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Vega-Alonso T, Lozano-Alonso J, Estévez-Iglesias L, Ordax-Díez A, Arrieta-Antón E, Díaz-Rodríguez Á, Yañez-Ortega JL, Santos-Lozano A, Nuñez-Torres R, Perez-Caro M, Pita G, Pinto-Labajo R, Alonso Ramos MJ, Álamo-Sanz R, García-Montero AC, Gonzalez-Neira A. Health and wellbeing status of the long-lived individuals of the Spanish LONGECYL cross-sectional study. Arch Public Health 2024; 82:77. [PMID: 38769585 PMCID: PMC11103821 DOI: 10.1186/s13690-024-01305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 05/04/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND The increase in life expectancy and long-lived individuals is a challenge for public health and provides an opportunity to understand the determinants of longevity. However, few studies have addressed the factors associated with the health status and quality of life in a long-lived individual population. We described the perceived health, clinical status, quality of life, and dependency for activities of daily living in a representative population in Castile and Leon, Spain. METHODS A sample of 759 long-lived individuals aged 95 years and older was studied by the Health Sentinel Network of Castile and Leon (Spain) through a health examination and a structured questionnaire covering quality of life (EQ-5D-3), lifestyle habits, diet, working life and family health. A blood sample was taken for the study of biological and genetic markers. Chi Square and logistic regression OR with 95% confidence intervals were used to analyze the determinants of the long-lived individuals' health status. The significant level for the bivariate analysis was established at 0.05. RESULTS Perceived health was good, very good or excellent in 64.2%, while only 46.0% had a quality-of-life index above 0.5 (ranging from 0 to 1) and 44.1% maintained acceptable independence for activities of daily living. Quality-of-life index was higher in the oldest, (OR 7.98 [2,32-27.41]) above 100 years compared to those under 98, and men had better values for independence than women (OR 2.43 [1.40-4.29]). Cardiovascular diseases were the most prevalent (85.5%), but neurological and mental diseases and vision problems had the highest impact on quality of life and independence. CONCLUSION The long-lived individuals of Castile and Leon have a relatively well-preserved health status, although the perception of health is higher than that describing their quality of life and dependence. The quality of life was higher in the oldest age group and showed differences according to sex, with a better quality of life in men. Public health policies and programs should take in account the differences by sex and age as well as the prevention and control of the main conditions related with poor quality of life or dependence. Future research must include the interaction among genetic, socioeconomic, environmental, and other clinical factors in the quality of life and disability of long-lived individuals.
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Affiliation(s)
- Tomás Vega-Alonso
- Dirección General de Salud Pública. Consejería de Sanidad, Valladolid, Spain.
- Consejería de Sanidad. Dirección General de Salud Pública, Paseo de Zorrilla, 1, Valladolid, 47071, España.
| | - José Lozano-Alonso
- Dirección General de Salud Pública. Consejería de Sanidad, Valladolid, Spain
| | | | - Ana Ordax-Díez
- Dirección General de Salud Pública. Consejería de Sanidad, Valladolid, Spain
| | - Enrique Arrieta-Antón
- Gerencia Regional de Salud. Consejería de Sanidad. Area de Salud de Segovia, Segovia, Spain
| | - Ángel Díaz-Rodríguez
- Gerencia Regional de Salud. Consejería de Sanidad. Area de Salud de Ponferrada, Ponferrada, Spain
| | | | | | - Rocío Nuñez-Torres
- Unidad de Genotipado Humano-CEGEN, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - María Perez-Caro
- Banco Nacional de ADN, Universidad de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Gillermo Pita
- Unidad de Genotipado Humano-CEGEN, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Rosa Pinto-Labajo
- Banco Nacional de ADN, Universidad de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | | | - Rufino Álamo-Sanz
- Dirección General de Salud Pública. Consejería de Sanidad, Valladolid, Spain
| | - Andrés-C García-Montero
- Banco Nacional de ADN, Universidad de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Anna Gonzalez-Neira
- Unidad de Genotipado Humano-CEGEN, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
