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Isse HM, Lukande R, Sereke SG, Odubu FJ, Nassanga R, Bugeza S. Correlation of the ultrasound thyroid imaging reporting and data system with cytology findings among patients in Uganda. Thyroid Res 2023; 16:26. [PMID: 37653537 PMCID: PMC10472606 DOI: 10.1186/s13044-023-00169-1] [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: 11/23/2022] [Accepted: 06/10/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Ultrasonography is a noninvasive modality for the initial assessment of thyroid nodules. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) has demonstrated good performance in differentiating malignant thyroid nodules. However, the combination of ACR TI-RADS categories and cytology has not been studied extensively, in Uganda. The study aims to correlate ACR TI-RADS with cytology among patients referred for US-guided fine-needle aspiration at Mulago National Referral Hospital. METHODS This was a hospital-based cross-sectional study that recruited 132 patients with thyroid nodules. Spearman's correlation was used to establish a relationship between TI-RADS and cytology findings. The diagnostic accuracy of TI-RADS was assessed using sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. RESULTS Of 132 study participants, 90% (n = 117) were females, and the mean age was 41 ± 13 years. One hundred sixty-one thyroid nodules were analyzed. More than half of the thyroid nodules (54.7%, n = 87) were solid or almost solid, 96.9% (n = 154) were shaped wider than tall, 57.2% (n = 91) had smooth margins, 83.7% (n = 133) were hyperechoic or isoechoic, and 88.7% (n = 141) had no echogenic foci. TI-RADS 3 was the most common at 42.9% (n = 69). The proportions of malignancy for TI-RADS 4 and TI-RADS 5 were 73.3% and 85.7%, respectively. The correlation between ACR TI-RADS and the Bethesda system of thyroid classification scores was r = 0.577. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of ACR TI-RADS were 90.9%, 98.5%, 90%, 99.3%, 62.3, and 0.1, respectively. CONCLUSION We found that ACR TI-RADS classification is an appropriate and noninvasive method for assessing thyroid nodules in routine practice. It can safely reduce the number of unnecessary fine-needle aspiration in a significant proportion of benign thyroid lesions. Thyroid nodules classified as TI-RADS 3 should be followed routinely. ACR TI-RADS should be standardized as the screening tool in resource-limited areas.
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Affiliation(s)
- Hamdi Mohamed Isse
- Department of Radiology and Radiotherapy, College of Health Science, MakerereUniversity, Kampala, Uganda.
| | - Robert Lukande
- Department of Pathology, College of Health Science, MakerereUniversity, Kampala, Uganda
| | - Senai Goitom Sereke
- Department of Radiology and Radiotherapy, College of Health Science, MakerereUniversity, Kampala, Uganda
| | - Fualal Jane Odubu
- Department of Surgery, College of Health Science, Makerere University, Kampala, Uganda
| | - Rita Nassanga
- Department of Radiology and Radiotherapy, College of Health Science, MakerereUniversity, Kampala, Uganda
| | - Samuel Bugeza
- Department of Radiology and Radiotherapy, College of Health Science, MakerereUniversity, Kampala, Uganda
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Akushevich I, Yashkin A, Ukraintseva S, Yashin AI, Kravchenko J. The Construction of a Multidomain Risk Model of Alzheimer's Disease and Related Dementias. J Alzheimers Dis 2023; 96:535-550. [PMID: 37840484 PMCID: PMC10657690 DOI: 10.3233/jad-221292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and related dementia (ADRD) risk is affected by multiple dependent risk factors; however, there is no consensus about their relative impact in the development of these disorders. OBJECTIVE To rank the effects of potentially dependent risk factors and identify an optimal parsimonious set of measures for predicting AD/ADRD risk from a larger pool of potentially correlated predictors. METHODS We used diagnosis record, survey, and genetic data from the Health and Retirement Study to assess the relative predictive strength of AD/ADRD risk factors spanning several domains: comorbidities, demographics/socioeconomics, health-related behavior, genetics, and environmental exposure. A modified stepwise-AIC-best-subset blanket algorithm was then used to select an optimal set of predictors. RESULTS The final predictive model was reduced to 10 features for AD and 19 for ADRD; concordance statistics were about 0.85 for one-year and 0.70 for ten-year follow-up. Depression, arterial hypertension, traumatic brain injury, cerebrovascular diseases, and the APOE4 proxy SNP rs769449 had the strongest individual associations with AD/ADRD risk. AD/ADRD risk-related co-morbidities provide predictive power on par with key genetic vulnerabilities. CONCLUSION Results confirm the consensus that circulatory diseases are the main comorbidities associated with AD/ADRD risk and show that clinical diagnosis records outperform comparable self-reported measures in predicting AD/ADRD risk. Model construction algorithms combined with modern data allows researchers to conserve power (especially in the study of disparities where disadvantaged groups are often grossly underrepresented) while accounting for a high proportion of AD/ADRD-risk-related population heterogeneity stemming from multiple domains.
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Affiliation(s)
- Igor Akushevich
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Arseniy Yashkin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Svetlana Ukraintseva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Anatoliy I. Yashin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Julia Kravchenko
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
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Ayyadevara S, Ganne A, Balasubramaniam M, Shmookler Reis RJ. Intrinsically disordered proteins identified in the aggregate proteome serve as biomarkers of neurodegeneration. Metab Brain Dis 2022; 37:147-152. [PMID: 34347206 PMCID: PMC8748380 DOI: 10.1007/s11011-021-00791-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/04/2021] [Indexed: 11/26/2022]
Abstract
A protein's structure is determined by its amino acid sequence and post-translational modifications, and provides the basis for its physiological functions. Across all organisms, roughly a third of the proteome comprises proteins that contain highly unstructured or intrinsically disordered regions. Proteins comprising or containing extensive unstructured regions are referred to as intrinsically disordered proteins (IDPs). IDPs are believed to participate in complex physiological processes through refolding of IDP regions, dependent on their binding to a diverse array of potential protein partners. They thus play critical roles in the assembly and function of protein complexes. Recent advances in experimental and computational analyses predicted multiple interacting partners for the disordered regions of proteins, implying critical roles in signal transduction and regulation of biological processes. Numerous disordered proteins are sequestered into aggregates in neurodegenerative diseases such as Alzheimer's disease (AD) where they are enriched even in serum, making them good candidates for serum biomarkers to enable early detection of AD.
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Affiliation(s)
- Srinivas Ayyadevara
- Central Arkansas Veterans Healthcare Service, Little Rock, AR, 72205, USA.
- Reynolds Institute on Aging, Department of Geriatrics, University of Arkansas for Medical Sciences, 629 Jack Stephens Drive, Little Rock, AR, 72205, USA.
- BioInformatics Program, University of Arkansas at Little Rock and University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
| | - Akshatha Ganne
- BioInformatics Program, University of Arkansas at Little Rock and University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Meenakshisundaram Balasubramaniam
- Reynolds Institute on Aging, Department of Geriatrics, University of Arkansas for Medical Sciences, 629 Jack Stephens Drive, Little Rock, AR, 72205, USA
| | - Robert J Shmookler Reis
- Central Arkansas Veterans Healthcare Service, Little Rock, AR, 72205, USA.
- Reynolds Institute on Aging, Department of Geriatrics, University of Arkansas for Medical Sciences, 629 Jack Stephens Drive, Little Rock, AR, 72205, USA.
