed: 12/25/2022]
Abstract
The aim of the present study was to investigate levels of physical activity and risk factors for inactivity in older adults living in an urban area in the interior of the Amazonas state, Brazil. Data were collected between 2013 and 2015 from 274 individuals 60 years of age or older who resided in the interior of the Brazilian Amazon. Sociodemographic, general health, functional capacity and physical performance were associated with self-referred physical activity level. A multivariate analysis, after adjustment, showed that being a man, having a body mass index above 27kg/m2, never having lived in riverside communities and having less than three associated chronic diseases were independent risk factors for low levels of physical activity among elderly residing in the interior of the Brazilian Amazon. Few studies have been conducted about the characteristics that are singular to this population. Our results suggest that the physical activity level and, consequently, the aging process of the elderly is influenced by where they have resided throughout their lives. Additionally, the results showed particular risk factors associated with low physical activity level among older adults residing in the interior of the state of Amazonas.
Collapse
Affiliation(s)
- Renato Campos Freire Junior
- Institute of Health and Biotechnology, Federal University of Amazonas, Coari, Brazil; Laboratory of Assessment and Rehabilitation of Equilibrium, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | | | - Grasiely Faccin Borges
- Health Sciences Centre, Federal University of Southern Bahia, Texeira de Freitas, Brazil
| | | | - Daniela Cristina Carvalho de Abreu
- Laboratory of Assessment and Rehabilitation of Equilibrium, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| |
Collapse
|
35
|
Ma W, Hagan KA, Heianza Y, Sun Q, Rimm EB, Qi L. Adult height, dietary patterns, and healthy aging. Am J Clin Nutr 2017; 106:589-596. [PMID: 28592610 PMCID: PMC5525116 DOI: 10.3945/ajcn.116.147256] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 05/04/2017] [Indexed: 01/17/2023] Open
Abstract
Background: Adult height has shown directionally diverse associations with several age-related disorders, including cardiovascular disease, cancer, decline in cognitive function, and mortality.Objective: We investigated the associations of adult height with healthy aging measured by a full spectrum of health outcomes, including incidence of chronic diseases, memory, physical functioning, and mental health, among populations who have survived to older age, and whether lifestyle factors modified such relations.Design: We included 52,135 women (mean age: 44.2 y) from the Nurses' Health Study without chronic diseases in 1980 and whose health status was available in 2012. Healthy aging was defined as being free of 11 major chronic diseases and having no reported impairment of subjective memory, physical impairment, or mental health limitations.Results: Of all eligible study participants, 6877 (13.2%) were classified as healthy agers. After adjustment for demographic and lifestyle factors, we observed an 8% (95% CI: 6%, 11%) decrease in the odds of healthy aging per SD (0.062 m) increase in height. Compared with the lowest category of height (≤1.57 m), the OR of achieving healthy aging in the highest category (≥1.70 m) was 0.80 (95% CI: 0.73, 0.87; P-trend < 0.001). In addition, we found a significant interaction of height with a prudent dietary pattern in relation to healthy aging (P-interaction = 0.005), and among the individual dietary factors characterizing the prudent dietary pattern, fruit and vegetable intake showed the strongest effect modification (P-interaction = 0.01). The association of greater height with reduced odds of healthy aging appeared to be more evident among women with higher adherence to the prudent dietary pattern rich in vegetable and fruit intake.Conclusions: Greater height was associated with a modest decrease in the likelihood of healthy aging. A prudent diet rich in fruit and vegetables might modify the relation.
