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Deeg DJH, Hoogendijk EO, van Schoor NM, Schaap LA, Lima Passos V. Joint Trajectories of Performance-Based and Self-Reported Physical Functioning in Older Adults: A 20-Year Longitudinal Study in the Netherlands. J Aging Health 2024:8982643241273298. [PMID: 39167684 DOI: 10.1177/08982643241273298] [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: 08/23/2024]
Abstract
BACKGROUND The well-known disablement process has been conceptualized as a series of transitions between progressive states of functional decline. We studied joint patterns of change within disablement states defined as walking speed, grip strength, and self-reported disability. METHODS 1702 participants aged 65 and over were included from the Longitudinal Aging Study Amsterdam, spanning seven waves over 20 years (1996-2016). Group-based multi-trajectory modeling yielded trajectory clusters (TCs) of different patterns of change, further characterized by baseline sociodemographic characteristics, physical and cognitive health, and survival rate. RESULTS Five TCs were identified, distinguished by increasing baseline age. Walking speed and disability showed generally concomitant trajectories. Women had poorer trajectories in grip strength than men, but not in walking speed and disability. Poor physical health distinguished especially the poorest, and cognitive impairment distinguished especially the one-before-poorest from the better TCs. DISCUSSION The findings suggest that the disablement states are not generally distinct or sequential.
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Affiliation(s)
- Dorly J H Deeg
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Laura A Schaap
- Faculty of Science, Department of Health Sciences, Amsterdam Public Health Research Institute/Ageing and Later Life program, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Valéria Lima Passos
- Maastricht University, Faculty of Health, Medicine and Life Sciences, Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons, Dublin, Ireland
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Das S, Bagepally BS, Eerike M, Cherian JJ, Dasgupta S, Mathews G, Rao S. Performance in a Balance Test and Prediction of All-Cause Mortality in Community-Dwelling Elderly Ambulatory Individuals: A Systematic Review and Meta-analysis. Res Aging 2024; 46:437-448. [PMID: 38336358 DOI: 10.1177/01640275241232392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Objective: This systematic review and meta-analysis was performed to evaluate the association between an inability to perform a static balance test and mortality in community-dwelling older ambulatory individuals. Methods: PubMed, Embase, and Scopus were searched for relevant cohort studies. Hazard ratios (HR) were pooled (random-effect model). Meta-regression was performed with independent demographic variables (PROSPERO ID: CRD42022381137). Results: A total of 11,713 articles were screened and 15 were included. An inability to perform a static balance test was significantly associated with a higher risk of mortality irrespective of whether confounding variables were considered [HR, 1.14 (95% CI: 1.07-1.21); p < .001; i2, 87.96% (p < .01)] or not [HR, 1.11 (95% CI: 1.03-1.20); p = .01; i2, 95.28% (p < .01)] (both moderate GRADE evidence). Also, this association was correlated with progressive age. Conclusion: An inability to successfully complete a static balance test was significantly associated with a higher risk of mortality among community-dwelling older ambulatory individuals.
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Affiliation(s)
- Saibal Das
- Indian Council of Medical Research - Centre for Ageing and Mental Health, Kolkata, India
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bhavani S Bagepally
- Indian Council of Medical Research - National Institute of Epidemiology, Chennai, India
| | - Madhavi Eerike
- Department of Pharmacology, All India Institute of Medical Sciences, Bibinagar, India
| | - Jerin J Cherian
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Indian Council of Medical Research, New Delhi, India
| | - Shreyashi Dasgupta
- Department of Clinical and Experimental Pharmacology, Calcutta School of Tropical Medicine, Kolkata, India
| | - George Mathews
- Sports Authority of India, Lakshmibai National College of Physical Education, Trivandrum, India
| | - Shailaja Rao
- Department of Geriatric Medicine, Government Medical College, Aurangabad, India
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Liu Y, Xu L, Xu Y, Chen T, Zhu G, Chen Y. Dose-response association between walking speed and all-cause mortality: A systematic review and meta-analysis of cohort studies. J Sports Sci 2024; 42:1313-1322. [PMID: 39133765 DOI: 10.1080/02640414.2024.2390302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 08/02/2024] [Indexed: 09/01/2024]
Abstract
This review aims to investigate the dose-response relationship between walking speed and all-cause mortality. PubMed, Web of Science, Embase and Cochrane Library were searched to September, 2023 for cohort studies. A meta-analysis estimated the overall hazard ratio (HR) of mortality incidence and 95% Confidence Interval (CI) for individuals with the fastest walking speed compared to those with the slowest walking speed. Subgroup analyses were conducted based on sex, age and speed-measuring methods. Dose-response meta-analyses were examined by using "mvmeta" packages available in STATA. A total of 13 studies involving 530,841 participants were included. Of these, 11 studies provided data for dose-response meta-analyses. Individuals in the fastest walking-speed category had a 43% lower risk of all-cause mortality compared to those in the slowest walking-speed category (HR = 0.57, 95% CI 0.48-0.66). There was an inverse linear dose-response relationship between walking speed and all-cause mortality; for every 0.1 m/s increment in walking speed, the risk of mortality decreased by 6% (HR = 0.94; 0.92-0.96). There was an inverse nonlinear dose-response relationship between them when participants' age was larger than 65 years, but linear dose-response relationships were detected in both the timed walking speed test and self-reported walking speed measurements.
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Affiliation(s)
- Yujia Liu
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Long Xu
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Yi Xu
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Tong Chen
- Library of Jingwen, Jiangsu Normal University, Xuzhou, China
| | - Gengyin Zhu
- College of Physical Education, Chongqing University, Chongqing, China
| | - Yu Chen
- College of Physical Education, Chongqing University, Chongqing, China
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Su D, Liu Y, Su Y, Zhang X, Chan P. Cognitive impairment is a risk factor for decreased physical performance in the elderly. Heliyon 2024; 10:e32132. [PMID: 38867948 PMCID: PMC11168380 DOI: 10.1016/j.heliyon.2024.e32132] [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: 10/27/2023] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024] Open
Abstract
Background This study aimed to show a 3-year trajectory of physical performance among Chinese elderly in Beijing communities and explore the associations between new adverse events during the 3-year follow-up period and decreased physical performance. Methods A longitudinal observational study included baseline data and transitional information of physical performance from 456 community elders (mean age 67.3 ± 4.9 years, female 43.2 %) at a 3-year follow-up. The Mini-Mental State Examination (MMSE) and the Short Physical Performance Battery (SPPB) were used to measure cognition and physical performance, respectively. The number of chronic diseases, cognitive impairment, malnutrition, depression, knee pain, falls, and frailty were the principal independent variables in multivariate logistic regression analysis. Results The proportion of the elderly with poor physical performance (26.97 %) increased to 42.11 % and the proportion of those with good physical performance (44.96 %) dropped to 30.48 % after the three-year follow-up. As for physical performance transitions, 39.47 % of the elderly progressed to a worsening physical status. After adjustment for covariates, only new onset cognitive impairment (OR: 5.17; 95%CI: 2.01-14.54; P = 0.001) was associated with physical performance deterioration. Conclusion Cognitive impairment is an independent risk factor for decreased physical performance in elderly people. Active interventions targeted at cognitive impairment could help promote healthy aging.
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Affiliation(s)
- Dan Su
- Department of Geriatrics, Liangxiang Hospital of Beijing Fangshan District, Beijing, 102400, China
- Department of Geriatrics, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
| | - Ying Liu
- Department of Neurology, Beijing Shunyi Hospital, Beijing, Beijing, 101300, China
| | - Yangling Su
- Department of Geriatrics, Liangxiang Hospital of Beijing Fangshan District, Beijing, 102400, China
| | - Xiaojun Zhang
- Department of Geriatrics, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
- Department of Internal Medicine, Beijing Massage Hospital, Beijing, 100021, China
| | - Piu Chan
- Department of Geriatrics, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China
- Clinical Center for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, 100053, China
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Zhong P, Yang S, Liu R, Zhu Z, Zhang Y, Cheng W, Wang W. Handgrip strength and risks of diabetic vascular complications: Evidence from Guangzhou Diabetic Eye Study and UK cohorts. Br J Ophthalmol 2024:bjo-2023-324893. [PMID: 38816182 DOI: 10.1136/bjo-2023-324893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 05/15/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The purpose is to investigate the association between handgrip strength (HGS) and the risk of future diabetic complications in multicountry cohorts. METHODS The association between HGS and diabetic complications was evaluated using cox models among 84 453 patients with pre-diabetes and diabetes from the UK Biobank with a 12-year follow-up. The association between HGS and longitudinal microcirculatory damage rates was assessed among 819 patients with diabetes from the Guangzhou Diabetic Eye Study (GDES) with a 3-year follow-up. Participants were divided into three age groups (<56, 56-65 and ≥65 years), and each group was further subdivided into three HGS tertiles. RESULTS A 5 kg reduction in HGS was associated with increased risk for all-cause mortality (women, HR=1.10, 95% CI: 1.05 to 1.14; p<0.001; men, HR=1.13, 95% CI: 1.11 to 1.15; p<0.001). Women and men in the lowest HGS group exhibited 1.6-times and 1.3-1.5-times higher risk of myocardial infarction and stroke compared with the highest HGS group. In men, there was a higher risk of developing end-stage renal disease (HR=1.83, 95% CI: 1.30 to 2.57; p=0.001), while this was not observed in women. Both sexes in the lowest HGS group had a 1.3-times higher risk of diabetic retinopathy compared with the highest HGS group. In the GDES group, individuals with the lowest HGS showed accelerated microcirculatory damage in retina (all p<0.05). CONCLUSIONS Reduced HGS is significantly associated with a higher risk of diabetic complications and accelerated microvascular damage. HGS could serve as a practical indicator of vascular health in patients with pre-diabetes and diabetes.
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Affiliation(s)
- Pingting Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Shaopeng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Riqian Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Ziyu Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yongjie Zhang
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Weijing Cheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan Province, China
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Zhang J, Wang P, Pang Q, Wang S, Zhang A. Handgrip strength is associated with cognitive function in older patients with stage 3-5 chronic kidney disease: results from the NHANES. Sci Rep 2024; 14:10329. [PMID: 38710751 DOI: 10.1038/s41598-024-60869-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/29/2024] [Indexed: 05/08/2024] Open
Abstract
In this study, we aimed to investigate the association between handgrip strength (HGS) and cognitive performance in stage 3-5 chronic kidney disease (CKD) patients aged ≥ 60 years. This cross-sectional study analyzed data from National Health and Nutrition Examination Survey (NHANES) database 2011-2014. Three tests were used to assess the cognitive performance, including consortium to establish a registry for Alzheimer's disease (CERAD), animal fluency test (AFT), and digit symbol substitution test (DSST). The multivariate linear regression analyses adjusting for confounding factors were utilized to evaluate the association of HGS with cognitive performance. A total of 678 older stage 3-5 CKD patients were included in this study. After adjusting for multiple factors, a higher HGS was positively associated with a higher CERAD-delayed recall and DSST score. In addition, our analysis indicated that HGS probably correlated with better performance of immediate learning ability in male, while working memory, sustained attention, and processing speed in female. HGS may be an important indicator for cognitive deficits in stage 3-5 CKD patients, especially for learning ability and executive function. Further research to explore the sex-specific and domain-specific and possible mechanisms are required.
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Affiliation(s)
- Jialing Zhang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Peixin Wang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Qi Pang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Shiyuan Wang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Aihua Zhang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China.
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China.
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Lin ME, Gallagher TJ, Straughan A, Marmor S, Adams ME, Choi JS. Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality. JAMA Otolaryngol Head Neck Surg 2024; 150:257-264. [PMID: 38329761 PMCID: PMC10853869 DOI: 10.1001/jamaoto.2023.4554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/10/2023] [Indexed: 02/09/2024]
Abstract
Importance Dizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown. Objective To examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-specific mortality. Design, Setting, and Participants This cohort study is a mortality follow-up study based on the 1999-2004 National Health and Nutrition Examination Survey. The study cohort included adults 40 years and older who completed questions about symptomatic dizziness, including problems with dizziness, balance, falling, and positional dizziness, within the past 12 months. Respondents were linked to mortality data through December 31, 2019. Data were analyzed from February to August 2023. Exposure Self-reported symptomatic dizziness. Main Outcomes and Measures All-cause and cause-specific (cardiovascular disease, diabetes, cancer, and unintentional injuries) mortality. Cox proportional hazard regression models were used to examine associations between symptomatic dizziness and all-cause and cause-specific mortality while adjusting for demographics and medical history. Results In this nationally representative cohort of 9000 middle-aged and older US adults (mean [SD] age, 61.8 [13.8] years; 4570 [50.8%] female), prevalence of symptomatic dizziness was 23.8%. Specifically, 18.3% reported problems with dizziness, 14.5% reported problems with balance, 5.7% reported problems with falling, and 3.8% reported dizziness when turning in bed (positional dizziness). At a median (range) of 16.2 (0.1-20.6) years of follow-up, all-cause mortality for adults with symptomatic dizziness was higher than for those without (45.6% vs 27.1%). Symptomatic dizziness was associated with elevated risk for cause-specific mortality from diabetes (hazard ratio [HR], 1.66; 95% CI, 1.23-2.25), cardiovascular disease (HR, 1.33; 95% CI, 1.12-1.55), and cancer (HR, 1.21; 95% CI, 0.99-1.47) but not unintentional injuries (HR, 0.98; 95% CI, 0.51-1.88). Reporting problems with balance or falling was associated with increased all-cause mortality (balance: HR, 1.27; 95% CI, 1.17-1.39; and falling: HR, 1.52; 95% CI, 1.33-1.73), cardiovascular disease-specific mortality (balance: HR, 1.41; 95% CI, 1.20-1.66; and falling: HR, 1.49; 95% CI, 1.15-1.94), and diabetes-specific mortality risks (balance: HR, 1.74; 95% CI, 1.26-2.39; and falling: HR, 2.01; 95% CI, 1.26-3.18). There was no association between positional dizziness and mortality (HR, 0.98; 95% CI, 0.82-1.19). Conclusions and Relevance In this cohort study, symptomatic dizziness was associated with increased risk for all-cause and diabetes-, cardiovascular disease-, and cancer-specific mortality. The imprecision of the effect size estimate for cancer-specific mortality prevents making a definitive conclusion. Future studies are needed to determine whether symptomatic dizziness indicates underlying health conditions contributing to mortality or if early intervention for imbalance and falls can reduce mortality risk.
