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Joundi RA, Hu B, Rangarajan S, Leong DP, Islam S, Smith EE, Mirrakhimov E, Seron P, Alhabib KF, Assembekov B, Chifamba J, Yusuf R, Khatib R, Felix C, Yusufali A, Mohammadifard N, Rosengren A, Oguz A, Iqbal R, Yeates K, Avezum A, Kruger I, Anjana R, Pvm L, Gupta R, Zatońska K, Barbarash O, Pelliza E, Rammohan K, Li M, Li X, Ismail R, Lopez-Jaramillo P, Evans M, O'Donnell M, Yusuf S. Activity limitations, use of assistive devices, and mortality and clinical events in 25 high-income, middle-income, and low-income countries: an analysis of the PURE study. Lancet 2024; 404:554-569. [PMID: 39068950 DOI: 10.1016/s0140-6736(24)01050-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/04/2024] [Accepted: 05/16/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The focus of most epidemiological studies has been mortality or clinical events, with less information on activity limitations related to basic daily functions and their consequences. Standardised data from multiple countries at different economic levels in different regions of the world on activity limitations and their associations with clinical outcomes are sparse. We aimed to quantify the prevalence of activity limitations and use of assistive devices and the association of limitations with adverse outcomes in 25 countries grouped by different economic levels. METHODS In this analysis, we obtained data from individuals in 25 high-income, middle-income, and low-income countries from the Prospective Urban Rural Epidemiological (PURE) study (175 660 participants). In the PURE study, individuals aged 35-70 years who intended to continue living in their current home for a further 4 years were invited to complete a questionnaire on activity limitations. Participant follow-up was planned once every 3 years either by telephone or in person. The activity limitation screen consisted of questions on self-reported difficulty with walking, grasping, bending, seeing close, seeing far, speaking, hearing, and use of assistive devices (gait, vision, and hearing aids). We estimated crude prevalence of self-reported activity limitations and use of assistive devices, and prevalence standardised by age and sex. We used logistic regression to additionally adjust prevalence for education and socioeconomic factors and to estimate the probability of activity limitations and assistive devices by age, sex, and country income. We used Cox frailty models to evaluate the association between each activity limitation with mortality and clinical events (cardiovascular disease, heart failure, pneumonia, falls, and cancer). The PURE study is registered with ClinicalTrials.gov, NCT03225586. FINDINGS Between Jan 12, 2001, and May 6, 2019, 175 584 individuals completed at least one question on the activity limitation questionnaire (mean age 50·6 years [SD 9·8]; 103 625 [59%] women). Of the individuals who completed all questions, mean follow-up was 10·7 years (SD 4·4). The most common self-reported activity limitations were difficulty with bending (23 921 [13·6%] of 175 515 participants), seeing close (22 532 [13·4%] of 167 801 participants), and walking (22 805 [13·0%] of 175 554 participants); prevalence of limitations was higher with older age and among women. The prevalence of all limitations standardised by age and sex, with the exception of hearing, was highest in low-income countries and middle-income countries, and this remained consistent after adjustment for socioeconomic factors. The use of gait, visual, and hearing aids was lowest in low-income countries and middle-income countries, particularly among women. The prevalence of seeing close limitation was four times higher (6257 [16·5%] of 37 926 participants vs 717 [4·0%] of 18 039 participants) and the prevalence of seeing far limitation was five times higher (4003 [10·6%] of 37 923 participants vs 391 [2·2%] of 18 038 participants) in low-income countries than in high-income countries, but the prevalence of glasses use in low-income countries was half that in high-income countries. Walking limitation was most strongly associated with mortality (adjusted hazard ratio 1·32 [95% CI 1·25-1·39]) and most consistently associated with other clinical events, with other notable associations observed between seeing far limitation and mortality, grasping limitation and cardiovascular disease, bending limitation and falls, and between speaking limitation and stroke. INTERPRETATION The global prevalence of activity limitations is substantially higher in women than men and in low-income countries and middle-income countries compared with high-income countries, coupled with a much lower use of gait, visual, and hearing aids. Strategies are needed to prevent and mitigate activity limitations globally, with particular emphasis on low-income countries and women. FUNDING Funding sources are listed at the end of the Article.
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Affiliation(s)
- Raed A Joundi
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada.
| | - Bo Hu
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
| | - Darryl P Leong
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
| | | | | | | | | | | | | | | | - Rita Yusuf
- Independent University, Dhaka, Bangladesh
| | - Rasha Khatib
- Advocate Aurora Research Institute, Milwaukee, WI, USA
| | | | | | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aytekin Oguz
- Istanbul Medeniyet University, Istanbul, Türkiye
| | | | | | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz and UNISA, São Paulo University, São Paulo, Brazil
| | | | | | - Lakshmi Pvm
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Rajasthan, India
| | | | | | | | | | - Mengya Li
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaocong Li
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rosnah Ismail
- Universiti Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Marc Evans
- Philippine General Hospital, Manila, Philippines
| | | | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
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Ramalivhana FW, Veldsman T, Moss SJ. Assessment of non-communicable disease risk factors, functional performance, and health-related quality of life in adults: a comparative analysis in low-resourced urban and rural areas of South Africa. BMC Public Health 2024; 24:1580. [PMID: 38867182 PMCID: PMC11170915 DOI: 10.1186/s12889-024-18964-2] [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: 12/04/2023] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Globally, disparities between non-communicable disease (NCD) risk factors, functional performance, and health-related quality of life (HRQoL) exist in people living in rural and low-resourced urban settings. Evidence of these health differences determined with objective NCD risk factors and functional performance measurements in South Africa, is scarce. Therefore, the study aimed to determine the differences in NCD risk factors, functional performance and HRQoL between rural and low-resourced urban areas. METHODS The study recruited 311 adults (35-80 years) presenting with at least one NCD risk factor from low-resourced urban- (n = 183) and rural (n = 128) communities. Objective measurements of physical activity (PA) by means of combined heart rate and accelerometery, body composition employing skinfolds, peripheral lipid and glucose concentrations, blood pressure, functional performance indicators (handgrip, single leg stand, sit-to-stand, timed-up-and-go speed, predicted peak VO2 max); and HRQoL were measured according to standard procedures. Independent t-tests, Mann-Whitney U, and chi-square tests were performed to determine differences between the variables of low-resourced urban and rural settings. RESULTS The participants from the low-resourced urban setting were significantly older than the rural residents (59.1 ± 10.7 years vs. 52.8 ± 11.3 years; p = 0.001). NCD risk factors were significantly more prevalent in the low-resourced urban participants compared to rural participants, in particular for elevated systolic (85.8% vs. 62.5%; p = 0.001), and diastolic blood pressure (88.5% vs. 65.6%; p = 0.001), physical inactivity (95.9% vs. 87.7%; p = 0.026), increased cholesterol concentrations (22.1% vs. 8.7%; p = 0.002), and increased waist circumference (61.9% vs. 49.2%; p = 0.027). Low-resourced urban residents presented with a higher average body fat percentage (27.69% ± 7.65% vs. 12.23% ± 4.67%; p < 0.001), and lower moderate to vigorous PA levels (37.19 ± 49.55 [95% CI = 29.12-45.27] vs. 62.92 ± 60.43 min/week [95% CI = 47.95-77.90]; p = 0.003) compared to rural residents. Rural residents showed significantly better functional performance, including peak VO2 (23.99 ± 9.89 vs. 16.95 ± 7.64 ml/min/kg; p = 0.001) and single leg stand (right leg: 44.96 ± 18.47 vs. 20.87 ± 19.18 s; p = 0.001) as well as higher HRQoL for the physical (51.06 ± 8.14% vs. 45.62 ± 11.13%; p < 0.001) and mental (54.75 ± 8.24% vs. 48.91 ± 12.27%; p < 0.001) component scores compared to participants from the low-resourced urban areas. CONCLUSION NCD risk factors, functional performance, and HRQoL significantly differ in rural communities compared to low-resourced urban communities in South Africa. Urban areas' most prevalent risk factors were elevated blood pressure, physical inactivity, and increased waist circumference. Participants from rural areas demonstrated significantly better functional performance, such as fitness and balance. HRQoL was better in rural settings than in urban settings. Future intervention programmes should be tailored for specific settings.
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Affiliation(s)
- Fhatuwani W Ramalivhana
- Physical Activity, Sport, and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Tamrin Veldsman
- Physical Activity, Sport, and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, Australia
| | - Sarah J Moss
- Physical Activity, Sport, and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
- North-West University, Private Bag X6001, Potchefstroom, 2531, South Africa.
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de Graaf D, de Vries NM, van de Zande T, Schimmel JJP, Shin S, Kowahl N, Barman P, Kapur R, Marks WJ, van 't Hul A, Bloem B. Measuring Physical Functioning Using Wearable Sensors in Parkinson Disease and Chronic Obstructive Pulmonary Disease (the Accuracy of Digital Assessment of Performance Trial Study): Protocol for a Prospective Observational Study. JMIR Res Protoc 2024; 13:e55452. [PMID: 38713508 PMCID: PMC11109858 DOI: 10.2196/55452] [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: 12/13/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Physical capacity and physical activity are important aspects of physical functioning and quality of life in people with a chronic disease such as Parkinson disease (PD) or chronic obstructive pulmonary disease (COPD). Both physical capacity and physical activity are currently measured in the clinic using standardized questionnaires and tests, such as the 6-minute walk test (6MWT) and the Timed Up and Go test (TUG). However, relying only on in-clinic tests is suboptimal since they offer limited information on how a person functions in daily life and how functioning fluctuates throughout the day. Wearable sensor technology may offer a solution that enables us to better understand true physical functioning in daily life. OBJECTIVE We aim to study whether device-assisted versions of 6MWT and TUG, such that the tests can be performed independently at home using a smartwatch, is a valid and reliable way to measure the performance compared to a supervised, in-clinic test. METHODS This is a decentralized, prospective, observational study including 100 people with PD and 100 with COPD. The inclusion criteria are broad: age ≥18 years, able to walk independently, and no co-occurrence of PD and COPD. Participants are followed for 15 weeks with 4 in-clinic visits, once every 5 weeks. Outcomes include several walking tests, cognitive tests, and disease-specific questionnaires accompanied by data collection using wearable devices (the Verily Study Watch and Modus StepWatch). Additionally, during the last 10 weeks of this study, participants will follow an aerobic exercise training program aiming to increase physical capacity, creating the opportunity to study the responsiveness of the remote 6MWT. RESULTS In total, 89 people with PD and 65 people with COPD were included in this study. Data analysis will start in April 2024. CONCLUSIONS The results of this study will provide information on the measurement properties of the device-assisted 6MWT and TUG in the clinic and at home. When reliable and valid, this can contribute to a better understanding of a person's physical capacity in real life, which makes it possible to personalize treatment options. TRIAL REGISTRATION ClinicalTrials.gov NCT05756075; https://clinicaltrials.gov/study/NCT05756075. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55452.
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Affiliation(s)
- Debbie de Graaf
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, Netherlands
| | - Nienke M de Vries
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, Netherlands
| | - Tessa van de Zande
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, Netherlands
| | - Janneke J P Schimmel
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, Netherlands
| | - Sooyoon Shin
- Verily Life Sciences, South San Fransisco, CA, United States
| | - Nathan Kowahl
- Verily Life Sciences, South San Fransisco, CA, United States
| | - Poulami Barman
- Verily Life Sciences, South San Fransisco, CA, United States
| | - Ritu Kapur
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, Netherlands
- Verily Life Sciences, South San Fransisco, CA, United States
| | - William J Marks
- Verily Life Sciences, South San Fransisco, CA, United States
| | - Alex van 't Hul
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, Nijmegen, Netherlands
| | - Bastiaan Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, Netherlands
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Böttinger MJ, Labudek S, Schoene D, Jansen CP, Stefanakis ME, Litz E, Bauer JM, Becker C, Gordt-Oesterwind K. "TiC-TUG": technology in clinical practice using the instrumented timed up and go test-a scoping review. Aging Clin Exp Res 2024; 36:100. [PMID: 38676844 PMCID: PMC11055724 DOI: 10.1007/s40520-024-02733-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/05/2024] [Indexed: 04/29/2024]
Abstract
Digitized assessments have a considerable potential to guide clinicial decision making and monitor progress and disease trajectories. The Timed Up and Go test (TUG) has been long established for assessment in geriatric medicine and instrumented versions (iTUG) have been developed and validated. This scoping review includes studies that applied the iTUG and aims to identify use cases to show where and how iTUG assessment could guide interventions and clinical management. The literature search was limited to peer-reviewed studies that performed pre- and post-intervention measurements with a 3-meter TUG instrumented with body-worn technology in samples of at least 20 subjects aged 60+ years. Of 3018 identified articles 20 were included. Four clinical use cases were identified: stratification for subsequent therapy, monitoring of disease or treatment-associated changes and evaluation of interventions in patients with idiopathic normal pressure hydrocephalus (1), and patients with Parkinson's disease (2); monitoring after joint replacement surgery (3), and evaluation after different exercise and rehabilitation interventions (4). The included studies show diversity in terms of iTUG technology and procedures. The identified use cases highlight clinical relevance and high potential for the clinical application of the iTUG. A consensual approach as well as comprehensive reporting would help to further exploit the potential of the iTUG to support clinical management. Future studies should investigate the benefits of segmental iTUG analysis, responsiveness and participants' perspectives on clinically meaningful changes in iTUG.
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Affiliation(s)
- Melissa J Böttinger
- Digital Unit, Center for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany.