Collapse
Affiliation(s)
| | | | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; and
| | - Qi Sun
- Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Eric B Rimm
- Departments of Epidemiology and,Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Lu Qi
- Departments of Epidemiology and .,Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; and.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
36
|
Franzon K, Byberg L, Sjögren P, Zethelius B, Cederholm T, Kilander L. Predictors of Independent Aging and Survival: A 16-Year Follow-Up Report in Octogenarian Men. J Am Geriatr Soc 2017; 65:1953-1960. [DOI: 10.1111/jgs.14971] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kristin Franzon
- Division of Geriatrics; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | - Liisa Byberg
- Division of Orthopedics; Department of Surgical Sciences; Uppsala University; Uppsala Sweden
| | - Per Sjögren
- Division of Clinical Nutrition and Metabolism; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | - Björn Zethelius
- Division of Geriatrics; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
- Medical Products Agency; Uppsala Sweden
| | - Tommy Cederholm
- Division of Clinical Nutrition and Metabolism; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | - Lena Kilander
- Division of Geriatrics; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| |
Collapse
|
37
|
Tetzlaff J, Muschik D, Epping J, Eberhard S, Geyer S. Expansion or compression of multimorbidity? 10-year development of life years spent in multimorbidity based on health insurance claims data of Lower Saxony, Germany. Int J Public Health 2017. [PMID: 28283685 DOI: 10.1007/s00038‐017‐0962‐9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Our study examined how life years spent in multimorbidity changed over a period of 10 years (2005-2014) and whether morbidity expansion or compression has taken place. There is a little evidence on whether life years gained due to increasing life expectancy are spent in good health, or if they are accompanied by morbidity expansion. METHODS The analyses are based on German administrative claims data. Multimorbidity was defined as a combination of at least six chronic conditions and polypharmacy. After having estimated age-standardized prevalence, time trends for life years with and without multimorbidity, and the proportion of life years spent in multimorbidity (morbidity ratio) were estimated. RESULTS Prevalence proportions of multimorbidity rose continuously. Increasing life expectancies were accompanied by increasing life years with multimorbidity, decreasing multimorbidity-free life years, and by an increasing morbidity ratio. CONCLUSIONS The lifespan spent in multimorbidity was increasing over time. Our findings indicate a growing burden of multimorbidity and an increasing proportion of life years with multiple chronic conditions. It can be concluded that an expansion of morbidity in absolute and in relative terms has occurred. The findings stress the importance of prevention, healthy lifestyles, and improved medical care strategies meeting the specific requirements of patients with multimorbidity.
Collapse
Affiliation(s)
- Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany.
| | - Denise Muschik
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | - Jelena Epping
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | - Sveja Eberhard
- AOK Niedersachsen-Statutory Health Insurance of Lower Saxony, Hanover, Germany
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| |
Collapse
|
38
|
Expansion or compression of multimorbidity? 10-year development of life years spent in multimorbidity based on health insurance claims data of Lower Saxony, Germany. Int J Public Health 2017; 62:679-686. [DOI: 10.1007/s00038-017-0962-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/08/2017] [Accepted: 02/20/2017] [Indexed: 11/26/2022] Open
|
39
|
Sternfeld B, Colvin A, Stewart A, Dugan S, Nackers L, El Khoudary SR, Huang MH, Karvonen-Gutierrez C. The Effect of a Healthy Lifestyle on Future Physical Functioning in Midlife Women. Med Sci Sports Exerc 2017; 49:274-282. [PMID: 27669444 PMCID: PMC5271600 DOI: 10.1249/mss.0000000000001109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE This study aimed to examine the prospective association between healthy lifestyle behaviors and objectively measured physical function in midlife women. METHODS Participants included 1769 racially/ethnically diverse women, ages 56-68 yr, from the Study of Women's Health Across the Nation cohort. Physical function was assessed at the 13th follow-up visit with the Short Physical Performance Battery (4-m walk, repeated chair stands, and balance test) and grip strength. A healthy lifestyle score (HLS), which ranged from 0 to 6, was calculated by averaging as many as three repeated measures of self-reported smoking, physical activity, and diet, all assessed before the 13th follow-up. Multivariable linear and logistic regressions modeled each component of physical performance as a function of HLS and, in separate models, of each lifestyle behavior, adjusted for the other behaviors. RESULTS In multivariable analyses, the time for the 4-m walk was 0.06 s faster (P = 0.001) for every 1 point increase in the HLS. The time for the repeated chair stands was significantly shorter by approximately 0.20 s. Neither grip strength nor balance problems were significantly associated with the HLS (P = 0.28 and P = 0.19, respectively). The model examining the individual health behaviors showed that only physical activity was significantly associated with physical performance. CONCLUSION Regular physical activity in early midlife has the potential to reduce the likelihood of physical functional limitations later in midlife.