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Affiliation(s)
- Matthew E. Lin
- Keck School of Medicine of the University of Southern California, Los Angeles
| | - Tyler J. Gallagher
- Keck School of Medicine of the University of Southern California, Los Angeles
| | - Alexander Straughan
- Department of Otolaryngology–Head & Neck Surgery, University of Minnesota Medical School, Minneapolis
| | - Schelomo Marmor
- Department of Surgery, University of Minnesota Medical School, Minneapolis
| | - Meredith E. Adams
- Department of Otolaryngology–Head & Neck Surgery, University of Minnesota Medical School, Minneapolis
| | - Janet S. Choi
- Department of Otolaryngology–Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles
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Chen X, Xie L, Xia X, Luo X, Chen J, Zhang J, Li Q, Zhang X, Jiang J, Yang M. Effects of measurement protocols and repetitions on handgrip strength weakness and asymmetry in patients with cancer. J Cachexia Sarcopenia Muscle 2024; 15:220-230. [PMID: 38014503 PMCID: PMC10834335 DOI: 10.1002/jcsm.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/29/2023] [Accepted: 10/03/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The use of handgrip strength (HGS) in clinical cancer research is surging. The association between HGS and outcomes in patients with cancer varied across studies, which might be due to the different measurement protocols for HGS. We aimed to answer three questions: (1) Did the use of various protocols for HGS, along with different numbers of repetitions, lead to significant differences in maximum HGS values? (2) If yes, were these differences clinically significant? (3) Did the differences in HGS protocols and repetitions affect the identification of HGS weakness or HGS asymmetry? METHODS We continuously recruited adult patients with solid tumours. Two protocols were used to measure HGS: Method A, following the American Society of Hand Therapists guidelines, and Method B, following the National Health and Nutrition Examination Survey guidelines. To analyse HGS, we used the maximal value obtained from either two or three repetitions of the dominant hand or four or six repetitions of both hands. RESULTS We included 497 patients (326 men and 171 women, median age: 58 years). The maximal HGS values, measured with Method B, were significantly higher than those measured by Method A in both men and women, despite repetitions (all P < 0.05). The maximum HGS values were significantly different across the repetition groups, regardless of measurement protocols and sex (all P < 0.01). The protocol-induced differences in maximal HGS values might be clinically meaningful in over 60% of men and 40% of women despite repetitions. The repetition-induced difference was only clinically significant in 4.3-17.8% of men and 4.1-14.6% of women. To identify HGS weakness, using Method A (six repetitions) as the 'gold' standard, the other protocols demonstrated an overall accuracy of 0.923-0.997 in men and 0.965-1 in women. To identify HGS asymmetry, using Method A (six repetitions) as the 'gold' standard, Method B (six repetitions) demonstrated a diagnostic accuracy of 0.972 in men and 0.971 in women. Method A (four repetitions) showed a diagnostic accuracy of 0.837 in men and 0.825 in women, while Method B (four repetitions) showed a diagnostic accuracy of 0.825 in men and 0.807 in women. CONCLUSIONS Both measurement protocols and repetitions significantly affect the maximal HGS values. The identification of HGS weakness is not significantly affected by either protocols or repetitions, while the identification of HGS asymmetry may be affected by different repetitions but not protocols.
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Affiliation(s)
- Xiaoyan Chen
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Lingling Xie
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Xin Xia
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaozhen Luo
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Jing Chen
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Jing Zhang
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - QinLan Li
- Department of Oncology, West China Hospital (Shangjin Nanfu Branch), Sichuan University, Chengdu, China
| | - Xuemei Zhang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaojiao Jiang
- Rehabilitation Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Yang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Hosoya M, Toi S, Yoshizawa H, Kitagawa K. Slow Gait Speed Predicts Incident Dementia, Mortality, and Long-Term Functional Outcome in Cerebral Small-Vessel Disease. J Alzheimers Dis 2024; 101:499-508. [PMID: 39213068 DOI: 10.3233/jad-240304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Background Gait impairment is observed in patients with small vessel disease (SVD); however, the association between gait function and long-term outcome remains unclear. Objectives This study aimed to clarify the predictive value of gait function on incident dementia, survival and functional outcome. Methods Data were derived from a Japanese cohort of patients with SVD. This study included 522 participants who underwent 3-m timed up and go test (TUG), and gait speed, TUG time, was divided into tertiles. Magnetic resonance imaging was used to evaluate severity of white matter hyperintensities, lacunes, and medial temporal atrophy. Primary outcome was dementia. All-cause death and functional outcome by modified Rankin scale at the last visit was also evaluated. Results The median age was 71 years, and median TUG time was 9.91 s. During follow-up period of 4.8 years, 32 cases of dementia occurred. Cox proportional hazard analysis revealed that slow gait speed (TUG time > 10.88 s) was associated with a significantly higher risk of incident dementia than fast (TUG time < 9.03) and middle (TUG time, 9.04-10.87 s) speeds after adjusting risk factors, Mini-Mental State Examination, SVD severity and brain atrophy (adjusted hazard ratio, 2.73; 95% confidence interval, 1.16-6.42, p = 0.022). Slow speed was also associated with mortality and poor functional outcome compared with other speeds (adjusted odds ratio, 4.19; 95% confidence interval 1.92-9.18, p < 0.001). Conclusions Gait function was associated with incident dementia, mortality and poor functional outcome independently of cognitive function, brain atrophy, and SVD severity.
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Affiliation(s)
- Megumi Hosoya
- Department of Neurology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Sono Toi
- Department of Neurology, Tokyo Women's Medical University Hospital, Tokyo, Japan
- Department of Medicine, Tokyo Women's Medical University, Adachi Medical Center, Tokyo, Japan
| | - Hiroshi Yoshizawa
- Department of Neurology, Tokyo Women's Medical University Hospital, Tokyo, Japan
- Department of Neurology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Japan
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital, Tokyo, Japan
- Department of Neurology, Suita Municipal Hospital, Suita, Osaka, Japan
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Bergaoui J, Latiri I, Chaouch H, Ben Abdallah J, Mrad S, Maatamri W, Letaief A, Ben Saad H. Evaluation of muscle strength and quality in North African patients with chronic hepatitis B: A pilot case control study. Libyan J Med 2023; 18:2204564. [PMID: 37096573 PMCID: PMC10132249 DOI: 10.1080/19932820.2023.2204564] [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: 04/26/2023] Open
Abstract
Early detection of alteration of muscle strength, quantity, and quality, and sarcopenia is useful in non-cirrhotic chronic hepatitis B (NC-CHB) patients. Studies, which explored the handgrip strength (HGS) are scarce with questionable results, and no previous case-control study explored the presence of sarcopenia.The aim of this study was to assess the muscle strength [i.e.; HGS absolute (HGSA), HGSA/body mass index (BMI)], muscle quantity [i.e.; appendicular skeletal muscle (ASM), ASM/height2, ASM/total body weight (TBW), ASM/BMI], and muscle quality [i.e.; HGSA/total muscle mass (TMM), HGSA/ASM] of NC-CHB patients.This was a case-control study. Cases (n = 26) were untreated NC-CHB patients, and controls (n = 28) were 'apparently' healthy participants. Muscle mass was estimated via the TMM (kg) and ASM (kg). Muscle strength was evaluated via the HGS data [i.e.; HGSA (kg), HGSA/BMI (m2)]. Six variants of HGSA were determined: highest values for the dominant and non-dominant hands, highest value between the two hands, averages of the three measurements for the two hands, and the average of the highest values of the two hands. Muscle quantity was expressed in three relative variants (ASM/height2, ASM/TBW, and ASM/BMI). Muscle quality was evaluated via relative HGS data adjusted by muscle mass (i.e.; HGSA/TMM, HGSA/ASM). Probable and confirmed sarcopenia were retained in front of low muscle strength, and low muscle strength and muscle quantity or quality, respectively.There were no significant differences between controls and NC-CHB patients in values of muscle i) Strength whatever the HGS' mode of expression (e.g.; HGSA/BMI: 1.59 ± 0.54 vs. 1.53 ± 0.54 m2, p = 0.622, respectively), ii) Quantity (e.g.; ASM/BMI: 0.79 ± 0.24 vs. 0.77 ± 0.23 m2, p = 0.883), and iii) Quality (e.g.; HGSA/ASM: 2.00 ± 0.25 vs. 2.01 ± 0.41, p = 0.952, respectively). One NC-CHB participant had a confirmed sarcopenia.To conclude, both controls and NC-CHB patients had similar HGS values. Only one NC-CHB patient had a confirmed sarcopenia.
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Affiliation(s)
- Jihene Bergaoui
- Research laboratory "Heart Failure, LR12SP09", Hospital Farhat HACHED, Sousse, Tunisia
| | - Imed Latiri
- Research laboratory "Heart Failure, LR12SP09", Hospital Farhat HACHED, Sousse, Tunisia
- Faculty of Medicine of Sousse, Department of Physiology, Sousse University, Sousse, Tunisia
| | - Houda Chaouch
- Department of Infectious Diseases, Viral Hepatitis Research Unit (UR12SP35), Hospital Farhat HACHED, Sousse, Tunisia
| | - Jihene Ben Abdallah
- Biochemistry Research Laboratory (LR18ES47), Hospital Farhat HACHED, Sousse, Tunisia
| | - Sawssen Mrad
- Biochemistry Research Laboratory (LR18ES47), Hospital Farhat HACHED, Sousse, Tunisia
| | - Wided Maatamri
- Haematological laboratory, Hospital Farhat HACHED, Sousse, Tunisia
| | - Amel Letaief
- Department of Infectious Diseases, Viral Hepatitis Research Unit (UR12SP35), Hospital Farhat HACHED, Sousse, Tunisia
| | - Helmi Ben Saad
- Research laboratory "Heart Failure, LR12SP09", Hospital Farhat HACHED, Sousse, Tunisia
- Faculty of Medicine of Sousse, Department of Physiology, Sousse University, Sousse, Tunisia
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11
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Hsu NW, Lin CH, Yang NP, Chen HC, Chou P. Handgrip strength is associated with mortality in community-dwelling older adults: the Yilan cohort study, Taiwan. BMC Public Health 2023; 23:2194. [PMID: 37940899 PMCID: PMC10631044 DOI: 10.1186/s12889-023-17058-9] [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: 06/06/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION Hand grip strength (HGS) is one of the methods to help early identification of physical frailty and sarcopenia, the major concerns in the aging societies. It is also crucial to evaluate its impact on mortality. However, the available evidence regarding such impact among specific age cohorts (65 to 74 years and above) is limited. This study tried to investigate the relationship between HGS and mortality among specific cohorts of the community-dwelling older individuals in Yilan, Taiwan. METHODS A seven-year longitudinal follow-up study was conducted involving 2,468 community-dwelling older individuals in Yilan. The participants were divided into two groups based on their quartiles of hand grip strength: with poor HGS and with good HGS. The association between HGS and mortality was examined using Cox proportional hazards models. RESULTS The analysis revealed that age, HGS, gender, medical history of cardiovascular diseases, body mass index, and wrist-hip ratio had significant impacts on seven-year survival. Specifically, individuals with poor HGS exhibited increased mortality, with an adjusted hazard ratio (HR) of 1.87 (95% CI: 1.52-2.30). Furthermore, the adverse effect of poor HGS on mortality was more pronounced in males aged 65-74 years (adjusted HR 4.12, 95% CI: 2.16-7.84), females aged 75 years or older (2.09, 1.43-3.04) and males aged 75 years or older (1.49, 1.07-2.07). CONCLUSION Poor hand grip strength is an independent risk factor for mid-term mortality among community-dwelling older individuals in Yilan. The assessment of HGS can serve as a valuable tool in identifying older individuals at higher risk of death.