- Network Aging Research, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany.
| | - Sarah Labudek
- Clinic for Psychiatry and Psychotherapy, Helios Hospital Schwerin, Schwerin, Germany
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
| | - Daniel Schoene
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
| | - Carl-Philipp Jansen
- Digital Unit, Center for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
| | - Marios-Evangelos Stefanakis
- Digital Unit, Center for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Network Aging Research, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
| | - Elena Litz
- Digital Unit, Center for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Network Aging Research, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Jürgen M Bauer
- Digital Unit, Center for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Network Aging Research, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Clemens Becker
- Digital Unit, Center for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
| | - Katharina Gordt-Oesterwind
- Digital Unit, Center for Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Network Aging Research, Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
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Thalén A, Ledberg A. Consequences of heterogeneity in aging: parental age at death predicts midlife all-cause mortality and hospitalization in a Swedish national birth cohort. BMC Geriatr 2024; 24:207. [PMID: 38424528 PMCID: PMC10903026 DOI: 10.1186/s12877-024-04786-9] [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: 08/07/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The processes that underlie aging may advance at different rates in different individuals and an advanced biological age, relative to the chronological age, is associated with increased risk of disease and death. Here we set out to quantify the extent to which heterogeneous aging shapes health outcomes in midlife by following a Swedish birth-cohort and using parental age at death as a proxy for biological age in the offspring. METHODS We followed a nationwide Swedish birth cohort (N = 89,688) between the ages of 39 and 66 years with respect to hospitalizations and death. Cox regressions were used to quantify the association, in the offspring, between parental age at death and all-cause mortality, as well as hospitalization for conditions belonging to the 10 most common ICD-10 chapters. RESULTS Longer parental lifespan was consistently associated with reduced risks of hospitalization and all-cause mortality. Differences in risk were mostly evident from before the age of 50 and persisted throughout the follow-up. Each additional decade of parental survival decreased the risk of offspring all-cause mortality by 22% and risks of hospitalizations by 9 to 20% across the 10 diseases categories considered. The number of deaths and hospitalizations attributable to having parents not living until old age were 1500 (22%) and 11,000 (11%) respectively. CONCLUSIONS Our findings highlight that increased parental lifespan is consistently associated with health benefits in the offspring across multiple outcomes and suggests that heterogeneous aging processes have clinical implications already in midlife.
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Affiliation(s)
- Anna Thalén
- Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden
| | - Anders Ledberg
- Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden.
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Theis S, Bitterlich N, von Wolff M, Stute P. Measuring Quality of Life: Incorporating Objectively Measurable Parameters within the Cross-Sectional Bern Cohort Study 2014 (BeCS-14). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:94. [PMID: 38248557 PMCID: PMC10815394 DOI: 10.3390/ijerph21010094] [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: 12/02/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
Up until now, the measurement of Quality of Life (QoL) was based on validated subjective rating tools rather than objective measurement. To become more independent of the self-assessment of probands, a way to objectively measure QoL should be found. A monocenter, cross-sectional, observational, non-interventional trial was performed from 2012 to 2014 at Inselspital Bern to evaluate the bio-functional status (BFS), a complex, generic, non-invasive, sex- and age-validated assessment tool, in a wide range of areas. A standardized battery of assessments was performed on 464 females and 166 males, ages 18 to 65 (n = 630). In addition to the survey of the BFS, participants replied-among others-to the validated questionnaire SF-36 for health-related QoL (n = 447, subgroup 1). Since the accepted cut-off value for BFA calculation is age ≥ 35 years, subgroup 2 included 227 subjects (all participants aged ≥ 35 years out of subgroup 1). In order to be able to compare the eight SF-36 subscales to BFS parameters, a comparable score set of single BFS items had to be constructed. Subsequently, we aimed to statistically identify BFS item combinations that best represented each SF-36 subscale. All eight SF-36 subscales were significantly represented by various different combinations of BFS items. A total of 24 single BFS items significantly correlated with SF-36 subscales, of which 15 were objective and nine were subjective. All eight SF-36 subscales were significantly represented by various different combinations of BFS items leading to stronger correlations (range five to nine BFS items), and overall, sex and age did not affect these associations, but in the SF-36 subscales 'bodily pain' (sex) and 'role limitations due to physical health problems' (age in men). To our knowledge, we are the first to correlate a validated set of 34 objective and 9 subjective parameters with subjectively evaluated SF-36 subscales. This first study on the objectifiability of the SF-36 questionnaire demonstrated that questions on quality of life can be answered independently of a subjective assessment by subjects in future scientific studies.
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Affiliation(s)
- Susanne Theis
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Division of Gynecological Endocrinology and Reproductive Medicine, Langenbeckstr. 1, 55131 Mainz, Germany;
| | - Norman Bitterlich
- Independent Researcher, Draisdorfer Str. 21, 09114 Chemnitz, Germany;
| | - Michael von Wolff
- University Clinic Bern, Division of Gynecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Inselspital Bern, Friedbühlstrasse 19, 3010 Bern, Switzerland;
| | - Petra Stute
- University Clinic Bern, Division of Gynecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Inselspital Bern, Friedbühlstrasse 19, 3010 Bern, Switzerland;
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Offermann J, Wilkowska W, Laurentius T, Bollheimer LC, Ziefle M. How age and health status impact attitudes towards aging and technologies in care: a quantitative analysis. BMC Geriatr 2024; 24:9. [PMID: 38172721 PMCID: PMC10765835 DOI: 10.1186/s12877-023-04616-4] [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: 05/26/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Increasing proportions of geriatric patients pose tremendous challenges for our society. Developments in assistive technologies have the potential to support older and frail people in aging and care. To reach a sustainable adoption of these technologies, the perceptions and wishes of future users must be understood. In particular, the relationships between individual health-related factors, and the perceptions of aging and using assistive technologies in severe health situations must be empirically examined. METHODS Addressing this research gap, our quantitative study (N = 570) investigates the impact of diverse future users' age and health status on their a) perceptions of aging, b) perceptions and acceptance of using assistive technologies in aging and care, as well as c) end-of-life decisions regarding technology usage. For this, four groups were segmented for the comparison of younger (< 50 years) healthy, younger chronically ill, older (50 + years) healthy, and older chronically ill participants. RESULTS The results revealed that health status is more decisive for age-related perceptions compared to age. The technology-related perceptions were slightly impacted by either chronological age or health status. The end-of-life decisions showed the most striking differences in the willingness to use assistive technologies, revealing older chronically ill participants to have more restrained attitudes towards technology usage than older healthy as well as all younger participants. CONCLUSIONS The findings suggest that the benefits of assistive technologies in private or professional care contexts should be communicated and implemented tailored to the respective user group's needs. Moreover, the results allow us to derive practical implications within the geriatric care context.
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Affiliation(s)
- Julia Offermann
- Chair for Communication Science & Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074, Aachen, Germany.
| | - Wiktoria Wilkowska
- Chair for Communication Science & Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074, Aachen, Germany
| | - Thea Laurentius
- Chair of Geriatrics & Department of Geriatric Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - L Cornelius Bollheimer
- Chair of Geriatrics & Department of Geriatric Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - Martina Ziefle
- Chair for Communication Science & Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074, Aachen, Germany
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Chowdhury D, Stolee P, Sims-Gould J, Tong C. "Think positive and don't die alone" - Foreign-born, South Asian older adults' perceptions on healthy aging. Int J Qual Stud Health Well-being 2023; 18:2253576. [PMID: 37691478 PMCID: PMC10496524 DOI: 10.1080/17482631.2023.2253576] [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: 01/19/2023] [Accepted: 08/27/2023] [Indexed: 09/12/2023] Open
Abstract
South Asians are the largest and fastest-growing racialized group in Canada, yet there are limited data on various aspects of health and well-being within this population. This includes the South Asian older adults' ethnoculturally informed perceptions of ageing. The study aimed to understand how social and cultural forces impact the meaning assigned to healthy ageing amongst older South Asians in Canada. We recruited with purposeful and snowball sampling strategies in Southern Ontario. We conducted in-depth focus group and individual interviews (n = 19) in five South Asian languages, employing a multilingual and cross-cultural qualitative approach. In our analysis, we identified three central themes: (a) taking care of body (b) taking care of mind and heart and (c) healthy ageing through the integration of mind and body. Our study demonstrates that older immigrants are a diverse and heterogeneous population and that their conception of healthy ageing is strongly influenced by their country of origin. This study also demonstrates how racialized foreign-born older adults might provide distinctive perspectives on the ageing process and on social theories of ageing due to their simultaneous immersion in and belonging to global majority and global minority cultures. This research also adds to the limited body of literature on the theories of ageing, despite migration trends, still has a white-centric lens.
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Affiliation(s)
- Diya Chowdhury
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Joanie Sims-Gould
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Catherine Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Department of Family Practice, University of British Columbia, Vancouver, Canada
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9
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Saila K, Clas-Håkan N, Prakash KC, Subas N. Longitudinal profiles of occupational physical activity during late midlife and their association with functional limitations at old age: a multi-cohort study. Int Arch Occup Environ Health 2023; 96:1245-1256. [PMID: 37515644 PMCID: PMC10560154 DOI: 10.1007/s00420-023-02003-5] [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: 04/14/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE The aim was to examine longitudinal profiles of occupational physical activity (OPA) from midlife to retirement and to investigate how the different OPA-profiles are associated with mobility limitations (ML) and activities of daily living (ADL-disability) at old age. METHODS Harmonized data from two cohort studies from Finland and the United States, that have followed people from midlife until old age were used. Repeated measurements of self-reported OPA were collected during approximately 11- to 12-year period. Persons who had data on OPA from ≥ 2 time points during the period from mid-working life to retirement were included. Latent class growth analysis was used to identify OPA-profiles. Risk ratios (RRs) with 95% confidence intervals for the associations of the OPA-profiles and later life MLs and ADL-disability were estimated. RESULTS Three OPA-profiles were identified in both cohorts: high-persistent, moderate-fluctuating, and low-persistent. For majority OPA remained stable: for workers reporting high or low levels of OPA at midlife, the physical demands of work likely persisted, whereas people reporting moderate level OPA had high fluctuation in their exposure level. Members of high-persistent and moderate-fluctuating OPA-profiles had increased risk of subsequent MLs at old age. The RRs for ADL-disability did not differ between the profiles. CONCLUSIONS Perceived OPA remains rather stable for workers reporting high or low physical work demands during midlife, yet fluctuating profiles also exist. Workers exposed to high or moderate OPA have higher risk for MLs when they reach old age. Establishing safe and health-promoting levels of OPA during late working life might have positive long-term consequences on healthy ageing.
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Affiliation(s)
- Kyrönlahti Saila
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.
- Gerontology Research Center, Tampere University, Tampere, Finland.
| | - Nygård Clas-Håkan
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
| | - K C Prakash
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
| | - Neupane Subas
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
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10
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Ohman A, Maxwell CJ, Tyas SL, Oremus M. Subtypes of social support availability are not differentially associated with memory: a cross-sectional analysis of the Comprehensive Cohort of the Canadian Longitudinal Study on Aging. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:354-369. [PMID: 35086434 DOI: 10.1080/13825585.2022.2030294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
This study investigated the association between subtypes of social support availability (SSA) and memory in persons aged 45 to 85 years (n = 24,719). We examined two memory outcomes using a modified Rey Auditory Verbal Learning Test (RAVLT)-immediate recall (RAVLT I) and delayed recall (RAVLT II)-and five subtypes of SSA: affectionate, emotional/informational, positive interactions, tangible, overall. We found statistically significant and adjusted positive associations between all SSA subtypes and memory, except for positive interactions and delayed recall memory. For RAVLT I, the regression coefficients (βˆs) ranged from 0.03 to 0.07; the βˆs for RAVLT II ranged from 0.02 to 0.05. The differences in βˆs for each SSA subtype (βˆ RAVLT I - βˆ RAVLT II) ranged from 0.00 to 0.02 (mean difference = 0.01; 95% confidence interval = -0.01 to 0.03). All effect sizes, regardless of SSA subtype or memory outcome, were small and clinically unimportant.
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Affiliation(s)
- Avery Ohman
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- School of Pharmacy, University of Waterloo, Waterloo, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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11
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Malkowski OS, Kanabar R, Western MJ. Socio-economic status and trajectories of a novel multidimensional metric of Active and Healthy Ageing: the English Longitudinal Study of Ageing. Sci Rep 2023; 13:6107. [PMID: 37055521 PMCID: PMC10102137 DOI: 10.1038/s41598-023-33371-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/12/2023] [Indexed: 04/15/2023] Open
Abstract
Healthy ageing research largely has a unidimensional focus on physical health, negating the importance of psychosocial factors in the maintenance of a good quality-of-life. In this cohort study, we aimed to identify trajectories of a new multidimensional metric of Active and Healthy Ageing (AHA), including their associations with socio-economic variables. A latent AHA metric was created for 14,755 participants across eight waves of data (collected between 2004 and 2019) from the English Longitudinal Study of Ageing (ELSA), using Bayesian Multilevel Item Response Theory (MLIRT). Then, Growth Mixture Modelling (GMM) was employed to identify sub-groups of individuals with similar trajectories of AHA, and multinomial logistic regression examined associations of these trajectories with socio-economic variables: education, occupational class, and wealth. Three latent classes of AHA trajectories were suggested. Participants in higher quintiles of the wealth distribution had decreased odds of being in the groups with consistently moderate AHA scores (i.e., 'moderate-stable'), or the steepest deterioration (i.e., 'decliners'), compared to the 'high-stable' group. Education and occupational class were not consistently associated with AHA trajectories. Our findings reiterate the need for more holistic measures of AHA and prevention strategies targeted at limiting socio-economic disparities in older adults' quality-of-life.