Collapse
Affiliation(s)
| | - Alicia Colvin
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Andrea Stewart
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | | | | | | | - Mei-Hua Huang
- Division of Geriatrics, University of California Los Angeles, Los Angeles, CA
| | | |
Collapse
|
40
|
Mosallanezhad Z, Sotoudeh GR, Jutengren G, Salavati M, Harms-Ringdahl K, Wikmar LN, Frändin K. A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people. Arch Gerontol Geriatr 2017; 70:123-129. [PMID: 28131051 DOI: 10.1016/j.archger.2017.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/29/2016] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIM Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. METHODS Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chi-square tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. RESULTS The measurement model yielded a reasonable fit to the data, χ2=110.93, df=38; CFI=0.97; RMSEA=0.047, with 90% C.I.=0.037-0.058. The model fit for the conceptual model was acceptable; χ2=271.64, df=39; CFI=0.91; RMSEA=0.084, with 90% C.I.=0.074-0.093. SES itself was not a direct predictor of HS (β=0.13, p=0.059) but it was a predictor of HS either through affecting PA (β=0.31, p<0.001) or I (β=0.57, p<0.001). CONCLUSION Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL.
Collapse
Affiliation(s)
- Zahra Mosallanezhad
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Iranian Research Centre on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Gholam Reza Sotoudeh
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden; Sina Trauma and Surgery Research Center (STSRC), Sina General Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Göran Jutengren
- Department of Work Life and Social Welfare, University of Borås, Sweden
| | - Mahyar Salavati
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Karin Harms-Ringdahl
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena Nilsson Wikmar
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Academic Primary Healthcare Centre, Stockholm County Council, Stockholm, Sweden
| | - Kerstin Frändin
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
41
|
Abstract
A medically relevant understanding of aging requires an appreciation for how time degrades specific, healthy features of individual organisms over the course of their lives. Zach Pincus and colleagues make a key step in this direction, using C. elegans as a model system.
Collapse
Affiliation(s)
- Simon Melov
- Buck Institute for Research on Aging, Novato, CA 94945, USA.
| |
Collapse
|
42
|
Morbidity compression, morbidity expansion, or dynamic equilibrium? The time trend of AOK-insured patients with type 2 diabetes in Lower Saxony, Germany. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0756-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
|
43
|
Jin Y, Tanaka T, Bandinelli S, Ferrucci L, Talegawkar SA. Overall Cardiovascular Health Is Associated With All-Cause and Cardiovascular Disease Mortality Among Older Community-Dwelling Men and Women. J Aging Health 2016; 29:437-453. [PMID: 27036884 DOI: 10.1177/0898264316635590] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The objective of this study was to assess the associations between cardiovascular health and all-cause and cardiovascular disease mortality among community-dwelling elderly. METHOD Secondary data analysis was performed using data collected as part of the InCHIANTI cohort procedures and included 928 participants (55% female) aged 65 years and older. Overall cardiovascular health was assessed using seven health behaviors and factors, scored 0 to 14, with higher scores indicating better cardiovascular health, modeled categorically as tertiles. Vitality status was ascertained using registry information. Cox proportional hazards models were used to examine the associations between cardiovascular health and all-cause and cardiovascular disease mortality. RESULTS After an average follow-up of 9.1 years, better overall cardiovascular health (highest tertile) was inversely associated with all-cause (hazard ratio [HR] = 0.68, 95% confidence interval [CI] = [0.51, 0.92]) and cardiovascular disease mortality (HR = 0.61, 95% CI = [0.38, 0.97]) compared with the lowest tertile. DISCUSSION Cardiovascular health, even in the elderly, is inversely associated with mortality.
Collapse
|
44
|
Vu THT, Lloyd-Jones DM, Liu K, Stamler J, Garside DB, Daviglus ML. Optimal Levels of All Major Cardiovascular Risk Factors in Younger Age and Functional Disability in Older Age: The Chicago Heart Association Detection Project in Industry 32-Year Follow-Up Health Survey. Circ Cardiovasc Qual Outcomes 2016; 9:355-63. [PMID: 27382089 DOI: 10.1161/circoutcomes.115.002519] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 05/27/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The associations of optimal levels of all major cardiovascular disease risk factors, that is, low risk, in younger age with subsequent cardiovascular disease morbidity and mortality have been well documented. However, little is known about associations of low-risk profiles in younger age with functional disability in older age. METHODS AND RESULTS The sample included 6014 participants from the Chicago Heart Association Detection Project in Industry Study. Low-risk status, defined as untreated systolic/diastolic blood pressure ≤120/≤80 mm Hg, untreated serum total cholesterol <5.18 mmol/l, not smoking, body mass index < 25 kg/m(2), and no diabetes mellitus, was assessed at baseline (1967 to 1973). Functional disability, categorized as (1) any disability in activities of daily living (ADLs), (2) any disability in instrumental ADLs but not in ADL, or (3) no disability, was assessed from the 2003 health survey. There were 39% women, 4% Black, with a mean age of 43 years and 6% low-risk status at baseline. After 32 years, 7% reported having limitations in performing any ADL and 11% in any instrumental ADL only. The prevalence of any ADL limitation was lowest in low-risk people and increased in a graded fashion with less-favorable risk factor groups (P trend <0.001). Compared with those with 2+ high-risk factors, the multivariable-adjusted odds of having any disability in ADLs versus no disability in people with low risk, any moderate risk, and 1 high-risk factor at baseline were lower by 58%, 48%, and 37%, respectively. Results were similar for instrumental ADLs, in both men and women. CONCLUSIONS Having an optimal cardiovascular disease risk factor profile at younger age is associated with the lowest rate of functional disability in older age.