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Affiliation(s)
- Nai-Wei Hsu
- Community Medicine Research Center & Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Public Health Bureau, Yilan County, Yilan, Taiwan
| | - Ching-Heng Lin
- Community Medicine Research Center & Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Nan-Ping Yang
- Community Medicine Research Center & Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Pesus Chou
- Community Medicine Research Center & Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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12
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Tavares NHC, Rodrigues BC, Arruda SPM, Szlejf C, Suemoto CK, Griep RH, Diniz MDFHS, Giatti L, Barreto SM, Araújo LF. Untangle the relationship of muscle mass and bone mineral content on handgrip strength: Results of ELSA-Brasil. CIENCIA & SAUDE COLETIVA 2023; 28:3191-3204. [PMID: 37971003 DOI: 10.1590/1413-812320232811.19372022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/02/2023] [Indexed: 11/19/2023] Open
Abstract
The study aims to investigate the independent association of muscle mass (MM) and bone mineral content (BMC) in the performance of the handgrip strength (HGS) test and whether there is effect modification by sex and age. In 12,491 participants from the ELSA-Brasil we estimated the associations between MM, BMC and HGS using linear regression models. All the analyses were performed for total population, also stratified for sex and age. For total population an interaction term was included between each explanatory variable of interest with sex and age to verify the presence of effect modification. We observed that the higher quintiles of MM and BMC were associated to an increasing in the mean of HGS compared to the first quintile, with greater magnitudes in men compared to women, also adults compared to elderly. When we estimated the independent effect of each exposure of interest, MM showed stronger effect in HGS in women, men and adults then BMC. In conclusion, we observed that higher amounts of MM and BMC are associated with higher HGS, regardless of sociodemographic characteristics, health conditions and lifestyle, with this effect being greater in men and adults.
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Affiliation(s)
- Nayranne Hivina Carvalho Tavares
- Programa de Pós-Graduação em Saúde Pública, Universidade Federal do Ceará. Av. Prof. Costa Mendes 1608, Bloco Didático, 5º andar, Rodolfo Teófilo. 60430-140 Fortaleza CE Brasil.
| | - Brena Custodio Rodrigues
- Programa de Pós-Graduação em Saúde Pública, Universidade Federal do Ceará. Av. Prof. Costa Mendes 1608, Bloco Didático, 5º andar, Rodolfo Teófilo. 60430-140 Fortaleza CE Brasil.
| | | | - Claudia Szlejf
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo. São Paulo SP Brasil
| | - Claudia Kimie Suemoto
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo. São Paulo SP Brasil
| | - Rosane Harter Griep
- Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fiocruz. Rio de Janeiro RJ Brasil
| | - Maria de F H S Diniz
- Faculdade de Medicina & Hospital das Clínicas/EBSER, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Luana Giatti
- Faculdade de Medicina & Hospital das Clínicas/EBSER, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Sandhi M Barreto
- Faculdade de Medicina & Hospital das Clínicas/EBSER, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Larissa Fortunato Araújo
- Programa de Pós-Graduação em Saúde Pública, Universidade Federal do Ceará. Av. Prof. Costa Mendes 1608, Bloco Didático, 5º andar, Rodolfo Teófilo. 60430-140 Fortaleza CE Brasil.
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13
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Goldney J, Dempsey PC, Henson J, Rowlands A, Bhattacharjee A, Chudasama YV, Razieh C, Laukkanen JA, Davies MJ, Khunti K, Yates T, Zaccardi F. Self-reported walking pace and 10-year cause-specific mortality: A UK biobank investigation. Prog Cardiovasc Dis 2023; 81:17-23. [PMID: 37778454 DOI: 10.1016/j.pcad.2023.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To investigate associations of self-reported walking pace (SRWP) with relative and absolute risks of cause-specific mortality. PATIENTS AND METHODS In 391,652 UK Biobank participants recruited in 2006-2010, we estimated sex- and cause-specific (cardiovascular disease [CVD], cancer, other causes) mortality hazard ratios (HRs) and 10-year mortality risks across categories of SRWP (slow, average, brisk), accounting for confounders and competing risk. Censoring occurred in September 30, 2021 (England, Wales) and October 31, 2021 (Scotland). RESULTS Over a median follow-up of 12.6 years, 22,413 deaths occurred. In women, the HRs comparing brisk to slow SRWP were 0.74 (95% CI: 0.67, 0.82), 0.40 (0.33, 0.49), and 0.29 (0.26, 0.32) for cancer, CVD, and other causes of death, respectively, and 0.71 (0.64, 0.78), 0.38 (0.33, 0.44), and 0.29 (0.26, 0.32) in men. Compared to CVD, HRs were greater for other causes (women: 39.6% [6.2, 72.9]; men: 31.6% [9.8, 53.5]) and smaller for cancer (-45.8% [-58.3, -33.2] and - 45.9% [-54.8, -36.9], respectively). For all causes in both sexes, the 10-year mortality risk was higher in slow walkers, but varied across sex, age, and cause, resulting in different risk reductions comparing brisk to slow: the largest were for other causes of death at age 75 years [women: -6.8% (-7.7, -5.8); men: -9.5% (-10.6, -8.4)]. CONCLUSION Compared to slow walkers, brisk SRWP was associated with reduced cancer (smallest reduction), CVD, and other (largest) causes of death and may therefore be a useful clinical predictive marker. As absolute risk reductions varied across age, cause, and SRWP, certain groups may particularly benefit from interventions to increase SRWP.
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Affiliation(s)
- Jonathan Goldney
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK.
| | - Paddy C Dempsey
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Joseph Henson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Alex Rowlands
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Atanu Bhattacharjee
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
| | - Yogini V Chudasama
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
| | - Cameron Razieh
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK; Office for National Statistics, Newport, UK
| | - Jari A Laukkanen
- Institute of Clinical Medicine and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District Hospital District, Department of Medicine, Finland District, Jyväskylä, Finland
| | - Melanie J Davies
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK; Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
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14
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Kim HJ, Jeong S, Suh MJ, Oh YH. Association of balance impairment with risk of incident cardiovascular diseases among older adults. Eur J Med Res 2023; 28:455. [PMID: 37875935 PMCID: PMC10594686 DOI: 10.1186/s40001-023-01426-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Rapid decline in balance is a hallmark of aging, elevating the risk of falls and other age-related geriatric illnesses among older adults. OBJECTIVE Our aim was to assess whether impairment in balance function is associated with the risk of incident CVD in older adults. DESIGN Retrospective cohort analysis. PARTICIPANTS A total of 129,024 participants who had undergone health screening between 2002 and 2009 were derived from the National Health Insurance Service-Senior cohort. MAIN MEASURES Balance impairment was evaluated using the open-eyes one-leg standing (OLS) test. The association between balance impairment and incident CVD was analyzed using the Cox proportional hazards regression model. All participants were followed up with until either the date of the first incident of CVD, death, or 31 December 2019. KEY RESULTS Those with abnormal balance function (< 10 s in OLS test) had a higher risk of CVD (adjusted hazard ratio [aHR] 1.23, CI 1.16-1.31). The association was significant in both the obese and the non-obese, but it seemed to be more pronounced in the latter. Results were supported by sensitivity analyses that did not include cases of CVD development in the first 1, 2, or 3 years and that used a different criterion to define balance dysfunction (< 9 s in OLS test). CONCLUSIONS Older adults with balance impairment were found to have an increased risk of incident CVD. Patients with impaired balance function may be a high-risk population who require preventive managements against CVD.
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Affiliation(s)
- Hye Jun Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03082, South Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, 13488, South Korea
| | - Michelle J Suh
- Department of Otorhinolaryngology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, 63241, South Korea.
| | - Yun Hwan Oh
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, 14353, South Korea.
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15
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Paterson J, Trevenen M, Hill K, Almeida OP, Yeap BB, Golledge J, Hankey GJ, Flicker L. Balance and Strength Measures are Associated With Mortality in Older Men. J Am Med Dir Assoc 2023; 24:1527-1532.e2. [PMID: 37187326 DOI: 10.1016/j.jamda.2023.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES As people age, rates of morbidity and mortality are heterogenous. Balance and strength performance may contribute to this, offering modifiable risk factors for mortality. We aimed to compare relationships of balance and strength performance with all-cause and cause-specific mortality. DESIGN The Health in Men Study, a cohort study, using wave 4 as baseline for analyses (2011-2013). SETTING AND PARTICIPANTS 1335 older men (>65 years old), initially recruited April 1996-January 1999 in Western Australia, were included. METHODS Physical tests included a strength (knee extension test) and balance measure (modified Balance Outcome Measure for Elder Rehabilitation (mBOOMER) Score), derived from baseline physical assessments. Outcome measures included all-cause, cardiovascular, and cancer mortality, ascertained via the WADLS death registry. Data were analyzed using Cox proportional hazards regression models (age as analysis time, adjusted for sociodemographic data, health behaviors, and conditions). RESULTS Four hundred seventy-three participants died before the end of follow-up (December 17, 2017). Better performance on both the mBOOMER score and knee extension test was associated with lower likelihood of all-cause [hazard ratio (HR) 0.83, 95% CI 0.80-0.87, and HR 0.96, 95% CI 0.95-0.98, respectively] and cardiovascular mortality (HR 0.82, 95% CI 0.77-0.87, and HR 0.96, 95% CI 0.94-0.98, respectively). Better mBOOMER score performance was associated with lower likelihood of cancer mortality (HR 0.90, 95% CI 0.83-0.98) only when including participants with prior cancer. CONCLUSIONS AND IMPLICATIONS In summary, this study demonstrates an association of poorer performance in both strength and balance with future all-cause and cardiovascular mortality. Notably, these results clarify the relationship of balance with cause-specific mortality, with balance equaling strength as a modifiable risk factor for mortality.
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Affiliation(s)
- Jack Paterson
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Michelle Trevenen
- Western Australian Centre for Health & Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Keith Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, School of Primary and Allied Health Care, Peninsula Campus, Frankston, Victoria, Australia
| | - Osvaldo P Almeida
- Western Australian Centre for Health & Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Queensland, Australia; Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
| | - Graeme J Hankey
- Medical School, University of Western Australia, Nedlands, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Leon Flicker
- Western Australian Centre for Health & Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia.
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16
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Hirata T. Impact of Frailty on Cardiovascular Disease in Older Adults. J Atheroscler Thromb 2023; 30:1104-1105. [PMID: 37407495 PMCID: PMC10499450 DOI: 10.5551/jat.ed240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023] Open
Affiliation(s)
- Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
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17
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Fujita Y, Shinkai S, Taniguchi Y, Miura Y, Tanaka M, Ohsawa I, Kitamura A, Ito M. Association Between Serum GDF15 Concentration and Total Mortality in Community-Dwelling Japanese Older Populations: The Involvement of Renal Dysfunction. J Gerontol A Biol Sci Med Sci 2023; 78:1701-1707. [PMID: 37190783 DOI: 10.1093/gerona/glad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Serum growth differentiation factor 15 (GDF15) is associated with age-related adverse outcomes. However, renal function has not been thoroughly evaluated in studies addressing the association between GDF15 and mortality. We aimed to clarify whether GDF15 is associated with total mortality after carefully controlling renal function markers. METHODS We divided 1 801 community-dwelling Japanese older adults into quartiles according to their serum GDF15 concentrations. The correlation of GDF15 with renal function and inflammation markers was assessed by calculating Spearman correlation coefficients. Cumulative survival rates of the quartiles were estimated. In a Cox regression analysis adjusted for confounders, the association between GDF15 and mortality was evaluated. The discriminative capacity of GDF15 for the prediction of mortality was assessed with receiver-operating characteristic analysis. RESULTS GDF15 was correlated with cystatin C (r = 0.394), β2-microglobulin (r = 0.382), C-reactive protein (r = 0.124), and interleukin-6 (r = 0.166). The highest GDF15 quartile showed poor survival compared to the others. Older adults with higher GDF15 were associated with an increased mortality risk, independent of demographics and clinically relevant variables (hazard ratio [95% confidence interval]: 1.98 [1.09-3.59]). This significant association disappeared when additionally adjusted for cystatin C (1.65 [0.89-3.05]) or β2-microglobulin (1.69 [0.91-3.12]). The ability to predict mortality was approximately comparable between GDF15 (area under the curve: 0.667), cystatin C (0.691), and β2-microglobulin (0.715). CONCLUSIONS Serum GDF15 is associated with total mortality in older Japanese after adjustment for major confounders. The increased mortality risk in older adults with higher GDF15 may be partly attributed to decreased renal function.
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Affiliation(s)
- Yasunori Fujita
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Graduate School of Nutrition and Health Science, Kagawa Nutrition University, Sakado, Saitama, Japan
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yu Taniguchi
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yuri Miura
- Research Team for Mechanism of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masashi Tanaka
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ikuroh Ohsawa
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Health Town Development Science Center, Yao City Health Center, Yao, Osaka, Japan
| | - Masafumi Ito
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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18
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Soltanisarvestani M, Lynskey N, Gray S, Gill JMR, Pell JP, Sattar N, Welsh P, Ho FK, Celis-Morales C, Peterman-Rocha F. Associations of grip strength and walking pace with mortality in stroke survivors: A prospective study from UK Biobank. Scand J Med Sci Sports 2023; 33:1190-1200. [PMID: 36932055 DOI: 10.1111/sms.14352] [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: 06/14/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Although stroke is an emerging cause of disability and mortality globally, associations between physical capability markers and mortality in stroke survivors are elusive. This study investigated the individual and combined associations of walking pace and grip strength with all-cause and stroke mortality in stroke survivors. METHODS Individual and combined associations of walking pace and grip strength with stroke deaths and all-cause mortality were investigated using Cox proportional-hazard models adjusted for sociodemographic, lifestyle, and health-related variables. RESULTS Seven thousand four hundred eighty-six stroke survivors from the UK Biobank study (aged 40-70 years; 42.4% women) were included in this prospective study. Over a median follow-up of 12.6 (IQR: 11.9-13.3) years, 1490 (19.9%) participants died, of whom 222 (3.0%) died from stroke. After adjusting for confounding factors, and compared to individuals in the average/brisk walking pace category, those who reported a slow walking pace had 2.00 (95% CI: 1.50-2.68) and 1.99 (95% CI: 1.78-2.23) times higher risk of stroke mortality and all-cause mortality, respectively. Similar associations were identified for participants with low grip strength compared with those with normal levels. For combined associations, those with both slow walking pace and low grip strength showed the highest risk of stroke mortality (hazard ratio: 2.86 [95% CI: 1.93-4.22]). Similar results were found for all-cause mortality. CONCLUSIONS Low grip strength and slow walking pace were associated with a higher risk of stroke and all-cause mortality in stroke survivors. If these associations are causal, improving physical capability among stroke survivors might potentially prolong survival.
