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Yang Q, Zhang Z, He P, Mao X, Jing X, Hu Y, Jing L. LC/MS-Based Untargeted Lipidomics Reveals Lipid Signatures of Sarcopenia. Int J Mol Sci 2024; 25:8793. [PMID: 39201479 PMCID: PMC11354784 DOI: 10.3390/ijms25168793] [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: 07/10/2024] [Revised: 07/27/2024] [Accepted: 07/29/2024] [Indexed: 09/02/2024] Open
Abstract
Sarcopenia, a multifactorial systemic disorder, has attracted extensive attention, yet its pathogenesis is not fully understood, partly due to limited research on the relationship between lipid metabolism abnormalities and sarcopenia. Lipidomics offers the possibility to explore this relationship. Our research utilized LC/MS-based nontargeted lipidomics to investigate the lipid profile changes as-sociated with sarcopenia, aiming to enhance understanding of its underlying mechanisms. The study included 40 sarcopenia patients and 40 control subjects matched 1:1 by sex and age. Plasma lipids were detected and quantified, with differential lipids identified through univariate and mul-tivariate statistical analyses. A weighted correlation network analysis (WGCNA) and MetaboAna-lyst were used to identify lipid modules related to the clinical traits of sarcopenia patients and to conduct pathway analysis, respectively. A total of 34 lipid subclasses and 1446 lipid molecules were detected. Orthogonal partial least squares discriminant analysis (OPLS-DA) identified 80 differen-tial lipid molecules, including 38 phospholipids. Network analysis revealed that the brown module (encompassing phosphatidylglycerol (PG) lipids) and the yellow module (containing phosphati-dylcholine (PC), phosphatidylserine (PS), and sphingomyelin (SM) lipids) were closely associated with the clinical traits such as maximum grip strength and skeletal muscle mass (SMI). Pathway analysis highlighted the potential role of the glycerophospholipid metabolic pathway in lipid me-tabolism within the context of sarcopenia. These findings suggest a correlation between sarcopenia and lipid metabolism disturbances, providing valuable insights into the disease's underlying mechanisms and indicating potential avenues for further investigation.
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Affiliation(s)
| | | | | | | | | | | | - Lipeng Jing
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China; (Q.Y.); (Z.Z.); (P.H.); (X.M.); (X.J.); (Y.H.)
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Enroth L, Halonen P, Tiainen K, Raitanen J, Jylhä M. Cohort profile: The Vitality 90+ Study-a cohort study on health and living conditions of the oldest old in Tampere, Finland. BMJ Open 2023; 13:e068509. [PMID: 36750290 PMCID: PMC9906174 DOI: 10.1136/bmjopen-2022-068509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
PURPOSE Vitality 90+ is an ongoing population-based study with repeated cross-sectional data collections. The study was designed to examine trends in health, functioning, living conditions, quality of life and care needs among the oldest old in Finland. PARTICIPANTS Nine mailed surveys have been conducted in the city of Tampere between 1995 and 2018. The first three surveys in 1995, 1996 and 1998 included all community-dwelling individuals aged 90 years or older; and the following six surveys in 2001, 2003, 2007, 2010, 2014 and 2018 covered all individuals in Tampere regardless of their living arrangements. In total, the surveys have included 5935 participants (8840 observations). Around 80% of the participants have been women. The participants' age range has been between 90 and 107 years. FINDINGS TO DATE The surveys have consistently asked the same questions over time, covering basic sociodemographic factors, morbidity, functioning, self-rated health (SRH), living arrangements, social relations, quality of life, care needs and providers of care. Survey data have been linked with national register data on health and social service use, mortality and medication. The main findings regarding the time trends show an increase in the proportion of people independent in activities of daily living and mobility. Along with improved functioning, the number of chronic conditions has increased, and SRH has shown a tendency to decline. In addition, we have found increasing occupational class inequalities in functioning and SRH over time. FUTURE PLANS The next round of data collection will be completed by the end of 2022. The Vitality 90+ Study welcomes research collaborations that fall within the general aims of the project. The research data 1995-2014 are archived at the Finnish Social Science Data Archive and the data for years 2018 and 2022 will be archived in 2023.
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Affiliation(s)
- Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Kristina Tiainen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
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Gender and physical frailty modify the association between abdominal obesity and functional disability in older adults. Aging Clin Exp Res 2022; 34:2013-2021. [PMID: 35752721 DOI: 10.1007/s40520-022-02167-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/26/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Abdominal obesity is associated with functional disability in older adults. AIM We evaluated whether this association was modified by gender and/or physical frailty. METHODS We used cross-sectional data from 12,583 participants in the third follow-up of the population-based Singapore Chinese Health Study, when participants had mean age of 74 years (range 63-97). Abdominal obesity was defined using waist circumference, physical frailty was established using the modified Cardiovascular Health Study phenotype, and functional disability was determined by the Lawton Instrumental Activities of Daily Living Scale. We used logistic regression models to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between abdominal obesity and disability. RESULTS Abdominal obesity was associated with increased likelihood of functional disability, and this association was stronger in women than in men [OR (95% CI): 1.27 (1.11-1.46) vs. 1.08 (0.93-1.25); P for interaction < 0.001]. Furthermore, there was a significantly stronger association between abdominal obesity and functional disability in participants who were physically frail compared to those who were not [OR (95% CI): 1.57 (1.19-2.08) vs. 1.11 (0.99-1.23); P for interaction = 0.003], and this phenomenon was observed in both genders. When compared to participants who were neither abdominally obese nor physically frail, participants who were both abdominally obese and physically frail had a synergistically increased risk of functional disability [OR (95% CI): 3.61 (3.03-4.30)]. CONCLUSIONS Women with abdominal obesity had higher risk of functional disability compared to men, and older adults who were both abdominally obese and physically frail had a synergistically increased risk of disability.