Collapse
Affiliation(s)
- Thanh-Huyen T Vu
- From the Department of Preventive Medicine (T.-H.T.V., D.M.L.-J., K.L., J.S., M.L.D.) and Department of Medicine, Feinberg School of Medicine (D.M.L.-J.), Northwestern University, Chicago, IL; and Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL (D.B.G., M.L.D.).
| | - Donald M Lloyd-Jones
- From the Department of Preventive Medicine (T.-H.T.V., D.M.L.-J., K.L., J.S., M.L.D.) and Department of Medicine, Feinberg School of Medicine (D.M.L.-J.), Northwestern University, Chicago, IL; and Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL (D.B.G., M.L.D.)
| | - Kiang Liu
- From the Department of Preventive Medicine (T.-H.T.V., D.M.L.-J., K.L., J.S., M.L.D.) and Department of Medicine, Feinberg School of Medicine (D.M.L.-J.), Northwestern University, Chicago, IL; and Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL (D.B.G., M.L.D.)
| | - Jeremiah Stamler
- From the Department of Preventive Medicine (T.-H.T.V., D.M.L.-J., K.L., J.S., M.L.D.) and Department of Medicine, Feinberg School of Medicine (D.M.L.-J.), Northwestern University, Chicago, IL; and Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL (D.B.G., M.L.D.)
| | - Daniel B Garside
- From the Department of Preventive Medicine (T.-H.T.V., D.M.L.-J., K.L., J.S., M.L.D.) and Department of Medicine, Feinberg School of Medicine (D.M.L.-J.), Northwestern University, Chicago, IL; and Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL (D.B.G., M.L.D.)
| | - Martha L Daviglus
- From the Department of Preventive Medicine (T.-H.T.V., D.M.L.-J., K.L., J.S., M.L.D.) and Department of Medicine, Feinberg School of Medicine (D.M.L.-J.), Northwestern University, Chicago, IL; and Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL (D.B.G., M.L.D.)
| |
Collapse
|
45
|
Yokota RTDC, Nusselder WJ, Robine JM, Tafforeau J, Deboosere P, Van Oyen H. Contribution of Chronic Conditions to the Disability Burden across Smoking Categories in Middle-Aged Adults, Belgium. PLoS One 2016; 11:e0153726. [PMID: 27105185 PMCID: PMC4841551 DOI: 10.1371/journal.pone.0153726] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/01/2016] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Smoking is considered the single most important preventable cause of morbidity and mortality worldwide, contributing to increased incidence and severity of disabling conditions. The aim of this study was to assess the contribution of chronic conditions to the disability burden across smoking categories in middle-aged adults in Belgium. METHODS Data from 10,224 individuals aged 40 to 60 years who participated in the 1997, 2001, 2004, or 2008 Health Interview Surveys in Belgium were used. Smoking status was defined as never, former (cessation ≥2 years), former (cessation <2 years), occasional light (<20 cigarettes/day), daily light, and daily heavy (≥20 cigarettes/day). To attribute disability to chronic conditions, binomial additive hazards models were fitted separately for each smoking category adjusted for gender, except for former (cessation <2 years) and occasional light smokers due to the small sample size. RESULTS An increasing trend in the disability prevalence was observed across smoking categories in men (never = 4.8%, former (cessation ≥2 years) = 5.8%, daily light = 7.8%, daily heavy = 10.7%) and women (never = 7.6%, former (cessation ≥2 years) = 8.0%, daily light = 10.2%, daily heavy = 12.0%). Musculoskeletal conditions showed a substantial contribution to the disability burden in men and women across all smoking categories. Other important contributors were depression and cardiovascular diseases in never smokers; depression, chronic respiratory diseases, and diabetes in former smokers (cessation ≥2 years); chronic respiratory diseases, cancer, and cardiovascular diseases in daily light smokers; cardiovascular diseases and chronic respiratory diseases in men and depression and diabetes in women daily heavy smokers. CONCLUSIONS Beyond the well-known effect of smoking on mortality, our findings showed an increasing trend of the disability prevalence and different contributors to the disability burden across smoking categories. This information can be useful from a public health perspective to define strategies to reduce disability in Belgium.