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Affiliation(s)
- Olivia S Malkowski
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Ricky Kanabar
- Department of Social and Policy Sciences, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Max J Western
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
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12
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Landré B, Ben Hassen C, Kivimaki M, Bloomberg M, Dugravot A, Schniztler A, Sabia S, Singh-Manoux A. Trajectories of physical and mental functioning over 25 years before onset of frailty: results from the Whitehall II cohort study. J Cachexia Sarcopenia Muscle 2023; 14:288-297. [PMID: 36397170 PMCID: PMC9891967 DOI: 10.1002/jcsm.13129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research on frailty, a major contributor to heterogeneity in health, is undertaken on older adults although the processes leading to frailty are likely to begin earlier in the life course. Using repeat data spanning 25 years, we examined changes in physical and mental functioning before the onset of frailty, defined using Fried's frailty phenotype (FFP). METHODS Functioning was measured using the Short-Form 36 General Health Survey (SF-36) on nine occasions from 1991 (age range 40-63 years) to 2015 (age range 63-85 years). The poorest of four FFP scores from 2002, 2007, 2012 and 2015 was used to classify participants as frail, pre-frail, or robust. We used linear mixed models with a backward timescale such that time 0 was the person-specific date of frailty classification for frail and pre-frail participants and the end of follow-up for robust participants. Analyses adjusted for socio-demographic factors, health behaviours, body mass index and multi-morbidity status were used to compare SF-36 physical (PCS) and mental (MCS) component summary scores over 25 years before time 0 as a function of FFP classification, with estimates extracted at time 0, -5, -10, -15, -20 and -25 years. We also used illness-death models to examine the prospective association between SF-36 component summary scores at age 50 and incident FFP-defined frailty. RESULTS Among 7044 participants of the Whitehall II cohort study included in the analysis [29% female, mean age 49.7 (SD = 6.0) at baseline in 1991], 2055 (29%) participants remained robust, and 4476 (64%) became pre-frail and 513 (7%) frail during follow-up. Frail compared with robust participants had lower SF-36 scores at t = -25 before onset of frailty with a difference of 3.4 [95% confidence interval (CI) 1.6, 5.1] in PCS and 1.8 (-0.2, 3.8) in MCS. At t = 0, the differences increased to 11.5 (10.5, 12.5) and 9.1 (8.0, 10.2), respectively. The differences in SF-36 between the robust and pre-frail groups, although smaller [at t = 0, 1.7 (1.2, 2.2) in PCS and 4.0 (3.4, 4.5) in MCS], were already observed 20 and 25 years, respectively, before the onset of pre-frailty. Prospective analyses showed that at age 50, scores in the bottom quartiles of PCS [hazard ratio (HR) compared with the top quartile = 2.39, 95% CI 1.85, 3.07] and MCS [HR = 1.49 (1.15, 1.93)] were associated with a higher risk of FFP-defined frailty at older ages. CONCLUSIONS Differences in trajectories of physical and mental functioning in individuals who developed physical frailty at older ages were observable 25 years before onset of FFP-defined frailty. These findings highlight the need for a life course approach in efforts to prevent frailty.
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Affiliation(s)
- Benjamin Landré
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Céline Ben Hassen
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Mika Kivimaki
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Mikaela Bloomberg
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Aline Dugravot
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Alexis Schniztler
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Séverine Sabia
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Université Paris Cité, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.,Department of Epidemiology and Public Health, University College London, London, UK
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13
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Gonzalez-Bautista E, de Souto Barreto P, Salinas-Rodriguez A, Manrique-Espinoza B, Sourdet S, Rolland Y, Rodríguez-Mañas L, Andrieu S, Vellas B. Development and Validation of a Cutoff for the Chair Stand Test as a Screening for Mobility Impairment in the Context of the Integrated Care for Older People Program. J Gerontol A Biol Sci Med Sci 2023; 78:104-110. [PMID: 35226732 DOI: 10.1093/gerona/glac055] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The 5-repetition chair stand test (CST) is increasingly being used to assess locomotion capacity in older adults. However, there is a lack of age-stratified cutoffs for adults aged ≥70 validated against a higher risk of functional loss. METHODS We used 2 population-based studies (Study on global AGEing and adult health in Mexico [SAGE Mexico] and Toledo Study for Healthy Aging [TSHA]) and receiver operating characteristic (ROC) analyses to develop and cross-validate age-stratified chair stand cutoffs with activities of daily living (ADL) disability as the outcome. Then, we used data from an randomized controlled trial (RCT) (Multidomain Alzheimer Preventive Trial [MAPT]) and a frailty day-hospital for external validation with cross-sectional and longitudinal measures of ADL disability. The merged sample of SAGE Mexico and TSHA was n = 1 595; sample sizes for external validation were: MAPT n = 1 573 and Frailty day-hospital n = 2 434. The Cox models for incident disability in MAPT had a mean follow-up of 58.6 months. RESULTS Cutoffs obtained were 14 second (ages 70-79) and 16 second (ages 80+). Those cutoffs identified older adults at higher odds of incident ADL disability odds ratio (OR) = 1.72 (95% confidence interval [CI] 1.06; 2.78) for ages 70-79 and odds ratio (OR) = 2.27 (95% CI 1.07; 4.80) in those aged 80+. Being a slow chair stander according to the cut points was associated with ADL disability in cross-sectional and longitudinal measures. CONCLUSIONS Fourteen- and 16-second cut points for the CST are suitable to identify people at higher risk of functional decline among older adults in Mexico and Toledo, Spain. Adjusting the cut point from 14 to 16 second generally improved the psychometric properties of the test. The validation of these cutoffs can facilitate the screening for limited mobility and the implementation of the Integrated Care for Older People program.
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Affiliation(s)
- Emmanuel Gonzalez-Bautista
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Philipe de Souto Barreto
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Aaron Salinas-Rodriguez
- Center for Surveys and Evaluation Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Betty Manrique-Espinoza
- Center for Surveys and Evaluation Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Sandrine Sourdet
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Yves Rolland
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | | | - Sandrine Andrieu
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | - Bruno Vellas
- Gérontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
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14
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Joannès C, Colineaux H, Guernec G, Castagné R, Kelly-Irving M. Toward a conceptual framework of health and its operational definition: an application in the 1958 British birth cohort. BMC Public Health 2023; 23:100. [PMID: 36639784 PMCID: PMC9840257 DOI: 10.1186/s12889-022-14967-z] [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: 06/13/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Defining and measuring Health presents a challenge, partly due to its conceptual pluralism. To measure Health as an ability to adapt and self-manage, we developed an approach within the theoretical framework of resources and reserves over the life course, recently proposed in the literature. We aimed to (i) use the conceptual framework developed to identify indicators of deteriorating health reserves, (ii) construct an overall health measure from these indicators, (iii) evaluate the association between the overall health measure and subsequent health outcomes and (iv) assess the robustness of our method. METHODS We used data from 7,043 individuals born in 1958 in Great Britain included in the National Child Development Study. An overall health measure was constructed via the sum of three selected indicators of deteriorating health reserves in mid-life: chronic widespread pain (CWP), Clinical Interview Schedule - revised (CIS-r), and allostatic load (AL). A three-category variable was defined: impaired/medium/optimal overall health. We explored criterion validity by modelling the relationships between the overall health measure, or each reserve taken separately at 44-45 years, and self-rated health at 46 years and mortality up to 58 years, corresponding to 14 years of follow up, using Cox and logistic regressions respectively. We performed comparative analyses to assess the robustness of the method. RESULTS Having an impaired overall health measure was significantly associated with all-cause premature mortality (HRimpaired = 2.74 [1.86; 4.05]) and an increased risk of later fair/poor/very poor self-rated health (ORimpaired = 7.50 [6.29; 8.95]). The overall health measure had a greater effect on the self-rated health estimates than each indicator of deteriorating health reserves considered separately (ORAL medium = 1.82 [1.59; 2.09]; ORAL high = 2.74 [2.37; 3.16]; ORCIS-r = 5.20 [4.45; 6.08]; ORCWP = 2.85 [2.53; 3.21]). CIS-r and allostatic load were also associated with premature mortality contrary to chronic widespread pain (HRAL medium1.82 [1.27; 2.61]; HRAL high = 3.10 [2.19; 4.40]; HRCIS-r = 1.77 [1.22; 2.56]; HRCWP = 1.32 [0.98; 1.76]). The multiple comparative analyses conducted allowed us to assess the robustness of our method within this cohort. CONCLUSIONS We proposed a method for measuring Health in mid-life in line with the concept of Health as the ability to adapt and self-manage and the concept of health reserves. This method may be applied and further developed within the field of social and positive epidemiology.
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Affiliation(s)
- Camille Joannès
- grid.15781.3a0000 0001 0723 035XEquity Research Team, CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Hélène Colineaux
- grid.15781.3a0000 0001 0723 035XEquity Research Team, CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Gregory Guernec
- grid.15781.3a0000 0001 0723 035XEquity Research Team, CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Raphaële Castagné
- grid.15781.3a0000 0001 0723 035XEquity Research Team, CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Michelle Kelly-Irving
- grid.15781.3a0000 0001 0723 035XEquity Research Team, CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France ,grid.15781.3a0000 0001 0723 035XInterdisciplinary Federal Research Institute On Health & Society (IFERISS), Université Toulouse III Paul Sabatier, Toulouse, France
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15
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Ruan J, Hu X, Liu Y, Han Z, Ruan Q. Vulnerability to chronic stress and the phenotypic heterogeneity of presbycusis with subjective tinnitus. Front Neurosci 2022; 16:1046095. [PMID: 36620444 PMCID: PMC9812577 DOI: 10.3389/fnins.2022.1046095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Age-related functional reserve decline and vulnerability of multiple physiological systems and organs, as well as at the cellular and molecular levels, result in different frailty phenotypes, such as physical, cognitive, and psychosocial frailty, and multiple comorbidities, including age-related hearing loss (ARHL) and/or tinnitus due to the decline in auditory reserve. However, the contributions of chronic non-audiogenic cumulative exposure, and chronic audiogenic stress to phenotypic heterogeneity of presbycusis and/or tinnitus remain elusive. Because of the cumulative environmental stressors throughout life, allostasis systems, the hypothalamus-pituitary-adrenal (HPA) and the sympathetic adrenal-medullary (SAM) axes become dysregulated and less able to maintain homeostasis, which leads to allostatic load and maladaptation. Brain-body communication via the neuroendocrine system promotes systemic chronic inflammation, overmobilization of energetic substances (glucose and lipids), and neuroplastic changes via the non-genomic and genomic actions of glucocorticoids, catecholamines, and their receptors. These systemic maladaptive alterations might lead to different frailty phenotypes and physical, cognitive, and psychological comorbidities, which, in turn, cause and exacerbate ARHL and/or tinnitus with phenotypic heterogeneity. Chronic audiogenic stressors, including aging accompanying ontological diseases, cumulative noise exposure, and ototoxic drugs as well as tinnitus, activate the HPA axis and SAM directly and indirectly by the amygdala, promoting allostatic load and maladaptive neuroplasticity in the auditory system and other vulnerable brain regions, such as the hippocampus, amygdala, and medial prefrontal cortex (mPFC). In the auditory system, peripheral deafferentation, central disinhibition, and tonotopic map reorganization may trigger tinnitus. Cross-modal maladaptive neuroplasticity between the auditory and other sensory systems is involved in tinnitus modulation. Persistent dendritic growth and formation, reduction in GABAergic inhibitory synaptic inputs induced by chronic audiogenic stresses in the amygdala, and increased dendritic atrophy in the hippocampus and mPFC, might involve the enhancement of attentional processing and long-term memory storage of chronic subjective tinnitus, accompanied by cognitive impairments and emotional comorbidities. Therefore, presbycusis and tinnitus are multisystem disorders with phenotypic heterogeneity. Stressors play a critical role in the phenotypic heterogeneity of presbycusis. Differential diagnosis based on biomarkers of metabonomics study, and interventions tailored to different ARHL phenotypes and/or tinnitus will contribute to healthy aging and improvement in the quality of life.
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Affiliation(s)
- Jian Ruan
- Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiuhua Hu
- Laboratory of Aging, Anti-aging & Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Clinical Geriatrics, Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuehong Liu
- Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhao Han
- Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qingwei Ruan
- Laboratory of Aging, Anti-aging & Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai, China,Shanghai Key Laboratory of Clinical Geriatrics, Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China,*Correspondence: Qingwei Ruan,
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Martínez Corrales G, Li M, Svermova T, Goncalves A, Voicu D, Dobson AJ, Southall TD, Alic N. Transcriptional memory of dFOXO activation in youth curtails later-life mortality through chromatin remodeling and Xbp1. NATURE AGING 2022; 2:1176-1190. [PMID: 37118537 PMCID: PMC7614430 DOI: 10.1038/s43587-022-00312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 10/19/2022] [Indexed: 12/03/2022]
Abstract
A transient, homeostatic transcriptional response can result in transcriptional memory, programming subsequent transcriptional outputs. Transcriptional memory has great but unappreciated potential to alter animal ageing as animals encounter a multitude of diverse stimuli throughout their lifespan. Here we show that activating an evolutionarily conserved, longevity-promoting transcription factor, dFOXO, solely in early adulthood of female fruit flies is sufficient to improve their subsequent health and survival in mid- and late life. This youth-restricted dFOXO activation causes persistent changes to chromatin landscape in the fat body and requires chromatin remodellers such as the SWI/SNF and ISWI complexes to program health and longevity. Chromatin remodelling is accompanied by a long-lasting transcriptional programme that is distinct from that observed during acute dFOXO activation and includes induction of Xbp1. We show that this later-life induction of Xbp1 is sufficient to curtail later-life mortality. Our study demonstrates that transcriptional memory can profoundly alter how animals age.
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Azzolino D, Spolidoro GCI, Mazzocchi A, Agostoni C, Cesari M. When the Pandemic Will Be Over: Lots of Hope and Some Concerns. Geriatrics (Basel) 2022; 7:116. [PMID: 36286219 PMCID: PMC9602026 DOI: 10.3390/geriatrics7050116] [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: 08/01/2022] [Revised: 10/12/2022] [Accepted: 10/16/2022] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic significantly threatened healthcare systems worldwide. The worst-hit population has been represented by older people with underlying chronic comorbidities, while children and adolescents developed mild or asymptomatic forms of the disease. However, certain medical conditions (i.e., obesity, respiratory, or neurological or immune disorders) may increase the risk for poor health outcomes even in young and middle-aged people. Beyond the direct negative effects of the infection, the pandemic posed several health challenges through an increase in psycho-social issues (i.e., anxiety, depression, fatigue, sleep alterations, loneliness, reduced assistance, and loss of income). Accordingly, the pandemic is negatively impacting the accumulation of the functional reserves of each individual, starting from early life. With the long-term effects of the pandemic to be seen in the coming years, clinicians must be prepared to manage such high clinical complexity of people they encounter, through the implementation of multidimensional and multidisciplinary interventions.