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Hajek A, Kretzler B, König HH. Prevalence and correlates of obesity among the oldest old. A systematic review, meta-analysis and meta-regression. Geriatr Gerontol Int 2022; 22:373-383. [PMID: 35362258 DOI: 10.1111/ggi.14382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/14/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
Thus far, the prevalence and correlates of obesity among the oldest have been identified in several studies. Nevertheless, there is a lack of a systematic review, meta-analysis and meta-regression synthesizing the existing observational studies. Consequently, our aim was to fill this knowledge gap. Three electronic databases were searched (Medline, PsycINFO, CINAHL) and an additional hand search was performed. Observational studies (both, cross-sectional and longitudinal) determining the prevalence and (preferably) the correlates of obesity in the oldest old (≥80 years) were included. Data extraction covered study design, measurement of obesity, analytical approach, sample characteristics and main results. In total, 19 studies were included. Reported prevalence of obesity in the community varied greatly (range 0.7%-71.5%). The pooled prevalence of obesity was 17.8% (95% CI: 13.3%-22.2%), with significant heterogeneity between studies (I2 = 99.7%, P < 0.001). There is evidence of a publication bias. Meta-regressions showed that some of the heterogeneity was explained by the types of measures of obesity and country of the respective sample. In conclusion, obesity remains a key challenge among the oldest old. Future research in this age bracket is urgently required in regions mostly neglected thus far (e.g., South America, Africa or Asia). Moreover, studies based on longitudinal data are required to clarify the determinants of obesity among the oldest old. Furthermore, studies based on objectively recorded obesity (e.g., waist circumference) are also required. Geriatr Gerontol Int 2022; 22: 373-383.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Runzer-Colmenares FM, Gutierrez GAE, Yance-Cacñahuaray G, Chambergo-Michilot D, Falvy-Bockos I, Vidal-Neira LF. Association Between Hip-Waist Ratio and Physical Performance in Older Adults. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/11566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chua KY, Lin X, Wang Y, Chong YS, Lim WS, Koh WP. Visceral fat area is the measure of obesity best associated with mobility disability in community dwelling oldest-old Chinese adults. BMC Geriatr 2021; 21:282. [PMID: 33910516 PMCID: PMC8082923 DOI: 10.1186/s12877-021-02226-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 01/23/2023] Open
Abstract
Background Although obesity can be clinically defined by body mass index (BMI), waist circumference, percent body fat, or visceral fat area, it is unclear which specific measure is best associated with mobility disability in oldest-old adults. Methods Among 589 Chinese participants aged 85 years and older in a population-based cohort in Singapore, we measured waist circumference, computed BMI, estimated appendicular skeletal muscle mass, percent body fat, and visceral fat area using bioelectrical impedance analysis, and evaluated mobility disability using the Loco-Check questionnaire. We computed areas under the receiver operating characteristic curves (AUCROC) to compare how well these measures discriminated between those with and without mobility disability. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between obesity defined by these measures and mobility disability. Results Compared to BMI, which had an AUCROC (95% CI) of 0.68 (0.64–0.72) for the discrimination of mobility disability, only visceral fat area had a significantly higher discriminative performance [AUCROC (95% CI) of 0.71 (0.67–0.75) (Padjusted = 0.002)]. The optimal cut-offs of visceral fat area for the discrimination of mobility disability were ≥ 104 cm2 in men and ≥ 137 cm2 in women. In fully adjusted models, only obesity defined by visceral fat area was significantly associated with mobility disability [OR (95% CI) of 2.04 (1.10–3.77)]; obesity defined by the other measures were not associated with mobility disability after adjusting for visceral fat. Conclusion In oldest-old adults, visceral fat area was the best discriminator for obesity associated with mobility disability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02226-6.
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Affiliation(s)
- Kevin Yiqiang Chua
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Xinyi Lin
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.,Singapore Clinical Research Institute, Singapore, Singapore
| | - Yeli Wang
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Wee-Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Dodds RM, Murray JC, Granic A, Hurst C, Uwimpuhwe G, Richardson S, Brayne C, Matthews FE, Sayer AA. Prevalence and factors associated with poor performance in the 5-chair stand test: findings from the Cognitive Function and Ageing Study II and proposed Newcastle protocol for use in the assessment of sarcopenia. J Cachexia Sarcopenia Muscle 2021; 12:308-318. [PMID: 33463015 PMCID: PMC8061374 DOI: 10.1002/jcsm.12660] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/08/2020] [Accepted: 11/24/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Poor performance in the 5-chair stand test (5-CST) indicates reduced lower limb muscle strength. The 5-CST has been recommended for use in the initial assessment of sarcopenia, the accelerated loss of muscle strength and mass. In order to facilitate the use of the 5-CST in sarcopenia assessment, our aims were to (i) describe the prevalence and factors associated with poor performance in the 5-CST, (ii) examine the relationship between the 5-CST and gait speed, and (iii) propose a protocol for using the 5-CST. METHODS The population-based study Cognitive Function and Ageing Study II recruited people aged 65 years and over from defined geographical localities in Cambridgeshire, Newcastle, and Nottingham. The study collected data for assessment of functional ability during home visits, including the 5-CST and gait speed. We used multinomial logistic regression to assess the associations between factors including the SARC-F questionnaire and the category of 5-CST performance: fast (<12 s), intermediate (12-15 s), slow (>15 s), or unable, with slow/unable classed as poor performance. We reviewed previous studies on the protocol used to carry out the 5-CST. RESULTS A total of 7190 participants aged 65+ from the three diverse localities of Cognitive Function and Ageing Study II were included (54.1% female). The proportion of those with poor performance in the 5-CST increased with age, from 34.3% at age 65-69 to 89.7% at age 90+. Factors independently associated with poor performance included positive responses to the SARC-F questionnaire, physical inactivity, depression, impaired cognition, and multimorbidity (all P < 0.005). Most people with poor performance also had slow gait speed (57.8%) or were unable to complete the gait speed test (18.4%). We found variation in the 5-CST protocol used, for example, timing until a participant stood up for the fifth time or until they sat down afterwards. CONCLUSIONS Poor performance in the 5-CST is increasingly common with age and is associated with a cluster of other factors that characterize risk for poor ageing such as physical inactivity, impaired cognition, and multimorbidity. We recommend a low threshold for performing the 5-CST in clinical settings and provide a protocol for its use.