Collapse
Affiliation(s)
- Renata Tiene de Carvalho Yokota
- Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium
- * E-mail:
| | | | - Jean-Marie Robine
- French Institute of Health and Medical Research (INSERM), Montpellier, France
- École Pratique des Hautes Études, Paris, France
| | - Jean Tafforeau
- Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Patrick Deboosere
- Department of Sociology, Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium
| | - Herman Van Oyen
- Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
| |
Collapse
|
46
|
Vos S, Janssen M, Goudsmit J, Lauwerijssen C, Brombacher A. From Problem to Solution: Developing a Personalized Smartphone Application for Recreational Runners following a Three-step Design Approach. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.proeng.2016.06.311] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
47
|
Zanjani S, Tol A, Mohebbi B, Sadeghi R, Jalyani KN, Moradi A. Determinants of healthy lifestyle and its related factors among elderly people. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2015; 4:103. [PMID: 27462645 PMCID: PMC4946259 DOI: 10.4103/2277-9531.171817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Medical and health advances have led to relative increases in human longevity and elderly population. Common diseases in elders can be prevented using healthy lifestyle. Identifying current status of the elderly is necessary to design educational intervention programs to improve their health and quality of life. Therefore, this study aimed at assessing the lifestyle of the elderly in Islamshar (suburban of Tehran). MATERIALS AND METHODS A descriptive - analytical study conducted among 480 elderly people over 60 years old referred to Islamshahr Health Center of Tehran University of Medical Sciences for a period of 12 months in 2012-2013. Data were collected through at two-part questionnaire including sociodemographic and health-related characteristics and healthy lifestyle instrument. Healthy lifestyle of the elderly was assessed using a 46 items self-report standard instrument with five subscales reflecting domains including exercise, nutrition, prevention, stress management, and social relationship. Finally, the data obtained were analyzed using the SPSS 18 software using an independent t-test, analysis of variance and ordinal logistic regression test at a significant level of P < 0.05. RESULTS Mean score of total healthy lifestyle was 148.56 ± 11.5. Men and women scored 151.95 ± 11.15 and 145 ± 10.32, respectively (P < 0.001). 76.2% of participants had moderately healthy lifestyle, and 23.8% had desirable healthy lifestyle. Marital status and gender were important factors in elderly healthy lifestyle. DISCUSSION The status of a healthy lifestyle among the elderly in Islamshar was relatively moderate. However, more studies are needed for further information to confirm study results. Study results were posed the necessity of tailoring specific interventional programs to achieve desirable healthy lifestyle.