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Affiliation(s)
- Domenico Azzolino
- Department of Clinical and Community Sciences, University of Milan, 20122 Milan, Italy
- Geriatric Unit, Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Italy
| | | | - Alessandra Mazzocchi
- Department of Clinical and Community Sciences, University of Milan, 20122 Milan, Italy
| | - Carlo Agostoni
- Department of Clinical and Community Sciences, University of Milan, 20122 Milan, Italy
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Matteo Cesari
- Department of Clinical and Community Sciences, University of Milan, 20122 Milan, Italy
- Geriatric Unit, Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Italy
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Bruderer-Hofstetter M, Gorus E, Cornelis E, Meichtry A, De Vriendt P. Influencing factors on instrumental activities of daily living functioning in people with mild cognitive disorder - a secondary investigation of cross-sectional data. BMC Geriatr 2022; 22:791. [PMID: 36217106 PMCID: PMC9552428 DOI: 10.1186/s12877-022-03476-8] [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: 06/08/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Finding a strategy to reduce the impact of cognitive decline on everyday functioning in persons suffering from cognitive impairment is a public health priority. Instrumental activities of daily living (IADL) are key to everyday functioning. Hence, it is essential to understand the influencing factors on IADL to develop specific interventions to improve everyday functioning in persons with mild cognitive disorder. Therefore, this study aimed to 1) explore different influencing factors on IADL functioning considering all domains of the International Classification of Functioning, disability, and health and 2) rank these factors. METHODS We performed a secondary analysis of a cohort including participants with amnestic mild cognitive impairment (a-MCI) or mild Alzheimer's Dementia (mild AD). The IADL functioning model was used as a starting point to estimate the effects of cognitive and physical function factors and personal and environmental factors on IADL functioning using multiple linear regression analysis, including subgroup analysis in persons with a-MCI. We used standardized coefficient estimates to relate the size of the predictor effects in the final model. RESULTS We included 105 participants (64 a-MCI, 41 mild AD); the mean age was 81.9 years (SD 4.9), with 70% females. Based on a multi-step approach and model fit, the final model included IADL functioning as the response variable and memory, attention, executive function, vision and hearing, mobility, balance, education, and social support as predictors. The final model explained 75% of the variability. The significant predictors in the model were mobility, balance, attention, and education, and were the predictors with the most considerable effects based on standardized coefficient estimates. The subgroup analysis, including only a-MCI participants, revealed a similar pattern. CONCLUSION Our results confirm that IADL functioning in people with mild cognitive disorder is influenced by cognitive and physical function and personal factors. The study provides further insight into understanding IADL functioning impairments in persons with mild impaired cognition and may be used to develop specific non-pharmacological interventions.
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland.
| | - Ellen Gorus
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Geriatrics Department, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Elise Cornelis
- Department of Occupational Therapy and Research & Development in Health & Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - Patricia De Vriendt
- Department Gerontology and Frailty in Ageing (FRIA) Research Group, Mental Health and Wellbeing (MENT) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium.,Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Occupational Therapy Programme, Ghent University, Ghent, Belgium
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Matsumoto K, Gondo Y, Masui Y, Yasumoto S, Yoshida Y, Ikebe K, Arai Y, Kabayama M, Kamide K, Akasaka H, Ishizaki T. Physical performance reference values for Japanese oldest old: a SONIC study. BMC Geriatr 2022; 22:748. [PMID: 36100911 PMCID: PMC9470232 DOI: 10.1186/s12877-022-03299-7] [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: 03/10/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022] Open
Abstract
Background The oldest old, defined as those aged 90 or over, is now the fastest-growing population sector. This study aimed to determine reference values for several physical performance measures (PPMs) among 90-year-olds using internationally standardized measurements and to clarify the characteristics of these indices by comparing their results for 90-year-olds with those for older people 70 and 80. Methods We used the Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians (SONIC) study data from 2010 to 2018. The study subjects were 70, 80, and 90-year-olds in the target area eligible to participate in the venue. Excluding those certified for long-term care, the final number of eligible persons is 70s cohort 1000 (2010), 80s cohort 973 (2011), and 90s cohort 690. 90s cohort only consisted of three survey waves: 2012, 2015, and 2018. We used hand grip strength and score on the Short Physical Performance Battery (SPPB) for our physical performance measurements. In addition, we statistically analyzed sex and age differences. Result The simple mean ± standard deviation (SD) for the 90-year-old respondents were in men, 24.1 ± 5.4 kg in hand grip strength, 0.80 ± 0.22 m/s in usual gait speed, 17.2 ± 6.73 s in 5times chair stand, 5.89 ± 4.42 s in tandem balance, and 8.3 ± 2.2 in SPPB respectively and in women, 14.4 ± 4.0 kg in hand grip strength, 0.72 ± 0.20 m/s in usual gait speed, 17.8 ± 7.89 s in 5times chair stand, 4.72 ± 4.35 s in tandem balance, and 7.5 ± 2.4 in SPPB, respectively. For all PPMs, the age 90 cohort was statistically significantly different from the age 70 and 80 cohorts (all trends P < 0.001). Hand grip strength decreased with a similar gradient with age cohort increase of 10 years for both sexes. In contrast, SPPB lower limb score showed a larger drop between the age 80 and 90 cohorts than between the age 70 and 80 cohorts. We also constructed sex-specific appraisal standards according to quintiles. Conclusions Our study yielded inclusive sex-specific reference values and appraisal standards for major physical performance measures not certified as requiring long-term care, community-dwelling, oldest old Japanese. The characteristics of age-related decline in physical performance differed between the upper and lower extremity assessments.
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Affiliation(s)
| | - Yasuyuki Gondo
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Yukie Masui
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Saori Yasumoto
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Yuko Yoshida
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Muscle Strength and Balance as Mediators in the Association between Physical Activity and Health-Related Quality of Life in Community-Dwelling Older Adults. J Clin Med 2022; 11:jcm11164857. [PMID: 36013095 PMCID: PMC9409764 DOI: 10.3390/jcm11164857] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
Lower extremity muscle strength (LEMS) and body balance (BB) are essential for older adults to maintain an upright posture and autonomously perform their basic activities of daily living. This study aimed to examine whether LEMS and BB mediate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in a large sample of community-dwelling older adults. This is a cross-sectional study carried out with 802 individuals, 401 males and 401 females (69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. PA and HRQoL were assessed by the Baecke Questionnaire and e SF-36, respectively. LEMS was assessed by the Senior Fitness Test and BB by the Fullerton Advance Balance (FAB). The serial mediation pathway model pointed out that LEMS and BB partially mediated the association between PA and HRQoL in approximately 39.6% and 47%, respectively. The total variance in HRQoL explained by the entire model was 98%. Our findings may indicate the role that LEMS and BB play in the relationship between PA and HRQoL in the older population.
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21
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Parker EA, Perez WJ, Phipps B, Ryan AS, Prior SJ, Katzel L, Serra MC, Addison O. Dietary Quality and Perceived Barriers to Weight Loss among Older Overweight Veterans with Dysmobility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159153. [PMID: 35954511 PMCID: PMC9367786 DOI: 10.3390/ijerph19159153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 12/28/2022]
Abstract
Healthier diets are associated with higher muscle mass and physical performance which may reduce the risk of developing frailty and disability later in life. This study examined the dietary quality and self-reported weight loss barriers among older (>60 years), overweight (BMI ≥ 25 kg/m2) Veterans with dysmobility (low gait speed, impaired mobility diagnosis, or a comorbidity that results in impaired mobility). Habitual dietary intake and healthy eating index (HEI-2015) were assessed using 24-h recalls and compared to US nationally representative dietary intake data and national recommendations. The “MOVE!11” Patient Questionnaire assessed weight loss barriers. The sample (n = 28) was primarily male (93%), black (54%) and obese (BMI = 35.5 ± 5.4 kg/m2) adults aged 69.5 ± 7.0 years with two or more comorbidities (82%); 82% were prescribed four or more medications. Daily intakes (mean ± SD) were calculated for total energy (2184 ± 645 kcals), protein (0.89 ± 0.3 g/kg), fruits (0.84 ± 0.94 cup·eq.), vegetables (1.30 ± 0.87 cup·eq.), and HEI-2015 (52.8 ± 13.4). Veterans consumed an average of 11% less protein than the recommendation for older adults (1.0 g/kg/d) and consumed fewer fruits and vegetables than comparisons to national averages (18% and 21%, respectively). Mean HEI-2015 was 17% below the national average for adults >65 years, suggesting poor dietary quality among our sample. Top weight loss barriers were not getting enough physical activity, eating too much and poor food choices. This data suggests that dietary quality is suboptimal in older, overweight Veterans with disability and highlights the need to identify strategies that improve the dietary intake quality of older Veterans who may benefit from obesity and disability management.
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Affiliation(s)
- Elizabeth A. Parker
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Correspondence: ; Tel.: +1-410-706-2833
| | - William J. Perez
- Baltimore VA Medical Center GRECC, VA Maryland Health Care System, Baltimore, MD 21201, USA; (W.J.P.); (B.P.); (A.S.R.); (S.J.P.); (L.K.)
| | - Brian Phipps
- Baltimore VA Medical Center GRECC, VA Maryland Health Care System, Baltimore, MD 21201, USA; (W.J.P.); (B.P.); (A.S.R.); (S.J.P.); (L.K.)
| | - Alice S. Ryan
- Baltimore VA Medical Center GRECC, VA Maryland Health Care System, Baltimore, MD 21201, USA; (W.J.P.); (B.P.); (A.S.R.); (S.J.P.); (L.K.)
- Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Steven J. Prior
- Baltimore VA Medical Center GRECC, VA Maryland Health Care System, Baltimore, MD 21201, USA; (W.J.P.); (B.P.); (A.S.R.); (S.J.P.); (L.K.)
- Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Leslie Katzel
- Baltimore VA Medical Center GRECC, VA Maryland Health Care System, Baltimore, MD 21201, USA; (W.J.P.); (B.P.); (A.S.R.); (S.J.P.); (L.K.)
- Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Monica C. Serra
- Division of Geriatrics, Gerontology & Palliative Medicine and the Sam & Ann Barshop Institute for Longevity & Aging Studies, UT Health San Antonio, San Antonio, TX 78229, USA;
- San Antonio GRECC, South Texas VA Health Care System, San Antonio, TX 78229, USA
| | - Odessa Addison
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Baltimore VA Medical Center GRECC, VA Maryland Health Care System, Baltimore, MD 21201, USA; (W.J.P.); (B.P.); (A.S.R.); (S.J.P.); (L.K.)
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22
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Scherbov S, Spitzer S, Steiber N. Thresholds for clinical practice that directly link handgrip strength to remaining years of life: estimates based on longitudinal observational data. BMJ Open 2022; 12:e058489. [PMID: 35868825 PMCID: PMC9315893 DOI: 10.1136/bmjopen-2021-058489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Muscle strength is a powerful predictor of mortality that can quickly and inexpensively be assessed by measuring handgrip strength (HGS). What is missing for clinical practice, however, are empirically meaningful cut-off points that apply to the general population and that consider the correlation of HGS with gender and body height as well as the decline in HGS during processes of normal ageing. This study provides standardised thresholds that directly link HGS to remaining life expectancy (RLE), thus enabling practitioners to detect patients with an increased mortality risk early on. DESIGN Relying on representative observational data from the Health and Retirement Study, the HGS of survey participants was z-standardised by gender, age and body height. We defined six HGS groups based on cut-off points in SD; we use these as predictors in survival analyses with a 9-year follow-up and provide RLE by gender based on a Gompertz model for each HGS group. PARTICIPANTS 8156 US American women and men aged 50-80 years. MAIN OUTCOME MEASURES Z-standardised HGS and all-cause mortality. RESULTS Even slight negative deviations in HGS from the reference group with [0.0 SD, 0.5 SD) have substantial effects on survival. RLE among individuals aged 60 years with standardised HGS of [-0.5 SD, 0.0 SD) is 3.0/1.4 years lower for men/women than for the reference group, increasing to a difference of 4.1/2.6 years in the group with HGS of [-1.0 SD, -0.5 SD). By contrast, we find no benefit of strong HGS related to survival. CONCLUSIONS HGS varies substantially with gender, age and body height. This confirms the importance of considering these heterogeneities when defining reference groups and risk thresholds. Moreover, survival appears to decrease at much higher levels of muscle strength than is assumed in previous literature, suggesting that medical practitioners should start to become concerned when HGS is slightly below that of the reference group.
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Affiliation(s)
- Sergei Scherbov
- International Institute for Applied Systems Analysis (IIASA), Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Laxenburg, Austria
| | - Sonja Spitzer
- Department of Demography, University of Vienna, Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna, Austria
| | - Nadia Steiber
- Department of Sociology, University of Vienna, Vienna, Austria
- Institute for Advanced Studies, Vienna, Austria
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Sievert LL, Huicochea-Gómez L, Cahuich-Campos D, Kent JA, Brown DE. Hand grip strength, standing balance, and rapid foot tapping in relation to the menopausal transition in Campeche, Mexico. Am J Hum Biol 2022; 34:e23781. [PMID: 35866928 DOI: 10.1002/ajhb.23781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/08/2022] [Accepted: 07/01/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This cross-sectional study investigated menopause status in relation to hand grip strength, standing balance, and rapid foot tapping. A secondary aim was to examine the relationship between physical performance and urban/rural residence with a focus on habitual daily tasks. METHODS Maya and non-Maya women (40-60 years) were drawn from urban and rural sites in Campeche, Mexico (n = 543). Demographic, reproductive, and lifestyle information was collected in face-to-face interviews along with anthropometric and physical function measures. Linear regression was used to evaluate menopause status in relation to strength, balance, and foot tapping speed while adjusting for residence, ethnicity, and other variables. RESULTS Hand grip strength was 22.5, 21.6, and 20.0 kg in pre-, peri-, and postmenopausal women, respectively, but menopause status was not significantly related to grip strength in models adjusted for age. Grip strength was negatively associated with age and socioeconomic index, and positively associated with height and weight, self-reported health, and hours/week spent grinding corn/making tortillas. Postural stability was 9.4, 6.9, and 5.6 s across menopause categories; and menopause status remained significant in adjusted models. The number of foot taps in 10 s was 35.7, 33.4, and 33.9 taps in pre-, peri-, and postmenopausal women. Parity was negatively associated with foot tapping in adjusted models. CONCLUSIONS While age is a key predictor of physical function in women aged 40-60 years, menopausal status appears to have additional influences on postural control beyond age alone. Hours spent grinding corn/making tortillas were significantly associated with grip strength among rural women.