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Affiliation(s)
- Richard Matthew Dodds
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - James C Murray
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Antoneta Granic
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Christopher Hurst
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Germaine Uwimpuhwe
- Department of Anthropology, Durham University, Durham, UK.,Durham Research Methods Centre, Durham University, Durham, UK
| | - Sarah Richardson
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Carol Brayne
- Cambridge Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Avan A Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
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Kuzuya M. Nutritional status related to poor health outcomes in older people: Which is better, obese or lean? Geriatr Gerontol Int 2020; 21:5-13. [PMID: 33200583 DOI: 10.1111/ggi.14088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 12/30/2022]
Abstract
Good nutritional status is crucial for maintaining growth and health in all stages of life. However, the relationship between nutritional status and health and the effect on various health-related outcomes differ, depending on the life stage. Many adverse outcomes in older adults, directly linked to different nutritional status, are not present in middle-aged adults, and their ideal nutritional status may differ. This article will review the optimal nutritional status, mainly evaluated by anthropometric measurements such as body mass index, for older adults from various perspectives. Overall, in older adults low body mass index is at higher risk of health problems such as mortality and difficulties in physical functioning compared with middle-aged adults, reducing the risk of health problems for overweight and (abdominal) obesity. Overweight may be more beneficial than lower level of normal weight in older-old and vulnerable older people. While, with or without obesity, skeletal muscle loss or weakness as well as unintentional weight loss induces health problems in older adults. The impact of metabolic syndrome on the prognosis of older adults is clearly reduced compared with middle-aged adults, requiring a shift in medical attention in older adults from metabolic syndrome to frailty. There are still many unclear points regarding the optimal nutritional status of older people, and further research is needed to support healthy longevity. Geriatr Gerontol Int 2021; 21: 5-13.
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Affiliation(s)
- Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
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Prevalence Of, and Factors Associated with, Obesity among the Oldest Old. A Study Protocol for a Systematic Review. Healthcare (Basel) 2020; 8:healthcare8030319. [PMID: 32899708 PMCID: PMC7551968 DOI: 10.3390/healthcare8030319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 11/17/2022] Open
Abstract
Some empirical studies have identified the prevalence of, and factors associated with, obesity among the oldest old. However, there is a lack of a systematic review synthesizing the existing evidence. Therefore, the purpose of our upcoming systematic review is to provide an overview of the evidence provided by observational studies. The current paper presents the protocol for this systematic review. We will search four electronic databases (Medline, PsycINFO, CINAHL, and Cochrane Library). Furthermore, we will perform a manual search (searching reference lists of included studies). Cross-sectional and longitudinal observational studies identifying the prevalence and preferably the factors associated with obesity among the oldest old (80 years and over) will be included. Data extraction will concentrate on study design, assessment of obesity and its associated factors, statistical analysis, sample characteristics, and key findings. We will evaluate the quality of the included studies. Two individuals will perform study selection, data extraction, and evaluation of study quality. We will present the results in figures, summary tables and narrative summaries. If data permits, a meta-analysis will be conducted.
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Hajek A, Brettschneider C, van der Leeden C, Lühmann D, Oey A, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Röhr S, Löbner M, Mösch E, Bickel H, Heser K, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Prevalence and factors associated with obesity among the oldest old. Arch Gerontol Geriatr 2020; 89:104069. [PMID: 32413689 DOI: 10.1016/j.archger.2020.104069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE To determine the prevalence of overweight and obesity, and to identify factors associated with obesity, among the oldest old. METHODS For this study, data from follow-up (FU) wave 7 and FU wave 8 of the "Study on Needs, Health Service Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary Care Patients (85+)" (AgeQualiDe) were used. At FU wave 7, the mean age was 88.9 years (SD: 2.9; 85-100 years). Body-mass-index (BMI) categories were defined according to the World Health Organization (WHO) thresholds: underweight (BMI < 18.5 kg/m²), normal weight (18.5 kg/m² ≤ BMI < 25 kg/m²), overweight (25 kg/m² ≤ BMI < 30 kg/m²), and obesity (BMI ≥ 30 kg/m²). Longitudinal regression analysis was used to determine factors associated with obesity. RESULTS At FU wave 7, 3.0 % were underweight, 48.9 % were normal weight, 37.9 % were overweight, and 10.2 % were obese. Regressions showed that the probability of obesity decreased with age (OR: 0.77 [95 % CI: .593-.999]) and less chronic conditions (OR: 1.32 [95 % CI: 1.11-1.57]). The probability of obesity was not associated with sex, educational level, marital status, social isolation, visual impairment, hearing impairment, depression, and dementia. CONCLUSION Nearly half of the individuals in very late life had excess weight. Thus, excess weight remains a major challenge, even in very old age. Given the demographic ageing in upcoming decades, this is an issue which we should be aware of.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
| | - Carolin van der Leeden
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
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Escourrou E, Durrieu F, Chicoulaa B, Dupouy J, Oustric S, Andrieu S, Gardette V. Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review. BMC FAMILY PRACTICE 2020; 21:58. [PMID: 32220228 PMCID: PMC7099824 DOI: 10.1186/s12875-020-01128-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 03/18/2020] [Indexed: 11/23/2022]
Abstract
Background The oldest old (individuals over 90 years) are a fast-growing population. Characterizing their specificity would be helpful to adapt health care. This study aimed to characterize the cognitive, functional, nutritional, and physical status of individuals over 90. Methods We conducted a systematic review of cross-sectional or cohort studies of individuals aged 90 years old or more, living at home or in a nursing home, in April 2018. Two reviewers selected eligible articles, extracted data, and evaluated the risk of bias (assessed by the Newcastle-Ottawa Scale). Results The search strategy identified 3086 references; 35 articles were included referring to 8 cross-sectional and 27 longitudinal studies. Dementia was diagnosed in 30–42.9% of study participants, cognitive impairment in 12–50%, and 31–65% had no cognitive impairment. In terms of activities of daily living, 14–72.6% of individuals had no difficulty, 35.6–38% had difficulty, and 14.4–55.5% were dependent. For instrumental activities of daily living, 20–67.9% needed help. Regarding nutritional status, the Mini Nutritional Assessment Short Form mean score ranged from 10.3 (SD: 1.8) to 11.1 (SD: 2.4). Eight to 32% of individuals could not stand up from a chair, 19–47% could stand without the use of their arms; and 12.9–15% were not able to walk 4 m. Conclusions These results suggest a heterogeneous population with a certain proportion of oldest old with a low level of disability. These findings suggest that a specific approach in the care of the oldest old could help prevent disability.
