1
|
Möller S, Lykkegaard J, Hansen RS, Stokholm L, Kjær NK, Ahrenfeldt LJ. Sensory impairments and the risk of cognitive decline and dementia across sex, age, and regions: Longitudinal insights from Europe. Arch Gerontol Geriatr 2024; 127:105584. [PMID: 39094402 DOI: 10.1016/j.archger.2024.105584] [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: 03/31/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND In aging populations, understanding predictors of cognitive decline is essential. We aimed to investigate the risk of cognitive decline and dementia by sensory impairments across sex, age, and European regions, and examined the mediating role of activities of daily living (ADL), physical activity, and depressive symptoms. METHODS A cohort study of 72,287 Europeans aged 50+ participating in at least two waves of the Survey of Health, Ageing and Retirement in Europe. We employed mixed-effects and time-to-event models, incorporating sex interactions, and adjusting for socio-demographic factors and medical history. RESULTS Compared to individuals with good vision and hearing, lower cognitive function was found for people with vision impairment (VI) (males: coef. -0.70, 95 % CI -0.95; -0.46; females: coef. -1.12, 95 % CI -1.33; -0.92), hearing impairment (HI) (males: coef. -0.64, 95 % CI -0.93; -0.35; females: coef. -0.96, 95 % CI -1.27; -0.65) and dual sensory impairment (DSI, i.e. VI and HI) (males: coef. -1.81, 95 % CI -2.16; -1.46; females: coef. -2.71, 95 % CI -3.05; -2.38), particularly among females. Moreover, higher dementia risk was observed among participants with VI (hazard ratio (HR) 1.29, 95 % CI 1.17; 1.43), HI (HR 1.18, 95 % CI 1.05; 1.34), and DSI (HR 1.62, 95 % CI 1.45; 1.81) with no sex-interactions. Findings were overall consistent across age and European regions. CONCLUSION The results suggest the necessity of preventing sensory impairments to maintain good cognitive function. Mitigating depressive symptoms, ADL limitations, and physical inactivity could potentially reduce a significant portion of the total effect of sensory impairments on cognitive decline.
Collapse
Affiliation(s)
- Sören Möller
- Open Patient data Explorative Network, Odense University Hospital, 5000 Odense, Denmark; The OPEN Research Unit, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Jesper Lykkegaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 6700 Esbjerg-Odense, Denmark
| | - Rikke Syrak Hansen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 6700 Esbjerg-Odense, Denmark
| | - Lonny Stokholm
- Open Patient data Explorative Network, Odense University Hospital, 5000 Odense, Denmark; The OPEN Research Unit, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Niels Kristian Kjær
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 6700 Esbjerg-Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 6700 Esbjerg-Odense, Denmark.
| |
Collapse
|
2
|
Luo YX, Zhou XH, Heng T, Yang LL, Zhu YH, Hu P, Yao XQ. Bidirectional transitions of sarcopenia states in older adults: The longitudinal evidence from CHARLS. J Cachexia Sarcopenia Muscle 2024; 15:1915-1929. [PMID: 39001569 PMCID: PMC11446714 DOI: 10.1002/jcsm.13541] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/05/2024] [Accepted: 06/15/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Sarcopenia, the age-related loss of muscle mass and function, brings multiple adverse outcomes including disability and death. Several sarcopenia consensuses have newly introduced the premorbid concept of possible sarcopenia and recommended early lifestyle interventions. Bidirectional transitions of premorbid states have been revealed in several chronic diseases yet not clarified in sarcopenia. This study aims to investigate the underlying transition patterns of sarcopenia states. METHODS The study utilized three waves of data from a nationally representative survey, the China Health and Retirement Longitudinal Study (CHARLS), and included community-dwelling individuals aged 60 years and older with at least two sarcopenia states assessments based on the Asian Working Group for Sarcopenia criteria 2019 (AWGS2019) between 2011 and 2015. The estimated transition intensity and probability between non-sarcopenia, possible sarcopenia, sarcopenia, and death were investigated using multi-stage Markov (MSM) models. RESULTS The study comprised 4395 individuals (49.2% female, median age 67 years) with a total of 10 778 records of sarcopenia state assessment, and the mean follow-up period was 3.29 years. A total of 24.5% of individuals with a current state of possible sarcopenia returned to non-sarcopenia, 60.3% remained possible sarcopenia, 6.7% progressed to sarcopenia, and 8.5% died by the next follow-up. The transition intensity of recovery to non-sarcopenia (0.252, 95% CI 0.231-0.275) was 2.8 times greater than the deterioration to sarcopenia (0.090, 95% CI 0.080-0.100) for individuals with possible sarcopenia. For individuals with possible sarcopenia, the estimated probabilities of recovering to non-sarcopenia, progressing to sarcopenia, and transitioning to death within a 1-year observation were 0.181, 0.066, and 0.035, respectively. For individuals with sarcopenia, the estimated probabilities of recovering to non-sarcopenia, recovering to possible sarcopenia, and transitioning to death within 1-year observation were 0.016, 0.125, and 0.075, respectively. In covariables analysis, age, sex, body mass index, physical function impairment, smoking, hypertension, and diabetes are important factors influencing bidirectional transitions. CONCLUSIONS The findings highlight the bidirectional transitions of sarcopenia states among older adults and reveal a notable proportion of possible sarcopenia show potential for recovery in the natural course. Screening and intensifying interventions based on risk factors may facilitate a recovery transition.
Collapse
Affiliation(s)
- Ya-Xi Luo
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Han Zhou
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tian Heng
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling-Ling Yang
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying-Hai Zhu
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Hu
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiu-Qing Yao
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Municipality Clinical Research Center for Geriatric Medicine, Chongqing, China
- Department of Rehabilitation Therapy, Chongqing Medical University, Chongqing, China
| |
Collapse
|
3
|
Liu X, Jiang T, Jiang Y, Li L, Cao Y. Prevalence of mild cognitive impairment and modifiable risk factors: A cross-sectional study in rural older adults with diabetes. Geriatr Nurs 2024; 59:549-556. [PMID: 39153464 DOI: 10.1016/j.gerinurse.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/15/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024]
Abstract
To determine the prevalence and modifiable risk factors for MCI in older adults with T2DM in rural China. This cross-sectional study encompassed 96 villages, employing a cluster sampling approach to recruit eligible older adults with T2DM as study participants. Logistic regression analysis was utilized to identify modifiable risk factors associated with MCI. Average marginal effects were calculated. The discriminatory performance of these risk factors in identifying MCI was evaluated by plotting the receiver operating curve and calculating the value of the area under the curve. A total of 898 older adults with T2DM in our study. The overall prevalence of MCI was 50.22 %. Independent associations with MCI were found in poor self-management ability of diabetes (OR = 0.808, 95 % CI: 0.808, 0.766), depressive symptoms (OR = 3.500, 95 % CI: 1.933, 6.337), moderate (OR = 0.936, 95 % CI: 0.017, 0.075) and high (OR = 0.939, 95 % CI: 0.016, 0.100) levels of physical activity, poorer oral health (OR = 2.660, 95 % CI: 2.226, 3.179), and lower grip strength (OR = 0.913, 95 % CI: 0.870, 0.958). The AUC was 0.967 (95 % CI 0.508-0.470). The prevalence of MCI was high among older adults with T2DM in rural areas of China. The self-management ability of diabetes, depressive symptoms, physical activity, oral health and grip strength were modifiable risk factors of MCI. Targeted interventions should be developed and implemented to address these modifiable risk factors, aiming to enhance cognitive function and mitigate the incidence of MCI in older adults with T2DM.
Collapse
Affiliation(s)
- Xueyan Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China
| | - Tianshu Jiang
- Center for Economic Research, Shandong University, 27 Shanda Nanlu, Licheng District, Jinan, Shandong Province, PR China
| | - Yuanyuan Jiang
- Department of Nursing, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China; Nursing Theory and Practice Innovation Research Center, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China
| | - Li Li
- Department of Nursing, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China; Nursing Theory and Practice Innovation Research Center, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China
| | - Yingjuan Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China; Department of Nursing, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China; Nursing Theory and Practice Innovation Research Center, Shandong University, 107 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, PR China.
| |
Collapse
|
4
|
MacKenzie EG, Snow NJ, Chaves AR, Reza SZ, Ploughman M. Weak grip strength among persons with multiple sclerosis having minimal disability is not related to agility or integrity of the corticospinal tract. Mult Scler Relat Disord 2024; 88:105741. [PMID: 38936325 DOI: 10.1016/j.msard.2024.105741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/23/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Mobility impairment is common in multiple sclerosis (MS); however, agility has received less attention. Agility requires strength and neuromuscular coordination to elicit controlled propulsive rapid whole-body movement. Grip strength is a common method to assess whole body force production, but also reflects neuromuscular integrity and global brain health. Impaired agility may be linked to loss of neuromuscular integrity (reflected by grip strength or corticospinal excitability). OBJECTIVES We aimed to determine whether grip strength would be associated with agility and transcranial magnetic stimulation (TMS)-based indices of corticospinal excitability and inhibition in persons with MS having low disability. We hypothesized that low grip strength would predict impaired agility and reflect low corticospinal excitability. METHODS We recruited 34 persons with relapsing MS (27 females; median [range] age 45.5 [21.0-65.0] years) and mild disability (median [range] Expanded Disability Status Scale 2.0 [0-3.0]), as well as a convenience sample of age- and sex-matched apparently healthy controls. Agility was tested by measuring hop length during bipedal hopping on an instrumented walkway. Grip strength was measured using a calibrated dynamometer. Corticospinal excitability and inhibition were examined using TMS-based motor evoked potential (MEP) and corticospinal silent period (CSP) recruitment curves, respectively. RESULTS MS participants had significantly lower grip strength than controls independent of sex. Females with and without MS had weaker grip strength than males. There were no statistically significant sex or group differences in agility. After controlling for sex, weaker grip strength was associated with shorter hop length in controls only (r = 0.645, p < .05). Grip strength did not significantly predict agility in persons with MS, nor was grip strength predicted by corticospinal excitability or inhibition. CONCLUSIONS In persons with MS having low disability, grip strength (normalized to body mass) was reduced despite having intact agility and walking performance. Grip strength was not associated with corticospinal excitability or inhibition, suggesting peripheral neuromuscular function, low physical activity or fitness, or other psychosocial factors may be related to weakness. Low grip strength is a putative indicator of early neuromuscular aging in persons with MS having mild disability and normal mobility.