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Kang G, Cheah MCC, Yen PB, Tan LB, Chong JNC, Cheang LY, Goh RJL, Lee MS, Tan TKC, Salazar E. Parenteral nutrition-related complications in older patients with acute intestinal failure: A descriptive cohort study. JPEN J Parenter Enteral Nutr 2024; 48:174-183. [PMID: 37991279 DOI: 10.1002/jpen.2578] [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: 06/27/2023] [Revised: 11/02/2023] [Accepted: 11/17/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Reported outcomes for parenteral nutrition (PN)-related complications in older adult patients with acute intestinal failure who are receiving PN in the acute hospital setting are limited. Our study aims to compare PN-related complications between older and younger adult patients. METHODS A retrospective descriptive study of inpatients who were administered PN from January 1, 2019, to December 31, 2019, was performed. Patients were categorized into older (≥65 years old) and younger (<65 years old) adult groups. RESULTS Two hundred thirty-five patients were included. There were 103 patients in the older adult group (mean age: 73.9 [SD: 6.9] years) and 132 patients in the younger adult group (mean age: 52.4 [SD: 12.5] years). There was a significantly higher Charlson Comorbidity Index score and lower Karnofsky score in the older adult group. The older adult group received significantly lower total energy (20.8 [SD: 7.8] vs 22.8 [SD: 6.3] kcal/kg/day), dextrose (3.1 [SD: 1.4] vs 3.6 [SD: 1.4] g/kg/day), and protein (1.1 [SD: 0.4] vs 1.2 [SD: 0.3] g/kg/day) than the younger group received. The mean length of stay was significantly shorter in the older adult group (35.9 [SD: 21.3] vs 59.8 [SD: 55.3]; P < 0.05). There was no significant difference in PN-related complications and clinical outcomes (catheter-related bloodstream infections, hypoglycemia or hyperglycemia, fluid overload, or inpatient mortality) between the two groups. CONCLUSION Despite more comorbidities in the older adult, the usage of PN in older adult patients with acute intestinal failure was associated with neither an increased rate of PN-related complications nor worse clinical outcomes when compared with that of younger patients.
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Affiliation(s)
- Garrett Kang
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore
| | - Mark Chang Chuen Cheah
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore
| | - Poh Bee Yen
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore
| | - Lee Boo Tan
- Department of Dietetics, Singapore General Hospital, Singapore, Singapore
| | - Janet Ngian Choo Chong
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore
| | - Lai Ye Cheang
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore
| | | | - Miaw Sim Lee
- Department of Dietetics, Singapore General Hospital, Singapore, Singapore
| | - Travis Kim Chye Tan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore
| | - Ennaliza Salazar
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore
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Cancer mortality in the oldest old: a global overview. Aging (Albany NY) 2020; 12:16744-16758. [PMID: 32882684 PMCID: PMC7521488 DOI: 10.18632/aging.103503] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND As a higher proportion of adults live beyond 85 years, their cancer burden is expected to increase. While trends among the oldest old are established for major epithelial cancers (breast, prostate, lung, and colorectal cancers), they are less studied for minor cancers. This study describes age trends of cancer mortality, with emphasis on individuals aged 85+ years. RESULTS Overall cancer mortality peaked at 85 years old and decreased or stabilized for all countries except the USA, France, and Japan, in which mortality continued to increase after age 85 years. For most countries, cancers of the oesophagus, stomach, liver, and larynx have a similar flat trend patterns across all ages. Bladder and kidney cancers as well as non-Hodgkin lymphoma, multiple myeloma, and leukemia showed a decreasing pattern after 85 years for UK, Germany, Italy and Poland. Lung cancer peaked at 80 years, although the age-specific peak among women did not follow the same pattern among all countries. Breast and prostate cancers increased after 85 years. CONCLUSION Mortality stabilized or decreased after age 85, particularly for non-hormonal cancers. Whether this reflects a true biological levelling of mortality rates, or lower validity of cancer registration among the oldest old, remains open to discussion. METHODS Completed death data were obtained from the World Health Organization (WHO) for eight countries (2000 to 2014). Age-specific mortality rates were calculated for each 5-year age group above age 64. Joinpoint regression models were used to identify significant changes in mortality trends by age.
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