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Affiliation(s)
- Maryam Soltanisarvestani
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Nathan Lynskey
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Stuart Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Fanny Peterman-Rocha
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
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Ramírez PC, de Oliveira DC, de Oliveira Máximo R, de Souza AF, Luiz MM, Delinocente MLB, Steptoe A, de Oliveira C, da Silva Alexandre T. Is dynapenic abdominal obesity a risk factor for cardiovascular mortality? A competing risk analysis. Age Ageing 2023; 52:6966518. [PMID: 36626317 PMCID: PMC9831270 DOI: 10.1093/ageing/afac301] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/17/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Dynapenic abdominal obesity has been shown as a risk factor for all-cause mortality in older adults. However, there is no evidence on the association between this condition and cardiovascular mortality. OBJECTIVE We aimed to investigate whether dynapenic abdominal obesity is associated with cardiovascular mortality in individuals aged 50 and older. METHODS A longitudinal study with an 8-year follow-up was conducted involving 7,030 participants of the English Longitudinal Study of Ageing study. Abdominal obesity and dynapenia were respectively defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). The outcome was cardiovascular mortality. The Fine-Grey regression model was used to estimate the risk of cardiovascular mortality as a function of abdominal obesity and dynapenia status in the presence of competing events controlled by socio-demographic, behavioural and clinical variables. RESULTS The risk of cardiovascular mortality was significantly higher in individuals with D/AO compared with ND/NAO (SHR 1.85; 95% CI: 1.15-2.97). D/NAO was also associated with cardiovascular mortality (SHR: 1.62; 95% CI: 1.08-2.44). CONCLUSION Dynapenic abdominal obesity is associated with cardiovascular mortality, with a larger effect size compared to dynapenia alone in individuals older than 50 years. Thus, prevention strategies and clinical interventions that enable mitigating the harmful effects of these conditions should be adopted to diminish such risk.
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Affiliation(s)
- Paula Camila Ramírez
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil,Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Dayane Capra de Oliveira
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Aline Fernanda de Souza
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Mariane Marques Luiz
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Address correspondence to: Tiago da Silva Alexandre, Departamento de Gerontologia, Universidade Federal de São Carlos, Rodovia Washington Luís, km 235, SP-310. CEP 13565-905, São Carlos, Brazil. E-mail: ;
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20
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He P, Zhou C, Ye Z, Liu M, Zhang Y, Wu Q, Zhang Y, Yang S, Xiaoqin G, Qin X. Walking pace, handgrip strength, age, APOE genotypes, and new-onset dementia: the UK Biobank prospective cohort study. Alzheimers Res Ther 2023; 15:9. [PMID: 36624486 PMCID: PMC9827642 DOI: 10.1186/s13195-022-01158-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/29/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The independent and additive associations of walking pace and grip strength on dementia risk and the potential modifying effects of age, APOE phenotypes, and other dementia risk factors on the walking pace and dementia relationships demand further clarification. We aimed to investigate the independent and additive relationships of walking pace and handgrip strength on the risk of new-onset dementia and examine the potentially modifying effects of age, APOE phenotypes, lifestyle factors, and family history of dementia in the relationships. METHODS A total of 495,700 participants from the UK Biobank, who were free of dementia at baseline, were included in this study. Walking pace was self-defined as slow, average, or brisk. Handgrip strength was assessed by dynamometer and was divided into sex-specific quartiles. The APOE genotypes were determined by a combination variant of rs429358 and rs7412. Other dementia risk factors, including education, physical activity, hypertension, depression, diabetes, and family history of dementia, were also collected. The primary outcome was new-onset all-cause dementia. RESULTS Over a median follow-up duration of 12.0 years, 3986 (0.8%) participants developed new-onset all-cause dementia. Compared with those with slow walking pace, participants with average (HR, 0.61; 95%CI: 0.55-0.68) or brisk (HR, 0.59; 95%CI: 0.52-0.67) walking pace had a significantly lower risk of new-onset all-cause dementia. Moreover, compared with those with both slow walking pace and lower handgrip strength (the first quartile), the lowest risk of new-onset all-cause dementia was observed in participants with both average or brisk walking pace and higher handgrip strength (the 2-4 quartiles) (HR, 0.45; 95%CI: 0.40-0.52). Notably, the negative relationship between walking pace and the risk of new-onset all-cause dementia was significantly reduced as APOE ε4 dosage increased (APOE ε4 dosages = 0 or 1: brisk vs. slow: HR, 0.55; 95%CI: 0.48-0.63; vs. APOE ε4 dosages = 2: brisk vs. slow: HR, 1.14; 95%CI: 0.77-1.68; P for interaction = 0.001) or age increased (< 58 [median]: brisk vs. slow: HR, 0.27; 95%CI: 0.18-0.41; vs. ≥ 58 years: brisk vs. slow: HR, 0.55; 95%CI: 0.48-0.63; P for interaction = 0.007). CONCLUSIONS Walking pace was inversely associated with new-onset dementia in the general population, especially in younger participants and those with lower APOE ε4 dosage. Participants with both faster walking pace and higher handgrip strength had the lowest risk of dementia, suggesting that maintaining both high handgrip strength and fast walking pace may be a more comprehensive strategy for preventing dementia risk.
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Affiliation(s)
- Panpan He
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Chun Zhou
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Ziliang Ye
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Mengyi Liu
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Yuanyuan Zhang
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Qimeng Wu
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Yanjun Zhang
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Sisi Yang
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Gan Xiaoqin
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
| | - Xianhui Qin
- grid.416466.70000 0004 1757 959XDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 China ,National Clinical Research Center for Kidney Disease, Guangzhou, 510515 China ,State Key Laboratory of Organ Failure Research, Guangzhou, 510515 China ,grid.508040.90000 0004 9415 435XGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515 China
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Xie K, Han X, Hu X. Balance ability and all-cause death in middle-aged and older adults: A prospective cohort study. Front Public Health 2023; 10:1039522. [PMID: 36699907 PMCID: PMC9868834 DOI: 10.3389/fpubh.2022.1039522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023] Open
Abstract
Objective The present study aimed to explore the relationship between balance ability and all-cause death in middle-aged and elderly people and to provide a basis for formulating a balanced training plan for middle-aged and older people in China. Methods Based on data from the China Health and Retirement Longitudinal Study (CHARLS) carried out in the years 2011, 2013, 2015, and 2018, 18,888 participants aged 45 years and above were included. Cox proportional hazard models were designed to evaluate the effect of balance ability on death events. Results The present study found that there was an association between balance ability and death among middle-aged and older people. Multivariate Cox proportional hazard regression model analysis showed that the risk of death decreased by 10% (HR = 0.90,95% CI: 0.85-0.95) for every second increase in balance ability. With balance ability <10 s as the reference group, the adjusted HRs were 0.61 (0.44-0.85) among middle-aged and elderly people. The death density of balance ability of <10 s was 73.87 per thousand person-years higher than that of ≥10 s. There was no interaction between balance ability and chronic disease, overweight, and obesity (P > 0.05). Conclusion The risk of all-cause death in middle-aged and older people increased with the decrease in balance ability and showed no statistical significance between chronic disease, overweight, and obesity, as corroborated by the present study.
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Affiliation(s)
- Kaihong Xie
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Han
- School of Health Humanities, Peking University Health Science Center, Beijing, China
| | - Xuanhan Hu
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China,*Correspondence: Xuanhan Hu ✉
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22
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Xie K, Han X, Lu J, Xu X, Hu X. Prediction model of all-cause death based on balance ability among middle-aged and older Chinese adults of overweight and obesity. Front Public Health 2022; 10:1039718. [PMID: 36620250 PMCID: PMC9815467 DOI: 10.3389/fpubh.2022.1039718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Advances in studies using body indicators to predict death risk. Estimating the balance ability of death risk in middle-aged and older Chinese adults with overweight and obesity is still challenging. Methods A retrospective analysis of the data from the China Health and Retirement Study from January 2011 to December 2018. A total of 8,632 participants were randomly divided into 7:3 a training group and a verification group, respectively. Univariable Cox analysis was used to prescreen 17 potential predictors for incorporation in the subsequent multivariable Cox analysis. Nine variables were included in the nomogram finally and validated with concordance index (C-index), calibration plots, Hosmer-Lemeshow test, and internal validation population. Results 287 participants were death in the training group. One hundred and thirteen participants were death in the verification group. A total of nine indicators were included in the modeling group, including gender, age, marriage, hypertension, diabetes, stroke, ADL, IADL, and balance ability to establish a prediction model. The nomogram predicted death with a validated concordance index of (C-index = 0.77, 95% CI: 0.74-0.80). The inclusion of balance ability variables in the nomogram maintained predictive accuracy (C-index = 0.77, 95% CI: 0.73-0.82). The calibration curve graph and Hosmer-Lemeshow test (P > 0.05 for both the modeling group and the verification group) showed the model has a good model consistency. Conclusion In the present study, we provide a basis for developing a prediction model for middle-aged and older people with overweight and obesity. In most cases, balance ability is more reversible than other predictors.
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Affiliation(s)
- Kaihong Xie
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Han
- School of Health Humanities, Peking University Health Science Center, Beijing, China
| | - Jia Lu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China,Xiao Xu ✉
| | - Xuanhan Hu
- The Second School of Clinical, Zhejiang Chinese Medical University, Hangzhou, China,*Correspondence: Xuanhan Hu ✉
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23
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López-Bueno R, Andersen LL, Koyanagi A, Núñez-Cortés R, Calatayud J, Casaña J, Del Pozo Cruz B. Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: A systematic review with dose-response meta-analysis. Ageing Res Rev 2022; 82:101778. [PMID: 36332759 DOI: 10.1016/j.arr.2022.101778] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND While handgrip strength is associated with all-cause and cause-specific mortality, whether such associations are dose-dependent is largely unknown. Therefore, we conducted a systematic review on the dose-response relationship of handgrip strength with all-cause mortality, cancer, and cardiovascular mortality. METHODS The data source included three electronic databases (PubMed/MEDLINE, Web of Science and Scopus) from inception to 8 February 2022. Prospective cohort studies of healthy adults with objective measures of handgrip strength were included. Two researchers independently screened studies, extracted data, and assessed risk of bias. We used estimates regarding handgrip strength categories to conduct a random forest model, and a two-stage random-effects hierarchical meta-regression model pooling study-specific estimates for dose-response relationship. Outcomes included all-cause, cancer, and cardiovascular mortality. REULTS Forty-eight studies comprising 3,135,473 participants (49.6% women, age range 35-85 years) were included. Random forest models showed a significant inverse association between handgrip strength and all-cause and cause-specific mortality. Dose-response meta-analyses showed that higher levels of handgrip strength significantly reduced the risk of all-cause mortality within 26-50 kg (Higgin´s I2 =45.7%) in a close-to-linear inverse fashion. Cancer and cardiovascular mortality displayed a trend towards a U-shaped association with a significant risk reduction between 16 and 33 kg (Higgin´s I2 =77.4%), and a close-to-linear inverse shaped and significant risk reduction ranging from 24 to 40 kg (Higgin´s I2 =79.7%) respectively. CONCLUSION There is strong evidence for an association between lower handgrip strength with higher all-cause, cancer, and cardiovascular mortality risk. The dose-response relationship of handgrip strength substantially varies depending on the cause of mortality.
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Affiliation(s)
- Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Spain; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, ICREA, Barcelona, Spain
| | - Rodrigo Núñez-Cortés
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain
| | - Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Faculty of Education, University of Cádiz, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain; Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Seville, Spain
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24
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Maekawa K, Ikeuchi T, Shinkai S, Hirano H, Ryu M, Tamaki K, Yatani H, Kuboki T, Kimura‐Ono A, Kikutani T, Suganuma T, Ayukawa Y, Gonda T, Ogawa T, Fujisawa M, Ishigaki S, Watanabe Y, Kitamura A, Taniguchi Y, Fujiwara Y, Edahiro A, Ohara Y, Furuya J, Nakajima J, Umeki K, Igarashi K, Horibe Y, Kugimiya Y, Kawai Y, Matsumura H, Ichikawa T, Ohkawa S, Baba K. Impact of number of functional teeth on independence of Japanese older adults. Geriatr Gerontol Int 2022; 22:1032-1039. [PMID: 36408675 PMCID: PMC10099778 DOI: 10.1111/ggi.14508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 11/22/2022]
Abstract
AIM To examine the relationship between the number of present and functional teeth at baseline and future incidence of loss of independence. METHODS Participants were community-dwelling older individuals who participated in a comprehensive geriatric health examination conducted in Kusatsu town, Japan, between 2009 and 2015. The primary endpoint was the incidence of loss of independence among participants, defined as the first certification of long-term care insurance in Japan. The numbers of present and functional teeth at baseline were determined via an oral examination. Demographics, clinical variables (e.g., history of chronic diseases and psychosocial factors), blood nutritional markers, physical functions, and perceived masticatory function were assessed. RESULTS This study included 1121 individuals, and 205 individuals suffered from loss of independence during the follow-up period. Kaplan-Meier estimates of loss of independence for participants with smaller numbers of present and functional teeth were significantly greater than for those with larger numbers of teeth. Cox proportional hazard analyses indicated that a smaller number of present teeth was not a significant risk factor after adjusting for demographic characteristics. However, the number of functional teeth was a significant risk factor after the adjustment (hazard ratio: 1.975 [1.168-3.340]). Additionally, higher hazard ratios were observed in other adjusted models, but they were not statistically significant. CONCLUSIONS The number of functional teeth may be more closely related to the future incidence of loss of independence than the number of present teeth. This novel finding suggests that prosthodontic rehabilitation for tooth loss possibly prevents the future incidence of this life-event. Geriatr Gerontol Int 2022; 22: 1032-1039.