Collapse
Affiliation(s)
- Evan G MacKenzie
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada
| | - Nicholas J Snow
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada
| | - Arthur R Chaves
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada; Neuromodulation Research Clinic, The Royal's Institute of Mental Health Research, ON, Canada; Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, QC, Canada
| | - Syed Z Reza
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada
| | - Michelle Ploughman
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada.
| |
Collapse
|
5
|
Alotaibi MM. Predictors of Hand Grip Strength in Adults Without Sarcopenia: Data From the NHANES, 2013-2014. Curr Dev Nutr 2024; 8:102149. [PMID: 38693967 PMCID: PMC11061696 DOI: 10.1016/j.cdnut.2024.102149] [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: 12/21/2023] [Revised: 03/12/2024] [Accepted: 03/24/2024] [Indexed: 05/03/2024] Open
Abstract
Background Grip strength measurement is used to estimate muscle strength and predict health status; yet, an accurate examination of grip strength predictors from body composition variable is lacking. Objectives This study aimed to examine the association of grip strength with lumbar bone mineral density (BMD) and total lean mass in adults without sarcopenia. Methods Adults without sarcopenia (N = 3100) were included from the NHANES, 2013-2014, in this cross-sectional study. Body mass (kg), body height (cm), body mass index (kg/m2), grip strength (kg), total percent fat (%), lumbar BMD (g/cm2), and total lean mass excluding bone mineral content (BMC, kg) were obtained and tested as predictors of grip strength. Results The regression analysis yielded a significant model [F(2,343732) = 71,284.2; R2 = 0.713; P < 0.001], with all predictors explaining ∼71.3% of the variance in grip strength. Age [β: -0.043; 95% confidence interval (CI): -0.040, -0.036], sex (β: -0.296; 95% CI: -6.431, -6.270), total percent fat (β: -0.245; 95% CI: -0.315, -0.308), lumbar BMD (β: 0.037; 95% CI: 2.529, 2.806), and total lean mass (β: 0.482; 95% CI: 0.001, 0.001) were all significant predictors of grip strength. Conclusions The predictive value of the BMD and total lean mass can serve as a useful measure in predicting grip strength and overall health status in adults without sarcopenia.
Collapse
Affiliation(s)
- Mansour M Alotaibi
- Department of Rehabilitation, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
- Center for Health Research, Northern Border Universit, Arar, Saudi Arabia
| |
Collapse
|
6
|
Grønkjær M, Mortensen EL, Wimmelmann CL, Flensborg-Madsen T, Osler M, Okholm GT. The Danish Aging and Cognition (DanACo) cohort. BMC Geriatr 2024; 24:238. [PMID: 38454360 PMCID: PMC10921587 DOI: 10.1186/s12877-024-04841-5] [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: 10/13/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND With aging populations worldwide, identification of predictors of age-related cognitive decline is becoming increasingly important. The Danish Aging and Cognition Cohort (DanACo) including more than 5000 Danish men was established to investigate predictors of age-related cognitive decline from young adulthood to late mid-life. CONSTRUCTION AND CONTENT The DanACo cohort was established through two separate data collections with identical designs involving a follow-up examination in late mid-life of men for whom intelligence test scores were available from their mandatory conscription board examination. The cohort consists of 5,183 men born from 1949 through 1961, with a mean age of 20.4 years at baseline and a mean age of 64.4 years at follow-up. The baseline measures consisted of height, weight, intelligence test score and educational level collected at the conscription board examination. The follow-up assessment consisted of a re-administration of the same intelligence test and a comprehensive questionnaire covering socio-demographic factors, lifestyle, and health-related factors. The data were collected in test sessions with up to 24 participants per session. Using the unique personal identification number assigned to all Danes, the cohort has been linked to data from national administrative and health registers for prospectively collected data on socioeconomic and health-related factors. UTILITY AND DISCUSSION The DanACo cohort has some major strengths compared to existing cognitive aging cohorts such as a large sample size (n = 5,183 men), a validated global measure of cognitive ability, a long retest interval (mean 44.0 years) and the availability of prospectively collected data from registries as well as comprehensive questionnaire data. The main weakness is the low participation rate (14.3%) and that the cohort consists of men only. CONCLUSION Cognitive decline is a result of a summary of factors across the life-course. The DanACo cohort is characterized by a long retest interval and contains data on a wealth of factors across adult life which is essential to establish evidence on predictors of cognitive decline. Moreover, the size of the cohort ensures sufficient statistical power to identify even relatively weak predictors of cognitive decline.
Collapse
Affiliation(s)
- Marie Grønkjær
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Cathrine Lawaetz Wimmelmann
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
- Centre for Childhood Health, Islands Brygge 41, 2300, Copenhagen S, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark
| | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
- Department of Public Health, Unit of Medical Psychology, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1353, Denmark.
- Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.
| |
Collapse
|
7
|
Poco LC, Finkelstein E, Sim D, Malhotra C. Weak grip strength predicts higher unplanned healthcare utilization among patients with heart failure. ESC Heart Fail 2024; 11:306-314. [PMID: 37990632 PMCID: PMC10804178 DOI: 10.1002/ehf2.14573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/23/2023] Open
Abstract
AIMS Frailty increases healthcare utilization and costs for patients with heart failure but is challenging to assess in clinical settings. Hand grip strength (GS) is a single-item measure of frailty yet lacks evidence as a potential screening tool to identify patients at risk of higher unplanned events and related healthcare costs. We examined the association of baseline and longitudinal GS measurements with healthcare utilization and costs among patients with advanced heart failure. METHODS AND RESULTS Between July 2017 and April 2019, we enrolled 251 patients with symptoms of advanced heart failure (New York Heart Association class III or IV) in a prospective cohort study in Singapore. We measured GS at baseline and every 4 months for 2 years and linked patients' survey data with their medical and billing records. We categorized patients as having weak GS if their GS measurement was below the 5th percentile of the age- and gender-specific normative GS values in Singapore. We assessed the association between baseline GS and healthcare utilization (unplanned and planned events and healthcare costs, total costs, and length of inpatient stay) over the next 2 years using regression models. We investigated the association between longitudinal 4-monthly GS assessments and the ensuing 4 months of healthcare utilization and costs using mixed-effects logistic and two-part regression models. At baseline, 22.5% of patients had weak GS. Baseline and longitudinal GS measurements were significantly associated with longer length of inpatient stay, greater likelihood of unplanned events, and higher related costs. Patients with weak GS had higher odds of an unplanned event occurring by 8 percentage points [95% confidence interval (CI) (0.01, 0.14), P = 0.026], incurred longer inpatient stays by 4 days [95% CI (1.97, 6.79), P = 0.003], and additional SG$ 4792 [US$ ~ 3594, 95% CI (1894, 7689), P = 0.014] in unplanned healthcare costs over the next 4 months. CONCLUSIONS GS is a simple tool to identify and monitor heart failure patients at risk of unplanned events, longer inpatient stays, and higher related healthcare costs. Findings support its routine use in clinical settings.
Collapse
Affiliation(s)
- Louisa Camille Poco
- Lien Centre for Palliative CareDuke‐NUS Medical School8 College RdSingapore169857
| | - Eric Finkelstein
- Lien Centre for Palliative CareDuke‐NUS Medical School8 College RdSingapore169857
- Program in Health Services and Systems ResearchDuke‐NUS Medical SchoolSingapore
| | - David Sim
- National Heart Centre SingaporeSingapore
| | - Chetna Malhotra
- Lien Centre for Palliative CareDuke‐NUS Medical School8 College RdSingapore169857
- Program in Health Services and Systems ResearchDuke‐NUS Medical SchoolSingapore
| |
Collapse
|
8
|
Hansen RS, Scheel-Hincke LL, Jeune B, Ahrenfeldt LJ. Sex differences in vision and hearing impairments across age and European regions : Findings from SHARE. Wien Klin Wochenschr 2024; 136:55-63. [PMID: 37280394 DOI: 10.1007/s00508-023-02223-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
AIM Although sensory impairments are common conditions among older people, research often fails to consider the role of sex. We examined sex differences in vision impairment and hearing impairment across age and European regions. METHODS We conducted a cross-sectional study based on a pooled sample of 65,656 females and 54,881 males aged 50 years and older participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Logistic regression models with robust standard errors providing odds ratios (OR) and 95% confidence intervals (CI) were used to examine associations. RESULTS European females had generally higher odds of vision impairment (OR 1.16, 95% CI 1.12-1.21) but lower odds of hearing impairment than European males (OR 0.70, 95% CI 0.67-0.73). The female disadvantage in vision increased with advancing age, whereas the female advantage in hearing decreased. No overall sex difference in vision was found in northern Europe, but females had more vision impairments than males in southern (OR 1.23, 95% CI 1.14-1.32), western (OR 1.14, 95% CI 1.08-1.21) and eastern (OR 1.10, 95% CI 1.02-1.20) Europe. Females were healthier than males in terms of hearing in all regions, with the largest female advantage in northern Europe (OR 0.58, 95% CI 0.53-0.64). CONCLUSION Our findings demonstrate an overall consistent pattern of sex differences in sensory impairments across Europe showing an increasing female disadvantage in vision and a decreasing female advantage in hearing with advancing age.
Collapse
Affiliation(s)
- Rikke Syrak Hansen
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Lasse Lybecker Scheel-Hincke
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Bernard Jeune
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark.
| |
Collapse
|
9
|
Jin Y, Hong C, Luo Y. Sex differences in cognitive aging and the role of socioeconomic status: Evidence from multi-cohort studies. Psychiatry Res 2023; 321:115049. [PMID: 36706558 DOI: 10.1016/j.psychres.2023.115049] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Sex differences exist in cognitive function, and socioeconomic status (SES) may play a role in changing these discrepancies. This study investigated the role of SES in contributing to sex differences in cognitive function. METHODS We conducted a pooled multi-cohort study on the basis of four comparative cohort studies from the UK, the US, Europe and China to assess sex differences and the role of SES in cognitive decline by birth cohort (1930-1938, 1939-1945, 1946-1968). Cognitive function was measured in three domains based on the mean and SD of the corresponding tests: episodic memory, working memory, and time orientation. SES was the summed scores of education and household wealth. FINDINGS 61,019 individuals were involved. Cognitive function of women declined faster than those of men as growing old (particularly after 80 years old). As SES increased, cognitive function increased more for women than for men in most cases among later-born cohorts (1930-1938, 1939-1945, 1946-1968) (e.g., episodic memory scores at 60 years old: women exhibited an increase from -0.09 [95%CI -0.12, -0.07] in low SES to 0.89 [0.86, 0.92] in high SES; men from -0.16 [-0.19, -0.14] to 0.59 [0.56, 0.62]). However, sex-specific cognitive benefits were absent in the oldest birth cohort (1895-1929). INTERPRETATION These findings highlight the importance of considering the role of SES in the discrepancy of sex difference in cognitive aging.
Collapse
Affiliation(s)
- Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Chenlu Hong
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China.
| |
Collapse
|
10
|
Ahrenfeldt LJ, Möller S, Hvidt NC, VanderWeele TJ, Stripp TA. Effect of religious service attendance on mortality and hospitalisations among Danish men and women: longitudinal findings from REGLINK-SHAREDK. Eur J Epidemiol 2023; 38:281-289. [PMID: 36646924 DOI: 10.1007/s10654-023-00964-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023]
Abstract
Research suggests a protective effect of religious service attendance on various health outcomes. However, most research has been done in religious societies, raising the question of whether these associations are also prominent in secular cultures. Here we examine mortality and hospitalisations by religious service attendance among men and women in a secular society. We performed a cohort study including 2987 Danes aged 40+ interviewed in SHARE from 2004 to 2007 and followed up in the Danish registries until 2018. We used Cox regressions and negative binomial regressions to examine associations, including interactions with sex and adjusting for age, wave, socioeconomic factors, lifestyle factors, body mass index, and history of diseases. Overall, 5.0% of men and 6.6% of women reported that they had taken part in a religious organisation within the last month. Among 848 deaths, we found lower mortality for people who attended religious services (hazard ratio (HR) 0.70; 95% CI 0.50-0.99). There was evidence for an association among women (HR 0.56; 95% CI 0.35-0.89), but not among men (HR 0.95; 95% CI 0.59-1.53). In contrast, regarding hospital admissions (n = 12,010), we found lower hospitalisation rates among men who attended religious services (incidence rate ratio (IRR) 0.67; 95% CI 0.45-0.98), whereas no association was found among women (IRR 0.95; 95% CI 0.70-1.29). Sensitivity analyses with E-values were moderately robust. Our results contribute to the limited literature on possible health benefits of religious service attendance in secular societies, demonstrating lower mortality among women and fewer hospitalisations among men.