- BioInformatics Program, University of Arkansas at Little Rock and University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
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Cao Z, Xu C, Yang H, Li S, Xu F, Zhang Y, Wang Y. Associations of BMI and Serum Urate with Developing Dementia: A Prospective Cohort Study. J Clin Endocrinol Metab 2020; 105:5904455. [PMID: 32918088 DOI: 10.1210/clinem/dgaa638] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/09/2020] [Indexed: 01/15/2023]
Abstract
CONTEXT Recent studies have suggested that a higher body mass index (BMI) and serum urate levels were associated with a lower risk of developing dementia. However, these reverse relationships remain controversial, and whether serum urate and BMI confound each other is not well established. OBJECTIVES To investigate the independent associations of BMI and urate, as well as their interaction with the risk of developing dementia. DESIGN AND SETTINGS We analyzed a cohort of 502 528 individuals derived from the UK Biobank that included people aged 37-73 years for whom BMI and urate were recorded between 2006 and 2010. Dementia was ascertained at follow-up using electronic health records. RESULTS During a median of 8.1 years of follow-up, a total of 2138 participants developed dementia. People who were underweight had an increased risk of dementia (hazard ratio [HR] = 1.91, 95% confidence interval [CI]: 1.24-2.97) compared with people of a healthy weight. However, the risk of dementia continued to fall as weight increased, as those who were overweight and obese were 19% (HR = 0.81, 95%: 0.73-0.90) and 22% (HR = 0.78, 95% CI: 0.68-0.88) were less likely to develop dementia than people of a healthy weight. People in the highest quintile of urate were also associated with a 25% (HR = 0.75, 95% CI: 0.64-0.87) reduction in the risk of developing dementia compared with those who were in the lowest quintile. There was a significant multiplicative interaction between BMI and urate in relation to dementia (P for interaction = 0.004), and obesity strengthens the protective effect of serum urate on the risk of dementia. CONCLUSION Both BMI and urate are independent predictors of dementia, and there are inverse monotonic and dose-response associations of BMI and urate with dementia.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chenjie Xu
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongxi Yang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shu Li
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Fusheng Xu
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuan Zhang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
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Vergeld V, Wienert J, Reinwand DA, Tan SL, Lippke S. An 8-Week Study on Social-Cognitive Variables for Physical Activity and Fruit and Vegetable Intake: Are there Stage Transitions? Appl Psychol Health Well Being 2020; 13:109-128. [PMID: 32869518 DOI: 10.1111/aphw.12218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Health behavior change can be modelled in terms of stages, and outcomes of transitions between stages can be categorized into progression, regression, and stagnation. Based on the Health Action Process Approach this study tested whether changes in social-cognitive variables are associated with transitions between stages regarding physical activity (PA) and fruit and vegetable intake (FVI). METHODS N = 132 participants (M = 50.86 years, SD = 13.17, 61.4% women) were assessed at baseline and 8 weeks later. Data were analysed using multivariate analyses of variance (MANOVA) and post-hoc comparisons. RESULTS Changes in motivational self-efficacy (η2 = 0.081), maintenance self-efficacy (η2 = 0.119), and recovery self-efficacy (η2 = 0.049) as well as positive outcome expectancies (η2 = 0.070), negative outcome expectancies (η2 = 0.055), and coping planning (η2 = 0.065) were associated with FVI stage progression. For PA, changes were not associated with stage progression. CONCLUSION To facilitate behavior change effectively, at least for FVI, it is essential to consider underlying mechanisms such as several aspects of self-efficacy in performing the desired health behaviors, outcome expectations, and planning how to overcome barriers. Additionally, the adoption of a stage approach may be a useful starting point to develop stage-matched interventions.
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Affiliation(s)
| | - Julian Wienert
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,University of Cologne, Cologne, Germany
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Faronbi JO, Ajadi AO, Gobbens RJ. Associations of chronic illnesses and socio-demographic factors with health-related quality of life of older adults in Nigeria: A cross-sectional study. Ghana Med J 2020; 54:164-172. [PMID: 33883761 PMCID: PMC8042799 DOI: 10.4314/gmj.v54i3.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The increase in life expectancy has brought about a higher prevalence of chronic illnesses among older people. OBJECTIVES To identify common chronic illnesses among older adults, to examine the influence of such conditions on their Health-Related Quality of Life (HRQoL), and to determine factors predicting their HRQoL. METHOD A population-based cross-sectional study was conducted involving 377 individuals aged 60 years and above who were selected using multi-stage sampling techniques in Olorunda Local Government, Osun State, Nigeria. Data were collected using an interviewer-administered questionnaire comprising socio-demographic characteristics, chronic illnesses, and the World Health Organization quality of life instrument (WHOQOL-BREF) containing physical health, psychological, social relationships, and environmental domains. RESULTS About half (51.5%) of the respondents reported at least one chronic illness which has lasted for 1-5 years (43.3%). The prevalence of hypertension was 36.1%, diabetes 13.9% and arthritis 13.4%. Respondents with chronic illness had significantly lower HRQoL overall and in the physical health, social relationships and the environmental domains (all p<0.05) compared to those without a chronic illness. Factors that predicted HRQoL include age, marital status, level of education, the presence of chronic illness and prognosis of the condition. CONCLUSION This study concluded that chronic illness is prevalent in Nigerian older people and significantly influence their HRQoL. Age, marital status, and level of education were associated with HRQoL in this group. FUNDING Postdoctoral fellowship from Consortium for Advanced Research Training in Afric.
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Affiliation(s)
- Joel O Faronbi
- Department of Nursing Science, College of Health Science, Obafemi Awolowo University, Ile-Ife, Nigeria
- Frail Elderly Research Support Group (FRESH), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Aishat O Ajadi
- Department of Nursing Science, College of Health Science, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Robbert J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands
- Zonnehuisgroep Amstelland, Amstelveen, the Netherlands
- Department of General Practices, University of Antwerp, Belgium
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Ording AG, Horváth-Puhó E, Veres K, Glymour MM, Rørth M, Sørensen HT, Henderson VW. Cancer and risk of Alzheimer's disease: Small association in a nationwide cohort study. Alzheimers Dement 2020; 16:953-964. [PMID: 32432415 DOI: 10.1002/alz.12090] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 01/03/2020] [Accepted: 01/30/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Small observational studies with short-term follow-up suggest that cancer patients are at reduced risk of Alzheimer's disease (AD) compared to the general population. METHODS A nationwide cohort study using Danish population-based health registries (1980-2013) with cancer patients (n = 949,309) to identify incident diagnoses of AD. We computed absolute reductions in risk attributed to cancer and standardized incidence rate ratios (SIRs) accounting for survival time, comparing the observed to expected number of AD cases. RESULTS During up to 34 years of follow-up of cancer survivors, the attributable risk reduction was 1.3 per 10,000 person-years, SIR = 0.94 (95% confidence interval 0.92-0.96). SIRs were similar after stratification by sex, age, and cancer stage, and approached that of the general population for those surviving >10 years. DISCUSSION Inverse associations between cancer and AD were small and diminished over time. Incidence rates in cancer survivors approached those of the general population, suggesting limited association between cancer and AD risk.