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Affiliation(s)
- Kenji Maekawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | | | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Kagawa Nutrition University Sakado Japan
| | | | - Masahiro Ryu
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Tokyo Dental College Tokyo Japan
| | - Katsushi Tamaki
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Kanagawa Dental University Graduate School Yokosuka Japan
| | - Hirofumi Yatani
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Osaka University Graduate School of Dentistry Osaka Japan
| | - Takuo Kuboki
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Aya Kimura‐Ono
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Okayama University Hospital Okayama Japan
| | - Takeshi Kikutani
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- The Nippon Dental University Tokyo Japan
| | - Takashi Suganuma
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Showa University School of Dentistry Tokyo Japan
| | - Yasunori Ayukawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Kyushu University Faculty of Dental Science Fukuoka Japan
| | - Tomoya Gonda
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Osaka University Graduate School of Dentistry Osaka Japan
| | - Toru Ogawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Tohoku University Graduate School of Dentistry Sendai Japan
| | - Masanori Fujisawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Meikai University School of Dentistry Sakado Japan
| | - Shoichi Ishigaki
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Osaka University Graduate School of Dentistry Osaka Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Faculty of Dental Medicine Hokkaido University Sapporo Japan
| | | | - Yu Taniguchi
- National Institute for Environmental Studies Ibaraki Japan
| | | | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | | | | | - Kento Umeki
- Nihon University School of Dentistry at Matsudo Chiba Japan
| | | | | | | | - Yasuhiko Kawai
- Nihon University School of Dentistry at Matsudo Chiba Japan
| | | | - Tetsuo Ichikawa
- Tokushima University Graduate School Institute of Biomedical Sciences Tokushima Japan
| | - Shuji Ohkawa
- Meikai University School of Dentistry Sakado Japan
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25
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Boonpor J, Parra-Soto S, Petermann-Rocha F, Ho FK, Celis-Morales C, Gray SR. Combined association of walking pace and grip strength with incident type 2 diabetes. Scand J Med Sci Sports 2022; 32:1356-1365. [PMID: 35612725 PMCID: PMC9544034 DOI: 10.1111/sms.14197] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/28/2022]
Abstract
The current study aims to investigate the combined association of walking pace and grip strength with incident type 2 diabetes (T2D). A total of 205 738 participants (mean age 56.6 ± 8.1 years, 115 139 [56.0%] women) without diagnosed or unknown diabetes at baseline from the UK Biobank study were included in this prospective study. Walking pace was self-reported as slow, average, or brisk. Grip strength was measured using a dynamometer and classified as weak, average, and strong. The combined association of walking pace and grip strength with incident T2D was investigated using Cox-proportional hazards models with a 2-year landmark analysis. The additive interaction was conducted by estimating relative excess risk due to interaction (RERI). After the median follow-up period of 5.4 years (interquartile range: 4.8-6.5), 5082 (2.5%) participants were diagnosed with T2D. Compared to brisk-strong individuals (reference group), people who were slow-weak had a higher risk of T2D (hazard ratio: 1.64 [95% CI, 1.42-1.89]) after adjusting for all covariates. There were dose-response gradients across both walking pace and grip strength variables. There was a modest amount of negative additive interaction (RERI; -0.06 [95% CI, -0.16; -0.01]. To conclude, slower pace and weaker grip strength were associated with a higher risk of developing T2D, independent of sociodemographics, lifestyle, and adiposity. Combining walking pace and grip strength might be a practical approach to screening people who are at increased risk of developing T2D.
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Affiliation(s)
- Jirapitcha Boonpor
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Solange Parra-Soto
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fanny Petermann-Rocha
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Handgrip strength measurement protocols for all-cause and cause-specific mortality outcomes in more than 3 million participants: A systematic review and meta-regression analysis. Clin Nutr 2022; 41:2473-2489. [DOI: 10.1016/j.clnu.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/16/2022] [Accepted: 09/11/2022] [Indexed: 11/22/2022]
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Yokoyama K, Ihira H, Matsuzaki-Kihara Y, Mizumoto A, Miyajima R, Sasaki T, Kozuka N, Ikeda N. Association between Productive Roles and Frailty Factors among Community-Dwelling Older Adults: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10838. [PMID: 36078554 PMCID: PMC9517858 DOI: 10.3390/ijerph191710838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
The employment rate of older people in Japan is expected to increase in the future owing to the increase in the retirement age. Preventing frailty is imperative to maintaining productive roles of older adults. Therefore, this study aimed to examine the association between productive roles and frailty factors among community-dwelling older adults. A total of 135 older adults, enrolled in 2017, participated in the study. Productive roles and domains related to frailty were measured. We measured usual gait speed and grip strength for the physical domain; Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15) scores for the cognitive and mental domains; and social role and group activity for the social domain. Multivariate-adjusted logistic regression models revealed that having productive roles was associated with faster usual gait speed (odds ratios [OR] = 1.05; 95% confidence interval [CI], 1.01-1.08; p = 0.005) and lower GDS-15 score (OR = 0.79; 95% CI, 0.64-0.97; p = 0.023). These results suggest that health promotion to maintain gait speed and prevent depressive symptoms may contribute to maintaining productivity in community-dwelling older adults.
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Affiliation(s)
- Kazuki Yokoyama
- Department of Occupational Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Hikaru Ihira
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | | | - Atsushi Mizumoto
- Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, Eniwa 061-1449, Japan
| | | | - Takeshi Sasaki
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Nozomu Ikeda
- Department of Occupational Therapy, School of Health Sciences, Sapporo Medical University, Sapporo 060-8556, Japan
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Holanda CMDA, Nóbrega PVDN, Maciel ÁCC. Physical performance as a predictor of mortality in nursing home residents: A five-year survival analysis. Geriatr Nurs 2022; 47:151-158. [PMID: 35914492 DOI: 10.1016/j.gerinurse.2022.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/04/2022]
Abstract
This study developed a five-year survival analysis to verify the relationship between the Short Physical Performance Battery (SPPB) and death in older adults residing in nursing homes (NHs). A total of 114 residents of NHs in Northeast Brazil participated in the follow-up. In addition to the SPPB, the older adults answered questions about sociodemographic and health condition information. The relationship between physical performance and mortality was evaluated using the Kaplan Meier survival curves and Cox proportional regression. As a result, 61.40% of the participants presented low performance and 41.22% died. Low physical performance increased the chance of death by 2.77 times in five years (adjusted Hazard Ratio 2.77; 95% CI 1.40-5.50; p < 0.01). Low SPPB Gait Speed Test also represented a 2.58-fold increased risk of dying (adjusted HR 2.58; 95% CI 1.38-4.83; p < 0.01). The results of this study showed that low physical performance can predict the mortality of older adults residing in NHs over five years.
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Affiliation(s)
- Cristina Marques de Almeida Holanda
- Postgraduate program in Physiotherapy, Federal University of Rio Grande do Norte, Avenue Senador Salgado Filho, Natal-RN-Brazil, CEP: 59200-000.
| | | | - Álvaro Campos Cavalcanti Maciel
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Avenue Senador Salgado Filho, Natal-RN-Brazil. CEP: 59200-000
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Silva CDFR, Gonçalves Ohara D, Pena Matos A, Nunes Pinto ACP, Sousa Pegorari M. Short physical performance battery as a predictor of mortality in community-dwelling older adults: a longitudinal study in the Brazilian Amazon region. PeerJ 2022; 10:e13630. [PMID: 35846876 PMCID: PMC9285644 DOI: 10.7717/peerj.13630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/02/2022] [Indexed: 01/17/2023] Open
Abstract
Background The Short Physical Performance Battery (SPPB) is an instrument for assessing physical performance widely used in research among the elderly in multiple settings. We did not find Brazilian longitudinal studies that aimed to analyze the predictive capacity and accuracy of the SPPB among community-dwelling older adults and no systematic reviews were found on the accuracy of the SPPB in predicting mortality in community- dwelling older adults. This study aimed to analyze the capacity and accuracy of the SPPB for predicting mortality in community-dwelling older adults, as well as to determine cut-off points for men and women. Method Longitudinal observational study conducted with 411 (70.1 ± 7.25 years) community-dwelling older adults, between 2017 and 2020 (37.7 ± 6.24 months). Physical performance was evaluated using the SPPB and information on the all-cause mortality rate was also recorded. Multivariate Cox regression analyses and curves were performed using the Kaplan-Meier method. Receiver Operating Characteristic (ROC) curves were constructed, with the parameters of area under the ROC curve (AUC) to determine cutoff points for discriminating mortality, considering a significance level of 5% (p < 0.05) and 95% confidence interval (CI) 95%. Results Older adults with very low and low physical performance in the SPPB, showed higher risks of mortality (HR = 9.67; 95% CI [1.20-77.65]; HR = 4.06; 95% CI [1.09-15.01]), respectively. In the subtest's analysis, older adults with low performance in the balance (HR = 0.54; 95% CI [0.36-0.81]) and gait speed tests (HR = 0.50; 95% CI [0.33-0.76]) showed greater risks of dying. The same was reproduced for categories in each test (participants that scored 2 points in the balance test had an HR = 5.86; 95% CI [1.84-18.61] and 2 points in the gait speed test, HR = 5.07; 95% CI [1.76-14.58]. The cutoff point ≤ 9 in the SPPB set the discriminator criterion for mortality in older people of both sexes. Conclusions The SPPB, as well as the balance and gait speed subtests were predictors of mortality, and the SPPB is accurate in predicting mortality among community-dwelling older adults.
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O’Keefe P, Mann FD, Clouston S, Voll S, Muniz-Terrera G, Lewis N, Wanström L, Hofer SM, Rodgers JL. Getting a Grip on Secular Changes: Age-Period-Cohort Modeling of Grip Strength in the English Longitudinal Study of Ageing. J Gerontol A Biol Sci Med Sci 2022; 77:1413-1420. [PMID: 34244743 PMCID: PMC9255688 DOI: 10.1093/gerona/glab192] [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: 03/04/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Grip strength is a popular and valuable measure in studies of physical functional capabilities in old age. The influence of historical trends and differential period-specific exposures can complicate the interpretation of biomarkers of aging and health and requires careful analysis and interpretation of aging, birth cohort, and period effects. This study evaluates the effects of aging, period, and cohort on grip strength in a population of adults and older adults. METHODS We use more than 27 000 observations for individuals at least 50 years of age, born in approximately 1910-1960, from the English Longitudinal Study of Ageing to examine a variety of multilevel and cross-classified modeling approaches to evaluate age, period, and cohort effects. Our results extended Hierarchical Age-Period-Cohort modeling and compared our results with a set of 9 submodels with explicit assumptions to determine the most reliable modeling approach. RESULTS Findings suggest grip strength is primarily related to age, with minimal evidence of either period and/or cohort effects. Each year's increase in a person's age was associated with a 0.40-kg decrease in grip strength, though this decline differs by gender. CONCLUSIONS We conclude that as the population ages, grip strength declines at a systematic and predictable rate equal to -0.40 kg per year (approximately -0.50 kg for men and -0.30 kg for women) in residents of England aged 50 and older. Age effects were predominant and most consistent across methodologies. While there was some evidence for cohort effects, such effects were minimal and therefore indicative that grip strength is a consistent physiological biomarker of aging.