Collapse
Affiliation(s)
- Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark.
| | - Sören Möller
- Open Patient Data Explorative Network, Odense University Hospital, 5000, Odense, Denmark
- Research unit OPEN, Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, 5000, Odense, Denmark
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Tobias Anker Stripp
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| |
Collapse
|
11
|
Huemer MT, Kluttig A, Fischer B, Ahrens W, Castell S, Ebert N, Gastell S, Jöckel KH, Kaaks R, Karch A, Keil T, Kemmling Y, Krist L, Leitzmann M, Lieb W, Meinke-Franze C, Michels KB, Mikolajczyk R, Moreno Velásquez I, Pischon T, Schipf S, Schmidt B, Schöttker B, Schulze MB, Stocker H, Teismann H, Wirkner K, Drey M, Peters A, Thorand B. Grip strength values and cut-off points based on over 200,000 adults of the German National Cohort - a comparison to the EWGSOP2 cut-off points. Age Ageing 2023; 52:6998045. [PMID: 36702514 PMCID: PMC9879709 DOI: 10.1093/ageing/afac324] [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: 06/13/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The European Working Group on Sarcopenia in Older People (EWGSOP) updated in 2018 the cut-off points for low grip strength to assess sarcopenia based on pooled data from 12 British studies. OBJECTIVE Comparison of the EWGSOP2 cut-off points for low grip strength to those derived from a large German sample. METHODS We assessed the grip strength distribution across age and derived low grip strength cut-off points for men and women (peak mean -2.5 × SD) based on 200,389 German National Cohort (NAKO) participants aged 19-75 years. In 1,012 Cooperative Health Research in the Region of Augsburg (KORA)-Age participants aged 65-93 years, we calculated the age-standardised prevalence of low grip strength and time-dependent sensitivity and specificity for all-cause mortality. RESULTS Grip strength increased in the third and fourth decade of life and declined afterwards. Calculated cut-off points for low grip strength were 29 kg for men and 18 kg for women. In KORA-Age, the age-standardised prevalence of low grip strength was 1.5× higher for NAKO-derived (17.7%) compared to EWGSOP2 (11.7%) cut-off points. NAKO-derived cut-off points yielded a higher sensitivity and lower specificity for all-cause mortality. CONCLUSIONS Cut-off points for low grip strength from German population-based data were 2 kg higher than the EWGSOP2 cut-off points. Higher cut-off points increase the sensitivity, thereby suggesting an intervention for more patients at risk, while other individuals might receive additional diagnostics/treatment without the urgent need. Research on the effectiveness of intervention in patients with low grip strength defined by different cut-off points is needed.
Collapse
Affiliation(s)
- Marie-Theres Huemer
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Beate Fischer
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Nina Ebert
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Dusseldorf, Germany
| | - Sylvia Gastell
- NAKO Study Center South Berlin/Brandenburg, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Karl-Heinz Jöckel
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany,State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Yvonne Kemmling
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Claudia Meinke-Franze
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Karin B Michels
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Ilais Moreno Velásquez
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany,Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Core Facility Biobank, Berlin, Germany,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sabine Schipf
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Börge Schmidt
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany,Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Hannah Stocker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Henning Teismann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Kerstin Wirkner
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany,Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Michael Drey
- Department of Medicine IV, University Hospital, LMU Munich, Geriatrics, 80336 Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany,German Center for Diabetes Research (DZD), München-Neuherberg, Germany,Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Barbara Thorand
- Address correspondence to: Prof. Dr. Barbara Thorand. Tel: +49 (0)89/3187-4480.
| |
Collapse
|
12
|
Huebner M, Riemann B, Hatchett A. Grip Strength and Sports Performance in Competitive Master Weightlifters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2033. [PMID: 36767396 PMCID: PMC9915202 DOI: 10.3390/ijerph20032033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Grip strength (GS) is correlated with major muscle group strength; weakness and asymmetry in older adults are predictive of future disease and functional limitation risk. GS at different ages and hand symmetry for Olympic-style weightlifters and their association with performance have not been established. GS was measured in 164 athletes participating in the 2022 World Master Weightlifting Championships. The objectives wereto study the magnitude of the age-associated decline in GS in weightlifters and the association of GS with weightlifting performance. Hand symmetry was considered as a potential factor in successful lifts. Ages ranged from 35 to 90 (mean 53 years). Participants reported weekly training averages of 8.3 h of weightlifting and 4.1 additional hours of physical activities. The age-associated decline in GS was less steep than the decline in weightlifting performance. GS was lower in weightlifters compared to athletes in other sports that require grasping or force application (t = -2.53, p=0.053 for females; t = -2.62, p= 0.029 for males). The rate of decline was similar across different populations (weightlifters, other athletes, community-dwelling adults). Height and age were associated with GS, but performance level and training hours were not. GS was associated with snatch performance (t = 3.56, p < 0.001) but not with clean and jerk (t = 0.48, p = 0.633).
Collapse
Affiliation(s)
- Marianne Huebner
- Department of Statistics and Probability, Michigan State University, East Lansing, MI 48824, USA
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA
| | - Bryan Riemann
- Department of Health Sciences and Kinesiology, Armstrong Campus-Georgia Southern University, Savannah, GA 31419, USA
| | - Andrew Hatchett
- Department of Exercise and Sport Science, Aiken-University of South Carolina, Aiken, SC 29801, USA
| |
Collapse
|
13
|
Olsen CDH, Möller S, Ahrenfeldt LJ. Sex differences in quality of life and depressive symptoms among middle-aged and elderly Europeans: results from the SHARE survey. Aging Ment Health 2023; 27:35-42. [PMID: 34915773 DOI: 10.1080/13607863.2021.2013434] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES We examine sex differences in quality of life (QoL) and depressive symptoms across age and European regions. METHODS We performed a large cross-sectional study based on 64,552 women and 53,647 men aged 50+ who participated in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Linear and logistic regression models were used to examine associations with QoL (CASP-12) and depressive symptoms (EURO-D). RESULTS Women reported slightly lower QoL (coefficient -0.78, 95% CI -0.92; -0.65) and more depressive symptoms (odds ratio (OR) 2.23, 95% CI 2.13; 2.34) than men. Sex differences in QoL increased with advancing age, whereas sex differences in depressive symptoms were stable across age groups. No overall sex difference in QoL was found in Northern Europe, but women had lower QoL than men in Western (coefficient -0.49, 95% CI -0.69; -0.29), Southern (coefficient -1.35, 95% CI -1.61; -1.09) and Eastern (coefficient -0.72, 95% CI -1.05; -0.39) Europe. However, sex differences varied within the specific CASP-12 items, with women having overall lower control and autonomy, but more self-realisation, than men. Women reported more depressive symptoms than men in all regions, with the largest overall sex difference in Southern Europe (OR 2.62, 95% CI 2.40; 2.86). A female disadvantage was found for most of the EURO-D items, with the largest sex differences for 'tearfulness', 'depression' and 'sleep'. CONCLUSION Middle-aged and elderly European women report lower QoL and more depressive symptoms than European men, lending support for the male-female health survival paradox.
Collapse
Affiliation(s)
- Camilla Dahl Haislund Olsen
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark.,The OPEN Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
14
|
Wu Z, Woods RL, Chong TT, Orchard SG, Shah RC, Wolfe R, Storey E, Sheets KM, Murray AM, McNeil JJ, Ryan J. Grip strength, gait speed, and trajectories of cognitive function in community-dwelling older adults: A prospective study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12388. [PMID: 36815873 PMCID: PMC9927855 DOI: 10.1002/dad2.12388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/08/2022] [Accepted: 11/22/2022] [Indexed: 02/16/2023]
Abstract
Introduction This study investigated whether grip strength and gait speed predict cognitive aging trajectories and examined potential sex-specific associations. Methods Community-dwelling older adults (n = 19,114) were followed for up to 7 years, with regular assessment of global function, episodic memory, psychomotor speed, and executive function. Group-based multi-trajectory modeling identified joint cognitive trajectories. Multinomial logistic regression examined the association of grip strength and gait speed at baseline with cognitive trajectories. Results High performers (14.3%, n = 2298) and low performers (4.0%, n = 642) were compared to the average performers (21.8%, n = 3492). Grip strength and gait speed were positively associated with high performance and negatively with low performance (P-values < 0.01). The association between grip strength and high performance was stronger in women (interaction P < 0.001), while gait speed was a stronger predictor of low performance in men (interaction P < 0.05). Discussion Grip strength and gait speed are associated with cognitive trajectories in older age, but with sex differences. Highlights There is inter-individual variability in late-life cognitive trajectories.Grip strength and gait speed predicted cognitive trajectories in older age.However, sex-specific associations were identified.In women, grip strength strongly predicted high, compared to average, trajectory.In men, gait speed was a stronger predictor of low cognitive performance trajectory.
Collapse
Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Robyn L. Woods
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Trevor T.‐J. Chong
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
- Department of Clinical NeurosciencesSt Vincent's HospitalMelbourneVictoriaAustralia
| | - Suzanne G. Orchard
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Rory Wolfe
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Elsdon Storey
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Kerry M. Sheets
- Department of MedicineDivision of Geriatric and Palliative MedicineHennepin HealthcareMinneapolisMinnesotaUSA
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical ResearchMinneapolisMinnesotaUSA
| | - John J. McNeil
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Joanne Ryan
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| |
Collapse
|
15
|
Fors S, Illinca S, Jull J, Kadi S, P Phillips S, Rodrigues R, Vafaei A, Zolyomi E, Rehnberg J. Cohort-specific disability trajectories among older women and men in Europe 2004-2017. Eur J Ageing 2022; 19:1111-1119. [PMID: 36692740 PMCID: PMC9729672 DOI: 10.1007/s10433-022-00684-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 01/26/2023] Open
Abstract
As the population of Europe grows older, one crucial issue is how the incidence and prevalence of disabilities are developing over time in the older population. In this study, we compare cohort-specific disability trajectories in old age across subsequent birth cohorts in Europe, during the period 2004-2017.We used data from seven waves of data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Mixed effects logistic regression models were used to model trajectories of accumulation of ADL limitations for subsequent birth cohorts of older women and men in different European regions. The results showed that there were sex differences in ADL and IADL limitations in all regions for most cohorts. Women reported more limitations than men, particularly in Eastern and Southern rather than Northern and Western Europe. Among men in Eastern, Northern and Western Europe, later born cohorts reported more disabilities than did earlier born birth cohorts at the same ages. Similar patterns were observed for women in Northern and Western Europe. In contrast, the risk of disabilities was lower in later born cohorts than in earlier born birth cohorts among women in Eastern Europe. Overall, results from this study suggest that disability trajectories in different cohorts of men and women were by and large similar across Europe. The trajectories varied more depending on sex, age and region than depending on cohort.
Collapse
Affiliation(s)
- Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Stockholm, Sweden.