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Affiliation(s)
- Emile Escourrou
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France. .,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France. .,Maison de Santé Pluri Professionnelle Universitaire La Providence, 1 avenue Louis Blériot, 31500, Toulouse, France.
| | - Florence Durrieu
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Bruno Chicoulaa
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Julie Dupouy
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France.,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Stéphane Oustric
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France.,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Maison de Santé Pluri Professionnelle Universitaire La Providence, 1 avenue Louis Blériot, 31500, Toulouse, France
| | - Sandrine Andrieu
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Service d'épidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Virginie Gardette
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Service d'épidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
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12
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Baker JF, Long J, Leonard MB, Harris T, Delmonico MJ, Santanasto A, Satterfield S, Zemel B, Weber DR. Estimation of Skeletal Muscle Mass Relative to Adiposity Improves Prediction of Physical Performance and Incident Disability. J Gerontol A Biol Sci Med Sci 2019; 73:946-952. [PMID: 28958026 DOI: 10.1093/gerona/glx064] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/29/2017] [Indexed: 12/21/2022] Open
Abstract
Purpose We assessed the discrimination of lean mass estimates that have been adjusted for adiposity for physical functioning deficits and prediction of incident disability. Methods Included were 2,846 participants from the Health, Aging and Body Composition Study with available whole-body dual energy absorptiometry measures of appendicular lean mass index (ALMI, kg/m2) and fat mass index (FMI, kg/m2). Age-, sex-, and race-specific Z-Scores and T-Scores were determined by comparison to published reference ranges. ALMI values were adjusted for FMI (ALMIFMI) using a novel published method. Sex-stratified analyses assessed associations between lean mass estimates and the physical performance score, ability to complete a 400-meter walk, grip strength, and incident disability. Dichotomized definitions of low lean for age and sarcopenia were examined and their performance compared to the ALM-to-BMI ratio. Results Compared to ALMI T-Scores and Z-Scores, the ALMIFMI scores demonstrated stronger associations with physical functioning, and were similarly associated with grip strength. Greater FMI Z-Scores and T-Scores were associated with poor physical functioning and incident disability. Definitions of low lean for age and sarcopenia using ALMIFMI (compared to ALMI) better discriminated those with poor physical functioning and a greater risk of incident disability. The ALM-to-BMI ratio was modestly associated with grip strength and physical performance, but was not associated with completion of the 400-meter walk or incident disability, independent of adiposity and height. Conclusion Estimation of skeletal muscle mass relative to adiposity improves correlations with physical performance and prediction of incident disability suggesting it is an informative outcome for clinical studies.
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Affiliation(s)
- Joshua F Baker
- Division of Rheumatology, Philadelphia Veterans Affairs Medical Center, Pennsylvania.,School of Medicine, University of Pennsylvania, Philadelphia.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia
| | - Jin Long
- Department of Pediatrics and Medicine, Stanford University, California
| | - Mary B Leonard
- Department of Pediatrics and Medicine, Stanford University, California
| | - Tamara Harris
- Laboratory of Epidemiology and Population Sciences, National Institute of Aging, Bethesda, Maryland
| | - Matthew J Delmonico
- Department of Kinesiology, University of Rhode Island, Kingston.,Health Science Center, University of Tennessee, Memphis
| | - Adam Santanasto
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Suzanne Satterfield
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Pennsylvania
| | - Babette Zemel
- Department of Kinesiology, University of Rhode Island, Kingston
| | - David R Weber
- Health Science Center, University of Tennessee, Memphis.,Division of Endocrinology and Diabetes, Golisano Children's Hospital, University of Rochester, New York
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13
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14
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Lv YB, Yuan JQ, Mao C, Gao X, Yin ZX, Kraus VB, Luo JS, Chen HS, Zeng Y, Wang WT, Wang JN, Shi XM. Association of Body Mass Index With Disability in Activities of Daily Living Among Chinese Adults 80 Years of Age or Older. JAMA Netw Open 2018; 1:e181915. [PMID: 30646143 PMCID: PMC6324469 DOI: 10.1001/jamanetworkopen.2018.1915] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging. OBJECTIVE To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older. DESIGN, SETTING, AND PARTICIPANTS Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014. MAIN OUTCOMES AND MEASURES Disability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence. RESULTS Among the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P < .001 for trend). When BMI was categorized by Chinese guidelines, the underweight group (BMI <18.5) showed significantly increased risk of disability in ADL (hazard ratio, 1.34; 95% CI, 1.28-1.41) and the overweight or obese group (BMI ≥24.0) showed significantly decreased risk of disability in ADL (hazard ratio, 0.84; 95% CI, 0.78-0.91) compared with the normal weight group (BMI 18.5 to <24.0) (P < .001 for trend). CONCLUSIONS AND RELEVANCE Higher BMI was associated with a lower risk of disability in ADL among Chinese adults age 80 years or older, which suggests that current recommendations for BMI may need to be revisited. More attention should be paid on underweight, rather than overweight or obesity, for the prevention of disability in ADL after age 80 years.