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Affiliation(s)
- Anne G Ording
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Katalin Veres
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Mikael Rørth
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Victor W Henderson
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Epidemiology & Population Health, Stanford University, Stanford, California.,Department of Neurology & Neurological Sciences, Stanford University, Stanford, California
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8
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Correlation between potentially inappropriate medication and Alzheimer’s disease among the elderly. Arch Gerontol Geriatr 2020; 87:103842. [DOI: 10.1016/j.archger.2019.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/22/2019] [Accepted: 03/11/2019] [Indexed: 02/05/2023]
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9
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Ording AG, Veres K, Horváth-Puhó E, Glymour MM, Rørth M, Henderson VW, Sørensen HT. Alzheimer’s and Parkinson’s Diseases and the Risk of Cancer: A Cohort Study. J Alzheimers Dis 2019; 72:1269-1277. [DOI: 10.3233/jad-190867] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Anne G. Ording
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Katalin Veres
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Mikael Rørth
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Victor W. Henderson
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Henrik T. Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
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10
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Cho GJ, Hwang SY, Lee KM, Choi KM, Hyun Baik S, Kim T, Han SW, Yoo HJ. Association Between Waist Circumference and Dementia in Older Persons: A Nationwide Population-Based Study. Obesity (Silver Spring) 2019; 27:1883-1891. [PMID: 31689005 DOI: 10.1002/oby.22609] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 07/05/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined whether a positive association exists between waist circumference (WC) and dementia among older persons. METHODS The study population comprised 872,082 participants aged 65 years and older who participated in a Korean national health screening examination between January 1, 2009, and December 31, 2009. Adjusted hazard ratios and 95% CIs for dementia during follow-up from 2009 to 2015 were calculated according to baseline BMI and WC categories. RESULTS After a multivariate adjustment that included BMI, the hazard ratios for dementia showed a stepwise increase according to the increase in WC categories by 5 cm from 85 to 90 cm in men and from 80 to 85 cm in women until ≥ 110 cm (from 1.06 [95% CI: 1.03-1.09] to 1.64 [95% CI: 1.37-1.94] in men and from 1.04 [95% CI: 1.02-1.07] to 1.58 [95% CI: 1.36-1.84] in women). The influence of the current WC category for abdominal obesity on the risk of dementia was different according to BMI; especially, the normal weight men and women with abdominal obesity had a prominent increased risk of dementia compared with those without abdominal obesity. CONCLUSIONS Abdominal obesity, as measured by WC, was associated with significantly increased risk of dementia after adjustment for general obesity.
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Affiliation(s)
- Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Soon Young Hwang
- Department of Biostatistics, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyu-Min Lee
- School of Industrial Management Engineering, Korea University, Seoul, Republic of Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sung Won Han
- School of Industrial Management Engineering, Korea University, Seoul, Republic of Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
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Akushevich I, Kravchenko J, Yashkin AP, Yashin AI. Time trends in the prevalence of cancer and non-cancer diseases among older U.S. adults: Medicare-based analysis. Exp Gerontol 2018; 110:267-276. [PMID: 29932968 PMCID: PMC6876855 DOI: 10.1016/j.exger.2018.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/30/2018] [Accepted: 06/17/2018] [Indexed: 12/15/2022]
Abstract
Longer lifespan is accompanied by a larger number of chronic diseases among older adults. Because of a growing proportion of older adults in the U.S., this brings the problem of age-related morbidity to the forefront as a major contributor to rising medical expenditures. We evaluated 15-year time trends (from 1998 to 2013) in the prevalence of 48 acute and chronic non-cancer diseases and cancers in older U.S. adults aged 65+ and estimated the annual percentage changes of these prevalence trends using SEER-Medicare and HRS-Medicare data. We found that age-adjusted prevalence of cancers of kidney, pancreas, and melanoma, as well as diabetes, renal disease, limb fracture, depression, anemia, weight deficiency, dementia/Alzheimer's disease, drug/medications abuse and several other diseases/conditions increased over time. Conversely, prevalence of myocardial infarction, heart failure, cardiomyopathy, pneumonia/influenza, peptic ulcer, and gastrointestinal bleeding, among others, decreased over time. There are also diseases whose prevalence did not change substantially over time, e.g., a group of fast progressing cancers and rheumatoid arthritis. Analysis of trends of multiple diseases performed simultaneously within one study design with focus on the same time interval and the same population for all diseases allowed us to provide insight into the epidemiology of these conditions and identify the most alarming and/or unexpected trends and trade-offs. The obtained results can be used for health expenditures planning for growing sector of older adults in the U.S.
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Affiliation(s)
- Igor Akushevich
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States of America.
| | - Julia Kravchenko
- Division of Surgical Sciences, Department of Surgery, Duke University School of Medicine, Duke University, Durham, NC, United States of America
| | - Arseniy P Yashkin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States of America
| | - Anatoliy I Yashin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States of America
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12
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Yashin AI, Fang F, Kovtun M, Wu D, Duan M, Arbeev K, Akushevich I, Kulminski A, Culminskaya I, Zhbannikov I, Yashkin A, Stallard E, Ukraintseva S. Hidden heterogeneity in Alzheimer's disease: Insights from genetic association studies and other analyses. Exp Gerontol 2018; 107:148-160. [PMID: 29107063 PMCID: PMC5920782 DOI: 10.1016/j.exger.2017.10.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/20/2017] [Accepted: 10/22/2017] [Indexed: 02/08/2023]
Abstract
Despite evident success in clarifying many important features of Alzheimer's disease (AD) the efficient methods of its prevention and treatment are not yet available. The reasons are likely to be the fact that AD is a multifactorial and heterogeneous health disorder with multiple alternative pathways of disease development and progression. The availability of genetic data on individuals participated in longitudinal studies of aging health and longevity, as well as on participants of cross-sectional case-control studies allow for investigating genetic and non-genetic connections with AD and to link the results of these analyses with research findings obtained in clinical, experimental, and molecular biological studies of this health disorder. The objective of this paper is to perform GWAS of AD in several study populations and investigate possible roles of detected genetic factors in developing AD hallmarks and in other health disorders. The data collected in the Framingham Heart Study (FHS), Cardiovascular Health Study (CHS), Health and Retirement Study (HRS) and Late Onset Alzheimer's Disease Family Study (LOADFS) were used in these analyses. The logistic regression and Cox's regression were used as statistical models in GWAS. The results of analyses confirmed strong associations of genetic variants from well-known genes APOE, TOMM40, PVRL2 (NECTIN2), and APOC1 with AD. Possible roles of these genes in pathological mechanisms resulting in development of hallmarks of AD are described. Many genes whose connection with AD was detected in other studies showed nominally significant associations with this health disorder in our study. The evidence on genetic connections between AD and vulnerability to infection, as well as between AD and other health disorders, such as cancer and type 2 diabetes, were investigated. The progress in uncovering hidden heterogeneity in AD would be substantially facilitated if common mechanisms involved in development of AD, its hallmarks, and AD related chronic conditions were investigated in their mutual connection.
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Affiliation(s)
- Anatoliy I Yashin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA.
| | - Fang Fang
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Mikhail Kovtun
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Deqing Wu
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Matt Duan
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Konstantin Arbeev
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Igor Akushevich
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Alexander Kulminski
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Irina Culminskaya
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Ilya Zhbannikov
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Arseniy Yashkin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Eric Stallard
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA
| | - Svetlana Ukraintseva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Durham, NC 27705, USA.