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Affiliation(s)
- Patrick O’Keefe
- Department of Neurology, Oregon Health & Science University, Portland, USA
| | - Frank D Mann
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, New York, USA
| | - Sean Clouston
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, New York, USA
| | - Stacey Voll
- Institute on Aging & Lifelong Health, University of Victoria, British Columbia, Canada
| | | | - Nathan Lewis
- Institute on Aging & Lifelong Health, University of Victoria, British Columbia, Canada
- Department of Psychology, University of Victoria, British Columbia, Canada
| | | | - Scott M Hofer
- Institute on Aging & Lifelong Health, University of Victoria, British Columbia, Canada
- Department of Neurology, Oregon Health & Science University, Portland, USA
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Nascimento CFD, Roman Lay AA, Duarte YAO, Chiavegatto Filho ADP. Functional mobility and 10-year all-cause and cause-specific mortality in older people from São Paulo, Brazil. Braz J Phys Ther 2022; 26:100431. [PMID: 35944315 PMCID: PMC9379516 DOI: 10.1016/j.bjpt.2022.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/24/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A better understanding of performance in functional mobility tasks related to the mortality patterns for the different causes of death for the Brazilian older population is still a challenge. OBJECTIVE To analyze if gait speed and chair stand test performance are associated with mortality in older adults, and if the overall mobility status changes the effect of other mortality risk factors. METHODS The data were from SABE (Health, Well-being and Aging Study), a multiple-cohort study conducted in São Paulo, Brazil, with a representative sample of people aged 60 and more. Cox regression models were used to analyze 10-year all-cause and cause-specific mortality with consideration for gait speed and the chair stand test. RESULTS Of the 1411 participants, 26% died during the follow-up. The performance in the chair stand test had a more consistent association with mortality (hazard ratio (HR)=1.03, 95%CI: 1.00, 1.05) than gait speed. Being unable to perform the test also increased the risk to die by all-cause (HR=1.71, 95%CI: 1.21, 2.42) and by diseases of the circulatory system (HR=2.14, 95%CI: 1.25, 3.65). The stratified analysis of mobility performance changed the effects of some of the mortality risk factors, such as cognitive impairment and multimorbidity. CONCLUSIONS The chair stand test could be a better choice than 3-meters walking test as a mortality predictor. In addition, the impact of cognitive decline and multimorbidity were greater among those with reduced mobility, supporting the development of preventive interventions and public policies targeted at more vulnerable groups of older adults.
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Araujo CG, de Souza E Silva CG, Laukkanen JA, Fiatarone Singh M, Kunutsor S, Myers J, Franca JF, Castro CL. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. Br J Sports Med 2022; 56:975-980. [PMID: 35728834 DOI: 10.1136/bjsports-2021-105360] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Balance quickly diminishes after the mid-50s increasing the risk for falls and other adverse health outcomes. Our aim was to assess whether the ability to complete a 10- s one-legged stance (10-second OLS) is associated with all-cause mortality and whether it adds relevant prognostic information beyond ordinary demographic, anthropometric and clinical data. METHODS Anthropometric, clinical and vital status and 10-s OLS data were assessed in 1702 individuals (68% men) aged 51-75 years between 2008 and 2020. Log-rank and Cox modelling were used to compare survival curves and risk of death according to ability (YES) or inability (NO) to complete the 10-s OLS test. RESULTS Overall, 20.4% of the individuals were classified as NO. During a median follow-up of 7 years, 7.2% died, with 4.6% (YES) and 17.5% (NO) on the 10-s OLS. Survival curves were worse for NO 10-s OLS (log-rank test=85.6; p<0.001). In an adjusted model incorporating age, sex, body mass index and comorbidities, the HR of all-cause mortality was higher (1.84 (95% CI: 1.23 to 2.78) (p<0.001)) for NO individuals. Adding 10-s OLS to a model containing established risk factors was associated with significantly improved mortality risk prediction as measured by differences in -2 log likelihood and integrated discrimination improvement. CONCLUSIONS Within the limitations of uncontrolled variables such as recent history of falls and physical activity, the ability to successfully complete the 10-s OLS is independently associated with all-cause mortality and adds relevant prognostic information beyond age, sex and several other anthropometric and clinical variables. There is potential benefit to including the 10-s OLS as part of routine physical examination in middle-aged and older adults.
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Affiliation(s)
| | | | - Jari Antero Laukkanen
- Institute of Clinical Medicine, University of Eastern Finland, Kyopio, Finland.,Central Finland Health Care District, Department of Medicine, Jyväskylä, Finland
| | - Maria Fiatarone Singh
- School of Health Sciences and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Setor Kunutsor
- Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, UK
| | - Jonathan Myers
- Cardiology Division, VA Palo Alto Health Care System and Stanford University, Palo Alto, California, USA
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Kobayashi T, Morimoto T, Ono R, Otani K, Mawatari M. Is grip strength useful in screening to predict the severity of locomotive syndrome? J Orthop Sci 2022:S0949-2658(22)00080-X. [PMID: 35477671 DOI: 10.1016/j.jos.2022.03.011] [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: 12/22/2021] [Revised: 03/04/2022] [Accepted: 03/16/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study was conducted to investigate the relationship between grip strength and the 25-question Geriatric Locomotive Function Scale (GLFS-25) score and the diagnosis of locomotive syndrome (LS), and the usefulness of grip strength in screening for LS. METHODS This cross-sectional study was conducted on 2251 community-dwelling residents (male, n = 1035; female, n = 1216). Subjects with GLFS-25 scores of 0-6 points, 7-15 points, 16-23 points, and 24-100 points were diagnosed with non-LS, LS-1, LS-2, and LS-3, respectively. Multivariate linear regression and multivariate logistic regression analyses were performed to assess the relationship between grip strength and the GLFS-25 score and LS after adjustment for age, sex, and body mass index. A conventional receiver operating characteristic (ROC) curve analysis was used to calculate the optimal cutoff value of grip strength for predicting the severity of LS. The discriminative ability of the model was assessed using the area under the ROC curve (AUC). RESULTS The multivariate linear regression analysis showed that grip strength was significantly associated with the GLFS-25 score. The multivariate logistic regression analysis revealed that grip strength was significantly associated with the diagnosis of LS. The optimal cutoff values of grip strength for identifying LS-1 or more, LS-2 or more, and LS-3 or more were 36.0 kg (sensitivity 65.7%, specificity 57.1%, AUC 0.66), 35.0 kg (sensitivity 70.0%, specificity 57.5%, AUC 0.70), and 34.0 kg (sensitivity 67.2%, specificity 62.5%, AUC 0.70), respectively, in males, and 24.0 kg (sensitivity 69.1%, specificity 45.4%, AUC 0.61), 23.0 kg (sensitivity 69.5%, specificity 52.3%, AUC 0.67), and 22.0 kg (sensitivity 69.1%, specificity 61.0%, AUC 0.69) in females. CONCLUSIONS The use of grip strength in screening to predict the severity of LS may not be clinically useful. However, the results will increase our understanding of the relationship between grip strength and the GLFS-25 scores and LS.
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Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Koji Otani
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
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Marín-Jiménez N, Cruz-León C, Perez-Bey A, Conde-Caveda J, Grao-Cruces A, Aparicio VA, Castro-Piñero J, Cuenca-García M. Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review. J Clin Med 2022; 11:jcm11020328. [PMID: 35054020 PMCID: PMC8779466 DOI: 10.3390/jcm11020328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.
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Affiliation(s)
- Nuria Marín-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Carolina Cruz-León
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alejandro Perez-Bey
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
- Correspondence: ; Tel.: +34-65-7588624
| | - Julio Conde-Caveda
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alberto Grao-Cruces
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, 18071 Granada, Spain;
- Sport and Health University Research Centre, University of Granada, 18007 Granada, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Magdalena Cuenca-García
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
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Larsson BAM, Johansson L, Mellström D, Johansson H, Axelsson KF, Harvey N, Vandenput L, McCloskey E, Liu E, Sundh D, Kanis JA, Lorentzon M. One leg standing time predicts fracture risk in older women independent of clinical risk factors and BMD. Osteoporos Int 2022; 33:185-194. [PMID: 34498096 PMCID: PMC8758616 DOI: 10.1007/s00198-021-06039-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/15/2021] [Indexed: 11/28/2022]
Abstract
In women of ages 75-80 years, a low one leg standing time (OLST) was associated with an increased risk of incident fractures, independently of bone mineral density and clinical risk factors. OLST contributed substantially to fracture probability, indicating that the test should be considered when evaluating fracture risk in older women. INTRODUCTION Physical function and risk of falls are important risk factors for fracture. A few previous studies have suggested that a one leg standing time (OLST) less than 10 s predicts fracture risk, but the impact of OLST, in addition to known clinical risk factors, for fracture probability is unknown. The aim of this study was to determine the independent contribution of OLST to fracture probability in older women. METHODS The Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures (SUPERB) is a prospective population-based study of 3028 women 75-80 years old, recruited from the greater Gothenburg area in Sweden. At baseline, information on risk factors was collected using questionnaires, bone mineral density was measured with dual-energy X-ray absorptiometry (DXA), and OLST was performed. RESULTS During a median follow-up of 3.6 years (IQR 1.5 years), X-ray-verified incident fractures were identified using health records. OLST was available in 2405 women. OLST less than 10 s was associated with an increased risk for incident hip fracture (Hazard Ratio (HR) 3.02, 95% Confidence Interval (CI) [1.49-6.10]), major osteoporotic fracture (HR 95% CI 1.76 [1.34-1.46]), and nonvertebral fracture (HR 95% CI 1.61 [1.26-2.05]) in Cox regression analyses adjusted for age, height, and weight. Depending on BMD, the 4-year fracture probability increased by a factor of 1.3 to 1.5 in a 75-year-old woman with a low OLST (<10 s). CONCLUSION A low OLST has a substantial impact on fracture probability and should be considered when evaluating fracture risk in older women.
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Affiliation(s)
- B A M Larsson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L Johansson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - D Mellström
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - H Johansson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - K F Axelsson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Närhälsan Norrmalm Health Centre, Skövde, Sweden
| | - N Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK
| | - L Vandenput
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - E McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
- MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
| | - E Liu
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - D Sundh
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - J A Kanis
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - M Lorentzon
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
- Region Västra Götaland, Department of Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
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Wang L, Song P, Cheng C, Han P, Fu L, Chen X, Yu H, Yu X, Hou L, Zhang Y, Guo Q. The Added Value of Combined Timed Up and Go Test, Walking Speed, and Grip Strength on Predicting Recurrent Falls in Chinese Community-dwelling Elderly. Clin Interv Aging 2021; 16:1801-1812. [PMID: 34675495 PMCID: PMC8502011 DOI: 10.2147/cia.s325930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/11/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose To determine whether combined performance-based models could exert better predictive values toward discriminating community-dwelling elderly with high risk of any-falls or recurrent-falls. Participants and Methods This prospective cohort study included a total of 875 elderly participants (mean age: 67.10±5.94 years) with 513 females and 362 males, recruited from Hangu suburb area of Tianjin, China. All participants completed comprehensive assessments. Methods We documented information about sociodemographic information, behavioral characteristics and medical conditions. Three functional tests—timed up and go test (TUGT), walking speed (WS), and grip strength (GS) were used to create combined models. New onsets of any-falls and recurrent-falls were ascertained at one-year follow-up appointment. Results In total 200 individuals experienced falls over a one-year period, in which 66 individuals belonged to the recurrent-falls group (33%). According to the receiver operating characteristic curve (ROC), the cutoff points of TUGT, WS, and GS toward recurrent-falls were 10.31 s, 0.9467 m/s and 0.3742 kg/kg respectively. We evaluated good performance as “+” while poor performance as “–”. After multivariate adjustment, we found “TUGT >10.31 s” showed a strong correlation with both any-falls (adjusted odds ratio (OR)=2.025; 95% confidence interval (CI)=1.425–2.877) and recurrent-falls (adjusted OR=2.150; 95%CI=1.169–3.954). Among combined functional models, “TUGT >10.31 s, GS <0.3742 kg/kg, WS >0.9467 m/s” showed strongest correlation with both any-falls (adjusted OR=5.499; 95%CI=2.982–10.140) and recurrent-falls (adjusted OR=8.260; 95%CI=3.880–17.585). And this combined functional model significantly increased discriminating abilities on screening recurrent-fallers than a single test (C-statistics=0.815, 95%CI=0.782–0.884, P<0.001), while not better than a single test in predicting any-fallers (P=0.083). Conclusion Elderly people with poor TUGT performance, weaker GS but quicker WS need to be given high priority toward fall prevention strategies for higher risks and frequencies. Meanwhile, the combined “TUGT–, GS–, WS+” model presents increased discriminating ability and could be used as a conventional tool to discriminate recurrent-fallers in clinical practice.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Peiyu Song
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Cheng Cheng
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, People's Republic of China
| | - Peipei Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Liyuan Fu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaoyu Chen
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Hairui Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xing Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Lin Hou
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yuanyuan Zhang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Qi Guo
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
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do Nascimento CF, dos Santos HG, de Moraes Batista AF, Roman Lay AA, Duarte YAO, Chiavegatto Filho ADP. Cause-specific mortality prediction in older residents of São Paulo, Brazil: a machine learning approach. Age Ageing 2021; 50:1692-1698. [PMID: 33945604 DOI: 10.1093/ageing/afab067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Populational ageing has been increasing in a remarkable rate in developing countries. In this scenario, preventive strategies could help to decrease the burden of higher demands for healthcare services. Machine learning algorithms have been increasingly applied for identifying priority candidates for preventive actions, presenting a better predictive performance than traditional parsimonious models. METHODS Data were collected from the Health, Well Being and Aging (SABE) Study, a representative sample of older residents of São Paulo, Brazil. Machine learning algorithms were applied to predict death by diseases of respiratory system (DRS), diseases of circulatory system (DCS), neoplasms and other specific causes within 5 years, using socioeconomic, demographic and health features. The algorithms were trained in a random sample of 70% of subjects, and then tested in the other 30% unseen data. RESULTS The outcome with highest predictive performance was death by DRS (AUC-ROC = 0.89), followed by the other specific causes (AUC-ROC = 0.87), DCS (AUC-ROC = 0.67) and neoplasms (AUC-ROC = 0.52). Among only the 25% of individuals with the highest predicted risk of mortality from DRS were included 100% of the actual cases. The machine learning algorithms with the highest predictive performance were light gradient boosted machine and extreme gradient boosting. CONCLUSION The algorithms had a high predictive performance for DRS, but lower for DCS and neoplasms. Mortality prediction with machine learning can improve clinical decisions especially regarding targeted preventive measures for older individuals.