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Affiliation(s)
- Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin-Qiu Yuan
- Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, Philadelphia
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Shuai Chen
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
- Center for Study of Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Wen-Tao Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiao-Nan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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15
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Goins RT, Schure M, Jensen PN, Suchy-Dicey A, Nelson L, Verney SP, Howard BV, Buchwald D. Lower body functioning and correlates among older American Indians: The Cerebrovascular Disease and Its Consequences in American Indians Study. BMC Geriatr 2018; 18:6. [PMID: 29304750 PMCID: PMC5756432 DOI: 10.1186/s12877-017-0697-8] [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] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 12/19/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND More than six million American Indians live in the United States, and an estimated 1.6 million will be aged ≥65 years old by 2050 tripling in numbers since 2012. Physical functioning and related factors in this population are poorly understood. Our study aimed to assess lower body functioning and identify the prevalence and correlates of "good" functioning in a multi-tribe, community-based sample of older American Indians. METHODS Assessments used the Short Physical Performance Battery (SPPB). "Good" lower body functioning was defined as a total SPPB score of ≥10. Potential correlates included demographic characteristics, study site, anthropometrics, cognitive functioning, depressive symptomatology, grip strength, hypertension, diabetes mellitus, heart disease, prior stroke, smoking, alcohol use, and over-the-counter medication use for arthritis or pain. Data were collected between 2010 and 2013 by the Cerebrovascular Disease and Its Consequences in American Indians Study from community-dwelling adults aged ≥60 years (n = 818). RESULTS The sample's mean age was 73 ± 5.9 years. After adjustment for age and study site, average SPPB scores were 7.0 (95% CI, 6.8, 7.3) in women and 7.8 (95% CI, 7.5, 8.2) in men. Only 25% of the sample were classified with "good" lower body functioning. When treating lower body functioning as a continuous measure and adjusting for age, gender, and study site, the correlates of better functioning that we identified were younger age, male gender, married status, higher levels of education, higher annual household income, Southern Plains study site, lower waist-hip ratio, better cognitive functioning, stronger grip strength, lower levels of depressive symptomatology, alcohol consumption, and the absence of hypertension, diabetes mellitus, and heart disease. In our fully adjusted models, correlates of "good" lower body functioning were younger age, higher annual household income, better cognitive functioning, stronger grip, and the absence of diabetes mellitus and heart disease. CONCLUSIONS These results suggest that "good" lower body functioning is uncommon in this population, whereas its correlates are similar to those found in studies of other older adult populations. Future efforts should include the development or cultural tailoring of interventions to improve lower body functioning in older American Indians.
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Affiliation(s)
- R. Turner Goins
- College of Health and Human Sciences, Western Carolina University, 3971 Little Savannah Road, Cullowhee, NC 28723 USA
| | - Mark Schure
- Community Health, Montana State University, 305 Herrick Hall, Bozeman, MT 59717 USA
| | - Paul N. Jensen
- Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 USA
| | - Astrid Suchy-Dicey
- College of Medicine, Initiative for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
| | - Lonnie Nelson
- College of Nursing, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
| | - Steven P. Verney
- Department of Psychology, University of New Mexico, Logan Hall, MSC03-2220, 1 University of New Mexico, Albuquerque, NM 87131-0001 USA
| | - Barbara V. Howard
- MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, 6525 Belcrest Road, Suite 700, Hyattsville, MD 20782 USA
| | - Dedra Buchwald
- College of Medicine, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
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16
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Ozturk GZ, Egici MT, Bukhari MH, Toprak D. Association between body mass index and activities of daily living in homecare patients. Pak J Med Sci 2017; 33:1479-1484. [PMID: 29492082 PMCID: PMC5768848 DOI: 10.12669/pjms.336.13748] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective Overweight or obesity may cause many chronic illnesses. Furthermore, several studies have shown that high body mass index is associated with mortality and morbidity among the elderly. Therefore, obesity or being overweight could adversely affect the performance of activities of daily living. In this study our aim was to investigate the association between Body Mass Index and Activity of Daily Living in Homecare Patients. Method The records of 2016 from the homecare unit of Sisli Hamidiye Etfal Training and Research Hospital were retrospectively reviewed. During this period, 1105 patients visited this facility. Unconscious or bedridden patients (hemiplegia, hemiparesia, and tetraparesis) and patients with incomplete data were excluded from the study. Therefore, the survey was completed with 250 files, which included all the data needed for our research. Age, gender, Body Mass Index and Barthel Index scores were recorded to the statistical program; p≤0.05 was considered as statistically significant. Results One hundred fifty one (60.4%) were women, and 99 (39.6%) were men. The relations between gender and age, weight, and Barthel index scores were not statistically significant. There was a significant positive correlation between weight and Barthel index scores as well as between Body Mass Index and Barthel index scores (r = 0.190; p = 0.003). The patients were divided into two groups: Group-I (underweight and normal weight) and Group-II (overweight and obese). Group-II exhibited a much higher ability to perform Activity of Daily Living than Group-I (p = 0.002). Conclusion Some studies report that obesity is protective against Activity of Daily Living, but the opposite is reported in some others. Our study showed increased values of Body Mass Index and Activity of Daily Living ability, which are indicative of protective effects. The relationship between Body Mass Index and physical disability is not yet proven to be linear.
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Affiliation(s)
- Guzin Zeren Ozturk
- Guzin Zeren Ozturk, Family Medicine Specialist, Sisli Hamidiye Etfal Training and Research Hospital, Family Medicine Clinic, Istanbul, Turkey
| | - Memet Taskın Egici
- Memet Taskın Egici, Family Medicine Specialist, Sisli Hamidiye Etfal Training and Research Hospital, Family Medicine Clinic, Istanbul, Turkey
| | - Mulazim Hussain Bukhari
- Mulazim Hussain Bukhari, HOD, Department of Pathology, University of Lahore, Lahore - Pakistan
| | - Dilek Toprak
- Dilek Toprak, Associate Professor, Family Medicine, Sisli Hamidiye Etfal Training and Research Hospital, Family Medicine Clinic, Istanbul, Turkey
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17
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Shaw SC, Dennison EM, Cooper C. Epidemiology of Sarcopenia: Determinants Throughout the Lifecourse. Calcif Tissue Int 2017; 101:229-247. [PMID: 28421264 PMCID: PMC5544114 DOI: 10.1007/s00223-017-0277-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/30/2017] [Indexed: 12/25/2022]
Abstract
Sarcopenia is an age-related syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength; it is a major contributor to the risk of physical frailty, functional impairment in older people, poor health-related quality of life and premature death. Many different definitions have been used to describe sarcopenia and have resulted in varying estimates of prevalence of the condition. The most recent attempts of definitions have tried to integrate information on muscle mass, strength and physical function and provide a definition that is useful in both research and clinical settings. This review focuses on the epidemiology of the three distinct physiological components of sarcopenia, and highlights the similarities and differences between their patterns of variation with age, gender, geography and time and the individual risk factors that cluster selectively with muscle mass, strength and physical function. Methods used to measure muscle mass, strength and physical functioning and how differences in these approaches can contribute to the varying prevalence rates will also be described. The evidence for this review was gathered by undertaking a systematic search of the literature. The descriptive characteristics of muscle mass, strength and function described in this review point to the urgent need for a consensual definition of sarcopenia incorporating these parameters.