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13
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Akushevich I, Yashkin AP, Kravchenko J, Fang F, Arbeev K, Sloan F, Yashin AI. Identifying the causes of the changes in the prevalence patterns of diabetes in older U.S. adults: A new trend partitioning approach. J Diabetes Complications 2018; 32:362-367. [PMID: 29433960 PMCID: PMC5849520 DOI: 10.1016/j.jdiacomp.2017.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/28/2017] [Accepted: 12/29/2017] [Indexed: 11/23/2022]
Abstract
AIMS To identify how efforts to control the diabetes epidemic and the resulting changes in diabetes mellitus, type II (T2D) incidence and survival have affected the time-trend of T2D prevalence. METHODS A newly developed method of trend decomposition was applied to a 5% sample of Medicare administrative claims filed between 1991 and 2012. RESULTS Age-adjusted prevalence of T2D for adults age 65+ increased at an average annual percentage change of 2.31% between 1992 and 2012. Primary contributors to this trend were (in order of magnitude): improved survival at all ages, increased prevalence of T2D prior to age of Medicare eligibility, decreased incidence of T2D after age of Medicare eligibility. CONCLUSIONS Health services supported by the Medicare system, coupled with improvements in medical technology and T2D awareness efforts provide effective care for individuals age 65 and older. However, policy maker attention should be shifted to the prevention of T2D in younger age groups to control the increase in prevalence observed prior to Medicare eligibility.
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Affiliation(s)
- Igor Akushevich
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
| | - Arseniy P Yashkin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States.
| | - Julia Kravchenko
- Department of Surgery, Duke University School of Medicine, Durham, NC, United States
| | - Fang Fang
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
| | - Konstantin Arbeev
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
| | - Frank Sloan
- Department of Economics, Duke University, Durham, NC, United States
| | - Anatoliy I Yashin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
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14
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Yashkin AP, Akushevich I, Ukraintseva S, Yashin A. The Effect of Adherence to Screening Guidelines on the Risk of Alzheimer's Disease in Elderly Individuals Newly Diagnosed With Type 2 Diabetes Mellitus. Gerontol Geriatr Med 2018; 4:2333721418811201. [PMID: 30450369 PMCID: PMC6236474 DOI: 10.1177/2333721418811201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/02/2018] [Accepted: 10/15/2018] [Indexed: 12/12/2022] Open
Abstract
Objective: The aim of this study was to examine the possibility that type 2 diabetes and Alzheimer's disease may share common behavioral protective factors such as adherence to type 2 diabetes treatment guidelines given that these two diseases have both epidemiological and metabolic similarities. Method: The method used in this study is a retrospective cohort study of 3,797 U.S. Medicare fee-for-service beneficiaries aged 66+ newly diagnosed with type 2 diabetes and without a prior record of Alzheimer's disease based on the Health and Retirement Study. Results: Results of a left-truncated Cox model showed that adherence reduces the risk of Alzheimer's disease by 20% to 24%. Other significant effects were college education (hazard ratio [HR]: 0.65; p value: .023), stroke (HR: 1.40; p value: .013), and 4+ limitations in physical functioning (HR: 1.33; p value: .008). Discussion: Risk of Alzheimer's disease can be reduced by behavioral factors. Possible mechanisms may include earlier start of interventions to reduce blood glucose levels and improve insulin sensitivity.
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15
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Pokorski M, Barassi G, Bellomo RG, Prosperi L, Crudeli M, Saggini R. Bioprogressive Paradigm in Physiotherapeutic and Antiaging Strategies: A Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1116:1-9. [DOI: 10.1007/5584_2018_281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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16
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Ponomarenko P, Chadaeva I, Rasskazov DA, Sharypova E, Kashina EV, Drachkova I, Zhechev D, Ponomarenko MP, Savinkova LK, Kolchanov N. Candidate SNP Markers of Familial and Sporadic Alzheimer's Diseases Are Predicted by a Significant Change in the Affinity of TATA-Binding Protein for Human Gene Promoters. Front Aging Neurosci 2017; 9:231. [PMID: 28775688 PMCID: PMC5517495 DOI: 10.3389/fnagi.2017.00231] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 07/04/2017] [Indexed: 12/14/2022] Open
Abstract
While year after year, conditions, quality, and duration of human lives have been improving due to the progress in science, technology, education, and medicine, only eight diseases have been increasing in prevalence and shortening human lives because of premature deaths according to the retrospective official review on the state of US health, 1990-2010. These diseases are kidney cancer, chronic kidney diseases, liver cancer, diabetes, drug addiction, poisoning cases, consequences of falls, and Alzheimer's disease (AD) as one of the leading pathologies. There are familial AD of hereditary nature (~4% of cases) and sporadic AD of unclear etiology (remaining ~96% of cases; i.e., non-familial AD). Therefore, sporadic AD is no longer a purely medical problem, but rather a social challenge when someone asks oneself: “What can I do in my own adulthood to reduce the risk of sporadic AD at my old age to save the years of my lifespan from the destruction caused by it?” Here, we combine two computational approaches for regulatory SNPs: Web service SNP_TATA_Comparator for sequence analysis and a PubMed-based keyword search for articles on the biochemical markers of diseases. Our purpose was to try to find answers to the question: “What can be done in adulthood to reduce the risk of sporadic AD in old age to prevent the lifespan reduction caused by it?” As a result, we found 89 candidate SNP markers of familial and sporadic AD (e.g., rs562962093 is associated with sporadic AD in the elderly as a complication of stroke in adulthood, where natural marine diets can reduce risks of both diseases in case of the minor allele of this SNP). In addition, rs768454929, and rs761695685 correlate with sporadic AD as a comorbidity of short stature, where maximizing stature in childhood and adolescence as an integral indicator of health can minimize (or even eliminate) the risk of sporadic AD in the elderly. After validation by clinical protocols, these candidate SNP markers may become interesting to the general population [may help to choose a lifestyle (in childhood, adolescence, and adulthood) that can reduce the risks of sporadic AD, its comorbidities, and complications in the elderly].
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Affiliation(s)
- Petr Ponomarenko
- Children's Hospital Los Angeles, University of Southern CaliforniaLos Angeles, CA, United States
| | - Irina Chadaeva
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia.,Faculty of Natural Sciences, Novosibirsk State UniversityNovosibirsk, Russia
| | - Dmitry A Rasskazov
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia
| | - Ekaterina Sharypova
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia
| | - Elena V Kashina
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia
| | - Irina Drachkova
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia
| | - Dmitry Zhechev
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia
| | - Mikhail P Ponomarenko
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia.,Faculty of Natural Sciences, Novosibirsk State UniversityNovosibirsk, Russia
| | - Ludmila K Savinkova
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia
| | - Nikolay Kolchanov
- Division for System Biology, Institute of Cytology and Genetics of Siberian Branch of Russian Academy of SciencesNovosibirsk, Russia.,Faculty of Natural Sciences, Novosibirsk State UniversityNovosibirsk, Russia
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17
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Frain L, Swanson D, Cho K, Gagnon D, Lu KP, Betensky RA, Driver J. Association of cancer and Alzheimer's disease risk in a national cohort of veterans. Alzheimers Dement 2017; 13:1364-1370. [PMID: 28711346 DOI: 10.1016/j.jalz.2017.04.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/04/2017] [Accepted: 04/29/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION To examine the risk of Alzheimer's disease (AD) among cancer survivors in a national database. METHODS Retrospective cohort of 3,499,378 mostly male US veterans aged ≥65 years were followed between 1996 and 2011. We used Cox models to estimate risk of AD and alternative outcomes (non-AD dementia, osteoarthritis, stroke, and macular degeneration) in veterans with and without a history of cancer. RESULTS Survivors of a wide variety of cancers had modestly lower AD risk, but increased risk of the alternative outcomes. Survivors of screened cancers, including prostate cancer, had a slightly increased AD risk. Cancer treatment was independently associated with decreased AD risk; those who received chemotherapy had a lower risk than those who did not. DISCUSSION Survivors of some cancers have a lower risk of AD but not other age-related conditions, arguing that lower AD diagnosis is not simply due to bias. Cancer treatment may be associated with decreased risk of AD.