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Cao C, Cade WT, Li S, McMillan J, Friedenreich C, Yang L. Association of Balance Function With All-Cause and Cause-Specific Mortality Among US Adults. JAMA Otolaryngol Head Neck Surg 2021; 147:460-468. [PMID: 33704356 DOI: 10.1001/jamaoto.2021.0057] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Importance Difficulty maintaining balance is common among individuals aged 40 years or older and increases the risk of falls. However, little is known about the association of balance function with long-term mortality outcomes in adults. Objective To investigate the association of balance function with all-cause and cause-specific mortality among US adults. Design, Setting, and Participants A prospective, population-based cohort study of a nationally representative sample of 5816 adults (weighted population, 92 260 641) from the US National Health and Nutrition Examination Survey was conducted from 1999 to 2004. Individuals aged 40 years or older who completed the modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces were included. Participants were linked to mortality data from the test date through December 31, 2015. Data analysis was conducted from February 1 to June 1, 2020. Exposures The modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces was used to measure balance function and define balance disorder according to sensory input. Main Outcomes and Measures Mortality associated with all causes, cardiovascular disease (CVD), and cancer. Results A total of 5816 adults (weighted mean [SE] age, 53.6 [0.2] years; 2897 [49.8%] women) were included in this cohort study. During up to 16.8 years of follow-up (median, 12.5 years; 68 919 person-years), 1530 deaths occurred, including 342 associated with CVD and 364 associated with cancer. Participants with balance disorder were at a higher risk of death from all causes, CVD, and cancer. After adjusting for sociodemographic characteristics, lifestyle factors, and chronic conditions, the hazard ratios (HRs) among participants with balance disorder compared with those without balance disorder were 1.44 (95% CI, 1.23-1.69) for all-cause mortality, 1.65 (95% CI, 1.17-2.31) for CVD mortality, and 1.37 (95% CI, 1.03-1.83) for cancer mortality. Furthermore, vestibular balance disorder was associated with increased mortality from all causes (HR, 1.31; 95% CI, 1.08-1.58), CVD (HR, 1.59; 95% CI, 1.12-2.27), and cancer (HR, 1.39; 95% CI, 1.04-1.86). Conclusions and Relevance In this nationally representative sample of US adults, balance disorder was associated with an increased risk of all-cause, CVD, and cancer mortality. Further studies are needed to confirm these findings and evaluate whether the observed associations represent a causal biological phenomenon and, if so, whether the effect is modifiable with a multicomponent exercise program.
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Affiliation(s)
- Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri
| | - W Todd Cade
- Doctor of Physical Therapy Division, Department of Orthopedics, Duke University School of Medicine, Durham, North Carolina
| | - Shengxu Li
- Children's Minnesota Research Institute, Children's Hospitals and Clinics of Minnesota, Minneapolis
| | - Jacqueline McMillan
- Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Christine Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Li CL, Chiu YC, Shyu YIL, Stanaway FF, Chang HY, Bai YB. Does physical activity protect older persons with frailty and cognitive impairment from excess all-cause mortality? Arch Gerontol Geriatr 2021; 97:104500. [PMID: 34388680 DOI: 10.1016/j.archger.2021.104500] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The main aim of this study was to examine how physical activity in combination with physical frailty and cognitive impairment affects risk of mortality in older adults. STUDY DESIGN A national sample of community-dwelling Taiwanese aged 65 years or older (n=2678) was followed for 5 years. MAIN OUTCOME MEASURES Frailty was determined based on the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) scale. The Mini-Mental State Examination was used to assess cognitive impairment. Information on self-reported physical activity was collected at baseline. The study cohort was followed until the date of death or the end of the study period (31 December 2018). Deaths were confirmed by the computerized data files of the National Register of Deaths. RESULTS A total of 417 deaths were recorded after 12415.2 person-years of follow-up. After adjustment for other factors, compared with active participants who were physically robust with normal cognition, inactive participants who were with either frail/pre-frail or cognitively impaired had hazard ratios for mortality of 2.65 (95% CI=[1.88-3.74]) and 3.09 (95% CI=[2.08-4.59]), respectively. Inactive participants with coexisting frailty/pre-frailty and cognitive impairment had the highest hazard ratio for mortality of 3.85 (95% CI=[2.73-5.45]). Being active was associated with a mortality reduction of 31%, 38%, and 42% in physically robust participants with normal cognition, those who were frail/pre-frail only, and those with cognitive impairment only, respectively. CONCLUSIONS Having a physically active life style has beneficial effects on survival in older persons with either frailty/pre-frailty or cognitive impairment.
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Affiliation(s)
- Chia-Lin Li
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan.
| | - Yu-Chan Chiu
- Department of Bio-Industry Communication and Development, National Taiwan University, Taipei, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Fiona F Stanaway
- University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Yuh-Bin Bai
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan
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Reductions in Muscle Strength and Range of Motion Cause Locomotion Disability via Locomotion-Related Functional Limitation in Japanese Older Adults: A Cross-Sectional Study. J Aging Res 2021; 2021:6627767. [PMID: 34306754 PMCID: PMC8282387 DOI: 10.1155/2021/6627767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/19/2021] [Accepted: 07/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background Functional issues (impairments, functional limitations, and disabilities) gradually occur with age. Nonetheless, maintaining physical capability may help prevent locomotion disabilities at an older age. The present study aimed to determine whether reductions in muscle strength and range of motion (ROM) cause locomotion disability via locomotion-related functional limitations among healthy older adults. Methods Data from a total of 144 participants (61 men, 83 women) were analyzed. To assess locomotion disability, the locomotor domain of the activities of daily living (ADLs) survey from the Ministry of Education, Culture, Sports, Science, and Technology of Japan was used. Muscle strength (grip strength) and two ROMs (hip flexion and knee flexion) were measured. To measure locomotion-related functional limitations, participants underwent a 10 m hurdle walking test and side-step test. Thereafter, path analysis was conducted for testing the hypothetical model. The goodness of fit in the model was assessed using statistical parameters, such as the chi-square value, goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and root mean square error of approximation (RMSEA). Results The analysis revealed a nonsignificant chi-square value (chi-square = 41.885; p=0.113), as well as high values of GFI (0.944), AGFI (0.904), CFI (0.970), and RMSEA (0.046), indicating that locomotion disability was caused by locomotion-related functional limitations, which were influenced by muscle strength and ROM. Conclusions The present study demonstrated that decreased muscle strength and ROM caused locomotion disability via locomotion-related functional limitations. Older adults should participate in physical exercise programs that focus on strengthening muscles and improving ROM to counteract age-related locomotion disability.
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Hirase T, Okubo Y, Sturnieks DL, Lord SR. Pain Is Associated With Poor Balance in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. J Am Med Dir Assoc 2021; 21:597-603.e8. [PMID: 32334772 DOI: 10.1016/j.jamda.2020.02.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/13/2020] [Accepted: 02/15/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Pain is a risk factor for falls in older adults, but the mechanisms are not well understood, limiting our ability to implement effective preventive strategies. The aim of this study was to systematically review and synthesize the literature that has examined the impact of pain on static, dynamic, multicomponent, and reactive balance in community-dwelling older adults. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Studies from inception to March 2019 were identified from electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL), contact with the primary authors, and reference lists of included articles. METHODS Cross-sectional and case-control studies that compared objective balance measures between older (minimum age 60 years) adults with and without pain were included. RESULTS Thirty-nine eligible studies (n = 17,626) were identified. All balance modalities (static, dynamic, multicomponent, and reactive) were significantly poorer in participants with pain compared to those without pain. Subgroup analyses revealed that chronic pain (pain persisting ≥3 months) impaired balance more than pain of unspecified duration. The effects of pain at specific sites (neck, lower back, hip, knee, and foot) on balance were not significantly different. CONCLUSIONS AND IMPLICATIONS Pain is associated with poor static, dynamic, multicomponent, and reactive balance in community-dwelling older adults. Pain in the neck, lower back, hip, knee, and foot all contribute to poor balance, and this is even more pronounced for chronic pain. Comprehensive balance and pain characteristic assessments may reveal mechanisms underlying the contribution of pain to instability and increased fall risk in older people.
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Affiliation(s)
- Tatsuya Hirase
- Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia.
| | - Yoshiro Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
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Sprague BN, Phillips CB, Ross LA. Cognitive Training Attenuates Decline in Physical Function Across 10 Years. J Gerontol B Psychol Sci Soc Sci 2021; 76:1114-1124. [PMID: 32484891 DOI: 10.1093/geronb/gbaa072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Poor physical function is associated with negative health and cognitive outcomes. Although nine studies demonstrated that cognitive training reduces age-related declines in physical function, only one study has examined the effects beyond immediate posttest changes. The first aim of this study was to assess the impact of three cognitive training programs on physical function measures across 10 years and the second aim was to examine whether baseline cognitive self-efficacy or depressive symptoms moderated training effects. METHOD Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial, older adults in a no-contact control condition (n = 698) were compared to those receiving processing speed (n = 702), memory (n = 703), or reasoning (n = 694) training. Intention-to-treat (ITT) and dosage analyses were conducted for grip strength and Turn 360. Participants were followed up to 10 years posttest. RESULTS There were no significant ITT effects of processing speed, memory, or reasoning training assignment to any physical function outcome (p > .05). Dosage models indicated that there were small age-related attenuation effects in Turn 360 decline with more processing speed training (b = -.011, p < .001), memory training (b = -.011, p < .001), and reasoning training (b = -.012, p < .001). There was no significant transfer to grip strength. These training gains were greater for those with more baseline depressive symptoms who received more processing speed training (b = -.001, p < .001). DISCUSSION This is the first study to demonstrate the effects of cognitive training to complex physical function across 10 years.
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Affiliation(s)
- Briana N Sprague
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | | | - Lesley A Ross
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park.,Department of Psychology, Clemson University, South Carolina
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Wen Y, Liao J, Yin Y, Liu C, Gong R, Wu D. Risk of falls in 4 years of follow-up among Chinese adults with diabetes: findings from the China Health and Retirement Longitudinal Study. BMJ Open 2021; 11:e043349. [PMID: 34103310 PMCID: PMC8190046 DOI: 10.1136/bmjopen-2020-043349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study was to determine the incidence of falls and identify baseline factors increased risk for incident falls over time among people with diabetes. DESIGN This study was a secondary analysis using the baseline and 4 years of follow-up data from the China Health and Retirement Longitudinal Study (CHARLS). SETTING A nationally representative survey of 17 500 Chinese residents aged 45 years and older were recruited in the baseline national survey in 2011. These participants were followed up every 2 years. PARTICIPANTS A total of 1238 middle-aged and older adults with diabetes and no history of falls at baseline were included in the current study. PRIMARY AND SECONDARY OUTCOME MEASURES Information on incidence of falls and medical treatment resulting from falls were determined by self-report. RESULTS The findings showed that the incidence of falls was 29.4% during 4 years of follow-up. Participants with incident falls were younger, were more likely to be women, had lower education level and were less likely to be current drinkers. In addition, former drinkers were 2.22 times more likely to fall. Socially active individuals were 47% less likely to fall compared with those without social activities. Every 5 kg increase in grip strength was associated with a 13% lower risk of falls. A 10 mg/dL higher total cholesterol and 1 mg/dL higher blood urea nitrogen were associated with a 4% and 6% higher risk of falls. Finally, participants with depressive symptoms were 1.47 times more likely to fall compared with those without depressive symptoms. CONCLUSIONS These findings underscore the importance of developing a fall prevention programme for those with diabetes, and this programme should address potentially modifiable risk factors, including levels of total cholesterol, blood urea nitrogen, social activity, depressive symptoms and grip strength.
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Affiliation(s)
- Yue Wen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Liao
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yiqiong Yin
- Gastrointestinal Department, West China Hospital, Sichuan University, Chengdu, China
| | - Chunjuan Liu
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, Chengdu, China
| | - Renrong Gong
- Department of Surgery, West China Hospital, Sichuan University/ Department of Surgery, West China School of Nursing, Sichuan University /Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Dongmei Wu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Department of Nursing, The Fourth People's Hospital of Chengdu & Chengdu Mental Health Center, Chengdu, China
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García-Arango V, Osorio-Ciro J, Aguirre-Acevedo D, Vanegas-Vargas C, Clavijo-Usuga C, Gallo-Villegas J. [Predictive validity of a functional classification method in older adultsValidação preditiva de método de classificação funcional em idosos]. Rev Panam Salud Publica 2021; 45:e15. [PMID: 33643398 PMCID: PMC7905750 DOI: 10.26633/rpsp.2021.15] [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: 06/30/2020] [Accepted: 07/14/2020] [Indexed: 11/26/2022] Open
Abstract
Objetivo. Evaluar la validez predictiva de un método de clasificación funcional (CF) sobre el uso de los servicios de urgencias y hospitalización, mortalidad y costos de la atención en salud en adultos mayores. Métodos. Estudio de cohorte retrospectivo que incluyó 2 168 adultos mayores en un programa de atención de las enfermedades crónicas no transmisibles (ECNT) en Medellín (Colombia). Los pacientes fueron estratificados según un método de CF con base en el estado funcional, presencia de factores de riesgo y control de la comorbilidad. Durante un año de seguimiento, se evaluó la validez predictiva de la CF sobre los desenlaces estudiados; se midieron la discriminación y la calibración con el estadístico-C y de Hosmer-Lemeshow (H-L), respectivamente. Resultados. El promedio de edad fue 74,6 ± 7,9 años; el 40,8% (n = 884) fueron hombres y 7,7% (n = 168) murieron. El riesgo de muerte (razón de posibilidades [OR, por su sigla en inglés]: 1,767; 3,411; 8,525), hospitalización (OR: 1,397; 2,172; 3,540) y un costo elevado de la atención en salud (OR: 1,703; 2,369; 5,073) aumentaron en la medida que hubo un deterioro en la CF, clases 2B, 3 y 4, respectivamente. El modelo predictivo para el desenlace muerte mostró una buena capacidad de discriminación (estadístico-C = 0,721) y calibración (estadístico de H-L = 10,200; P = 0,251). Conclusión. Existe una relación de dosis y respuesta entre el deterioro de la CF y un riesgo más elevado de muerte, hospitalización y costo elevado. La CF tiene validez predictiva para la tasa de mortalidad y podría utilizarse para la estratificación de adultos mayores en programas de atención de las ECNT con miras a dirigir las acciones de intervención.