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Affiliation(s)
- S C Shaw
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK.
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, OX3 7LE, UK.
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18
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Kritchevsky SB, Lovato L, Handing EP, Blair S, Botoseneanu A, Guralnik JM, Liu C, King A, Marsh AP, Pahor M, Rejeski WJ, Spring B, Manini T. Exercise's effect on mobility disability in older adults with and without obesity: The LIFE study randomized clinical trial. Obesity (Silver Spring) 2017; 25:1199-1205. [PMID: 28653499 PMCID: PMC5567861 DOI: 10.1002/oby.21860] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Some data suggest that obesity blunts the benefits of exercise on mobility in older adults. This study tested the homogeneity of the effect of a physical activity intervention on major mobility disability (MMD) across baseline obesity classifications in the Lifestyle Interventions and Independence for Elders (LIFE) Study. LIFE randomized 1,635 sedentary men and women aged 70 to 89 years to a moderate-intensity physical activity (PA) or health education program. METHODS MMD, defined as the inability to walk 400 m, was determined over an average follow-up of 2.6 years. Participants were divided into four subgroups: (1) nonobese (BMI < 30 kg/m2 ; n = 437); (2) nonobese with high waist circumference (WC > 102 cm [men], > 88 cm [women]; n = 434); (3) class 1 obesity (30 kg/m2 ≤ BMI < 35 kg/m2 ; n = 430); and (4) class 2 + obesity (BMI ≥ 35 kg/m2 ; n = 312). Cox proportional hazard modeling was used to test an obesity by intervention interaction. RESULTS The PA intervention had the largest benefit in participants with class 2 + obesity (hazard ratio 0.69, 95% confidence interval 0.48, 0.98). However, there was no statistically significant difference in benefit across obesity categories. CONCLUSIONS A structured PA program reduced the risk of MMD even in older adults with extreme obesity.
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Affiliation(s)
| | - Laura Lovato
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Steven Blair
- Departments of Exercise Science and Epidemiology/Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Anda Botoseneanu
- Department of Health and Human Services and Institute of Gerontology, University of Michigan, Dearborn and Ann Arbor, MI, USA
| | - Jack M. Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christine Liu
- Department of Geriatrics, Boston University School of Medicine, Boston, MA, USA
| | - Abby King
- Departments of Health Research & Policy and Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Anthony P. Marsh
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Marco Pahor
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, FL, USA
| | - W. Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Todd Manini
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, FL, USA
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19
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Dennison EM, Sayer AA, Cooper C. Epidemiology of sarcopenia and insight into possible therapeutic targets. Nat Rev Rheumatol 2017; 13:340-347. [PMID: 28469267 DOI: 10.1038/nrrheum.2017.60] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Musculoskeletal ageing is a major public health concern owing to demographic shifts in the population. Sarcopenia, generally defined as the age-related loss of muscle mass and function, is associated with considerable risk of falls, loss of independence in older adults and hospitalization with poorer health outcomes. This condition is therefore associated with increased morbidity and health care costs. As with bone mass, muscle mass and strength increase during late adolescence and early adulthood, but begin to decline substantially from ∼50 years of age. Sarcopenia is characterized by many features, which include loss of muscle mass, altered muscle composition, infiltration with fat and fibrous tissue and alterations in innervation. A better understanding of these factors might help us to develop strategies that target these effects. To date, however, methodological challenges and controversies regarding how best to define the condition, in addition to uncertainty about what outcome measures to consider, have delayed research into possible therapeutic options. Most pharmacological agents investigated to date are hormonal, although new developments have seen the emergence of agents that target myostatin signalling to increase muscle mass. In this review we consider the current approaching for defining sarcopenia and discuss its epidemiology, pathogenesis, and potential therapeutic opportunities.
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Affiliation(s)
- Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,School of Biological Sciences, Victoria University of Wellington, Kelburn Parade, Wellington 6012, New Zealand
| | - Avan A Sayer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,Institute of Neuroscience, Henry Wellcome Building, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne NE1 7RU, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University, Campus for Ageing and Vitality, Westgate Road, Newcastle upon Tyne NE4 5PL, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DN, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford OX3 7LD, UK
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20
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Lisko I, Tiainen K, Raitanen J, Jylhävä J, Hurme M, Hervonen A, Jylhä M, Stenholm S. Body Mass Index and Waist Circumference as Predictors of Disability in Nonagenarians: The Vitality 90+ Study. J Gerontol A Biol Sci Med Sci 2017; 72:1569-1574. [DOI: 10.1093/gerona/glx032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
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21
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David CN, Mello RB, Bruscato NM, Moriguchi EH. Overweight and Abdominal Obesity Association with All-Cause and Cardiovascular Mortality in the Elderly Aged 80 and Over: A Cohort Study. J Nutr Health Aging 2017; 21:597-603. [PMID: 28448093 DOI: 10.1007/s12603-016-0812-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the association between overweight and abdominal obesity with all-cause and cardiovascular mortality in the elderly aged 80 and over. DESIGN A prospective cohort study. SETTING A population-based study of community-dwelling very elderly adults in a city in southern Brazil. PARTICIPANTS 236 very elderly adults, number that represents 85% of the population aged 80 and over living in the city in the period (mean age 83.4 ± 3.2). MEASUREMENTS Overweight and abdominal obesity were assessed using recommended cut-off points for body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR). The association between these anthropometric measurements and all-cause and cardiovascular mortality were independently estimated by Cox proportional hazards model. Kaplan-Meier was used to assess survival time. RESULTS Increased WC (>80cm F and >94cm M) and WHtR (>0.53 F and >0.52 M) were associated with lower all-cause mortality, but only WHtR remained associated even after controlling for residual confounding (HR 0.55 CI95% 0.36-0.84; p<0.001). Additionally increased WC was independently associated with lower mortality from cardiovascular diseases (HR 0.57 CI95% 0.34-0.95; p<0.030). BMI and WHR did not show significant independent association with mortality in the main analysis. CONCLUSION Greater abdominal fat accumulation, as estimated by WC and WHtR, presented an association with lower allcause and cardiovascular mortality in the elderly aged 80 and over, but not by BMI and WHR.