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Affiliation(s)
| | | | | | - Jane A Kent
- Department of Kinesiology, UMass Amherst, Amherst, Massachusetts, USA
| | - Daniel E Brown
- Department of Anthropology, University of Hawaii, Honolulu, Hawaii, USA
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Santos CJ, Paciência I, Ribeiro AI. Neighbourhood Socioeconomic Processes and Dynamics and Healthy Ageing: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116745. [PMID: 35682327 PMCID: PMC9180257 DOI: 10.3390/ijerph19116745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people’s health. Three bibliographic databases—PubMed, Web of Science, and Scopus—were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O’Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (n = 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (n = 114), followed by gentrification (n = 5), segregation (n = 2), and urban renewal (n = 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.
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Affiliation(s)
- Cláudia Jardim Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Correspondence: ; Tel.: +351-222-061-820
| | - Inês Paciência
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90570 Oulu, Finland;
- Biocenter Oulu, University of Oulu, P.O. Box 5000, 90570 Oulu, Finland
| | - Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
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Norris T, Blodgett J, Rogers N, Hamer M, Pinto Pereira S. Obesity in early adulthood and physical functioning in mid-life: Investigating the mediating role of c-reactive protein. Brain Behav Immun 2022; 102:325-332. [PMID: 35301057 PMCID: PMC9048926 DOI: 10.1016/j.bbi.2022.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/07/2022] [Accepted: 03/12/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Obesity in adulthood is associated with reduced physical functioning (PF) at older ages. However, mechanisms underpinning this association are not well understood. We investigated whether and the extent to which C-reactive protein (CRP) mediates the association between early-adult obesity and mid-life PF. METHODS We used data from 8495 participants in the 1958 British birth cohort study. Body mass index (BMI), CRP and PF were measured at 33, 45 and 50y, respectively. Poor PF was defined as the lowest (sex-specific) 10% on the Short-form 36 Physical Functioning subscale. We accounted for prospectively measured confounders in early-life (e.g., social class at birth) and in mid-adulthood (e.g., 42y comorbidities). We decomposed the total effect of early-adult obesity on mid-life PF into direct and indirect (via CRP) effects, by employing a mediation analysis based on parametric g-computation. RESULTS The estimated total effect of obesity at 33y on poor PF at 50y, expressed as an odds ratio (OR), was 2.41 (95% CI: 1.89, 3.08). The direct effect of obesity on poor PF (i.e., not operating via CRP), was 1.97 (95% CI: 1.51, 2.56), with an indirect effect of 1.23 (95% CI: 1.10, 1.37). As such, the proportion of the total effect which was mediated by the effect of obesity on CRP at 45y, was 23.27% (95% CI: 8.64%, 37.90%). CONCLUSION Obesity in early-adulthood was associated with over twice the odds of poor PF in mid-life, with approximately 23% of the obesity effect operating via a downstream effect on CRP. As current younger generations are likely to spend greater proportions of their life course in older age and with obesity, both of which are associated with poor PF, there is an urgent need to identify mechanisms, and thus potential modifiable intermediaries, linking obesity to poor PF.
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Affiliation(s)
- T. Norris
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom
| | - J.M. Blodgett
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom
| | - N.T. Rogers
- Centre for Diet and Activity Research, MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - M. Hamer
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom
| | - S.M. Pinto Pereira
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom,Corresponding author at: Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom.
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Ginting ML, Wong CH, Lim ZZB, Choo RWM, Carlsen SCH, Sum G, Vrijhoef HJM. A Patient-Centred Medical Home Care Model for Community-Dwelling Older Adults in Singapore: A Mixed-Method Study on Patient's Care Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084778. [PMID: 35457642 PMCID: PMC9030670 DOI: 10.3390/ijerph19084778] [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] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023]
Abstract
Patient-Centred Medical Home (PCMH) is a strategy to enhance patient-centredness to improve care experience. We aimed to understand patient experience of an integrated PCMH model for complex community-dwelling older adults in Singapore. We used a mixed-method design with a prospective single-group pre-post quantitative component and a concurrent qualitative component. Participants were administered the validated Consumer Assessment of Health Providers and Systems Clinician & Group Survey (CG-CAHPS) at baseline (N = 184) and 6-month (N = 166) post-enrolment. We conducted focus group discussions (FGDs) on a purposive sample of 24 participants. Both methods suggest better care experience in PCMH relative to usual care. There were improvements in the CG-CAHPS measures on patient–provider communication, care coordination, office staff interactions, support for patients in caring for their own health, and provider rating in PCMH relative to usual care. In the FGDs, participants reported benefits of consolidated appointments and positive experience in sustained patient–provider relationship, shared-decision making, and family/caregiver engagement in PCMH. Participants may not fully comprehend the concept of integrated care, hindering both the effective communication of the intended care model and perceived benefits such as the provision of multidisciplinary team-based care.
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Affiliation(s)
- Mimaika Luluina Ginting
- Geriatric Education and Research Institute, Singapore 768024, Singapore; (C.H.W.); (Z.Z.B.L.); (R.W.M.C.); (S.C.H.C.); (G.S.)
- Correspondence:
| | - Chek Hooi Wong
- Geriatric Education and Research Institute, Singapore 768024, Singapore; (C.H.W.); (Z.Z.B.L.); (R.W.M.C.); (S.C.H.C.); (G.S.)
- Tsao Foundation, Singapore 168730, Singapore
- Health Services & Systems Research, Duke-NUS, Singapore 169857, Singapore
| | - Zoe Zon Be Lim
- Geriatric Education and Research Institute, Singapore 768024, Singapore; (C.H.W.); (Z.Z.B.L.); (R.W.M.C.); (S.C.H.C.); (G.S.)
| | - Robin Wai Munn Choo
- Geriatric Education and Research Institute, Singapore 768024, Singapore; (C.H.W.); (Z.Z.B.L.); (R.W.M.C.); (S.C.H.C.); (G.S.)
| | - Sheena Camilla Hirose Carlsen
- Geriatric Education and Research Institute, Singapore 768024, Singapore; (C.H.W.); (Z.Z.B.L.); (R.W.M.C.); (S.C.H.C.); (G.S.)
| | - Grace Sum
- Geriatric Education and Research Institute, Singapore 768024, Singapore; (C.H.W.); (Z.Z.B.L.); (R.W.M.C.); (S.C.H.C.); (G.S.)
| | - Hubertus Johannes Maria Vrijhoef
- Panaxea, B.V., 1098 XH Amsterdam, The Netherlands;
- Department of Patient & Care, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
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Calatayud J, Morera Á, Casaña J, Del Pozo Cruz B, Andersen LL, López-Bueno R. Occupational physical activity trends from 1987 to 2017: A nationally representative sample of 160,509 Spanish adults. Eur J Sport Sci 2022; 23:851-858. [PMID: 35332838 DOI: 10.1080/17461391.2022.2058418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To estimate temporal and updated trends of OPA among Spanish adult population during the period between 1987 and 2017. METHODS We used all available rounds of the Spanish National Health Survey (160,509 adults, mean age 44.6 years [SD 16.6], 50.3% women) and multivariate regressions to determine temporal trends of high OPA from 1987 to 2017 in the general working population of Spain. RESULTS The highest OPA prevalence was observed for participants aged 31-49 years in the 2003 survey. The prevalence of high OPA was generally low, but increased slightly over time in the 18-30, 50-64, and 65-75 years old (p<0.001 for trend). In contrast, a general reduction in OPA was observed in the 16-17 years old (p<0.001 for trend). Men consistently showed higher OPA prevalence than women. CONCLUSIONS This study reports an increase in OPA prevalence in Spain from 1987 to 2017, which is low and significant in most socio-demographic groups, but small in absolute terms. The youngest group had a marked decreased in OPA prevalence over the course of the study. Men consistently showed higher OPA prevalence than women, but differences have become smaller in recent years. Our results may assist in the establishment of interventional strategies and future policies among specific subgroups.Highlights: There is an increase in OPA prevalence in Spain from 1987 to 2017.The youngest group had a marked decreased in OPA prevalence over the course of the study.Men consistently showed higher OPA prevalence than women, but differences have become smaller in recent years.Frequent national surveillance of OPA to monitor long-term development of the working environment should be mandatory.
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Affiliation(s)
- Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Álvaro Morera
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 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
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Rubén López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.,National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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28
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Nie C, Li Y, Li R, Yan Y, Zhang D, Li T, Li Z, Sun Y, Zhen H, Ding J, Wan Z, Gong J, Shi Y, Huang Z, Wu Y, Cai K, Zong Y, Wang Z, Wang R, Jian M, Jin X, Wang J, Yang H, Han JDJ, Zhang X, Franceschi C, Kennedy BK, Xu X. Distinct biological ages of organs and systems identified from a multi-omics study. Cell Rep 2022; 38:110459. [PMID: 35263580 DOI: 10.1016/j.celrep.2022.110459] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/06/2021] [Accepted: 02/08/2022] [Indexed: 12/13/2022] Open
Abstract
Biological age (BA) has been proposed to evaluate the aging status instead of chronological age (CA). Our study shows evidence that there might be multiple "clocks" within the whole-body system: systemic aging drivers/clocks overlaid with organ/tissue-specific counterparts. We utilize multi-omics data, including clinical tests, immune repertoire, targeted metabolomic molecules, gut microbiomes, physical fitness examinations, and facial skin examinations, to estimate the BA of different organs (e.g., liver, kidney) and systems (immune and metabolic system). The aging rates of organs/systems are diverse. People's aging patterns are different. We also demonstrate several applications of organs/systems BA in two independent datasets. Mortality predictions are compared among organs' BA in the dataset of the United States National Health and Nutrition Examination Survey. Polygenic risk score of BAs constructed in the Chinese Longitudinal Healthy Longevity Survey cohort can predict the possibility of becoming centenarian.
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Affiliation(s)
- Chao Nie
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Yan Li
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Rui Li
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Yizhen Yan
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Detao Zhang
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Tao Li
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Zhiming Li
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Yuzhe Sun
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Hefu Zhen
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Jiahong Ding
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Ziyun Wan
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Jianping Gong
- Medical Examination Center, The Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Yanfang Shi
- Department of Neurosurgery, The Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Zhibo Huang
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Yiran Wu
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Kaiye Cai
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Yang Zong
- BGI-Shenzhen, Shenzhen 518083, China
| | - Zhen Wang
- BGI-Shenzhen, Shenzhen 518083, China
| | - Rong Wang
- BGI-Shenzhen, Shenzhen 518083, China
| | - Min Jian
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Xin Jin
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Jian Wang
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Huanming Yang
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China
| | - Jing-Dong J Han
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Center for Quantitative Biology (CQB), Peking University, Beijing 100871, China
| | - Xiuqing Zhang
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China.
| | - Claudio Franceschi
- Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky State University, Nizhny Novgorod, Russia.
| | - Brian K Kennedy
- Healthy Longevity Translation Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Centre for Health Longevity, National University Health System, Singapore, Singapore; Singapore Institute of Clinical Sciences, Agency for Science, Technology and Research (A(∗)STAR), Singapore, Singapore.
| | - Xun Xu
- BGI-Shenzhen, Shenzhen 518083, China; China National GeneBank, Shenzhen 518120, China.
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Wang C, Huertas DS, Rowe JW, Finkelstein R, Carstensen LL, Jackson RB. Rethinking the urban physical environment for century-long lives: from age-friendly to longevity-ready cities. NATURE AGING 2021; 1:1088-1095. [PMID: 35937461 DOI: 10.1038/s43587-021-00140-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
In response to increasing life expectancies and urbanization, initiatives for age-friendly cities seek to facilitate active and healthy aging by strengthening supports and services for older people. While laudable, these efforts typically neglect early-life exposures that influence long-term well-being. With a focus on the urban physical environment, we argue that longevity-ready cities can accomplish more than initiatives focused solely on old age. We review features of cities that cumulatively influence healthy aging and longevity, discuss the need for proactive interventions in a changing climate, and highlight inequities in the ambient physical environment, especially those encountered at early ages, that powerfully contribute to disparities in later life stages. Compared with strategies aimed largely at accommodating older populations, longevity-ready cities would aim to reduce the sources of disadvantages across the life course and simultaneously improve the well-being of older people.
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Affiliation(s)
- Chenghao Wang
- Department of Earth System Science, Stanford University, Stanford, CA, USA.,Stanford Center on Longevity, Stanford, CA, USA
| | - Diego Sierra Huertas
- Stanford Center on Longevity, Stanford, CA, USA.,Department of Psychology, Stanford University, Stanford, CA, USA
| | - John W Rowe
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ruth Finkelstein
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, NY, USA
| | - Laura L Carstensen
- Stanford Center on Longevity, Stanford, CA, USA.,Department of Psychology, Stanford University, Stanford, CA, USA
| | - Robert B Jackson
- Department of Earth System Science, Stanford University, Stanford, CA, USA.,Woods Institute for the Environment and Precourt Institute for Energy, Stanford University, Stanford, CA, USA
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30
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Wong PH, Kourtit K, Nijkamp P. The ideal neighbourhoods of successful ageing: A machine learning approach. Health Place 2021; 72:102704. [PMID: 34758442 DOI: 10.1016/j.healthplace.2021.102704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/24/2021] [Accepted: 10/24/2021] [Indexed: 01/30/2023]
Abstract
Ageing outcomes are shaped by not only health conditions, but also their interactions with the external environment. While the effects of some specific neighbourhood characteristics such as rurality on ageing have been evaluated in various studies, we still know little about the relative importance of particular natural and urban environments and how the impact varies at different stages of the ageing process. This article addresses these knowledge gaps by analysing survey data from 33 European countries using a machine learning method called multivariate regression trees (MRT). Multiple wellbeing indicators are combined to form an ageing profile for each individual in the survey. After studying these profiles using MRT, we find that generally the affordability of health facilities is a major determinant of life satisfaction, self-rated health condition and mental wellbeing for individuals in most age groups. Other important but age-specific determinants are neighbourhood safety and accessibility to cultural facilities and to green areas. In contrast, characteristics such as urbanity, transportation and air quality do not significantly influence ageing outcomes. Our findings lend support to the resources theory in explaining ageing outcomes and suggest that more resources may have to be directed to improve the affordability and quality of health care services, the policing services and the accessibility to cultural and green areas in order to achieve more favourable ageing outcomes.