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Affiliation(s)
- Víctor García-Arango
- Universidad de Antioquia Medellín Colombia Universidad de Antioquia, Medellín, Colombia
| | - Jorge Osorio-Ciro
- Universidad de Antioquia Medellín Colombia Universidad de Antioquia, Medellín, Colombia
| | | | - Catalina Vanegas-Vargas
- Institución Prestadora de Servicios de Salud Universitaria Medellín Colombia Institución Prestadora de Servicios de Salud Universitaria, Medellín, Colombia
| | - Carmen Clavijo-Usuga
- Institución Prestadora de Servicios de Salud Universitaria Medellín Colombia Institución Prestadora de Servicios de Salud Universitaria, Medellín, Colombia
| | - Jaime Gallo-Villegas
- Universidad de Antioquia Medellín Colombia Universidad de Antioquia, Medellín, Colombia
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Berge JE, Nordahl SHG, Aarstad HJ, Goplen FK. Long-Term Survival in 1,931 Patients With Dizziness: Disease- and Symptom-Specific Mortality. Laryngoscope 2021; 131:E2031-E2037. [PMID: 33609042 DOI: 10.1002/lary.29465] [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: 10/17/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate mortality among patients referred for suspected vestibular disorder and to examine whether specific symptoms or disorders predict long-term survival among patients with dizziness or vertigo. STUDY DESIGN Retrospective cohort study. METHODS This retrospective cohort study analyzed long-term survival data. Consecutive patients examined for suspected vestibular disease at an otolaryngology clinic completed a detailed questionnaire regarding symptoms and comorbidities. RESULTS The study included 1,931 patients. Their mean age (standard deviation) was 50.5 (16.5) years, and 60% were women. The mean follow-up period was 20.6 years (range, 15.3-27.5 years). The standardized mortality ratio for the entire cohort compared with the Norwegian age- and sex-matched population was 1.03 (95% confidence interval [CI]: 0.94-1.12), illustrating no difference in overall survival. Patients with a cerebrovascular cause of dizziness had higher mortality in adjusted Cox regression analyses (hazard ratio [HR] 1.56, 95% CI: 1.11-2.19), whereas patients reporting periodic or short attacks of dizziness had lower mortality (HR 0.62 [0.50-0.77] and 0.76 [0.63-0.93], respectively). Reported unsteadiness between dizziness attacks was associated with higher mortality with an HR of 1.30 (95% CI: 1.08-1.57). CONCLUSION This long-term study found comparable mortality rates between patients evaluated for suspected vestibular disorder and that of the general population. However, subgroup analyses showed reduced mortality in patients with periodic or short attacks of dizziness and increased mortality in patients with unsteadiness between attacks or cerebrovascular causes of dizziness. The time course of vestibular symptoms should be determined, and thorough evaluation including fall risk and comorbidities must be considered in patients with nonepisodic symptoms. LEVEL OF EVIDENCE 3 Laryngoscope, 131:E2031-E2037, 2021.
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Affiliation(s)
- Jan Erik Berge
- Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Otorhinolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Stein Helge Glad Nordahl
- Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hans Jørgen Aarstad
- Department of Otorhinolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Frederik Kragerud Goplen
- Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Otorhinolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Charles A, Buckinx F, Locquet M, Reginster JY, Petermans J, Gruslin B, Bruyère O. Prediction of Adverse Outcomes in Nursing Home Residents According to Intrinsic Capacity Proposed by the World Health Organization. J Gerontol A Biol Sci Med Sci 2021; 75:1594-1599. [PMID: 31562812 DOI: 10.1093/gerona/glz218] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the predictive value of the domains of intrinsic capacity (ie, cognition, locomotion, sensory, vitality, and psychosocial) proposed by the World Health Organization (WHO) on the 3-year adverse health outcomes of nursing home residents. METHODS A 3-year incidence of mortality, falls, repeated falls, and autonomy decline (ie, a one-unit increase in the Katz score) was assessed in a cohort of Belgian nursing home residents. Cognition was assessed using the Mini-Mental State Examination (MMSE). For locomotion, balance, gait speed and chair stand performance were evaluated by the Short Physical Performance Battery test. The sensory domain was measured using the Strawbridge questionnaire for audition and vision. For vitality, abdominal circumference, body mass index, nutritional status (by Mini Nutritional Assessment [MNA]) and handgrip strength were assessed. Psychosocial status was evaluated by the EQ-5D and the Center for Epidemiological Studies Depression scale. Missing data were handled by multiple imputations. Cox proportional hazard models, logistic regressions, and analysis of variance were used for the analyses. RESULTS In the multivariable model, a one-unit increase in balance performance and in the nutrition score decreased the probability of death by 12% (Hazard ratio [HR] = 0.88; 95% confidence interval [CI] 0.78-0.99) and 4% (HR = 0.96; 95% CI 0.93-0.99), respectively. The risk of falling decreased when there was a one-unit increase in balance performance (HR = 0.87, 95% CI 0.79-0.96) and in the nutrition score (HR = 0.96, 95% CI 0.93-0.98). No association was found for intrinsic capacity and repeated falls. Low scores in nutrition (odds ratio = 0.86, 95% CI 0.77-0.96) were associated with a higher probability of autonomy decline. CONCLUSION Some domains of intrinsic capacity predicted health outcomes among nursing home residents. Nutrition and balance should be regularly checked among this population.
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Affiliation(s)
- Alexia Charles
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Fanny Buckinx
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Médéa Locquet
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.,Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Bastien Gruslin
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.,Department of Sport and Rehabilitation Sciences, University of Liège, Belgium
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Nomura Y, Shimada M, Kakuta E, Okada A, Otsuka R, Tomizawa Y, Taguchi C, Arikawa K, Daikoku H, Sato T, Hanada N. Mortality-and Health-Related Factors in a Community-Dwelling of Oldest-Older Adults at the Age of 90: A 10-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249584. [PMID: 33371399 PMCID: PMC7768389 DOI: 10.3390/ijerph17249584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 02/06/2023]
Abstract
Mortality is obviously intended for epidemiological studies of community-dwelling older adults. There are several health-related factors associated with nutritional status and mortality. The aim of this study was to elucidate the risk factor for mortality in community-dwelling oldest-older adults at the age of 90 and clarify the structure of health-related factors associated with mortality. A 10-year follow-up study was performed for 93 subjects at the age of 90. The mean and median of their survival days were 2373 and 2581 days for women, and 1694 and 1793 days for men. By Cox's proportional hazards model, health-related factors associated with mortality were self-assessed for chewing ability, activities of daily living (ADLs), serum albumin, total cholesterol, serum creatinine, and gripping power for women but not for men. These factors interacted with each other, and the association of these factors was different in women and men. Self-assessed chewing ability was a powerful risk factor for mortality in women at the age of 90. It acted independently from nutritional status. For older adults, addressing healthy food choices together with improved oral functions is useful. However, risk factors for mortality may depend on the life stage of subjects. To investigate the risk factor for the mortality, the life course approach is necessary.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
- Correspondence: ; Tel.: +81-45-580-8462
| | - Mieko Shimada
- Department of Dental Hygiene, Chiba Prefectural University of Health Sciences, Chiba 261-0014, Japan;
| | - Erika Kakuta
- Department of Oral Bacteriology, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan;
| | - Ayako Okada
- Department of Translational Research, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
| | - Ryoko Otsuka
- Department of Translational Research, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
| | - Yasuko Tomizawa
- Department of Cardiovascular Surgery, Tokyo Women’s Medical University, Tokyo 162-8666, Japan;
| | - Chieko Taguchi
- Department of Preventive and Public Oral Health, School of Dentistry at Matsudo, Nihon University, Matsudo 470-2101, Japan; (C.T.); (K.A.)
| | - Kazumune Arikawa
- Department of Preventive and Public Oral Health, School of Dentistry at Matsudo, Nihon University, Matsudo 470-2101, Japan; (C.T.); (K.A.)
| | - Hideki Daikoku
- Iwate Dental Association, Morioka 020-0045, Japan; (H.D.); (T.S.)
| | - Tamotsu Sato
- Iwate Dental Association, Morioka 020-0045, Japan; (H.D.); (T.S.)
| | - Nobuhiro Hanada
- Department of Translational Research, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
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48
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Zhao X, Huang H, Gu Y. Age score for assessing motor function in Chinese community-dwelling older women. J Women Aging 2020; 34:170-180. [PMID: 33319638 DOI: 10.1080/08952841.2020.1859936] [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] [Indexed: 10/22/2022]
Abstract
The study aimed to develop a physical fitness age score to assess motor function in community-dwelling elderly women and verify its validity. Principal component analysis was employed to build a physical fitness age score based on motor function variables. Validation test showed that the physical fitness age in the exercised older women was significantly lower than their chronological age, while no significant difference was observed between the physical fitness age and the chronological age in the normal elderly. The findings suggest that physical fitness age score is a valid approach to evaluate motor function in Chinese community-dwelling elderly women.
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Affiliation(s)
- Xiaoguang Zhao
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Huiming Huang
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Yaodong Gu
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
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49
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Andrasfay T. Changes in Physical Functioning as Short-Term Predictors of Mortality. J Gerontol B Psychol Sci Soc Sci 2020; 75:630-639. [PMID: 30388248 DOI: 10.1093/geronb/gby133] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Both performance-based and self-reported measures of physical functioning are predictors of mortality. There has been relatively little research examining whether their changes predict mortality. This study examines whether 5-year changes in performance-based and self-reported measures of functioning predict subsequent mortality. METHOD Data are from the 2006 wave of the Social Environment and Biomarkers of Aging Study, 2011 wave of the Taiwan Longitudinal Study of Aging, and mortality follow-up through 2015. Gompertz proportional hazard models predict mortality from changes in ability to complete performance-based tests and changes in performance-based and self-reported functioning. RESULTS Incident inability to complete at least one performance-based test of functioning is associated with twice the risk of subsequent 4-year mortality. Conditional on the baseline measurement, a one standard deviation (SD) decline in grip strength is associated with a 61% increased risk of 4-year mortality; a one-SD decline in walking speed and a one-SD increase in self-reported limitations are both associated with around a 40% increased risk of 4-year mortality. Conditional on the most recent measurement of functioning, prior change is not significantly associated with subsequent mortality. DISCUSSION Repeated measures of performance-based and self-reported functioning are valuable in that they provide an updated measurement of functioning.
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Li TC, Wu CW, Li CI, Wu FY, Liao LN, Liu CS, Lin CH, Wang MC, Yang CW, Lin CC. Interactions among IGF-1, AKT2, FOXO1, and FOXO3 variations and between genes and physical activities on physical performance in community-dwelling elders. PLoS One 2020; 15:e0239530. [PMID: 32986769 PMCID: PMC7521683 DOI: 10.1371/journal.pone.0239530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/09/2020] [Indexed: 12/22/2022] Open
Abstract
This study assessed the interactions among IGF-1, AKT2, FOXO1, and FOXO3 variations and the interactions of gene and physical activity on handgrip strength, arm muscle mass-adjusted handgrip (armGrip), gait speed (GS), timed up and go (TUG), and leg press strength (LPS). Nine single nucleotide polymorphisms (SNPs) containing three IGF-1 SNPs (rs6214, rs5742692, and rs35767), two AKT2 SNPs (rs892119 and rs35817154), two FOXO1 SNPs (rs17446593 and rs10507486), and two FOXO3 SNPs (rs9480865 and rs2153960) were genotyped in 472 unrelated elders with a mean age of 73.8 years. We observed significant interactions of IGF-1 SNP rs6214 and rs35767 with regular physical activity on TUG and GS; and AKT2 SNP rs892119 and FOXO3 SNP rs9480865 with regular physical activity on armGrip. Genotype GG of IGF-1 rs6214 and rs35767 in individuals without regular physical activity had poor performance in TUG and GS, as well as GG of AKT2 rs892119 decreased armGrip in individuals without regular physical activity. After FDR adjustment, no significant gene-gene interactions were found. A sedentary lifestyle may increase the risk of impairing physical performance and regular physical activity is a remedy for sarcopenia, even a little regular physical activity can overcome carrying some risk alleles in this pathway.
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Affiliation(s)
- Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Healthcare Administration, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Ching-Wei Wu
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Fang-Yang Wu
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Li-Na Liao
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Mu-Cyun Wang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chuan-Wei Yang
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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