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Affiliation(s)
- Laura Frain
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
| | - David Swanson
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Kelly Cho
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA; Massachusetts Veterans Epidemiology and Resource Information Center (MAVERIC), VA Boston Healthcare System (VABHS), Jamaica Plain, MA, USA
| | - David Gagnon
- Massachusetts Veterans Epidemiology and Resource Information Center (MAVERIC), VA Boston Healthcare System (VABHS), Jamaica Plain, MA, USA; Boston University School of Public Health, Boston, MA, USA
| | - Kun Ping Lu
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Rebecca A Betensky
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jane Driver
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA; Massachusetts Veterans Epidemiology and Resource Information Center (MAVERIC), VA Boston Healthcare System (VABHS), Jamaica Plain, MA, USA; Geriatric Research Education and Clinical Center, VABHS, Jamaica Plain, MA, USA.
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18
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The influence of caregivers' burden on the quality of life for caregivers of older adults with chronic illness in Nigeria. Int Psychogeriatr 2017; 29:1085-1093. [PMID: 28287058 DOI: 10.1017/s1041610216002295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND This study investigated the impact of caregivers' burden on health-related quality of life (HRQoL) among the caregivers of older adults, and tested the predictive effect of burden and socio-demographic factors on HRQoL. METHODS The study employed a cross-sectional design. Three hundred and twenty-five caregivers of older adults with chronic illness were purposively selected. Data were collected using the Zarit Burden Interview and Short Form (SF-36) Health Survey. Data were analyzed descriptively and inferentially. RESULTS Findings revealed that 59.1% of caregivers experienced severe burden. In measuring the HQRoL, respondents performed poorly in seven domains: Role limitation due to emotional problems (19.69 ± 9.46), Energy/fatigue (43.47 ± 16.46), Emotional well-being, (45.83 ± 13.93), Social functioning (49.09 ± 18.46), Role limitation due to physical function (43.33 ± 10.15), Physical functioning (43.6 ± 18.73), and General health (37.31 ± 12.09). Respondents, however, showed a higher score in the pain domain (56.77 ± 35.79). Furthermore, findings revealed a positive correlation between caregivers' burden and General health (r = 0.342), Emotional well-being (r = 0.222), and Physical functioning (r = 0.083). Similarly, there is a negative correlation between caregivers' burden and Social functioning (r = -0.618), Role limitation due to physical activities (r = 0.459), Role limitation due to emotional well-being (r = -0.530), and Energy/fatigue domains (r = -0.509). In addition, burden of caregiving (β=-3.142119, p = 0.000) and age (β=0.612752, p = 0.011) are predictors of the quality of life of caregivers. DISCUSSION This study concluded that there is a high prevalence of caregivers' burden resulting in poor HQRoL. In addition, burden and age are predictors of the quality of life of caregivers.
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19
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Nolen SC, Evans MA, Fischer A, Corrada MM, Kawas CH, Bota DA. Cancer-Incidence, prevalence and mortality in the oldest-old. A comprehensive review. Mech Ageing Dev 2017; 164:113-126. [PMID: 28502820 PMCID: PMC7788911 DOI: 10.1016/j.mad.2017.05.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 05/01/2017] [Accepted: 05/08/2017] [Indexed: 12/16/2022]
Abstract
Chronic health conditions are commonplace in older populations. The process of aging impacts many of the world's top health concerns. With the average life expectancy continuing to climb, understanding patterns of morbidity in aging populations has become progressively more important. Cancer is an age-related disease, whose risk has been proven to increase with age. Limited information is published about the epidemiology of cancer and the cancer contribution to mortality in the 85+ age group, often referred to as the oldest-old. In this review, we perform a comprehensive assessment of the most recent (2011-2016) literature on cancer prevalence, incidence and mortality in the oldest-old. The data shows cancer prevalence and cancer incidence increases until ages 85-89, after which the rates decrease into 100+ ages. However the number of overall cases has steadily increased over time due to the rise in population. Cancer mortality continues to increase after age 85+. This review presents an overview of plausible associations between comorbidity, genetics and age-related physiological effects in relation to cancer risk and protection. Many of these age-related processes contribute to the lowered risk of cancer in the oldest-old, likewise other certain health conditions may "protect" from cancer in this age group.
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Affiliation(s)
- Shantell C Nolen
- Department of Neurology, UC Irvine Medical Center, United States; Department of Epidemiology, UC Irvine, United States.
| | - Marcella A Evans
- School of Medicine, UC Irvine Medical Center, United States; Department of Epidemiology, UC Irvine, United States
| | - Avital Fischer
- School of Medicine, UC Irvine Medical Center, United States; Department of Epidemiology, UC Irvine, United States
| | - Maria M Corrada
- Department of Neurology, UC Irvine Medical Center, United States; Institute for Memory Impairment and Neurological Disorders, United States
| | - Claudia H Kawas
- Department of Neurology, UC Irvine Medical Center, United States; Institute for Memory Impairment and Neurological Disorders, United States; Department of Neurobiology and Behavior, UC Irvine, United States
| | - Daniela A Bota
- Department of Neurology, UC Irvine Medical Center, United States; Chao Family Comprehensive Cancer Center, UC Irvine Medical Center, United States; Department of Neurological Surgery, UC Irvine Medical Center, United States
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20
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Akushevich I, Yashkin AP, Kravchenko J, Fang F, Arbeev K, Sloan F, Yashin AI. Theory of partitioning of disease prevalence and mortality in observational data. Theor Popul Biol 2017; 114:117-127. [PMID: 28130147 DOI: 10.1016/j.tpb.2017.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 01/13/2023]
Abstract
In this study, we present a new theory of partitioning of disease prevalence and incidence-based mortality and demonstrate how this theory practically works for analyses of Medicare data. In the theory, the prevalence of a disease and incidence-based mortality are modeled in terms of disease incidence and survival after diagnosis supplemented by information on disease prevalence at the initial age and year available in a dataset. Partitioning of the trends of prevalence and mortality is calculated with minimal assumptions. The resulting expressions for the components of the trends are given by continuous functions of data. The estimator is consistent and stable. The developed methodology is applied for data on type 2 diabetes using individual records from a nationally representative 5% sample of Medicare beneficiaries age 65+. Numerical estimates show excellent concordance between empirical estimates and theoretical predictions. Evaluated partitioning model showed that both prevalence and mortality increase with time. The primary driving factors of the observed prevalence increase are improved survival and increased prevalence at age 65. The increase in diabetes-related mortality is driven by increased prevalence and unobserved trends in time-periods and age-groups outside of the range of the data used in the study. Finally, the properties of the new estimator, possible statistical and systematical uncertainties, and future practical applications of this methodology in epidemiology, demography, public health and health forecasting are discussed.