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden.
| | - Stefania Illinca
- European Center for Social Welfare Policy and Research, Vienna, Austria
| | - Janet Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Selma Kadi
- European Center for Social Welfare Policy and Research, Vienna, Austria
| | - Susan P Phillips
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Ricardo Rodrigues
- European Center for Social Welfare Policy and Research, Vienna, Austria
| | - Afshin Vafaei
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Eszter Zolyomi
- European Center for Social Welfare Policy and Research, Vienna, Austria
| | - Johan Rehnberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Stockholm, Sweden
| |
Collapse
|
16
|
Trends in activities of daily living disability among Chinese older adults from 1998 to 2018: an age-period-cohort analysis. Eur J Ageing 2022; 19:1167-1179. [PMID: 36692744 PMCID: PMC9729626 DOI: 10.1007/s10433-022-00690-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 01/26/2023] Open
Abstract
This study aims to investigate the age, period, and cohort effects on trends in activities of daily living (ADL) disability among Chinese older adults; and to explore these three temporal effects on gender and residence disparities in disability. We utilized multiple cross-sectional waves of the Chinese Longitudinal Healthy Longevity Survey data (1998-2018), including 89,511 participants aged above 65 years old. Our measurement of disability is the number of ADL items (dressing, bathing, indoor transferring, toileting, eating, and continence) participants can't perform independently. Hierarchical age-period-cohort cross-classified random effects models were conducted to investigate age, period and cohort trends in ADL disability. Results showed that ADL disability increased with age at an increasing rate. A V-shaped cohort trend and a fluctuated period trend were identified. Females and urban residents were associated with more ADL limitations. When age increased, the gender and residence gaps in disability further increased. The cohort-based gender and residence inequalities in ADL limitations converged with successive cohorts. The period-based residence gap in ADL limitations diverged throughout the 20-year period, while the corresponding period-based change in gender disparity was not significant. These findings suggested that age, period, and cohort had different and independent effects on ADL disability among Chinese older adults. The age effect on trends in ADL is stronger compared to period and cohort effects. The gender and residence disparities in disability increased with age and decreased with successive cohorts. These patterns might help inform healthcare planning and the priorities for medical resource allocation accordingly.
Collapse
|
17
|
Huang J, Wang X, Zhu H, Huang D, Li W, Wang J, Liu Z. Association between grip strength and cognitive impairment in older American adults. Front Mol Neurosci 2022; 15:973700. [PMID: 36533125 PMCID: PMC9750162 DOI: 10.3389/fnmol.2022.973700] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND AND AIMS Exponential population aging has led to an increased prevalence of cognitive impairment worldwide. Hand grip strength, which may be associated with physical activity, could be a useful predictor of cognitive impairment. However, few studies have reported the association, if any, between hand grip strength and cognitive function. METHODS We used data obtained from the National Health and Nutrition Examination Survey between 2011-2012 and 2013-2014 to investigate the association between hand grip strength and cognitive impairment. Cognitive impairment was assessed using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), animal fluency (AF), and digit symbol substitution test (DSST) scores. Cutoff values of CERAD < 5, AF < 14, and DSST < 34 were used to define cognitive impairment. In this cross-sectional study, we used odds ratios to determine the potential usefulness of hand grip strength for the prediction of cognitive impairment. RESULTS This study included 2,623 participants aged ≥60 years. The DSST results showed that hand grip strength was associated with a low risk of cognitive impairment and that subgroup analysis showed that male sex, 60-69 years of age, and the Non-Hispanic (NH)-White, NH Black, and Asian were associated with a significantly low risk of cognitive impairment. The CERAD test results showed that 70-79 years of age and the NH White were significantly associated with a low risk of cognitive impairment. By following full adjustment, we did not observe statistically significant differences between hand grip strength and cognitive impairment based on the CERAD test. The AF test results showed that >80 years of age, female sex, and the NH White were associated with a significantly low risk of cognitive impairment. The most important finding is that a linear association lies between grip strength and cognitive impairment, as well as a sex-based linear association. Machine learning of the XGBoost model suggests that grip strength is one of the top two most important negative predictor variables. CONCLUSION We observed an inverse relationship between hand grip strength and cognitive impairment, which might suggest a shared underlying mechanism that needs to be further investigated using a large-scale prospective clinical trial to validate our findings.
Collapse
Affiliation(s)
- Jian Huang
- Department of Neurology, Xijing Hospital, Airforce Military Medical University, Xi'an, China
| | - Xinping Wang
- Department of Geriatrics, Air Force 986 Hospital, Xi'an, China
| | - Hao Zhu
- Department of Neurology, Xianyang First People's Hospital, Xianyang, China
| | - Dong Huang
- Department of Neurology, The Second People's Hospital of Shaanxi Province, Xi'an, China
| | - Weiwang Li
- Department of Neurology, Xi'an Daxing Hospital, Xi'an, China
| | - Jing Wang
- Department of Neurology, Xi'an First Hospital, Xi'an, China
| | - Zhirong Liu
- Department of Neurology, Xijing Hospital, Airforce Military Medical University, Xi'an, China
| |
Collapse
|
18
|
Torres Z, Oliver A, Tomás JM. Mapping Protective Performance of Social Network Types on Health and Quality of Life in Older People in European Regions. J Aging Health 2022:8982643221142078. [DOI: 10.1177/08982643221142078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives: To identify social network profiles using Latent Profile Analysis (LPA), to study the relationships of these profiles with health markers, mental health, quality of life, and cognitive functioning, and to compare profiles across European regions. Methods: 27,272 participants from the Wave 8 of the SHARE project, aged 65 or older (M = 74.95, SD = 7.17) from Europe. Statistical analyses included LPAs followed by MANOVAs to compare the profiles and the health markers. Results: Five profiles were identified: family, friends, spouse, diverse, and others. A no network group was also added. The prevalence of the specific profiles differed across European regions. Individuals with no network and those categorized into the others profile presented the worst health outcomes. Discussion: The “friends” network is more protective toward cognitive functioning and physical health and the “spouse” and “family” ones are more protective toward mental health. The variability according to European regions is discussed.
Collapse
Affiliation(s)
- Zaira Torres
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Amparo Oliver
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - José M. Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| |
Collapse
|
19
|
Huebner M, Lawrence F, Lusa L. Sex Differences in Age-Associated Rate of Decline in Grip Strength When Engaging in Vigorous Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11009. [PMID: 36078725 PMCID: PMC9518361 DOI: 10.3390/ijerph191711009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Handgrip strength (GS) is used as an indicator of overall muscle strength and health outcomes for aging adults. GS has also been evaluated as a potential link with sport performances. We quantified the age-associated decline in grip strength for males and females engaged in weekly vigorous physical activity, differentiated by body mass, and investigated whether there was an acceleration of decline at any age. The Survey of Health, Ageing and Retirement in Europe is a multinational complex panel data survey with a target population of individuals aged 50 years or older. Data from 48,070 individuals from 20 European countries, collected from 2004 to 2015, were used in multivariable regression models to study the association of age and body weight with grip strength for individuals engaged in vigorous physical activity at least once a week. The annual rate of change in GS differed for males and females; it was constant from ages 50 to 55 years and then accelerated for females, possibly due to the menopausal transition. In contrast, the decline in GS accelerates with each year of increase in age for males. Higher body mass was associated with an increase in GS, but the increase was less pronounced for older males. The increase in GS diminished with a body mass above the median even with engagement in weekly vigorous physical activities. GS reference values for individuals engaged in vigorous physical activity add to existing reference values for general populations.
Collapse
Affiliation(s)
- Marianne Huebner
- Department of Statistics and Probability, Michigan State University, East Lansing, MI 48824, USA
| | - Frank Lawrence
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI 48824, USA
| | - Lara Lusa
- Department of Mathematics, Natural Sciences and Technology, University of Primorska, 6000 Koper, Slovenia
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| |
Collapse
|
20
|
Brown MT, Mutambudzi M. Psychiatric history and later-life cognitive change: effect modification by sex, race and ethnicity. Aging Ment Health 2022:1-8. [PMID: 36016466 DOI: 10.1080/13607863.2022.2116398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objective: We explored associations between psychiatric history and cognitive functioning, and differences by sex and race/ethnicity (SRE) in 20,155 Health and Retirement Study (1995-2014) participants aged 65 or older.Methods: Multi-level growth curve models examined cognition scores and their trajectories over time by SRE.Results: A history of psychiatric, emotional, or nervous problems was significantly related to cognition scores and rates of decline. Hispanic and Black participants had significantly lower cognition scores at age 75 and steeper rates of decline than White females, and Black race and the Hispanic race/ethnicity-sex interaction erased the protective effects of being female.Conclusions: Future research should include specific psychiatric diagnoses. Population level findings as reported here, along with aggregate findings from similar studies, can inform interventions and policies regarding support for populations that are vulnerable to mental illness and to subsequent cognitive decline.
Collapse
Affiliation(s)
- Maria T Brown
- School of Social Work and Aging Studies Institute, Syracuse University, Syracuse, NY, USA
| | - Miriam Mutambudzi
- Department of Public Health, Falk College, Syracuse University, Syracuse, NY, USA
| |
Collapse
|
21
|
Wang M, Yin D, Liu L, Zhou S, Liu Q, Tian H, Wei J, Zhang K, Wang G, Chen Q, Zhu G, Wang X, Si T, Yu X, Lv X, Zhang N. Features of cognitive impairment and related risk factors in patients with major depressive disorder: A case-control study. J Affect Disord 2022; 307:29-36. [PMID: 35358550 DOI: 10.1016/j.jad.2022.03.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cognitive impairment (CI) is a common symptom contributing to functional loss in major depressive disorder (MDD). However, the features of CI and its related risk factors in young and middle-aged MDD patients remain unclear. METHODS In this case-control study, 18- to 55-year-old acute-onset MDD patients and healthy controls (HCs) were recruited from nine centers in China. MDD patients were diagnosed based on the DSM-IV, the Mini-International Neuropsychiatric Interview, and a 17-item Hamilton Rating Scale for Depression score ≥ 14. Cognitive function, including attention/vigilance, learning, memory, processing speed and executive function, was assessed with a neuropsychological battery and compared between MDD patients and HCs. MDD patients scoring 1.5 SDs below the mean HC score in at least 2 domains were defined as having CI. Logistic regression analysis was used to identify risk factors for CI in MDD patients. RESULTS Compared with HCs (n = 302), MDD patients (n = 631) showed significant impairment in all cognitive domains (P < 0.001); 168 MDD patients (26.6%) had CI. Male sex (OR: 1.712; 95% CI: 1.165-2.514; P < 0.01) was positively correlated with CI; age of first onset (OR: 0.974; 95% CI: 0.957-0.991; P < 0.05) and comorbid anxiety disorders (OR: 0.514; 95% CI: 0.332-0.797; P < 0.01) were negatively correlated with CI. LIMITATIONS Biomarkers and neuroimaging were not used to investigate the possible biological mechanism and neural basis of CI in MDD. CONCLUSIONS CI was prominent in adults with acute-onset MDD; male sex and younger age of first onset were independent risk factors, and comorbid anxiety disorders were a protective factor.