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Affiliation(s)
- C N David
- Renato Bandeira de Mello, Hospital de Clínicas de Porto Alegre, 2350, Ramiro Barcelos st., Division of Internal Medicine; room 700, Porto Alegre, Rio Grande do Sul 90035903, Brazil,
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22
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Lana A, Struijk E, Guallar-Castillón P, Martín-Moreno JM, Rodríguez Artalejo F, Lopez-Garcia E. Leptin concentration and risk of impaired physical function in older adults: the Seniors-ENRICA cohort. Age Ageing 2016; 45:819-826. [PMID: 27515676 DOI: 10.1093/ageing/afw142] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 07/04/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND leptin resistance, which may develop during the ageing process, stimulates the production of pro-inflammatory cytokines and insulin resistance that could impair the muscle function. However, the role of leptin on physical functioning among older adults has not yet been elucidated. OBJECTIVE to examine the association between serum leptin levels and physical function impairment in older adults. DESIGN AND SETTING prospective study of 1,556 individuals 60 years and older from the Seniors-ENRICA cohort, who were free of physical function limitation at baseline. MAIN OUTCOME MEASURE serum leptin was measured in 2008-10, and incident functional limitation was assessed through 2012. Self-reported limitations in agility and mobility were assessed with the Rosow and Breslau scale, limitation in the lower extremity function was measured with the Short Physical Performance Battery, and impairment in the overall physical performance with the physical component summary of the SF-12. RESULTS after adjustment for potential confounders and compared to individuals in the lowest quartile of leptin concentration, those in the highest quartile showed increased risk of impaired physical function; the odds ratio (95% confidence interval) and P-trend was: 1.95 (1.11-3.43), P = 0.006 for self-reported impaired mobility; 1.76 (1.08-2.87), P = 0.02 for self-reported impaired agility; 1.48 (1.02-2.15), P = 0.04 for limitation in the lower extremity function; and 1.97 (1.20-3.22), P = 0.01, for decreased overall physical performance. These associations were only modestly explained by C-reactive protein and insulin resistance. Moreover, the associations held across groups with varying health status and were independent of estimated total body fat. CONCLUSIONS higher leptin concentration was associated with increased risk of impaired physical function. Preserving metabolic function during the old age could help delaying physical function decline.
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Affiliation(s)
- Alberto Lana
- Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Jose María Martín-Moreno
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Fernando Rodríguez Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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23
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[Obesity in old age and its importance for functionality and frailty]. Z Gerontol Geriatr 2016; 49:573-580. [PMID: 27637579 DOI: 10.1007/s00391-016-1133-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/09/2016] [Accepted: 08/18/2016] [Indexed: 10/21/2022]
Abstract
In later life a high body mass index (BMI) is associated with the lowest age-related mortality rate. The BMI range used by the World Health Organization (WHO) to classify overweight, a BMI of 25-30 kg/m2, can be regarded as normal weight in old age; nevertheless, obesity is associated with an increased risk of disability and of a deterioration in physical functionality, particularly among older age groups. This relationship to obesity has also been established for frailty. For this reason, a reduction in weight may be appropriate under functional aspects if BMI values exceed 30 kg/m2; however, such a decision cannot be made on the basis of an individual BMI alone. The functional status, body composition, comorbidities and, in particular the life perspectives of the patient should also be taken into consideration. If weight loss is intended, it must always be performed under strict medical supervision involving optimized protein intake, a carefully calculated moderate reduction in calories and adequate physical training. In the case of chronically ill elderly patients, weight reduction is not usually appropriate. Restrictive diets of any kind should principally be critically viewed in old age because even temporary inadequate energy intake may lead to accelerated deterioration of muscle and bone structure.