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Affiliation(s)
- I Akushevich
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States.
| | - A P Yashkin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
| | - J Kravchenko
- Department of Surgery, Duke University School of Medicine, Durham, NC, United States
| | - F Fang
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
| | - K Arbeev
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
| | - F Sloan
- Department of Economics, Duke University, Durham, NC, United States
| | - A I Yashin
- Biodemography of Aging Research Unit, Center for Population Health and Aging, Duke University, Durham, NC, United States
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21
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Freedman DM, Wu J, Chen H, Kuncl RW, Enewold LR, Engels EA, Freedman ND, Pfeiffer RM. Associations between cancer and Alzheimer's disease in a U.S. Medicare population. Cancer Med 2016; 5:2965-2976. [PMID: 27628596 PMCID: PMC5083750 DOI: 10.1002/cam4.850] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/29/2016] [Accepted: 07/11/2016] [Indexed: 01/04/2023] Open
Abstract
Several studies have reported bidirectional inverse associations between cancer and Alzheimer's disease (AD). This study evaluates these relationships in a Medicare population. Using Surveillance, Epidemiology, and End Results (SEER) linked to Medicare data, 1992-2005, we evaluated cancer risks following AD in a case-control study of 836,947 cancer cases and 142,869 controls as well as AD risk after cancer in 742,809 cancer patients and a non-cancer group of 420,518. We applied unconditional logistic regression to estimate odds ratios (ORs) and Cox proportional hazards models to estimate hazards ratios (HRs). We also evaluated cancer in relation to automobile injuries as a negative control to explore potential study biases. In the case-control analysis, cancer cases were less likely to have a prior diagnosis of AD than controls (OR = 0.86; 95% CI = 0.81-0.92). Cancer cases were also less likely than controls to have prior injuries from automobile accidents to the same degree (OR = 0.83; 95% CI = 0.78-0.88). In the prospective cohort, there was a lower risk observed in cancer survivors, HR = 0.87 (95% CI = 0.84-0.90). In contrast, there was no association between cancer diagnosis and subsequent automobile accident injuries (HR = 1.03; 95% CI = 0.98-1.07). That cancer risks were similarly reduced after both AD and automobile injuries suggest biases against detecting cancer in persons with unrelated medical conditions. The modestly lower AD risk in cancer survivors may reflect underdiagnosis of AD in those with a serious illness. This study does not support a relationship between cancer and AD.
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Affiliation(s)
- Daryl Michal Freedman
- Department of Health and Human Services, National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
| | - Jincao Wu
- Department of Health and Human Services, National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Honglei Chen
- Aging and Neuro-epidemiology Group, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, North Carolina
| | - Ralph W Kuncl
- Department of Biology, University of Redlands, Redlands, California
| | - Lindsey R Enewold
- Department of Health and Human Services, National Institutes of Health, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Eric A Engels
- Department of Health and Human Services, National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Neal D Freedman
- Department of Health and Human Services, National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Ruth M Pfeiffer
- Department of Health and Human Services, National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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22
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Chuang YF, An Y, Bilgel M, Wong DF, Troncoso JC, O'Brien RJ, Breitner JC, Ferruci L, Resnick SM, Thambisetty M. Midlife adiposity predicts earlier onset of Alzheimer's dementia, neuropathology and presymptomatic cerebral amyloid accumulation. Mol Psychiatry 2016; 21:910-5. [PMID: 26324099 PMCID: PMC5811225 DOI: 10.1038/mp.2015.129] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/14/2015] [Accepted: 07/22/2015] [Indexed: 11/09/2022]
Abstract
Understanding how midlife risk factors influence age at onset (AAO) of Alzheimer's disease (AD) may provide clues to delay disease expression. Although midlife adiposity predicts increased incidence of AD, it is unclear whether it affects AAO and severity of Alzheimer's neuropathology. Using a prospective population-based cohort, Baltimore Longitudinal Study of Aging (BLSA), this study aims to examine the relationships between midlife body mass index (BMI) and (1) AAO of AD (2) severity of Alzheimer's neuropathology and (3) fibrillar brain amyloid deposition during aging. We analyzed data on 1394 cognitively normal individuals at baseline (8643 visits; average follow-up interval 13.9 years), among whom 142 participants developed incident AD. In two subsamples of BLSA, 191 participants underwent autopsy and neuropathological assessment, and 75 non-demented individuals underwent brain amyloid imaging. Midlife adiposity was derived from BMI data at 50 years of age. We find that each unit increase in midlife BMI predicts earlier onset of AD by 6.7 months (P=0.013). Higher midlife BMI was associated with greater Braak neurofibrillary but not CERAD (Consortium to Establish a Registry for Alzheimer's Disease) neuritic plaque scores at autopsy overall. Associations between midlife BMI and brain amyloid burden approached statistical significance. Thus, higher midlife BMI was also associated with greater fibrillar amyloid measured by global mean cortical distribution volume ratio (P=0.075) and within the precuneus (left, P=0.061; right, P=0.079). In conclusion, midlife overweight predicts earlier onset of AD and greater burden of Alzheimer's neuropathology. A healthy BMI at midlife may delay the onset of AD.
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Affiliation(s)
- Y-F Chuang
- Clinical and Translational Neuroscience Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Y An
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - M Bilgel
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
- Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D F Wong
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science and Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J C Troncoso
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R J O'Brien
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J C Breitner
- Centre for Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - L Ferruci
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - S M Resnick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - M Thambisetty
- Clinical and Translational Neuroscience Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
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Abstract
Multimorbidity, the co-occurrence of multiple physical or psychological illnesses, is prevalent particularly among older adults. The number of Americans with multiple chronic diseases is projected to increase from 57 million in 2000 to 81 million in 2020. However, behavioral medicine and health psychology, while focusing on the co-occurrence of psychological/psychiatric disorders with primary medical morbidities, have historically tended to ignore the co-occurrence of primary medical comorbidities, such as diabetes and cancer, and their biopsychosocial implications. This approach may hinder our ecologically valid understanding of the etiology, prevention, and treatment for individual patients with multimorbidity. In this selective review, we propose a heuristic behavioral framework for the etiology of multimorbidity. More acknowledgment and systematic research on multiple, co-existing disorders in behavioral medicine are consistent with the biopsychosocial model's emphasis on treating the "whole person," which means not considering any single illness, its symptoms, risk factors, or mechanisms, in isolation. As systems analytics, big data, machine learning, and mixed-model trajectory analyses, among others, come online and become more widely available, we may be able to tackle multimorbidity more holistically, efficiently, and satisfactorily.
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Qiu M, Qiu H, Jin Y, Wei X, Zhou Y, Wang Z, Wang D, Ren C, Luo H, Wang F, Zhang D, Wang F, Li Y, Yang D, Xu R. Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value. J Cancer 2016; 7:694-701. [PMID: 27076851 PMCID: PMC4829556 DOI: 10.7150/jca.14185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/22/2016] [Indexed: 12/18/2022] Open
Abstract
Purpose: Even with the development of new biopsy methods, diagnosis of pancreatic cancer is sometimes without histological evidence. The aim of our study is to find out the status of pancreatic cancer patients who are diagnosed without pathologic confirm and the prognostic value of pathologic diagnosis. Methods: We identified 52,759 pancreatic adenocarcinoma patients from the Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression model was used to identify factors relating to no pathologic diagnosis. Multivariable Cox regression model identified potential prognostic factors. All statistical tests were two-sided. Results: There were 6206 (11.76%) patients without pathologic diagnosis. Older age, reported from nursing/convalescent home/hospice or physician's office/private medical practitioner, early year of diagnosis, larger tumor size, pancreatic head cancer, unmarried patients, uninsured and stage I disease all contributed to no pathologic diagnosis. Median cause specific-survival for patients with and without pathologic diagnosis were 7.72 and 3.52 months, respectively. The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001. Conclusions: Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients. New diagnostic methods are needed to get the pathologic diagnosis.