Collapse
Affiliation(s)
- Meisheng Wang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Deju Yin
- Department of Neurology, Taizhou People's Hospital, Taizhou, China
| | - Lijun Liu
- Department of Psychological Medicine, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Shuzhe Zhou
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Qi Liu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Hongjun Tian
- Nankai University Affiliated Anding Hospital, Tianjin Mental Health Center, Tianjin, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Gang Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Qiaoling Chen
- Department of Psychiatry, Dalian Seventh People's Hospital, Dalian, China
| | - Gang Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Xueyi Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Mental Health Institute of Hebei Medical University, Shijiazhuang, China
| | - Tianmei Si
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xin Yu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaozhen Lv
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.
| | - Nan Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
| |
Collapse
|
22
|
Wang X, Bai Z, He Y, Wu Q. Relationship between blood amyloid A and resting magnetic resonance functional brain connections in patients with obstructive sleep apnea-hypopnea syndrome. Sleep Breath 2022; 27:477-485. [PMID: 35503197 DOI: 10.1007/s11325-022-02613-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the relationship between serum amyloid A (SAA) concentrations in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their magnetic resonance imaging (MRI) of resting brain function. METHODS Male patients with OSAHS were enrolled from January to June 2019 in Suzhou Ninth People's Hospital Affiliated to Soochow University, and nineteen healthy male volunteers were selected as the normal control group. The patients with OSAHS were divided into mild, moderate, and severe groups according to their apnea-hypopnea index (AHI). Early in the morning after the polysomnography (PSG), blood samples were collected and serum levels of serum amyloid A (SAA) were measured by enzyme-linked immunosorbent assay. All subjects were scored by the Auditory Verbal Learning Test (AVLT) scale. Resting brain function images of healthy male volunteers and patients in the severe group were collected by 3.0 T magnetic resonance scanner. SPSS25.0 software was used for statistical analysis. RESULTS The SAA of the OSAHS group (n = 43) were higher than those of control group (n = 19). The scores of AVLT-immediate and AVLT-delay in the severe OSAHS group were lower than those in the control group (P < 0.05), and it was negatively correlated with SAA. In the severe OSAHS group, the rest state Function Connection (rsFC) in temporal lobe, marginal lobe, and frontal lobe was lower than that in the control group (P < 0.05) and was significantly negatively correlated with SAA. The rsFC in bilateral parietal lobes was higher than that in the control group (P < 0.05), was significantly positively correlated with SAA, and was negatively correlated with AVLT-delay. CONCLUSIONS The significant increase in SAA concentration in patients with OSAHS correlated with brain rsFC intensity, providing a reference role for the diagnosis, treatment, and prognosis of cognitive dysfunction in patients with OSAHS.
Collapse
Affiliation(s)
- Xiang Wang
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China
| | - Zhiyu Bai
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China
| | - Yaqing He
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China
| | - Qiaozhen Wu
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China.
| |
Collapse
|
23
|
Srivastava S, Muhammad T, Paul R, Thomas AR. Multivariate decomposition analysis of sex differences in functional difficulty among older adults based on Longitudinal Ageing Study in India, 2017-2018. BMJ Open 2022; 12:e054661. [PMID: 35487710 PMCID: PMC9058763 DOI: 10.1136/bmjopen-2021-054661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study investigates the gender disparities in difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) and explores its contributing factors among older adults in India. DESIGN A cross-sectional study was conducted using country representative survey data. SETTING AND PARTICIPANTS The present study uses the data from the Longitudinal Ageing Study in India, 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India. PRIMARY AND SECONDARY OUTCOME MEASURES Difficulty in ADL and IADL were the outcome variables. Descriptive statistics and bivariate analysis were carried out to present the preliminary results. Multivariate decomposition analysis was used to identify the contributions of covariates that explain the group differences to average predictions. RESULTS There was a significant gender differential in difficulty in ADL (difference: 4.6%; p value<0.001) and IADL (difference: 17.3%; p value<0.001). The multivariate analysis also shows significant gender inequality in difficulty in ADL (coefficient: 0.046; p value<0.001) and IADL (coefficient: 0.051; p value<0.001). The majority of the gender gap in difficulty in ADL was accounted by the male-female difference in levels of work status (18%), formal education (15% contribution), marital status (13%), physical activity (9%), health status (8%) and chronic morbidity prevalence (5%), respectively. Equivalently, the major contributors to the gender gap in difficulty in IADL were the level of formal education (28% contribution), marital status (10%), alcohol consumption (9%), health status (4% contribution) and chronic morbidity prevalence (2% contribution). CONCLUSION Due to the rapidly increasing ageing population, early detection and prevention of disability or preservation of daily functioning for older adults and women in particular should be the highest priority for physicians and health decision-makers.
Collapse
Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Ronak Paul
- International Institute for Population Sciences, Mumbai, Maharashtra, India
| | | |
Collapse
|
24
|
Geyer S, Kuhlmann BG, Beller J, Grasshoff J. The role of school education in time-dependent changes of cognitive abilities in cohorts from midlife to old age. Aging Ment Health 2022; 27:729-735. [PMID: 35486386 DOI: 10.1080/13607863.2022.2068132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES It is examined whether older adults' cognitive ability in terms of delayed recall and verbal fluency is improving over time, whether this occurs over all educational levels and both sexes, and whether these changes are due to increasing proportions of individuals with higher education. METHODS Analyses are based on the German samples of the Survey on Health, Ageing and Retirement in Europe (waves 2004 and 2013). RESULTS Achievement levels increased over time and in all age groups. Improvements over educational levels occurred in parallel, differences between educational levels in the earlier survey were later reproduced at higher levels. Increasing proportions of individuals with higher education did not explain improvements of cognitive ability. No sex differences emerged. CONCLUSION Improved cognitive abilities could not be explained by upward shifts of educational levels. Improvements in higher age groups may foster improved health status and prolonged self-determined life in the older population.
Collapse
Affiliation(s)
- Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | - Beatrice G Kuhlmann
- Chair of Cognitive Psychology and Cognitive Aging, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Johannes Beller
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | - Julia Grasshoff
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany.,Central Institute of Mental Health, Mannheim, Germany
| |
Collapse
|
25
|
Oluwagbemigun K, Schnermann ME, Schmid M, Cryan JF, Nöthlings U. A prospective investigation into the association between the gut microbiome composition and cognitive performance among healthy young adults. Gut Pathog 2022; 14:15. [PMID: 35440044 PMCID: PMC9019932 DOI: 10.1186/s13099-022-00487-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/17/2022] [Indexed: 12/14/2022] Open
Abstract
Background There is emerging evidence that the gut microbiome composition is associated with several human health outcomes, which include cognitive performance. However, only a few prospective epidemiological studies exist and none among young adults. Here we address the gap in the literature by investigating whether the gut microbiome composition is prospectively linked to fluid intelligence among healthy young adults. Methods Forty individuals (65% females, 26 years) from the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study provided a fecal sample for gut microbiome composition and subsequently (average of 166 days) completed a cognitive functioning test using the Cattell’s Culture Fair Intelligence Test, revised German version (CFT 20-R). The assessment of the gut microbiome at the genera level was by 16S rRNA V3-V4 Illumina sequencing. The relative abundance of 158 genera was summarized into bacterial communities using a novel data-driven dimension reduction, amalgamation. The fluid intelligence score was regressed on the relative abundance of the bacterial communities and adjusted for selected covariates. Results The 158 genera were amalgamated into 12 amalgams (bacterial communities), which were composed of 18, 6, 10, 14, 8, 10, 16, 13, 12, 12, 3, and 11 genera. Only the 14-genera bacterial community, named the “Ruminococcaceae- and Coriobacteriaceae-dominant community” was positively associated with fluid intelligence score (β = 7.8; 95% CI: 0.62, 15.65, P = 0.04). Conclusion Among healthy young adults, the abundance of a gut bacterial community was associated with fluid intelligence score. This study suggests that cognitive performance may potentially benefit from gut microbiome-based intervention.
Collapse
Affiliation(s)
- Kolade Oluwagbemigun
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany.
| | - Maike E Schnermann
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| |
Collapse
|
26
|
Development in life expectancy with good and poor cognitive function in the elderly European Population from 2004-05 to 2015. Eur J Epidemiol 2022; 37:495-502. [PMID: 35394581 DOI: 10.1007/s10654-022-00860-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Living not just longer, but also cognitively healthier, and more independent lives is essential if European countries are to cope with the financial challenges that the shifting age composition of Europe's population presents. Here we investigate the change in life expectancy (LE) spent with good and poor cognitive function among older adults across Europe. METHODS LE with good/poor cognitive function was estimated by the Sullivan Method. Cross-sectional data on cognitive functioning was obtained from 23,213 (wave 1, 2004-05) and 40,874 (wave 6, 2015) 50+-year-olds of the Survey of Health, Ageing and Retirement in Europe (SHARE). Information on mortality was obtained from the Eurostat Database. Results for 70+-year-olds were emphasized. RESULTS LE with good cognitive function increased with 1.6 years from 10.7 years (95% CI: 10.6-10.9) in 2004-05 to 12.4 years (95% CI: 12.3-12.5) in 2015 for 70+-year-olds. Disparity was observed across sex and region. In 2004-05, a 70+-year-old woman could expect to spend 30.9% (95% CI: 29.4-32.4) of her remaining LE with poor cognitive function compared to 27.7% (95% CI: 26.0 -29.4) for men. In 2015, women (24.4% (95% CI: 23.4-25.3)) had considerably caught up with men (24.8% (95% CI:23.7.25.8)), shifting the pattern in favor of women. In 2004-05 and 2015, Northern Europeans had the lowest LE with poor cognitive function while Southern Europeans had the highest, but made the most improvement during the period. CONCLUSIONS Overall we find that LE with poor cognitive function has been compressed in the European population of 70+-year-olds.
Collapse
|
27
|
Herold SC, Hvidt NC, Möller S, Christensen K, Ahrenfeldt LJ. Is Religiousness Associated with Better Lifestyle and Health Among Danes? Findings from SHARE. JOURNAL OF RELIGION AND HEALTH 2022; 61:1621-1640. [PMID: 32488829 DOI: 10.1007/s10943-020-01050-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Evidence of a possible association between religion and health in secular societies is sparse. We therefore conducted a nationwide study using data from 1596 Danes aged 50 + who participated in the Survey of Health, Ageing and Retirement in Europe (SHARE) wave 1 (2004-2005) and were followed up between 2006 and 2015, to investigate the association between religiousness and health including a lifestyle index. Results from the longitudinal models adjusted for age and gender showed that being religiously educated by parents, taking part in a religious organization, and praying were factors associated with fewer risk factors of unhealthy lifestyle. Furthermore, being religiously educated was associated with lower odds of self-rated poor health and depressive symptoms. Results were overall consistent across the cross-sectional and longitudinal models and persisted after further adjustment for education and marital status. These findings provide support for a positive relationship between religiousness and health among Danes, particularly for those being religiously educated by their parents.
Collapse
Affiliation(s)
- Steffen Christensen Herold
- Research Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, 5000, Odense, Denmark
| | - Sören Möller
- OPEN - Odense Patient Data Explorative Network, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark
| | - Kaare Christensen
- Research Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark
- Department of Clinical Biochemistry, Odense University Hospital, 5000, Odense, Denmark
- Pharmacology and Department of Clinical Genetics, Odense University Hospital, 5000, Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Research Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark.
| |
Collapse
|
28
|
Association of Physical Activity With Cognitive Function Among Older Adults in Rural Sichuan, China. J Aging Phys Act 2022; 31:482-488. [DOI: 10.1123/japa.2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to explore the relationship between total physical activity and different dimensions of cognitive function (orientation, attention, and memory) among older adults in rural Sichuan, China. This cross-sectional study involved 715 older adults (average age of 72 years). Total PA was measured by the Physical Activity Scale for the Elderly, and cognitive function was assessed by the Telephone Interview for Cognitive Status (TICS) questionnaire. The multivariate linear regression analysis indicated that total PA and household PA were significantly associated with the overall Telephone Interview for Cognitive Status score (β = 0.143, p < .001; β = 0.115, p = .002, respectively), the orientation dimension (β = 0.142, p < .001; β = 0.131, p = .001, respectively), and the memory dimension (β = 0.179, p < .001; β = 0.134, p = .001, respectively). The study showed a positive association between total PA, household PA, and cognitive function in older adults, especially in the orientation dimension and the memory dimension of cognitive function.