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Affiliation(s)
- Pui-Hang Wong
- Maastricht University and UNU-MERIT, Boschstraat 24, 6211 AX Maastricht, the Netherlands.
| | - Karima Kourtit
- Open University, Heerlen, the Netherlands; Alexandru Ioan Cuza' University of Iași, Iași, Romania; Polytechnic University (UM6P), Ben Guerir, Morocco
| | - Peter Nijkamp
- Open University, Heerlen, the Netherlands; Alexandru Ioan Cuza' University of Iași, Iași, Romania; Polytechnic University (UM6P), Ben Guerir, Morocco; Adam Mickiewicz University, Poznan, Poland
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31
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Wahrendorf M, Chandola T, Goldberg M, Zins M, Hoven H, Siegrist J. Adverse employment histories and allostatic load: associations over the working life. J Epidemiol Community Health 2021; 76:374-381. [PMID: 34625518 PMCID: PMC8921582 DOI: 10.1136/jech-2021-217607] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022]
Abstract
Background Most studies on the health impact of occupational stress use single-point measures of stress at work. This study analyses the associations of properties of entire employment trajectories over an extended time period with a composite score of allostatic load (AL). Methods Data come from the French CONSTANCES cohort, with information on adverse employment histories between ages 25 and 45 and a composite score of AL (based on 10 biomarkers, range 0–10) among people aged 45 or older (47 680 women and 45 035 men). Data were collected by questionnaires (including retrospective employment histories) or by health examinations (including blood-based biomarkers). We distinguish six career characteristics: number of temporary jobs, number of job changes, number of unemployment periods, years out of work, mode occupational position and lack of job promotion. Results For both men and women, results of negative binomial regressions indicate that adverse employment histories are related to higher levels of AL, particularly histories that are characterised by a continued disadvantaged occupational position, repeated periods of unemployment or years out of work. Findings are adjusted for partnership, age and education, and respondents with a health-related career interruption or early retirement are excluded. Conclusions Our study highlights physiological responses as a mechanism through which chronic stress during working life is linked to poor health and calls for intervention efforts among more disadvantaged groups at early stages of labour market participation.
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Affiliation(s)
- Morten Wahrendorf
- Centre for Health and Society, Institute of Medical Sociology, Heinrich-Heine-University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Tarani Chandola
- Department of Social Statistics, University of Manchester, Manchester, UK
| | - Marcel Goldberg
- Population-Based Epidemiologic Cohorts Unit, INSERM, UMS 011, Villejuif, France.,Faculté de Médecine, Paris University, Paris, France
| | - Marie Zins
- Population-Based Epidemiologic Cohorts Unit, INSERM, UMS 011, Villejuif, France.,Faculté de Médecine, Paris University, Paris, France
| | - Hanno Hoven
- Centre for Health and Society, Institute of Medical Sociology, Heinrich-Heine-University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Johannes Siegrist
- Senior Professorship Work Stress Research, Heinrich-Heine-University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
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32
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Hauger AV, Holvik K, Bergland A, Ståhle A, Emaus N, Morseth B, Strand BH. Physical capability, physical activity, and their association with femoral bone mineral density in adults aged 40 years and older: The Tromsø study 2015-2016. Osteoporos Int 2021; 32:2083-2094. [PMID: 33864108 PMCID: PMC8510966 DOI: 10.1007/s00198-021-05949-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/01/2021] [Indexed: 11/28/2022]
Abstract
UNLABELLED Since muscles can influence bone growth and vice versa, we examined if level of physical activity and physical capability tests can predict areal bone mineral density (aBMD). Both high activity level and good test performance were associated with higher aBMD, especially in women. INTRODUCTION Muscle influences bone formation and vice versa. Tests of physical capability and level of physical activity reflect various muscle qualities. We assessed the associations between total hip aBMD and physical activity as well as a range of standardized physical capability tests in an adult general population. METHODS A total of 3 533 women and men aged 40-84 years, participating in the population-based cross-sectional Tromsø study in Norway in 2015-2016, were included. Linear regression was used to assess associations between aBMD and physical activity and the physical capability tests grip strength, Timed Up and Go (TUG), Short Physical Performance Battery (SPPB), and standing balance. Non-linear associations were examined in cubic spline models. Standardized regression coefficients were calculated to compare effect sizes across physical capability measures. RESULTS In fully adjusted models, higher physical activity was positively associated with total hip aBMD in both sexes compared to a sedentary lifestyle. All tests of physical capability were associated with aBMD in women, SPPB showing the strongest association although effect sizes were too small to indicate clinically significant differences (1 point increase corresponded to an aBMD increase of 0.009 g/cm2, CI = 0.005 to 0.012). In men, SPPB and its subtests were associated with aBMD with chair rises showing the strongest association (1 s increase in execution time corresponded to an aBMD decrease of 0.005 g/cm2, CI = 0.008 to 0.002). CONCLUSION Physical activity was associated with aBMD, and tests of physical capability can account for some of the aBMD variations in adults aged 40 years and older, especially in women.
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Affiliation(s)
- A V Hauger
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Postboks 4, St. Olavs plass, 0130, Oslo, Norway.
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473, Oslo, Norway.
| | - K Holvik
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473, Oslo, Norway
| | - A Bergland
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Postboks 4, St. Olavs plass, 0130, Oslo, Norway
| | - A Ståhle
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 14183, Huddinge, Sweden
| | - N Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - B Morseth
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Department of Clinical Therapeutic Services, University Hospital of Northern Norway, Tromsø, Norway
| | - B H Strand
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473, Oslo, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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Azzolino D, Spolidoro GCI, Saporiti E, Luchetti C, Agostoni C, Cesari M. Musculoskeletal Changes Across the Lifespan: Nutrition and the Life-Course Approach to Prevention. Front Med (Lausanne) 2021; 8:697954. [PMID: 34532328 PMCID: PMC8438318 DOI: 10.3389/fmed.2021.697954] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/22/2021] [Indexed: 12/12/2022] Open
Abstract
Aging is characterized by the progressive decline of muscle mass and function, the so-called sarcopenia. Also bone loss is widespread among older people. Sarcopenia and osteopenia/osteoporosis are associated with several adverse outcomes including falls, risk of fractures, functional decline, frailty, and mortality. Recently, the life-course approach to prevent or delay functional decline has become very popular. Regarding musculoskeletal health, there is suggestive evidence that acting during critical or sensitive periods of life in which each person build-up its biological reserves may influence the rate of functional decline in the later stages of life. A life-course approach to musculoskeletal health should take place during early life when plasticity allows more easily the attainment of the peak of the musculoskeletal system driven by environmental stimuli. The rate of the subsequent decline will depend on the peak previously reached. Nutrition and physical exercise are important environmental factors that can influence musculoskeletal development by favoring and maintaining peak bone and muscle mass and strength. Here we provide an overview of body composition changes occurring across the lifespan and strategies based on nutrition and physical exercise to support musculoskeletal health as well as minimizing losses during older life.
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Affiliation(s)
- Domenico Azzolino
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | | | - Edoardo Saporiti
- Specialization School in Geriatrics, University of Milan, Milan, Italy
| | - Costanza Luchetti
- Specialization School in Geriatrics, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Cesari
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
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Gai Tobe R, Izumida N. Gender disparity in the individual attitude toward longevity among Japanese population: Findings from a national survey. PLoS One 2021; 16:e0254779. [PMID: 34407083 PMCID: PMC8372936 DOI: 10.1371/journal.pone.0254779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 07/02/2021] [Indexed: 11/21/2022] Open
Abstract
The unprecedented population aging brings profound influences to the social values of longevity. The individual attitudes toward the expended life time deserves scrutiny, as it reflects the impacts of social networks and social welfare on people’s life and wellbeing. This study aims to examine whether and how gender disparity is affecting the individual anticipation to longevity among Japanese citizen. We used the dataset of National Survey on Social Security and Peoples Life implemented in 2017 to calculate the odds ratios (OR) of the individual anticipation to longevity. Besides gender, other demographic characteristics, physical and mental health, the experience of nursing care for the elderly, financial conditions and social networks are examined by performing the multilevel mixed-effects logistic regression analysis. The results indicate the robust effects of gender disparity on the individual aspiration for longevity. The proportion of those who inclined the positive statement on longevity was estimated to be 69.7% (95% CI: 68.6% - 70.9%) in the whole population, and 70.9% (95% CI: 69.4% - 72.5%) and 68.7% (95% CI: 67.1% - 70.2%) in male and female, respectively. Besides gender, independent factors significantly affecting the individual valuation of longevity include age, annual household income, the experience of nursing care, household saving, having a conversation with others and the availability of reliable partner(s) for relevant supports; while the common factors affecting the outcome variable were self-perceived health status and mental distress measured by K6. The interaction of gender and these significant factors were determined as well. In conclusion, with relevant representativeness and quality of data source, this analysis adds knowledge on gender disparity in the individual anticipation on longevity. The findings are suggestive to reform the social security system in the super aged society.
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Affiliation(s)
- Ruoyan Gai Tobe
- Department of Social security Empirical Research, National Institute of Population and Social Security Research, Tokyo, Japan
- * E-mail:
| | - Nobuyuki Izumida
- Department of Social security Empirical Research, National Institute of Population and Social Security Research, Tokyo, Japan
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35
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Landré B, Fayosse A, Ben Hassen C, Machado-Fragua MD, Dumurgier J, Kivimaki M, Sabia S, Singh-Manoux A. Terminal decline in objective and self-reported measures of motor function before death: 10 year follow-up of Whitehall II cohort study. BMJ 2021; 374:n1743. [PMID: 34348957 PMCID: PMC8336001 DOI: 10.1136/bmj.n1743] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To examine multiple objective and self-reported measures of motor function for their associations with mortality. DESIGN Prospective cohort study. SETTING UK based Whitehall II cohort study, which recruited participants aged 35-55 years in 1985-88; motor function component was added at the 2007-09 wave. PARTICIPANTS 6194 participants with motor function measures in 2007-09 (mean age 65.6, SD 5.9), 2012-13, and 2015-16. MAIN OUTCOME MEASURES All cause mortality between 2007 and 2019 in relation to objective measures (walking speed, grip strength, and timed chair rises) and self-reported measures (physical component summary score of the SF-36 and limitations in basic and instrumental activities of daily living (ADL)) of motor function. RESULTS One sex specific standard deviation poorer motor function in 2007-09 (cases/total, 610/5645) was associated with an increased mortality risk of 22% (95% confidence interval 12% to 33%) for walking speed, 15% (6% to 25%) for grip strength, 14% (7% to 23%) for timed chair rises, and 17% (8% to 26%) for physical component summary score over a mean 10.6 year follow-up. Having basic/instrumental ADL limitations was associated with a 30% (7% to 58%) increased mortality risk. These associations were progressively stronger when measures were drawn from 2012-13 (mean follow-up 6.8 years) and 2015-16 (mean follow-up 3.7 years). Analysis of trajectories showed poorer motor function in decedents (n=484) than survivors (n=6194) up to 10 years before death for timed chair rises (standardised difference 0.35, 95% confidence interval 0.12 to 0.59; equivalent to a 1.2 (men) and 1.3 (women) second difference), nine years for walking speed (0.21, 0.05 to 0.36; 5.5 (men) and 5.3 (women) cm/s difference), six years for grip strength (0.10, 0.01 to 0.20; 0.9 (men) and 0.6 (women) kg difference), seven years for physical component summary score (0.15, 0.05 to 0.25; 1.2 (men) and 1.6 (women) score difference), and four years for basic/instrumental ADL limitations (prevalence difference 2%, 0% to 4%). These differences increased in the period leading to death for timed chair rises, physical component summary score, and ADL limitations. CONCLUSION Motor function in early old age has a robust association with mortality, with evidence of terminal decline emerging early in measures of overall motor function (timed chair rises and physical component summary score) and late in basic/instrumental ADL limitations.
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Affiliation(s)
- Benjamin Landré
- Université de Paris, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Aurore Fayosse
- Université de Paris, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Céline Ben Hassen
- Université de Paris, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Marcos D Machado-Fragua
- Université de Paris, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Julien Dumurgier
- Université de Paris, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
- Cognitive Neurology Center, Lariboisière - Fernand Widal Hospital, AP-HP, Université de Paris, Paris, France
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Séverine Sabia
- Université de Paris, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Université de Paris, Inserm U1153, CRESS, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
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36
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Impact of a patient-centered medical home demonstration on quality of life and patient activation for older adults with complex needs in Singapore. BMC Geriatr 2021; 21:435. [PMID: 34301199 PMCID: PMC8299640 DOI: 10.1186/s12877-021-02371-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/01/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The first Patient-Centered Medical Home (PCMH) demonstration in Singapore was launched in November 2016, which aimed to deliver integrated and patient-centered care for patients with bio-psycho-social needs. Implementation was guided by principles of comprehensiveness, coordinated care, shared decision-making, accessible services, and quality and safety. We aimed to investigate the impact of implementing the PCMH in primary care on quality of life (QoL) and patient activation. METHODS The study design was a prospective single-arm pre-post study. We applied the 5-level EuroQol 5-dimension (EQ-5D-5L) and Visual Analog Scale (EQ VAS) instruments to assess health-related QoL. The CASP-19 tool was utilised to examine the degree that needs satisfaction was fulfilled in the domains of Control, Autonomy, Self-realisation, and Pleasure. The 13-item Patient Activation Measure (PAM-13) was used to evaluate knowledge, skills and confidence in management of conditions and ability to self-care. Multivariable linear regression models with random intercepts were applied to examine the impact of the PCMH intervention on outcome measures at 3 months and 6 months post-enrolment, compared to baseline. RESULTS We analysed 165 study participants enrolled into the PCMH from November 2017 to April 2020, with mean age 77 years (SD: 9.9). Within-group pre-post (6 months) EQ-5D-5L Index (β= -0.01, p-value = 0.35) and EQ VAS score (β=-0.03, p-value = 0.99) had no change. Compared to baseline, there were improvements in CASP-19 total score at 3 months (β = 1.34, p-value = 0.05) and 6 months post-enrolment (β = 1.15, p-value = 0.08) that were marginally out of statistical significance. There was also a significant impact of the PCMH on the CASP-19 Pleasure domain (β = 0.62, p = 0.03) at 6 months post-enrolment, compared to baseline. We found improved patient activation from a 15.2 % reduction in the proportion of participants in lower PAM levels, and a 23.4 and 16.7 % rise in proportion for higher PAM levels 3 and 4, respectively, from 3 months to 6 months post-enrolment. CONCLUSIONS Preliminary demonstration of the PCMH model shows evidence of improved needs satisfaction and patient activation, with potential to have a greater impact after a longer intervention duration.