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Affiliation(s)
- Miaozhen Qiu
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China.; 2. Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Huijuan Qiu
- 3. Department of VIP, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Ying Jin
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Xiaoli Wei
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Yixin Zhou
- 3. Department of VIP, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Zixian Wang
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Deshen Wang
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Chao Ren
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Huiyan Luo
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Feng Wang
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Dongsheng Zhang
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Fenghua Wang
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Yuhong Li
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
| | - Dajun Yang
- 4. Department of Experimental Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, China
| | - Ruihua Xu
- 1. Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, China
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25
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Freedman DM, Wu J, Chen H, Engels EA, Enewold LR, Freedman ND, Goedert JJ, Kuncl RW, Gail MH, Pfeiffer RM. Associations between cancer and Parkinson's disease in U.S. elderly adults. Int J Epidemiol 2016; 45:741-51. [PMID: 26989123 DOI: 10.1093/ije/dyw016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Several studies suggest that cancer is reduced before and after a Parkinson's disease (PD) diagnosis. However, determining relationships among diseases of ageing is challenging due to possible biases in ascertaining disease. This study evaluates the PD and cancer relationship, addressing potential biases. METHODS Using Surveillance, Epidemiology, and End Results-Medicare linked data (1992-2005) of adults ≥ 65 years, we assessed PD risk after cancer comparing PD in 743 779 cancer patients with PD in a non-cancer group (n = 419 432) in prospective cohort analyses. We also conducted a case-control study of 836 947 cancer cases and 142 869 controls to assess cancer following PD. We applied Cox proportional hazards models to estimate hazards ratios (HRs) for PD after cancer and unconditional logistic regression to estimate odds ratios (ORs) for PD preceding cancer, controlling for physician visits and other factors. To explore biases in ascertaining cancer, we examined relationships between cancer and automobile accident injuries, which we expected to be null. RESULTS No association was observed between cancer and subsequent PD [HR = 0.97; 95% confidence interval (CI) = 0.92-1.01] nor between cancer and subsequent automobile injuries (HR = 1.03; 95% CI = 0.98-1.07). One site, lung cancer, was associated with subsequent reduced PD, which may reflect confounding by smoking. In the case-control analysis, PD was associated with reduced subsequent cancer, overall (OR = 0.77; 95% CI = 0.71-0.82) and for several cancer sites. However, the automobile injury/ subsequent cancer association was similar (OR = 0.83; 95% CI = 0.78-0.88), suggesting a cancer detection bias after serious health outcomes. CONCLUSIONS In totality, our data do not support a biological relationship between PD and cancer.
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Affiliation(s)
- D Michal Freedman
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
| | - Jincao Wu
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, MD, USA
| | - Honglei Chen
- National Institute of Environmental Health Sciences, Aging and Neuroepidemiology Group, Research Triangle Park, NC, USA
| | - Eric A Engels
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
| | - Lindsey R Enewold
- National Cancer Institute, Division of Cancer Control and Population Sciences, Rockville, MD, USA and
| | - Neal D Freedman
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
| | - James J Goedert
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
| | - Ralph W Kuncl
- University of Redlands, Department of Biology, Redlands, CA, USA
| | - Mitchell H Gail
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
| | - Ruth M Pfeiffer
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
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26
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Akushevich I, Kravchenko J, Arbeev KG, Ukraintseva SV, Land KC, Yashin AI. Health Effects and Medicare Trajectories: Population-Based Analysis of Morbidity and Mortality Patterns. BIODEMOGRAPHY OF AGING 2016. [DOI: 10.1007/978-94-017-7587-8_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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27
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Stepanova M, Rodriguez E, Birerdinc A, Baranova A. Age-independent rise of inflammatory scores may contribute to accelerated aging in multi-morbidity. Oncotarget 2015; 6:1414-21. [PMID: 25638154 PMCID: PMC4359303 DOI: 10.18632/oncotarget.2725] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 11/10/2014] [Indexed: 01/04/2023] Open
Abstract
Aging is associated with an increase in a chronic, low-grade inflammation. This phenomenon, termed “inflammaging” is also a risk factor for both morbidity and mortality in the elderly. Frequent co-occurrence of chronic diseases, known as multi-morbidity, may be explained by interconnected pathophysiology of these conditions, most of which depend on its inflammatory component. Here we present an analysis of the U.S. National Health and Nutrition Examination Survey data collected between 1999 and 2008, for the presence, and the number, of chronic diseases along with HDL-cholesterol, C-reactive protein, white blood cell count, lymphocyte percent, monocyte percent, segmented neutrophils percent, eosinophils percent, basophils percent, and glycohemoglobin levels. Importantly, even after adjustment for age and BMI, many inflammatory markers continued to be associated to multi-morbidity. C-reactive protein (CRP) levels and Glasgow Prognostic Score (GPS) were most dramatically increased in parallel with an accumulation of chronic diseases, and may be utilized as multi-morbidity predictors. These observations point at background inflammation as direct, age-independent contributor to an accumulation of the disease burden. Our findings also suggest a possibility that systemic inflammation associated with chronic diseases may explain accelerated aging phenomenon previously observed among the patients with heavy disease burden.
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Affiliation(s)
- Maria Stepanova
- Center for the Study of Chronic Metabolic Diseases, School of System Biology, George Mason University, Fairfax, VA, USA.,Betty and Guy Beatty Center for Integrated Research, Inova Health Systems, Falls Church, VA, USA
| | - Edgar Rodriguez
- Center for the Study of Chronic Metabolic Diseases, School of System Biology, George Mason University, Fairfax, VA, USA
| | - Aybike Birerdinc
- Center for the Study of Chronic Metabolic Diseases, School of System Biology, George Mason University, Fairfax, VA, USA.,Betty and Guy Beatty Center for Integrated Research, Inova Health Systems, Falls Church, VA, USA
| | - Ancha Baranova
- Center for the Study of Chronic Metabolic Diseases, School of System Biology, George Mason University, Fairfax, VA, USA.,Betty and Guy Beatty Center for Integrated Research, Inova Health Systems, Falls Church, VA, USA.,Research Center for Medical Genetics RAMS, Moscow, Russian Federation.,Atlas Biomed Group, Moscow, Russia
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28
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Puzzling role of genetic risk factors in human longevity: "risk alleles" as pro-longevity variants. Biogerontology 2015; 17:109-27. [PMID: 26306600 PMCID: PMC4724477 DOI: 10.1007/s10522-015-9600-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/19/2015] [Indexed: 02/07/2023]
Abstract
Complex diseases are major contributors to human mortality in old age. Paradoxically, many genetic variants that have been associated with increased risks of such diseases are found in genomes of long-lived people, and do not seem to compromise longevity. Here we argue that trade-off-like and conditional effects of genes can play central role in this phenomenon and in determining longevity. Such effects may occur as result of: (i) antagonistic influence of gene on the development of different health disorders; (ii) change in the effect of gene on vulnerability to death with age (especially, from “bad” to “good”); (iii) gene–gene interaction; and (iv) gene–environment interaction, among other factors. A review of current knowledge provides many examples of genetic factors that may increase the risk of one disease but reduce chances of developing another serious health condition, or improve survival from it. Factors that may increase risk of a major disease but attenuate manifestation of physical senescence are also discussed. Overall, available evidence suggests that the influence of a genetic variant on longevity may be negative, neutral or positive, depending on a delicate balance of the detrimental and beneficial effects of such variant on multiple health and aging related traits. This balance may change with age, internal and external environments, and depend on genetic surrounding. We conclude that trade-off-like and conditional genetic effects are very common and may result in situations when a disease “risk allele” can also be a pro-longevity variant, depending on context. We emphasize importance of considering such effects in both aging research and disease prevention.