Collapse
|
29
|
Cooper R, Shkolnikov VM, Kudryavtsev AV, Malyutina S, Ryabikov A, Arnesdatter Hopstock L, Johansson J, Cook S, Leon DA, Strand BH. Between-study differences in grip strength: a comparison of Norwegian and Russian adults aged 40-69 years. J Cachexia Sarcopenia Muscle 2021; 12:2091-2100. [PMID: 34605224 PMCID: PMC8718040 DOI: 10.1002/jcsm.12816] [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] [Received: 01/06/2021] [Revised: 08/03/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Identifying individuals with low grip strength is an initial step in many operational definitions of sarcopenia. As evidence indicates that contemporaneous Russian populations may have lower mean levels of grip strength than other populations in northern Europe, we aimed to: compare grip strength in Russian and Norwegian populations by age and sex; investigate whether height, body mass index, education, smoking status, alcohol use and health status explain observed differences and; examine implications for case-finding low muscle strength. METHODS We used harmonized cross-sectional data on grip strength and covariates for participants aged 40-69 years from the Russian Know Your Heart study (KYH) (n = 3833) and the seventh survey of the Norwegian Tromsø Study (n = 5598). Maximum grip strength (kg) was assessed using the same protocol and device in both studies. Grip strength by age, sex and study was modelled using linear regression and between-study differences were predicted from these models. Sex-specific age-standardized differences in grip strength and in prevalence of low muscle strength were estimated using the European population standard of 2013. RESULTS Normal ranges of maximum grip strength in both studies combined were 33.8 to 67.0 kg in men and 18.7 to 40.1 kg in women. Mean grip strength was higher among Tromsø than KYH study participants and this difference did not vary markedly by age or sex. Adjustment for covariates, most notably height, attenuated between-study differences but these differences were still evident at younger ages. For example, estimated between-study differences in mean grip strength in fully adjusted models were 2.2 kg [95% confidence interval (CI) 1.4, 3.1] at 40 years and 1.0 kg (95% CI 0.5, 1.5) at 65 years in men (age × study interaction P = 0.09) and 1.1 kg (95% CI 0.4, 1.9) at age 40 years and -0.2 kg (95% CI -0.7, 0.3) at 65 years in women (age × study interaction P < 0.01). CONCLUSIONS We found between-study differences in mean grip strength that are likely to translate into greater future risk of sarcopenia and poorer prospects of healthy ageing for Russian than Norwegian study participants. For example, the average Russian participant had a similar level of grip strength to a Norwegian participant 7 years older. Our findings suggest these differences may have their origins in childhood highlighting the need to consider interventions in early life to prevent sarcopenia.
Collapse
Affiliation(s)
- Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research CentreManchester Metropolitan UniversityManchesterUK
| | - Vladimir M. Shkolnikov
- International Laboratory for Population and HealthNational Research University Higher School of EconomicsMoscowRussia
- Laboratory of Demographic DataMax Planck Institute for Demographic ResearchRostockGermany
| | - Alexander V. Kudryavtsev
- Northern State Medical UniversityArkhangelskRussian Federation
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and GeneticsSiberian Branch of Russian Academy of SciencesNovosibirskRussia
- Novosibirsk State Medical UniversityNovosibirskRussia
| | - Andrew Ryabikov
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and GeneticsSiberian Branch of Russian Academy of SciencesNovosibirskRussia
- Novosibirsk State Medical UniversityNovosibirskRussia
| | | | - Jonas Johansson
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Sarah Cook
- Faculty of Epidemiology and Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - David A. Leon
- International Laboratory for Population and HealthNational Research University Higher School of EconomicsMoscowRussia
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
- Faculty of Epidemiology and Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
| | - Bjørn Heine Strand
- Norwegian Institute of Public HealthOsloNorway
- Norwegian National Advisory Unit on Ageing and HealthVestfold Hospital TrustTønsbergNorway
- Department of Geriatric MedicineOslo University HospitalOsloNorway
| |
Collapse
|
30
|
Arokiasamy P, Selvamani Y, Jotheeswaran AT, Sadana R. Socioeconomic differences in handgrip strength and its association with measures of intrinsic capacity among older adults in six middle-income countries. Sci Rep 2021; 11:19494. [PMID: 34593926 PMCID: PMC8484588 DOI: 10.1038/s41598-021-99047-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/20/2021] [Indexed: 12/18/2022] Open
Abstract
Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity-a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO's Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.
Collapse
Affiliation(s)
- P Arokiasamy
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India
| | - Y Selvamani
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India.
| | - A T Jotheeswaran
- Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Ritu Sadana
- Head, Ageing and Health, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| |
Collapse
|
31
|
Scheel-Hincke LL, Ahrenfeldt LJ, Andersen-Ranberg K. Sex differences in activity and health changes following COVID-19 in Europe - Results from the SHARE COVID-19 survey. Eur J Public Health 2021; 31:1281-1284. [PMID: 34406382 PMCID: PMC8436396 DOI: 10.1093/eurpub/ckab096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
While a female advantage in the overall survival from the coronavirus disease 2019 (COVID-19) has been demonstrated, potential sex differences in health changes are not investigated. In a sample of 21 395 men and 29 139 women aged 50+ from the SHARE COVID-19 survey, we investigated sex differences in social activities, self-rated health and mental health following the COVID-19 outbreak. We found considerable sex differences in all European regions with women experiencing larger negative changes across all social activities and health measures than men lending support for the male–female health-survival paradox.
Collapse
Affiliation(s)
- Lasse L Scheel-Hincke
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, 5000, Denmark)
| | - Linda J Ahrenfeldt
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, 5000, Denmark)
| | - Karen Andersen-Ranberg
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, 5000, Denmark).,Department of Geriatric Medicine, Odense University Hospital, Odense, 5000, Denmark).,Department of Clinical Research, University of Southern Denmark, Odense, 5000, Denmark)
| |
Collapse
|
32
|
Aandstad A. Reference data on anthropometrics, aerobic fitness and muscle strength in young Norwegian men and women. Eur J Appl Physiol 2021; 121:3189-3200. [PMID: 34390403 PMCID: PMC8505311 DOI: 10.1007/s00421-021-04784-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/05/2021] [Indexed: 12/16/2022]
Abstract
Purpose Anthropometrics, aerobic fitness and muscle strength are measured in one-third of all 18-year-old Norwegian men and women during yearly selection for compulsory military service. The large sample size and geographical representativity make these data valuable for reference. The main purpose of this study was to present reference data for anthropometrics and physical fitness in young Norwegian men and women. Methods All 154,659 subjects (66% men and 34% women, 17–21 years old) who completed physical examinations at conscript selection from 2011 to 2019 were included in the study. Body mass index (BMI) was calculated from height and weight measurements. Peak oxygen uptake (VO2peak) was estimated from performance on a maximal treadmill test. Muscle strength was measured by isometric chest and leg press, or seated medicine ball throw, standing long jump and pull-ups. Results Mean BMI (SD) was 23.1 (3.4) and 22.9 (3.3) kg·m−2 in men and women, respectively (P < 0.001), and 24% of men and 21% of women had a BMI ≥ 25 kg·m−2. Estimated VO2peak was 52.9 (4.6) and 42.7 (3.9) mL·kg−1·min−1 in men and women, respectively (P < 0.001). Men performed significantly better than women on all muscle strength tests, with corresponding effect sizes varying from 1.14 for isometric leg press to 2.96 for seated medicine ball throw. Conclusion The presented reference data on physical fitness in young Norwegian men and women can be used to evaluate population health, serve as reference material for future studies and describes sex differences in several physical fitness parameters. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-021-04784-4.
Collapse
Affiliation(s)
- Anders Aandstad
- Section for Military Leadership and Sport, Norwegian Defence University College, P.O. Box 1550 Sentrum, N-0015, Oslo, Norway.
| |
Collapse
|
33
|
Nielsen CR, Ahrenfeldt LJ, Jeune B, Christensen K, Lindahl-Jacobsen R. Healthy life expectancy by frailty state in Europe from 2004 to 2015: findings from SHARE. Eur J Public Health 2021; 31:554-560. [PMID: 33615329 PMCID: PMC8485734 DOI: 10.1093/eurpub/ckab012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As populations age, the possible consequences of increased frailty are a major concern for the health sector. Here, we investigate how life expectancy with and without frailty has changed during a 10-11-year-period across Europe. METHODS The Sullivan method was used to investigate changes in life expectancy with and without frailty in 10 European countries. Frailty status (non-frail, pre-frail and frail) was determined by use of the Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI). Data on frailty prevalence was obtained from 21 698 individuals in wave 1 (2004-05) and 38 859 individuals in wave 6 (2015) of the SHARE. Information on mortality was obtained from the Eurostat Database. RESULTS In 2015, women aged 70 spent 25.0% (95% CI: 24.0-26.1) of their remaining life expectancy in a frail state, and the number for men was 11.5% (95% CI: 10.7-12.3). Southern Europeans spent 24.2% (95% CI: 22.9-25.4) of their remaining life expectancy in a frail state and the numbers for Central Europeans and Northern Europeans were 17.0% (95% CI: 16.0-17.9) and 12.2% (95% CI: 10.9-13.5), respectively. From 2004-05 to 2015, life expectancy increased by 1.1 years (from 15.3 to 16.4 years) for 70-year-old Europeans. Similarly, non-frail life expectancy increased by 1.1 years (95% CI: 0.8-1.4), whereas no significant changes in life expectancy in frail states were observed. CONCLUSIONS This study suggests that Europeans today spend more years in a non-frail state than Europeans did 10-11 years ago. Our findings reflect a considerable inequality by gender and region.
Collapse
Affiliation(s)
- Camilla Riis Nielsen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Interdisiciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Bernard Jeune
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Interdisiciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
34
|
Lee D, Son T. Structural connectivity differs between males and females in the brain object manipulation network. PLoS One 2021; 16:e0253273. [PMID: 34115811 PMCID: PMC8195422 DOI: 10.1371/journal.pone.0253273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
Object control skills are one of the most important abilities in daily life. Knowledge of object manipulation is an essential factor in improving object control skills. Although males and females equally try to use object manipulation knowledge, their object control abilities often differ. To explain this difference, we investigated how structural brain networks in males and females are differentially organized in the tool-preferring areas of the object manipulation network. The structural connectivity between the primary motor and premotor regions and between the inferior parietal regions in males was significantly higher than that in females. However, females showed greater structural connectivity in various regions of the object manipulation network, including the paracentral lobule, inferior parietal regions, superior parietal cortices, MT+ complex and neighboring visual areas, and dorsal stream visual cortex. The global node strength found in the female parietal network was significantly higher than that in males but not for the entire object manipulation, ventral temporal, and motor networks. These findings indicated that the parietal network in females has greater inter-regional structural connectivity to retrieve manipulation knowledge than that in males. This study suggests that differential structural networks in males and females might influence object manipulation knowledge retrieval.