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Wilkowska W, Offermann-van Heek J, Laurentius T, Bollheimer LC, Ziefle M. Insights Into the Older Adults' World: Concepts of Aging, Care, and Using Assistive Technology in Late Adulthood. Front Public Health 2021; 9:653931. [PMID: 34277537 PMCID: PMC8283565 DOI: 10.3389/fpubh.2021.653931] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/08/2021] [Indexed: 12/21/2022] Open
Abstract
The ongoing demographic change forces different stakeholders to cope with increasing needs in nursing care and the economic costs. Consequences arising from the population aging can be supported by assistive technologies to maintain older individuals' autonomy. However, older adults' opinions on the assistance of health-related technologies and their attitudes toward aging and care largely remain underexplored. This paper provides a geriatric and socio-technical perspective, investigating individual perceptions of (a) aging, (b) nursing care, and (c) the adoption of assistive technologies in a cross-national subject group. For this purpose, N = 384 individuals (60+ years) participated in an online survey. Findings indicate that most older adults are open to assistive technologies and that individual care preferences contribute to a successful adoption of these technologies. Among individual factors, health status, and gender affect respondents' opinions the most. Our findings help to understand older adults' acceptance of assistive technologies and contribute to the research on the nursing care in private and professional environments.
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Affiliation(s)
- Wiktoria Wilkowska
- Department of Communication Science & Human-Computer Interaction Center, Rheinisch-Westfsche Technische Hochschule Aachen: RWTH Aachen University, Aachen, Germany
| | - Julia Offermann-van Heek
- Department of Communication Science & Human-Computer Interaction Center, Rheinisch-Westfsche Technische Hochschule Aachen: RWTH Aachen University, Aachen, Germany
| | - Thea Laurentius
- Department of Geriatrics & Department of Geriatric Medicine, Rheinisch-Westfsche Technische Hochschule Aachen: RWTH Aachen University, Aachen, Germany
| | - L Cornelius Bollheimer
- Department of Geriatrics & Department of Geriatric Medicine, Rheinisch-Westfsche Technische Hochschule Aachen: RWTH Aachen University, Aachen, Germany
| | - Martina Ziefle
- Department of Communication Science & Human-Computer Interaction Center, Rheinisch-Westfsche Technische Hochschule Aachen: RWTH Aachen University, Aachen, Germany
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Mandville-Anstey SA, Ward P, Cameron E, Browne M, Foley H. Aging as a Productive Process: A Critical Analysis of Aging Policy in Newfoundland and Labrador, Canada. J Aging Soc Policy 2021; 34:1-19. [PMID: 34139958 DOI: 10.1080/08959420.2021.1927612] [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: 10/21/2022]
Abstract
There has been a growing focus on healthy aging in the political agenda. Discourses contained within policy documents have the potential to shape our notions of healthy aging and well-being. This comprehensive critical document analysis of provincial aging policies in Newfoundland and Labrador (2006-2015) contributes to a larger research study exploring aging women's notions of health and the body in relation to the aging process. The findings highlight how healthy aging discourses focus on the concept of productivity and how a certain type of health is required for ongoing contribution. The paper concludes by arguing that if healthy aging is framed around one's ability to remain productive, notions of health will remain limited to an externalized measure of output versus subjective experience of well-being.
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Affiliation(s)
| | - Pamela Ward
- Faculty, Centre for Nursing Studies St. John's, Canada.,Adjunct Professor, Memorial University St. John's, Canada
| | - Erin Cameron
- Assistant Professor, Northern Ontario School of Medicine, Thunder Bay, Canada
| | | | - Holly Foley
- PhD Candidate, Memorial University, St. John's, Canada
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Wahrendorf M, Hoven H, Deindl C, Lunau T, Zaninotto P. Adverse Employment Histories, Later Health Functioning and National Labor Market Policies: European Findings Based on Life-History Data From SHARE and ELSA. J Gerontol B Psychol Sci Soc Sci 2021; 76:S27-S40. [PMID: 32322883 DOI: 10.1093/geronb/gbaa049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We investigate associations between adverse employment histories over an extended time period and health functioning in later life, and explore whether national labor market policies moderate the association. METHODS We use harmonized life-history data from the Gateway to Global Aging Data on two European studies (SHARE and ELSA) linked to health beyond age 50 (men = 11,621; women = 10,999). Adverse employment histories consist of precarious, discontinued, and disadvantaged careers between age 25 and 50, and we use depressive symptoms, grip strength, and verbal memory as outcomes. RESULTS Adverse employment histories between age 25 and 50 are associated with poor health functioning later in life, particularly repeated periods of unemployment, involuntary job losses, weak labor market ties, and disadvantaged occupational positions. Associations remain consistent after adjusting for age, partnership history, education and employment situation, and after excluding those with poor health prior to or during working life. We find no variations of the associations by national labor market policies. DISCUSSION Our study calls for increased intervention efforts to improve working conditions at early career stages. Despite the importance in shaping employment histories, the role of national policies in modifying the impact of employment on health is less clear.
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Affiliation(s)
- Morten Wahrendorf
- Institute of Medical Sociology, Centre for Health and Society, Heinrich-Heine-University Düsseldorf, Medical Faculty, Germany
| | - Hanno Hoven
- Institute of Medical Sociology, Centre for Health and Society, Heinrich-Heine-University Düsseldorf, Medical Faculty, Germany
| | - Christian Deindl
- Institute of Medical Sociology, Centre for Health and Society, Heinrich-Heine-University Düsseldorf, Medical Faculty, Germany
| | - Thorsten Lunau
- Institute of Medical Sociology, Centre for Health and Society, Heinrich-Heine-University Düsseldorf, Medical Faculty, Germany
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, UK
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Karunananthan S, Moodie EEM, Bergman H, Payette H, Diehr PH, Wolfson C. Physical Function and Survival in Older Adults: A longitudinal study accounting for time-varying effects. Arch Gerontol Geriatr 2021; 96:104440. [PMID: 34119809 DOI: 10.1016/j.archger.2021.104440] [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: 02/09/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE OF THE STUDY Variation in physical function in older adults over time raises several methodological challenges in the study of its association with survival, many of which have largely been overlooked in previous studies. The objective of this study is to examine the relationship between time-varying measures of physical function and survival in men and women aged 70 years and over, while accounting for the time-varying effects of health and lifestyle characteristics. METHODS 1,846 women and 1,245 men in the Cardiovascular Health Study followed annually for up to 10 years beginning at age 70-74 years were included. We estimated the effect of gait speed and grip strength on survival over the subsequent year, using age as the timescale. RESULTS A 0.1m/s higher gait speed was associated with a 12% decrease in the likelihood of death in the subsequent year among women (HR 0.88, 95% CI 0.82-0.94). There was no statistically significant effect of gait speed on survival among men (HR 0.97, 95% CI 0.91 to 1.03), or of grip strength on survival among women (HR 0.97, 95% CI 0.95-1.00) or men (HR 0.99, 95% CI 0.97-1.01), over one year. CONCLUSIONS Upon using time-varying measures of physical function while accounting for time-varying effects of health and lifestyle characteristics, higher gait speed was associated with increased survival among the women in our study. We found no evidence of an association between gait speed and one-year survival in men, or between grip strength and one-year survival in women or men.
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Affiliation(s)
- Sathya Karunananthan
- Bruyère Research Institute, Ottawa, Ontario; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec.
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec
| | - Howard Bergman
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec
| | - Hélène Payette
- Research Centre on Aging, Integrated Academic Health Centre and Social Services in the Eastern Townships, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec
| | - Paula H Diehr
- Department of Health Services, University of Washington, Seattle, WA
| | - Christina Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec; Department of Medicine, McGill University Montreal, Quebec; Research Institute of the McGill University Health Centre, Montreal, Quebec
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Gietel-Basten S. Adopting an adaptation‑mitigation‑resilience framework to ageing. Age Ageing 2021; 50:693-696. [PMID: 33951147 DOI: 10.1093/ageing/afaa282] [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: 10/13/2020] [Indexed: 11/14/2022] Open
Abstract
Population ageing is presented as one of the 'grand challenges' of the 21st century. Yet, policies designed to offset these challenges seem to be a jumbled, disjointed mix with no clear, overarching narrative. One of the successes of climate change science is the development of a clear, distinguishable framework to plan action: adaptation, mitigation and resilience. This framework can be applied to designing better policy for ageing: adapting to support people in need today; mitigating future challenges by ensuring that people and institutions 'age better'; and building resilience by developing both a longer-term perspective and policy learning framework.
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Affiliation(s)
- Stuart Gietel-Basten
- Center for Aging Science & Division of Social Science, The Hong Kong University of Science and Technology, Kowloon, Hong Kong SAR, People's Republic of China
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Hewlings SJ, Draayer K, Kalman DS. Palm Fruit Bioactive Complex (PFBc), a Source of Polyphenols, Demonstrates Potential Benefits for Inflammaging and Related Cognitive Function. Nutrients 2021; 13:nu13041127. [PMID: 33808068 PMCID: PMC8066389 DOI: 10.3390/nu13041127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/11/2022] Open
Abstract
Cognitive function is a key aspect of healthy aging. Inflammation associated with normal aging, also called inflammaging is a primary risk factor for cognitive decline. A diet high in fruits and vegetable and lower in calories, particularly a Mediterranean Diet, may lower the risk of age-related cognitive decline due in part to the associated high intake of antioxidants and polyphenols. A phenolic, Palm Fruit Bioactive complex (PFBc) derived from the extraction process of palm oil from oil palm fruit (Elaeis guineensis), is reported to offset inflammation due to its high antioxidant, especially vitamin E, and polyphenol content. The benefit is thought to be achieved via the influence of antioxidants on gene expression. It is the purpose of this comprehensive review to discuss the etiology, including gene expression, of mild cognitive impairment (MCI) specific to dietary intake of antioxidants and polyphenols and to focus on the potential impact of nutritional interventions specifically PFBc has on MCI. Several in vitro, in vivo and animal studies support multiple benefits of PFBc especially for improving cognitive function via anti-inflammatory and antioxidant mechanisms. While more human studies are needed, those completed thus far support the benefit of consuming PFBc to enhance cognitive function via its anti-inflammatory antioxidant functions.
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Affiliation(s)
- Susan J. Hewlings
- The Herbert H & Grace A. Dow College of Health Professions, Nutrition, Central Michigan University, Mt. Pleasant, MI 48859, USA
- Nutrasource/GRAS Associates, Scientific Affairs, Guelph, ON N1G0B4, Canada;
- Correspondence:
| | - Kristin Draayer
- EDGE Veterinary Vaccines Consulting Group, 315 MAIN STREET 201, Ames, IA 50010, USA;
| | - Douglas S. Kalman
- Nutrasource/GRAS Associates, Scientific Affairs, Guelph, ON N1G0B4, Canada;
- Nutrion Department, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
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Rogers NT, Power C, Pinto Pereira SM. Birthweight, lifetime obesity and physical functioning in mid-adulthood: a nationwide birth cohort study. Int J Epidemiol 2021; 49:657-665. [PMID: 31218351 DOI: 10.1093/ije/dyz120] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Evidence is scant on long-term implications of childhood obesity and body mass index (BMI) gains over the life-course for poor physical functioning (PF). The objective was to establish whether (i) birthweight and BMI across the life-course, (ii) BMI gains at specific life-stages and (iii) age of obesity onset were associated with PF at 50 y. METHODS In the 1958 British birth cohort (n = 8674), BMI (kg/m2) was calculated using height and weight [measured (7, 11, 16, 33 and 45 y); self-reported (23 and 50 y)]. PF was assessed at 50 y using the validated PF subscale of the Short-form 36 survey; the bottom (gender-specific) 10% was classified as poor PF. Missing data were imputed via multiple imputation. Associations were examined using logistic regression, adjusting for health and social factors. RESULTS Birthweight was not associated with PF. At each adult age, odds of poor PF were highest for obese (vs normal), e.g. for 23 y obesity the odds ratio (OR)adjusted for poor PF was 2.28 (1.34, 3.91) and 2.67 (1.72, 4.14) in males and females respectively. BMI gains were associated with poor PF, e.g. for females, ORadjusted per standard deviation (SD) in BMI gain 16-23 y was 1.28 (1.13, 1.46); for BMI gains 45-50 y it was 1.36 (1.11, 1.65). Longer duration of obesity was associated with poor PF, e.g. in males, ORadjusted was 2.32 (1.26, 4.29) for childhood obesity onset and 1.50 (1.16, 1.96) for mid-adulthood onset (vs never obese, P-trend < 0.001). CONCLUSION Obesity, BMI gains, and earlier obesity onset were associated with poor PF in mid-adulthood, reinforcing the importance of preventing and delaying obesity onset.