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29
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Yashin AI, Arbeev KG, Arbeeva LS, Wu D, Akushevich I, Kovtun M, Yashkin A, Kulminski A, Culminskaya I, Stallard E, Li M, Ukraintseva SV. How the effects of aging and stresses of life are integrated in mortality rates: insights for genetic studies of human health and longevity. Biogerontology 2015; 17:89-107. [PMID: 26280653 DOI: 10.1007/s10522-015-9594-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/25/2015] [Indexed: 12/21/2022]
Abstract
Increasing proportions of elderly individuals in developed countries combined with substantial increases in related medical expenditures make the improvement of the health of the elderly a high priority today. If the process of aging by individuals is a major cause of age related health declines then postponing aging could be an efficient strategy for improving the health of the elderly. Implementing this strategy requires a better understanding of genetic and non-genetic connections among aging, health, and longevity. We review progress and problems in research areas whose development may contribute to analyses of such connections. These include genetic studies of human aging and longevity, the heterogeneity of populations with respect to their susceptibility to disease and death, forces that shape age patterns of human mortality, secular trends in mortality decline, and integrative mortality modeling using longitudinal data. The dynamic involvement of genetic factors in (i) morbidity/mortality risks, (ii) responses to stresses of life, (iii) multi-morbidities of many elderly individuals, (iv) trade-offs for diseases, (v) genetic heterogeneity, and (vi) other relevant aging-related health declines, underscores the need for a comprehensive, integrated approach to analyze the genetic connections for all of the above aspects of aging-related changes. The dynamic relationships among aging, health, and longevity traits would be better understood if one linked several research fields within one conceptual framework that allowed for efficient analyses of available longitudinal data using the wealth of available knowledge about aging, health, and longevity already accumulated in the research field.
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Affiliation(s)
- Anatoliy I Yashin
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA. .,The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Room A102E, Durham, NC, 27705, USA.
| | - Konstantin G Arbeev
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Liubov S Arbeeva
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Deqing Wu
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Igor Akushevich
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Mikhail Kovtun
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Arseniy Yashkin
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Alexander Kulminski
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Irina Culminskaya
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Eric Stallard
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Miaozhu Li
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Svetlana V Ukraintseva
- The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA.,The Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, 2024 W. Main Street, Room A105, Durham, NC, 27705, USA
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30
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Arbeev KG, Akushevich I, Kulminski AM, Ukraintseva SV, Yashin AI. Biodemographic Analyses of Longitudinal Data on Aging, Health, and Longevity: Recent Advances and Future Perspectives. ADVANCES IN GERIATRICS 2015; 2014:957073. [PMID: 25590047 PMCID: PMC4290867 DOI: 10.1155/2014/957073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Biodemography became one of the most innovative and fastest growing areas in demography. This progress is fueled by the growing variability and amount of relevant data available for analyses as well as by methodological developments allowing for addressing new research questions using new approaches that can better utilize the potential of these data. In this review paper, we summarize recent methodological advances in biodemography and their diverse practical applications. Three major topics are covered: (1) computational approaches to reconstruction of age patterns of incidence of geriatric diseases and other characteristics such as recovery rates at the population level using Medicare claims data; (2) methodological advances in genetic and genomic biodemography and applications to research on genetic determinants of longevity and health; and (3) biodemographic models for joint analyses of time-to-event data and longitudinal measurements of biomarkers collected in longitudinal studies on aging. We discuss how such data and methodology can be used in a comprehensive prediction model for joint analyses of incomplete datasets that take into account the wide spectrum of factors affecting health and mortality transitions including genetic factors and hidden mechanisms of aging-related changes in physiological variables in their dynamic connection with health and survival.
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Affiliation(s)
- Konstantin G Arbeev
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Igor Akushevich
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Alexander M Kulminski
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Svetlana V Ukraintseva
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Anatoliy I Yashin
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
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31
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Li C, Xu C, Ma H, Ni B, Chen J, Chen T, Zhang H, Zhao J. Video-assisted thoracoscopic lobectomy with a single utility port is feasible in the treatment of elderly patients with peripheral lung cancer. Thorac Cancer 2014; 5:219-24. [PMID: 26767004 DOI: 10.1111/1759-7714.12081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 11/10/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Video-assisted thoracoscopic (VATS) lobectomy with a single utility port has emerged as a new technology in recent years. The aim of this study is to review the technology in the treatment of elderly patients with peripheral lung cancer. METHODS We retrospectively analyzed the clinical data of 21 elderly patients with peripheral lung cancer who underwent single utility port VATS lobectomy from February 2011 to February 2013 in the First Affiliated Hospital of Soochow University (VATS group). The clinical outcomes and postoperative complications were then compared to data from 32 elderly patients who underwent lobectomy by thoracotomy (TL group). RESULTS No mortality occurred during the postoperative period in either group. There was no statistical difference in surgery duration, the quantity of lymph node dissection or intraoperative blood loss between the VATS and TL groups. However, significant differences existed in the postoperative hospital stay (6.19 ± 1.69 days vs. 8.22 ± 2.55 days), time to first activity out of bed (20.57 ± 7.72 hours vs. 26.81 ± 9.27 hours), chest drainage duration (4.24 ± 1.04 days vs. 5.22 ± 1.29 days), and total postoperative drainage volume (642.86 ± 158.18 mL vs. 787.81 ± 211.55 mL) between the VATS and TL groups (P <0.05). The percentage of patients with no complications in the VATS group (85.71%) is significantly higher when compared with the TL group (56.25%, P <0.05). CONCLUSION VATS lobectomy with a single utility port is a safe and feasible surgical procedure for selected elderly patients with peripheral lung cancer.
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Affiliation(s)
- Chang Li
- Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China; Soochow University Laboratory of Cancer Molecular Genetics, Medical College of Soochow University Suzhou, China; Suzhou Key Laboratory for Cancer Molecular Genetics Suzhou, China
| | - Chun Xu
- Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China
| | - Haitao Ma
- Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China
| | - Bin Ni
- Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China
| | - Jun Chen
- Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China
| | - Tengfei Chen
- Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China
| | - Hongtao Zhang
- Soochow University Laboratory of Cancer Molecular Genetics, Medical College of Soochow University Suzhou, China; Suzhou Key Laboratory for Cancer Molecular Genetics Suzhou, China
| | - Jun Zhao
- Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Soochow University, Medical College of Soochow University Suzhou, China; Soochow University Laboratory of Cancer Molecular Genetics, Medical College of Soochow University Suzhou, China; Suzhou Key Laboratory for Cancer Molecular Genetics Suzhou, China
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