Collapse
Affiliation(s)
- Dongha Lee
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
- * E-mail:
| | - Taekwon Son
- Korea Brain Bank, Korea Brain Research Institute, Daegu, Republic of Korea
| |
Collapse
|
35
|
Ahrenfeldt LJ, Möller S. The Reciprocal Relationship between Socioeconomic Status and Health and the Influence of Sex: A European SHARE-Analysis Based on Structural Equation Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095045. [PMID: 34068750 PMCID: PMC8126237 DOI: 10.3390/ijerph18095045] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 01/19/2023]
Abstract
It is well recognized that socioeconomic status (SES) is an important determinant of health, but many studies fail to address the possibility of reverse causation. We aim to investigate the reciprocal relationship between trajectories of SES and health, and how these associations differ by sex. We performed a longitudinal study including 29,824 men and 37,263 women aged 50+ participating in at least two consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using structural equation modeling, we found that baseline household income and wealth led to improvements in cognitive function, grip strength, quality of life and depressive symptoms, and a better initial health led to higher income and wealth for both sexes. However, the results indicated that the relative effect of cognitive function and grip strength on SES trajectories was overall greater than the corresponding effect of SES on health changes, particularly regarding income among women, but for quality of life and depressive symptoms, the reverse was indicated, though most pronounced for the associations with wealth. The reciprocal associations between SES and physical function were stronger for men than for women, whereas most associations with cognitive function and mental health were similar between sexes. This study demonstrates that both social causation and health selection contribute to social inequalities in health, but the influence of each direction and the importance of sex differences may vary according to the health outcomes investigated.
Collapse
Affiliation(s)
- Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
- Correspondence: ; Tel.: +45-6550-3844
| | - Sören Möller
- OPEN–Open Patient Data Explorative Network, Odense University Hospital, 5000 Odense, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| |
Collapse
|
36
|
Abstract
OBJECTIVES One's personal social network constitutes a contextual framing factor for late-life cognitive function. This study examined the association between network type at baseline and changes in three cognitive measures: immediate recall, delayed recall, and fluency, two years hence, among Europeans aged 50 and older. PARTICIPANTS Data were taken from Waves four and five of the Survey of Health, Ageing, and Retirement in Europe of adults aged 50 and above (N = 50,071). MEASUREMENTS The latent class analysis was applied to a set of criterion variables. The procedure yielded five distinct network types: multi-tie (6%), family-rich (23%), close-family (49%), family-poor (12%), and friend-enhanced (10%). The network types were then regressed on the cognition measures at follow-up, controlling for the respective baseline cognition scores, as well as for age, gender, education, self-rated health, mobility difficulty, and country. RESULTS Respondents in family-poor network types had poorer cognition scores at follow-up, compared to those in the modal close-family network, while those in multi-tie networks had consistently better scores. The family-rich network and the friend-enhanced network also had a somewhat better cognitive function. CONCLUSIONS Having varied sources of network ties, e.g. friendship ties and/or several types of family relationships, is beneficial to the cognitive health of older adults over time. Networks based mainly on ties with relatives other than spouse and children, on the other hand, have poorer cognitive outcomes. Older people in this latter group face an increased risk for cognitive decline and should receive assistance in enhancing their interpersonal environments.
Collapse
|
37
|
Zhang L, Liu S, Li Y, Li S, Wu Y. Associations of Sleep Quality with Gait Speed and Falls in Older Adults: The Mediating Effect of Muscle Strength and the Gender Difference. Gerontology 2021; 68:1-7. [PMID: 33895741 DOI: 10.1159/000514894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Although previous studies have reported the significant associations of sleep quality with gait speed and falls, the mechanisms underlying these associations are unclear. We aimed to examine the gender-specific associations of sleep quality with gait speed and falls among older adults and to explore the possible mediating effect of muscle strength on these relationships. METHODS Data were taken from wave 6 (2012-2013) of the English Longitudinal Study of Aging (ELSA), including 7,664 participants aged 60 years and older. Sleep quality and falls were assessed by self-report. Gait speed was measured by the "timed walking test" and then adjusted by height. As an indicator of overall muscle strength, grip strength was measured by using the Smedley dynamometer. Baron and Kenny's causal steps and the Karlson/Holm/Breen method were used to examine the mediating effect. RESULTS Higher sleep quality was associated with the higher level of gait speed (β = 0.008, p = 0.031 in men; β = 0.008, p = 0.017 in women) and with lower prevalence of falls (OR = 0.878, 95% CI: 0.773, 0.998 in men; OR = 0.874, 95% CI: 0.792, 0.965 in women). Grip strength mediated these associations in men but not in women, and the mediating effects of grip strength can explain 23.74 and 11.01% of the total effect of sleep quality on gait speed and falls, respectively. CONCLUSION Our findings help explain the mechanism underlying the associations of sleep quality with gait speed and falls. Effort to maintain the mobility of the older men should focus on improving both sleep quality and muscle strength.
Collapse
Affiliation(s)
- Li Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Shuqin Liu
- Department of Emergency, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yujie Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Suyun Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| |
Collapse
|
38
|
Burden and prevalence of risk factors for severe COVID-19 in the ageing European population - a SHARE-based analysis. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:2081-2090. [PMID: 33868899 PMCID: PMC8036158 DOI: 10.1007/s10389-021-01537-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/30/2021] [Indexed: 01/08/2023]
Abstract
Aim International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aimed to describe the distribution of these risk factors across Europe. Subject and methods Prevalence of risk factors for severe COVID-19 was identified based on interviews from 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results A total of 75.3% of the study population (corresponding to approx. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (approx. 36 million men and 43 million women) had at least two factors, and 21.2% (approx. 17 million men and 20 million women) had at least three risk factors. The prevalence of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions Information about the prevalence of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 and thus to decide appropriate strategies to mitigate the pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-021-01537-7.
Collapse
|
39
|
Ahrenfeldt LJ, Otavova M, Christensen K, Lindahl-Jacobsen R. Sex and age differences in COVID-19 mortality in Europe. Wien Klin Wochenschr 2021; 133:393-398. [PMID: 33351155 PMCID: PMC7755064 DOI: 10.1007/s00508-020-01793-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/30/2020] [Indexed: 01/08/2023]
Abstract
AIM To examine the magnitude of sex differences in survival from the coronavirus disease 2019 (COVID-19) in Europe across age groups and regions. We hypothesized that men have a higher mortality than women at any given age but that sex differences will decrease with age as only the healthiest men survive to older ages. METHODS We used population data from the Institut National D'Études Démographiques on cumulative deaths due to COVID-19 from February to June 2020 in 10 European regions: Denmark, Norway, Sweden, The Netherlands, England and Wales, France, Germany, Italy, Spain and Portugal. For each region, we calculated cumulative mortality rates stratified by age and sex and corresponding relative risks for men vs. women. RESULTS The relative risk of dying from COVID-19 was higher for men than for women in almost all age groups in all regions. The overall relative risk ranged from 1.11 (95% confidence interval, CI 1.01-1.23) in Portugal to 1.54 (95% CI 1.49-1.58) in France. In most regions, sex differences increased until the ages of 60-69 years, but decreased thereafter with the smallest sex difference at age 80+ years. CONCLUSION Despite variability in data collection and time coverage among regions, the study showed an overall similar pattern of sex differences in COVID-19 mortality in Europe.
Collapse
Affiliation(s)
- Linda Juel Ahrenfeldt
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark.
| | - Martina Otavova
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark
- Interdisciplinary Center on Population Dynamics, University of Southern Denmark, 5000, Odense, Denmark
| | - Kaare Christensen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, 5000, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark
- Interdisciplinary Center on Population Dynamics, University of Southern Denmark, 5000, Odense, Denmark
| |
Collapse
|
40
|
Kim J, Lee M, Dan H. Gender Differences in Factors Affecting Life Satisfaction of the Elderly with Multimorbidity in Korea. NURSING REPORTS 2021; 11:54-63. [PMID: 34968312 PMCID: PMC8608087 DOI: 10.3390/nursrep11010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/24/2021] [Accepted: 01/28/2021] [Indexed: 12/21/2022] Open
Abstract
To enhance the life satisfaction of the elderly with multimorbidity, it is necessary to investigate the relevant factors and to examine the differences in factors according to gender. The aim of this study was to identify factors affecting life satisfaction of the elderly with multimorbidity in the community by gender in Korea. We analyzed data from 2140 participants with multimorbidity who were aged 65 or older and participated in the Korean Longitudinal Study of Ageing (KLoSA) in 2016. A multivariate linear regression analysis was conducted to examine the factors affecting life satisfaction among male and female older participants with multimorbidity. The most common pattern of multimorbidity of women was hypertension and arthritis/rheumatism, while that of men was hypertension and diabetes mellitus. Some factors, such as depression, exercise, and number of chronic diseases, affected both male and female participants, but others related to life satisfaction varied by gender. Therefore, it is necessary to consider the characteristics of multiple chronic diseases, and policy support should be provided in consideration of gender differences to improve the life satisfaction of the elderly.
Collapse
Affiliation(s)
- Jeonghyun Kim
- College of Nursing, Ewha Womans University, Seoul 03760, Korea;
| | - Minkyung Lee
- Infectious Disease Department, Weill Cornell Medicine, New York, NY 10065, USA;
| | - Hyunju Dan
- College of Nursing, Ewha Womans University, Seoul 03760, Korea;
- Correspondence:
| |
Collapse
|
41
|
Zupo R, Griseta C, Battista P, Donghia R, Guerra V, Castellana F, Lampignano L, Bortone I, Lozupone M, Giannelli G, De Pergola G, Boeing H, Sardone R, Panza F. Role of plant-based diet in late-life cognitive decline: results from the Salus in Apulia Study. Nutr Neurosci 2021; 25:1300-1309. [PMID: 33448914 DOI: 10.1080/1028415x.2020.1853416] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Consistency among population-based studies investigating the relationship between diet and cognition in older inhabitants in the Mediterranean area is poor. The present study investigated whether diet changes over 12 years were associated with cognitive function in older people in Southern-Italy. METHODS From the 'Salus in Apulia Study', that includes the MICOL and GreatAGE Studies, 584 participants were selected, firstly enrolled in MICOL3 (M3) and later in the GreatAGE Study (MICOL4, M4). Foods and micronutrients intake were recorded in both studies, and global cognitive function in M4, assessed with the Mini Mental State Examination. RESULTS Plant-based foods, particularly coffee and vegetables, as well as vitamin A sources, were inversely associated to age-related cognitive impairment. Alcohol consumption showed a detrimental role on cognition, while red meat appeared to be beneficial in the present study, although its role is traditionally considered harmful for cognitive function. DISCUSSION Our study confirmed that a traditional Mediterranean dietary pattern based on agricultural products and low alcohol consumption may help to prevent/delay age-related cognitive impairment.