Collapse
Affiliation(s)
- Samaneh Zanjani
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Azar Tol
- Department of Health Education and Promotion, Tehran University of Medical Sciences Tehran, Iran
| | - Bahram Mohebbi
- Department of Cardiology, Shahid Hashemi Nejad Hospital, School of Medicine, University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, Tehran University of Medical Sciences Tehran, Iran
| | - Keramat Nouri Jalyani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Tehran, Iran
| | - Azita Moradi
- Department of Health Education and Promotion, Tehran University of Medical Sciences Tehran, Iran
| |
Collapse
|
48
|
Vogt S, Mielck A, Berger U, Grill E, Peters A, Döring A, Holle R, Strobl R, Zimmermann AK, Linkohr B, Wolf K, Kneißl K, Maier W. Neighborhood and healthy aging in a German city: distances to green space and senior service centers and their associations with physical constitution, disability, and health-related quality of life. Eur J Ageing 2015. [PMID: 28804360 DOI: 10.1007/sl0433-015-0345-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
The composition of the residential environment may have an independent influence on health, especially in older adults. In this cross-sectional study, we examined the associations between proximity to two features of the residential environment (green space and senior service centers) and three aspects of healthy aging (self-rated physical constitution, disability, and health-related quality of life). We included 1711 inhabitants from the city of Augsburg, Germany, aged 65 years or older, who participated in the KORA-Age study conducted in 2008/2009. We calculated the Euclidian distances between each participant's residential address and the nearest green space or senior service center, using a geographic information system. Multilevel logistic regression models were fitted to analyze the associations, controlling for demographic and socioeconomic factors. Contrary to expectations, we did not find clear associations between the distances to the nearest green space or senior service center and any of the examined aspects of healthy aging. The importance of living close to green space may largely depend on the study location. The city of Augsburg is relatively small (about 267,000 inhabitants) and has a high proportion of greenness. Thus, proximity to green space may not be as important as in a densely populated metropolitan area. Moreover, an objectively defined measure of access such as Euclidian distance may not reflect the actual use. Future studies should try to assess the importance of resources of the residential environment not only objectively, but also from the resident's perspective.
Collapse
Affiliation(s)
- Susanne Vogt
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Andreas Mielck
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Ursula Berger
- Institute for Medical Information Processing, Biometrics and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometrics and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Angela Döring
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Rolf Holle
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Ralf Strobl
- Institute for Medical Information Processing, Biometrics and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Anja-Kerstin Zimmermann
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Birgit Linkohr
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Kathrin Wolf
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Klaus Kneißl
- City of Augsburg, Department of Social Planning, Schießgrabenstr. 4, 86150 Augsburg, Germany
| | - Werner Maier
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| |
Collapse
|
49
|
Pizzorno L. Personalized Lifestyle Medicine Institute, October 2014: A Seminal Moment in the 21st Century's Transformation of Health Care. Integr Med (Encinitas) 2015; 14:64-71. [PMID: 26770168 PMCID: PMC4712868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
50
|
Czajkowski SM, Powell LH, Adler N, Naar-King S, Reynolds KD, Hunter CM, Laraia B, Olster DH, Perna FM, Peterson JC, Epel E, Boyington JE, Charlson ME. From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol 2015; 34:971-82. [PMID: 25642841 PMCID: PMC4522392 DOI: 10.1037/hea0000161] [Citation(s) in RCA: 580] [Impact Index Per Article: 64.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Given the critical role of behavior in preventing and treating chronic diseases, it is important to accelerate the development of behavioral treatments that can improve chronic disease prevention and outcomes. Findings from basic behavioral and social sciences research hold great promise for addressing behaviorally based clinical health problems, yet there is currently no established pathway for translating fundamental behavioral science discoveries into health-related treatments ready for Phase III efficacy testing. This article provides a systematic framework for developing behavioral treatments for preventing and treating chronic diseases. METHOD The Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral treatment development features a flexible and progressive process, prespecified clinically significant milestones for forward movement, and return to earlier stages for refinement and optimization. RESULTS This article presents the background and rationale for the ORBIT model, a summary of key questions for each phase, a selection of study designs and methodologies well-suited to answering these questions, and prespecified milestones for forward or backward movement across phases. CONCLUSIONS The ORBIT model provides a progressive, clinically relevant approach to increasing the number of evidence-based behavioral treatments available to prevent and treat chronic diseases. (PsycINFO Database Record
Collapse
Affiliation(s)
- Susan M Czajkowski
- Clinical Applications and Prevention Branch, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health
| | - Lynda H Powell
- Department of Preventive Medicine, Rush University Medical Center
| | - Nancy Adler
- Department of Psychiatry, Center for Health and Community, University of California, San Francisco
| | | | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University
| | - Christine M Hunter
- Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Barbara Laraia
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley
| | - Deborah H Olster
- Office of Behavioral and Social Sciences Research, Office of the Director, National Institutes of Health
| | - Frank M Perna
- Behavioral Research Program, National Cancer Institute, National Institutes of Health
| | | | - Elissa Epel
- Department of Psychiatry, Center for Health and Community, University of California, San Francisco
| | - Josephine E Boyington
- Clinical Applications and Prevention Branch, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health
| | - Mary E Charlson
- Center for Integrative Medicine, Weill Cornell Medical College
| |
Collapse
|