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Affiliation(s)
- Nina Trivedy Rogers
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK.,UCL Research Department of Epidemiology & Public Health, London, UK
| | - Chris Power
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Snehal M Pinto Pereira
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK.,UCL Research Department of Epidemiology & Public Health, London, UK
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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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Mactaggart I, Baker S, Bambery L, Iakavai J, Kim MJ, Morrison C, Poilapa R, Shem J, Sheppard P, Tanguay J, Wilbur J. Water, women and disability: Using mixed-methods to support inclusive WASH programme design in Vanuatu. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 8:100109. [PMID: 34327430 PMCID: PMC8315363 DOI: 10.1016/j.lanwpc.2021.100109] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 01/08/2023]
Abstract
Background Adequate access to water, sanitation and hygiene (WASH) is imperative for health and wellbeing, yet people with disabilities, people with incontinence and people who menstruate often experience unmet WASH requirements. Methods In 2019 we completed a mixed-methods study in two provinces of Vanuatu, (SANMA and TORBA). The study comprised 1) a population-based disability survey using the Washington Group Short-Set 2) a nested case-control study to explore associations between WASH, disability and gender, and 3) an in-depth qualitative assessment of the experiences of WASH users with additional requirements: people with and without disabilities who menstruate, or experience incontinence. Finding 11,446 households (response rate 85%) were enrolled into the survey. All-age disability prevalence across the two provinces was 2.6% (95% Confidence Interval 2.5-2.8), increasing with age. 814 people with, and 702 people without disabilities participated in the case-control study. People with disabilities were statistically more likely to experience barriers in seven of eight intra-household indicators. WASH-related stigma, reliance on informal caregivers, and under-resourcing of WASH personnel were critical issues for people who menstruate or experience incontinence. Interpretation People with disabilities, people with incontinence and people who menstruate in Northern Vanuatu face continued challenges in accessing safe, affordable and appropriate WASH that meets their requirements. Outputs from this study have supported progression towards gender and disability-inclusive WASH programming in the area and highlighted the value of mixed-methods research. Funding The research was funded by the Australian Government's Water for Women fund and donations from the Australian public.
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Affiliation(s)
- Islay Mactaggart
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Sally Baker
- Melbourne School of Population Health, University of Melbourne, 207 Bouverie St, Carlton, VIC 3053, Australia
| | - Luke Bambery
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Judith Iakavai
- Vanuatu Society for People with Disability (VSPD), Vanuatu
| | - Min Jung Kim
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Chloe Morrison
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Relvie Poilapa
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Jeanine Shem
- World Vision Vanuatu, Rue Artoi M/S, P.O Box 247, Port Vila, Vanuatu
| | - Phillip Sheppard
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Jamie Tanguay
- Vanuatu National Statistics Office, Port Vila, Vanuatu
| | - Jane Wilbur
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Ng N, Eriksson M, Guerrero E, Gustafsson C, Kinsman J, Lindberg J, Lindgren H, Lindvall K, Lundgren AS, Lönnberg G, Sahlen KG, Santosa A, Richter Sundberg L, Weinehall L, Wennberg P. Sustainable Behavior Change for Health Supported by Person-Tailored, Adaptive, Risk-Aware Digital Coaching in a Social Context: Study Protocol for the STAR-C Research Programme. Front Public Health 2021; 9:593453. [PMID: 33732674 PMCID: PMC7957003 DOI: 10.3389/fpubh.2021.593453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The Västerbotten Intervention Programme (VIP) in the Region Västerbotten Sweden is one of the very few cardiovascular disease (CVD) prevention programmes globally that is integrated into routine primary health care. The VIP has been shown as a cost-effective intervention to significantly reduce CVD mortality. However, little is known about the effectiveness of a digital solution to tailor risk communication strategies for supporting behavioral change. STAR-C aims to develop and evaluate a technical platform for personalized digital coaching that will support behavioral change aimed at preventing CVD. Methods: STAR-C employs a mixed-methods design in seven multidisciplinary projects, which runs in two phases during 2019–2024: (i) a formative intervention design and development phase, and (ii) an intervention implementation and evaluation phase. In the 1st phase, STAR-C will model the trajectories of health behaviors and their impact on CVDs (Project 1), evaluate the role of the social environment and social networks on behavioral change (Project 2) and assess whether and how social media facilitates the spread of health information beyond targeted individuals and stimulates public engagement in health promotion (Project 3). The findings will be utilized in carrying out the iterative, user-centered design, and development of a person-tailored digital coaching platform (Project 4). In the 2nd phase, STAR-C will evaluate the implementation of the coaching programme and its effectiveness for promoting behavioral change and the spreading of health information across social networks and via social media (Project 5). The cost-effectiveness (Project 6) and ethical issues (Project 7) related to the coaching programme intervention will be evaluated. Discussion: The STAR-C research programme will address the knowledge and practice research gaps in the use of information technologies in health promotion and non-communicable disease (NCD) prevention programmes in order to narrow the health inequality gaps. Ethics: STAR-C has received approval from the Swedish Ethical Review Authority (Dnr. 2019-02924;2020-02985). Dissemination: The collaboration between Umeå University and Region Västerbotten will ensure the feasibility of STAR-C in the service delivery context. Results will be communicated with decision-makers at different levels of society, stakeholders from other regions and healthcare professional organizations, and through NGOs, local and social media platforms.
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Affiliation(s)
- Nawi Ng
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden.,School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Eriksson
- Department of Social Work, Faculty of Social Sciences, Umeå University, Umeå, Sweden
| | - Esteban Guerrero
- Department of Computing Science, Faculty of Science and Technology, Umeå University, Umeå, Sweden
| | | | - John Kinsman
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Jens Lindberg
- Department of Social Work, Faculty of Social Sciences, Umeå University, Umeå, Sweden
| | - Helena Lindgren
- Department of Computing Science, Faculty of Science and Technology, Umeå University, Umeå, Sweden
| | - Kristina Lindvall
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Anna Sofia Lundgren
- Department of Culture and Media Studies, Faculty of Arts and Humanities, Umeå University, Umeå, Sweden
| | - Göran Lönnberg
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Klas-Göran Sahlen
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Richter Sundberg
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Lars Weinehall
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Patrik Wennberg
- Public Health Unit, Region Västerbotten, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
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Cardiovascular and musculoskeletal health disorders associate with greater decreases in physical capability in older women. BMC Musculoskelet Disord 2021; 22:192. [PMID: 33593350 PMCID: PMC7888167 DOI: 10.1186/s12891-021-04056-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/31/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Good physical capability is an important part of healthy biological ageing. Several factors influencing physical capability have previously been reported. Long-term reports on physical capability and the onset of clinical disorders and chronic diseases are lacking. Decrease in physical capacity has been shown to increase mortality. This study focuses on the prevalence of chronic diseases. The primary objective of the study was to reveal the association between physical capability and morbidity. Secondary objectives included the validity of self-reported physical capability and the association between baseline physical capability and mortality. METHODS The OSTPRE (Kuopio Osteoporosis Risk Factor and Prevention Study) prospective cohort involved all women aged 47-56 years residing in the Kuopio Province, Finland in 1989. Follow-up questionnaires were mailed at five-year intervals. Physical capability questions were first presented in 1994. From these women, we included only completely physically capable subjects at our baseline, in 1994. Physical capability was evaluated with five scale self-reports at baseline and in 2014 as follows: completely physically capable, able to walk but not run, can walk up to 1000 m, can walk up to 100 m and temporarily severely incapable. The prevalences of selected chronic diseases, with a minimum prevalence of 10% in 2014, were compared with the change in self-reported physical capability. Additionally, associations between long-term mortality and baseline physical capability of the whole 1994 study population sample were examined with logistic regression. The correlation of self-reported physical capability with functional tests was studied cross-sectionally at the baseline for a random subsample. RESULTS Our study population consisted of 6219 Finnish women with a mean baseline age of 57.0 years. Self-reported physical capability showed statistically significant correlation with functional tests. Cardiovascular diseases and musculoskeletal disorders show the greatest correlation with decrease of physical capability. Prevalence of hypertension increased from 48.7% in the full physical capability group to 74.5% in the "able to walk up to 100 metres" group (p < 0.001). Rheumatoid arthritis showed a similar increase from 2.1 to 7.4% between these groups. Higher baseline body mass index (BMI) decreases long-term capability (P < 0.001). Women reporting full physical capability at baseline had a mortality rate of 15.1%, in comparison to 48.5% in women within the "able to walk up to 100 m" group (p = 0.357). Mortality increased steadily with worsening baseline physical capability. CONCLUSIONS The results of this study show that chronic diseases, particularly cardiovascular and musculoskeletal disorders, correlate with faster degradation of physical capability in the elderly. Similar results are shown for increase in BMI. We also demonstrate that the risk of mortality over a 20-year period is higher in individuals with poor baseline physical capability.
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Moving from the Margins: Towards an Inclusive Urban Representation of Older People in Zimbabwe’s Policy Discourse. SOCIETIES 2021. [DOI: 10.3390/soc11010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Population ageing has become a major global demographic shift but perhaps less noticeable in the Global South. Zimbabwe, like many African countries, is experiencing and will continue to witness an increase in older age, hence questioning its readiness to handle such change. Ageing in Zimbabwe is currently occurring in the context of increasing poverty, political unrest, changing family structures, and weakening infrastructures. Despite this, Zimbabwe is committed to promoting change and betterment for its citizens through adherence to international agendas and national development strategies. However, the first step towards the realisation of an inclusive urban environment begins with a fair representation of the various actors and social groups. This review paper is aimed at examining the representation of Zimbabwe’s older people, a subject that has rarely been the focus of critical analysis, concentrating on the political discourse in urban development programmes. A sample of 45 international and national policy documents published post-2002, was carefully selected and inspected to determine the level of presence of older people using discourse analysis. The findings reveal that in the context of the efforts made towards a Zimbabwe that is inclusive of all citizens, the idea of older persons as subjects of rights and active participants has yet to truly gain sufficient currency. There is a dominance of a one-dimensional perspective across the majority of the publications, with older people constructed as “dependent”, “vulnerable” and “passive”, overseeing vital contributions to society. A realistic and more empowering representation of this social group, showing them as active caregivers rather than passive recipients is therefore a necessity if Zimbabwe is to fulfil its vision of inclusivity.
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Mack-Inocentio D, Menai M, Doré E, Doreau B, Gaillard C, Finaud J, Pereira B, Duché P. Large-Scale Assessment of Health-Related Physical Fitness in French Older Adults: Feasibility and Validity. Front Public Health 2021; 8:487308. [PMID: 33392123 PMCID: PMC7773917 DOI: 10.3389/fpubh.2020.487308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/18/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study aims to assess the validity, internal consistency, implementation, and feasibility of a sequence of tests, the Vitality Test Battery, designed to measure physical fitness, at a large scale in French older adults. Methods: A total of 528 volunteers (age ≥60 years) took the battery of 10 tests: 6-min walk, trunk strength, hand grip strength, medicine ball throwing, 30-s chair stand, flexibility, balance, plate tapping, ruler drop, and dual task. Results: Internal consistency was high, with the Cronbach alpha coefficients at around 0.77, explaining 64% of the variance. The test–retest correlations (0.3–0.6) between the items were acceptable and displayed an internal consistency property. Although five components explained 65% of the variance, all the items were kept because their eigenvalues were near to 0.9. External consistency was validated by a significant decrease in fitness scores (p < 0.001) with age and body mass index. Discussion: The Vitality Test Battery is a safe, valid tool for assessing physical fitness in persons aged over 60 years.
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Affiliation(s)
- Damien Mack-Inocentio
- Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Clermont-Ferrand, France.,Centre de Recherche en Nutrition Humaine d'Auvergne, Inra, Clermont-Ferrand, France
| | - Mehdi Menai
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques; CRNH IdF, Bobigny, France
| | - Eric Doré
- Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Clermont-Ferrand, France.,Centre de Recherche en Nutrition Humaine d'Auvergne, Inra, Clermont-Ferrand, France
| | - Bastien Doreau
- Université Clermont Auvergne, CNRS, Laboratoire d'Informatique, de Modélisation et d'Optimisation des Systèmes, Clermont-Ferrand, France
| | - Camille Gaillard
- Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Clermont-Ferrand, France.,Centre de Recherche en Nutrition Humaine d'Auvergne, Inra, Clermont-Ferrand, France
| | - Julien Finaud
- Association Sportive Montferrandaise, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Unité de Biostatistiques (DRCI), Clermont-Ferrand, France
| | - Pascale Duché
- Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Clermont-Ferrand, France.,Université de Toulon, Laboratoire Impact de l'Activité Physique sur la Santé (IAPS), Toulon, France
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50
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Terraneo M. The Effect of Material and Social Deprivation on Well-Being of Elderly in Europe. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2020; 51:167-181. [PMID: 33342332 DOI: 10.1177/0020731420981856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this work, attention is paid to 2 explanatory factors of successful aging. The first is material deprivation. There is growing evidence that poverty is associated with the onset of physical and mental disorders and, broadly, with aspects such as life satisfaction and happiness. The second factor is social deprivation. Social exclusion affects health due to lack of emotional and concrete support; moreover, participation in social activities among older people is associated with greater longevity and a lower risk of disability. The study describes the effect of material and social deprivation on depression (measured through the EURO-D scale) and quality of life (through CASP-12 scale), for individuals aged 50 and older in 14 European countries. Data is derived from Wave 5 of the SHARE project. To estimate the effect of material and social deprivation on outcomes and to determine whether it is moderated by the country in which people live, we apply 2 multi-group path models, respectively, for people aged 65 or younger and for those aged 66 years or older. Findings indicate that higher material and social deprivation is associated with greater levels of stress and worse quality of life. The effect of social deprivation would be stronger than that of material deprivation, and this result seems to be valid in all countries considered, although their intensity varies significantly between them.
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Affiliation(s)
- Marco Terraneo
- Department of Sociology and Social Research, 165458University of Milano-Bicocca, Milan, Italy
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