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Al-Kuraishy HM, Al-Gareeb AI. Effect of orlistat alone or in combination with Garcinia cambogia on visceral adiposity index in obese patients. JOURNAL OF COMPLEMENTARY MEDICINE RESEARCH 2016; 5:408-414. [PMID: 27757272 PMCID: PMC5061485 DOI: 10.5455/jice.20160815080732] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 07/31/2016] [Indexed: 02/03/2023]
Abstract
Aim: The objective of this study was to estimate the effect of orlistat alone and in combination with Garcinia cambogia on visceral adiposity index (VAI) in obese patients. Patients and Methods: A total of 99 obese male patients were recruited with aged range between 37 and 46 years. They were randomized into three equal groups, first group treated with orlistat 120 mg/day, second group treated with G. cambogia 166 mg/day, and third group treated with orlistat 120 mg/day plus G. cambogia 166 mg/day. The duration of the treatments was three consecutive months. Body mass index (BMI), VAI, blood pressure, blood glucose, total lipid profile, atherogenic index, and cardiac risk ratio were recorded at baseline and after 3 months. Results: The treatment with G. cambogia leads to reduction in VAI P < 0.05, whereas orlistat has a beneficial effect on cardiometabolic profiles without a reduction in VAI P > 0.05. Combined therapy of G. cambogia plus orlistat showed the more significant effect in reduction of VAI P < 0.05, cardiometabolic profiles and anthropometric measures P < 0.01 compared to pretreatment period. Conclusion: Combination of G. cambogia with orlistat lead to more significant effect than orlistat alone in amelioration of cardiometabolic profile and VAI in obese patients.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Therapeutic, Medical Faculty College of Medicine, Al-Mustansiriya University, P.O. Box 14132, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Therapeutic, Medical Faculty College of Medicine, Al-Mustansiriya University, P.O. Box 14132, Baghdad, Iraq
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Enroth L, Raitanen J, Hervonen A, Lehtimäki T, Jylhävä J, Hurme M, Jylhä M. Cardiometabolic and Inflammatory Biomarkers as Mediators Between Educational Attainment and Functioning at the Age of 90 Years. J Gerontol A Biol Sci Med Sci 2015; 71:412-9. [PMID: 26328604 DOI: 10.1093/gerona/glv105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 06/12/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Low socioeconomic status is associated both with poorer functioning and elevated levels of inflammatory and cardiometabolic biomarkers; however, knowledge of such relations for the oldest old is limited. Our aim was to study whether education is associated with cardiometabolic (cholesterol levels, body mass index, and leptin) and inflammatory (C-reactive protein, interleukin-6, interleukin-1Ra) biomarkers for the 90-year-olds who participated in the Vitality 90+ study. In addition, we investigated whether these biomarkers explain educational inequalities in functioning. METHODS All persons in Tampere, Finland, who were born in 1909 or 1910, were invited to participate, irrespective of their health status or dwelling place. The sample consisted of 262 participants who went through the home interview and blood tests. The socioeconomic status indicator used was the highest education, and physical functioning was assessed using the Barthel index. The association of education with individual and combined biomarker scores, and with functioning, was analyzed cross-sectionally applying generalized linear models. RESULTS The low- and mid-level-educated participants had greater odds of belonging to the high risk group in cardiometabolic biomarkers than did the high-educated. Differences were statistically significant in three individual biomarkers (high-density lipoprotein-cholesterol, leptin, and body mass index) and in a cardiometabolic score. There were no educational differences in inflammatory biomarkers. When all biomarkers were combined, they mediated educational differences in functioning on an average of 23%. After controlling for smoking, alcohol use and diseases, biomarkers mediated part of the differences between the mid-level- and high-educated. CONCLUSIONS High education was associated with better cardiometabolic biomarkers and functioning among the 90-year-olds. In part, educational inequalities in functioning were explained by cardiometabolic biomarkers.
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Affiliation(s)
- Linda Enroth
- School of Health Sciences and Gerontology Research Center, University of Tampere, Finland.
| | - Jani Raitanen
- School of Health Sciences and Gerontology Research Center, University of Tampere, Finland. UKK Institute for Health Promotion Research, Tampere, Finland
| | - Antti Hervonen
- School of Health Sciences and Gerontology Research Center, University of Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, School of Medicine, University of Tampere, Finland. Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Juulia Jylhävä
- Gerontology Research Center, University of Tampere, Finland. Department of Microbiology and Immunology, School of Medicine, University of Tampere, Finland
| | - Mikko Hurme
- Gerontology Research Center, University of Tampere, Finland. Department of Microbiology and Immunology, School of Medicine, University of Tampere, Finland. Department of Microbiology, Fimlab Laboratories, Tampere, Finland
| | - Marja Jylhä
- School of Health Sciences and Gerontology Research Center, University of Tampere, Finland. Institute for Advanced Social Research, University of Tampere, Finland
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Obesity in Older Adults: Prevalence, Health Risk and Management of Care Among Nursing Home Residents. CURRENT GERIATRICS REPORTS 2015. [DOI: 10.1007/s13670-015-0137-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kiesswetter E, Schrader E, Diekmann R, Sieber CC, Volkert D. Varying Associations Between Body Mass Index and Physical and Cognitive Function in Three Samples of Older Adults Living in Different Settings. J Gerontol A Biol Sci Med Sci 2015; 70:1255-61. [PMID: 25910844 DOI: 10.1093/gerona/glv048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 03/25/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The study investigates variations in the associations between body mass index (BMI) and (a) physical and (b) cognitive function across three samples of older adults living in different settings, and moreover determines if the association between BMI and physical function is confounded by cognitive abilities. METHODS One hundred ninety-five patients of a geriatric day hospital, 322 persons receiving home care (HC), and 183 nursing home (NH) residents were examined regarding BMI, cognitive (Mini-Mental State Examination), and physical function (Barthel Index for activities of daily living). Differences in Mini-Mental State Examination and activities of daily living scores between BMI groups (<22, 22-<25, 25-<30, 30-<35, ≥35kg/m(2)) were tested by analysis of covariance considering relevant confounders. RESULTS Activities of daily living and Mini-Mental State Examination impairments increased from the geriatric day hospital over the HC to the NH sample, whereas prevalence rates of obesity and severe obesity (35%, 33%, 25%) decreased. In geriatric day hospital patients cognitive and physical function did not differ between BMI groups. In the HC and NH samples, cognitive abilities were highest in obese and severely obese subjects. Unadjusted mean activities of daily living scores differed between BMI groups in HC receivers (51.6±32.2, 61.8±26.1, 67.5±28.3, 72.0±23.4, 66.2±24.2, p = .002) and NH residents (35.6±28.6, 48.1±25.7, 39.9±28.7, 50.8±24.0, 57.1±28.2, p = .029). In both samples significance was lost after adjustment indicating cognitive function as dominant confounder. CONCLUSIONS In older adults the associations between BMI and physical and cognitive function were dependent on the health and care status corresponding to the setting. In the HC and the NH samples, cognitive status, as measured by the Mini-Mental State Examination, emerged as an important confounder within the association between BMI and physical function.
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Affiliation(s)
- Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
| | - Eva Schrader
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Rebecca Diekmann
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. Department for Geriatric Medicine, Carl von Ossietzky Universität Oldenburg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
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