Collapse
Affiliation(s)
- Roberta Zupo
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Chiara Griseta
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | | | - Rossella Donghia
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy.,Unit of Epidemiology and Biostatistics, National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Vito Guerra
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy.,Unit of Epidemiology and Biostatistics, National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Fabio Castellana
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Luisa Lampignano
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Ilaria Bortone
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Madia Lozupone
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy.,Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Giovanni De Pergola
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy.,Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Heiner Boeing
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy.,Department of Epidemiology (closed), German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Rodolfo Sardone
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| | - Francesco Panza
- Healthy Aging Phenotypes Research Unit - 'Salus in Apulia Study' - National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Bari, Italy
| |
Collapse
|
42
|
Yu B, Steptoe A, Niu K, Jia X. Social Isolation and Loneliness as Risk Factors for Grip Strength Decline Among Older Women and Men in China. J Am Med Dir Assoc 2020; 21:1926-1930. [DOI: 10.1016/j.jamda.2020.06.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/03/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022]
|
43
|
Ahrenfeldt LJ, Nielsen CR, Möller S, Christensen K, Lindahl-Jacobsen R. Burden and prevalence of risk factors for severe COVID-19 disease in the ageing European population - A SHARE-based analysis. RESEARCH SQUARE 2020:rs.3.rs-73657. [PMID: 32935092 PMCID: PMC7491580 DOI: 10.21203/rs.3.rs-73657/v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Aim: International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aim to describe the distribution of these risk factors across Europe. Subject and Methods: Prevalence of risk factors for severe COVID-19 was identified based on interview for 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results: A total of 75.3% of the study population (corresponding to app. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (app. 36 million men and 43 million women) had at least two factors and 21.2% (app. 17 million men and 20 million women) had at least three risk factors. The prevalences of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions: Information about the prevalences of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 disease and thus to decide appropriate strategies to mitigate the pandemic.
Collapse
|
44
|
Bae SM. The association between health-related factors, physical and mental diseases, social activities, and cognitive function in elderly Koreans: a population-based cross-sectional study. Psychogeriatrics 2020; 20:654-662. [PMID: 32567147 DOI: 10.1111/psyg.12561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/01/2020] [Accepted: 04/24/2020] [Indexed: 11/27/2022]
Abstract
AIM The purpose of this study was to verify the association of cognitive function with health-related variables, diseases, and social activities. METHODS Data from the 2016 Korean Longitudinal Study of Aging were analyzed. The participants of that study were 5678 adults aged 60 years or older living in 17 major Korean regions nationwide. RESULTS Hierarchical multiple regression analyses indicated that gender, age, education, marital status, depressive symptoms, body mass index, regular exercise, activities of daily living, instrumental activities of daily living, hand grip strength, and social activities were all significantly associated with cognitive function in elderly Koreans. However, socioeconomic status, diabetes, smoking, alcohol consumption, attendance at school reunions, volunteer work, and participation in political or civic organizations had no impact on cognitive function. First, the results indicated that men had better cognitive function than women; likewise, married individuals and those with a higher level of education also had better cognitive function. As age increased, cognitive function declined. Second, higher body mass index was related to poorer cognitive function, whereas regular exercise was positively associated with better cognitive function. In addition, higher activities of daily living and instrumental activities of daily living scores were associated with poorer cognitive function. Third, depressive symptoms were negatively associated with cognitive function. Finally, religious activities, social activities, and participation in leisure activities, cultural events, and sports were associated with better cognitive functioning. The possibility of reverse association exists between some of the variables (e.g. religious activity and cognitive function), and it is necessary to verify this possibility through a longitudinal study. The biggest limitation is that this is a cross-sectional study, which made it unfeasible to investigate the causal pathways. CONCLUSIONS This study suggests that regularly exercising and attending social activities each help to improve cognitive function in the elderly.
Collapse
Affiliation(s)
- Sung-Man Bae
- Department of Psychology and Psychotherapy, College of Health Science, Dankook University, Cheonan, Chungnam, South Korea
| |
Collapse
|
45
|
Douma JAJ, Verdonck-de Leeuw IM, Leemans CR, Jansen F, Langendijk JA, Baatenburg de Jong RJ, Terhaard CHJ, Takes RP, Chinapaw MJ, Altenburg TM, Buffart LM. Demographic, clinical and lifestyle-related correlates of accelerometer assessed physical activity and fitness in newly diagnosed patients with head and neck cancer. Acta Oncol 2020; 59:342-350. [PMID: 31608747 DOI: 10.1080/0284186x.2019.1675906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Objective measurements of levels of physical activity and fitness in patients with head and neck cancer (HNC) are lacking. Furthermore, demographic, clinical and lifestyle-related correlates of low levels of physical activity and fitness in patients with HNC are unknown. This study aims to investigate the levels of accelerometer that assessed physical activity and fitness in patients with HNC and to identify their demographical, clinical and lifestyle-related correlates.Methods: Two hundred and fifty-four patients who were recently diagnosed with HNC and participated in the NETherlands QUality of life and Biomedical cohort studies In head and neck Cancer (NET-QUBIC) study were included. Physical activity (accelerometer), cardiorespiratory fitness (Chester Step Test), hand grip strength (hand dynamometer) and lower body muscle function (30-second chair-stand test) were assessed. Multivariable linear regression analyses with a stepwise forward selection procedure were used.Results: Patients spent 229 min/d in physical activity of which 18 min/d in moderate-to-vigorous physical activity. The mean predicted VO2max was 27.9 ml/kg/min, the mean hand grip strength was 38.1 kg and the mean number of standings was 14.3. Patients with lower educational level, more comorbidity and higher tumor stage spent significantly less time in physical activity. Older patients, females and patients with a higher tumor stage had significantly lower cardiorespiratory fitness levels. Older patients, females, patients with more comorbidity, patients with normal weight and patients who have never smoked had significantly lower hand grip strength. Older patients, patients with lower educational level, smokers and patients with more comorbidity had a significantly lower function of lower body muscle.Conclusions: Pre-treatment levels of physical activity, cardiorespiratory fitness and lower body muscle function are low in patients with HNC. Based on this study, exercise programs targeted and tailored to patients with low levels of physical activity and fitness can be developed.
Collapse
Affiliation(s)
- J. A. J. Douma
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - I. M. Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Section Clinical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - C. R. Leemans
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - F. Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Section Clinical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - J. A. Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R. J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, ErasmusMC, ErasmusMC Cancer Centre, Rotterdam, The Netherlands
| | - C. H. J. Terhaard
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R. P. Takes
- Department of Otorhinolaryngology & Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M. J. Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - T. M. Altenburg
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - L. M. Buffart
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| |
Collapse
|
46
|
Ahrenfeldt LJ, Pedersen JK, Thinggaard M, Christensen K, Lindahl-Jacobsen R. Sex differences in health and mortality by income and income changes. J Epidemiol Community Health 2019; 74:225-231. [PMID: 31844031 DOI: 10.1136/jech-2019-213096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/27/2019] [Accepted: 11/28/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The adverse association between income, health and survival is well documented, but little is known about how income trajectories influence health and survival for men and women. We aim to investigate sex differences in mortality and hospitalisations by income and income changes. METHODS We performed a population-based, nationwide study including 1 063 787 Danes born 1935-1955 and residing in Denmark during 1980-2015. Income was calculated during two age intervals: 45-49 and 55-59 years. The average income was divided into quartiles for men and women separately, which formed the basis for the income trajectories. Individuals were followed up from age 60 until 2014/2015 for hospital admission and mortality, respectively. RESULTS Men had higher mortality and were more hospitalised than women. Sex differences in mortality were most pronounced for people with stable low income (relative difference in hazard=1.93; 95% CI 1.89 to 1.98) and a downward income trajectory (1.91; 95% CI 1.85 to 1.98) with smaller sex differences for people with an upward trajectory (1.59; 95% CI 1.56 to 1.62) and stable high income (1.37; 95% CI 1.33 to 1.41). A similar pattern was found for family income. Regarding hospitalisations, similar results were found, though less pronounced. Investigation of mortality and hospitalisations by all possible trajectories demonstrated that income at ages 55-59 was an important predictor of mortality, with increasing mortality for decreasing income quartile. CONCLUSION Income trajectories as a proxy for change in social position have a larger influence on men's than women's health and mortality. Income in the late 50s is an important predictor of mortality, particularly for men.
Collapse
Affiliation(s)
- Linda Juel Ahrenfeldt
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jacob Krabbe Pedersen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mikael Thinggaard
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Clinical Genetics, Odense University Hospital, Odense, Denmark.,Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
47
|
Ahrenfeldt LJ, Möller S, Thinggaard M, Christensen K, Lindahl-Jacobsen R. Sex Differences in Comorbidity and Frailty in Europe. Int J Public Health 2019; 64:1025-1036. [PMID: 31236603 PMCID: PMC7237816 DOI: 10.1007/s00038-019-01270-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 06/07/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To examine sex differences in prevalent comorbidity and frailty across age and European regions. METHODS This is a cross-sectional study based on 113,299 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe from 2004-2005 to 2015. Sex differences in the Comorbidity Index and the Frailty Phenotype were investigated using ordinal logistic regressions. RESULTS European women had generally higher odds of prevalent comorbidity (OR 1.11, 95% CI 1.07-1.15) and frailty (OR 1.56, 95% CI 1.51-1.62). Sex differences increased with advancing age. No overall sex difference in comorbidity was found in Western Europe, but women had more comorbidity than men in Eastern (OR 1.30, 95% CI 1.18-1.44), Southern (OR 1.23, 95% CI 1.15-1.30), and Northern (OR 1.08, 95% CI 1.01-1.16) Europe. Women were frailer than men in all regions, with the largest sex difference in Southern Europe (OR 1.84, 95% CI 1.72-1.96). CONCLUSIONS European women are frailer and have slightly more comorbidity than European men lending support for the male-female health survival paradox.
Collapse
Affiliation(s)
- Linda Juel Ahrenfeldt
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark.
| | - Sören Möller
- OPEN - Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mikael Thinggaard
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| |
Collapse
|
48
|
Scheel-Hincke LL, Möller S, Lindahl-Jacobsen R, Jeune B, Ahrenfeldt LJ. Cross-national comparison of sex differences in ADL and IADL in Europe: findings from SHARE. Eur J Ageing 2019; 17:69-79. [PMID: 32158373 DOI: 10.1007/s10433-019-00524-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Women experience greater longevity than men, but have poorer health, although sex differences vary across health measures and geographical regions. We aim to examine sex differences in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) over age across European regions in a cross-sectional setting including 51,292 men and 62,007 women aged 50+ from a pooled sample of waves 1 (2004-2005) to 6 (2015) in the Survey of Health, Ageing and Retirement in Europe. ADL and IADL were dichotomised into no limitations and at least one limitation. Binomial regression models were used to estimate absolute and relative sex differences. Women had higher risk than men of ADL limitations (RR = 1.21, 95% CI 1.16; 1.27) and IADL limitations (RR = 1.54, 95% CI 1.48; 1.60), corresponding to risk differences of 1.3% and 5.7%, respectively. When we stratified by age groups and regions, sex differences in ADL were found in all age groups in Southern Europe, in the age groups 65-79 years and 80+ years in Western and Eastern Europe, and from the age of 80 in Northern Europe. For IADL, sex differences were found in all age groups in the four European regions, except from ages 50-64 in Eastern Europe. The absolute sex differences increased with age in all European regions. In conclusion, our results lend support for the male-female health survival paradox by showing that European women have higher risk of ADL and IADL limitations than European men and that sex differences increase with advancing age.
Collapse
Affiliation(s)
- Lasse Lybecker Scheel-Hincke
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Sören Möller
- 2OPEN - Odense Patient data Explorative Network, Odense University Hospital, 5000 Odense, Denmark.,3Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Rune Lindahl-Jacobsen
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Bernard Jeune
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Linda Juel Ahrenfeldt
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| |
Collapse
|